Generale Pathology, Immunology and Medical Microbiology

A.Y. 2019/2020
Overall hours
MED/04 MED/07
Learning objectives
The integrated course of General Pathology, Immunology and Medical Microbiology aims to provide the tools to understand the molecular mechanisms and the pathogenesis of human diseases. In addition, the course will provide the bases for understanding the mechanisms of immune defenses, innate and acquired, implemented by the host. The Medical Microbiology module aims at describing the microorganisms causing the most common viral, bacterial or parasitic human diseases and the mechanisms of their pathogenicity.
Expected learning outcomes
The students will be able to define the molecular mechanisms of human, communicable and not communicable diseases and the basis of immunity and inflammation. They will be able to recognize the causes (aetiology) and the mechanisms (pathogenesis) of diseases, and to understand and use common medical words and meanings. The students will recognize the structure, genomic organization, replication and pathogenesis of the most common human diseases caused by viruses, bacteria and parasites. For each microorganism, they will define the interactions with the host and the bases for therapeutic intervention. Moreover, they will develop methods to investigate any disease and to critically analyze scientific publications on the field.
Course syllabus and organization

Single session

Lesson period
First semester
Prerequisites for admission
The Course of General Pathology, Immunology and Medical Microbiology is scheduled on the I semester of the III year of the Pharmacological curriculum.
To be admitted to the written test the students have to pass first the exams of Biochemistry, Human physiology with anatomy and General Microbiology as indicated in the Manifesto degli Studi
Assessment methods and Criteria
At the end of the course the students will take a written test.
The written test consists in brief answers (about one A4 page) to 6 open questions (6 questions for the Patology+Immunology Module; 2 questions for the medical Microbiology module), chosen at random for each student among a list of approx. 120 questions regarding all the subjects of the program. The questions are different in each academic year and are made available to the students at the end of the lessons on the Ariel web site.
Each student has 15 min/answer, therefore the total length of the written test is 90 minutes.
A score from 1 to 5 is assigned to each answer; to pass the test, the total score must be equal or greater than 18/30. For exceptional tests, the score may go up to 30/30 cum laude. The student must answer to all the questions of the test. The student can withdraw before the end of the test, and that will be recorded, and can repeat the exam at the next available date.
Generale Pathology and Immunology
Course syllabus
Immunology and Immunopathology (3 ECTS)
Tissue response to damage- Inflammatory response and innate immunity
Acute inflammation-Vascular events. Vasodilatation with hyperaemia. Increased vascular permeability. Edema formation. Production of vascular mediators. Arachidonic acid metabolism: prostaglandins and leukotrienes.
Myeloid cells involved in inflammation and innate immunity and their functions. Macrophage subpolpulations, phagocytosis and intracellular killing mechanisms.
Inflammatory cytokines: Interleukin 1, Tumor Necrosis Factor, Interleukin 6.
Chemotaxis and chemotactic factor, the family of chemokines, the adhesion molecules. The complement system.
Systemic effects of acute inflammation: leukocytosis, fever, acute phase proteins
Chronic Inflammation: general features and etiology. Histological features. Cells of chronic inflammation. Macrophages, fibroblasts
Chronic Inflammatory lesions: abscesses, ulcers, granulomas.
Recovery and tissue repair. Types of Tissue regeneration. Repair (scars and fibrosis). Fibrogenic and anti-fibrogenic cytokines. Angiogenesis. Mechanisms of Wound healing. Pathological aspects of the repair. The role of stem cells in tissue repair.
Acquired Immunity and related diseases
-Features of Innate and acquired immunity. Lymphoid cells and primary and secondary organs.
Antigen recognition, generation of receptor diversity in B and T lymphocytes; structure of antige receptors and their gene rearrangements.
Structure and functuions of MHC molecules of class I and II, antigen presentation
- Humoral immune response: B Lymphocytes: origin, characteristics and functions. Structure of antibodies. Primary and secondary antibody response. Effector mechanisms of antibodies. Monoclonal antibodies.
- Cell-mediated immunity. T Lymphocytes: origin, characteristics and functions. Subpopulation of T lymphocytes: T helper, T cytotoxic and T regulatory.
-Role of stimulatory or suppressive cytokines in T lymphocyte activation. Immune check-points.
Principle of vaccination and characteristics of different vaccines. Immunopathology
Hypersensitivity reactions: Type I, immediate hypersensitivity reaction, Allergy or athopy.
Damage caused by cytotoxic antibodies. Immune complex diseases.
Delayed type hypersensitivity (tuberculin- contact DTH)
Immunological tolerance and autoimmune diseases: general features and details on selected diseases: rheumathoid arthritis, Systemic Lupus erythematosus, Type I diabetes, Myasthenia gravis, Celiac disease.

