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Transcript of Bubble Boy Disease Severe combined immunodeficiency (SCID) It is a genetic disorder in which the...
Bubble Boy DiseaseSevere combined immunodeficiency (SCID)
It is a genetic disorder in which the adaptive immune system is nonfunctional.
SCID is a severe form of heritable immunodeficiency. It is also known as the “bubble boy” disease because its victims are extremely vulnerable to infectious diseases and some of them, such as David Vetter, become famous for living in a sterile environment.
The human immunodeficiency virus (HIV) infects and destroys a particular type of white blood cells.
white blood cell
HIV
The human immunodeficiency virus (HIV) infects and destroys a particular type of white blood cells.
white blood cell
HIV
Over time, the immunity of the infected person may be seriously weakened, resulting in AIDS.
white blood cell
HIV
Patients usually die from infections that are harmless in healthy people.
white blood cell
HIV
What is immunity1
• Protects from pathogens and foreign molecules
– Parasites
– Bacteria
– Viruses
• Removes dead or damaged cells
• Attempts to recognize and remove abnormal cells
Immune System: Functions
9
• Incorrect responses
– Autoimmune disease (Type 1 diabetes)
• Overactive responses
– Allergies
• Lack of response
– Immunodeficiency disease (AIDS)
Immune System: Pathologies
26.1 Non-specific defence mechanisms
immune system ( 免疫系
統 )
pathogens
• provides body defence
Immune system
specific defence
mechanisms ( 特異性
防禦機制 )
non-specific defence
mechanisms ( 非特異性防
禦機制 )
• provide general protection against pathogens
• prevent the entry of all types of foreign substances
non-specific
Non-specific defence mechanisms
• include physical and chemical barriers
first line of defence ( 第一道防線 )
Non-specific defence mechanisms
blood clotting
• include physical and chemical barriers
Non-specific defence mechanisms
phagocytosis
inflammatory responses
• physical structures that prevent pathogens from entering the body
Physical barriers
• covers the whole body
Physical barriers1 Skin
layer of dead cells
- constantly worn away and replaced by new cells
2 Ciliated epithelium of the respiratory tract
Physical barriers
ciliated epithelial cell
closely packed cellsphysical barrier
2 Ciliated epithelium of the respiratory tract
Physical barriers
mucus-secreting cell
produces sticky mucus traps dust and pathogens
2 Ciliated epithelium of the respiratory tract
Physical barriers26.1 Non-specific defence mechanisms
cilia
beating action
moves dust and pathogens in mucus up from the bronchi to the pharynx
2 Ciliated epithelium of the respiratory tract
Physical barriers
dust and pathogens are swallowed or coughed out
cilia
beating action
• chemical secretions that may kill or stop the growth of pathogens
Chemical barriers
• secreted by sebaceous glands
1 Sebum
• a natural antiseptic ( 消毒劑 )
• kills pathogens on the skin
sebum
Chemical barriers
• contains hydrochloric acid
2 Gastric juice• secreted by gastric glands
• kills pathogens in the food in the stomach
gastric juice
Chemical barriers
3 Tears and saliva• secreted by tear glands
tears
Chemical barriers
3 Tears and saliva• secreted by salivary glands
Chemical barriers
breaks down the cell walls of certain bacteria on the conjunctiva and in the mouth cavity
Chemical barriers
• contain lysozyme ( 溶菌酶 )
3 Tears and saliva
4 Vaginal secretion
inhibits the growth of pathogens in the vagina
• acidic
Chemical barriers
Mucus is a chemical barrier that kills pathogens. mucus
In fact, mucus is a physical barrier that only traps pathogens without killing them.mucus
1 Examine a prepared slide of mammalian skin under a microscope using low power magnification or a skin model.
26.1
Identifying features of mammalian skin that are related to body defence
2 Identify the structures that are related to body defence.
prevents pathogens from entering through the wound
• blood clot ( 血凝塊 ) seals the wound and stops breeding
Blood clotting
• formation of a blood clot:
Blood clotting
- a blood vessel damaged
- blood platelets attracted to the wound
- blood platelets release chemicals
Blood clotting• formation of a blood clot:
insoluble fibrin ( 纖
維蛋白 )
soluble protein fibrinogen ( 纖維蛋白原 )
Blood clotting
red blood cell
blood platelet
white blood cell
• formation of a blood clot:
- blood cells trapped in the net of fibrin
- blood clot dries to form a scab ( 痂 ) covering the wound
Blood clotting• formation of a blood clot:
• carried out by phagocytes ( 吞噬細胞 )
Phagocytosis
phagocyte
bacterium
Phagocytosis
pathogen phagocyte
nucleusenzymes
Phagocytosis1 A phagocyte engulfs a pathogen.
Phagocytosis2 The pathogen is digested by enzymes.
Phagocytosis3 The digested pathogen is released.
