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Medical Immunology

教学大纲

 

Syllabus for Immunology

 Credit:  6  

Total Hour:  90    (Theory Hour:60      Experiment Hour:30         )

Primary Course:Cell Biology, Histology, Genetics, Anatomy, Biochemistry, Physiology

Major:MBBS

Text Book:Textbook of Medical Immunology; Tristram G. Parslow; Secience Press, 1th edition

Give a course in CollegeSchool of Medical Science and Laboratory Medicine

一、The nature and task of the course

Immunology is one of major subjects for medical students, in which its study covers from introduction to the constitution and functions of immune system to its usage in diagnosis and treatment in clinical. In addition, as an applied discipline, immunology tightly linked with basic and clinic medicine. So, the study in this course is very helpful for students to further study other medical courses and to understand medicine better. Here, this syllabus is designed for MBBS students, and will introduce the basic contents and associated evaluation standard in immunology.

二、The essential and object of the course

Chapter 1   Fundaments of Immunology

1、Teaching Content

a. Immunity.  Innate immunity, adaptive immunity

b. Immune cells. Phagocytes, Lymphocytes, antigen presenting cells

c. Lymphoid tissue and organs. Primary lymphoid organs, secondary lymphoid tissues and organs, lymphocyte traffic and recirculation.

d. Pathological immunity and immune diseases.

  1. Teaching Object
  2. Know well: Innate immunity and adaptive immunity, lymphocytes, primary and secondary lymphoid organs.
  3. Intimately know: antigen presenting cells
  4. Know: lymphocyte traffic and recirculation, pathological immunity and immune diseases.

 

Chapter 2   Brief history and prospect of immunology.

  1. Teaching Content
  1. Empirical immunology.
  2. Scientific immunology. Discovery of pathogens and application of vaccines, Discovery and application of antibodies, cellular immunity, immune tolerance, clonal selection theory.
  3. Modern immunology. Diversity of antigen receptors, Discovery of signal transduction pathway, discovery of programmed cell death, hematogenesis and development of immune cells, immunological application.
    1. Teaching Object
      1. Know well: cellular immunity, immune tolerance, clonal selection
      2. Intimately know: discovery of pathogens and application of vaccine, diversity of antigen receptors
      3. Know: Discovery and application of antibodies, immunological application

 

Chapter 3  Antigen

1、Teaching Content

a. Properties of antigen.                                  

b. Characteristics of antigen.Specificity,foreignness.

c. Factors influencing immunogenicity.Physicochemical properties of antigens effect of host,physicochemical properties of antigens,effect of host,mode of contact.

d. Classification of antigens.TD-Ag and TI-Ag, classification based on relationship with host.

e. Non-specific stimulators.Super antigen, adjuvant, mitogen.

2、Teaching Object

Know well: antigen, TD-Ag and TI-Ag, classification based on relationship with host, Super antigen,adjuvant.

Intimately know: Specificity,foreignness, mitogen.

Know: Physicochemical properties of antigens effect of host, physicochemical properties of antigens,effect of host,mode of contact.

 

Chapter 4   Immunoglubulins

  1. Teaching Content
  1. Organization of immunoglobulins.Molecular structure of immunoglobulins,J Chain and secretory component,enzymatic digestion products of immunoglobulins
  2. Immunoglobulin classes and subclasses.Immunoglobulin classes,subclasses and types,isotypes,allotypes and idiotypes of immunoglobulins.
  3. Biological abtivities of immunoglobulins.Activities of variable regions,activities of constant regions.
  4. Biological properties and functions of immunoglobulin classes.IgG,IgA,IgM,IgD,IgE.

2、Teaching Object

Know well: Isotypes,allotypes and idiotypes of immunoglobulins, IgG,IgA,IgM,IgD,IgE.

Intimately know: Immunoglobulin classes,subclasses and types.

Know: Molecular structure of immunoglobulins,J Chain and secretory component,enzymatic digestion products of immunoglobulins, Activities of variable regions,activities of constant regions.

