HUMAN DEFENSES AGAINST

INFECTIONS
Pathogenesis of Infectious Disease
Nonspecific Host Defense Mechanisms
Specific Host Defense Mechanisms
path
disease
Terminologies
Terms r/t “path”
 Terminologies
Terms r/t “path”

PATHOGEN

disease-causing microbes
 Terminologies
Terms r/t “path”

PATHOLOGY

study of the structural and functional

manifestation of disease
 Terminologies
Terms r/t “path”

PATHOLOGIST

someone specialized in pathology

 Terminologies
Terms r/t “path”

PATHOGENICITY

ability to cause disease

 Terminologies
Terms r/t “path”

PATHOGENESIS

step or mechanisms involved in the

development of a disease
 Terminologies
Why infection does not always occur?

anatomic and
receptor sites
 Terminologies
Why infection does not always occur?

antibacterial
factors at the site
where pathogens
land
 Terminologies
Why infection does not always occur?

microbial antagonism
by indigenous
microflora
 Terminologies
Why infection does not always occur?

production of
bacteriocins by
indigenous
microflora
 Terminologies
Why infection does not always occur?

individual’s
nutritional and
overall health
 Terminologies
Why infection does not always occur?

person may have

developed immunity
against particular
microorganism
 Terminologies
Why infection does not always occur?

phagocytic WBCs
engulf and
destroy pathogens
 Terminologies
Stages in the course of a disease
Intensity of S/Sx

Time
 Terminologies
Stages in the course of a disease

[incubation period]
initial contact – first symptom
 Terminologies
Stages in the course of a disease

[prodromal period]
Earliest symptoms are notable
“out of sorts” /
“coming down with something”
 Terminologies
Stages in the course of a disease

[period of illness]
a.k.a. period of invasion
period of most communicability
 Terminologies
Stages in the course of a disease

[period of illness]
infectious agent multiplies at its
highest level, exhibits its greatest
toxicity, and becomes well
established in its target tissue
 Terminologies
Stages in the course of a disease

[convalescent period]
recovery period
patient‘s strength and health
gradually return

If not,
 sign
v s symptom

objective subjective
evidence of a evidence of a
disease disease
 Examples
sign
vital signs
laboratory results

objective
evidence of a
disease
 Examples
symptom
pain
tinnitus
blurred vision
itching
chills subjective
evidence of a
disease
Asymptomatic or
Subclinical
symptom
disease a patient is
unaware of
because he or she
is not experiencing subjective
symptoms evidence of a
disease
Asymptomatic or
Subclinical
symptom
Gonorrhea
(+) male | (-) female

subjective
Trichomoniasis evidence of a
(-) male | (+) female disease
 Terminologies

SYNDROME

a certain complex of signs and

symptoms

Acquired Immunodeficiency Syndrome

Severe Acute Respiratory Syndrome
Asperger’s Syndrome
 Terminologies
Classifications of infection

According to site affected

Localized Systemic
 Terminologies
Classifications of infection

According to onset and duration

Acute Chronic
Subacute
[measles] [Koch’s disease]
[bacterial endocarditis]
[mumps] [Hansen’s disease]
 Terminologies
Classifications of infection

According to sequence of infection

Primary infection Secondary infection Latent infection

Host defense mechanism

The three lines of elaborate and

highly complex defense
Host defense mechanism

First and second line

Nonspecific
Host defense mechanism

Third line
Specific
Host defense mechanism
Host defense mechanisms

Nonspecific host defense Specific host defense

First line of Second line

defense of defense Third line of defense
Host defense mechanism
Host defense mechanisms

Nonspecific host defense Natural, built-

Specific host defense

in body
components
First line of Second line
defense of defense Thirdthat destroy all
line of defense

types of
foreign
substances
Host defense mechanism
Host defense mechanisms

Nonspecific host defense The 1st line:

Specific host defense

surface
protection
First line of Second line
defense of defense Thirdcomposed
line of defense of
anatomical and
physiological
barrier
Host defense mechanism
Host defense mechanisms

Nonspecific host defense The 2 nd

line:
Specific host defense
nonspecific
cellular and
Thirdchemical
First line of Second line
defense of defense line of defense
responses
[phagocytes,
fever,
inflammation]
 Host defense mechanism
Host defense mechanisms

