BackComprehensive Study Notes: Viruses, Antimicrobial Drugs, Immunology, and Hypersensitivity
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Viruses: Structure and Replication
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, function as attachment factors (fake cell receptors) to facilitate entry into host cells and increase virulence.
Viral Replication Pathways
Primary method: Lytic cycle
Goals of viral replication:
Copy genetic material
Assemble new viral particles
Lytic cycle steps:
Attachment: Virus binds to host cell surface.
Uncoating: Viral capsid is removed, and genetic material enters the 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 the virus to remain dormant and evade the immune system.
Can switch to the lytic cycle under certain conditions (e.g., weakened immunity).
Viral Genomes and Replication Enzymes
Types of viral genomes:
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)
Viral Replication Pathways by Genome Type
dsDNA virus: Uses host DDRP to make mRNA from (-) DNA strand; DDDP copies DNA genome.
ss(+) DNA virus: DDDP makes (-) DNA, DDRP makes (+) RNA (mRNA), DDDP copies DNA.
ss(-) DNA virus: DDRP makes mRNA, DDDP copies DNA strands.
ss(+) RNA virus: (+) RNA acts as mRNA, translated by ribosomes; RDRP makes (-) RNA, which is then used to make more (+) RNA.
ss(-) RNA virus: RDRP (carried in the virion) makes (+) RNA (mRNA), which is translated; RDRP also makes more (-) RNA.
dsRNA virus: (+) RNA is translated; RDRP copies RNA genome.
ss(+) RNA retrovirus: RDDP makes (-) DNA, DDDP makes (+) DNA, viral DNA integrates into host genome, mRNA is made and translated.
Antiviral Drug Targets
RDRP is an ideal antiviral target because it is not present in human cells.
Antimicrobial Drugs
General Principles
All antibiotics have risks and side effects.
Common bacterial targets:
Cell wall synthesis
Bacterial ribosomes
DNA replication
Cell Wall Synthesis Inhibitors
Example: Beta-lactams (e.g., penicillin)
Mechanism: Inhibit peptidoglycan synthesis
Effective against: Gram-positive bacteria
Side effects: Allergic reactions, gastrointestinal upset (due to disruption of gut flora)
Ribosomal Inhibitors
Bacterial ribosomes: 70S; Eukaryotic ribosomes: 80S
Examples: Tetracycline (targets 30S), Azithromycin (targets 50S), Gentamycin (targets 30S)
Side effects:
Tetracycline: Tooth discoloration (especially in children, binds calcium in developing teeth)
Azithromycin: Blocks Ca2+ channels, may cause arrhythmia
Gentamycin: Nephrotoxicity, hearing loss (due to mitochondrial targeting)
Note: Mitochondria evolved from prokaryotes, so ribosomal inhibitors may affect mitochondrial function.
DNA Replication Inhibitors
Bacteria use DNA gyrase; humans use topoisomerase
Example: Ciprofloxacin
Mechanism: Inhibits DNA gyrase
Side effects: Tendon rupture, agitation, seizures (due to GABA receptor blockade)
Metabolic Inhibitors
Example: Sulfa drugs (e.g., trimethoprim)
Mechanism: Inhibit folate synthesis (not used by humans)
Side effects: Stevens-Johnson Syndrome (severe skin reaction), arrhythmia
Antibiotic Risk Ranking (Lowest to Highest)
Penicillin < Tetracycline < Azithromycin < Gentamycin < Ciprofloxacin < Sulfa drugs
Antibiotic Development
Pharmaceutical companies are reluctant to develop new antibiotics due to limited profitability and shelf life compared to chronic medications.
Microbial Growth and Quantification
Plate Count Assays
Used to estimate the number of viable bacteria in a sample.
