Tbilisi State Medical University

Educational Program for Dental Medicine/

International Faculty of Medicine and Stomatology

Title of study course:

Immunology
Level of education:
One Step Educational Program in Dental Medicine

Type of the course: Core; IV semester

Educational One-Step Educational Program in Dental Medicine
program/faculty: International faculty of Medicine and Stomatology
Language of study English
Study course author Department of Immunology
and instructors:
Professor Tinatin Chikovani,
Associate Professors: Ia Pantsulaia, Nino Kikodze, Nona Janikashvili
Number of ECTS 4 credits - 120 hours. Among them:
credits: Contact hours – 60 hours
Lectures – 14X2= 28 hours, seminars – 15X2=30 hours, final exam - 2 hours.
Independent study hours - 60 hours
Preparation to lectures 13X1=13 hours
Preparation to seminars 13X2=26 hours
Preparation to quizzes 5X2=10 hours
Preparation to final examination 11 hours
Objective of the study This course will introduce the student to the underlying principles of
course: immunology. Its primary emphasis will be on the cellular and non-cellular
components of the human immune system and the way these components
interact to provide immunity.

Course admission Human physiology 2

requirements: Medical biochemistry 2
Teaching & learning Teaching is done through two hours lecture and two hours small group
methods: seminars per week. Lectures are designed to deliver main concepts of the
topic. Small group seminars are based on case–based study. Students are
required to prepare presentations. Information technologies and library
resources should be widely consulted.
Course description: Study of immunological principles and concepts.
1. Introduction to the Immune System
The immune system protects us from pathogens. Phagocytes and lymphocytes
are key mediators of immunity. Specificity and memory are two essential
features of adaptive immune responses. Antigens are molecules that are
recognized by receptors on lymphocytes. An immune response occurs in two

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 Tbilisi State Medical University
Educational Program for Dental Medicine/
International Faculty of Medicine and Stomatology

phases - antigen recognition and antigen eradication. Vaccination depends on

the specificity and memory of adaptive immunity. Inflammation is a response
to tissue damage. The immune system may fail (immunopathology).
2. Cells, Tissues, and Organs of the Immune System
Phagocytic cells. Development and differentiation of different cell lineages.
Eosinophils, basophils, mast cells, platelets, NK cells. Antigen-presenting
cells. B and T cells. Lymphoid organs and tissues. Primary lymphoid organs.
Systemic lymphoid organs - spleen and lymph nodes. Mucosa-associated
lymphoid tissue (MALT). Lymphocytes recirculation.
3. Inflammation. Complement System
Complement is central to the development of inflammatory reactions.
Complement activation pathways. The complement system is controlled to
protect the host. Complement has a variety of functions. Complement
deficiencies illustrate the homeostatic roles of complement.
The phased arrival of leukocytes in inflammation. Leukocyte migration to
lymphoid tissues. Plasma enzyme systems modulate inflammation and tissue
remodeling.
4. Mechanisms of Innate Immunity
Innate immune responses do not depend on immune recognition by
lymphocytes. The body's responses to damage include inflammation,
phagocytosis, and clearance of debris and pathogens, and remodelling and
regeneration of tissues. Pathogen-associated molecular patterns (PAMPs) are
distinctive biological macromolecules that can be recognized by the innate
immune system. Microbicidal proteins are part of the innate immune system.
5. T Cell Receptors and MHC Molecules
The T cell antigen receptor (TCR). The two types of TCR may have distinct
functions. TCRs are encoded by several sets of genes. Major
histocompatibility complex (MHC) molecules. Class I and class II MHC
molecules bind to peptides derived from different sources. HLA-A, HLA-B,
and HLA-C gene loci encode class I MHC molecules. HLA-DP, HLA-DQ,
AND HLA-DR gene loci encode class II MHC molecules. An individual's
MHC haplotype affects susceptibility to disease. CD1 is an MHC class 1-like
molecule that presents lipid antigens.
6. Antibodies
Immunoglobulin recognize and bind antigens. All immunoglobulin isotypes,
with the exception of IgD, are bifunctional. Immunoglobulin Structure.

