Mechanisms of diseases
A.Y. 2020/2021
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
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
· 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
Lesson period: year
Assessment methods: Esame
Assessment result: voto verbalizzato in trentesimi
Course syllabus and organization
Single session
Responsible
For the lessons of the 1st semester the teaching, given the current health situation, will be carried out entirely at a distance.
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 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 the written test 1 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.
Registration through SIFA is mandatory.
· 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 the written test 1 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.
Registration through SIFA is mandatory.
Biochemistry
Course syllabus
0. Introduction to MOD and its organization
BLOCK 1: CELLULAR PATHOLOGY
1. Mechanisms of cellular adaptation, injury and death
2. Oxidative stress in human health and diseases
3. Intra- and extracellular accumulations leading to human diseases
4. The stem cell
5. Cellular senescence and aging (A)
6. Hydrophilic vitamins in health and disease I
7. Hydrophobic vitamins in health and disease II
BLOCK 2: MEDICAL GENETICS
1. Principles of molecular diseases
2. Genetic pleyotrophy
3. Genetic heterogeneity (A)
4. The position effect
5. When genotype is not predictive of phenotype
6. The genetics of complex diseases
7. From Mendelian to complex diseases
8. Epigenetics and human diseases I
9. Epigenetics and human diseases II (A)
10. Pharmacogenetics and pharmacogenomics
BLOCK 3: BASIC CONCEPTS ON PATHOGENS
1. The good and bad of microorganisms
2. Prokaryotic cell structure and function (A)
3. Microbial pathogenesis
4. Mechanisms of Antimicrobial Resistance
5. Fungal structure, function, and pathogenesis
6. Basic concepts of parasitology (A)
7. Parasites of medical relevance (A)
8. Viruses: structure, genetics and evolution
9. Viruses: classification and replication properties
10. Viruses: pathogenesis of viral infections
BLOCK 4: VIROLOGY
1. RNA positive viruses I: picornaviridae
2. RNA positive viruses II: flaviviridae
3. RNA positive and negative viruses
4. RNA negative viruses I
5. RNA negative viruses II
6. Viral hepatitis I: Hepatitis A virus, Hepatitis B virus, Hepatitis D virus
7. Viral hepatitis II: Hepatitis C virus, Hepatitis E virus, Hepatitis G virus
8. DNA viruses: herpesviridae
9. DNA viruses: parvoviridae, adenoviridae, papillomaviridae
10. DNA viruses: polyomaviridae (A)
11. Retroviridae: Human immunodeficiency virus
12. Retroviridae: Human immunodeficiency virus
13. Delta retroviruses, Human endogenous retroviruses, prions (A)
BLOCK 5: MICROBIOLOGY
1. Toxigenic bacteria
2. Pyogenic bacteria
3. Spore-forming bacteria
4. Intracellular bacteria (A)
5. Granulomatous infections
6. Granulomatous infections-Part II Clinical cases
7. Bacteria infecting the gut
8. Bacteria living in the gut - Focus on microbiome
9. Microorganisms infecting the central nervous system
10. Neisseria meningitidis (A)
11. Nosocomial pathogens (A)
12. Sepsis ad Septic shock
13. Invasive fungal infections
14. Biologicals and infection risk (A)
BLOCK 6: INFLAMMATION AND INNATE IMMUNITY
1. Origin of innate immune cells: hematopoiesis (A)
2. The acute inflammatory response
3. Cell mediators of acute inflammation
4. Soluble mediators of acute inflammation
5. Leukocyte recruitment (A)
6. Pathogen recognition in innate immunity I
7. Pathogen recognition in innate immunity II (A)
8. The complement system
9. Pathogen killing
10. Immunometabolism (A)
11. Resolution of the inflammatory response
12. Tissue repair and fibrosis
13. Chronic inflammation
14. Acute phase reaction and systemic inflammation
BLOCK 7: ADAPTIVE IMMUNITY
1. From innate to adaptive immunity: basic concepts
2. Antigen processing and presentation
3. Antigen presenting cells
4. T cells development
5. Tolerance (A)
6. T cells functions
7. B cells development
8. Antibodies
9. Immune response polarization
10. Immune circuits in chronic inflammation
11. Negative regulators of the immune response (A)
12. Immunometabolism in adaptive immunity ( A)
13. Immune response memory (A)
BLOCK 8: IMMUNOPATHOLOGY
1. Immune responses to viruses
2. Immune responses to intracellular bacteria
3. Immune responses to extracellular bacteria and fungi
4. The immune system at the epithelial barriers (A)
5. The interaction between microbiome and the immune system (A)
6. Hypersensitivity reactions - part I
7. Hypersensitivity reactions - part II
8. Autoimmunity
9. Primary immunodeficiencies A
10. Acquired immunodeficiencies
11. Transplantation immunology
12. Systemic metabolism and immune response in complex diseases (A)
13. Immunosenescence
BLOCK 9: ONCOLOGY
1. Introduction to tumors
