23276 - General Pathology and Immunology

Learning outcomes

At the end of the course, the student is able to understand the determining causes and pathogenetic mechanisms of human diseases, as well as the etiopathogenesis of the fundamental alterations of the structures, functions and control mechanisms at the various levels of integration. The student also knows the biological principles and bases on which the functioning and regulation of the immune response are based, without neglecting the pathophysiological aspects of the altered immune response in the main diseases.

Course contents

• Introduction to General Pathology. Definitions and nomenclatures.

• Environmental pathologies. Chemical pollution. Radiation, electric current and heat pathologies. Pathologies from incorrect nutrition and malnutrition or malnutrition.

• Hereditary genetic diseases. Types of transmission. Monogenic diseases; diseases from chromosomal alterations. Genetic risk factors and association with HLA. Genetic-environment interaction.

• Alterations in cell growth; hypertrophy, hypotrophy; metaplasia, anaplasia. Cell death processes: necrosis and apoptosis, pyroptosis. Cellular senescence and autophagy.

• Inflammation, definition, characteristics and symptoms. Molecular mechanisms of inflammation. Cells involved in the inflammatory process. Role in the physiological responses of the organism. Molecules that promote or extinguish inflammation: prostaglandins, leukotrienes and thromboxanes, cytokines and chemokines.

• Acute and chronic inflammations; ulcers and granulomas. Repair of tissue damage. Wound healing by first and second intention.

• Inflammation as a driver of aging (inflammaging) and as a cause of disease. The "cytokine release storm": the example of Covid-19.

• The body's immune defenses. Organs and tissues of the immune system. Innate immunity: physical barriers, preformed proteins, professional phagocytes, NK cells, other immunocompetent populations (NKT, gamma-delta lymphocytes).

• Specific immunity: characteristics and functions, cell antigen receptors of specific immunity (membrane antibodies and TCR), antigen recognition; generation of the repertoire of receptors, clonal distribution. MHC molecules and their role. B lymphocytes: characteristics of B lymphocytes; Secreted antibodies: structure, functions, classification. T lymphocytes: characteristics of helper (CD4 +) and cytotoxic (CD8 +) T lymphocytes. Tolerance: recognition and distinction between self and non-self; self tolerance. • Effector phases of the immune response. Complement; Activation of M1 and M2 macrophages; delayed-type hypersensitivity; activation of cytotoxic T lymphocytes; response to intra and extra cellular bacteria; response to viruses and parasites. Vaccines, vaccination strategies, types of vaccines.

• Immunopathology: the alterations of the immune response; classification of immunopathologies; type I hypersensitivity: allergies; hypersensitivity of type II, III and IV; disruption of tolerance and autoimmunity; congenital and acquired immunodeficiencies, HIV and AIDS. Transplant immunology: classification of transplants: auto-, allo- and xenografts; biological basis of transplant rejection; the types of rejection; GVHD;

strategies to avoid rejection: HLA typing, immunosuppressive drugs. • Tumors. Benign and malignant tumors: carcinomas and sarcomas. Oncogenesis: oncogenic and tumor suppressor genes. Cell cycle modifications. Cellular immortalization. Tumor angiogenesis, neoplastic invasiveness and metastasis.

• Cancer immunology. Carcinogenesis by chemical or physical agents. Viral carcinogenesis. Genetic and environmental risk factors. Natural history of the tumor. Gradation and staging of tumors.

• Outline of endocrine physiopathology. The main hormones, characteristics, production and function. The hormone receptors. The hypothalamus-pituitary-target glands axis. Primary and secondary hypofunctions and hyperfunctions.

• Metabolic diseases: Obesity and type I and II diabetes mellitus. Hypercholesterolemia and Atherosclerosis: molecular mechanisms and risk factors.

Readings/Bibliography

G.M. Pontieri, Elements of general pathology, 2012 (III edition), Piccin

G.M. Pontieri, Elements of general physiopathology, 2012 (III edition), Piccin M.

Parola, General Pathology and elements of Pathophysiology, 2012 (II edition), EdiSES

Lakhani, Dilly, Finlayson, Gandhi, Carolini, Del Rosso, The basics of general pathology, 2020, CEA

Teaching methods

Lectures with ppt presentations. Possibility to follow the lessons online on the Teams platform

Assessment methods

Verification of learning takes place only through the final exam, which ascertains the acquisition of the expected knowledge and skills. The evaluation of the knowledge acquired by the student is based on the administration of a single questionnaire consisting of 60 questions for the Integrated Course of Pathological Sciences, with multiple choice (4 possible choices) and one correct answer. The questions will be divided as follows: 30 questions regarding the teaching of General Pathology and Immunology and 10 questions for each of the remaining courses (Clinical Biochemistry, Clinical Pathology and General Pharmacology). The total time allowed for the exam is 50 minutes. The exam is considered positively passed starting from 36 correct answers, corresponding to the mark of 18/30.

Teaching tools

Lecture notes on general pathology by Prof. Luigi Barbieri and Enrico Strocchi (http://amsacta.unibo.it/3941/) The teaching material presented in class will be made available on https://virtuale.unibo.it/ in electronic format

Office hours

See the website of Aurelia Santoro