Importance of Biochemistry for the future medical doctor.
Distinctive properties of living systems. General organization of metabolism. General concepts of nutrition.
Daily energy expenditure. Basal metabolic rate. Calorie content of different nutrients. Energy deposits in the body. Ideal body weight.
Nutritional needs, macro-and micronutrients, essential nutrients, biochemical basis of adequate nutrition.
Work and energy in living organisms, variations in free energy, exergonic and endergonic reactions, coupled reactions. High-energy bonds.
ATP and high energy molecules. ATP and cellular work. Ion pumps, muscle contractions, biosynthetic work.
ATP homeostasis. General concepts of oxidative metabolism.
Mitochondrial bioenergetics. Redox reactions in biological systems. Oxidases and dehydrogenases. NAD and FAD. General concepts of the Krebs cycle.
Electron transport and oxidative phosphorylation. Structure of the inner mitochondrial membrane.
Definition of needs in terms of energy and nutrients. Recommended daily nutrient intake. Basal metabolic rate, methods for the evaluation of basal metabolic rate.
Electron transport and energy. Molecular mechanism and regulation of oxidative phosphorylation. Electron transport and proton gradient. Chemiosmotic coupling and ATP synthesis. Uncoupling of oxidative phosphorylation.
Oxygen needs in the human body. Hemoglobin and oxygen transport. Oxygen binding curve of hemoglobin.
Structure of heme and of hemoglobin. Cooperative binding of oxygen by hemoglobin. Hemoglobin and myoglobin.
Transport of oxygen and of carbon dioxide. Influencers of oxygen binding by hemoglobin. Physiological variants of hemoglobin.
Energy needs, diet-induced thermogenesis. Energy needs in physical activity.
Enzymes. General properties of enzymes as catalysts, efficiency, specificity and regulation. Enzyme-substrate complex.
Nomenclature of enzymes.
General principles of catalytic mechanisms by enzymes. Environmental factors influencing enzyme activity. Kinetics of enzyme-catalyzed reactions. The Michaelis-Menten equation. Km, Vmax. Km at work. Regulation of enzyme activity, general concepts and specific examples. Enzyme inhibition, allosteric regulation and allosteric kinetics. Covalent modifications.
Digestion of food substances and absorption of nutrients. Digestive juices and digestion enzymes.
Evaluation of optimal body weight, body mass index (BMI), BMI and metabolic syndrome.
Protein nutritional needs.
Regulation of digestive secretion and digestion. Zymogens. Digestion of carbohydrates and proteins.
Alimentary fibers. Bile juice, lipases and lipid digestion. Absorption of lipids, synthesis of chylomicrons.
Terminal digestion. Biochemical basis of alimentary intolerances. Absorption of sugars and aminoacids. Nutrients in the bloodstream. Glycaemia, glycemic curves, glycemic index of foods.
General concepts of hormone regulation of glycaemia. Synthesis and release of insulin. Hypoglycemic effect of insulin.
Nutrients in cereals, beans, fruits and vegetables. Importance of fibers. Importance of mineral nutrients.
Carbohydrate nutritional needs. Glycemic index and glycemic load.
Effects of insulin on liver, adipose tissue and skeletal muscle.
Glucose metabolism. Uptake of glucose by cells and tissues. Metabolic fate of glucose in the cells. Glycolysis. Aerobic and anaerobic glycolysis.
Free radicals and reactive oxygen species (ROS). Formation of ROS in the human body.
Glycolysis in detail. Regulation of glucose metabolic fate in different tissues. Regulation of glycolysis. Glucokinase, hexokinase. Phosphofructokinase, its allosteric regulation. Importance of fructose 2, 6-bisphosphate.
Hormonal regulation of metabolism, general principles.
Signal transduction, G protein-coupled receptors. Second messengers. Cyclic AMP. Glucagon receptor, adrenergic receptors. Hormonal regulation of fructose 2, 6-bisphosphate levels in liver and hearth.
Reactivity of ROS with different biomolecules. Oxidative stress.
Other pathways of signal transduction: PLC, PKC, PIP2, PI3K e PIP3, DAG, IP3 and Ca2+.
Glycogen. Glycogen in liver and muscle. Synthesis and degradation of glycogen. Regulation of glycogen metabolism.
Integrated regulation of carbohydrate metabolism. Insulin, glucagon, adrenalin, nervous input.
The pentose phosphate pathway. Oxidative and nonoxidative reactions in the pentose phosphate pathway. Importance of NADPH in different tissues. Glutathione and oxidative stress.
Metabolism of fructose and galactose. Polyol pathway. Glucuronic acid.
Lipid metabolism. Fatty acids and triglycerides. Lipids as energy substrates. Lipid as energy source under different physiological conditions.
Lipoproteins and lipoprotein lipase. The adipose tissue: deposit and mobilization of fat. Free fatty acids in hyper- and in hypoglycemia. Regulation of fats mobilization.