 

Chapter 5  The complement system

  1. Teaching Content
  1. Introduction.Component of complement system,nomenclature.
  2. Pathways of complement activation,classical pathway,the lectin pathway,terminal sequence and the membrane attack complex.
  3. Regulation of complement system activation.Self-regulator,fluid-phase regulator,solid-phase regulator.
  4. Biological consequences of complement activation.Cell lysis,opsonization andphagocytosis,viral neutralization, inflammation,regulation of cells,clearance of immune complex.

2、Teaching Object

Know well: classical pathway, Biological consequences of complement activation.

Intimately know: the lectin pathway,terminal sequence and the membrane attack complex.

Know: Component of complement system,nomenclature, Regulation of complement system activation.

 

Chapter 6   Cytokines

  1. Teaching Content
  1. Introduction.
  2. Classification and biological activities of cytokines,Interleukins,tumor necrosis factor,interferon,hematopoietic colony-stimulating factors,transforming growth factor,cheokines.
  3. Cytokin receptors.IL-1 receptor,TNF-α receptor,IL-2 receptor,chemokine receptor.
  4. Clinical application.
  1. Teaching Object

Know well: Introduction.

Intimately know: Interleukins, tumor necrosis factor,interferon, hematopoietic colony-stimulating factors,transforming growth factor,cheokines, IL-1 receptor,TNF-α receptor,IL-2 receptor,chemokine receptor.

Know: Clinical application.

 

Chapter 7  Major histocompatible complex

  1. Teaching Content
  1. Structure and genetics of MHC.Classical MHC gene complex,MHC molecules,other MHC genes.
  2. MHC polymorphism.Concept of polymorphism,linkage disequilibrium and haplotype,generation and significance of MHC polymorphism.
  3. Peptide-MHC interaction.Molecular basis,characteristics.
  4. HLA and clinical medicine.HLA and graft rejection,HLA related-diseases,HLA and diseases.
  1. Teaching Object

Know well: Classical MHC gene complex,MHC molecules,other MHC genes. Molecular basis,characteristics.

Intimately know: Concept of polymorphism,linkage disequilibrium and haplotype,generation and significance of MHC polymorphism.

Know: HLA and graft rejection,HLA related-diseases,HLA and diseases.

 

Chapter 8  Leukocyte differentiation antigens and adhesion molecules

  1. Teaching Content
  1. Leukocyte differentiation antigens.Concept of leukocyte differentiation antigens,concept of cluster of differentiation
  2. Cell adhesion molecules.Intergrin family,selection family,immunoglobulin superfamily,functions of cell adhesion molecules.
  3. Clinical application of CD molecules,Cam and monoclonal antibodies against CD molecules and cam.Elucidation of pathogenesis,diagnosis and prognosis in clinical use,prevention and trement for diseases.
  1. Teaching Object

Know well: Concept of leukocyte differentiation antigens,concept of cluster of differentiation, Cell adhesion molecules.

Intimately know: Intergrin family,selection family,immunoglobulin superfamily,functions of cell adhesion molecules.

Know: Cam and monoclonal antibodies against CD molecules and cam.Elucidation of pathogenesis,diagnosis and prognosis in clinical use,prevention and trement for diseases.

 

Chapter 9 Hematopoietic stem cells

  1. Teaching Content
  1. Origin and surface markers of hematopoietic stem cells.Origin of hematopoietic stem cells, surface markers of hematopoietic stem cells.
  2. Differentiation of hematopoietic stem cells.The factors affect differentiation of hematopoietic stem cells,development of lineage-committed progenitors.
  1. Teaching Object

Know well: Surface markers of hematopoietic stem cells,the factors affect differentiation of hematopoietic stem cells,

Intimately know: Origin of hematopoietic stem cells

Know: Development of lineage-committed progenitors.

 

Chapter 10  Cells of innate immunity

  1. Teaching Content
  1. Phase of innate immunity
  2. Cells of innate immunity.Epithelials,phagocytes,neutrophils,mononuclear phagocytes:the monocyte-macrophage system,NKcells, γ:δ Tcells,B1 B cells,NK Tcells.
  3. Receptors of innate cells.Pattern-recognition receptors,toll like receptor.
  1. Teaching Object

Know well: Cells of innate immunity, Pattern-recognition receptors,toll like receptor.

