Generale Pathology, Immunology and Medical Microbiology
A.Y. 2024/2025
Learning objectives
The integrated course of General Pathology, Immunology and Medical Microbiology aims to train graduates in Biotechnology, Pharmaceutical curriculum, with adequate knowledge and skills on the molecular and pathological mechanisms underlying diseases and their resolution.
The General Pathology and Immunology lessons will provide students with the elements to study the mechanisms underlying the disease by looking at the therapeutic approaches in progress and development. In particular, the course will focus on etiology (cause of disease), pathogenesis (cellular and molecular mechanisms), and biological and molecular bases of infectious or non-communicable diseases. Furthermore, the course will provide basic knowledge of the mechanisms of innate and acquired immune host responses.
The Medical Microbiology lessons will provide new and deep knowledge of the structural characteristics, replicative strategies, pathogenicity mechanisms, and evolution of the main viruses of clinical interest and nosocomial bacteria (ESKAPEs). Emphasis will be given to vaccination strategies, antiviral and antimicrobial therapies, their mechanisms of action, and the mechanisms of onset of resistance to antiviral and antimicrobial drugs.
The General Pathology and Immunology lessons will provide students with the elements to study the mechanisms underlying the disease by looking at the therapeutic approaches in progress and development. In particular, the course will focus on etiology (cause of disease), pathogenesis (cellular and molecular mechanisms), and biological and molecular bases of infectious or non-communicable diseases. Furthermore, the course will provide basic knowledge of the mechanisms of innate and acquired immune host responses.
The Medical Microbiology lessons will provide new and deep knowledge of the structural characteristics, replicative strategies, pathogenicity mechanisms, and evolution of the main viruses of clinical interest and nosocomial bacteria (ESKAPEs). Emphasis will be given to vaccination strategies, antiviral and antimicrobial therapies, their mechanisms of action, and the mechanisms of onset of resistance to antiviral and antimicrobial drugs.
Expected learning outcomes
At the end of the course, the student will be able to:
- describe the main molecular and cellular mechanisms that represent the pathogenetic basis of human pathologies (cell and tissue damage, adaptation, and cell death, acute and chronic inflammation).
- describe the main molecular and cellular mechanisms at the base of the immune system, both in health conditions and during disease (hypersensitivity, autoimmune diseases).
- explain the main cellular alterations and molecular mechanisms in neoplastic, inflammatory (atherosclerosis, infections), and genetic diseases.
- illustrate the etiology, signs and symptoms, and pathogenetic mechanisms of the main respiratory system diseases
- describe the morphology and taxonomic classification of viruses of clinical interest, including viral replicative, pathogenetic and evolutionary mechanisms
- know the traditional and molecular biology techniques for the study and isolation of viral agents of clinical interest
- describe the main therapeutic and vaccination approaches used against the main viral infections and the related resistance mechanisms
- describe the taxonomy, virulence, therapeutic strategies, and resistance mechanisms of the main nosocomial bacteria (ESKAPEs)
Furthermore, students will correctly use the necessary medical/scientific terminology, will develop methods to investigate any disease, and will critically analyze scientific publications on the field.
- describe the main molecular and cellular mechanisms that represent the pathogenetic basis of human pathologies (cell and tissue damage, adaptation, and cell death, acute and chronic inflammation).
- describe the main molecular and cellular mechanisms at the base of the immune system, both in health conditions and during disease (hypersensitivity, autoimmune diseases).
- explain the main cellular alterations and molecular mechanisms in neoplastic, inflammatory (atherosclerosis, infections), and genetic diseases.
- illustrate the etiology, signs and symptoms, and pathogenetic mechanisms of the main respiratory system diseases
- describe the morphology and taxonomic classification of viruses of clinical interest, including viral replicative, pathogenetic and evolutionary mechanisms
- know the traditional and molecular biology techniques for the study and isolation of viral agents of clinical interest
- describe the main therapeutic and vaccination approaches used against the main viral infections and the related resistance mechanisms
- describe the taxonomy, virulence, therapeutic strategies, and resistance mechanisms of the main nosocomial bacteria (ESKAPEs)
Furthermore, students will correctly use the necessary medical/scientific terminology, will develop methods to investigate any disease, and will critically analyze scientific publications on the field.
Lesson period: First semester
Assessment methods: Esame
Assessment result: voto verbalizzato in trentesimi
Single course
This course can be attended as a single course.