Inflammatory responsesAnimation
wound is infected
pathogens
1 Capillary increases its permeability.
Inflammatory responses
capillary
2 More phagocytes come out of the capillary.
Inflammatory responses
phagocyte
3 Phagocytes engulf and digest the pathogens in the tissue.
Inflammatory responses
carrying out phago-cytosis
• increased blood flow and accumulation of tissue fluid infected area becomes red, hot,
swollen and painful
Inflammatory responses
inflammation ( 炎症 )
• pus ( 膿 ) may form inside the wound
Inflammatory responses
- consists of the remains of killed pathogens and dead phagocytes
Tissue damage triggers the inflammatory response
Tissue injury; release ofchemical signals such as
histamine
1 2 3Dilation and increased leakinessof local blood vessels; migration
of phagocytes to the area
Phagocytes (macrophages andneutrophils) consume bacteria
and cell debris; tissue heals
Pin
Skin surface
Bacteria
Chemicalsignals
Whiteblood cell
Swelling
Phagocytes andfluid moveinto area
Phagocytes
The inflammation can disinfect tissues
and limit further infection
The inflammatory response mobilizes nonspecific defense forces
The lymphatic system becomes a crucial battleground during infection
It returns tissue fluid to the circulatory system It fights infections
Lymphatic system = lymphatic ducts and lymph nodes
Lymphatic system
Right lymphaticduct, entering
vein
Thoracicduct
Appendix
Tonsil
Lymph nodes
Thoracic duct,
entering vein
Thymus
Spleen
Bonemarrow Lymphatic
vessels
LYMPHATICVESSEL
VALVE
Bloodcapillary
Tissue cells
Interstitialfluid
LYMPHATICCAPILLARY
Masses oflymphocytes and
Macrophages
Primary lymph organs : Thymus and bone marrow
Secondary lymph organs : lymph nodes
This lymphatic vessel is taking up fluid from tissue spaces in the skin
• It will return it as lymph to the blood
– Lymph contains less oxygen and fewer nutrients than interstitial fluid
LYMPHATICVESSEL
VALVE
Bloodcapillary
Interstitialfluid
LYMPHATICCAPILLARY
Tissue cells
Lymph nodes are key sites for fighting infection
They are packed with lymphocytes and macrophages
Figure 23.3C, D
Masses oflymphocytes and
macrophages
Lymphocytes
Macrophages
Outer capsule oflymph node
1 Non-specific defence mechanisms prevent the entry of
.
all types of
foreign substances
2a The first line of defence includes and
barriers that prevent pathogens from entering the blood and other tissues.
physical chemical
• Covers the to prevent the entry of pathogens
Physical ChemicalBarrier: Skin
2b Possible entrance of pathogens:
Body surface
whole body
Method of prevention:
• An antiseptic that pathogens
Physical ChemicalBarrier: Sebum
killsMethod of prevention:
2b Possible entrance of pathogens:
Body surface
• Cells are packed to prevent the entry of pathogens
Physical
Chemical
Barrier: Ciliated
epithelium
2c Possible entrance of pathogens:
Respiratory tract
closelyMethod of
prevention:
• traps pathogens
Physical
Chemical
Barrier: Ciliated
epithelium
MucusMethod of
prevention:
2c Possible entrance of pathogens:
Respiratory tract
beat to move the trapped pathogens upwards
Physical
Chemical
Barrier: Ciliated
epithelium
CiliaMethod of
prevention:
2c Possible entrance of pathogens:
Respiratory tract
or coughed out
• The trapped pathogens are then
Physical
Chemical
Barrier: Ciliated
epithelium
swallowed
Method of
prevention:
2c Possible entrance of pathogens:
Respiratory tract
• Contains to kill pathogens
Physical
Chemical
Barrier: Gastric juice
2d Possible entrance of pathogens:
Stomach
hydrochloric acidMethod of
prevention:
• Contains to kill pathogens
Physical
Chemical
Barrier: Tears
2e Possible entrance of pathogens:
Eyes
lysozymeMethod of
prevention:
• Contains lysozyme to kill pathogens
Physical
Chemical
Barrier:
2f Possible entrance of pathogens:
Mouth
Saliva
Method of
prevention:
• Acidity the growth of pathogens
Physical
Chemical
Barrier: Vaginal
secretion
2g Possible entrance of pathogens:
Vagina
inhibitsMethod of
prevention:
3 Pathogens can get into the body
seals blood clotting
through a wound on the skin. By , a blood clot is formed which the wound to prevent the entry of pathogens.
4 Phagocytosis is the process by which phagocytes pathogens.
engulf
in the infected area dilate, and capillaries there increase their .
5 In an inflammatory response, arterioles
permeability
More blood flows to the area and more come out of the capillaries to engulf and kill the pathogens in the tissues.
5phagoctyes
and result from the increased blood flow, and
6 Signs of inflammation:
Redness heat
and result from the accumulation of tissue fluid.swelling pain
Non-specific vs specific immunity
• adaptive immune response (應變性 ) / specific immunity
• Major characteristics of adaptive immune response
• 多樣性 (Diversity)
• 專一性( specificity )
• 記憶性( memory )
• 自我辨識( self/non-self recognition )
The Nature of ImmunityImmunity was originally used to indicate exemption from
taxes and this meaning still exits in the term "diplomatic
immunity".