2. Distinctive features of benign, precancerous and malignant growth
3. Metabolic derangements in cancer cells
4. The genetic basis of cancer (A)
5. Sporadic and familial cancer (A)
6. Molecular basis of cancer
7. Carcinogenesis: physical and chemical agents (A)
8. Health impacts of air pollution (A)
9. Carcinogenesis: infectious agents (A)
10. Immune responses to tumors
11. CAR T cells in cancer immunotherapy (A)
12. Inflammation and cancer
13. Metabolic changes in patients with tumors (A)
14. Angiogenesis
15. Tumor angiogenesis
BLOCK 10: VASCULAR PATHOLOGY
1. Hemostasis and coagulation
2. Atherosclerosis (A)
3. Thrombotic disease (A)
4. Shock
5. Anemias (A)
BLOCK 11: BIOTECHNOLOGY APPROACHES IN TRANSLATIONAL MEDICINE
1. From somatic cells to stem cells
2. New technologies for the diagnosis and the therapies of immunologic diseases
3. From genetics to immunology: the auto-inflammatory diseases case
4. Regulation and ethics of modern technology in modern medicine
5. Flow cytometry applications in immunopathology
BLOCK 1: CELLULAR PATHOLOGY
1. Mechanisms of cellular adaptation, injury and death
2. Oxidative stress in human health and diseases
3. Intra- and extracellular accumulations leading to human diseases
4. The stem cell
5. Cellular senescence and aging (A)
6. Hydrophilic vitamins in health and disease I
7. Hydrophobic vitamins in health and disease II
BLOCK 2: MEDICAL GENETICS
1. Principles of molecular diseases
2. Genetic pleyotrophy
3. Genetic heterogeneity (A)
4. The position effect
5. When genotype is not predictive of phenotype
6. The genetics of complex diseases
7. From Mendelian to complex diseases
8. Epigenetics and human diseases I
9. Epigenetics and human diseases II (A)
10. Pharmacogenetics and pharmacogenomics
BLOCK 3: BASIC CONCEPTS ON PATHOGENS
1. The good and bad of microorganisms
2. Prokaryotic cell structure and function (A)
3. Microbial pathogenesis
4. Mechanisms of Antimicrobial Resistance
5. Fungal structure, function, and pathogenesis
6. Basic concepts of parasitology (A)
7. Parasites of medical relevance (A)
8. Viruses: structure, genetics and evolution
9. Viruses: classification and replication properties
10. Viruses: pathogenesis of viral infections
BLOCK 4: VIROLOGY
1. RNA positive viruses I: picornaviridae
2. RNA positive viruses II: flaviviridae
3. RNA positive and negative viruses
4. RNA negative viruses I
5. RNA negative viruses II
6. Viral hepatitis I: Hepatitis A virus, Hepatitis B virus, Hepatitis D virus
7. Viral hepatitis II: Hepatitis C virus, Hepatitis E virus, Hepatitis G virus
8. DNA viruses: herpesviridae
9. DNA viruses: parvoviridae, adenoviridae, papillomaviridae
10. DNA viruses: polyomaviridae (A)
11. Retroviridae: Human immunodeficiency virus
12. Retroviridae: Human immunodeficiency virus
13. Delta retroviruses, Human endogenous retroviruses, prions (A)
BLOCK 5: MICROBIOLOGY
1. Toxigenic bacteria
2. Pyogenic bacteria
3. Spore-forming bacteria
4. Intracellular bacteria (A)
5. Granulomatous infections
6. Granulomatous infections-Part II Clinical cases
7. Bacteria infecting the gut
8. Bacteria living in the gut - Focus on microbiome
9. Microorganisms infecting the central nervous system
10. Neisseria meningitidis (A)
11. Nosocomial pathogens (A)
12. Sepsis ad Septic shock
13. Invasive fungal infections
14. Biologicals and infection risk (A)
BLOCK 6: INFLAMMATION AND INNATE IMMUNITY
1. Origin of innate immune cells: hematopoiesis (A)
2. The acute inflammatory response
3. Cell mediators of acute inflammation
4. Soluble mediators of acute inflammation
5. Leukocyte recruitment (A)
6. Pathogen recognition in innate immunity I
7. Pathogen recognition in innate immunity II (A)
8. The complement system
9. Pathogen killing
10. Immunometabolism (A)
11. Resolution of the inflammatory response
12. Tissue repair and fibrosis
13. Chronic inflammation
14. Acute phase reaction and systemic inflammation
BLOCK 7: ADAPTIVE IMMUNITY
1. From innate to adaptive immunity: basic concepts
2. Antigen processing and presentation
3. Antigen presenting cells
4. T cells development
5. Tolerance (A)
6. T cells functions
7. B cells development
8. Antibodies
9. Immune response polarization
10. Immune circuits in chronic inflammation
11. Negative regulators of the immune response (A)
12. Immunometabolism in adaptive immunity ( A)
13. Immune response memory (A)
BLOCK 8: IMMUNOPATHOLOGY
1. Immune responses to viruses
2. Immune responses to intracellular bacteria
3. Immune responses to extracellular bacteria and fungi
4. The immune system at the epithelial barriers (A)
5. The interaction between microbiome and the immune system (A)
6. Hypersensitivity reactions - part I
7. Hypersensitivity reactions - part II
8. Autoimmunity
9. Primary immunodeficiencies A
10. Acquired immunodeficiencies
11. Transplantation immunology
12. Systemic metabolism and immune response in complex diseases (A)