Course syllabus and organization
Single session
Responsible
Lesson period
First semester
Course syllabus
General pathology and Immunology (7 ECTS)
- General definitions: homeostasis, signs and symptoms of diseases, extrinsic and intrinsic causes of disease
- Cellular and tissue responses to damage.
Intrinsic and extrinsic factors for acute and chronic damage; reversible effects and cellular adaptive responses (atrophy, hyperplasia, metaplasia, dysplasia); cellular aging. Accumulation disorders: steatosis, amyloidosis. Cell death (necrosis, apoptosis, pyroptosis). Autophagy
- Immunology: innate and acquired immune responses
- 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 subpopulations, 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
Recovery and tissue repair. Types of Tissue regeneration. Repair (scars and fibrosis). Angiogenesis. Mechanisms of wound healing. Pathological aspects of the repair. The role of stem cells in tissue repair.
Chronic Inflammation: general features and etiology. Histological features. Cells of chronic inflammation. Macrophages, fibroblasts. Chronic Inflammatory lesions: granulomas.
- Acquired Immunity
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, Myasthenia gravis, Celiac disease.
Physiopathology
- 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.
Other pathologies
- Genetic and congenital diseases with examples of monogenic diseases. Autosomal dominant or recessive or etherocromosomal-related diseases. with examples like familial hyperlipidemia, sickle cells anemia, thalassemia, cystic fibrosis, hemophilia A & B, and others. Chromosomal abnormalities, Down syndrome and other chromosomic diseases.
- Pathophysiology of the respiratory system: infectious diseases, asthma, chronic obstructive pulmonary disease, interstitial diseases, lung tumors
- High burden diseases related to poverty (malaria, leishmaniases)
Practical lessons (1ECTS)
Labster platform and group work
Medical Microbiology (3ECTS)
Introduction to Virology
1. Viruses: structure, genomes and replication (3h)
2. Viral transmission and pathogenesis: acute, chronic, persistent and latent infection (3h)
3. Therapies and mechanisms of resistance (3h)
Medical virology:
4. Herpesviridae & Papillomaviridae (3h)
5. Orthomixoviridae & Para/pneumomixoviridae (3h)
6. Coronaviridae e Retroviridae (3h)
7. Viral hepatitis: HBV, HAV, HCV, HDV, HEV (3h)
Nosocomial infections and superbugs:
8. ESKAPE pathogens (3h)
- General definitions: homeostasis, signs and symptoms of diseases, extrinsic and intrinsic causes of disease
- Cellular and tissue responses to damage.
Intrinsic and extrinsic factors for acute and chronic damage; reversible effects and cellular adaptive responses (atrophy, hyperplasia, metaplasia, dysplasia); cellular aging. Accumulation disorders: steatosis, amyloidosis. Cell death (necrosis, apoptosis, pyroptosis). Autophagy
- Immunology: innate and acquired immune responses
- 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 subpopulations, 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
Recovery and tissue repair. Types of Tissue regeneration. Repair (scars and fibrosis). Angiogenesis. Mechanisms of wound healing. Pathological aspects of the repair. The role of stem cells in tissue repair.
Chronic Inflammation: general features and etiology. Histological features. Cells of chronic inflammation. Macrophages, fibroblasts. Chronic Inflammatory lesions: granulomas.
- Acquired Immunity
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, Myasthenia gravis, Celiac disease.
Physiopathology
- 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.
Other pathologies
- Genetic and congenital diseases with examples of monogenic diseases. Autosomal dominant or recessive or etherocromosomal-related diseases. with examples like familial hyperlipidemia, sickle cells anemia, thalassemia, cystic fibrosis, hemophilia A & B, and others. Chromosomal abnormalities, Down syndrome and other chromosomic diseases.
- Pathophysiology of the respiratory system: infectious diseases, asthma, chronic obstructive pulmonary disease, interstitial diseases, lung tumors
- High burden diseases related to poverty (malaria, leishmaniases)
Practical lessons (1ECTS)
Labster platform and group work
Medical Microbiology (3ECTS)
Introduction to Virology
1. Viruses: structure, genomes and replication (3h)
2. Viral transmission and pathogenesis: acute, chronic, persistent and latent infection (3h)
3. Therapies and mechanisms of resistance (3h)
Medical virology:
4. Herpesviridae & Papillomaviridae (3h)
5. Orthomixoviridae & Para/pneumomixoviridae (3h)
6. Coronaviridae e Retroviridae (3h)
7. Viral hepatitis: HBV, HAV, HCV, HDV, HEV (3h)
Nosocomial infections and superbugs:
8. ESKAPE pathogens (3h)
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 must pass first the exams of Biochemistry, Human physiology with anatomy and General Microbiology, as indicated in the Manifesto degli Studi.