Intimately know:

Know: Phase of innate immunity

 

Chapter 11  T lymphocytes

  1. Teaching Content

a.T cell ontogeny.Stages of thymocyte development,positive and negative selection of thymocytes.

b.Surface proteins of T lymphocytes.TCR-CD3 complex,CD4 and CD8 coreceptors,costimulatory molecules,mitogen receptors.

c.T lymphocytes subsets and functions.Helper T lymphocytes,cytotoxic T lymphocytes,memory T lymphocytes,regulatory T cells.

  1. Teaching Object

Know well: Stages of thymocyte development,positive and negative selection of thymocytes. Helper T lymphocytes,cytotoxic T lymphocytes,memory T lymphocytes,regulatory T cells.

Intimately know:

Know: TCR-CD3 complex,CD4 and CD8 coreceptors,costimulatory molecules,mitogen receptors.

 

Chapter 12 B lymphocytes

  1. Teaching Content
  1. Development of B lymphocytes.The B cells development in the bone marrow, the B cells maturation in germinal centers.
  2. Surface markers of B lymphocytes.BCR complex,surrogate BCR complex,other surface markers.
  3. Subsets and functions of B lymphocytes.B1 cells and their functions,B2 cells and their functions,immune regulation.
  1. Teaching Object

Know well: BCR complex,surrogate BCR complex,other surface markers.

Intimately know: B1 cells and their functions,B2 cells and their functions,immune regulation.

Know: The B cells development in the bone marrow, the B cells maturation in germinal centers.

 

Chapter 13 Organization and diversity of antigen receptor genes

  1. Teaching Content
  1. Structure of antigen receptor genes.The gene structure of BCR, the gene structure of TCR.
  2. Rearrangement of antigen receptor genes
  3. The diversity antigen receptor genes.BCR,TCR.
  1. Teaching Object

Know well: BCR,TCR.

Intimately know: Rearrangement of antigen receptor genes.

Know: The gene structure of BCR, the gene structure of TCR.

 

Chapter 14 Innate immune response

  1. Teaching Content
  1. Components involved in innate immune response.The skin and the mucosal surfaces,immune cells involved in innate immune response,humoral proteins of innate immunity.
  2. The recognition mechanism of immune response.Pathogen associated molecular pattersn(PAMPs),pattern recognition receptor(PRR)
  3. The biological significance of innate immune response.
  1. Teaching Object

Know well: The biological significance of innate immune response.,immune cells involved in innate immune response.

Intimately know: humoral proteins of innate immunity.

Know: The skin and the mucosal surfaces. Pathogen associated molecular pattersn(PAMPs),pattern recognition receptor(PRR)

 

Chapter 15 Antigen presentation

  1. Teaching Content
  1. Antigen presenting cells.MPS,antigen presenting and presentation by dendritic cells,antigen presenting and presentation by B lymphocytes.
  2. Antigen processing and presentation.Processing of exogenous and endogenous antigens,MHC and antigen processing and presentation,CD1 related antigen presentation.
  1. Teaching Object

Know well: MPS,antigen presenting and presentation by dendritic cells,antigen presenting and presentation by B lymphocytes.

Intimately know: Processing of exogenous and endogenous antigens, MHC and antigen processing and presentation.

Know: CD1 related antigen presentation.

 

Chapter 16 T cell recognitions and response of antigens

  1. Teaching Content

a.T cell recognitions of antigens

b.Signals for T cells activation.Stimulators of  T cells activation,double signals for T cells activation.

c.Signal transduction of T cell activation.Receptor Cross-Iinking,cytoplasmic signaling by TCR.

d.Transcription factor activation and gene expression

e.Functions of effector T cells. Functions of CD4+TH1 cells, Functions of CD8+cytotoxic T cells.

