39305 - Applied Medical Biochemistry

Learning outcomes

The student will be able to acquire knowledge on analytical procedures and on the interpretation of biochemical profiles and serum markers in the main biological fluids. The student will be able to understand the meaning of a biochemical-clinical profile for the maintenance of the state of health or for the evaluation of a specific pathological condition. At the end of the course the student will also acquire the knowledge to understand the role that a healthy lifestyle plays in the modification of biochemical-clinical parameters and in the prevention of pathologies.

Course contents

Program:

1. PRE-ANALYTICAL and ANALYTICAL PHASE: from taking the biological sample to the report. Collection, handling and storage of the biological sample. Main interferents in a blood sample. Concepts of analytical performance. Methodological errors. Concepts of false positive and negative. Reference values and biological variability. 1.1. Main techniques used in clinical biochemistry. Deepening of spectrophotometric, immunochemical and electrophoretic techniques.

1.2. Dosages of enzymatic activity. Continuous, discontinuous, direct, indirect and coupled methods. Lactate test and sports activity.

2. BLOOD

2.1. Composition and main blood cells

2.2. Plasma and serum

2.3. Complete blood count. Main analytical parameters and their clinical significance.

2.4. Doping test for erythropoietin

2.5. Blood test and pathological pictures. The iron cycle. Importance of nutrition in anemias. Main anemias associated with sporting activity.

2.6. Alterations of haemocrocytometric parameters in athletes.

3. URINE

3.1. Composition and main components

3.2. Urine analysis. Physical, chemical characteristics and examination of the sediment. Test strips for semi-quantitative analysis of urine. Pathophysiological conditions associated with alterations in analytical parameters.

3.3. Urine analysis and doping

3.4. Urine test and biological passport

4. BIOCHEMICAL PROFILES of clinical relevance

4.1. Carbohydrate profile. Glucose metabolism and hormonal regulation. Diabetes mellitus. Glycated hemoglobin and glycemic curve. Enzyme dosage methods and operation of portable glucose meters.

4.2. Protein profile. Plasma proteins and their functions. Albumin, complement proteins and acute phase proteins. Pre-albumin and nutritional status. Protidogram and pathological states.

4.3. Lipid profile. Plasma lipoproteins: production and main functions. Oxysterols, phytosterols and essential fatty acids. Enzymatic assay of cholesterol.

5. ENZYMATIC and BIOCHEMICAL PROFILES of ORGANS and EQUIPMENT

5.1. Enzymes and Isoenzymes. Brief review of the functioning of an enzyme and hints of enzymatic kinetics. Use of enzymes in clinical biochemistry. Possible interferents of an enzyme assay. Definition of isoenzyme. Enzymatic profiles.

5.2. Dosage of enzymes for diagnostic purposes. Description of the main enzymes used in diagnostics, evaluation of their clinical significance and description of the method of assaying the enzymatic activity and for the evaluation of the related isoforms. Lactic dehydrogenase, creatine kinase, aminotransferase, alkaline phosphatase, acetylcholinesterase. Enzymes and muscle activity.

5.3. Cardiac profile. Myocardial infarction and atherosclerotic plaque. Main diagnostic markers. Myoglobin and troponins. Enzymatic profile. Heart failure and decompensation: main biomarkers. Influence of lifestyle. Sports and cardiac markers.

5.4. Liver and pancreatic profile. Hints of liver function. Liver damage markers: cytolysis markers, cholestasis markers, protidosynthesis markers and conjugation markers. Enzymatic profiles and clinical significance. Evaluation of transaminases in sports. Pancreatic profile: amylase and lipase. Pancreatic enzymes and nutrition.

5.5. Biochemical profiles in bone and muscle pathologies. Brief hints of bone biology and calcium regulation. Bone markers and bone pathologies associated with vitamin D deficiency. Muscle enzymatic profile and clinical significance.

6. TUMOR MARKERS. Personalized medicine. Tumorigenesis. Concept of oncogenes and tumor suppressors. Characteristics of tumor markers and description of the main tumor markers in diagnostics. Concept of liquid biopsy and circulating markers. Physical activity and lifestyles in the prevention and treatment of cancer.

7. LABORATORY MEDICINE and LIFESTYLES. Importance of lifestyles for the prevention of chronic diseases: diabetes, cardiovascular disease and osteoporosis. Irisin, the sport hormone: possible therapeutic implications.

PRACTICAL EXERCISES IN THE BIOLOGICAL LABORATORY (8h, only for the LM course in Human Nutrition)

• Operation and preparation of a biological hood (video + practice)

• Work in sterile conditions (vieo + practice)

• Practical learning of the use of the automatic pipettor (video + practice)

• Practical learning of the use of micropipettes (video + practice)

• Operation of a portable blood glucose meter with strip for blood glucose measurement

• Operation of a portable instrument for the measurement of lactate by means of strips

• Semi-quantitative multi-parametric analysis of the chemical characteristics of a urine sample using reactive strips

• Semi-quantitative analysis of ketone bodies (acetate) present in a urine sample through mono-parametric reactive strips

• Quantitative measurement of the concentration of lactate in various biological samples by building a calibration curve by using a 'standard' with a known concentration. Colorimetric analysis and reading via a multiplate reader at a specific wavelength. Construction of the calibration curve using an Excel spreadsheet and interpolation of the absorbance data of the unknown sample (urine or tumor cell culture medium) for the determination of the lactate concentration in the unknown sample, taking into account the dilution factor.

Readings/Bibliography

Biochimica Clinica Essenziale. E. Albi. Zanichelli.

Biochimica Clinica di Laboratorio. M. Ciaccio. Edises.

Power point of theoretical lessons.

Teaching methods

Frontal lessons. Practical exercises (biological laboratory).

Assessment methods

Oral exam.

Teaching tools

The teacher participates in the Integrative Digital Education program. All the contents shown in class, together with other general information, are available in advance on the Virtual platform. The recording of the lessons will be made available through the Panopto and Virtual platform.

Office hours

See the website of Francesca Fornari