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Eksamen 5 kapittler, Fungi patologi - Coggle Diagram

- - - - Surface of the bacteria:
        Proteins, gly co pro teins, li po pro teins, li po po ly sac cha rides (Gramnegative), and lipoteichoic ac ids (Grampositive)
        
        pili(fimbriae), flagella, fibril, capsule
        
        complex contribution
        
        both physicochemical aspect and more specific ligandreceptor type aspect
        
        designated adhesins + distinct binding partners (receptors)
        
        Type 1(tooth) and type 2(epithelium) fimbriae(pili)
        
        Adhesins:
        Gram(-): fim briae or major outer membrane proteins
        Gram (+): fi brils, fim briae, pili, cell wall linked sur face pro teins
        
        Colonisation order:
        Secondary colonizers (e.g., F. nucleatum, P. gingivalis, and T. forsythia), which do not effectively compete with the primary colonizers in binding to the tooth surface, adhere to primary colonizers.
        
        Streptococcal adhesion(Mutans)
        
        Adhesion to salivary pelicle**
        by major surface protein SpaP or P1
        
        SspA/B, the AgI/II for other Streps:
        _* initial pelicle binding and better collagen binding
        
        For binding of gram (-) such as: Porphy-romonas gingivalis and C. albicans,
        
        Coadhesion with P. gingivalis by SspA/B pro tein
        
        Adhesion to salivary reseptors:
        sal i vary starchdegrading en zyme αamylase:
        
        am y lase binding proteins AbpA + AbpB
        
        Role in adhesion
        
        Support mi cro bial nu tri tion
        
        Synthesis of extrascellular polysaccarides:
        ad here to smooth sur faces and me di ate the coadhesion of bac te rial cells by cell surfaceassociated glu canbinding pro teins.
        
        at tach ment of strep to cocci to glu cans into the pelicle
        
        me di at ing coadhesion of strep to cocci
        
        Coagreggations:
        In fact, struc tur ally dis tinct con glom er a tions of mul ti ple coadhering and met a bol i cally com pat i ble bac te rial spe cies are com mon in plaque (
    - - 1. Accumulate on surface:
        * solidliquid interfaces wih viscous bound ary laye
        
        Frictional drag and tur bu lent downsweeps assist surface contact
        
        Irregularities provide shear stress shelter
        
        Brownian motion consentrate bact on surface
        2. Avoid displacement by:
        Wan der Walls/hydrogen binding, divalent cation bridging and hydrophobic interactions
        3. Tissuespecific binding (tropism) :
        Adhesin binding or stereochemical interaction with cognate receptors
        
        more effective on fim briae or fi brils
        
        correlation with bacterial favorible locations:
        S. sanguinis= tooth, while S. salivarius=dorsum tongue
        
        Coordinated ex pres sion of a num ber of bac te rial cell ac tiv i ties
    - - Eruption: on hard, nonshedding surfaces
      - Transients
      - streptococci(80%) and actinomyces
      - Puberty: Gram negative an aer obes and spi ro chetes,
      - Faktorer: grad ual agerelated changes, physi cal ex er cise lev els, and psy cho log i cal stress, im mune func tion or sali vary flow rate. life style events,
      - Plaque forming: un sightly and mal odor ous and causes in flam ma tion of the gin gi val tis sues (gums).
      - Ptogenic microbal combinations: clearly con trib ute to oral dis ease
      - Role of commensials:
        
        com pet ing for ad he sion re cep tors and by pro duc ing toxic met a bolic prod ucts or bac te rio cins.
        
        pro duc ing toxic met a bolic prod ucts or bac te rio cins.
        
        Streptococcus, Lactobacillus, Haemophilus, and Neisseria spe cies:
        pro duce IgA pro te ases that spe cifi cally cleave se cre tory IgA an ti bod ies
      - S. san gui nis is de pen dent on the pres ence of teeth
      - Timing of occurance and antagonism:
        S. san gui nis (9 mnth)
        S. mutans occurs much later (26 mnth)
        
        initial adhesion events (pri mary col o ni za tion) dur ing the ac qui sition phase can shape the mi cro bial plaque com mu nity
    - - Bacterial adhesion to surface:
        * Localiza tion at surfaces
        
        Coaggregation
        
        Surface of the tooth:
        sa li vacoated sur faces of the teeth, along with the epi thelium of the cheeks, gums, and tongue
      - Protectivness of saliva:
        * an ti mi cro bial com po nents a
        
        ol e cules (ag glu ti nins) th
        
        me chan i cal shear ing forces
  - - - Metabolic synnergy
        
        ad he sion and me tab o lism are in tri cately linked
        
        Shaped by
        
        enviromental factors: tem per a ture, shear forces, and nu tri ent sup ply,
        2.intrinsic in flu ences of coadhesion, com mu ni ca tion (dis cussed be low), and mi cro bial me tab o lism.
        