The 3rdNonspecific
line: host defense Specific host defense

Specific host defenses that

must be developed
First line of Second line
uniquely
defensefor each microbe Third line of defense
of defense

through the action of

specialized WBC;
Not innate
 First line of defense
impede entry not only of microbes
but any foreign object, whether
living or not
 First line of defense
SKIN
composition:
epithelial cells
that have become
compacted,
cemented
together, and
impregnated with
an insoluble
protein, keratin
 First line of defense
SKIN

any disruption in the integrity of the

skin may provide a portal of entry
 First line of defense
SKIN

the sloughing off of dead skin cells

also removes potential pathogens
 First line of defense
SKIN

dryness, acidity and temperature

below 37 degrees centigrade
inhibit growth of microorganisms
First line of defense
SKIN

oily sebum released by the

sebaceous glands also contain
fatty acids
 First line of defense
SKIN

perspiration has two purposes

flushing of microorganisms from

pores and the surface of the skin
 First line of defense
SKIN

perspiration has two purposes

contains lysozyme which hydrolyzes

peptidoglycan in bacterial cell
wall
First line of defense
MUCOUS MEMBRANE
physical or mechanical
barrier to pathogen as long
as it is intact

mucus produced by the

membranes serves to
entrap invaders
 First line of defense
MUCOUS MEMBRANE
substances contained in mucus

lactoferrin, a protein that binds with

iron
 First line of defense
MUCOUS MEMBRANE
substances contained in mucus

lysozyme, that degrades

peptidoglycan of bacterial cell wall

present in nasal secretions, saliva

and tears
 First line of defense
MUCOUS MEMBRANE
substances contained in mucus

lactoperoxidase that produces

superoxide radicals which are toxic to
bacteria
First line of defense

cilia present on
epithelial cells
 First line of defense

swallowing of
saliva
First line of defense
GASTROINTESTINAL SYSTEM

digestive enzymes

acidity of the stomach

alkalinity of the intestines

First line of defense
GASTROINTESTINAL SYSTEM
stomach acid
+
bile salts
+
rapid flow of GI contents
small intestine is
relatively free of
bacteria
First line of defense
GENITOURINARY SYSTEM
urinary tract is usually sterile

urination continually flush

microorganisms
 First line of defense
GENITOURINARY SYSTEM
conditions that may lead to UTI

infrequent urination
failure to urinate after intercourse
obstructions of urine flow
 First line of defense
GENITOURINARY SYSTEM
low pH of vagina inhibits colonization

oral contraceptives increase vaginal

pH
First line of defense

blinking and
lacrimation flush the
eye’s surface with
tears and rid it of its
irritant
 First line of defense
MICROBIAL ANTAGONISM

competition for colonization

competition for nutrients
production of substances that kill
other microorganisms [bacteriocins]
 First line of defense
MICROBIAL ANTAGONISM

effectiveness decreases after

prolonged administration of broad-
spectrum antibiotics
 Second line of defense

Description Works by:

Transferrin
glycoprotein  deprives
synthesized in the bacteria of vital
liver having high nutrient
affinity for iron
 Second line of defense

Description Works by:

Fever
stimulated by  Stimulating WBCs
pyrogenic  Reducing available
(fever-producing) free plasma iron
substances  Inducing
production of IL-1
 Second line of defense
Invasion of
pathogen (Gram
Release of
negative bacteria) endotoxin

WBC Ingestion of
(macrophage) endotoxin by
produce IL-1 WBC

IL-1 stimulates Prostaglandins resets

hypothalamic
release of thermostat to a
prostaglandins higher level

ore body temp

equals
Vasoconstr
ermostat point iction
 Second line of defense

Description Works by:

Interferons
antiviral proteins  Interfering with
produced by virus- viral multiplication
infected cells  Activating certain
NK cells
 Second line of defense

Description Works by:

Inflammation
a complex series of  Localizing an
events following a infection
local injury,  Preventing the
irritation, microbial spread of
invasion or microbial invaders
bacterial toxin
 Second line of defense

Description Works by:

