The last lecture in the immunology strand of the BMS3020 Chronic Disease module, looking at direct and indirect infection pathogenesis and chronic interferon and infection of HPV leading to cervical cancer.
BMS3020 CHRONIC DISEASE
LECTURE 17 – Infection Pathogenesis
KEY CONCEPT/ ESSAY QUESTION: Chronic Infection = Chronic
Inflammation?
Chronic inflammation is the main driver of chronic disease but not all chronic infection cause
prolonged inflammation in sickness.
Infection, Inflammation and Sickness
- Tissue Damage: Redness, heat, swelling, pain and dysfunction of the inflamed organs
- Feel sick: Neurological effects including pain, lethargy and depression
- Are they connected?
Pathogens can
damage tissues in
a variety of
different ways
DIRECT:
1. Exotoxin production – Can
kill or damage tissues/cells
1. Endotoxin – Excite
inflammation which will kill
or damage the cells
2. Direct cytopathic effect –
More for virus action
INDIRECT:
1. Immune complexes – Large Ag can bind many antibodies which cross link and deposit in small
capillaries, can lead to kidney disease
2. Anti-host antibody – Antigen can have similarities to host-antigen, so the antibody can cross
react and attack self-cells
3. Cell-mediated immunity – NK cell and CD8 T cell killing, lysing of cells and tissue damage
- Tissue damage is a driving force for inflammation under infection conditions
- Healthy tissue gets initial viral infection and the immune response causes tissue damage
- But hopefully, if the immune response can control
viral loads there is tissue repair, immune memory
and pathogen clearance
- However, if IR fails to control pathogen, it can cause
pathogen persistence which have many mechanisms
(above) to drive chronic inflammation
- This chronic inflammation causes chronic immune
activation (adaptive immune response)
- Inflammation becomes more and more severe as
tissue repair (still occurring) is unsuccessful due to
continuous damage and remodelling process
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