        Syntrophy(eating together):
        Haemophilus, Neisseria, and Staphy-lococcus
        
        Interrelationships in catabolism:
        due to differ ences in the ef fi ciency of substrate utili za tion
        
        Require from bacteria to have diverse substrate utilization: Streptococci in nasopharynix require other bact to utilize oligosaccaride sugar residues by eks gly can hy drolases.
        
        Coadhesion: win-win
        
        Veillonella + S. mutans: transient rise in pH >more carb fermentation > more lactate and amylase > better binding/metabo
        
        . Veillonella + S. salivarius on the dor sum of the tongue
        
        S. gordonii + A. oris: arginine + catalase production
        
        P. gingivalis + S. gordonii + F. nucleatum: provides O2-low enviroment + pH neutrolising
    - - Shedd or not shedd - that is the "?"
        Tooth: sa li vacoated sur face, rather than enamel it self, that bac te ria ad here
        Epithelium: : ep i the lial layer sur face mol e cules fi bro nectin and lami nin, along with other proteins and pro teo gly cans.
        
        Recuire the multiplicity of adhesins from bacteria
  - - - B. Competence 113
        
        Streptococci:
        * The pro cess of up take and in cor po ra tion, by one cell, of DNA ex truded by an other is termed trans for ma tion and only appear in competance state
        
        Competance is generated through sig nal ing mech a nism in volv ing an ex tra cel lu lar pep tide pher o mone des ig nated com pe tencestimulating pep tide (CSP)
        
        Stages: crit i cal thresh old level>ex pres sion of genes that are in volved in CSP > DNA up take and re com bi na tion
        
        Result: tol er ate acid stress and adapt to low pH and alarming to other bact about on com ing stress con di tions
      - C. Contact- Dependent Interactions 114
        
        P. gingivalis + S. gordonii: interbacterial com mu ni ca tion
        Converging of signaling events byty ro sine ki nase and phos phatase result in in creases the vir ulence of the P. gingivalis
        
        Result : more al ve olar bone loss than each of them alone
      - D. Antagonism 114
        
        Not mutually benificiall interaction, but still synnergy:
        *Eks: sy ringe like man ner to in ject a neigh bor ing cell with toxic com pounds.
        
        Streptococcal bac te rio cins secretion in hibi tory to bac te rial growth and forming pores on Gram (+)
        
        Thioether amino acid lanthionine are termed (lantibiotics):
        S. mutans and S. salivarius
        
        mod i fi ca tion and trans port pro teins, genes for im mu nity, and sen sor and reg u la tory pro tein genes
        
        act as sig nal ing mol e cules be tween strep to cocci and stim u late a de fen sive re sponse within the pop u la tion. St
        
        play im por tant roles in de ter min ing the com po si tion of oral mi cro bial com mu ni ties.
        
        P. gingivalis + S. cristatus: ar gi nine deiminase and reduced attatchment
      - E. Multicomponent Interactions 115
        
        The net out come, the tem po ral and spa tial re la tion ships determine the net out come
        
        Eks: A. actinomycetemcomitans main tains a “safe” dis tance from the strep to coc cus to min i mize ex po sure to per ox ide while still al low ing lac tate uti li za tion
        
        In oral strep to cocci: The key role is on bacteriocins and H 2 O 2 and interstreptococcal interractions
        
        Naigbouring bacteries have naigbouring means of communication
      - F. Communication with Host Cells 116
        
        Host cell pathogen barriers
        
        gin gi val crev ice pro vid a barrier
        
        hinder in gress of bac te ria into the vasculation
        
        re sponding to the pres ence of bac te
        
        eposess a com mu ni ca tion net work btw bacteria and host
        
        recuires the adaptivity of the host immune system to evade bact
        
        Ex of effect::
        
        cy to kines to cell lifeordeath de ci sions through both ne crotic and ap o pto tic path ways.
        