  1. Teaching Object

Know well: T cell recognitions of antigens, Stimulators of  T cells activation,double signals for T cells activation. Functions of CD4+TH1 cells, Functions of CD8+cytotoxic T cells.

Intimately know: Transcription factor activation and gene expression

Know: Receptor Cross-Iinking,cytoplasmic signaling by TCR.

 

Chapter 17 B cell recognitions and response of antigens

  1. Teaching Content

a.B cell response to T cell-dependent antigen.Clonal selection and antigen recognition of B cells,signaling by BCR complex and B cell coreceptors,effects of TH cell and B cells,development and differentiation of B cells in germinal centers.

b.B cell response to T cell-independent-antigen.B cell response to type 1 of TI antigens, B cell response to type 2 of TI antigens.

c.Rules of antibody production.Immunoglobulin secretion,primary and secondary response.

d.Mucosal immune response.Mucosa-associated lymphoid tissue,secretory Ig and transcytosis.

2、 Teaching Object

Know well: Immunoglobulin secretion,primary and secondary response.

Intimately know: Effects of TH cell and B cells,development and differentiation of B cells in germinal centers. B cell response to type 1 of TI antigens, B cell response to type 2 of TI antigens. Mucosa-associated lymphoid tissue,secretory Ig and transcytosis.

Know: Clonal selection and antigen recognition of B cells, signaling by BCR complex and B cell coreceptors,

 

Chapter 18 Immunoregulation

  1. Teaching Content
  1. Role of antigen,antibody and complement.Role of antigen,role of antibody, role of complement.
  2. Role of signaling components and molecules.Role of activating signaling components and molecules, role of suppressing signaling components and molecules.
  3. Role of cells.Role of T cell subtypes, role of the idiotypic network, role of apoptosis.
  4. Neuroendocrine immune system regulation.Role of neuroendocrine system,immunoregulation among population.
  1. Teaching Object

Know well: Role of antigen,role of antibody, role of complement,role of T cell subtypes, role of apoptosis.

Intimately know: Role of activating signaling components and molecules, role of suppressing signaling components and molecules. role of the idiotypic network

Know: Role of neuroendocrine system,immunoregulation among population.

 

Chapter 19 Immune tolerance

  1. Teaching Content
  1. The development and representation of immune tolerance.Innate tolerance,acquired tolerance.
  2. Mechanisms of immune tolerance.Central tolerance,peripheral tolerance.
  3. Immune tolence and clinical medicine.Establishment and maintenance of immune tolence,abrogation of immune tolerance.
  1. Teaching Object

Know well: Central tolerance,peripheral tolerance.

Intimately know: Innate tolerance,acquired tolerance.

Know: Establishment and maintenance of immune tolence,abrogation of immune tolerance.

 

Chapter 20 Hypersensitivity

  1. Teaching Content
  1. Type Ⅰhypersensitivity.Component and cells, immune pathogenesis, Type Ⅰhypersensitivity-associated diseases,therapy for Type Ⅰhypersensitivity.
  2. TypeⅡhypersensitivity. Immune pathogenesis, typeⅡhypersensitivity -associated diseases.
  3. TypeⅢhypersensitivity. Immune pathogenesis, typeⅢhypersensitivity -associated diseases.
  4. TypeⅣhypersensitivity. Immune pathogenesis, diseases caused by delayed-type . hypersensitivity.
  1. Teaching Object

Know well: Component and cells, immune pathogenesis, Type Ⅰhypersensitivity-associated diseases, Immune pathogenesis, typeⅡhypersensitivity -associated diseases. Immune pathogenesis, typeⅢhypersensitivity -associated diseases.

Intimately know: Immune pathogenesis, diseases caused by delayed-type . hypersensitivity.

Know: Therapy for Type Ⅰhypersensitivity.

