GENERAL PATHOLOGY 1

Academic Year:

2018/2019

Accademic year of supply:

2019/2020

Course code:

608199

Year of study:

Language:

Italian

Divisions:

Degree:

Course of Single Cycle Degree 6 years in MEDICINE AND SURGERY

Credits:

Course in italian:

see details

Prerequisites

The student must know basic elements of biochemistry, biology, genetics
and phsycis, as welll as those concerning anatomy, histology and
physiology. The student should be able to describe main biochemical and
biological processes of cells and human body, transmission of genetic
diseases, physical laws underlying physiological processes, the
composition and the anatomical organization of tissues.
Students not attending lesson and working students must know the basic
elements of propedeutic topics and how to use them in order to reach
learning objectives.

Methods of Provision

Oral lessons, supported by slides that will be made available to the students.
Lessons will present the main conceptual frame of each subject, summoning questions or doubts from the audience and indicating bibliographic references for the study of the subject.
Slides are to be considered an essential, yet NOT exhaustive, didactic resource.
Some hours will be dedicated to practical training for well defined topics.

Contents

Lectures will concern five main subjects:
- CELLULAR PATHOLOGY:
INURY, ADAPTATION, AND CELL DEATH;
- MOLECULAR AND GENETIC PATHOLOGY;
- INFLAMMATION;
- TISSUE RENEWAL AND REPAIR
- NEOPLASIA;
INNATE IMMUNITY.;
ANTIGEN RECOGNITION;
DEVELOPMENT OF THE RECEPTOR REPERTOIRE;
ANTIGEN PRESENTATION TO T LYMPHOCYTES;
DEVELOPMENT AND SURVIVAL OF LYMPHOCYTES; CELL-MEDIATE IMMUNE RESPONSE;
HUMORAL IMMUNE RESPONSE;
THE MUCOSAL IMMUNE SYSTEM;
DYNAMICS OF THE INNATE AND ACQUIRED IMMUNE SYSTEMS;
- IMMUNOPATHOLOGY

Objectives

The main objective of the course in General Pathology 1 is to provide the basis for the knowledge of the underlying mechanisms related to general disease processes including: cellular alterations and inflammation, genetic disorders and tumor development.
The main objective of the course in Immunology is the comprehension of
the immune system and its components and the relative associated
diseases. In particular, the students will learn topics covering the
organization, mechanisms and regulation of innate and specific immune
system, the response against the main classes of microrganisms, and the
different pathologies associated to the immune system (I.e.,
hypersensitivity reactions, autoimmune diseases, immunodeficiencies, and transplant rejection.

Expected results and skills

The course is aimed to make the student know the basic processes by which cells and tissues respond to injury. Since these pathological processes form the basis for our modern understanding of disease, a clear understanding of each of these processes is central to the practice of medicine.

Recommended Bibliography

1) Robbins, Cotran, " Le basi patologiche delle malattie", Elsevier, Milano – Nona edizione.
2) Pontieri, Patologia generale e fisiopatologia generale. Vol. 1, VI ed., Piccin
3) Rubin R., Strayer D.S., Patologia generale (Patologia d'organo e molecolare), PICCIN - Sesta Edizione.
4) Strachan, Read, Genetica molecolare umana, UTET, Torino.
5)AK Abbas, AH Lichtman, S. Pillai, Immunologia cellulare e molecolare,
Edra, IX edizione, 2018.
6) K Murphy, Immunobiologia di Janeway, VIII edizione, Piccin-Nuova
Libraria, 2014.

Evaluation methods

Type of exam:

Oral

Verification of learning:

The final evaluation will consist in an oral examination. At each student will be administered questions concerning subjects listed in the detailed program. The verified uncapability to define correctly the subject, will prevent the successful completion of the exam. The outcome will be also negative if, during the discussion, the student will exhibit severe pitfalls, not compatible with an adequate understanding of the subject.
The proof will be oral.

