B9751 - IMMUNOLOGIA (AK)

Learning outcomes

Upon completion of the Immunology course, students will have acquired a solid understanding of the immune system as a fundamental defense mechanism of the human body, including its potential applications in immunotherapy, as well as of immune system dysfunctions as causes of disease. They will be able to apply their knowledge of the basic mechanisms of the immune system and their alterations to the understanding of specific pathological conditions.

Course contents

This course is integrated with the courses in Molecular Pathology (Proff. Paolo Garagnani e Giulia Gallerani)) and Medical Genetics (Prof. Elena Bonora).

The Immunology course consists of the following topics:

• Introduction to the Immune System (IS): functions and characteristics of the SI; nomenclature and definitions; innate and specific immunity; immune system cells: lymphocytes, macrophages, granulocytes, dendritic cells, etc. Primary and secondary response.
• IS organs and tissues: generative and secondary organs (bone marrow, thymus, lymph nodes, spleen, SI associated with mucosae and membranes). Lymphatic system and lymphocyte recirculation.
• Innate immunity: physical barriers, preformed proteins, professional phagocytes, NK, NKT cells, gamma-delta lymphocytes. Mechanisms of phagocytosis and killing of pathogens. Role and receptors of NK cells (NKC, LRC). Mechanisms of antigen recognition in innate immunity (TLR, RIG, NLR and inflammasome). The memory of Innate Immunity: trained immunity.
• Specific/Adaptive immunity: characteristics and functions, cell antigen receptors of the specific immunity (membrane antibodies and TCR), antigen recognition; generation of the repertoire of receptors, somatic recombination, clonal distribution. MHC molecules, antigen processing and presentation; proteasome and immunoproteasome. Dendritic cells.
• B lymphocytes: characteristics of B lymphocytes, development, maturation and activation; structure of the B cell antigen receptor; role in the immune response: secreted antibodies: functions, classification. Monoclonal antibodies, uses in diagnosis and therapy.
• T lymphocytes: characteristics of helper (CD4 +) and cytotoxic (CD8 +) T lymphocytes, development and activation; structure of the antigen receptor of T lymphocytes; functions in the immune response: cell-mediated immunity. Production of cytokines, Th1, Th2, innate and induced Treg lymphocytes. T cell suppression and T CD8+ cytotoxicity. Regional immunity: the intestinal mucous membranes. Relations with the intestinal microbiota; Th17 lymphocytes. Engineered T lymphocytes: CAR-T cells.
• Cooperation among T, B and APC cells: costimulation; the role of accessory molecules; T-dependent and T-independent responses.
• Cytokines and Cytokine Receptors.

• Tolerance: discrimination between self and non-self; self-tolerance. Mechanisms of central tolerance and peripheral tolerance (anergy, deletion, suppression).
• Effector phases of the immune response: Activation of M1 and M2 macrophages; activation of helper and cytotoxic T lymphocytes, germinal center reaction.
• Completion of effector mechanisms of humoral immunity: complement, its regulation and possible deficits.
• Immunity to pathogens: extra and intra-cellular bacteria, viruses and parasites.Overview of the mechanisms of the immune system to eliminate pathogens and mechanisms of evasion of the immune response by the pathogens themselves. Types of vaccines and vaccination strategies and risk assessment.
• Immunopathology: alterations of the immune response; classification of immunopathologies; type I hypersensitivity: allergies; hypersensitivity types II, III and IV; breakdown of tolerance and distinct autoimmune diseases in types II-III-IV.
• Congenital immunodeficiencies relating to innate and adaptive immunity. Acquired immunodeficiencies: HIV and AIDS.
• Transplant immunology: classification of transplants: auto-, allo- and xenotransplants; biological basis of transplant rejection; types of rejection; GVHD; strategies to avoid rejection: HLA typing, immunosuppressive drugs Immunity and cancer: antigenic characteristics of tumors; ability of the IS to recognize cancer cells.
• Immunotherapies: Monoclonal Abs, CAR-T cells.
• How the IS ages: immunosenescence. Consequences of decreased immune response on susceptibility to aging-associated diseases. Inflammation as an immunological driver of aging (inflammaging).

