MICROgpm.docx

MICROBIOLOGY 1 parcial 29 sep 2do parcial 10 noviembre 2 faltas permitidas Enviar presentación si no la mandas, repruebas automático Bacteria cariogenica, aciduric, aci Jeringas irrigadoras de plástico para conductos curvos, tienen dos salidas de agua, ojos en endo, se comprobó que es mas eficaz q...

MICROBIOLOGY 1 parcial 29 sep 2do parcial 10 noviembre 2 faltas permitidas Enviar presentación si no la mandas, repruebas automático Bacteria cariogenica, aciduric, aci Jeringas irrigadoras de plástico para conductos curvos, tienen dos salidas de agua, ojos en endo, se comprobó que es mas eficaz que las metálicas. TruNatomy densplay TRATAMIENTOS es importante Mi tema: BACTERIAL PATHOGENS OF CLINICAL INTEREST IN ODONTOLOGY PREPARAR ppt*** Viridans streptococci ORAL STREPTOCOCCI Mutans: Non mutans pueden causar endocarditis, Polysacaride extracelular hace que el biofilm sea difícil de quita INMMUNE SYSTEM INMMUNITY Is defined as resistance to disease, specifically resistance to infectious disease. The collections of cells, tissues and molecules that mediate resistance to infection. Disease --- died or survive. People who survive they are immune at the second infection. Antibodies COV in china Study experiment with pustules from the sick cows by the EDWARD JENNER 1786, chickenpuds two grups, control grup and placebo grup, for the VIRUELA. IMMUNE RESPONSE Coordinated reaction of immune cells and molecules to eliminate infection. IMPORTANCE OF THE IMMUNE SYSTEM IN THE HEALTH AND DISEASE. Non self- defense Protect against to infections ---- Capacity to recognize agents MUTATED CELLS --- defense against tumors. Tumor is a cell that is different cells SELF--- the immune system can injure and induce an allergic autoimmune NON-SELF INNATE INMMUNITY SPECIFIC Specific receptors such as toll like- receptors (TLRs) First response against 0-12 hours 99% of the infections are recognize in this point. NO MEMORY RESPONSE ADAPTIVE IMMUNITY Second response 1-7 days and more Memory response INNATE IMMUNITY Provides the early line of defense against infections MO Innate immunity response in the first 12 hours upon infection and last for several days. innate immunity IS SPECIFIC specific receptors, such as Toll like receptors TLRs destroy microorganism infectors. toll like receptors TRLs are involved in the recognition of microorganisms, such as LPS, BACTERIAL DNA, VIRAL RNA, LIPOTEICOID ACID, etc. These receptors allow carrier cells to discriminate between self and foreign according to the type of signal that is transmitted inside the cell. Stimulation of TLRs can lead to the detection of invasion of microorganisms such as bacteria, fungi, viruses and protozoa, activation of the innate immune response.cells and molecules of the innate immunity are already found in the blood and lymph. Innate immunity does not induce MEMORY RESPONSE LIPOSACARAIDE: Gramm negative bacteria in the membrane COMPONENTS OF Innate I Cells: phagocytic cells (macrophages, neutrophils), NK cells and granulocytes (neutrophils, basophils, eosinophils) Blood proteins: complement system, protein C reactive, cytokines. NEUTROPHILS Are generated in the bone marrow from myeloid precursors. They are the first leukocytes to be recruited to an inflammatory site. Are also known as polymorphonuclear cells PMNs. They are the first players during acute inflammation. Are the first players during acute inflammation EX: PERIODONTITIS Are mainly recruited during periodontitis In the granules of neutrophils they have enzymes, the granules are secreted when they do their function and these have metalloproteinases. Metalloproteinases: Type 9 function of destroying bacteria that are in periodontal disease Type 8 a collagenolytic enzyme that can initiate the digestion of type I collagen, the most dominant type of interstitial collagen in periodontal tissues. Collagen degradation is considered to be one of the key factors in uncontrolled tissue destruction in periodontitis. Numerous studies have shown that elevated levels of MMP-8, gingival crevicular fluid (CGF) and saliva samples are associated with the progression of periodontal disease. What are matrix metalloproteinases? MMPs are proteins that are members of the extracellular matrix (ECM) which are able, in their immediate environment, to activate growth factors, surface receptors and adhesion molecules (5). These metalloproteinases constitute