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 Tbilisi State Medical University
Educational Program for Dental Medicine/
International Faculty of Medicine and Stomatology

Classes of antibody in mammals - IgG, IgA, IgM, IgD, and IgE. Antibody
affinity. Receptors for immunoglobulin constant regions (Fc receptors).
Immunoglobulins diversity.
7. Antigen Presentation
T cells recognize peptide fragments bound to major histocompatibility
complex (MHC) class I or II molecules. MHC class I molecules associate with
endogenously synthesized peptides. MHC class II molecules are loaded with
exogenous proteins. Co-stimulatory molecules are essential for T cell
activation. CD4 binds to MHC class II and CD8 to MHC class I molecules.
Antigen presentation affects the subsequent course of an immune response.
8. Cell Cooperation in the Antibody Response
The primary development of B cells is antigen-independent. T-independent
(TI) antigens activate B cells without requiring T cell help. T-dependent (TD)
antigens require T cell to activate B cells. B and T cell activation follow
similar patterns. Cytokine secretion from CD4 + T cells is important in B cell
proliferation and differentiation. B cell affinity maturation takes place in the
germinal centers. B cells switch to another immunoglobulin class (class
switching) by recombining heavy chain genes.
9. Cell-mediated Cytotoxicity
NK cells express a variety of receptors. Cytotoxicity is effected by direct
cellular interactions, cytokines, and granule exocytosis. Macrophages,
neutrophils, and eosinophils are non-lymphoid cytotoxic effectors.
10. Regulation of the Immune Response
Many factors govern the outcome of any immune response. The APC may
affect the immune response. Immunoglobulins can influence the immune
response. T cells regulate the immune response. CD4+ T cells can deviate
immune responses to TH1- or TH2-type responses. Regulatory T cells may
belong to the CD4 or CD8 subpopulations. They can inhibit responses by the
production of suppressive cytokines such as IL-10 and TGFβ. The
neuroendocrine system influences immune responses. Immunological
tolerance is a state of unresponsiveness for a particular antigen. Central
tolerance takes place during T cell development in the thymus. A variety of
mechanisms maintain tolerance in peripheral lymphoid organs. Tolerance can
be induced artificially
11. Defence Against Infectious Agents
Immunity to Viruses. Innate immune mechanisms - interferon, NK cells, and

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 Tbilisi State Medical University
Educational Program for Dental Medicine/
International Faculty of Medicine and Stomatology

macrophages. Adaptive (specific) immune response. Viruses have evolved

strategies to evade the immune response. Responses to viral antigens can
cause tissue damage.
Immunity to Bacteria and Fungi. Mechanisms of protection from bacteria can
be deduced from their structure and pathogenicity. Successful pathogens have
evolved mechanisms to avoid phagocyte-mediated killing. The response to
bacteria can result in immunological tissue damage.
Immunity to Protozoa and Worms. Innate immune responses are the first line
of immune defense. T and B cells are pivotal in the development of immunity.
Macrophages, neutrophils, eosinophils, and platelets can kill both protozoa
and worms. IgE antibodies play a critical role in defense against helminths.
The biological role of immediate hypersensitivity is to control helminth
infections such as schistosomiasis, hookworm, or ascariasis. However, it is
likely to be a combination of effector TH2 cells, basophils, and eosinophils, as
well as IgE antibodies on mast cells, that control these worms. Parasites have
many different escape mechanisms.
12. Immediate Hypersensitivity (Type I).
Classification of Coombs and Gell. Allergens - antigens that give rise to
immediate hypersensitivity and contribute to asthma. IgE antibodies play a
critical role in defense against helminths.
IgE is distinct from the other dimeric immunoglobulins. Mast cells and
basophils contain histamine. Multiple genes have been associated with asthma
in different populations. Skin tests. Several different pathways contribute to
the chronic symptoms of allergy. Allergens contribute to asthma.
Immunotherapy can be used for hay fever and anaphylactic sensitivity. New
approaches for treating allergic disease.
13. Hypersensitivity (Type II)
Type II hypersensitivity is mediated by antibodies binding to specific cells.
Type II hypersensitivity reactions may target cells. Hemolytic disease of the
newborn. Type II hypersensitivity reactions may target tissues. Damage to
tissues may be produced by antibody to functional cell surface receptors
through Fab regions. In doing so, they may enhance or inhibit the normal
activity of the receptor. Examples include myasthenia gravis, pemphigus, and
Goodpasture's syndrome. The role of autoantibodies in disease is not always
clear. Antibodies to intracellular components are not normally pathogenetic,
but they may be diagnostically useful. Cytotoxic antibodies are increasingly

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 Tbilisi State Medical University
Educational Program for Dental Medicine/
International Faculty of Medicine and Stomatology

being used for therapeutic indications.