Inflammation
a complex series of  Neutralizing any
events following a toxin being
local injury, produced
irritation, microbial  Aiding in the
invasion or repair of damaged
bacterial toxin tissue
Second line of defense
Tissue injury

Vasodilation

Increased permeability

Emigration of leukocytes

Chemotaxis

Phagocytosis
 Second line of defense

English Latin
Redness
Heat
Edema
Pain
Loss of function
 Second line of defense

English Latin
Redness Rubor
Heat Calor
Edema Tumor
Pain Dolor
Loss of function Functio laesa
 Second line of defense

Cellular
Elements of
Human Blood
Second line of defense
Second line of defense
 Functions of the immune system
recognize destroy those
between self which are non-
and non-self self
Functions of the immune system

Lymphocytes

B cells
T cells
o Helper T
o Cytotoxic T
NK cells
 Immune System

T cell
B cells
Cytotoxic
Helper T
T
 Immune System

Antibody-mediated Cell-mediated
involves antibodies involves different cell types
antibodies play a major role antibodies have no major role
 Immune System

Antibody-mediated Cell-mediated
involves antibodies involves different cell types
antibodies play a major role antibodies have no major role
 Antibody-mediated

IgM
IgA
IgD
IgG
IgE
Acquired Immunity

Natural Artificial
active active
[exposure] [vaccine]

Natural Artificial
passive passive
[maternal] [globulin]
 Vaccines

Types of Vaccines
Attenuated
weakened pathogens
Examples:
Viral: MMR, Varicella, OPV (Sabin)
Bacterial: BCG, cholera, typhoid fever
 Vaccines

Types of Vaccines
Inactivated
made from killed pathogens
Examples:
Viral: Hep A, encephalitis, IPV (Salk), rabies
Bacterial: Anthrax, typhoid (subcutaneous)
 Vaccines

Types of Vaccines
Subunit
antigenic portions
Examples:
Hep B, whooping cough
 Vaccines

Types of Vaccines
Conjugate
conjugating bacterial capsular antigen
Examples:
Hib, meningococcal meningitis
 Vaccines

Types of Vaccines
Toxoid
made from exotoxin that has been
inactivated
Examples:
Diphtheria, tetanus
Expanded
Program
on
B
C
G

D
P
T

O
P
V

H
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B
M
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 Bacille-Calmette-Guerin (BCG)
Minimum age at 1st dose: At birth
Dosage: 0.05 mL
Number of doses: 1
Interval between doses: -
Route of administration: Intradermal
Site: Right deltoid
Vaccine Type: Attenuated
Diphtheria Pertussis Tetanus (DPT)
Minimum age at 1st dose: 6 weeks
Dosage: 0.5 mL
Number of doses: 3
Interval between doses: 4 weeks
Route of administration: Intramuscular
Site:Upper outer
thigh
Vaccine type: Toxoid, killed
 Oral Polio Vaccine (OPV)
Minimum age at 1st dose: 6 weeks
Dosage: 2 drops
Number of doses: 3
Interval between doses: 4 weeks
Route of administration: Oral
Site: Mouth
Vaccine type: Attenuated
 Hepatitis B vaccine
Minimum age at 1st dose: At birth
Dosage: 0.5 mL
Number of doses: 3
Interval between doses: 6/8 weeks
Route of administration: Intramuscular
Site: Upper outer
thigh
Vaccine type: recombinant
 Measles vaccine
Minimum age at 1st dose: 9 months
Dosage: 0.5 mL
Number of doses: 1
Interval between doses: -
Route of administration: Subcutaneous
Site: Outer part of
the upper arm
Vaccine type: Attenuated
 Tetanus toxoid
Minimum age at 1st dose: AEAPDP
Dosage: 0.5 mL
Number of doses: 5
Interval between doses: 1/6/12/12 mos.
Route of administration: Intramuscular
Site: Deltoid
 Storage

Most sensitive to -Oral Polio Vaccine -15 to -25 degrees

heat -Measles Celsius (freezer)

-DPT
Least sensitive to -Hepa B 2 to 8 degrees
heat -BCG Celsius (body of
-Tetatus Toxoid refrigerator)