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Case Study: A patient diagnosed with AIDS questions why he tested positive…

- - - - HIV First enters the host by either blood or semen contaminated w/the virus
        
        The virus targets CD4 cells
        
        It can go one of 2 ways or both ways
        
        Lytic stage
        
        If the HIV starts reverse transcribing a lot of viral DNA in cell
        
        His cell could notice and use Ifi16, an inflammatory cascade causes the cell to self-destruct (pyroptosis)
        
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        Being that AIDS does not occur until the host's immune sys. is so compromised that they have trouble fighting off ordinary infections
        
        It is likely that it is at this stage when a flood of viruses were released into his system
        
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        Lysogenic stage
        
        Virus combines w/hosts genetic material while host cell is unaware (provirus)
        
        As the cell replicates genetic material, the virus also replicates
        
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        Being that the patient did not have any symptoms for nearly a yr, the virus may have been early in this stage in it's evolution
    - - HIV is transmitted in body secretions
        
        Such as
        
        Semen
        
        He could have contacted it through sexual intercourse w/a partner that had the virus
        
        Blood
        
        Possibilities
        
        He could have used a blood contaminated needle that had the virus
        
        Could have acquired the contaminated blood through someone else's blood getting into a wound
        
        Considering the age at which he acquired the virus, it seems unlikely that he could of received it from an infected mother
- - - - Being that the innate sys. is left to defend the body
        
        Persistent
        
        Inflammation
        
        Damage to cells & tissues due to virus initiate an inflammation response
        
        There will be much histamine in sys. due to the mast cells releasing it
        
        Fever
        
        The innate sys. responds to virus by
        
        Producing pyrogens to turn up the heat
        
        In an effort to get rid of the virus
        
        Swollen lymph nodes
        
        Due to the large amount of lymphocytes trying to fight off the virus
        
        They rush -> lymph nodes
        
        Sore & weak body
        
        Due to the NK cells in the innate sys. killing self-cells in an attempt to attack the virus
    - - Beginning from the destruction of T cells
        
        As the virus infects the CD4 T more of them die
        
        Being that CD4 cells directs the adaptive immune sys.
        
        If many of these are wiped out, the body is mainly left with the innate immune sys. to defend itself
        
        Also, since some of these T cells become regulator cells, that secrete cytokines
        
        Interferon chemicals are not interfering w/the virus reproduction cycle & warn other cells to the extent that will help fight off the virus
        
        Interlukin chemicals are not able to increase much WBCs to help fight off virus
        
        Being that cytokines also enhance activity of
        
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        Being that CD4 cells DIRECT the ADAPTIVE IMMUNE RESPONSE, B cell and cytotoxic T cells cannot be activated
        
        In this case, the innate response is left to fight invaders
  - - - Opportunistic infections can occur
        
        This can occur when other bacteria & viruses take advantage of the body's weakened defenses
        
        It is at this stage that AIDS is ordinarily diagnosed
        
        These infections include
        
        Respiratory infections
        
        Pneumonia #
        
        This can occur due to the innate response being poor and a bacterium can get into the alveoli causing this
        
        Bacterial infections
        
        Tuberculosis
        
        Due to neutraphil & monocyte cells being reduced, it is much harder for them to fight off the bacteria
        
        Viral infections
        
        Hepatitis C
        
        Patient can easily be infected by HVA & HVF to the point the innate sys. cannot fight it off
        
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        From CD4 cells falling too low
    - - Can lead to
        
        Fibrosis
        
        Tissue remodeling
        
        This can cause the lymphatic tissue to atrophy
        
        Such as
        
        Lymph nodes
        
        GALT (Gastrointestinal associated lymphatic tissue)
        
        Death of even a common cold
        
        This weakens the immune sys even more
        
        Being that merely the innate immune defense is the only one at work
        
        This makes it easy for another virus or bacteria to cause
        
        Pneumonia
        
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  - - - An antiviral is needed to target a virus
- - - - Components of immune sys.
        
        Innate defenses (NON SPECIFIC)
        
        This does NOT matter what your infected with
        
        1st & 2nd line of defense
        
        Internal defenses
        
        Phagocytes
        
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        Fever
        
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        Inflammation
        
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        NK cells (Grenade throwers)
        
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        Antimicrobial proteins
        
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        Others
        
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        Surface barriers
        
        Keeping things out
        
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        Adaptive defenses (SPECIFIC)
        
        Specific the antigen of that pathogen
        
        3rd line of defense
        
        In some cases, takes days or never
        
        Antibody/antigen side
        
        5 Cells of adaptive respones
        
        Cellular immunity
        
        T cells
        
        Cell mediated #
        
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        Role: Direct attack on pathogens & attack any infected cells
        
        Humoral immunity AKA Antibody mediated
        
        B cells #
        
        Plasma cells
        
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        Memory B cells
        
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        Role: To make antibodies
        