14. Hypersensitivity (Type III)
Diseases caused by immune complexes. Immune complexes can trigger a
variety of inflammatory processes. Experimental models demonstrate the
main immune complex diseases. Immune complexes are normally removed by
the mononuclear phagocyte system. The size of immune complexes affects
their deposition. Immune complex deposition in the tissues results in tissue
damage. Deposited immune complexes can be visualized using
immunofluorescence.
15. Hypersensitivity (Type IV)
DTH reflects the presence of antigen-specific CD4 T cells. Three variants of
type IV hypersensitivity reaction - contact, tuberculin, and granulomatous.
Many chronic diseases manifest type IV granulomatous hypersensitivity:
tuberculosis, leprosy, schistosomiasis, sarcoidosis, and Crohn's disease.
16. Autoimmunity and Autoimmune Disease
Autoimmunity is associated with disease. Genetic factors play a role in the
development of autoimmune diseases. Controls on the development of
autoimmunity can be bypassed. Microbial cross-reacting antigens and
cytokine dysregulation can lead to autoimmunity. Treatment of autoimmune
disease.
17. Immunity to Cancers
Tumors can induce immunity. Tumor antigens. Vigorous anti-tumor immune
responses are compromised by regulatory mechanisms. Tumors elicit
immunity in their primary host, and such immunity is downregulated.
Regulatory cells such as CD25+ CD4+ T cells and inhibition of activated anti-
tumor T cells through T cell molecules such as CTLA-4 are involved in
downregulation of tumor immunity.
18. Primary Immunodeficiency
Defects in B cell function. Defects in T cell function. Severe combined
immunodeficiency (SCID), MHC class II deficiency, ataxia telangiectasia (AT),
the Wiskott-Aldrich syndrome (WAS), and the DiGeorge anomaly.
Hereditary complement component defects. Genetic defects of phagocytes.
Leukocyte adhesion deficiency (LAD).
19. Secondary Immunodeficiency
Some drugs selectively alter immune function. Nutrient deficiencies are
generally associated with impaired immune responses. HIV infection.

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 Tbilisi State Medical University
Educational Program for Dental Medicine/
International Faculty of Medicine and Stomatology

Combination therapy for AIDS.

20. Transplantation and Rejection
The immune response in transplantation depends on a variety of factors.
Rejection results from a variety of different immune effector mechanisms.
HLA matching is one of two major methods for preventing rejection of
allografts. Successful organ transplantation depends on the use of
immunosuppressive drugs. The ultimate goal in transplantation is to induce
donor-specific tolerance.
21. Vaccination and Immunotherapy
Study course Assessment of student’s achievements/academic performance is conducted
assessment system: according to the order #3, 5.01.2007, by Minister of education and science of
Georgia. The grading system allows:
a. Five positive assessments:
A- Excellent - 91-100 points
B- Very good - 81 – 90 points
C- Good - 71 -80 points
D- Satisfactory – 61-70 points
E- Enough – 51 – 60 points

b. Two negative assessments:

(Fx) – didn’t pass– 41-50 points of maximum grading points, considerable
further work required from the student and he/she is given a chance
to pass additional(secondary) exam.
(F) - Fail – 40 points and less of maximum grading point, meaning that
the work of a student isn’t acceptable and further work is required to
learn the subject over again.

Credits can only be obtained after appropriate assessment of the learning

outcomes within the syllabus the student has achieved, which is expressed by
one of the positive assessments above.
- The student has the right to make up exam in the same semester.
- The interval between the final and additional exam should be no less
than 5 days.

