The Common Cold: Causes and Pathogenesis

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Questions and Answers

What is the mechanism by which several viral non-structural proteins affect host membrane metabolism?

  • They inhibit cell division to prevent the host from destroying the virus.
  • They hijack regulatory mechanisms to induce remodeling, forming replication organelles. (correct)
  • They modify the genome of the host to ensure viral escape.
  • They directly destroy the membranes of the host cells.

Which receptor is primarily associated with the binding of Coxsackie A Virus to host cells?

  • Sialic acid receptors found on nerve cells.
  • CD55 found on macrophages.
  • Integrin molecules found on leukocytes.
  • ICAM-1 present on epithelial and endothelial cells. (correct)

Which of the following diseases is NOT caused by Coxsackie A Virus?

  • Herpangina
  • Hand Foot and Mouth disease
  • Rhinovirus infection
  • Poliomyelitis (correct)

What is the primary transmission route for Coxsackie A Virus?

<p>Fecal-oral route and respiratory aerosols. (A)</p> Signup and view all the answers

What structural characteristic is notable for Coxsackie A Virus?

<p>It is icosahedral and lacks an envelope, being stable at low pH. (B)</p> Signup and view all the answers

What is the initial symptom of the common cold?

<p>Nasal stuffiness (B)</p> Signup and view all the answers

Which virus is primarily associated with causing the common cold?

<p>Rhinovirus (D)</p> Signup and view all the answers

What mechanism leads to nasal congestion in the late phase of a common cold?

<p>Dilation of large learning paranasal veins (C)</p> Signup and view all the answers

Which cytokine is NOT typically elevated in nasal secretions during a cold?

<p>Tumor necrosis factor (TNF) (B)</p> Signup and view all the answers

What usually triggers the secretion of nasal glandular fluids during a cold?

<p>Cholinergic stimulation (D)</p> Signup and view all the answers

What is the primary cause of sore throat and rhinorrhea during a cold?

<p>Bradykinin production (D)</p> Signup and view all the answers

Which of the following is a potential consequence of a common cold if secondary bacterial infections occur?

<p>Paranasal sinusitis (D)</p> Signup and view all the answers

What symptom develops later in the progression of a common cold due to laryngeal irritation?

<p>Cough (C)</p> Signup and view all the answers

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Study Notes

The Common Cold

  • The common cold is a respiratory illness with symptoms like nasal stuffiness, sneezing, headache, rhinorrhea, general malaise, lacrimation, sore throat, and low-grade fever.
  • The most common causes are Rhinovirus and Human Coronavirus.
  • Other viruses associated with cold-like symptoms include influenza, parainfluenza virus, respiratory syncytial virus (RSV), adenovirus, coxsackie virus, human metapneumovirus, and bocavirus.

Pathogenesis of the Common Cold

  • Viruses enter the body through inhalation.
  • They infect cells lining the nasal passages and pharynx, attaching to viral receptors like ICAM-1, aminopeptidase N (APN), and sialic acid.
  • Influenza is known to damage nasal epithelium by destroying ciliated columnar epithelial cells.
  • Rhinovirus infections do not cause destruction of the nasal epithelium but rather induce inflammatory changes with hyperemia, edema, and leukocyte inflammation.
  • Cytokines like IL-1β, IL-6, and IL-8 are elevated in nasal secretions during colds.
  • Bradykinin production contributes to sore throat and rhinorrhea.
  • The watery nasal discharge in the early phase is a mixture of nasal glandular secretions and plasma transudate.
  • Nasal glands are activated through cholinergic stimulation.
  • The nasal congestion in the late phase is caused by the dilation of large capacitance veins (sinuses) in the nasal epithelium, leading to swelling and blockage.
  • The cough in later stages often arises from irritation of the larynx by mucus.
  • Secondary bacterial infections by normal flora can lead to mucopurulent secretions.
  • Severe cases can result in blockage of the sinus ostia or Eustachian tube, causing paranasal sinusitis or otitis media.

Coxsackie A Virus

  • Belongs to the Picornaviridae family and the Enterovirus genus.
  • Structure: Icosahedral, no envelope, stable at pH 3.
  • Genome: (+) ssRNA, polyadenylated at the 3' end, with Vpg covalently linked to the 5' end. Contains 3' and 5' untranslated regions with an internal ribosome entry site (IRES) in the 5' UTR.
  • Associated with childhood diseases: Herpangina and Hand Foot and Mouth disease (caused by A16).
  • Coxsackie A21 and A24 can cause rhinovirus-like symptoms and a maculopapular rash.
  • The VP1 protein at the vertices of the virion contains a canyon structure that binds to the cell receptor.
  • Receptor for Coxsackie A: ICAM-1 expressed on epithelial cells, fibroblasts and endothelial cells; and decay accelerating factor CD55.
  • Transmission: Fecal-oral route and by respiratory aerosols.
  • Host cell range: Oropharynx epithelium for replication and skin following a secondary viremia.

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