        Antibodies are produced by Bcells
        
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        Triggered by
        
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        APCs (Antigen presenting cells)
        
        Function: Engulf antigens, then present fragments of them
        
        Dendritic cells
        
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        B lymphocytes
        
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        Macrophages
        
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        Antigens & haptens
        
        Complete antigens
        
        Reactivity
        
        Causes an immune response & is able to interact w/antibodies
        
        Immunogenicity
        
        Ability to stimulate lymphocytes to multiply
        
        Incomplete antigens
        
        AKA Haptens
        
        Molecs that are not antigens by themselves but when combined to others molecs can work like one
        
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        Antigenic determinants
        
        Part of the antigen that really matters
        
        This binds to antibody or receptor
        
        Self antigens: MHC proteins
        
        Major histocompatibility complex
        
        Receptor for self proteins, a bracket for antigens
      - Differences between a viral & bacterial infection
        
        Viral infection
        
        Characteristics of viruses
        
        They are nonliving
        
        Tiny
        
        They only live seconds -> minutes outside of host
        
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        How immune sys. fights off a virus in a healthy organism
        
        1st line of defense: Surface barriers
        
        Mucous traps virus
        
        Cilla sweep the contaminated mucus -> pharynx to be swallowed or digested
        
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        Bacterial infection
        
        Characteristics of bacteria
        
        They are single celled microorganisms
        
        Bigger than viruses
        
        They live almost everywhere
        
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        How immune sys. fights off bacterial infection
        
        1) Leukocytosis - Monocytes & neutraphils -> Bloof from bone marrow
        
        2) Margination - Neutraphils cling to capillary wall
        
        Diapedesis - Neutraphils flatten & squeeze out of capillaries
        
        Chemotaxis - Neutraphils follow chemical trail
        
        The neutraphil then engulfs the bacterium
      - Stages of a virus
        
        Virus goes into cell
        
        Lysogenic stage
        
        "Hitch a ride method"
        
        Keeps the host alive
        
        The virus combines w/hosts genetic information while the host doesn't know its there -> AKA Provirus
        
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        Differences between HIV & AIDS
        
        HIV
        
        Human immunodeficiency virus
        
        Process
        
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        Lytic stage
        
        "Impatient method"
        
        Virus takes over cell's machinery to make copies of viruses genetic material
        
        The cells ends up replicating so many viruses that it lyses
        
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        https://www.youtube.com/watch?v=J4BN4dARpio
        
        Bacterial phages
        
        Inject their genetic material -> cell
        
        Every other virus uses 1 or 2 ways
        
        If not enveloped, they trick cells to let them in
        
        If enveloped, can directly fuse w/membrane or use receptor
    - - Organs & cells
        
        Functions of specific leukocytes
        
        Leukocytes (WBCs) #
        
        Agranulocytes
        
        Do not have granules
        
        Lymphocytes
        
        Specialized WBCs that make up the specific immune sys.
        
        T lymphocytes
        
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        B lymphocytes
        
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        Natural killer cells (NK)
        
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        Monocytes
        
        These differentiate into macrophages
        
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        Megakaryocytes
        
        These cells breakdown into platelets
        
        AKA Thrombocytes
        
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        Function
        
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        Granulocytes
        
        Eosinophil
        
        1-3% of WBCs
        
        Involved in allergic rxns & involved in killing parasites
        
        Basophils
        
        0.3-1% of WBCs
        
        Contains
        
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        Neutrophils
        
        Phagocytic cells that ingest bacteria & some fungi
        
        50-70% of WBCs
        
        Contains granules
        
        Ameba-like cells
        
        Lymphoid cells
        
        Found in lymph organs & connective tissues of other organs
        
        Lymphocytes
        
        B lymphocytes
        
        Protect body by
        
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        T lymphocytes
        
        Directly attack infected cells & foreign antigens
        
        Macrophages
        
        They phagocytose foreign substances
        
        Dendritic cells
        
        Capture antigens & bring them back -> lymph node
        
        Reticular cells
        
        Fibroblast-like cells that produce the reticular fiber stroma
        
        The network that supports the other cell types in lymph organs
        
        Lymphoid organs
        
        Primary lymph organs
        
        Red bone marrow
        
        Where B cells mature
        
        Thymus
        
        Where T cells mature
        
        Has no follicles
        
        Stroma consists of epithelial cells
        
        Atrophies after puberty
        
        Secondary lymph organs
        
        Where mature lymphocytes first encounter their antigens & are activated
        
        Spleen
        
        Function
        
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        Largest lymph organ in body
        
        Contains
        
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        Collections of MALT (mucosa-associated lymph tissue)
        
        Form
        
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        Lymph tissues located in mucous membranes throughout body
        
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        Lymph nodes
        
        Most important lymph organ
        
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        2 Functions
        
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