Mechanisms of diseases

A.Y. 2019/2020
24
Max ECTS
300
Overall hours
SSD
BIO/10 MED/03 MED/04 MED/07
Language
English
Learning objectives
The course focuses on the causes of cell, tissue, and organ injury (general pathology), on the major groups of microbial pathogens that cause human diseases (microbiology), on the principal mechanisms of responses to injury and defense (inflammation and immunity), and on the general processes of the most relevant causes of human diseases (genetics, vascular pathology, oncology).
Integrating contributions from different disciplines, the course offers a comprehensive description of the main different mechanisms of disease organized in 11 modules:
A. Cellular pathology
B. Medical genetics
C. Basic concepts on pathogens
D. Virology
E. Microbiology
F. Inflammation and innate immunity
G. Adaptive immunity
H. Immunopathology
I. Oncology
J. Vascular pathology
K. Biotechnology approaches in translational medicine
Expected learning outcomes
At the end of the course, students will gain understanding of:
· general pathological mechanisms leading to cell injury and death
· how the body reacts to physical and biological agents to recover homeostasis
· molecular and cellular basis for inflammatory disease states
· normal and abnormal functions of the innate and adaptive immune system
· genetic bases of human diseases
· main microbial pathogens and body's immune reactions to infections
· molecular basis of neoplastic diseases
· molecular basis of vascular alterations
Course syllabus and organization

Single session

Responsible
Prerequisites for admission
To take the Mechanisms of Diseases exam, students must have already taken all the exams of the first year (Fundamentals of Basic Sciences, Cells Molecules and Genes 1 and 2, Human Body).
Assessment methods and Criteria
The exam will be based on two written parts and three oral parts:
The exam will be based on two written parts and three oral parts:
· The WRITTEN TEST 1 will be based on 30 multiple choice questions of general pathology, immunology and microbiology;
· The WRITTEN TEST 2 is composed of 32 multiple choice questions of genetics (16 questions), biochemistry (8 questions) and methodology (8 questions). Each exact answer will value one point and the test will result in a mark from 18 to 30L
· The ORAL EXAMINATION 1 will evaluate general pathology and will result in a mark from 18 to 30.
· The ORAL EXAMINATION 2 will evaluate immunology and will result in a mark from 18 to 30.
· The ORAL EXAMINATION 3 will evaluate microbiology and will result in a mark from 18 to 30.

The written test 1 has a threshold of 23/30 and will not contribute to the final mark.
The written test 2 and all oral examinations tests will contribute to the final mark according to the following algorithm based on the proportion of the CFUs dedicated to each subject:

Written test 2 (genetics/biochemistry/methodology; 4 CFU): mark x/30 x 0.15
Oral examination 1 (general pathology; 7 CFU): mark x/30 x 0.3
Oral examination 2 (immunology; 7 CFU): mark x/30 x 0.3
Oral examination 3 (microbiology; 6 CFU): mark x/30 x 0.25
The final score will be implemented with the score obtained in the journal club session (from 0 to 2 points).

Written tests can be taken independently from each other.
Only students who have passed both written tests are allowed to take the oral examinations.
The written exams and the oral examinations can be sustained in different dates.
The oral examination sessions 1&2 have to be taken in a single session, the oral examination session 3 can be taken independently from 1&2.
Marks obtained in the different sessions will be considered valid indefinitely.
Biochemistry
Course syllabus
BLOCK A - CELLULAR PATHOLOGY
1. Mechanisms of cellular adaptation, injury and death (Della Bella)
2. Oxidative stress in human health and diseases (Della Bella)
3. Intra- and extracellular accumulations leading to human diseases (Della Bella)
4. The stem cell (Della Bella)
5. Cellular senescence and aging (Della Bella)
6. Vitamins in health and disease I (Riboni)
7. Vitamins in health and disease II (Riboni)
8. Mechanisms of disease by air pollution agents (visiting professor)

BLOCK B - MEDICAL GENETICS
1. Principles of molecular diseases (Finelli)
2. Genetic pleyotrophy (Ratti)
3. Genetic heterogeneity (Ratti)
4. The position effect (Finelli)
5. When genotype is not predictive of phenotype (Finelli)
6. From Mendelian to complex diseases (Finelli)
7. The genetics of complex diseases (Ratti)
8. Epigenetics and human diseases I (Ratti)
9. Epigenetics and human diseases II (Ratti)
10. Pharmacogenetics and pharmacogenomics (Ratti)


BLOCK C - BASIC CONCEPTS ON PATHOGENS
1. The good and bad of microorganisms (Borghi)
2. Prokaryotic cell structure and function (Borghi)
3. Microbial pathogenesis (Borghi)
4. Fungal structure, function, and pathogenesis (Borghi)
5. Basic concepts of parassitology (Ferrante)
6. Parasites of medical relevance (Ferrante)
7. Viruses: structure, genetics and evolution (Delbue)
8. Viruses: classification and replication properties (Delbue)
9. Viruses: pathogenesis of viral infections (Delbue)