The maximum assessment point in the course/discipline is 100 points. Among

them:
- Interim assessment (sum of points allocated to knowledge assessment
components) - 60 points;
- Final (summative) exam - 40 points;
- Final exam assessment is positive in case of getting 24 and more points

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 Tbilisi State Medical University
Educational Program for Dental Medicine/
International Faculty of Medicine and Stomatology

(60% and more of maximum grading points);

The student has the right to take the final exam if his /her overall grade
(according interim assessment and maximal grading point of final exam) is at
least 51points.

Components of Assessment:
1. Class activity – 15 scores

Student’s class activity is assessed using short daily tests in the seminars. Test
comprises 30 MCQ or True/False questions. Each correct answer is evaluated
by 0.5 scores.

Overall class activity during semester is average score of 10 daily tests’ scores.

2. Presentation – 5 scores
Student’ presentation is evaluated by:
a) Importance of the topic. Importance of the topic is not expressed - 0 scores;
importance of the topic is clearly formulated - 1 score.
b) Presentation format. Presentation meets criteria applicable to scientific
presentation – 1 score; presentation does not meet criteria applicable to
scientific presentation – 0 scores.
c) Content of presentation. Immunopathogenesis of the disease is not
discussed – 0 scores; the recent literature sources are not consulted,
immunological methods of diagnosis and immune approaches in treatment
are not presented - 0.5 scores; all above-mentioned components are well
presented in the presentation – 1 score.
d) Oral presentation. Well substantiated, effective interactive presentation is
evaluated by 1 score; substantiated, non-effective presentation is evaluated by
0.5 scores; poorly designed presentation is evaluated by 0 scores.
e) Provision of answers to questions from audience. Student provides
unsatisfactory answers to the questions – 0 scores; student provides
satisfactory answers to some questions - 0.5 scores; student provides
satisfactory answers to all questions – 1 score.
If in the presentation an academic fraud - plagiarism, falsification and etc. is
determined, the student in this component will not be evaluated.

3. Midterm quizzes – 40 (20X2) scores

Each quiz is evaluated by 20 scores. Quiz 1 includes General Immunology
issues. Student is required to demonstrate knowledge of issues that are
discussed at lectures and seminars. Quiz 2 takes place at the end of course of
Immunology and involves issues of Specific Immunology. Quizzes contain 40

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 Tbilisi State Medical University
Educational Program for Dental Medicine/
International Faculty of Medicine and Stomatology

MCQ tests. Every correct answer is evaluated by 0.5 scores.

4. Final exam – 40 scores

Student is required to demonstrate knowledge of material presented at
lectures and seminars. The exam is oral. Exam ticket includes 8 tasks. Each is
evaluated by 5 scores.
5 scores - The student is well prepared, correctly explains all issues.
Answers to the questions are comprehensive, correct and justified
4 scores - The student is aware of the problem and the issue. Answers to
the questions are with minor mistakes.
3 scores - The student possesses partially a material of the syllabus.
answers to the questions are correct, but incomplete /
unsubstantiated.
2 scores - The student’s knowledge is very superficial, answers the simple
questions.
1 score – Student has almost no knowledge of any topic in the ticket, is
not able to answer the questions.
0 scores - The student is not ready.

Course literature Required literature:

 Male, D., Brostoff, J., Roth, D., Roitt, I. Immunology (ninth Edition)
ELSEVIER. 2020
 Abbas, Lichtman, Pillai Cellular and Molecular Immunology, 9th
edition, 2017
Additional reading:
 Levinson. Medical Microbiology and Immunology. 16th edition, 2020

Abovementioned literature could be found in library and in the department

of Immunology.

The following web resources could be consulted for tests, clinical cases and
animations:

 http://www.roitt.com
 Elispot assay https://www.youtube.com/watch?v=pmdoA8Xiviw
 The Enzyme Linked Immunosorbent Assay
https://www.youtube.com/watch?v=zR_xlV5v_f4 (ELISA) 
https://www.youtube.com/watch?v=RRbuz3VQ100
 Immunofluorescence assay (IFA) - Immunology Virtual
Lab https://www.youtube.com/watch?v=64Svwvc_rMA
 Flow Cytometry Virtual Lab https://www.youtube.com/watch?
v=kgvY5L79oRw

