BackComprehensive Study Notes: Viruses, Antimicrobial Drugs, and Immunology
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Viruses: Structure, Replication, and Genomes
Basic Viral Structure
All viruses possess two essential structures:
Genetic material (DNA or RNA)
Capsid (protein coat surrounding the genetic material)
Optional structures include:
Envelope: A lipid membrane derived from the host cell, helps the virus evade the immune system by mimicking host membranes.
Spike proteins: Glycoproteins protruding from the envelope or capsid, function as attachment factors (fake cell receptors) to facilitate entry into host cells and increase virulence.
Viral Replication Pathways
Primary method: Lytic phase
Goals of viral replication:
Copy genetic material
Assemble new viral particles
Lytic cycle steps:
Attachment: Virus binds to host cell surface.
Uncoating: Capsid is shed, viral genome enters host cell.
Assembly: New viral genomes and proteins are synthesized and assembled into new virions.
Lysis: Host cell bursts, releasing new viruses.
Alternative pathway: Lysogenic cycle (Lysogenesis)
Viral genome integrates into host chromosome and replicates with the cell.
Allows virus to hide from immune system; can reactivate into lytic cycle under stress or immune suppression.
Viral Genomes and Replication Enzymes
Possible viral genome types:
Double-stranded DNA (dsDNA)
Single-stranded (+) DNA
Single-stranded (−) DNA
Double-stranded RNA (dsRNA)
Single-stranded (+) RNA
Single-stranded (−) RNA
Key enzymes:
DDDP: DNA-dependent DNA polymerase (makes DNA from DNA)
DDRP: DNA-dependent RNA polymerase (makes RNA from DNA)
RDRP: RNA-dependent RNA polymerase (makes RNA from RNA; not found in human cells, making it a good antiviral target)
RDDP: RNA-dependent DNA polymerase (reverse transcriptase; makes DNA from RNA, used by retroviruses)
Summary Table: Viral Genome Replication Pathways
Genome Type | Key Enzymes | Replication Pathway |
|---|---|---|
dsDNA | DDDP, DDRP | DNA enters cell, DDRP makes mRNA, ribosomes make proteins, DDDP copies DNA |
ss(+) DNA | DDDP, DDRP | DDDP makes (−) DNA, DDRP makes mRNA, DDDP copies DNA |
ss(−) DNA | DDRP, DDDP | DDRP makes mRNA, DDDP makes (+) DNA |
ss(+) RNA | RDRP | Ribosome makes proteins and RDRP, RDRP makes (−) RNA, then (+) RNA |
ss(−) RNA | RDRP (brought by virus) | RDRP makes (+) RNA, ribosome makes proteins, RDRP makes (−) RNA |
dsRNA | RDRP | Ribosome makes proteins and RDRP, RDRP copies RNA |
ss(+) RNA (retrovirus) | RDDP, DDDP | RDDP makes (−) DNA, DDDP makes (+) DNA, integrates into host genome |
Additional info: (+) RNA is equivalent to mRNA; only a few antibiotics are risk-free; RDRP is a unique viral target.
Antimicrobial Drugs: Mechanisms and Effects
Common Antibiotic Targets
Cell wall synthesis (e.g., β-lactams like penicillin)
Bacterial ribosomes (e.g., tetracycline, azithromycin, gentamycin)
DNA replication (e.g., ciprofloxacin targets DNA gyrase)
Metabolic pathways (e.g., sulfa drugs inhibit folate synthesis)
Mechanisms of Action and Side Effects
Drug/Class | Target/MOA | Effective Against | Side Effects |
|---|---|---|---|
β-lactams (Penicillin) | Blocks peptidoglycan synthesis | Gram-positive bacteria | Allergic reactions, GI upset |
Tetracycline | 30S ribosomal subunit | Bacteria | Teeth discoloration (esp. in children) |
Azithromycin | 50S ribosomal subunit | Bacteria | Blocks Ca2+ channels, arrhythmia |
Gentamycin | 30S ribosomal subunit | Bacteria | Nephrotoxicity, hearing loss |
Ciprofloxacin | DNA gyrase | Bacteria | Tendon rupture, agitation, seizures |
Sulfa drugs (Trimethoprim) | Folate synthesis | Bacteria | Stevens-Johnson Syndrome, arrhythmia |
Bacterial ribosomes: 70S; Eukaryotic ribosomes: 80S
Mitochondria have prokaryotic-like ribosomes, so ribosomal inhibitors can affect mitochondria (e.g., hearing loss with gentamycin).
DNA gyrase is unique to bacteria; humans use topoisomerase.
Antibiotic Risk Ranking (Lowest to Highest)
Penicillin
Tetracycline
Azithromycin
Gentamycin
Ciprofloxacin
Sulfa drugs
Plate Count Assays and Dilution Calculations
Colony-forming units (cfu/ml) are calculated as:
$\text{cfu/ml} = \frac{\text{Number of colonies}}{\text{Volume plated (ml)} \times \text{Dilution factor}}$
FDA convention: count plates with 30–300 colonies.
