Module Code: Module Title: Module Convenor: Discipline Committee: IMM I Principles of Human Immunology Dr Karla Lemmert Emeritus Professor Jennifer Rolland Date Module Outline reviewed: November 14, 2006 Date Module Outline modified: Date Module Outline modified: May 5, 2007 May 17, 2011 Date Module Outline modified: December 3, 2013 Page 1
A. Objectives This Module is the foundation Module in immunology and is designed to provide the candidate with a working knowledge of human immunology on which further modules examining disease states and diagnostic procedures are based. The Module does not assume any previous formal study of immunology but does assume that a candidate undertaking his Module has a good grounding in biological science. Immunology is often regarded as a complex discipline with boundaries that are poorly defined with other disciplines such as cell and molecular biology, microbiology and biochemistry. Reliance on experimental animal data to illustrate immune mechanisms and support current immunological theory is often distracting to students interested in clinical and diagnostic immunology. This Module is specifically designed to provide a broad working knowledge of human defense mechanisms. On completion of the Module the candidate will be expected to understand the general concepts of immunology in the context of the normal state. B. Interrelationship of the Module to Other Modules This Module provides the basic knowledge framework on the normal immunological state on which underpins all the Diagnostic Modules C. Brief Description Module IMM II Human Immunodeficiency Disorders & Lymphoid Neoplasias Module IMM III Autoimmunity and Principles of Transplantation Immunology Module IMM IV Infectious Diseases and Tumor Immunology This Module will provide a broad working knowledge of the basic concepts in immunology on which underpin clinical and Diagnostic Modules, which follow. No prior study of immunology is required to undertake this Module. Background studies in biological science would be an advantage. D. Content 1. Components of the Immune System 1.1 Anatomy of the Lymphoid System Primary and secondary lymphoid organs Sources of leucocytes and their differentiation from the pluripotent stem cell. An understanding of the factors which regulate the differentiation pathways is required 1.2 Innate Immunity The cells and soluble factors that comprise the innate immune system How these operate together in protecting the individual against pathogens and other environmental challenges 1.3 Acquired Immunity Cells and soluble mediators that are responsible for the generation of an acquired immune response Lymphocyte surface markers of differentiation and function Ontogeny of acquired immune system Objective: To understand broadly the respective components of the immune system and how these components develop and work together in providing defence. 2. The generation of specific immune responses 2.1 Antigen Processing and Presentation The role of antigen receptor molecules and molecules of the Major Histocompatibility Complex in the initiation of immune responses Page 2
Antigen presenting cells and mechanisms of antigen processing and presentation by these cells to induce specific T cell and B cell responses to antigen 2.2 T cell Responses to Antigen Structure of the T cell receptor and the basis of specific antigen response T cell activation and maturation and control TH 1, TH 2 and soluble mediators T cell memory Cytotoxic T cell responses and NK T cells 2.3 B cell Responses to Antigen B cell activation and maturation Antibodies their nature and role Antigen antibody interaction: affinity, avidity and cross- reactivity B cell memory 2.4 Regulatory Mechanisms of Immunity The genetic basis of immune regulation The role of cytokines and T cells in orchestrating the immune response and control mechanisms must be clearly understood 2.5 Lymphocytic trafficking in the establishment of immune responses and the role of cytokines, chemokine s and adhesion molecules in this process Objective: To understand how specific immune responses are induced and regulated in the normal state. 3. Complement Nature and function of complement molecules The classical, alternative and lectin complement pathways activation and regulation Biological activities of complement: opsonisation and clearance of immune complexes, chemotaxis, cytolysis, inflammation and immune-regulation Objective: To understand interaction between the complement system and host defence mechanisms and the importance of precise regulatory mechanisms in preventing tissue damage. 4. Immune Tolerance and Apoptosis Immune surveillance The concept of central and peripheral tolerance T cell tolerance B cell tolerance Maintenance of tolerance Oral tolerance Apoptosis Objective: To understand how the distinction is made and maintained between self and nonself by the immune system. It is also important to understand how complex multicellular organisms deal with the constant process of cell death and removal of damaged or infected cells and the role of the immune system in this process. 5. Mucosal Immunity Innate mucosal immune mechanisms (structural, mucous, cilia, peristalsis, enzymes, phagocytes, defensins, Toll-receptors) Mucosal immune induction sites (Peyer s patches, NALT, BALT) Lymphocyte migration and homing to mucosal effecter sites The secretion of IgA at mucosal surfaces and the role of secretary IgA in mucosal defense Objective: Most infectious organisms enter the host through mucosal sites. Hence, the Page 3
E. Rationale for Content objective of this topic is to understand how the innate mucosal immune mechanisms provide a barrier against foreign insult and how acquired immune responses are induced and focused to mucosal sites. The concepts of innate and acquired immunity and the respective regulation mechanisms enable and facilitate an understanding the immune basis of diagnostic techniques and interpretation of diagnostic data in the clinical setting. F. Examination Under the Fellowship Regulations, a 3-hour written examination will be held at the completion of each Module. Each examination will contain a mixture of short answer questions and essay style questions. In some examinations, clinical and laboratory management case based scenarios will be include in the question mix. Examination for this Module will focus on an overall understanding of the principal concepts and regulatory mechanisms across the five major topic themes: Components of the Immune System The Generation of Specific Immune Responses Complement Immune Tolerance Mucosal Immunity Questions will be evenly divided across the 5 topic themes. The examination will consist of: Two essay questions, each with a total value of 35 marks; suggested time allocation 30 minutes per essay total 60 minutes. Twenty short answer questions, each worth five marks total value for the short answer questions 100 marks; suggested time allocation five minutes per question total 100 minutes. Twenty minutes for re-reading and review. There will be an initial reading time of fifteen minutes, during which no writing will be permitted. G. Texts and Supporting Material The following texts all provide an excellent resource for this module. It is suggested that you glance through the texts and select one that appeals to you and you purchase that text. You should, from time to time, consult the other texts in the library to broaden your reading. Roitt, Janeway and to a lesser extent Tizard, are good resource books for the diagnostic Modules. 1. Ezekowitz RAB and Hoffman JA Innate Immunity (1 st Edn) Humana Press, 2003 ISBN: 1588290468 2. Delves PJ, Martin SJ, Burton DR and Roitt IM Roitt s Essential Immunology (12 th Edn) Wiley-Blackwell, 2011 ISBN: 9781405196833 3. Male D, Brostoff J, Roth D and Roitt I Immunology (8 th Edn) Saunders, 2012 ISBN: 9780323080583 4. Kindt TJ, Goldsby RA and Osborne BA Kuby Immunology (6 th Edn) WH Freeman and Company, 2007 Page 4
ISBN: 1429202114 5. Murphy K Janeways Immunobiology (8 th Edn) Garland Science, 2012 ISBN: 0815342438 H. Appointment of a Mentor Each candidate is required to nominate a mentor for the Module at the time of application for entry and into the Fellowship Program. If a candidate is unable to nominate a mentor then the candidate should contact the Module Convenor for assistance. The appointment of a mentor is made by the Examinations Council. I. Module Communications Module Convenor: Pro-Vice Chancellor (Health) Griffith University Gold Coast campus QLD 4222 Phone +61 7 5678 0711 Fax +61 7 5678 0795 email: allan.cripps@griffith.edu.au Discipline Committee: Dr Karla Lemmert Emeritus Professor Jennifer Rolland J. Candidate Feedback Immediately following notification of the examination result each candidate will be asked to complete a feedback questionnaire on the Module. However, feedback at anytime during the study of the Module is encouraged through the mentor or directly to the Module Convenor. Page 5