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 Tbilisi State Medical University
Educational Program for Dental Medicine/
International Faculty of Medicine and Stomatology

https://www.youtube.com/watch?v=B2zreF2dnWk
https://www.youtube.com/watch?v=EQXPJ7eeesQ
https://www.youtube.com/watch?v=EQXPJ7eeesQ

Study course outcomes/ Course learning outcomes:

competencies:
Knowledge and understanding
By the end of course, student knows

 Basics of the immune system and its involvement in health and disease.
 the components of the innate immune system and inflammation,
 the complement system, its components and their biological action s in
inflammation,
 the biochemical structures mediation to the functional properties of the
immunoglobulins
 substances that amplify, regulate, and modulate the immune response
 the physiological significance of the immunoglobulins and accessory
substances in health and disease,
 clinical methods for their detection and measurement, and to state their
significance in the clinical laboratory,
 the physiology and genetics of cells immediately involved in the immune
response such as macrophages, lymphocytes and effector cells such as
neutrophils.
 the immune response to different types of microorganisms
 immunology of autoimmunity
 immunology of hypersensitivity
 immunology of transplantation
 tumor immunology
 the ways of collecting data based on observations from laboratory tests or
clinical case studies.

Skills:
By the end of course, student can:
 use learnt concepts into daily professional routine performance, with
special emphasis on applying these skills at clinic.
 describe the major divisions of the immune system;
 describe humoral immunity
 discuss cell mediated immunity
 compare and contrast innate and acquired immunity
 discuss the role of specific cells of the immune system
 discuss the immune response to specific pathogens
 describe the nature of self and non-self

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 Tbilisi State Medical University
Educational Program for Dental Medicine/
International Faculty of Medicine and Stomatology

 describe how immune response is regulated

 describe the role of innate immune system in process of inflammation,
 explain the biological action of complement system and its components in
inflammation,
 explain the mechanisms of amplification, regulation, and modulation the
immune response
 use clinical methods in the clinical laboratory,
 accurately follow instructions and collect data based on observations from
laboratory tests or clinical case studies.
 identify immunological features and genetics of cells that mediate cell-
mediated immunity, transplantation, cancer, autoimmunity, and allergy,
 draw elementary inferences concerning the role of the immune response
in immunity to infection, immunity to cancer, allergy, hypersensitivity,
and autoimmunity,
 describe the consequences of inherited or acquired deficiencies in the
various elements of the immune laboratory diagnosis,
 state what elements are involved in host defences against viral infection
and disease,
 identify those viruses amenable to chemotherapy and chemoprophylaxis
and the effective drugs

Autonomy and responsibility:

Upon completion of this course students are able to:

 demonstrate an ability to work in group and exchange ideas concerning

course-related topics.
 define own learning skills in different situation.
 evaluate and share own and others’ attitude towards values, characteristic
for professional activity.
 make inferences and predictions based on interpretation of available data.
 read, write, and speak about Immunology with classmates and wide
public.
 maintain a robust curiosity about the way things work in human body.

Thematic plan of lectures and practical classes

Days
Lectures Content (14 lectures, each – 2 h.)
N

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 Tbilisi State Medical University
Educational Program for Dental Medicine/
International Faculty of Medicine and Stomatology

Introduction to the Immune System. The immune system protects us from pathogens.
Phagocytes and lymphocytes are key mediators of immunity. Specific2ity and memory
are two essential features of adaptive immune responses. Antigens are molecules that are
1. recognized by receptors on lymphocytes. An immune response occurs in two phases -
antigen recognition and antigen eradication. Vaccination depends on the specificity and
memory of adaptive immunity. Inflammation is a response to tissue damage. The
immune system may fail (immunopathology).

Inflammation. Complement System. Complement is central to the development of

inflammatory reactions. Complement activation pathways. The complement system is
controlled to protect the host. Complement has a variety of functions. Complement
2. deficiencies illustrate the homeostatic roles of complement. The phased arrival of
leukocytes in inflammation. Leukocyte migration to lymphoid tissues. Plasma enzyme
systems modulate inflammation and tissue remodeling.

Mechanisms of Innate Immunity. Innate immune responses do not depend on immune

recognition by lymphocytes. The body's responses to damage include inflammation,
phagocytosis, and clearance of debris and pathogens, and remodelling and regeneration
3. of tissues. Pathogen-associated molecular patterns (PAMPs) are distinctive biological
macromolecules that can be recognized by the innate immune system. Microbicidal
proteins are part of the innate immune system.