        in ter nal i za tion of the or gan isms into the host cells(uptake)
        (but not always, ex T. denticola)
        
        P. gingivalis
        
        fimbriamediated ad he sion to ep i the lial cell integrin re cep tors and ac ti va tion of the ac tin reorganizing host molecule cofilin.
        
        in ter fer ence with ex tra cel lu lar ma trix re pair and re or ga ni za tion. I
        
        in nate host im mu nity inhibiting: chemokines and interferons and JAK/STAT mediated epithelial apoptosis resistance + carcinomagenicity
      - A. Quorum Sensing 112
        
        Defi: cell den si tydependent reg u la tion of gene ex pres sion
        
        SIgnal molecule: autoinducer (AI) and treshold consentration
        
        Controlls vir u lence, com pe tence, con ju ga tion, an ti bi otic pro duc tion, mo til ity, spor u la tion, and biofilm for ma tion
        
        3 types by AL use:
        1.#ikkeODO: Gram (-):Gramnegative ac yl ated homo serine lac tones(AL-)
        
        Gram (+): oligopeptides
        
        G(+ and -): AL-2: S. gordonii
        
        LuxSbased sig nal ing: iron/virulence factors in P. gingivalis and leukotoxin in A. actinomycetemcomitans.
      - con tactdependent sig nal in through chem i cal sig nal ing mol e cules
    - - 3 lifestyle choices
        
        Means of signal transduction
        
        cyclic diGMP:
        
        mod u late protein ac tiv ity( by binding to diguanylate cy clases and phos pho di es ter ases) and transcriptional activity
        (by binding to riboswitches )
        
        Relevance to T denticola: mo til ity, biofilm for ma tion, and vir u lence.
        
        non coding small RNAs (sRNAs)
        *Modulate/ Block for ribosome and translation
        
        suited for regulation in dy namic environments ex: oral cavity:
        a rapid re sponse time, re duced en er getic cost com pared to transcriptional reg u la tion and ability to override ge netic pro grams
        
        Level of transcription:
        Activators bind to DNA in or near the pro moter re gions of genes and then in ter act with RNA and stimulate the rate of ini ti a tion of tran scrip tion // The opposite with repressors: im peding the ac tion of RNA poly mer ase
        
        Connected/dependent on cell sur face where sig nal ing is ini ti ated by phos phor y la tion of a sen sor mol e cule
        
        in saliva or crevicular fluid
        
        complex multispecies biofilms
        
        surfacesepithelial cells
        
        Dynamic enviroment change along the internalisation prosess
        
        Ex: in gin gi val crev ice, the amount of ox y gen de creases, os mo lar ity and pH in crease, and nu tri ents can be ob tained from gin gi val crevicular fluid (
        
        Requires from bacteria a rapid and sensitive responce
- - - - Tooth Structure and Development 252
        
        Caries is a biofilm and di etdependent dis ease
        mal nu tri tion, and poor di e tary habits, lack of prevention,
        Early childhood car ies (ECC)
        
        Sparse genetic, but still
        have to be considered
        as family desease
        
        Teeth structure
        
        Saliva + fluoride give
        buff er ing and remineralizing ca pac ity.
        
        Fluorid rolle:
        non-systemic effect
        
        Saliva is supersaturated
        
        Typer
        
        Root structure
        
        Supragingival structure
        
        Vevtyper
        
        Enamel
        amelo genesis;
        se cre tive, min er al iz ing,
        or re sorp tive mor phol ogy.
        Mineralising steps governed by amelogenin and enamelin(2):
        
        an ini tial se cre tion of a pro tein ma trix,
        
        min er al i za tion
        
        prism formation and amelogenin loss
        
        Enamelin:
        *as par tic and glu tamic acid resi dues
        
        is phos phor ylated.
        
