Lecture 33, 12/5; Immunology

Here is the audio for this day's lecture.

• Org group exam Dec. 10 8am
• Big Final Wed 7:30. Dec 12
• Portfolio due Friday Dec 14

• Flesh eating disease
• Necrotizing fasciitis caused by Streptococcus pyogenes (p551 in text).
• • 4-s → staphylococcal scolded skin syndrome (p548 in text)
• staphylococcus aureus
• • gas gang green
• clostridium perfringens
• • Immunology – classification of antibodies (handout from 11/28 titled “Immunology”)
• IgG – most of the antibody is IgG. It comes from mom through placenta.
• IGM – the macro antibody. Very large. It is a pintomer (5 IgG’s). Notable because it is the first antibody formed. Soaks up a lot of antigen.
• IgA – a dimer, two monomers held together. Get it from mothers milk - colostrums. Coats GI tract of infant protecting from diarrhea. Also in other secretions such as saliva and urine. It is the secretory antibody.
• IgD, IgE – look like IgG. In smaller concentrations. Antibody usually on surface of B cells and helps it recognize antigens. IgE protective against parasitic diseases. It is associated with hypersensitivity. Anaphylactic shock (adverse reaction to penicillin).
• • Functional classes of antibodies (1st page of “Immunology” handout from 11/28)
• Opsonins - Antibodies that make the antigen more susceptible to phagocytosis.
• Antitoxins – antibodies that neutralize antitoxin toxins. We form them in response to a toxoid. Example – tetnus and diptheria. Shot lasts about 10 years
• • Chemical makeup of IgG – composed of four peptide chains. Two “h” chains. Twice the size of l chains. They are all held together by disulfide bonds. There is some CHO on the H chain. Divalent – two antigen binding sights. An IgM can bind 10, that is why it is one of the first ones produced → it soaks up the antigen and takes it out.
• • Fate of the foreign antigen (chart on p 5 of “Immunology” handout)
• Initial or Primary response - IgG
• Secondary or memory response or Anamnestic response.
• • T cells mature in the thymus. B cells come from bone marrow.
• • “The complex network …… defense mechanisms” (p2 from “Immunology” handout)
• plasma cell - When it differentiates it forms all the immunoglobulins. IgG, IgM, IgD, IgE.
• “T” helpers help b cells produce antibody’s. CD4 positives
• Multiple myeloma – too much antibody produced
• “T” killer. Virus antigen on outside of cell. T killer recognizes the viral antigen and kill the cell that is loaded with viruses.
• delayed hypersensitivity (another type of T cell) – poisen ivy, TB tests. T cells also produce lymphokines that modulate the immune response. Example of lymphokine is interferon. There are three types of interferon’s; alpha beta antivirul, gamma (modulates reactions), and interleukin (come from leucocytes). We have 65 interleukin produced by different cells.
• • VACCINES (p.7 of “Immunology” handout)
• guardisil
• rototeq – helps babies effected by diarrhea
• Related Organism
• • smallpox
• Killed Organisms – dead suspension of something like:
• • Cholera, whooping cough, polio (injectable. Discovered by Sulk), Influenza, rabies, typhoid fever, hepatitis A (havrix)
• Attenuated Organism – living organism that is a strain of a disesease that is not harmful. Developled by Pasteur.
• • MMR (measles, mumps, rubella), polio (oral), TB-BCG, Varivax (VZV)
• Acellular (parts of organism)
• • Capsule (HIB [Heamophilus Influenza Type b]
• • Pneumovax - capsule of strep pneumonae
• • Pili - whooping cough, purtussis.
• Recombanant
• • Hep. B. - Heptavax/Engerix
• Toxoids
• • Diphtheria, tetanus
• • Havrix – hepatitis A vaccine, inactivated (p8 of “Immunology” handout)
• • Immunodefiency diseases
• AIDs
• A gamma globulin anemia – b cell defect. Cant produce any antibody.
  
• T cell defect – if your thymus doesn’t grow. Digeorges syndrome (???not sure??)
  
• Severe combined immuno deficiency – b cell and t cell defects. SCID – bubble boy syndrome

Lecture 32, 12/3; Viruses, Immunology

Here is the audio.