BLOCK D - VIROLOGY
1. RNA positive viruses I: picornaviridae (Delbue)
2. RNA positive viruses II (Ferrante)
3. RNA positive and negative viruses (Ferrante)
4. RNA negative viruses I (Delbue)
5. RNA negative viruses II (Ferrante)
6. Viral hepatitis I: Hepatitis A virus, Hepatitis B virus, Hepatitis D virus (Ferrante)
7. Viral hepatitis II: Hepatitis C virus, Hepatitis E virus, Hepatitis G virus (Ferrante)
8. DNA viruses: herpesviridae (Delbue)
9. DNA viruses: parvoviridae, adenoviridae, papillomaviridae (Delbue)
10. DNA viruses: polyomaviridae (Ferrante)
11. Retroviridae: Human immunodeficiency virus (Delbue)
12. Retroviridae: Human immunodeficiency virus (Delbue)
13. Delta retroviruses, Human endogenous retroviruses, prions (Ferrante)

BLOCK E - MICROBIOLOGY
1. Toxigenic bacteria (Borghi)
2. Pyogenic bacteria (Borghi)
3. Spore-forming bacteria (Borghi)
4. Intracellular bacteria (Borghi)
5. Granulomatous infections (Borghi)
6. Bacteria infecting the gut (Borghi)
7. Microorganisms infecting the central nervous system (Borghi)
8. Nosocomial pathogens (Borghi)
9. Biologicals and infection risk (Borghi)

BLOCK F - INFLAMMATION AND INNATE IMMUNITY
1. Origin of innate immune cells: hematopoiesis (Marchesi)
2. The acute inflammatory response (Marchesi)
3. Cell mediators of acute inflammation (Marchesi)
4. Soluble mediators of acute inflammation (Marchesi)
5. Leukocyte recruitment (Marchesi)
6. Pathogen recognition in innate immunity I (Marchesi)
7. Pathogen recognition in innate immunity II (Marchesi)
8. The complement system (Marchesi)
9. Pathogen killing (Marchesi)
10. Immunometabolism 1 (Riboni)
11. Resolution of the inflammatory response (Marchesi)
12. Tissue repair and fibrosis (Marchesi)
13. Chronic inflammation (Marchesi)
14. Acute phase reaction and systemic inflammation (Marchesi)

BLOCK G - ADAPTIVE IMMUNITY
1. From innate to adaptive immunity: basic concepts (Locati)
2. Antigen processing and presentation (Locati)
3. Antigen presenting cells (Della Bella)
4. T cells development (Locati)
5. Tolerance (Locati)
6. T cells functions (Locati)
7. B cells development (Locati)
8. Antibodies (Locati)
9. Immune response polarization (Locati)
10. Immune circuits in chronic inflammation (Locati)
11. Negative regulators of the immune response (Locati)
12. Immunometabolism 2: adaptive immunity (Riboni)
13. Immune response memory (Locati)

BLOCK H - IMMUNOPATHOLOGY
1. Immune responses to viruses (Della Bella)
2. Immune responses to intracellular bacteria (Della Bella)
3. Immune responses to extracellular bacteria and fungi (Della Bella)
4. The microbiome and its impact on immune responses (visiting professor)
5. Mucosal immunity (Della Bella)
6. Hypersensitivity reactions - part I (Della Bella)
7. Hypersensitivity reactions - part II (Della Bella)
8. Autoimmunity (Della Bella)
9. Primary immunodeficiencies (Della Bella)
10. Acquired immunodeficiencies (Mavilio)
11. Transplantation immunology (Della Bella)
12. Immunosenescence (Della Bella)
13. Systemic metabolism and immune response in complex diseases (Della Bella, Riboni)
14. Food and health: facts and fakes (visiting professor)
BLOCK I - ONCOLOGY
1. Introduction to tumors (Della Bella)
2. Distinctive features of benign, precancerous and malignant growth (Della Bella)
3. Metabolic derangements in cancer cells (Riboni)
4. The genetic basis of cancer (Finelli)
5. Sporadic, familiar and hereditary cancer (Finelli)
6. Molecular basis of cancer (Della Bella)
7. Carcinogenesis: physical and chemical agents (Della Bella)
8. The oncogenic risk of smoke (visiting professor)
9. Carcinogenesis: infectious agents (Della Bella)
10. Immune responses to tumors (Della Bella)
11. Inflammation and cancer (Della Bella)
12. Angiogenesis (Della Bella)
13. Tumor angiogenesis (Della Bella)
14. Metabolic changes in patients with tumors (Della Bella, Riboni)

BLOCK J - VASCULAR PATHOLOGY
1. Hemostasis and coagulation (Marchesi)
2. Atherosclerosis (Marchesi)
3. Thrombotic diseases (Marchesi)
4. Shock (Marchesi)
5. Anemias (Marchesi)