        Ameloginine:
        proline and his ti dine as well as glu ta mate and leu cine
        
        Dentin
        
        More bone realted
        
        Originate from mesoderm
        
        Arise from OB secretion
        
        Contains ca 20% type I collagen
        
        Permeability and compressibility
        
        rise pain and the rate of tooth decay
        
        Cementum
        
        From mesoderm
        
        Similar to dentin
        
        thin and softer
        
        more acidsoluble
        
        Inferior to enamel
      - Sites of Carious Lesions 253
        
        a. Coronal Caries 253
        
        supragingival caries require spe cialized colonization mech a nisms, while pits and fissure or erupting teeth carries don't
        
        Pit and fissure carries
        
        runs along enamel rods perpendicular to
        the dentine
        
        Front is named zone of ac iddemineralized dentin
        
        Rampat caries
        
        caries assosiated with predisposing factors
        ex sucrose rich or hyposalivation
        
        Secondary caries
        
        occurs around pre vi ously re stored sites
        
        b. Root Surface Caries 254
        
        Eldery population concern( less gingiva)
        
        Cementum inferior to enamel
        
        Discoloration and changes in tex ture
      - Diet and Dental Caries 254
        
        a. Cariogenic Effect of the Diet 254
        
        Substrate for production of:
        
        polysaccharides and acids,
        
        cariogenic biofilms
        
        Extracellular polysaccharides
        
        Rich in glucans
        
        Provide:
        
        Bacterial binding
        
        colonization
        
        stability/cohesiveness/protection
        
        diffusion of fermentable substrates
        
        limiting action of saliva
        
        acidification
        
        Cariogenic factors:
        
        Frequency, intervall and duration of sugar ingestion
        
        Physical food properties
        
        Action of saliva
        
        Les diverse / acidogenic microbiota
        
        soy bean, wheat germ, to ma toes, and carrots
        - Food factors: amount of protein and its com po si tion, lipid con cen tra tion, amounts of phos phate and cal cium, and the pres ence of food pre ser va tives such as so dium ben zo ate
        -Enviromental factors: lead and sele nium in drinking water
        
        Starch cariogenicity
        
        Little contribution alone, but enchanced in
        combination with sugar
        
        Boost physical retention, virulence of cariogenic bacteria
        especially S. mutans's insoluble polysaccarids/acid production
        
        Is holding pH above 5.5 is enogh?
        
        No, because of biofilm ma trix as a dif fu sionlimiting bar rier
        and lower actual pH within the biofilm despite saliva
        
        b. Anticariogenic Properties of Food 256
        
        Cheese anticariogenic properties:
        
        fatty ac ids, ca sein pep tides, or nisin
        
        in creased cal cium, phos phate lev els
        
        intense stim u la tion of sali vary flow.
        
        copper and iron reduce enamel solubility
        
        Sugar substitutes:
        
        poorly me tab o lized by bac te ria ( are not substrates)
        
        not en hance car i o genic bac te rial col o ni za tion
      - Cariogenic Dental Biofilm Formation 257
        
        Adhesion to acquired enamel pellicle: convering to glucanrich matrix
        
        host molecules de : pro linerich pro teins, statherin, his ti dinerich pro teins, mu cins, am y lase (in ac tive form), ly so zyme, lactoperoxidase, and se cre tory IgA (SIgA).
        
        com bi na tion of phys i cal and adhesinpellicle re cep tor mech a nisms
        
        Microbal contribution: acid i fi ca tion or in duc ing po ly sac cha ride pro duc tion, reduced divercity(competition)
        
        Promote de min er al iza tion
        
        Sucrose
        
        Glucan
        
        Glucan rich matrix
        
        The virulence factor
        
        Fasilitate adhesion and cohesion
        
        Contributes to diffusion limiting
        
        Facilitates acidic micro environments
        
        provide struc ture to the biofilm,
        
        provides bind ing sites,
        
        pro tects mi cro or gan isms
        
        Gtf an Ftf exo en zymes produce glucan polmers
        and provide binding sies and increase mcb population
        
        Organisms in cariogenic biofilm:
        
        ac ti no my ces, lac to ba cilli, bifidobacteria,
        Scardovia,Candida albicans
      - Biochemical Composition of the Cariogenic Biofilm 258
        
        con certed ac tions of Gtf and Ftf en zymes
        
        n de pen dently of cellu lar source of en ergy
        
        in crease the cariogenic ity of the biofilm
        
        Presence of inorganic ions
        
        dis so lu tion (or not) of the min eral part of the teeth.
        