an important family of zinc-dependent endopeptidases. Its activity is regulated by specific inhibitors known as tissue inhibitors of metalloproteinases called TIMPs (5). Se han descrito 25 miembros de la familia MMPs, que se clasifican en cinco subfamilias dependiendo de su función y estructura: colagenasas, gelatinasas, estromelisinas, metaloproteasas de membrana (MT-MMPs) y otras MMPs La función de las MMP es degradar las proteínas integrantes de la matriz extracelular (MEC) en su medio ambiente inmediato y activar factores de crecimiento, receptores de superficie y moléculas de adhesión; el desbalance en su producción repercute en aumento de la degradación de proteínas y, por tanto, la progresión de las enfermedades en las que éstas se ven implicadas. Se pueden detectar niveles elevados de las MMPs en enfermedades del sistema nervioso central, incluyendo la enfermedad de Alzheimer, la isquemia cerebral, las infecciones, la enfermedad de Parkinson y la esclerosis múltiple. Las MMP son proteasas extracelulares requeridas en numerosos procesos relacionados con el desarrollo, la regeneración y la enfermedad. La degradación de proteínas extracelulares es esencial para que cualquier célula individual pueda interaccionar con su ambiente circundante y para que los organismos multicelulares funcionen y se desarrollen. Las MMP también degradan moléculas de la superficie celular y otras proteínas pericelulares, reguladoras del comportamiento celular en diversas vías. In periodontal pockets there is a group of neutrophils, PMNs, cells. As not enough neutrophils arrive for the number of bacteria, metalloproteinases begin to destroy the bone and there is more bone loss. They cause side effects by destroying tissue. MACROPHAGES Second to arrive in inflammation Appear late in the cellular immune response and represent a transition between acute and chronic inflammation. Differentiated from blood monocytes which arise from bone marrow. Are tissue-resistant or infiltrated immune cells Eliminate MO by phagocytosis. Upon resolution of inflammation, macrophages mediate tissue repair RELEVANCE OF INNATE IMMUNITY Rapid response to infection Rapid response to tissue damage Promotes inflammation. Initiate tissue repairs Initiate adaptative immune response, thus promoting the activation of lymphocytes. ADAPTATIVE IMMUNITY Is initiated when an innate immunity response FAILS to eliminate an infection. 1-7 days Represents a delayed defense mechanism against infections MO There is a delay of 4-7 days for the initial adaptative immunity It reaches their maximum response at day 7-10 POSTINFECTION. It takes 1 week to produce antibodies. Wait 30 days for the best antibody maturation in vaccines, and with one dose is not enough AI--- can remember and respond more vigorously to repeated exposures to the same MO (immune memory) Vacuna de Hepatitis cada 3 años se refuerza, si eres persona de alto riesgo COMPONENTS OF THE AI CELLS: Lymphocytes--- ARE cells produced in the bone marrow and migrate into the blood and lymph. ARE spherical cells with a prominent nucleus stained in purple, they showed a small cytoplasm stained in blue. BLOOD PROTEINS: foto pedir NORMAL WHITE BLOOD CELL COUNT 1 NEUTROPHILS 2 lymphocytes 3 Monocytes What a Hight white blood count mean? A bacterial or viral infection An inflammatory disease such as rheumatoid arthritis An allergic reaction Leukemia or Hodgkin disease Tissue damage from a burn injury or surgery What a LOW white blood count mean? Bone marrow damage. This may be caused by infections, disease or tx such as chemotherapy. Cancers that affect the bone marrow An autoimmune disorder, such as LUPUS or SLE HIV/ AIDS DURING THE COURSE OF AN INFECTION Neutrophils mostly target bacterial infections. Lymphocytes mostly target viral infections A higher-than-normal amount of neutrophils is known as neutrophilia A lower-than-normal amount of is known as NEUTROPHENIA A higher-than-normal amount of Lymphocytes is known as Lymphocytosis A lower-than-normal amount of Lymphocytes is known as LYMPHOPHENIA LYMPHOCYTES T--- cellular Immunity…. Arise in the bone marrow, and migrate to blood and mature in the THYMUS. Refer to thymus derived thymus. The expression of various membrane proteins is used to distinguish distinct population of lymphocytes. B—humoral immunity—arise and mature in the bone marrow, are cells that mediate the antibody response. T lymphocytes