Physiopathology (3 ECTS)
Cellular damage. intrinsic and extrinsic factors for acute and chronic damage; reversible effects and cellular adaptive responses (atrophy, hyperplasia, metaplasia, dysplasia); cellular aging. Irreversible damage. Cell death (necrosis, apoptosis, pyroptosis, autophagy)
Epidemiology. Tumor mortality and morbility. Environmental causes. Tumor classification. Functional and morphological features of benign and malignant tumors. Tumor invasiveness and metastatization. Tumor angiogenesis.
Carcinogenesis: general principles.
Genetic of tumor transformation: Protooncogenes, Oncogene and oncosuppressor genes.
Tumor caused by infectious agents ( virus or bacteria); familial and hereditary cancers.
Stadiation and diagnosis of cancer; conventional methods, histology, immunodiagnosis, liquid biopsy, monoclonal antibodies in cancer diagnosis and therapy. Tumor markers.
Immunotherapy and tumor gene therapy. Prevention and screening.

Genetic and congenital diseases with examples of monogenic diseases
Chromosomal abnormalities, Down symdrome
Autosomal dominant or recessive or etherocromosomal-related diseases. With examples like
familial hyperlipidemia, sickle cells anemia, thalassemia, cystic fibrosis, hemophilia A & B, and others

Physio-pathology of cardiovascular diseases (brief introduction)
Atherosclerosis: formation, growth and development of atherosclerotic plaque; risk factors for atherosclerosis. Thrombosis, metabolic syndrome, hypertension.
Teaching methods
The course consists of 6 ECTS (48h) of lectures given by the Professor of the Course and occasionally seminars by external experts on particular subjects. Power point presentations or short videos are usually used and are provided to the students in the Ariel site of the course. In addition, there is 1 ECTS of practical work which includes 8 h of laboratory training for each student, divided in 2 sessions. 1. histological examination by the microscope of fixed tissues or cells to identify signs of different pathologies (atherosclerosis, anemia, tumours); 2. induction of erythroid differentiation in vitro and measure of haemoglobin producing cells by benzidine staining. The remaining 8h of practical work are organized as team working or project development. Both types of practical work are under the supervision of dedicated part time tutors.
Teaching Resources
Fabio Celotti. Patologia generale e fisiopatologia, II Ed, EdiSES. 2013 under revision and with on line update
Pontieri GM Elementi di Patologia generale & Fisiopatologia generale, IV Ed Piccin 2018
Kumar V et al Robbins. Fondamenti di Patologia e Fisiopatologia IX edizione- EDRA 2013
Abbas AK. et al Le basi dell' Immunologia EDRA 2017
In addition all the slide presentation and other material given by the teachers is available from the Ariel web site of Biotechnology-K06
Medical Microbiology
Course syllabus
Introduction to Virology
1. Viruses: structure, genomes and evolution
2. Viruses: classification and replicative strategies
3. Pathogenesis of the viral infection
Description of the main viral families associated with human diseases: structure, genomic organization, replication and pathogenesis:
4. Picornaviridae
5. Flaviviridae
6. Togaviridae and Coronaviridae
7. Orthomixoviridae and Paramixoviridae
8. Retroviridae: HIV
9. I virus responsabili delle epatiti: Hepadnaviridae (Hepatitis B Virus), Hepatitis A-C-D-E Viruses
10. Herpesviridae and Papillomaviridae
11 and 12: Description of (i) structural and morphological properties, (ii) reproduction and transmission (iii) pathogenetic mechanisms of the main parassitic infections associated with human diseases: malaria and leishmania.
Teaching methods
The Module of Medical Microbiology consists of 3 CFU (24h) of lectures given by the Professor of the Course and occasionally seminars by external experts on particular subjects. Power point presentations or short videos are usually used and are provided to the students in the Ariel site of the course.
Teaching Resources
Jawetz, Melnick & Adelberg's
Microbiologia Medica
Casa Editrice Piccin

G. Antonelli, M. Clementi, G. Pozzi, G.M. Rossolini
Principi di Microbiologia Medica
Casa Editrice Ambrosiana CEA

Murray, Rosenthal, Pfaller
Microbiologia Medica. Edra
In addition all the slide presentation and other material given by the teachers is available from the Ariel web site of Biotechnology-K06
Generale Pathology and Immunology
Practicals: 8 hours
Single bench laboratory practical: 8 hours
Lessons: 48 hours
Professors: Corbett Yolanda, D'Alessandro Sarah, Taramelli Donatella
Turno 1
Professor: Corbett Yolanda
Turno 2
Professor: Corbett Yolanda
Turno 3
Professor: Corbett Yolanda
Turno 4
Professor: D'Alessandro Sarah
Medical Microbiology
Lessons: 24 hours
Professor: Delbue Serena
to be defined
via Carlo Pascal, 36 - 20133 MILANO