        com po nents of the tooth min eral are most relevant
        
        bacteria bind cal cium ions via being negatively charged
        
        biofilm is the cite of pre cip i ta tion of cal cium phos phates
        
        Sucrose reduce inorganic ions by making + extracellular polysacc
        especcially of calcium, phosphate and fluoride
      - Physicochemical Phenomena in Dental Biofilm 260
        
        Loss of enamel/dentine
        
        Hydroxyappatite is higly insoluble unless
        in acidic enviroment
        
        Saliva is hypersaturated and make teeth gane minerals, but dillutes with drop in pH
        
        1 h af ter the con sump tion of a fer ment able car bo hy drate, the fluid of the biofilm has acidic pH val ues
        
        differ not only in com po si tion also in the crys tal line struc ture size of the crys tals: dentine stays for lon ger pe ri ods of time be low the crit i cal val ues for den tin
      - Caries Prevention Using Fluoride 261
        
        fluorapatite [Ca 10 (PO 4 ) 6 F 2 ]
        
        Fluor reduce crit i cal pH for net min eral loss,
        1 ph below normal (5.5>4.5)
        
        fluo ride gels or var nishes contains high 10,000
        ppm fluo ride)
        
        lim ited ef fects against sugar me tab o lism and biofilm for ma tion at
        
        spe ciesspecific an ti mi cro bial pep tides er alternative terapi
      - Experimental Caries Models 262
        
        a. Laboratorial Methods 262
        
        biofilm ef fect on the car ies pro cess.
        
        sig nifi cant lim i ta tions path o log i cal pro cess of the dis ease and
        
        can not be used to as sess an ti mi cro bial or antibiofilm agents
        
        b. Animal Models 263
        
        c. In Situ (Intraoral) Models 264
  - - - a. Exopolysaccharides and Biofilm Matrix 272
        
        Exopolysaccaride role
        
        Production of polysaccarides linked by α1,3 and α1,6glucosyl linkages and fructants guarded by glucosyltransferases (Gtfs) enzymes
        
        In order to do that bacteria have to be coated by se creted Gtfs.
        
        Form core of the ma trixscaffold in car i o genic bio flms
        
        Harbor other molecules such as extracellular DNA
        
        less influ enced by the di et.
        
        Role og Gtfs
        GtfC is pri marily found in the pel li cle in an en zy mat i cally ac tive form
        provide 3D n vi ron men tal and bi o log i cal niches for different bacteries, additionaly it act as a dif fu sion modulator helping favor ac cu mu lation of me tab o lites and sugar above neutrolizing acids
        
        Types are B,C,D
        
        GtfC is pri marily found in the pel li cle in an en zy mat i cally ac tive form.
        
        GttB can con vert them into glu can pro duc ers.
        Steps: 1)form a na scent po ly meric ma trix, result in cell clus ter ing, and 2) con tin u ous po ly sac cha ride pro duc tion and expands, forming a core of EPSenmeshed bac te rial cells
        
        Can also be regulated by bac te rial sec ond ary mes sen ger cyclic diAMP and quo rumsensing
      - b. Sugar Transport and Acid Production 274
        
        Feast-orfamine cycles
        
        Caries requre also trans port and pro duc tion of lac tic acid. Bacteria have to resist both starvation and excess carbs, otherwise ac cu mu la tion of toxic gly co lytic in ter me di ates, overacidifcation of the cy to plasm, and os motic stress
      - c. Acid Stress Tolerance and Survival 275
      - d. Other Stress Resistance- and Virulence- Related Mechanisms 278
      - S. mutans
        
        S. mutans only use su crose and not mo no meric sug ars.
        
        Adhesive and cohesive biofilm formation:
        Metabolism steps: sucrose -> in sol u ble glu cose po ly mers (glu cans) -> EPS matrix formation bio flms
        
        ef f ciently trans port and me tab o lize a large num ber of differ ent sug ars into acids.
        
        can sur vive at acidic pH by having acid tol er ance re sponse (ATR),
        
        The main source of Gtfs which form exopolysaccarides
        
        mul ti ple twocomponent sig nal trans duc tion sys tems t help to respond quickly
        
        produce lac tic, for mic, and ace tic acids
    - - a. Commensal- Pathogen Interactions 280
      - b. Acidogenic Interactions 281
      - c. Alkalinogenic Interactions 282
      - d. Bacterial- Fungal interactions 282
    - - ac cu mu la tion of path o gens mod u late the eco log i cal changes in the lo cal microbiota
        