• • Medically important human viruses
• • HSV-1, HSV-2 → herpes, oral and genital
• • RSV → respiratory sincicial virus. Mom can give it to the baby.
• • EBV → mono and burkettes lymphona
• • VZV → chicken pox and shingles
• • HPV → human papiloma virus. Causes warts. Some strains are associated with cervical cancer. (this is why Guardisil is popular)
• • Adenovirus → upper respiratory infections, not a cold
• • HAV → Hep A virus. Fecal/oral → contaminated water/food. There is a vaccine for it.
• • HBV → Hep B virus. Blood borne or semen. Linked with liver cancer. There is a vaccine for it.
• • HCV → Hep C virus. Similar transimission to Hep B. Used to be called transfusion disease. No vaccine.
• • Rotavirus → severe diarrhea in babies and toddlers. Rotateq combats this disease.
• • Rubella virus → German measles
• • Variola virus → supposedly eradicated. Smallpox
• • Rabies virus → rabies. Bullet shaped virus. Most deadly.
• • Measles virus → MMR takes care of it
• • Influenza → old get vaccinated. Hypermutability – changes very quickly. This is why you need a flu shot every year.
• • Hantavirus - Navajo flu → Comes from little white mice.
• • CMV – Cytomegalo virus → Babies, toddlers, and AIDs patients are susceptible.
• • Rhinovirus → common cold, 120 different strains (that is why there is no vaccine).
• • Echo/Coxsackle viruses - Noro virus → Causes gastroenteritis. Cruise ship disease.
• • Mumps virus → can move to testicles in guys. MMR vaccine takes care of it.
• • St. Louis Encephalitis virus (SLE) → mosquito borne
• • West Nile → mosquito borne
• • HIV-1 and HIV-2 → takes out all T helper cells. Allows for opportunistic disease to come in.
• • HTLV-1 and HTLV-2 - human T cell lymphoma viruses → Can cause cancer.
• • AID’s related infections – sheet from handout showing diseases AID’s patients get with time.
• o Bacterial skin infections are one of the first things you see.
• o Thrush comes in (usually a good indicator of AID’s)
• o Severe athletes foot
• o PCP, histo, herpes, crypto
• • IMMUNOLOGY
• o Winter viruses are typically airborne
• • 1st line of defense – Mechanical factors
• o lysosymes – good against gram (+).
• o Organisms can’t go through the skin EXCEPT for rabbit fever
• o Mucus is sticky and holds organisms
• o Normal flora – prevent pathogens from colonizing
• • Second line of defense - Cellular factors
• o If disease comes into bloodstream white blood cells will come to do phagocytosis (discovered by Meintchnekoff). Interferon was initially up to 10,000$ a shot.
• o Inflammation – heat, redness, swelling, pain. This is the bodies way of localizing an infection.
• • Third line; antibody formation. Takes 10-14 days
• o Acquired immunity
• • Types of acquired immunity
• o Active immunity – we form the antibodies (long lasting)
• • Artificially acquired - vaccines
• Naturally acquired – infections
• • Acute or sub-acute
• o Passive immunity – someone else is forming the antibodies
• • Artificially acquired – HBIG
• • Immune globulin – immediate protection but does not last long (about a month). They are preformed antibodies.
• • Naturally acquired – HgG and IgA
• IgG is given from the mother to baby across the placenta. IgA is from mothers milk – it coats intestine of baby and prevents diarrhea in baby. Rototeq can cause this diarrhea.
• • Classes of antibodies
• o “Y” usually represents antibodies
• o IgG – the most important one, we have the most of this in our blood. 80-85% of all the antibodies we carry is IgG. Major protective antibody in blood. If you run into an antigen it is IgG that will probably attach to it. It is also the one that comes from mom to baby over placenta.

Lecture 30, 11/28; Immunology

Here is the audio for today's lecture.

• Be sure to have your lab number on your write up of AIDS week
• Lab practical next teus. About 80minutes.
o 8 lab 2
o 10 lab 3
o 12 lab 4
o 2pm+4pm either lab 1+5

• • IMMUNOLOGY
• o Back of page 2 from handout from 11/28 “Immunology”
• o B cells are associated with plasms cells. Plasma cells produce all those antibodies. T cells tend to be regulatory in nature. We know cd4+. That is the cell that HIV likes. T-helper helps the B cells. HIV destroys the communication between these two cells.
• o Side notes: candida albicans (budding)– thrush
• • Toxoplasmosis – protozoan
• • Valley fever - fungal
• • PCP – fungal
• • Herpes – virus
• o Vaccines
• • Cowpox vaccine is given instead of smallpox. They share antigens
• • Engerix-b – recombinant vaccine
• • Handout from 11/26 “Infection and Disease” - definitions
• o Toxoids - diphtheria, tetanus
• o vaccine – simple suspensions of antigens. When given to an individual the production of antibodies is stimulated
• o virulence – capacity or ability to cause disease. Highly virulent organisms – rabies, ebola. Low virulence organism – candida albicans (must be given an opportunity to cause disease)
• o zoonosis – diseases of animals that can be transmitted to man. Example – Lyme, Anthrax. Fungal zoonosis – ringworm, microsporum canis. Protozoan zoonosis – taxoplasmosis gondii. Prion zoonosis – mad cow disease. Viral zoonosis – rabies. Most of our emerging diseases are zoonosis.
• o Nosocomial infections (from the hospital) – if you see puss it is either a staph or a strep. Bacteria that account for 70% of nosocomial infections (these are the main 4): E. coli → UTI, Staph aureus, enterococcus faecalis. pseudomonas aeruginosa – blue green puss
• • STAGES OF INFECTIOUS DISEASE
• o Incubation period – time of exposure to time of symptoms
• o Prodromal stage – highly communicable, disease can spread easily at this stage.
• o Clinical stage – peak symptoms
• o Decline stage – first signs of recovery, could also become latent or hidden. Disease that does this → herpes. You are also are developing antibodies.
• o Convalescent stage – return to recovery
• • SUMMARY OF EVENTS IN THE TRANSMISSION OF DISEASE
• o Portals of exit
• • Feces
• • Urine
• • Discharges from mouth and nose
• • Saliva – rabies, mononucleosis
• • Blood
• o Portals of entry: skin, respiratory