 

Chapter 21 Autoimmunity and autoimmune diseases

  1. Teaching Content
  1. Introduction.Autoimmunity,autoimmune disease,classification,characteristics.
  2. Immunologic pathogenesis and typical diseases.Autoantibodies directly mediated tissue damage, autoantibodies modulate cell function, autoantibodies form damaging immune complexes,cell mediated immunity in pathogenesis.
  3. Factors in development of autoimmune.Autoantigens,abnormal expression of Fas/Fasl,genetic factors,infections.
  4. Treatment of autoimmune disease.
  1. Teaching Object

Know well: Autoimmunity,autoimmune disease

Intimately know: Classification,characteristics, autoantibodies directly mediated tissue damage, autoantibodies modulate cell function, autoantibodies form damaging immune complexes,cell mediated immunity in pathogenesis. Autoantigens,abnormal expression of Fas/Fasl,genetic factors,infections.

Know: Treatment of autoimmune disease.

 

Chapter 22 Immunodeficiency diseases

  1. Teaching Content
  1. Introduction.
  2. Primary/Congenital immunodeficiency diseases. Congenital B cell immunodeficiency disorders, Congenital T cell/cellular immunodeficiency disorders, combined immunodeficiency disorders,complement deficiencies,phagocytic defects.
  3. Secondary immunodeficiency.HIV and AIDS.
  4. Treatment of immunodeficiency.
  1. Teaching Object

Know well: Introduction.

Intimately know: Primary/Congenital immunodeficiency diseases,secondary immunodeficiency.HIV and AIDS.,

Know: Treatment of immunodeficiency.

 

Chapter 23 Tumor immunology

  1. Teaching Content
  1. Tumor antigens.Classification by specificity of antigen, classification by origin and nature of antigen.
  2. Mechanisms of anti-tumor effects.Cellular immunity,humoral immunity.
  3. Mechanisms of tumor escape.Tumor cell-associated factors,host immune system-associated factors.
  4. Tumor immunodiagnosis
  5. Tumor immunotherapy.Cellular immunotherapy, humoral immunotherapy,tumor vaccines.
  1. Teaching Object

Know well: Tumor antigens. Classification by specificity of antigen, classification by origin and nature of antigen,mechanisms of tumor escape,

Intimately know:Mechanisms of anti-tumor effects.

Know: Tumor immunodiagnosis, tumor immunotherapy.

 

Chapter 24 transplantation immunology

  1. Teaching Content
  1. Immunogic basis of allograft rejection.Attributes of allograft rejection,target antigens of allograft rejection,cells basis of allograft rejection,recognition of alloantigens.
  2. Allograft rejection types and mechansms.HVGR,GVHR.
  3. Prevention and treatment of allograft rejection.Donor selection,immunosuppressive agents,specific tolerance to transplantation antigens.
  1. Teaching Object

Know well: cells basis of allograft rejection, donor selection,immunosuppressive agents,specific tolerance to transplantation antigens.

Intimately know: Attributes of allograft rejection,target antigens of allograft rejection, allograft rejection types and mechansms.HVGR,GVHR.

Know:

 

Chapter 25 Immunodiagnosis

1、Teaching Content

  1. Detection of antigens and antibodies.Principles of antigens-antibody reaction,detection of antigens and antibodies.
  2. Detection of cellular immunity.Lymphocyte isolation and phenotyping, lymphocyte function assays,phagocype function assays.
  3. Clinical analysis of immune system by molecular genetic techniques.Hybridization,polymerase chain reaction,genome sequencing.
  4. Application of immunologic tests.Selection and evaluation of immune-tests.

2、Teaching Object

Know well: Principles of antigens-antibody reaction,detection of antigens and antibodies, polymerase chain reaction.

Intimately know: Lymphocyte isolation and phenotyping, lymphocyte function assays,phagocype function assays.

Know: Hybridization, genome sequencing, selection and evaluation of immune-tests.

 

Chapter 26 Immunotherapy

  1. Teaching Content
  1. Definition and classification
  2. Molecular immunotherapy.Molecular vaccines,antibody immunotherapy,cytokine therapy,microbe antigen vaccine.
  3. Cellular immunotherapy.Adoptive immunotherapy,stem cells transplantation.
  4. BRMs and immunosupressors.BRMs, immunosupressors.
  1. Teaching Object

Know well: Definition

Intimately know: classification

Know: Molecular immunotherapy, cellular immunotherapy,BRMs and immunosupressors.