A ntigenic specificity To distinguish subtle difference among
antigens I mmunologic memory
A second encounter with the same antigen induces a heightened state of immune reactivity
D iversity To recognize billions of uniquely different
structures on foreign antigens S elf/nonself recognition
To respond only to foreign antigens
Characteristics of Adaptive immunity
26.2 Specific defence mechanisms
antigens ( 抗原 )
lymphocytes ( 淋巴細胞 )
B cells T cells
immune responses ( 免疫反應 )
activate
carry out
Two kinds of lymphocytes carry out the immune responseB cells secrete
antibodies that attack antigens
T cells attack cells infected with pathogens
LymphocytesBONE MARROW
Stem cell
Immaturelymphocytes
Viablood
Antigenreceptors
B cell
HUMORALIMMUNITY
CELL-MEDIATEDIMMUNITY
T cell
THYMUS
Viablood
OTHER PARTSOF THE
LYMPHATICSYSTEM
Lymph nodes,spleen, and otherlymphatic organs Final
maturation of B and T cellsin lymphatic
organ
and self antigens
• stimulate immune responses
Antigens
• two groups:
foreign antigens
- come from outside of the bodye.g. cell surface proteins of viruses
or toxins from bacteria
virussurface proteins
foreign antigens
• stimulate immune responses
Antigens
• two groups:
and self antigens
- produced by the person’s own body e.g. surface proteins on red blood cells
red blood cell
surface proteins
• immune system can usually recognize self antigens and does not attack them
Antigens
Antigens
humoral immune responses (HIR) ( 體液免疫反應 )
foreign antigens not yet entered the host cells
B cells
activate
carry out
• B cells are formed and mature in the bone marrow
Humoral immune responses
• B cells have antigen receptors that only bind with a specific antigen
Triggered by a specific antigen, a B cell differentiates into an effector cell
The effector cell is called a plasma cellThe plasma cell secretes antibodies
B cells are the main warriors of humoral immunity
Humoral immune responsesactivated by antigens and helper T cells
B cell
multiplies and differentiates into
memory B cell
plasma cell
Humoral immune responses
plasma cell
Antibodies to act against antigens
produces
Humoral immune responses• antibody is a Y-shaped protein
molecule
polypeptide chains
disulphide bond
antigen-binding site
Antigens are molecules to which antibodies bind
Antigens have specific regions where antibodies bind to them
Antibody Amolecules
Antigen
Antibody Bmolecule
Antigenicdeterminants
Antigen-binding
sites
Humoral immune responses
antigen-antibody complex
antigen
Humoral immune responses• production of antibodies is specific
- each type of antigen leads to the production of only one type of antibody
3D animation
Humoral immune responses
1 Lysis ( 溶菌 )a Antibodies attach to pathogen and make holes in it.
Actions of antibodies
antibodies
pathogen (virus or bacterium)
Animation
Humoral immune responses
1 Lysis ( 溶菌 )a Antibodies attach to pathogen and make holes in it.
Actions of antibodies
Humoral immune responses
1 Lysis ( 溶菌 )b Pathogen is lysed ( 被溶解 ) and killed.
Actions of antibodies
hole
Humoral immune responses
2 Help in phagocytosis
a Antibodies attach to pathogen.
Actions of antibodies
pathogen
phagocyteantibody
Humoral immune responses
b Phagocyte detects the antibodies and engulfs the pathogen.
Actions of antibodies
2 Help in phagocytosis
Humoral immune responses
c Pathogen is killed by phagocytosis.
Actions of antibodies
2 Help in phagocytosis
Humoral immune responses
3 Stick pathogens into clumps
- pathogens stuck together by antibodies and cannot reproduce or enter cells
Actions of antibodies
pathogens
antibodies
Humoral immune responses26.2 Specific defence mechanisms
3 Stick pathogens into clumps
- pathogens stuck together by antibodies and cannot reproduce or enter cells
Actions of antibodies
Humoral immune responses
4 Neutralize toxins of pathogens
- antibodies act as antitoxins ( 抗毒素 ) to neutralize toxins
Actions of antibodies
antibodies
toxins
Humoral immune responses26.2 Specific defence mechanisms
4 Neutralize toxins of pathogens
Actions of antibodies
- antibodies act as antitoxins ( 抗毒素 ) to neutralize toxins
Binding of antibodies to antigens
inactivates antigens by
Neutralization
(blocks viral binding sites;
coats bacterial toxins)
Agglutination
of microbes
Precipitation of
dissolved antigens
Make holes in cell membrane
Virus
Bacterium
Bacteria
Antigen
molecules
Complement
molecule
Foreign cell Hole
Enhances
Phagocytosis
Macrophage
Cell lysis
Leads to
When an antigen enters the body, it activates only lymphocytes with complementary receptorsB and T cells multiply into clones of specialized
effector cells that defend against the triggering antigen
This is called clonal selection
Clonal selection musters defensive forces against specific antigens
Figure 24.7
Antigen molecules
Variety ofB cells in a lymph node
Cell growth
division, and
differentiation
Clone of manyeffector cells
secretingantibodies
Antibodymolecules
Antigen receptor(antibody oncell surface)
Endoplasmicreticulum
In the primary immune response, clonal selection produces memory cellsThese cells may confer lifelong immunity
The initial immune response results in a type of “memory”
When memory cells are activated by subsequent exposure to an antigen, they mount a more rapid and massive secondary immune response
Figure 24.8B
Unstimulated lymphocyte
First exposure to antigen
FIRST CLONE
Memory cells
Effector cellsSecond exposure to antigen
SECOND CLONE
More memory cells
New effector cells
Figure 24.9
PRIMARY RESPONSE
(initial encounter
with antigen)
Antigen
Antigen receptoron a B cell
Antigen binding
to a B cell
Memory B cell
Antibody
molecules
Plasma cell
Cell growth,
division, and
differentiation
SECONDARY RESPONSE
(can be years later)
Cell division,
differentiation
Larger clone
of cells
Plasma cell
Antibody
molecules
Later
exposure
to
same antigen
Memory B cell
Clone ofcells
Cell-mediated immune response