Examples:
Milk sample: 54 colonies from 1 ml of 1:1000 dilution → 54,000 cfu/ml
Well water: 83 colonies from 1 ml of 1:10,000 dilution → 830,000 cfu/ml
Ocean water: 191 colonies from 0.1 ml of 1:100 dilution → 191,000 cfu/ml
Immunology: Innate and Adaptive Immunity
Overview of the Immune System
Innate immunity: First line of defense, rapid but non-specific (e.g., skin, macrophages, dendritic cells, mast cells, complements, cytokines).
Adaptive immunity: Slower but highly specific and effective (B-cells, T-cells, memory cells).
Bone marrow: Produces pluripotent stem cells (can become any blood cell).
Lymph nodes: Filter blood/dead cells, site of immune cell activation.
Thymus: Site of T-cell maturation and selection.
Cells of the Immune System
Cell Type | Origin | Function |
|---|---|---|
Macrophage | Monocyte (myeloid) | Phagocytosis, antigen presentation, inflammation |
Dendritic cell | Myeloid/lymphoid | Antigen presentation, activates naive T cells |
Mast cell | Myeloid | Histamine release, inflammation, allergy |
Neutrophil | Myeloid | Phagocytosis, first responder |
Eosinophil | Myeloid | Attack parasites |
Basophil | Myeloid | Inflammation, allergy |
B cell | Lymphoid | Antibody production |
T cell (Helper/Killer) | Lymphoid | Coordinate/adaptive response, cytotoxicity |
Natural Killer cell | Lymphoid | Kill infected/tumor cells |
Major Histocompatibility Complex (MHC)
MHC I: Present on all nucleated cells (not RBCs); presents endogenous antigens to CD8+ (Killer T) cells.
MHC II: Present on antigen-presenting cells (macrophages, dendritic cells); presents exogenous antigens to CD4+ (Helper T) cells.
Immune Response Steps
Pathogen entry (e.g., cut in skin)
Recognition by macrophages (via PAMPs/antigens such as peptidoglycan, LPS)
Phagocytosis and cytokine release
Activation of mast cells (histamine release, inflammation)
Complement activation (MAC formation, opsonization)
Recruitment of neutrophils, monocytes (diapedesis)
Activation of adaptive immunity (antigen presentation to T and B cells)
Antibodies (Immunoglobulins)
Type | Structure | Function |
|---|---|---|
IgM | Pentamer | Agglutination, complement activation |
IgD | Monomer | Membrane-bound, function unclear |
IgE | Monomer | Histamine release, allergy, no agglutination |
IgA | Dimer | Agglutination, antiviral |
IgG | Monomer | Opsonization, agglutination, crosses placenta, neutralizes toxins |
Antibody regions: Variable (antigen specificity), Constant (antibody class)
Hypersensitivity Reactions
Types of Hypersensitivity
Type | Mechanism | Antibody Involved | Examples |
|---|---|---|---|
I (Immediate) | IgE binds mast cells, histamine release | IgE | Allergies, anaphylaxis |
II (Cytotoxic) | IgG/IgM bind cells, complement activation | IgG, IgM | Hemolytic anemia, thrombocytopenia, Rh incompatibility |
III (Immune Complex) | Immune complexes deposit in tissues | IgG, IgM | Serum sickness, nephritis |
IV (Delayed) | T-cell mediated, no antibodies | None | Contact dermatitis, TB test, poison ivy |
Type I: Sensitization on first exposure, reaction on second (anaphylaxis: bronchoconstriction, hypotension, hives)
Type II: Antibodies bind to cells (e.g., RBCs), complement activation, cell lysis (e.g., penicillin-induced anemia)
Type III: Immune complexes deposit in capillaries, activate complement, cause inflammation (e.g., nephritis after strep)
Type IV: T-cell mediated, delayed (24–72 hrs), no antibodies (e.g., poison ivy, latex allergy)
Key Terms and Concepts
Opsonization: Antibody/complement coating enhances phagocytosis.
Agglutination: Clumping of pathogens by antibodies, facilitates clearance.
Antibody-Dependent Cell-Mediated Cytotoxicity (ADCC): Antibodies direct immune cells to kill target cells; safer than chemotherapy/radiation.
Stevens-Johnson Syndrome: Severe allergic reaction affecting skin and mucous membranes.
Diapedesis: Movement of white blood cells from blood vessels into tissues.
Example: Rh Incompatibility
First pregnancy (Rh− mother, Rh+ baby): IgG antibodies form, but baby is usually unaffected.
Second pregnancy: Maternal IgG attacks fetal RBCs, causing anemia and possible death.
Summary Table: Immune Cell Differentiation
Stem Cell | Progenitor | Final Cell Types | System |
|---|---|---|---|
Pluripotent stem cell | Myeloid | Erythrocyte, megakaryocyte (platelets), myeloblast (neutrophil, monocyte, eosinophil, basophil), dendritic cell | Innate |
Pluripotent stem cell | Lymphoid | B cell, T cell, natural killer cell | Adaptive |
Additional info: The immune system can be harmful if misdirected (autoimmunity, allergies). Memory cells provide rapid response upon re-exposure to pathogens. MHC presentation is crucial for self/non-self recognition and prevention of autoimmunity.