 

Chapter 27 Immunoprevention

  1. Teaching Content
  1. Artificial immunization.Atificial active immunization, atificial passive  immunization,planned immunization.
  2. Development of new vaccines. Basic requirements for vaccines,development of  new vaccines.
  3. Application of vaccines.Prevention of infectious diseases, prevention of tumor,others.      
  1. Teaching Object

Know well:

Know: Artificial Immunization, development of New Vaccines.

Intimately know: Application of vaccines.

 

三、The distribution of the total hour):

 

Chapter

Theory Hour

Experiment Hour

Fundaments of Immunolgy

2

 

Brief history and prospect of immunology

2

 

Antigen

2

 

Immunoglobulins

3

 

Complement system

2

 

Cytokines

2

 

Major histocompatible complex

3

 

Leukocyte differentiation antigen and adhesion molecules

2

 

Hematopoietic stem cells

2

 

T lymphocytes

3

 

B lymphocytes

2

 

Organization and diversity of antigen receptor genes

2

 

Innate immune response

2

 

Antigen presentation

2

 

T cells recognitions and responses of antigen

4

 

B cells recognitions and responses of antigens

4

 

Immunoregulation

2

 

Immune tolerance

2

 

Hypersensitivity

4

 

Autoimmunity and autoimmune diseases

2

 

Tumor immunology

2

 

Transplantation

2

 

Immunodiagnosis

2

 

Immunotherapy

2

 

Immunoprevention

2

 

Immunoprecipitation

 

4

Immunoelectrophoresis

 

     4

Agglutination

 

4

Complement associated test

 

3

Immunofluorescence and flow cytometry

 

4

ELISA or ELISPOT

 

2

Antibody- forming cells test

 

3

Cellular immune function assay

 

6

Western Blot (Alternate)

 

3

Total

60

30


四、Illustration

  1. After lecture and practice, students need do group discussion.
  2. PPT need to be used in teaching.
  3. After practice, students need do experiment reporter.
  4. Western bolt will be worked as alternate in immunological practice.

五、Reference

1. Abul K. Abbas MBBS, et al.  Cellular and Molecular Immunology.

2. David K. Male, et al. Immunolgy.

 

                                              Maker: Sheng Xia

                                             Censor: Sheng Xia  

 

Syllabus for Immunology Practice

 

Credit 6               Experiment Hour: 30 

Primary Course:Cell Biology, Histology, Genetics, Anatomy, Biochemistry, Physiology

Major:MBBS

一、The nature and task of the course

Immunology is an applied discipline, and used in diagnosis and prevention in clinic. Immunological practice was design to help students understanding the principles of immune response, immune reaction in vitro and its use in clinic diagnosis. This syllabus is designed for MBBS students, and will introduce basic experiments in cellular and humor immunity. It will also show evaluation standards in these experiments. 

二、The essential and object of the course

The works in immunological practice which students need to do are list below:

  1. Know well the experiment principle, protocol of experiment before starting practice,
  2. Observe the phenomena, write down result in experiments,
  3. Discuss the practice and make practice reporter. 

 

 

Experiment No

 

Hour

备注

  1.  

Immunoprecipitation

4

 

  1.  

Immunoelectrophoresis

4

 

  1.  

Agglutination

4

 

  1.  

Complement associated test

3

 

  1.  

Immunofluorescence and flow cytometry

4

 

  1.  

ELISA or ELISPOT

2

 

  1.  

Antibody- forming cells test

3

 

  1.  

Cellular immune function assay

6

 

  1.  

Western Blot (Alternate)

3

 

*:The experiment can be adjusted according to teaching schedule.

 

四、Practice grading

Practice grading depends on attendance, practice and practice reporter. Practice performance will be 20 percent of course score. 

五、Reference:

Current protocols in immunology: A laboratory technology in both English and Chinese. Science Press, 2009

 

                                     

                                             Maker: Sheng Xia

                                            Censor: Sheng Xia