Procedure:
Serial dilution of sample (e.g., 1:10 dilution series)
Plating a known volume on agar
Counting colonies after incubation
Calculation: $\text{CFU/mL} = \frac{\text{Number of colonies}}{\text{Volume plated (mL)} \times \text{Dilution factor}}$
FDA convention: Count plates with 30–300 colonies
Immunology: Innate and Adaptive Immunity
Overview of the Immune System
Innate immunity: First line of defense, rapid but non-specific
Adaptive immunity: Slower, highly specific, and has memory
Functions: Protects against pathogens (bacteria, viruses, fungi, parasites), allergens, and chemicals
Primary Immune Organs and Cells
Bone marrow: Produces pluripotent stem cells
Lymph nodes: Filter blood and dead cells; sites for lymphocyte activation
Thymus: Site of T-cell maturation
Innate Immune System Components
Macrophages (APCs): Phagocytize pathogens, present antigens
Dendritic cells (APCs): Capture antigens, migrate to lymph nodes to activate T cells
Mast cells: Release histamine, cause inflammation and vasodilation
Complement proteins: Form membrane attack complex (MAC) to lyse bacteria
Cytokines: Mediate inflammation and fever
Adaptive Immune System Components
B cells: Produce antibodies
T-killer (cytotoxic) cells: Destroy infected or flagged cells
Helper T cells: Coordinate immune response, link innate and adaptive immunity
Memory cells: Provide long-term immunity
Immune Cell Development
Pluripotent stem cells (in bone marrow) differentiate into:
Lymphoid progenitors (adaptive immunity): Immature B cells, T cells, Natural Killer cells
Myeloid progenitors (innate immunity): Erythroblasts (RBCs), megakaryoblasts (platelets), myeloblasts (WBCs), immature dendritic cells
Major Histocompatibility Complex (MHC)
MHC I: Present on all nucleated cells (except RBCs)
MHC II: Present on macrophages and dendritic cells
Critical for self/non-self recognition and T cell activation
Antigen Presentation and Immune Activation
APCs present antigens to Helper T cells (CD4+)
Helper T cells activate B cells and cytotoxic T cells (CD8+)
Double-check mechanism prevents autoimmunity
Antibody Structure and Function
Antibodies (immunoglobulins, Ig) are proteins with:
Variable region: Determines antigen specificity
Constant region: Determines antibody class (IgG, IgM, etc.)
Classes and functions:
IgM: Pentamer, agglutination, complement activation
IgD: Membrane-bound, function unclear
IgE: Triggers histamine release, allergic responses
IgA: Dimer, agglutination, antiviral properties
IgG: Most abundant, crosses placenta, opsonization, neutralizes toxins
Hypersensitivity Reactions
Types of Hypersensitivity
Type | Mechanism | Antibody Involvement | Examples |
|---|---|---|---|
I (Immediate) | IgE-mediated, mast cell degranulation | Yes (IgE) | Allergies, anaphylaxis |
II (Cytotoxic) | IgG/IgM bind to cell-bound antigens, complement activation | Yes (IgG, IgM) | Hemolytic anemia, thrombocytopenia, Rh incompatibility |
III (Immune Complex) | Antigen-antibody complexes deposit in tissues | Yes (IgG, IgM) | Serum sickness, post-strep nephritis |
IV (Delayed) | T cell-mediated, no antibodies | No | Contact dermatitis, TB skin test, poison ivy |
Type I Hypersensitivity (Immediate)
First exposure: Sensitization, IgE produced and binds mast cells
Second exposure: Antigen cross-links IgE, mast cell degranulation, histamine and leukotriene release
Symptoms: Anaphylaxis (bronchoconstriction, hypotension, hives)
Type II Hypersensitivity (Cytotoxic)
Antibodies bind to antigens on cells (e.g., RBCs, platelets), activate complement, cause cell lysis
Examples: Penicillin-induced hemolytic anemia, Rh incompatibility in pregnancy
Type III Hypersensitivity (Immune Complex)
Immune complexes (antigen-antibody) deposit in tissues, activate complement, cause inflammation
Examples: Serum sickness, post-strep nephritis, dust-induced alveolitis
Type IV Hypersensitivity (Delayed, Cell-Mediated)
Mediated by T cells and macrophages, not antibodies
Examples: Contact dermatitis (poison ivy), TB skin test, latex allergy
Symptoms develop 24–72 hours after exposure
Key Terms and Concepts
Opsonization: Enhanced phagocytosis by coating pathogens with antibodies or complement
Agglutination: Clumping of pathogens by antibodies, facilitates phagocytosis
Antibody-Dependent Cell-Mediated Cytotoxicity (ADCC): Immune cells kill antibody-coated target cells; safer than chemotherapy/radiation for some therapies
Diapedesis: Movement of white blood cells from blood vessels into tissues
PAMPs (Pathogen-Associated Molecular Patterns): Molecules on pathogens recognized by innate immune cells (e.g., peptidoglycan, LPS)
Sample Calculations
CFU/mL calculation example:
Plate has 54 colonies, plated from 1 mL of 1:1000 dilution: $54 \times 1000 = 54,000$ CFU/mL
Plate has 83 colonies, plated from 1 mL of 1:10,000 dilution: $83 \times 10,000 = 830,000$ CFU/mL
Plate has 191 colonies, plated from 0.1 mL of 1:100 dilution: $191 \times 10 \times 100 = 191,000$ CFU/mL
Additional Info
Gene expression differences, not DNA sequence, determine cell type (e.g., nerve vs. muscle cell).
Thymic deletion removes self-reactive T cells; failure can lead to autoimmune diseases (e.g., diabetes, multiple sclerosis).
Memory in adaptive immunity ensures rapid and robust response upon re-exposure to the same antigen.