B9751 - IMMUNOLOGIA (LZ)

Learning outcomes

Upon completion of the Immunology course, students will: understand the basics of the immune system as a fundamental defense mechanism for the body, including potential immunotherapeutic applications, and its alterations as a cause of disease; and be able to apply their knowledge of the basic mechanisms of the immune system and its alterations to specific pathologies.

Course contents

Introduction to the Immune System (IS): functions and characteristics of the IS; nomenclature and definitions; innate and specific immunity; cells of the immune system: lymphocytes, macrophages, granulocytes, dendritic cells, etc. Primary and secondary response.

IS organs and tissues: generative and secondary organs (bone marrow, thymus, lymph nodes, spleen, IS associated with mucous membranes). Lymphatic system and lymphocyte recirculation.

Innate immunity: physical barriers, preformed proteins, professional phagocytes, NK cells, NKT, gamma-delta lymphocytes. Mechanisms of phagocytosis and killing of pathogens. Role and receptors of NK cells (NKC, LRC). Antigen recognition mechanisms in I. innate (TLR, RIG, NLR and inflammasome). The memory of Innate Immunity: trained immunity.

Specific immunity: characteristics and functions, antigen receptors of cells of specific immunity (membrane antibodies and TCR), antigen recognition; generation of the receptor repertoire, 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 lymphocyte antigen receptor; functions in the immune response: Secreted antibodies: structure, functions, classification. Monoclonal antibodies, uses in diagnosis and therapy.

T lymphocytes: characteristics of helper (CD4+) and cytotoxic (CD8+) T lymphocytes, development, maturation and activation; structure of the T lymphocyte antigen receptor; functions in the immune response: cell-mediated immunity. Production of cytokines, Th1, Th2 lymphocytes, natural and induced Tregs. Cytotoxic action. Regional immunity: the intestinal mucous membranes. Relationships with the gut microbiota; Th17 lymphocytes. Engineered T lymphocytes: CAR-T.

Cooperation between T, B and APC cells: co-stimulation: role of accessory molecules; T-dependent and T-independent responses; suppression of the T response. Cytokines and cytokine receptors. Th1 and Th2 responses.

Tolerance: recognition and distinction 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; delayed-type hypersensitivity; activation of cytotoxic T lymphocytes.

Effector mechanisms of humoral immunity: the complement system, its functions, regulation and possible deficits.

Immunity to pathogens: extra and intra-cellular bacteria, viruses and parasites. Overview of the mechanisms of the immune system responses to pathogens and mechanisms of evasion of the immune response by pathogens. Types of vaccines and compulsory vaccinations: vaccination strategies and risk assessment.

Immunopathology: the alterations of the immune response; classification of immunopathologies; type I hypersensitivity: allergy; hypersensitivity of type II, III and IV; disruption of tolerance and autoimmune diseases: molecular mechanisms, examples and possible therapeutic approaches.

Congenital immunodeficiencies related to innate and adaptive immunity. 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.

Immunity and cancer: antigenic characteristics of tumors; capacity of the S.I. to recognize cancer cells. Immunotherapies: Monoclonal Ab, checkpoint inhibitors, CAR-T cells.

How SI Ages: Immunosenescence. Consequences of decreased immune response on susceptibility to age-associated diseases. Inflammation as an immunological driver of aging (inflammaging). Inflammatory storm and cytokine release.

Readings/Bibliography

Abbas, Lichtman, Pillai: Immunologia Cellulare e Molecolare, 2022 (decima edizione), Piccin Libraria.

Dianzani e Puccillo (a cura di): Immunologia e Immunopatologia, Edi-Ermes, 2022

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

Teaching methods

Frontal lectures with ppt presentations

Assessment methods

The final examination is designed to assess the achievement of the course learning objectives, namely the acquisition of the fundamental concepts of Immunology, Medical Genetics, Genetic Pathology, and Molecular Oncology. The examination aims to evaluate students’ ability not only to recall core knowledge but also to apply it appropriately and to integrate concepts through logical and critical reasoning.

Assessment for the Integrated Course in Immunology and Molecular Pathology consists of a written examination and an oral examination.

The written examination covers the Immunology component.

The oral examination covers the Molecular Pathology and Medical Genetics components.

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:

Immunology (5 ECTS credits)

Medical Genetics (1 ECTS credit)

Molecular Pathology: Genetic Pathology (2 ECTS credits)

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 take the exam, students must have attended at least 60% of the lectures.

The Immunology exam is in written form and consists of two parts:

- The first part includes two open-ended questions on topics covered in the syllabus. Each question contributes 10 points out of 30 to the final grade. An insufficient answer to either question (<6 out of 10) results in a failing grade for the entire paper.

- The second part consists of 40 true-or-false questions on topics covered in the syllabus. Each correct answer is worth 3/10 points; each incorrect answer carries a penalty of -1/10 points. There are 12 points available for this second part.

Further information on exam grading may be requested during the first lesson of the course. The use of paper (concept maps, summaries), electronic media, or AI is not permitted during the exam.

Students with specific learning disabilities (SLD) or temporary or permanent disabilities are encouraged to contact the University's Disability and Specific Learning Disabilities Office well in advance (https://site.unibo.it/studenti-con-disabilita-e-dsa). The Office will propose appropriate accommodations, which must be submitted to the course instructors for approval at least 15 days before the examination. Approval will be granted taking into account both the student's needs and the course learning objectives.

Final Grade Scale of the Integrated Course

Fail (<18/30): Inadequate preparation, characterized by significant gaps in knowledge and serious, repeated conceptual errors.

18–19/30: Adequate knowledge of the fundamental concepts without major deficiencies. Overall acceptable presentation and use of scientific terminology.

20–24/30: Sound knowledge of the fundamental concepts. Partial ability to analyze and integrate information independently. Clear presentation and appropriate scientific language.

25–29/30: Good to very good preparation, or excellent preparation with minor inaccuracies in presentation that prevent the highest grade. Ability to analyze and integrate concepts independently. Logical organization of concepts and good command of scientific terminology.

30–30 cum laude: Comprehensive, well-established, and accurate knowledge of all course topics. Excellent ability to frame and discuss scientific issues, analyze and integrate concepts independently, and present information clearly with complete mastery of the appropriate scientific terminology.

Teaching tools

PPT files available at https://virtuale.unibo.it portal.

Office hours

See the website of Stefano Salvioli