Teaching methods
The part 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 specific subjects. Power point presentations or short videos are usually used and are provided to the students in the Moodle 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 microscopy 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 part of Medical Microbiology consists of 3 CFU (24h) of lectures given by the Professor of the Course and occasionally seminars by external experts on specific subjects. Power point presentations are usually used and are provided to the students in the Ariel site of the course.
The part of Medical Microbiology consists of 3 CFU (24h) of lectures given by the Professor of the Course and occasionally seminars by external experts on specific subjects. Power point presentations are usually used and are provided to the students in the Ariel site of the course.
Teaching Resources
All the material and slides will be provided by the teachers on the MyAriel web site
Books:
General pathology and Immunology
1. Fabio Celotti. Patologia generale e fisiopatologia, II Ed, EdiSES. 2013 under revision and with on line update
2. Pontieri GM Elementi di Patologia generale & Fisiopatologia generale, IV Ed Piccin 2018
3. RUBIN Patologia generale - l'essenziale, PICCIN 2015
4. Abbas AK. et al Le basi dell'Immunologia EDRA 2017
Medical Microbiology
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
Books:
General pathology and Immunology
1. Fabio Celotti. Patologia generale e fisiopatologia, II Ed, EdiSES. 2013 under revision and with on line update
2. Pontieri GM Elementi di Patologia generale & Fisiopatologia generale, IV Ed Piccin 2018
3. RUBIN Patologia generale - l'essenziale, PICCIN 2015
4. Abbas AK. et al Le basi dell'Immunologia EDRA 2017
Medical Microbiology
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
Assessment methods and Criteria
At the end of the course the students will take a written test.
For the Pathology-Immunology part, the written test consists in brief answers to 4 open questions randomly chosen for each student among a list of approximately 120 questions which cover 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 MyAriel web site. A score from 0 to 5 is assigned to each answer.
For the Medical Microbiology part, the written test consists in 20 multiple-choice questions regarding all the subjects of the program. A score of 0.5 is assigned to each right answer; zero point is assigned to each wrong or missing answer.
Each student has 15 min/answer for open questions, and 30 minutes for the multiple-choice questions; therefore, the total length of the written test is 90 minutes.
To pass the exam, the total score must be equal or greater than 18/30. The student must answer to all the open questions and to at least 5 multiple 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.
For the Pathology-Immunology part, the written test consists in brief answers to 4 open questions randomly chosen for each student among a list of approximately 120 questions which cover 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 MyAriel web site. A score from 0 to 5 is assigned to each answer.
For the Medical Microbiology part, the written test consists in 20 multiple-choice questions regarding all the subjects of the program. A score of 0.5 is assigned to each right answer; zero point is assigned to each wrong or missing answer.
Each student has 15 min/answer for open questions, and 30 minutes for the multiple-choice questions; therefore, the total length of the written test is 90 minutes.
To pass the exam, the total score must be equal or greater than 18/30. The student must answer to all the open questions and to at least 5 multiple 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.
MED/04 - EXPERIMENTAL MEDICINE AND PATHOPHYSIOLOGY - University credits: 8
MED/07 - MICROBIOLOGY AND CLINICAL MICROBIOLOGY - University credits: 3
MED/07 - MICROBIOLOGY AND CLINICAL MICROBIOLOGY - University credits: 3
Practicals: 8 hours
Single bench laboratory practical: 8 hours
Lessons: 80 hours
Single bench laboratory practical: 8 hours
Lessons: 80 hours
Shifts:
Professors:
Alteri Claudia, D'Alessandro Sarah
Turno 1
Professor:
D'Alessandro SarahTurno 2
Professor:
Calvo Alvarez EstefaniaTurno 3
Professor:
Calvo Alvarez EstefaniaTurno 4
Professor:
Calvo Alvarez EstefaniaProfessor(s)
Reception:
Available on Teams and in presence, day and time to be agreed upon via e-mail
Teams or in presence
Reception:
to be defined
via Carlo Pascal, 36 - 20133 MILANO