FACTORS THAT AFFECT HEALTH

• INDIVIDUAL
• COMMUNITY HEALTH
• ENVIRONMENTAL SANITATION
Host defense mechanism
 Host Defenses
• Resistance
– Ability to ward off disease
– Varies among organisms and individuals within the same
species
• Immunity - mechanisms used by the body as
protection against microbes and other foreign agents;
self vs. non-self
• Nonspecific immunity (innate, natural, inborn)
– Defenses against any pathogen
• Specific immunity
– Resistance to a specific pathogen
 Cell types: Cell types:
Macrophages, dendritic cells, B lymphocytes
neutrophils (natural killer cells T lymphocytes
& complement)
INBORN ACQUIRED
Activation: active prior to Activation: active by exposure
exposure
Host Defenses
First line of defense – physical & chemical barriers
 First line of defense – physical & chemical
barriers
• Intact, unbroken skin (Broken skin = port of entry)
• Almost all bacteria are incapable to penetrate a few
helminths (hookworm & schistosoma) may
• skin predominantly inhabited by Staphylococcus
epidermidis
• How?
• Dryness
• temperature
• Low pH (acidic) of skin;
• bacteriocidal secretion by the sebaceous glands
• Desquamation – sloughing of epithelium
• Perspiration (sweat contain lysozymes – attack bacterial cell wall)
• Exception: Staphylococcus aureus in moist area
 First line of defense – physical & chemical
barriers
• Eyes
– Blinking of eyelids
– Tears containing lysozymes
• Outer ear canal
– Wax contains antibacterial components
 First line of defense – physical & chemical
barriers
• Mucus membranes – layers of mucosal
cells that line body cavities that open to
the outside (digestive, genitourinary and
respiratory tracts)
– Mucus is produced by the mucosal cells
• Contains antimicrobial substance such as
lysozymes, lactoferrin (sequester iron)
• Mucosal cells are rapidly dividing  flush out
of body along with attached bacteria
 First line of defense – physical & chemical
barriers
• Digestive tract
– Mouth and lower digestive tract – lots of bacteria
(mostly anaerobes e.g. Bacteroides, anaerobic
streptococci [Streptococcus mutans in mouth] and
Clostridium in colon )
– How?
• Mucus
• Saliva (contains lysozyme)
• Bile (alkaline) in small intestine
• Stomach acids
• Defecation (feces contains up to 50% bacteria !)
• Mucus contain antibacterial agents, antibodies and
immune cells called phagocytes
 First line of defense – physical & chemical
barriers

• Genitourinary tract
– Urinary tract is sterile in a health person except
the distal urethra
– How?
• Urination
• Secretion (vaginal and seminal fluid)
• Low pH of vagina (presence of several
Lactobacillus sp., Candida albicans)
 First line of defense – physical & chemical
barriers
• Respiratory tract
– Nose - nasal hair, mucus
secretions (phagocytes
and antibacterial
enzymes), irregular
chambers
– ciliated epithelium (nasal
cavity, sinuses, bronchi
and trachea)
– Cough reflexes
– Alveolar macrophages
 First line of defense – physical & chemical
barriers
• Microbial antagonism
– Normal flora vs. invaders
• Compete for colonization sites
• Compete for nutrients
• Produce bacteriocins

– Administration of broad spectrum antibiotics may kill

only certain members of the normal flora, leaving the
others to overgrow  superinfection
e.g. yeast in vagina – yeast vaginitis
Clostridium difficile in colon – diarrhea and colitis
 Second line of defense
• Once beyond the protective outer barrier of the body, the
invading microbes will encounter a series of nonspecific cellular
and chemical defense mechanisms

• Mechanisms:
– Inflammation – a series of events that removes or contain the offending
agent and repair the damage
– Chemotaxis – movement of cells toward a chemical influence
(chemokines or chemotatic agents)
– Phagocytosis – process in which cell ingest foreign particulate matter
e.g. microbes

• Many are carried out by the white blood cells in blood

 Blood Components
• Fluid portion
– Serum: liquid portion of clotted blood
– Plasma: liquid portion with clotting factors
– Contains antibodies & other proteins
• Clotting factors (proteins)
– Fibrinogen
– Prothrombin
• Formed elements
– Erythrocytes – red blood cells (RBC) – carry oxygen and carbon
dioxide; no nucleus
– Leukocytes – white blood cells (WBC) - defense
– Platelets – thrombocyte particles – clotting; no nucleus
 Second line of defense – formed element in blood

Monocytes Neutrophils Basophils

(marcophage)
Lymphocytes Eosinophils
Erthrocytes Platelets
(RBC)

Wright’s stain of the peripheral blood cells can identify granulocytes based
on properties of the granules. It contain two dyes:

• Eosin dye stains basic cell components  reddish

• Methylene blue dye stain acidic cell components  blue-ish
 Second line of defense
• Acute phase proteins
– set of plasma proteins whose level increases during
infection to enhance host defense mechanisms
– e.g. complement proteins, coagulating factors,
transferrins

• Cytokines
– small secreted proteins produced by cells
– Communication between different defense systems
– Examples: interleukins, interferons
 Second line of defense

• Fever
– Pyrogens are substances that stimulate fever
• External, e.g. bacterial endotoxin
• Internal (endogenous), e.g. interleukins (IL-
1)
– Body temperature increases in response to pyrogens
to:
• Stimulate WBC to deploy & destroy microbes
• increase in immunological response (e.g.
proliferation and activation of lymphocytes)
• Slow down growth of or kill pathogens
 Second line of defense
• Interferons
– Anti-viral proteins produced by virus-infected cells (eventually died)
– Alert system to prevent virus from infecting other cells and to
stimulate certain lymphocytes
 Second line of defense
• The complement systems
– Consists of ~30 proteins that complement the
action of the immune system
– Functions:
• Inflammation
• Stimulate leukocytes
• Lyse bacteria
• Increase phagocytosis by opsonization
 Opsonization
• Process by which phagocytosis is facilatated by deposition of opsonins
• Opsonins can be complement proteins, or antibodies
• e.g. encapsulated bacteria
• Deficiency in complement system may lead to increase susceptibility to
certain infections.
 Inflammation
• Four cardinal signs
• Major events
– Redness
– Vasodilation
– Heat – Increase permeability
– Swelling of capillaries
– Pain – Mobilization of
leukocytes to site of
injury (chemotaxis &
• Primary functions emigration)
– Localize infection – Phagocytosis
– Neutralize toxins at
injury site
– Repair damage tissue
 Second Line of Defense
Inflammation
Inflammation – cont.

(Chemotaxis)
Phagocytosis is the ingestion of microorganisms or other
matter by a cell. Many white blood cells engulf invasive
microorganisms by the process of phagocytosis. The
steps in phagocytosis are:

– 1. Chemotaxis is the process by which phagocytes

are attracted to microorganisms.
– 2. Attachment: The phagocyte then adheres to the
microbial cell. This adherence may be facilitated by
opsonization – coating the microbe with plasma
proteins.
– 3. Ingestion: Pseudopods of phagocytes engulf the
microorganism and enclose it in a phagosome to
complete ingestion.
– 4. Digestion: Lysosomes fuse with the phagosome
to form a digestive vacuole. The microbe is killed
and digested.
Second Line of Defense
Phagocytosis

Figure 16.8a