Beta-oxidation and its regulation. Other ways to oxidize fatty acids:
Amino acid metabolism, general principles. Human dietary requirement for amino acids. Transamination reaction. Glutamate dehydrogenase reaction. Ammonium transport in the body: role of glutamine.
Amino acids as energy substrates. Glucogenic and ketogenic amino acids. Synthesis of carbamoyl phosphate. Urea cycle.
Catabolism of branched chain amino acids. Catabolism of histidine. Catabolism of phenylalanine and tyrosine, biochemical basis of phenylketonuria. Amino acids decarboxylation. Synthesis of catecholamines.
Endogenous defenses against oxidative stress.
Central role of pyruvate. Pyruvate dehydrogenase and its regulation.
Krebs cycle, general principles. Krebs cycle in hyper- and hypoglycemia. Role of citrate.
Krebs cycle in detail. Anaplerotic reactions. Krebs cycle as source of intermediates for biosynthesis. Regulation of Krebs cycle. Krebs cycle and urea cycle. Transport of reduced coenzymes to the mitochondrion.
Citrate in the cytosol. Fatty acids synthesis and deposition of fats in the adipose tissue.
AcetylCoa carboxylase and fatty acid synthase. Synthesis of fatty acids other than palmitic acid: elongation, hydroxylation, introduction of double bonds. Essentia fatty acids.
Synthesis and deposit of triglycerides.
Gluconeogenesis and glucose homeostasis. Gluconeogenesis and synthesis of ketone bodies.
Antooxidants from foods. Carotenoids, beta-carotene, vitamin A. Lycopene. Tocopherols. Vitamin C. Polyphenols.
A summary of energy metabolism.
Biochemistry of cholesterol. Biological roles of cholesterol. Needs and sources of cholesterol.
Biosynthesis of cholesterol and its regulation.
Structure and features of plasma lipoproteins. Metabolism of plasma lipoproteins. Biochemical basis of dyslipidemia.
Metabolic fate of cholesterol in different tissues. Bile acids. Steroid hormones.
Metabolism of purines and pyrimidines. De novo synthesis and salvage pathways. Degradation of nucleotides. Biochemical basis of hyperuricemia and gout.
Biochemistry of folates. SAM.
Metabolism of ethanol.
Dietary needs of lipids.
Role of unsaturated lipids in the regulation of lipoprotein metabolism.
Hormone Biochemistry: general principles, regulation of hormone production.
Hormones of the hypothalamus. Pituitary hormones. GH and prolactin.
Thyroid hormones. Hormonal regulation of calcium homeostasis. Vitamin D.
Transport plasma proteins.
Biochemistry of steroid hormones. Glucocorticoids. Aldosterone, renin-angiotensin system.
Sex steroids. Synthesis and biological roles of progesterone.
How to set up a diet. Importance of diet in the management of hypertension, diabetes and dyslipidemia.
Chemical synapses and neurotransmitter, neurotransmitter receptors. Acetylcholine, Catecholamines, aspartate, glutamate, GABA and glycine as neurotransmitters.
Eicosanoids biochemistry. Cyclooxygenase pathway, prostaglandins and thromboxanes. Omega-6 vs. omega-3 fatty acids.
Overview on the lipooxygenase pathway, isoprostanes, epoxides, endocannabinoids.
Blood biochemistry. Platelet aggregation and blood clotting.
Biochemical basis of diabetes. Insulin receptor and signal transduction. Link between obesity and diabetes. Metabolic alterations in the obese adipose tissue.
Biochemistry of muscle contraction. Energy metabolism in muscles. Anaerobic and aerobic metabolism in the skeletal muscle. Overview on hearth muscle and smooth muscle.
Heme metabolism. Iron homeostasis.
Biological membranes, organization and functions. Glycerolipids and sphingolipids.
Glycolipids, glycoproteins and proteoglycans.
Vitamin A and biochemistry of vision.
Prerequisites for admission
The acknowledge acquired by passing the exam "Chimica e propedeutica biochimica" of the 1 semester of the 1 year is required as reported in the Manifesto degli Studi
Assessment methods and Criteria
The method for verifying the learning and the evaluation criteria are:
- the examination procedure includes a written test and, only once it has been passed, an oral test. Both tests are mandatory and are held on the same day
- the typology of the written test is a test with multiple choice answers lasting 1 hour and 30 minutes, while the oral test is an oral interrogation
- the evaluation parameters are: knowledge of the chemical transformations that take place in the human organism at cellular, tissue and integrated level; knowledge of the biochemical mechanism of normal biological phenomena and the chemical and molecular basis of the homeostasis of the human organism; discussion of the consequences of the alterations of these mechanisms; ability to organize knowledge discursively; capacity for critical reasoning on the study carried out; quality of the speech; expertise in the use of scientific language
- the type of evaluation used is the grade in thirty
- there are no intermediate tests or pre-exam sessions