BLOCK K - BIOTECHNOLOGY APPROACHES IN TRANSLATIONAL MEDICINE
1. From somatic cells to stem cells (Mavilio)
2. New technologies for the diagnosis and the therapies of immunologic diseases (Mavilio)
3. From genetics to immunology: the auto-inflammatory diseases case (Mavilio)
4. Regulation and ethics of modern technology in modern medicine (Mavilio)
5. Flow cytometry applications in immunopathology (Mavilio)
Teaching methods
The course is mainly based on lectures and seminars and includes the following tutorial activities:
· PBL sessions:
· Lab practicals:
o Microbiology
o Journal club session
Teaching Resources
PATHOLOGY
· AK Abbas, AH Lichtman, S Pillai. CELLULAR AND MOLECULAR IMMUNOLOGY. 8th ed. Elsevier 2015
IMMUNOLOGY
· V Kumar, AK Abbas, JC Aster. ROBBINS AND COTRAN, PATHOLOGIC BASIS OF DISEASES. 9th ed. Elsevier 2015
MICROBIOLOGY
· P Murray, K Rosenthal, M Pfaller. MEDICAL MICROBIOLOGY. 8th ed. Elsevier 2016
Genetics
Course syllabus
The course is based on a strong integration of different disciplines, thus the program of the single disciplines cannot be extracted form the program of the whole course which is reported in module Biochemistry.
Teaching methods
The course is mainly based on lectures and seminars and includes the following tutorial activities:
· PBL sessions:
· Lab practicals:
o Microbiology
o Journal club session
Teaching Resources
PATHOLOGY
· AK Abbas, AH Lichtman, S Pillai. CELLULAR AND MOLECULAR IMMUNOLOGY. 8th ed. Elsevier 2015
IMMUNOLOGY
· V Kumar, AK Abbas, JC Aster. ROBBINS AND COTRAN, PATHOLOGIC BASIS OF DISEASES. 9th ed. Elsevier 2015
MICROBIOLOGY
· P Murray, K Rosenthal, M Pfaller. MEDICAL MICROBIOLOGY. 8th ed. Elsevier 2016
General pathology and immunology
Course syllabus
The course is based on a strong integration of different disciplines, thus the program of the single disciplines cannot be extracted form the program of the whole course which is reported in module Biochemistry.
Teaching methods
The course is mainly based on lectures and seminars and includes the following tutorial activities:
· PBL sessions:
· Lab practicals:
o Microbiology
o Journal club session
Teaching Resources
PATHOLOGY
· AK Abbas, AH Lichtman, S Pillai. CELLULAR AND MOLECULAR IMMUNOLOGY. 8th ed. Elsevier 2015
IMMUNOLOGY
· V Kumar, AK Abbas, JC Aster. ROBBINS AND COTRAN, PATHOLOGIC BASIS OF DISEASES. 9th ed. Elsevier 2015
MICROBIOLOGY
· P Murray, K Rosenthal, M Pfaller. MEDICAL MICROBIOLOGY. 8th ed. Elsevier 2016
Microbiology
Course syllabus
The course is based on a strong integration of different disciplines, thus the program of the single disciplines cannot be extracted form the program of the whole course which is reported in module Biochemistry.
Teaching methods
The course is mainly based on lectures and seminars and includes the following tutorial activities:
· PBL sessions:
· Lab practicals:
o Microbiology
o Journal club session
Teaching Resources
PATHOLOGY
· AK Abbas, AH Lichtman, S Pillai. CELLULAR AND MOLECULAR IMMUNOLOGY. 8th ed. Elsevier 2015
IMMUNOLOGY
· V Kumar, AK Abbas, JC Aster. ROBBINS AND COTRAN, PATHOLOGIC BASIS OF DISEASES. 9th ed. Elsevier 2015
MICROBIOLOGY
· P Murray, K Rosenthal, M Pfaller. MEDICAL MICROBIOLOGY. 8th ed. Elsevier 2016
Biochemistry
BIO/10 - BIOCHEMISTRY - University credits: 1
Lessons: 12 hours
General pathology and immunology
MED/04 - EXPERIMENTAL MEDICINE AND PATHOPHYSIOLOGY - University credits: 2013
Practicals: 32 hours
Lessons: 132 hours
Problem Based Learning: 24 hours
Genetics
MED/03 - MEDICAL GENETICS - University credits: 2
Lessons: 24 hours
Microbiology
MED/07 - MICROBIOLOGY AND CLINICAL MICROBIOLOGY - University credits: 6
Practicals: 16 hours
Lessons: 60 hours
Professor(s)
Reception:
by appointment
San Paolo Hospital, blocco C, 8° floor
Reception:
On Appointment
Istituto Clinico Humanitas, Via A. ;anzoni 113, Rozzano, Milano