cell-mediated immune responses (CMIR)
infected cells or cancer cells
T cells
stimulate
carry out
• T cells have receptors on their surface that fit a specific antigen
• T cells are formed in the bone marrow and mature in the thymus gland ( 胸腺 )
Cell-mediated immune response
• several types: helper T cells, killer T cells and memory T cells
Cell-mediated immune response
thymus gland
activated by infected cells or cancer cells
helper T cell
B cell
carries out HIR
T helper cells activate HIR
activates
T cell
lymphokines ( 淋巴激活
素 )
activate phagocytes
Cell-mediated immune responseactivated by infected cells or cancer cells
helper T cell
activatessecretes
destroys cells directly
memory T cell
killer T cell ( 殺手 T 細
胞 )
Cell-mediated immune response
T cell
multiplies and differentiates
into
Cytotoxic T / killer T cells bind to infected body cells and destroy them by making hole in the cell membrane
Figure 24.13C
Cytotoxic T cell bindsto infected cell
1 2 3Perforin makes holes
in infected cell’s membraneInfected cell is destroyed
INFECTED CELL
Perforinmolecule
CytotoxicT cell
Foreignantigen
Holeforming
Killer T cells may attack cancer cells
The surface molecules of cancer cells are altered by the disease
Killer T cells may help prevent cancer
• immunological memory ( 免疫記憶 ): the ability of memory B cells and memory T cells to ‘remember’ the type of antigen from the previous exposure
Primary and secondary immune responses
Primary and secondary immune responses
• primary response occurs on the first exposure to an antigen
• secondary response occurs when the same antigen enters the body again
• usually slow / longer latent period• normally takes 3–14 days to
produce enough antibodies or cells
disease symptoms
• antigens have time to cause damage
Primary and secondary immune responses
Primary and secondary immune responses
• faster, stronger and lasts longer • memory cells multiply and differentiate
quickly into a larger number of plasma cells, killer T cells and memory cells
• kills the pathogen before it can multiply and cause a disease
0 7 14 21 28 35 days
conc
entr
atio
n of
an
tibod
ies
in b
lood
first exposure second exposure
primary response
secondary responserecovery
0 7 14 21 28 35 days
first exposure second exposure
primary response
secondary responserecovery
latent period ( 潛伏期 )
conc
entr
atio
n of
an
tibod
ies
in b
lood
0 7 14 21 28 35 days
first exposure second exposure
primary response
secondary responserecovery
concentration of antibodies
conc
entr
atio
n of
an
tibod
ies
in b
lood
0 7 14 21 28 35 days
first exposure second exposure
primary response
secondary responserecovery
period of existence of antibodies
conc
entr
atio
n of
an
tibod
ies
in b
lood
• immunity can be enhanced by vaccination
Principle of vaccination
introduction of vaccines ( 疫苗 ) into the body
Principle of vaccination• four types of vaccines:
1 Live, weakened pathogens
e.g. vaccines of measles, mumps, rubella
2 Killed pathogens
e.g. vaccines of poliomyelitis, rabies ( 狂犬病 )
• four types of vaccines:
3 Viral proteins
e.g. vaccine of whooping cough
4 Inactivated bacterial toxins
e.g. vaccines of diphtheria, tetanus
Principle of vaccination
Vaccines I# Many exotoxins can
be modified chemically so that they retain their antigenicity but are no
longer toxic. Such a modified exotoxin is
called a toxoid.
Vaccine II# Most agents used for immunization are either
attenuated or inactivated pathogens or inactivated
forms of natural microbial products.
Alternative immunization strategies using
bioengineered molecules eliminate exposure to
microorganisms and, in some cases, even to
protein antigen. Application of these
strategies may provide safer and more targeted
vaccines.
• vaccine contains an antigen
• introduced into the body orally or by injection
Principle of vaccination
- production of some antibodies and killer T cells
- production of memory cells that ‘remember’ the type of antigen
antigen in vaccine
primary response
stimulates
Principle of vaccination
- production of a larger amount of specific antibodies and killer T cells in a shorter time
invasion by the same antigen
secondary response
stimulates
Principle of vaccination
• makes use of the specificity and immunological memory
• protects the health of the community if a large number of people are vaccinated
• not completely without risk
Principle of vaccination
• given by antibodies produced by our own plasma cells
Active and passive immunity
• acquired naturally when a person recovers from an infection
• acquired artificially by vaccination
• start of the immunity is relatively slow
Active and passive immunity
• long lasting
Active and passive immunity
• given by direct transfer of antibodies from immune persons
Active and passive immunity • occurs naturally in babies when:
- antibodies diffuse from mother’s blood to embryo’s blood in placenta
Active and passive immunity
- babies are fed with breast milk
• occurs naturally in babies when:
Active and passive immunity
• occurs artificially when:
- antibodies are injected for treatment of diseases
• immunity starts immediately
• lost after a short period of time when the antibodies break down
fusing B cells specific for a single antigenic determinant with easy-to-grow tumor cells
Connection: Monoclonal antibodies are powerful tools in the lab and clinic
Antigen injected
into mouse
Tumor cells grown
in culture
B cells
(from spleen)
Tumor cells
Cells fused to
generate hybrid
cellsSingle hybrid cell
grown in culture
AntibodyHybrid cell culture,
producing monoclonal antibodies
These cells are useful in medical diagnosis
– Example: home pregnancy tests
• They are also useful in the treatment of
certain cancers
Autoimmune diseases : The immune system turns against the body’s own molecules, including SLE (紅斑狼瘡 ), RA (類風濕性關節炎 ), type I diabetes, asthma, Crohn’s disease 孔羅氏症 (消化道瘜肉 ),….