        Environmental changes increase the virulence
        
        Tooth pelicle: covered with al i vary gly co pro teins and bac te rial exo en zymes and po ly sac cha rides
        
        Pelikkelfile bakterier(S. mitis/Actinomyces): have hy dro pho bic or elec tro static spe cifc ad he sinreceptor in ter ac tions
      - Interactions host-bact: bal ance be tween com men sals and path o gens can be dis rupted by the host di
      - Role of non- Mutans bacteria
        
        lactate utilizing bacteries:Veillonella is not acid-tollerent but can survive unlike others and competing against them by se cret ing in hib i tory amounts of hy dro gen per ox ide (H 2 O 2 ) (in case of Streptococci) or generating alkali for neutralisation
        
        S. mutans ap pears to work syn er gis ti cally with other aciduric spe cies such as lac to ba cilli
        
        oral lac to ba cilli have low bind ing af fn ity to tooth sur faces and rather bind to retentive increased cre ated by ac idmediated de min er al iza tio cites prepared bu Streptococci, or the naturak teeth anatomy
        
        al kaligenerating bacte ria as Actinomyces spp. have been as so ci ated with root caries, but are benificial as al kaligenerating bacte ria
        
        Candida albicans can de velop a syn er gis tic in ter ac tion with S. mutans
      - Virulence factors modulating cariogenic biofilm:
        
        Abscense of buff er ing sa liva, formation of the EPSrich ma trix and acid i f ca tion of the milieu and pathogens’ ability to sur vive
        
        Requirements for bacteria are to ad here to teeth, form a ma trix, pro duce acid, and sur vive in the sub se quent lowpH
      - polymicrobial syn ergy and eco log i cal com pe ti tion
- - - - MEDIAN RHOMBOID GLOSSITIS
        
        Aspergilliosis
        
        Cryptococcosis
        
        Histoplasmosis
        
        Blastomycosis
        
        Paracoccidioidomycosis
        
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    - - ERYTHEMATOUS CANDIDIASIS
        
        CHRONIC ERYTHEMATOUS
        CANDIDIASIS
        
        PLAQUELIKE/NODULAR
        CANDIDIASIS
  - - - .
        
        .
        
        .
        
        .
        
        .
        
        .
        
        1 more item...
  - - - white plaques, patches, or flecks that are eas ily wiped off with a blunt in stru ment which er y them a tous mu cosa. pro duce bleed ing and reveal er y them a tous mu cosa. No pain
        
        an ti bi otic sore mouth often
        from broadspectrum an ti bi ot ics or cor ti co ste roid in hal ers use. Painfull.
        
        sharp demarcation
        
        can not be re moved by scraping, bilat era, buc cal mu cosa near the com mis sures or oc clu sal plane.mul ti fac to rial eti ol ogy. Risk of epithelial dysplasia
        
        er y thema and crusting , com mis sural region, bac te rial com po nent.
        
        di a mondshaped le sion,
        twothirds and pos te rior one third
        
        1 more item...
  - - - soft pal ate, oro phar ynx, tongue, buc cal mu cosa, and gin giva (gum
        
        .
        
        pal a tal mu cosa, maxil lary den tures
        
        .
        
        .
        
        .
        
        1 more item...
  - - - Smears, Cultures, not Biopsy
        
        smears or oral rinses or by cul ture.
        
        Hematological investigations of predisposing factors, rinse, culture. Instructions for denture use
        
        swab or oral rinse sam ples, mi cro scopic ex ami na tion , biopsy. Antifungals + surgical removal
        
        Hematological in vesti ga tions, mi cro scopic ex am, culture of swabs, Treatment of both lesional and asymptomatic tissue
        
        Not biopsy unless worry
        
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  - - - in fants, the el derly, and the ter mi nally, un der ly ing se ri ous med i cal con di tion
        
        .
        
        Those who not re move their den tures
        
        .
        
        Uncotrolled diabetes, HIV, poor dentures
        
        .
        
        1 more item...
  - - - mixed in flam ma tory cell in fil trate,
        gi ant cells + fun gal hy phae.
        
        .