Evaluation:

Final judgement

Extended Syllabus

1. INTRODUCTION TO THE STUDY OF GENERAL PATHOLOGY

2. GENETIC PATHOLOGY

Human genome and human genes. Identification of a gene causing a disease: positional and functional cloning. Alleles and polymorphisms. Mutations and their pathological meaning. Mendelian and complex inheritance. Molecular basis of dominance and recessiveness. Penetrance, expressivity and heterogeneity. Autosomal dominant disorders. Autosomal recessive disorders. Lyonization and X-linked disorders. Disorders associated with defects in structural proteins. Disorders associated with defects in receptor and transport proteins. Unstable trinucleotide diseases. Hereditary tumors.

3. CELL PATHOLOGY

Cellular responses to microenvironment changes. Causes of cell injury. Ischemic and hypoxic injury. Ischemia – reperfusion injury. Free radicals and oxidative injury. Direct and indirect chemical injury. Morphology of cell injury and necrosis. Tissue patterns of necrosis. Apoptosis. Causes of apoptosis. Morphologic and biochemical features of apoptosis. Mechanisms of apoptosis. Examples of apoptosis. Dysregulated apoptosis. Subcellular responses to injury. Stress proteins. Control of normal cell proliferation: cell – cycle components, cell surface receptors, inhibition of cell proliferation. Hyperplasia, hypertrohy, atrophy, metaplasia. Intracellular accumulations: lipids, proteins, glycogen, pigments. Amyloidosis.

4. INFLAMMATION

General features of inflammation. Receptors in innate immunity and inflammation. Exogenous and endogenous danger signals. Pro-inflammatory cytokines. Inflammasome. Acute inflammation: vascular changes and cellular events. Leucocytes and inflammation: types, chemotaxis, activation, phagocytosis, release of leucocyte products and leucocyte-induced tissue injury, defects in leucocyte function. Chemical mediators of inflammation. Preformed mediators. Plasma proteins. Neosynthesized mediators. Resolution of inflammation: lipoxins and resolvins. Morphologic patterns of acute inflammation. Outcomes of acute inflammation. Chronic inflammation: general features and causes. Cells in chronic inflammation. Granulomas. Morphologic patterns of chronic inflammation. Systemic effects of inflammation: acute phase response, Systemic Inflammatory Response Syndrome, fever.

5. TISSUE RENEWAL AND REPAIR

Healing. Regeneration. Stem cells. Extracellular matrix and cell-matrix interactions. Repair by healing, scar formation and fibrosis. Angiogenesis.Cutaneous wound healing.

6. ONCOLOGY

Definitions. Classifications of tumors.Benign and malignant tumors: general features (differentiation, rate of growth, local invasion, metastases). Epidemiology (occurrence, environmental factors, heredity). Cancer genetics. The maintenance of genomic integrity (common types of DNA damages, DNA repair systems, biological consequences of DNA damages).
Pathogenesis of tumor progression. Oncogenes. Tumor-suppressor genes. Cancer Stem Cells. Biology of tumors (angiogenesis, invasion, metastases). Causes of tumors (Chemical carcinogenesis, radiant energy, oncogenic viruses). Cancer immunology (tumor antigens, immune surveillance). Clinicalfeatures of tumors.

7. INNATE IMMUNITY.

Epithelial barriers, phagocytes, Natural Killer cells. The system of
complement. Role of interferons.

8. ANTIGEN RECOGNITION

Molecular structure of the B-cell receptor and antibodies. The T-cell
receptor and its co-receptors.

9. DEVELOPMENT OF THE RECEPTOR REPERTOIRE

Rearrangement of genes encoding for the B-cell and T-cell receptors.
Secondary diversification of the antibody repertoire.

10. ANTIGEN PRESENTATION TO T LYMPHOCYTES

Antigen processing through the immunoproteasome and the endocytic
pathways. The major histocompatibility complex. Response to
superantigens.

11. DEVELOPMENT AND SURVIVAL OF LYMPHOCYTES

Maturation of B and T lymphocytes. Positive and negative selection of T
lymphocytes in bone marrow and thymus. Maturation and survival of
lymphocytes in peripheral lymphoid tissue

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