Immunodeficiency diseases : Immune components are lacking, and infections recur. Innate immune deficiency : Severe combined immunodeficiency
(SCID) Acquired immune deficiency : AIDS
Physical and emotional stress may weaken the immune system
Connection: Malfunction or failure of the immune system causes disease
Arthritis X-ray
RA is an autoimmune disorder in which your own body mistakenly attacks healthy tissue, causing inflammation and damage to your joints.
About 1% of the US population suffers from RA. Patients usually develop the signs and symptoms of the disease between the ages of 35 and 50,
with women affected 2 to 3 times more often than are men.
Allergies are abnormal sensitivities to allergens in the surroundings
Connection: Allergies are overreactions to certain environmental antigens
Allergen
(pollen grain)
B cells make
antibodies
Antigenic
determinant
SENSITIZATION: Initial exposure to allergen
Antibodies
attach to
mast cell
B cell
(plasma cell)Histamine
Mast
cell
Allergen binds to
antibodies on
mast cell
Histamine is
released, causing
allergy symptoms
LATER EXPOSURE TO SAME ALLERGEN
Allergy-causing fungal spores
Figure 24.17x
The AIDS virus attacks helper T Cells This cripples both cell-mediated and humoral
immunity
So far, AIDS is incurableDrugs and vaccines offer hope for the future
Practicing safer sex could save many lives
Connection: AIDS leaves the body defenseless
Acquired immune deficiency syndrome (AIDS) is epidemic throughout much of the world
14,000 people are infected with the AIDS virus every dayHIV is the virus that causes AIDSHIV is transmitted mainly
in blood and semen Former L.A. Laker Magic
Johnson is one of 900,000 Americans who are HIV-positive
The Continuing Problem of HIV
AIDS is an immunodeficiency disease caused by a virus
In 1981, increased rates of two rare diseases, Kaposi’s sarcoma, and pneumonia caused by a protozoan P. carinii, were the first signals of a new threat to humans, later known as acquired immunodeficiency syndrome, or AIDS.Both conditions were previously known to occur
mainly in severely immunosuppressed individuals.People with AIDS are susceptible to opportunistic
diseases.
Kaposi’s Sarcoma
Unusual tumor arising from blood or lymphatic vessels in multiple locations
Tumor began to appear in young men with HIV○ 2000 time higher than period
before HIV○ So common among AIDS
patients became AIDS-defining condition
Causative agent - Pneumocystis carinii
Tiny fungus formerly considered a protozoan
Differs from many fungi in cell wall components○ Consequently resistant to many fungal
medications
Pathogenesis Spores of organism are inhaled into lung
○ Attach to alveolar wallsAlveoli fill with fluid, mononuclear cells
and organisms Alveolar walls become thickened and
scarred. Interferes with free passage of oxygen
Pneumocystosis( 肺孢子蟲病 )
In 1983, a retrovirus, now called human immunodeficiency virus (HIV), had been identified as the causative agent of AIDS.
With the AIDS mortality close to 100%, HIV is the most lethal pathogen ever encountered.Molecular studies reveal that the virus probably
evolved from another HIV-like virus in chimpanzees in central Africa and appeared in humans sometimes between 1915 and 1940.○ These first rare cases of infection and AIDS went
unrecognized.
Two major strains HIV-1 and HIV-2.HIV-1 is the more widely distributed and more
virulent.
Both strains infect cells that bear CD4 molecules, especially helper T cells and also macrophages, some lymphocytes and some brain cells.
HIV infected cells: Among the susceptible WBCs, what do they have in common?
CD4 functions as the major receptor for the virus.Other HIV receptors present on the surface of some
WBCs are implicated:
• Clues: Some people who are innately resistant to HIV-1 owe their resistance to defective chemokine receptors. chemokines – chemicals secreted by WBC when signaling with one another.
• What is your conclusion?
The entry of the virus requires not only CD4 on the surface of the susceptible cells but also a second protein molecule, a co-receptor. Defective chemokine receptor prevents HIV from binding and infecting cells.
What is your conclusion?
Once inside a cell, HIV RNA is reverse-transcribed, and the product DNA is integrated into the host genome.This directs the production of new virus particles.Because a retrovirus exists integrated in the host
genome of the infected cell, immune responses fail to eradicate it from the body.
Even more challenging : frequent mutational changes that occur in each round of virus replication.
Give two reasons why it is difficult to remove the virus from our body?
Give two reasons why it is difficult to remove HIV from our body?
•Because a retrovirus exists integrated in the host genome of the infected cell,
immune responses fail to eradicate it from the body.
•Even more challenging : frequent mutational changes that occur in each
round of virus replication.