General scheme of an immune response. Recognition of foreign. The principal

mechanisms of innate and adaptive immunity. The T cell antigen receptor (TCR). The
two types of TCR may have distinct functions. TCRs are encoded by several sets of
genes. Major histocompatibility complex (MHC) molecules. Class I and class II MHC
4.
molecules bind to peptides derived from different sources. HLA-A, HLA-B, and HLA-C
gene loci encode class I MHC molecules. HLA-DP, HLA-DQ, AND HLA-DR gene loci
encode class II MHC molecules. An individual's MHC haplotype affects susceptibility to
disease. CD1 is an MHC class 1-like molecule that presents lipid antigens.
BCR and Antibodies. Immunoglobulin recognize and bind antigens. Immunoglobulin
Structure. Classes of antibody in mammals - IgG, IgA, IgM, IgD, and IgE. Antibody
5.
affinity. Receptors for immunoglobulin constant regions (Fc receptors).
Immunoglobulins diversity.
6 Cell Cooperation in the Antibody Response The primary development of B cells is
antigen-independent. T-independent (TI) antigens activate B cells without requiring T
cell help. T-dependent (TD) antigens require T cell to activate B cells. B and T cell
activation follow similar patterns. Cytokine secretion from CD4 + T cells is important in

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 Tbilisi State Medical University
Educational Program for Dental Medicine/
International Faculty of Medicine and Stomatology

B cell proliferation and differentiation. B cell affinity maturation takes place in the
germinal centers. B cells switch to another immunoglobulin class (class switching) by
recombining heavy chain genes.

Regulation of the Immune Response. Many factors govern the outcome of any immune
response. The APC may affect the immune response. Immunoglobulins can influence
the immune response. T cells regulate the immune response. CD4+ T cells can deviate
7. immune responses to TH1- or TH2-type responses. Regulatory T cells may belong to the
CD4 or CD8 subpopulations. They can inhibit responses by the production of
suppressive cytokines such as IL-10 and TGFβ.

Defence Against Infectious Agents. Immunity to Viruses. Innate immune mechanisms -

interferon, NK cells, and macrophages. Adaptive (specific) immune response. Immunity
to Bacteria and Fungi. Mechanisms of protection from bacteria can be deduced from
their structure and pathogenicity. Successful pathogens have evolved mechanisms to
8. avoid phagocyte-mediated killing. Immunity to Protozoa and Worms. Innate immune
responses are the first line of immune defense. T and B cells are pivotal in the
development of immunity. Macrophages, neutrophils, eosinophils, and platelets can kill
both protozoa and worms. IgE antibodies play a critical role in defense against
helminths.

Immediate Hypersensitivity (Type I). Classification of Coombs and Gell. Allergens -

antigens that give rise to immediate hypersensitivity and contribute to asthma. IgE is
distinct from the other dimeric immunoglobulins. Mast cells and basophils contain
histamine. Multiple genes have been associated with asthma in different populations.
9. Hypersensitivity (Type II) Type II hypersensitivity is mediated by antibodies binding to
specific cells. Type II hypersensitivity reactions may target cells. Type II
hypersensitivity reactions may target tissues. Damage to tissues may be produced by
antibody to functional cell surface receptors through Fab regions. In doing so, they may
enhance or inhibit the normal activity of the receptor.

Hypersensitivity (Type III) Diseases caused by immune complexes. Immune complexes

can trigger a variety of inflammatory processes. Experimental models demonstrate the
main immune complex diseases. Immune complexes are normally removed by the
10. mononuclear phagocyte system. The size of immune complexes affects their deposition.
Immune complex deposition in the tissues results in tissue damage. Deposited immune
complexes can be visualized using immunofluorescence. Hypersensitivity (Type IV)
DTH reflects the presence of antigen-specific CD4 T cells. Three variants of type IV

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 Tbilisi State Medical University
Educational Program for Dental Medicine/
International Faculty of Medicine and Stomatology

hypersensitivity reaction - contact, tuberculin, and granulomatous.