13. Immunosenescence
BLOCK 9: ONCOLOGY
1. Introduction to tumors
2. Distinctive features of benign, precancerous and malignant growth
3. Metabolic derangements in cancer cells
4. The genetic basis of cancer (A)
5. Sporadic and familial cancer (A)
6. Molecular basis of cancer
7. Carcinogenesis: physical and chemical agents (A)
8. Health impacts of air pollution (A)
9. Carcinogenesis: infectious agents (A)
10. Immune responses to tumors
11. CAR T cells in cancer immunotherapy (A)
12. Inflammation and cancer
13. Metabolic changes in patients with tumors (A)
14. Angiogenesis
15. Tumor angiogenesis
BLOCK 10: VASCULAR PATHOLOGY
1. Hemostasis and coagulation
2. Atherosclerosis (A)
3. Thrombotic disease (A)
4. Shock
5. Anemias (A)
BLOCK 11: BIOTECHNOLOGY APPROACHES IN TRANSLATIONAL MEDICINE
1. From somatic cells to stem cells
2. New technologies for the diagnosis and the therapies of immunologic diseases
3. From genetics to immunology: the auto-inflammatory diseases case
4. Regulation and ethics of modern technology in modern medicine
5. Flow cytometry applications in immunopathology
Teaching methods
Synchronous learning: classroom lectures, lessons by distance learning on Teams, PBL on Teams, journal clubs
Asynchronous learning: The teaching staff will provide audio-video based (pre-recoreded, multimedia platforms), text-based (e-mail, electronic documents) and e-learning material. Students will then have chance to discuss the topic with the teaching staff during scheduled forum sessions.
Asynchronous learning: The teaching staff will provide audio-video based (pre-recoreded, multimedia platforms), text-based (e-mail, electronic documents) and e-learning material. Students will then have chance to discuss the topic with the teaching staff during scheduled forum sessions.
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
· 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
Synchronous learning: classroom lectures, lessons by distance learning on Teams, PBL on Teams, journal clubs
Asynchronous learning: The teaching staff will provide audio-video based (pre-recoreded, multimedia platforms), text-based (e-mail, electronic documents) and e-learning material. Students will then have chance to discuss the topic with the teaching staff during scheduled forum sessions.
Asynchronous learning: The teaching staff will provide audio-video based (pre-recoreded, multimedia platforms), text-based (e-mail, electronic documents) and e-learning material. Students will then have chance to discuss the topic with the teaching staff during scheduled forum sessions.
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
· 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
Synchronous learning: classroom lectures, lessons by distance learning on Teams, PBL on Teams, journal clubs
Asynchronous learning: The teaching staff will provide audio-video based (pre-recoreded, multimedia platforms), text-based (e-mail, electronic documents) and e-learning material. Students will then have chance to discuss the topic with the teaching staff during scheduled forum sessions.
Asynchronous learning: The teaching staff will provide audio-video based (pre-recoreded, multimedia platforms), text-based (e-mail, electronic documents) and e-learning material. Students will then have chance to discuss the topic with the teaching staff during scheduled forum sessions.
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
· 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
Synchronous learning: classroom lectures, lessons by distance learning on Teams, PBL on Teams, journal clubs
Asynchronous learning: The teaching staff will provide audio-video based (pre-recoreded, multimedia platforms), text-based (e-mail, electronic documents) and e-learning material. Students will then have chance to discuss the topic with the teaching staff during scheduled forum sessions.
Asynchronous learning: The teaching staff will provide audio-video based (pre-recoreded, multimedia platforms), text-based (e-mail, electronic documents) and e-learning material. Students will then have chance to discuss the topic with the teaching staff during scheduled forum sessions.
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
· 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
Professor:
Riboni Laura Piera Carla Giulia
General pathology and immunology
MED/04 - EXPERIMENTAL MEDICINE AND PATHOPHYSIOLOGY - University credits: 15
Practicals: 32 hours
Lessons: 132 hours
Problem Based Learning: 24 hours
Lessons: 132 hours
Problem Based Learning: 24 hours
Genetics
MED/03 - MEDICAL GENETICS - University credits: 2
Lessons: 24 hours
Professors:
Finelli Palma, Ratti Antonia
Microbiology
MED/07 - MICROBIOLOGY AND CLINICAL MICROBIOLOGY - University credits: 6
Lessons: 72 hours
Professor(s)
Reception:
On Appointment
Istituto Clinico Humanitas, Via A. ;anzoni 113, Rozzano, Milano