Because a retrovirus exists integrated / hidden in the host genome of the infected cell, immune responses fail to eradicate it from the body.
Even more challenging : frequent mutational changes occur in each round of virus replication fools our immune system – render immunologic memory and immune specificity ineffective.
Give two reasons why it is difficult to remove HIV from our body?
The body is then engaged in a Prolonged battle against HIV.(1) The immune response diminishes the initial viral
load, but HIV continues to replicate in lymphatic tissue.
(2) Viral load gradually rises as HIV is released from lymphatic tissue and helper T cell levels decrease. Consequence?
The body is then engaged in a Prolonged battle against HIV.(1) The immune response diminishes the initial viral
load, but HIV continues to replicate in lymphatic tissue.
(2) Viral load gradually rises as HIV is released from lymphatic tissue and helper T cell levels decrease. Consequence?
This results in extensive loss of humoral and cell-mediated immunity.
After an initial peak, virus levels in the blood fall as
anti-HIV antibodies,
produced 1 to 12 months after
infection, rise.
After the early drop in HIV levels in the blood, the virus continues to be produced by cells in the lymph nodes,
causing structural and functional damage.
In time, the concentration of HIV in the blood increases as a result of :
the breakdown of lymphatic tissue function and diminishing responses to the infection because of
the depletion of helper T cells.
The time required for an HIV infection to progress to severe
helper T cell depletion and AIDS varies greatly, but it currently averages
about ten years.
A person who is HIV-positive will have blood tested positive for the presence of antibodies to the virus.
However, a HIV-negative blood test result does not completely guarantee a safe blood supply, WHY?
because an infected individual may require several weeks to 6 months (window period) before anti-HIV antibodies become detectable.
After the early drop in HIV levels in the blood, the virus continues to be produced by cells in the lymph nodes, causing structural and functional damage.In time, the concentration of HIV in the blood
increases as a result of :the breakdown of lymphatic tissue function and
diminishing responses to the infection because of the depletion of helper T cells.
The time required for an HIV infection to progress to severe helper T cell depletion and AIDS varies greatly, but it currently averages about ten years.During most of this time, the individual exhibits
only moderate hints of illness, such as swollen lymph nodes and occasional fever.
How do you think doctors can monitor the progress of the disease?
by measuring changes in the level of T cells, although measures of viral load are a better
indicator of disease prognosis and of the effectiveness of anti-HIV treatment.
The time required for an HIV infection to progress to severe helper T cell depletion and AIDS varies greatly, but it currently averages about ten years.During most of this time, the individual exhibits
only moderate hints of illness, such as swollen lymph nodes and occasional fever.
How do you think doctors can monitor the progress of the disease?
by measuring changes in the level of T cells. Or measures of viral load - a better indicator of disease prognosis
and of the effectiveness of anti-HIV treatment.
At this time, HIV infection cannot be cured, and the progression to AIDS cannot be prevented.
New, expensive drug therapies can slow this progression.
Suggest how these drugs might work:
Combinations of these drugs (a cocktail) decrease viral load and therefore allow the number of helper T cells to rise.
slow viral replication by 1) inhibiting DNA synthesis, 2) inhibiting reverse transcriptase, and 3) protein synthesis inhibitors
At this time, HIV infection cannot be cured, and the progression to AIDS cannot be prevented.
New, expensive drug therapies can slow this progression.
Suggest how these drugs might work:
Combinations of these drugs (a cocktail) decrease viral load and therefore allow the number of helper T cells to rise.
slow viral replication by
•- inhibiting DNA synthesis,
•- inhibiting reverse transcriptase, and
•- protein synthesis inhibitors
Highly Active Anti-retroviral therapy (HAART)
Reverse transcriptase inhibitors and protease inhibitors, provide a "one-two punch," interrupting HIV's replication cycle at different points and reducing the virus in many cases to undetectable levels.
HOW ANTI-HIV DRUGS WORK Entry inhibitors bind to the
proteins on the outside of the HIV virus and stop it from entering the target cell (Fuzeon only).
Nucleoside reverse transcriptase inhibitors stop HIV copying its genes into the cell. Nucleosides are the building block for genes. The drugs supply faulty versions of these building blocks (drugs include abacavir, AZT, ddI, 3TC).
Non-nucleoside reverse transcriptase inhibitors also block the gene-copying process. They disable the enzyme that controls it (drugs include nevirapine and efavirenz).
Protease inhibitors disable protease, an enzyme which plays a key role in the formation of the new virus (drugs include amprenavir, lopinavir, ritonavir, nelfinavir).
HAART reduce the virus in many cases to undetectable levels.
• Even though ARV drugs are getting more powerful in inhibiting the effects of HIV, one must remember that these do not cure HIV infection and AIDS.
• Individuals who are on HAART can still transmit the virus to other people.
protease inhibitors
When the (HIV) replicates, it does not make perfect copies of itself but rather, creates new strains in the process. This means that an HIV+ person actually has many different strains of the virus inside his/her system.
Suggest why the ‘cocktail treatment’ is preferred rather than a single drug?
168
Suggest why the ‘cocktail treatment’ is preferred rather than a single drug?
• New strains of HIV which are resistant to the effects of a particular antiretroviral (ARV) drug may appear and then replicate quickly.