Express a surface protein CD4: helper T lymphocytes Th mediate inflammatory response, activation of macrophages, inflammation, activation of B lymphocytes CD8--- cytotoxic CTLs --- elimination of cells infected with virus, killing of tumoral cells Plasma cells after activation are b lymphocytes. Predecessor Plasma cells produce and secrets antibodies (immunoglobulins) into the blood. Tiene ribosomas aumenta su contenido y thats why es capaz de producir anticuerpos. ARE A TERMINALLY DIFFERENTIATED antibody secreting B lymphocyte. núcleo es más pequeño 1/3 de la proporción de la célula, porque esta relajado. forma de huevo LINFOCITOS---- Núcleo purpura y abarca 80-90 porciento de toda la célula, poco citoplasma. ANTIBODIES Immunoglobulins, gamma globulins are Y shaped glycoproteins that are produced by plasma cells Consist in 2 heavy H chains and 2 light L chains JOINED by disulfide bonds. Son las ss son enlaces covalentes, covalent bonds, RESPUESTA PRIMARIA First infection 0-7 Days. Primer contacto con el MO. Salen, Ig M (estos no son tan buenos para combatir las infecciones) RESPUESTA SECUNDARIA Repeat infection respuesta secundaria. Responden las MEMORY B cells al día 3 de una reinfección Ig G. 20-30 días se debe poner los refuerzos de vacunas SE producen los antibodies en consecuencia al orden de genes que tenemos son los que se van activando: Gen primero IgM Gen 2 Ig G Gen Ig A GENERAL FUNTIONS OF ANTIBODIES Ig M--- eliminate virus, primer antibody produced by the fetus--- is always the first antibody to be secreted in the primary immune response. Function: activation of complement Ig G— inmunidad neonatal, cruza la placenta. Is produced during the secondary immune response (a second exposure to the same antigen), MOST ABUNDANT Ig in SERUM. Crosses the placenta. Function: facilitate the engulfment and destruction of MO and toxins by phagocytes. Ig E--- only en allergic reaction, diagnostic para la alergia Ig A--- in saliva, secretory Ig A is found. Es a DIMER 2 antibodies unidos. Functions: limits the Access of pathogens, commensals, and food products to mucosal surfaces in a manner that avoids unnecessary damage to these delicate and vital tissue. Toma 2 bacterias es mas eficiente para eliminarlas. Diminished production of Ig A in saliva promotes multiplication of Aggregatibacter, Actinobacillus and Prevotella. 1 solo es 1 monomero 2 anticuerpos unidos DIMER---- IgA Pentámero Ig M Ganglios terminates—es donde se producen antibodies MOST ABUNDANTS IN SERUM Ig G 85% Ig A 7-15% Ig M 5% Ig D 0.3% Ig E 0.02% Mucositis periinplantaria es Reversible, es como gingivitis. Enrojecimiento, abultamiento, sangrado al sondeo. NO BONE LOSS. Periimplantitis periimplantaria es Irreversible, se pierde hueso y se debe quitar el implante y desbridar y limpiar, esperar para poder volver y colocar injertos para regeneración y volver a intentar implante. Perdida ósea de MAS DE 3mm pocket más de 6mm, sangrado, dolor, enrojecimiento. Movilidad Periodontitis Neutrófilos en inflamación aguda, función principal: eliminar bacterias y hongos. Los destruyen con un órgano llamado PHAGOSOME y las destruyen, con la producción de peróxido de hidrogeno es usado por los neutrófilos para la destrucción. Núcleo grande Granulomatosis crónica: problemas de producción de ROS (reactive oxigen spices) especies de oxígeno reactivas. Liquido crevicular que tiene: Ig A—contiene el líquido crevicular Mmp8 está en el líquido crevicular, y luego destruye tejido sano El fluido crevicular gingival (FCG) es una mezcla compleja de sustancias derivadas del suero, leucocitos, células del periodonto y bacterias orales, que desempeña un papel clave en el mantenimiento de la estructura del epitelio de unión y en la defensa antimicrobiana del periodonto. En el fluido gingival crevicular se han estudiado biomarcadores como proteínas del huésped que incluyen enzimas, inmunoglobulinas, interleuquinas, citoquinas, quimioquinas y prostaglandinas, que podrían ser de ayuda para evaluar el diagnóstico periodontal y los resultados del tratamiento, además de monitorear pacientes en riesgo de desarrollar periodontitis. Caso clínico para examen Supuración en un implante Perio moderada No smoke Periimplantitis en 46 hay mas biopelícula, facultative gran negative, anaerobic bacteria, es ma difícil eliminarlas, son resistentes a los AB de betta lactamasas Mucositis en 45 foto de bacterias Biopelícula transfiere