Generale Pathology, Immunology and Medical Microbiology

A.Y. 2021/2022
11
Max ECTS
96
Overall hours
SSD
MED/04 MED/07
Language
Italian
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 main aim of the course in medical microbiology is to provide new and deep knowledge on structure, replication, mechanisms of pathogenesis, diagnostic procedures and therapy of viruses, bacteria and parasites of medical interest.
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. At the end of the course, the students will be able to recognize the structure, genomic organization, replication and pathogenesis of the most common viruses, bacteria and parasites which cause diseases in the human population. The students will be able to recognize for each pathogen prevention strategies/cure models/treatment and diagnostic procedures. Moreover, they will develop methods to investigate any disease and to critically analyze scientific publications on the field.
Course syllabus and organization

Single session

Responsible
Lesson period
First semester
More specific information on the mode of delivery of the training activities for the Academic year 2021/22 will be provided over the coming months depending on the evolution of the public health situation
Course syllabus
UD of General pathology and Immunology
Immunology and Immunopathology (3.5 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, IL6. 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 functions 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. identification of Immune check-points.
Role of stimulatory or suppressive cytokines in T lymphocyte activation.
Immuno-prophylaxis. 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 (3.5 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)
Oncology
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.

Atherosclerosis: formation, growth and development of atherosclerotic plaque; risk factors for atherosclerosis. Thrombosis,
metabolic syndrome, hypertension.
Genetic and congenital diseases with examples of monogenic diseases
Chromosomal abnormalities, Down syndrome
Autosomal dominant or recessive or etherocromosomal-related diseases. with examples like familial hyperlipidemia, sickle cells anemia, thalassemia, cystic fibrosis, hemophilia A & B, and others
High burden diseases related to poverty ( malaria, laishmania)
Physio-pathology of cardiovascular diseases (brief introduction)

Module of Medical Microbiology
Introduction to Virology
1. Viruses: structure, genomes and replication (2h)
2. Viral transmission and pathogenesis: acute, chronic, persistent and latent infection (2h)
3.Antiviral therapies and resistance mechanisms (2h)
Medical virology:
4. Herpesviridae & Papillomaviridae (2h)
5. Togaviridae & Flaviviridae - Arboviruses (2h)
6. Coronaviridae (2h)
7. Orthomixoviridae & Paramixoviridae (2h)
8. Coronaviridae & Retroviridae: history of pandemics (2h)
9. Viral hepatitis: HBV, HAV, HCV, HDV, HEV (2h)
Nosocomial infections and superbugs:
10. Enterobacteriaceae: E.coli, Enterobacter, Klebsiella Pneumonia, Shigella, Salmonella (2h)
11. Micobacterium tuberculosis and NTM (2h)
12. Human Microbiota: definition and role in human diseases (2h)
Prerequisites for admission
The Course of General Pathology, Immunology and Medical Microbiology is scheduled in 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
Teaching methods
The Course consists of two didactic units (UD) of General pathology and Immunology and UD of Medical Microbiology. The UD of General pathology and Immunology consists of 7 ECTS (56h) 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 teachers and part time tutors. The UD 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 are usually used and are provided to the students in the Ariel site of the course.
Teaching Resources
UD of General pathology and Immunology
Fabio Celotti. Patologia generale e fisiopatologia, II Ed, EdiSES. 2013 in revisione
Pontieri GM Elementi di Patologia generale & Fisiopatologia generale, IV Ed Piccin 2018
L. Altucci, G. Berton et al
Patologia generale Volume I 2019 Ed. Idelson-Gnocchi
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 the course.
UD di Microbiologia Medica
1. G. Antonelli, M. Clementi, G. Pozzi, G.M. Rossolini Principi di Microbiologia Medica; Casa Editrice Ambrosiana CEA
2. Murray, Rosenthal, Pfaller Microbiologia Medica. Edra
3. All the slide-shows will be available at the Ariel web site of Biotech.
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 Pathology+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.
Unità didattica: Microbiologia medica
MED/04 - EXPERIMENTAL MEDICINE AND PATHOPHYSIOLOGY - University credits: 0
MED/07 - MICROBIOLOGY AND CLINICAL MICROBIOLOGY - University credits: 0
Lessons: 24 hours
Professor: Alteri Claudia
Unità didattica: Patologia generale e immunologia
MED/04 - EXPERIMENTAL MEDICINE AND PATHOPHYSIOLOGY - University credits: 0
MED/07 - MICROBIOLOGY AND CLINICAL MICROBIOLOGY - University credits: 0
Practicals: 8 hours
Single bench laboratory practical: 8 hours
Lessons: 56 hours
Shifts:
Turno 1
Professor: D'Alessandro Sarah
Turno 2
Professor: Calvo Alvarez Estefania
Turno 3
Professor: Calvo Alvarez Estefania
Turno 4
Professor: Milione Massimo
Professor(s)
Reception:
to be defined
via Carlo Pascal, 36 - 20133 MILANO