Question

Case 3a: Immune Cell Mutiny You are a doctor working in clinic in Kenya. You are treating a pregnant, female patient who has had the following recurrent symptoms for the past 9 months: fever, fatigue, sore throat, swollen glands, night sweats, diarrhea, and weight loss. When you interview the patient she tells you that her husband recently tested positive for HIV. However, he told her not to worry because HIV cannot be transmitted during heterosexual intercourse. Alarmed that your patient has been given inaccurate information, you immediately take a sample of the patient's blood and ask the clinical lab to analyze it. The lab results show detectable levels of gp120 in the patient's blood and a CD4 T cell count 200 cells per microliter of blood (14% of all lymphocytes). You determine that your pregnant patient is also HIV-positive NOTE: For the questions in this case, assume that the virus is only INTRACELLULAR. CD4+ T cells (T4 Count) # cells/microliter CD4 % CD8+ T cells CD4/CD8 Ratio T8 Count) Normal Sample Patient's Sample 600 and 1600 190 20-40% 14% cells/microliter 375 -1100 800 1.4 to 1 0.24 to 1 1. Starting with the point of entry (vagina) and ending in the blood (systemic infection), describe the components of the 1st line of defense (physical barriers, chemical barriers, and resident flora) the virus encountered during the infection process. Be sure to provide a BRIEF 1 sentence explanation of each part's function. bee 1a) Identify 3 physical/mechanical barriers in the female reproductive tract that will be encountered by the BREELY esplail howthese phyicalbariers virus. BRIEFLY explain how these physical barriers will be used to block entry of the virus 3 Physical Barriers Briefly Describe the Function of Each Barrier 1b) Identify 2_chemical barriers in the female reproductive tract that will be encountered by the virus. BRIEFLY explain how these non-specific, 1st line chemicals will be used to inactivate the virus 3 Chemical Barriers Briefly Describe the Function of Each Barrier 1c) Resident Flora in the Vagina and Reproductive Tract. List at least 1 example (Genus species) of a resident microbe that would be located in the female reproductive tract. 2. Starting with the point of entry (vagina) and ending in the blood (systemic infection) describe the components of the 2nd line of defense (non-specific immune cells, chemicals and processes) the virus encountered during the infection process. Be sure to provide a BRIEF 1 sentence explanation of each part's function. 2a) Identify 2 non-specific immune cells in the female reproductive tract that would be involved in the host reaction to the virus. BRIEFLY explain how these cells will be used to inactivate the virus. Non-Specific Cells Function 2b) Identify three, 2nd line chemicals released by the non-specific cells in Question 2a above, BRIEFLY describe the 2nd line process (inflammation, fever,and phagocytosis) that will be involved in the response. You do not have to describe each process step-by-step, but simply explain how that process will be used to inactivate the virus. List three What non-specific, 2nd line process (fever, inflammation, phagocytosis, lysis) does each cheical acivate? 2nd Line chemicalsp

Answer 1

1. The normally acidic pH in the female reproductive tract is the first line of defence against infection. The secretions contain epithelial cells and mucus that trap the microbes, preventing them from entering the vagina. Another barrier is the flora in the female reproductive tract (mainly Lactobacillus) which plays a key defensive role.

2. The second line of defence involves the immune cell. For the female reproductive tract in particular, the actual count and type of leukocyte varies with phase in the menstrual cycle. Dendritic cells, Treg and macrophages, expressing higher levels of HIV-1 receptors CD4, CCR and CXCR4. Macrophages also regulate the normal ovarian functions by regulating folliculogenesis and atresia