• For a treatment regimen to be effective over the long term, it has to include more than one ARV drug at a time. Taking two or more ARV drugs concurrently, known as combination therapy, can vastly reduce the rate at which drug resistance develops.
• HIV evolve quickly because it has a very short life cycle and high mutation rate.
Transmission of HIV requires the transfer of body fluids containing infected cells, such as semen or blood, from person to person:
Transmission of HIV
• Unprotected sex (that is, without a condom) among male homosexuals
• and transmission via nonsterile needles (typically among intravenous drug users)
• However, transmission of HIV among heterosexuals is rapidly increasing as a result of unprotected sex with infected partners.
So far, only one case of HIV transmission by kissing has been reported, and both individuals had bleeding gums.
Transmission of HIV from mother to child can occur during fetal development or during nursing. Mother-to-child transmission accounts for more than 90% of all HIV infections in infants and children worldwide.
HIV screening has virtually eliminated blood transfusions as a route of transmission in developed countries.
HIV is not transmitted by casual contact.
河南爱滋病村
马深义一家住在中国河南上蔡县文楼村,他的家庭就是爱滋病的受害者。他们一家五口人,有四人感染了艾滋病,只有 9 岁的大女儿是健康的。《好死不如赖活着》没有故事、没有情节、没有背景音乐、没有字正腔圆的叙述、没有宏大的场面,整部影片就是在纪录这个家庭的日常生活。影片的镜头从 2001年的春末夏初开始,历经盛夏、深秋、严冬,一直到春节,近距离地拍摄了马深义一家面对爱滋病和死亡的人生经历。
As of 2000 the Joint United Nations Program on AIDS estimates that 30 to 40 million people worldwide are living with HIV or HIV/AIDS.Of these, approximately 70% reside in sub-
Saharan Africa.The number of people with AIDS is expected to
grow by nearly 20% per year.
The best approach for slowing the spread of HIV is to educate people about the practices that transmit the disease, such as using nonsterile needles and having sex without a condom.
Any individual who has sex with a partner who had unprotected sex with another person during the past two decades risks exposure to HIV.
HIV on a lymphocyte
Figure 24.18x2
HIV budding collage ( 大雜燴 )
No approved vaccine
Most people infected are unaware
Virus on surfaces can be inactivated with commercially available disinfectants and heat at 56°C for more that 30 minutes
Knowledge of transmission greatest tool for control
Use of condoms not 100% effective but have been shown to decrease transmission
Avoidance of practices that favor HIV transmission
HIV Prevention and Treatment
Currently no approved vaccines In theory, vaccine could be used in two ways:
HIV vaccine prospects
Prevention vaccine
Immunize uninfected individuals against disease
Therapeutic vaccine
Boost immunity of those already infected
•get around HIV variability
•Be effective in preventing direct spread of HIV from cell to cell
Successful vaccine must
• Be capable of turning into disease-causing strain
• Be oncogenic – cancer causing
• Stimulate an autoimmune response
Successful vaccine must NOT
Vaccine trial in humans has been undertaken for at least 10 experimental vaccines
All have failed and prospects do not look
favorable
A monumental safe-sex message in Paris
A monumental safe-sex message in Paris
Pope says condoms are not the solution to Aids - they make it worse
A monumental safe-sex message in Paris
Pope Benedict stressed that the Roman Catholic Church is in the forefront of the
battle against Aids. The Vatican encourages sexual abstinence to fight
the spread of the disease.
Pope says condoms are not the solution to Aids - they make it worse
A monumental safe-sex message in Paris
2 million people die of Aids each year.
14,000 people get infected with HIV every day.
CountryPeople living
with HIV/AIDS
Adult (15-49) rate %
Women with
HIV/AIDS
Children with
HIV/AIDS
AIDS deaths
Orphans due to AIDS
Cameroon 610,000 5.3 320,000 54,000 37,000 330,000
Chad 210,000 3.4 110,000 23,000 11,000 120,000
Congo 77,000 3.4 40,000 7,900 5,100 51,000
Ghana 260,000 1.8 140,000 27,000 18,000 160,000
Kenya 1,500,000 6.3 760,000 180,000 80,000 1,200,000
Mozambique 1,400,000 11.5 760,000 130,000 74,000 670,000
Nigeria 3,300,000 3.6 1,700,000 360,000 220,000 2,500,000
South Africa 5,600,000 17.8 3,300,000 330,000 310,000 1,900,000
Total sub-Saharan Africa 22,500,000 5.0 12,100,000 2,300,000 1,300,000 14,800,000
Notes
Adults in this page are defined as men and women aged over 15, unless specified otherwise.
Children are defined as people under the age of 15, whilst orphans are children aged under 18 who have lost one or both parents to AIDS.
Sub-Saharan Africa HIV & AIDS statistics (2010)
There is no single perfect solution to the problem of Aids
Telling people to abstain doesn’t make everyone abstain
Telling people NOT to use condom undermines the effort of the fight against AIDs and makes a serious global public health problem in places where AIDs is
rapidly spreading e.g. Africa
Botswana, 23.9% of adults between 15 and 49 are HIV positive; Swaziland, where 26.1% of adults have HIV;
1 Antigens are substances that stimulate , activate the immune system to produce , and combine with specific antibodies.
immune responses
antibodies
26.2 Specific defence mechanisms
to act against specific antigens that have not yet entered host cells.
