Combined Bachelor's + Master's degree in Dentistry and Dental Prosthetics

General pathology and immunology (2016/2017)

Course code
4S02656
Credits
9
Coordinator
Stefano Ugel

Teaching is organised as follows:
Unit Credits Academic sector Period Academic staff
IMMUNOLOGIA 3 MED/04-EXPERIMENTAL MEDICINE AND PATHOPHYSIOLOGY 2° SEMESTRE Stefano Ugel
PATOLOGIA GENERALE 6 MED/04-EXPERIMENTAL MEDICINE AND PATHOPHYSIOLOGY 2° SEMESTRE Paolo Bellavite

Learning outcomes

The basic aim of the course is the acquisition of Pathology conceptual tools and science to explain the causes and mechanisms of human disease and the role of the immune system.
In particular, the objectives are:
1. To know the main factors of pathogenesis: chemical, physical and biological agents and their effects (biological damage) on living matter, on cells and tissues.
2. To know the reactions that are crucial to biological damage in acute and chronic pathophysiological processes, with particular reference to the mechanisms of inflammation, hemostasis and wound healing.
3. To know the etiology of the most common genetic diseases, congenital and acquired, with particular reference to the degenerative diseases of the blood vessels, to coagulopathies and cancer. Insights on oral diseases and the relationship between diseases and systemic diseases to dentistry.
4. To acquire the basic knowledge of of the fundamental biological mechanisms regulating the immune system functions
5. To acquire knowledge of scientific terms and language that are used in pathology for the purpose of
effective communication with other health care professionals.

Syllabus

INTRODUCTION.
In the issue of the state of health and disease concept. Etiology and Pathogenesis. Framework pathophysiology. Evolution of the disease. Acute and chronic diseases. Overview of the disease factors: endogenous and exogenous, physical, chemical, biological, lifestyle, excess and deficiency of nutrition and essential elements.
Pathology of various grades of complexity of molecular, cellular, systemic levels. Understanding the signs, symptoms and biochemical abnormalities. Concept of syndrome.
ETIOLOGY OF THE ENDOGENOUS FACTORS OF DISEASE.
Genetic origin of diseases. Mutations and abnormal karyotype. Biochemical mechanisms of genetic errors of metabolism. Submission of genetic diseases. Concept of family tree. Multifactorial and epigenetic inheritance.
The main human genetic diseases and notes on their molecular basis (eg .: cystic fibrosis, hemophilia, von Willebrand disease, Down, Klinefelter, Turner). Congenital pathology and teratogenicity. Introduction to methods for karyotype analysis, genome and transcriptome.
ETIOLOGY OF ENVIRONMENTAL DISEASE.
Physical causes of disease: radiation, high andlow temperatures, electricity. Chemical causes Disease: acids and alkalis, solvents, plant and animal poisons, toxic pollutants. Cigarette smoke.Mechanisms of action of bacterial toxins. Damage virus (general concepts of viral replication and cell damage). The oxygen in the pathogenesis of the disease. Sources of free radicals. Pathology of free radicals and lipid peroxidation.
REGRESSIVE PROCESSES OF CELLULAR AND EXTRACELLULAR MATRIX.
Cell death "accidental" and "programmed". The importance of calcium and excitotoxicity. The "stress" of the cell.
Steatosis, thesaurismoses. Amyloidosis. Pathology of collagen and elastin (fundamentals). Damage from hypoxia and defects of cellular respiration.
INFLAMMATION: GENERALITIES AND REGULATION.
Control of the microcirculation. Hyperemia. Exudate. Wheal. Edema. Ascites. Mediators of acute inflammation. Mast-
cells and basophils. Complement system. Kinins. Substance P, inflammation and pain. Role of coagulation and fibrinolysis in the inflammation.
CELLS OF INFLAMMATION.
Blood count. Leukocyte formula and functions of various cell types. Polymorphonuclear leukocytes. Structure and main functions. Leucocytosis and leucopeniae. Chemotaxis. Phagocytosis, killing of bacteria. Abscess. Phlegmon. Septicemia. Empyema. Pustule.Notes on the evaluation of the function of leukocytes and defects of biological defenses. Participation of leukocytes to inflammation. Prostaglandins and other mediators produced by leukocytes.General signs of inflammation. Fever. The "acute phase". Systemic effects of periodontitis.
CHRONIC INFLAMMATION
Mononuclear phagocytes. Inflammation and cell infiltration. Granulomas. Giant cells, epithelioid cellS. Mediators of chronic inflammation.Wound healing and repair processes. Fibrosis and sclerosis. The macrophage as antigen presenting cell (connection with immunology). Neuroimmunoendocrino concept of balance in relation to inflammation and stress response.
IMMUNOLOGY.
Anatomy, citology, biochemistry and genetics of the immune systemlymphoid organs, cells (lymphocytes, dendritic cells, macrophages, granulocytes) molecules (Immunoglobulins, T cell receptor, MHC and co-stimulatory molecules). Antigen-antibody reaction. Antigen processing and presentaiton. Cell-mediated and humoral response. Cytokines and cell cooperation. The complement system. The nasopharyngeal and oral immune system. Immunological techniques.
VASCULAR DISEASE AND HEMOSTASIS PATHOLOGY.
The hemostatic process. Structure and function of platelets. Vascular wall and control of blood fluidity. Recovery schema of blood clotting. Outline the main test for the evaluation of hemostasis. Bleeding: general etiopathogenesis. Defects that can lead to increased risk of bleeding. Pathophysiology of blood pressure. Various types of shock. Basic features of the framework of shock. Hemorrhagic shock with reference to other shocks.
Atherosclerosis. Atherosclerosis. Risk factors and pathogenic mechanisms.thrombosis. Embolism. Ischemia and infarction.
ONCOLOGY GENERALITIES
Regulation of cell growth. Receptors, transduction systems, genes involved.Disorders of cell growth than tumors.
Benign and malignant tumors. An outline of the nomenclature and classification of tumors. The natural history of cancer (initiation, promotion, progression). Molecular basis: oncogenes and anti-oncogenes. The invasiveness of cancer cells and metastasis. Carcinogenesis chemical, physical and viral. Epigenetics and cancer.

Assessment methods and criteria

Multiple choice test and tests with open answers. If necessary in accordance with the student we can carry out the interview.

Reference books
Author Title Publisher Year ISBN Note
Abul K. Abbas, Andrew H. Lichtman and Shiv Pillai Le basi dell' immunologia (Fisiopatologia del sistema immunitario) (Edizione 5) Edra LSWR S.p.A. 2014 978-88-214-4255-1




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