9797199 - DISEASE ONSET 1
Modulo General pathology and immunology

Subject

Learning outcomes

General pathology and immunology

By the end of the course, students will learn how cells respond and adapt to various conditions, including stress and injury, and the different types of cell death. Students will also learn about the main features of cancer cells, such as sustained growth, evasion of growth controls, and resistance to cell death.

Students will gain knowledge of the basic function of the immune system, the differences between innate and adaptive immune responses, and the roles of key immune cells.

Microbiology

The course aims to provide the student with the cognitive and methodological tools necessary to understand:

1) The mechanisms of infection in the host of microorganisms and parasites.

2) The essential biological characteristics of the microorganisms responsible for human infections.

3) The etiopathogenetic mechanisms.

4) Microorganisms responsible for human infections

5) Diagnostic assessment (outline) and in vitro sensitivity test

In particular, with reference to the objectives of learning, the essential biological characteristics of microorganisms and parasites responsible for human infections, the student must be able to:

i)                 Identify the different types of relationship that microorganisms   can determine with the host, differentiating colonization from disease;

ii)               Correlate the mechanisms of aggression of microorganisms and parasites with the various "types" of infection and induced pathological lesions;

iii)              Analyzing the critical factors that determine the contagion and spread of microorganisms and parasites, correlating them with the relative peculiar biological characteristics;

iv)              Define the vaccines used in infectious diseases (vaccine prophylaxis / vaccinotherapy); Define immune sera (seroprophylaxis and serotherapy) correlating it with the prevention of human infections and with the treatment of an infectious disease; traditional vaccines and recombinant vaccines, listing those currently in use.

By the end of the course, students will have gained knowledge of the basic host pathogen interactions.

Principles of anatomopathology

By the end of the course, students will learn:

•              management of histo-cytopathological samples and the correct methods of conservation techniques.

•              basic knowledge of human pathology, with particular reference to cellular, morphological, immunophenotypic and molecular alterations of inflammatory, immune and neoplastic diseases.

Subject

Course format

General pathology and immunology

The teaching will primarily be conducted through in-person lectures with a blend of theory and practical exercises. In the event that teaching is delivered in a blended or remote mode, necessary adjustments may be introduced compared to what has been previously stated, in order to adhere to the planned program as outlined in the Syllabus.

Microbiology

Principles of anatomopathology

Subject

Prerequisites

General pathology and immunology

Basic notions of Biology, Genetics, Biochemistry and Molecular Biology.

Microbiology

Basic notions of Biology, Genetics, Biochemistry and Molecular Biology.

Principles of anatomopathology

Basic notions of Biology, Genetics, Biochemistry and Molecular Biology.

Subject

Attendance

General pathology and immunology

Mandatory attendance.

Microbiology

Principles of anatomopathology

Subject

Course contents

General pathology and immunology

GENERAL PATHOLOGY

·        Cellular Adaptations. Hypertrophy, Hyperplasia, Atrophy, Metaplasia.

·        Cell Injury and Death. Necrosis, Apoptosis, Pyroptosis, Other types of cell death.

·        Natural History of The Tumor. Initiation; Promotion and Progression.

·        Sustained Proliferative Signaling and Evasion to Growth Suppressors in Cancer

·        Cancer cell Immortalization. Resistance to Cell Death.

·        Tumor Angiogenesis.

·        Molecular mechanisms of cancer-associated cachexia

·        Main concepts on pre-clinical and clinical studies

IMMUNOLOGY

·        General Characteristics of Immune Responses. The Concepts of Antigen and Antibody.

·        The Primary and Secondary Response to an Antigen.

·        Cells Involved in Innate and Adaptive Immune Responses. Antigen-Presenting Cells (APC). Macrophages. Natural Killer Cells. T And B Lymphocytes.

·        The Complement System

·        The Major Histocompatibility Complex. Class I And II MHC.

·        Cytokines and Cytokine Receptors.

·        T Lymphocyte Receptor (TCR) And B Lymphocyte Receptor (BCR).

·        Activation and Polarization of T Lymphocytes.

·        Immunological Memory

Microbiology

1. Bacteria, virus and fungi of medical interest: Morphological characteristics, structure and function of the main structural components; biofilms, notions of biochemistry, physiology and microbial genetics; organization of viral particles

2. Pathogenesis of bacterial, viral and fungi infections: the infectious process, from adhesion to the expression of virulence, eradication, pathogenic mechanisms, toxins

3. Host-parasite relationship: extra and intracellular pathogens, host responses

4. Infection control: a) Sterilization, disinfection, anti-sepsis; b) antimicrobials, hints of action and resistance mechanisms; antibiogram and efficacy measures.

5. Immune prophylaxis: immune sera and vaccines; vaccines obtained with traditional and recombinant methods.

Principles of anatomopathology

·        Introduction to anatomopathology

·        Method of fixation of biological material using formalin.