2 Humoral immune response uses antibodies
26.2 Specific defence mechanisms
them.
of pathogens anda Antibodies may attach to the
3 How antibodies act against pathogens:
antigens
26.2 Specific defence mechanisms
lyse
phagocytes the pathogens more easily.
b Antibodies may help theengulf
26.2 Specific defence mechanisms
3 How antibodies act against pathogens:
, preventing them from reproducing or entering cells.
c Antibodies may help pathogens stick into clumps
26.2 Specific defence mechanisms
3 How antibodies act against pathogens:
which neutralize the toxins secreted by pathogens.
d Antibodies may act as antitoxins
26.2 Specific defence mechanisms
3 How antibodies act against pathogens:
cells.
4 Cell-mediated immune response uses to destroy cells infected with specific antigens and
T cells
26.2 Specific defence mechanisms
cancer
5 Compare B cells and T cells:
26.2 Specific defence mechanisms
B cells T cells
Formed in Bone marrow
Mature in Bone marrow Thymus gland
- which produce to act against
antigens that have not yet entered host cells
5 Compare B cells and T cells:
26.2 Specific defence mechanisms
Plasma cellsantibodies
B cells give rise to:
- which ‘remember’ the type of and are responsible for the secondary response
5 Compare B cells and T cells:
26.2 Specific defence mechanisms
Memory B cellsantigen
B cells give rise to:
- which destroy infected cells or cancer cells directly
- which can activate other T cells and B cells
5 Compare B cells and T cells:
26.2 Specific defence mechanisms
Helper T cells
Killer T cells
T cells give rise to:
- which ‘remember’ the type of antigen and are responsible for the secondary response
5 Compare B cells and T cells:
26.2 Specific defence mechanisms
Memory T cellsT cells give rise to:
5 Compare B cells and T cells:
26.2 Specific defence mechanisms
B cells T cellsResponsible for
CMIRHIR
6 Distinguish primary and secondary responses:
26.2 Specific defence mechanisms
Primary response Secondary response
Effected by stimulation of B cells and T cells
Effected by stimulation of memory B cells
memory T cellsand
26.2 Specific defence mechanisms
Primary response Secondary response
latent period
( response)
latent period
( response)
Longer
slower
Shorter
faster
6 Distinguish primary and secondary responses:
26.2 Specific defence mechanisms
Primary response Secondary response
amount
of antibodies and
killer T cells
produced
amount of
antibodies and killer T
cells produced
Smaller Larger
6 Distinguish primary and secondary responses:
26.2 Specific defence mechanisms
Primary response Secondary response
Lasts for a Lastsshort longer
period of time
6 Distinguish primary and secondary responses:
pathogens, killed pathogens, or inactivated bacterial toxins.
, which contains an , into the body. A vaccine may contain live and
7a Vaccination is the introduction of a vaccine
26.2 Specific defence mechanisms
antigen
weakenedviral proteins
of the specific defence mechanisms. The vaccine produces a response.
and Vaccination makes use of the7b
specificity
26.2 Specific defence mechanisms
immunological
memory
primary
Any subsequent invasion by the same in the vaccine will produce a response, giving enhanced immunity to the disease.
antigen
26.2 Specific defence mechanisms
secondary
7b
8 Distinguish active immunity and passive immunity:
26.2 Specific defence mechanisms
own plasma cells immune persons
Active immunity Passive immunity
Antibodies are produced by our
Antibodies are transferred from
26.2 Specific defence mechanisms
from an infectionrecovers
andplacenta
breast-feeding
8 Distinguish active immunity and passive immunity:
Active immunity Passive immunity
Acquired naturally when a person
Acquired naturally through the diffusion of antibodies in the
26.2 Specific defence mechanisms
vaccination injection
8 Distinguish active immunity and passive immunity:
Active immunity Passive immunity
Acquired artificially by (for disease prevention)
Acquired artificially by of antibodies (for the treatment of diseases)
26.2 Specific defence mechanisms
slow fast
8 Distinguish active immunity and passive immunity:
Active immunity Passive immunity
Start of immunity is Start of immunity is
26.2 Specific defence mechanisms
longer short
8 Distinguish active immunity and passive immunity:
Active immunity Passive immunity
Lasts Lasts for a period of time
What is immunity?1Immunity is the ability of the body to resist a disease.
Which type of white blood cell is 2
Helper T cells are necessary to activate the defensive reactions of the body.
necessary to activate the defensive reactions of the body?
How does a low level of those white3With only a low level of helper T cells, few B cells and T cells are activated to carry out immune responses.
blood cells lead to weakened immunity?
Body defence
non-specific defence
mechanisms
consists of
specific defence mechanisms
non-specific defence mechanisms
physical barriers
include
chemical barriers
blood clotting
phagocytosis
inflammatory response
physical barriers
chemical barriers
form
first line of defence
phagocytosis
phagocytes
carried out by
specific defence mechanismsinclude
humoral immune response
cell-mediated immune response
T cellscarried out by
helper T cellssome are
carried out by
B cells
activate
T cells
lymphokinescan secrete
phagocytes
activate
T cellsmultiply and differentiate into
killer T cells
memory T cells
B cellsmultiply and differentiate into
memory B cells
plasma cells
antibodies
produce
memory B cells
responsible for
immunological memory
memory T cells