Immunity to Cancers. Tumors can induce immunity. Tumor antigens. Vigorous anti-
tumor immune responses are compromised by regulatory mechanisms. Tumors elicit
11. immunity in their primary host, and such immunity is downregulated. Regulatory cells
such as CD25+ CD4+ T cells and inhibition of activated anti-tumor T cells through T cell
molecules such as CTLA-4 are involved in downregulation of tumor immunity.

Autoimmunity and Autoimmune Disease. Autoimmunity is associated with disease.

Genetic factors play a role in the development of autoimmune diseases. Controls on the
12. development of autoimmunity can be bypassed. Microbial cross-reacting antigens and
cytokine dysregulation can lead to autoimmunity. Treatment of autoimmune disease.

Primary Immunodeficiency.Defects in B cell function. Defects in T cell function. Severe

combined immunodeficiency (SCID), MHC class II deficiency, ataxia telangiectasia (AT),
the Wiskott-Aldrich syndrome (WAS), and the DiGeorge anomaly. Hereditary
complement component defects. Genetic defects of phagocytes. Leukocyte adhesion
13. deficiency (LAD).

Secondary Immunodeficiency Some drugs selectively alter immune function. Nutrient

deficiencies are generally associated with impaired immune responses. HIV infection.
Combination therapy for AIDS.

Transplantation and Rejection. The immune response in transplantation depends on a

variety of factors. Rejection results from a variety of different immune effector
14. mechanisms. HLA matching is one of two major methods for preventing rejection of
allografts. Successful organ transplantation depends on the use of immunosuppressive
drugs. The ultimate goal in transplantation is to induce donor-specific tolerance.

Days Content of Practical Classes and Seminars (15 classes, each – 2 h.)
N
Intracellular and extracellular markers of immune cells Cells and organs of immune
system.
1. Immunophenotyping. Cytometry. Daily test for the assessment of class activity.
Discussion of clinical cases about phases of maturation of T and B cells and clonal
selection of lymphocytes.

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 Tbilisi State Medical University
Educational Program for Dental Medicine/
International Faculty of Medicine and Stomatology

Inflammation and complement

2. Daily test for the assessment of class activity. Discussion of clinical cases about
mechanisms of inflammation and complement system.

Antigen Recognition and Presentation

3. Daily test for the assessment of class activity. Discussion of clinical cases about TCR and
MHC class I and II molecules.

Antibodies
4. Daily test for the assessment of class activity. Discussion of clinical cases about
generation and structure of antibodies.
Adaptive immune response
Daily test for the assessment of class activity. Discussion of clinical cases about
5. processing and presentation of antigen; generation of primary immune response and
immunologic memory.

Regulation of the Immune Response

6. Daily test for the assessment of class activity. Discussion of clinical cases about
regulatory factors of immune response.

Laboratory hour
7. To visit laboratory. Immunological assays. Clinical and laboratory assessment of immune
system.

Midterm Quiz. Cells and organs of immune system. Inflammation. Regulation of

8. immune response.

Defence Against Infectious Agents

9.
Discussion of clinical cases about immune response against pathogens.
Hypersensitivity (type I, type II)
10. Daily test for the assessment of class activity. Discussion of clinical cases about
haemolytic anemia of newborns and allergic reactions caused by drugs.

Hypersensitivity (type III and type IV)

11. Daily test for the assessment of class activity. Differentiation of types of hypersensitivity
reactions in clinical cases.

12. Immunity to Cancers. Autoimmunity and Autoimmune Disease

Daily test for the assessment of class activity. Discussion of clinical cases about
experimental treatment of cancer. Daily test for the assessment of class activity.

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 Tbilisi State Medical University
Educational Program for Dental Medicine/
International Faculty of Medicine and Stomatology

Discussion of clinical cases about autoimmune diseases.

Immunodeficiencies
13. Daily test for the assessment of class activity. Discussion of clinical cases about T, B cell
and complement deficiencies in patients.

Transplantation and Rejection

14. Discussion of clinical cases about clinical forms of rejection, post-transplantation
treatment.

Midterm Quiz. Immune response against microbes. Hypersensitivity reactions. Cancer.

15.
Autoimmune diseases. Immunodeficiencies. Transplantation.

15