·        Phases of preparation of a histological slide: sampling, processing, paraffin embedding, cutting, staining.

·        Intraoperative/extemporaneous examination: methods of execution, indications, examples of applicability.

·        Incisional and excisional biopsy; endoscopic biopsy.

·        Diagnostic cytology: exfoliative, needle aspiration, by apposition: applications.

·        Immunohistochemistry.

·        Molecular biology to predict prognosis and treatment

·        Necrosis and apoptosis

·        Inflammation

Subject

Textbooks

General pathology and immunology

General Pathology

·        Robbins and Cotran, Pathologic Basis of Disease, 10^th edition, Elsevier (2020)

·        Weinberg, The Biology of Cancer, 2^nd edition, Garland Science, (2014)

Immunology

·        Janeway, Immunobiology, 10^th edition, Norton & Company (2022)

Additional educational material (slides, videos, handouts, etc.) will be distributed or indicated during the lessons.

Microbiology

The most recent edition of one of these texts chosen by the student:

TEXT 1: Medical Microbiology - Murray - EDRA Edition

TEXT 2: Medical Microbiology - Sherris - EMSI Edition

TEXT 3: Principles of medical microbiology - Antonelli G., Clementi M., Pozzi G., Rossolini G.M. - Ambrosiana Publishing House

https://onlinelibrary.wiley.com/doi/book/10.1002/9780470688618

Any additional educational material (slides, videos, handouts, etc.) will be distributed or indicated during the lessons.

Principles of anatomopathology

·        Pranab Dey, Basic and Advanced Laboratory Techniques in Histopathology and Cytology, Latest edition, Springer (2022)

·        Robbins and Kumar, Basic Pathology, 11th edition, Elsevier (2022) Any additional educational material (slides, videos, handouts, etc.) will be distributed or indicated during the lessons.

Any additional educational material (slides, videos, handouts, etc.) will be distributed or indicated during the lessons.

Subject

Assessment methods

General pathology and immunology

The final assessment of acquired knowledge is conducted by a blend of written and oral examination. The grade is expressed on a scale of thirty, up to a maximum of 30/30 cum laude (with honors). The final grade is determined by the weighted average of the scores obtained in the course subjects.

The oral examination consists of an interview during which questions will cover at least three different topics from the course curriculum. The assessments aim to evaluate: i) the level of knowledge in the disciplines; ii) the ability to apply this knowledge to solve specific problems related to the disciplines (autonomous problem-solving); iii) clarity of expression; iv) proficiency in medical-scientific language. The assessment of learning can also be conducted remotely if the conditions necessitate it.

For the assignment of the final grade, the following parameters will be considered:

·        Score 29-30 with honors: The student demonstrates an in-depth knowledge of the topics, promptly and correctly integrates and critically analyzes presented situations, independently solving even highly complex problems. They possess excellent communication skills and command medical-scientific language proficiently.

·        Score 26-28: The student has a good understanding of the topics, can integrate and critically and logically analyze presented situations, can fairly independently solve complex problems, and presents topics clearly using appropriate medical-scientific language.

·        Score 22-25: The student has a fair understanding of the topics, although it may be limited to the main areas. They can integrate and critically analyze presented situations, although not always in a linear fashion, and present topics clearly with moderate language proficiency.

·        Score 18-21: The student has minimal knowledge of the topics, possesses modest ability to integrate and critically analyze presented situations, and presents topics sufficiently clearly, although their language proficiency may be underdeveloped.

·        Exam not passed: The student lacks the minimum required knowledge of the core content of the course. Their ability to use specific language is minimal or nonexistent, and they are unable to independently apply acquired knowledge.

Subject

Examples of common questions and/or exercises

General pathology and immunology

·        Differences between necrosis, apoptosis, and pyroptosis.

·        Explain the signaling pathway of the main cytokines

·        Discuss the molecular mechanisms behind the sustained proliferative signaling of cancer

·        Description of statistical approaches for the analyses of pre-clinical and clinical data

Microbiology

The Microbiology test is aimed at assessing the level of knowledge regarding the provisions of the specific training objectives, the ability to know how to apply the basic knowledge acquired to the clinic (microbiological implications) and for the resolution of specific problems concerning the relationships between the pathogen and the host 

The test takes place through an oral exam.

The oral exam consists of an interview in which 2-3 questions will be asked which concern at least n. 3 different topics of the program (bacteriology, virology and mycology). The test allows to verify: i) the level of knowledge about the main human pathogenic microorganisms; ii) the ability to apply this knowledge to define virulence and pathogenic power in human infections, as well as the main methods of controlling the infection itself; iii) clarity of presentation; iv) the property of medical-scientific language.

Principles of anatomopathology

·        Explain the differences between necrosis and apoptosis

·        Types of histological and cytological examination.

·        Immunohistochemical profile of mesenchymal neoplasm

·        Describe the applications of excisional biopsy