Readings/Bibliography

Immunologia e Immunopatologia (Umberto Dianzani et al.). Edi-Ermes. 2022

Abbas, Lichtman, Pillai, Immunologia Cellulare e Molecolare, 2018 (decima edizione), Ed. Elsevier-Masson.

Geha, Notarangelo: Casi Studio in Immunologia, 2019 (settima edizione), Piccin

Amadori e Zanovello, Lezioni di immunologia e immunopatologia – 2020, Piccin Editore

Janeway, Immunobiologia, 2019 (nona edizione), Ed. Piccin-Nuova Libraria.

Teaching methods

Teaching is delivered through face-to-face lectures supported by PowerPoint presentations and selected short videos. The instructors will also use the Wooclap platform to promote active student participation and interaction during class.

In the event of emergencies affecting on-campus teaching, lectures may be delivered online via the Microsoft Teams platform.

Assessment methods

Assessment for the Integrated Course in Immunology and Molecular Pathology consists of a written examination and an oral examination, respectively. In particular, the written examination covers the Immunology component and the oral examination covers the Molecular Pathology and Medical Genetics components.

The use of AI is not allowed during exams. Any use constitutes a violation of academic integrity.

The two examinations may be taken in separate examination sessions. A passing grade (≥18/30) obtained in either examination remains valid for one calendar year.

To pass the integrated course, students must obtain a passing grade in each of the following components:

1. Immunology (5 ECTS credits)
2. Medical Genetics (1 ECTS credit)
3. Molecular Pathology: Genetic Pathology (2 ECTS credits)
4. Molecular Oncology (3 ECTS credits)

The final grade is calculated as the weighted average (based on ECTS credits) of the four component grades. A grade of 30 in all four components results in a final grade of 30 with honors (30 cum laude).

To be eligible to take the examination, students must attend at least 60% of the scheduled lectures. Students who do not meet this attendance requirement will be required to complete additional supervised study activities assigned and monitored by the course instructor.

The Immunology assignment  consists of two parts, both of which must be completed:

- the first part consists of two free-answer questions on themes of the Course. Every question can contribute to the final mark with 10 points out of 30. Insufficient answer (<6 out of 10) to one of these questions leads to test failure with no further evaluation of the second part.

- the second part consists of 40 quiz of the type "true-or-false" on themes of the Course. Every correct answer contributes with 3/10 points, every wrong answer leads to a penalty of -1/10. The total points available for this parts are 12.

Further information on exam evaluation can be required during the first lesson of the Course.

In case of a National or local emergency:

the exams are given online with the Microsoft Teams platform in oral form until new provisions. Students must register as usual in Almaesami, and they will receive an e-mail with the link and timetable of the exam session.

The aim of the oral exam is to evaluate the knowledge of the student on the course's topics and the capability to perform logical connections.

Grading procedure:

- knowledge of a very limited number of topics and limited analytical capacity → 18-19 out of 30;

- knowledge of a limited number of topics and basic analytical capacity → 20-24 out of 30;

- knowledge of a consistent number of topics and good analytical capacity → 25-29 out of 30;

- knowledge of all topics and very good analytical capacity → 30-30L out of 30.

Students with learning disorders and\or temporary or permanent disabilities: please, contact the office responsible (https://site.unibo.it/studenti-con-disabilita-e-dsa/en/for-students) as soon as possible so that they can propose acceptable adjustments. The request for adaptation must be submitted in advance (15 days before the exam date) to the lecturer, who will assess the appropriateness of the adjustments, taking into account the teaching objectives.

Teaching tools

The primary teaching resource consists of lecture slides presenting the key concepts and essential content that students are expected to master. The lecture slides will be made available through the VIRTUALE online learning platform.

In addition, students are required to watch 38 educational videos/short films, accompanied by self-assessment quizzes (available in both English and Italian), covering the fundamental concepts emphasized during the face-to-face lectures. These learning materials will be permanently available on VIRTUALE.

Students are also required to access and/or download the supporting teaching materials from the platform. Completion of these activities will be monitored by the course instructor.

Office hours

See the website of Miriam Capri