genes de resistencia a las bacterias Plásmidos: que son genes de resistencia de las bacterias, Betalactamasas: rompen anillo de las tienen genes blacfxa y blaTEM, Las bacterias son resistentes, Exacerbación de respuestas IMMUNES Tipe 1 allergy Ig E dx blood test de IgE y presencia de células mastocitos y liberación de histamine. Type 2 Ig G Ig M cell surfaces, transfusions sanguineas, need host blood cell Type 3 Ig G IgM systhematic lupus erythematosus y sclerosis multipl, polyarterioris nodosa, dx? Prueba ANA blood. —prueba antígeno antinuclear contra el DNA, se activan las células diagnostico= PRUEBA ANA blood test Type 4 Delayed Hypersensitivity CD4 CD8 directly kill tissue cells, dermatitis reaction reduces oxygen no se que son los que dañan al tejido fotoo presentación ARTHRITIS REUMATOID dx: IL17 en sangre Aguda: citocinas, pcr, ANAPHYLATOXIS son 8 celulas pero las mas importantes son C5a C4a C3a HIPERSENSIBILITY- AUTOIMMUNITY ANAPHYLACTIC SHOCK: tx: systemic epinephrine, antihistamines La histamine es lo que inflama los tejidos, hace que la faringe se cierre y no este la respiración correcta. Se ve afectado corazón, bronquios, DIABETES: Impaired insuline production Ketoacidosis? Se hace acida la sangre, ph de 7.4 deciende, exceso de cuerpos cetónicos, hiperglicemia, sace energía de ácidos grasos y liberan cuerpos cetónicos y estos se quedan circulando lo que hace que se haga mas acida la sangre. TIPO 1: 5% DE LA POBLACION. Se afectan mas los NIÑOS. Is caused by a deficiency of insulin. B cell destruction mediated by CD4+ son los policias, fallan no reconocen las células pancreáticas y llaman a CD8+ y linfocitos B para eliminar a estas células no reconocidas. Hipersensibilidad TIPO 4 Insuline: transport CH to every part of the body. Diabetes tipo 2 es la mas común: se reconoce la insulina, pero cuerpo 85-95% de los px la padecen RHEUMATOID ARTHRITIS Inflammatory disease, involve joints, inflammation of the synovium associated with destruction of the joint cartilage and bone. Inflammatory response of the body TX: corticoesteroides. TNF THERAPIES--- ANTICUERPOS NEUTRALIZANTES CONTRA EL TNF Se producen citocinas TNF que hacen que destruyen las art--- LUPUS SLE, mujeres 18-30años chronic, articulaciones y riñones, hinchazón de manos pies, perdida de cabello, dolor de cabeza, hemolytic anemia, rashes, arthritis y glumeronefritis, CNS. No pueden estar en el sol, porque aumenta la muerte celular Linf B y T: TX: no hay cura para esta enfermedades. PEMPHIGUS VULGARIS: the most common, oral lesion, enf ampollosas, depositos de autoantibodies Desplegamiento de queratositos por acantolisis, unidos por desmosomas, la acantolisis destruyen la unión de los desmosomas. Ig G. el espacio que queda se llena con agua, lo que hace el liquido de las ampollas. VEGETANS Uno es mas superficial que el otro Vulgar actúa en desmosomas--- ocurre más externos en la epidermis descamación de su epitelio Foliácea actúa más internamente en la dermis MYASTEMIA GRAVIS Debilidad y fatiga aguda acetilcolina NT, NEUROVASCULAR DISORDER, muscle weakness, muscle fatige. Adultthood Tx: inmunosupresores, bloquea la degradación de acetylcoline by cholinesterase enzime., corticoesteroides, transfucion de sangre INFLAMMATION Tissue injuries Physical agents Chemical angent LOCAL SINGS OF INFLAMATION RUBOR redness TUMOR swelling CALOR heat DOLOR pain FUNTION LOSS FUNTION TYPES OF INFLAMMATION ACUTE: short duration, accumulation of luid and plasma , intravascular activation of platelets. FEW DAYS, bacteria injured tissues, major cells: b¿neutrophils basophiles…. Mediadores: vasodylators---histamine,. Morphologic patterns: serus inflam, fribrous El primero que llega es NEUTROFILO LUEGO 2 basofile CHRONIC PERMEABILITY FACTORS: mediadores quimicos Arachidonic acid: fatty acid, diet directly, Phagocytosis: CHRONIC INFLAMMATION + 2 weeks, long lasting, persist months or even years. more importants LYNPHOCITES (B y T) and Macrophages (con la quimiotaxis llama alas demás células al lugar de la inflamacion) blood test: CRP, ESR medications: nonesteroidal NSAIDs ibuprophen and naproxen, corticosterioids—PREDNISONE Inmmunosupresors---- lifestyle modifications: diet, exercise, stress management, smoking cessation. Beneficios de inflamacion : defensa contra infections, reparación y recuperación de tejidos, insolation of infected áreas, enhanncement of inmmune surveillance, fever response, …