Core Curriculum Outline and Reading List Last Reviewed:May 2011 The Allergy and Immunology Training Program Directors’ (TPD) Core Curriculum Outline and Reading List serves as a guide for: TPD and trainees in meeting the requirements of the Residency Review Committee The Reading List Subcommittee The In-Training Examination Subcommittee. This document provides a framework for training programs to design an individualized course of study that supplements the diverse strengths and weaknesses of each fellowship training program and faculty. It is updated every three years, and is consistent with the requirements of the Residency review Committee for training in allergy and immunology. In an effort to keep the materials as current as possible, email Mariana Duran at [email protected] with supplemental inforamtion. Suggestions will be reviewed at the end of each calendar year. Allergy and Immunology Training Program Directors’ Core Curriculum Outline and Reading List Click on any of the Core Curriculum topics to view the citation and abstract of the reading(s) or activities selected for each Core Curriculum topic. Strategies and resources for acquiring the body of knowledge within the Basic Science Core Curriculum might include structured didactic programs, TPD-recommended textbooks, TPD reading list, and regional or national seminars. The knowledge obtained through the basic science curriculum serves as the foundation for diagnosis and therapy for immunologic and allergic disorders. 1 I. Basic Immunology........................................................................................................................ 10 A. Overview of the Immune System ........................................................................................... 10 1. Organization and Functions of the Immune System............................................................ 10 a. Thymic development and shaping peripheral systemic T-cell immunity ........................ 10 b. Cutaneous Immunity........................................................................................................ 11 c. Intestinal/Mucosal Immunity ........................................................................................... 11 d. Primary Immune Function of Cellular Elements of the Immune System........................ 12 i. T-cells ........................................................................................................................... 12 ii. B cells .......................................................................................................................... 13 iii. Neutrophils ................................................................................................................. 14 iv. Eosinophils.................................................................................................................. 15 v. Mast cells ..................................................................................................................... 15 vi. Basophils..................................................................................................................... 16 vii. Antigen presenting cells ............................................................................................ 17 viii. Natural Killer Cells................................................................................................... 18 ix. NKT cells.................................................................................................................... 19 x. Platelets........................................................................................................................ 19 xi. Epithelium................................................................................................................... 20 B. Immune Mechanisms .............................................................................................................. 20 1. Innate versus adaptive immunity ......................................................................................... 20 a. Complement and the innate immune response................................................................. 21 b. Pattern Recognition Receptors......................................................................................... 23 c. Natural Antimicrobial Agents.......................................................................................... 25 i. reactive oxygen species ................................................................................................ 25 ii. releasable granule proteins .......................................................................................... 25 2. Major histocompatibility complex – molecular structure and function............................... 26 3. Immunogenetics – Gene rearrangements in the generation of immune system diversity ... 27 4. Antigen-presenting cells – processing and presentation of conventional and superantigens .................................................................................................................................................. 28 5. Gell and Coombs Classification of Immune Responses...................................................... 29 a. Type I –Immediate Hypersensitivity Response ............................................................... 30 i. IgE binding and signal transduction ............................................................................. 30 ii preformed and newly synthesized mediator release ..................................................... 31 iii late phase reactions...................................................................................................... 32 b. Type II – Antibody induced reactions Response ............................................................. 32 c. Type III – Immune-Complex mediated reactions ............................................................ 32 d. Type IV – Cell mediated /Delayed Hypersensitivity Response....................................... 33 6. T cell mediated immunity .................................................................................................... 34 a. T cell activation – T cell receptor structure and function, epitope recognition and accessory molecules in signal transduction ......................................................................... 34 b. Cytokines and co-stimulatory molecules in T cell activation.......................................... 35 c. T cell mediated immune responses – participating cells. Properties and functions of antigen presenting cells........................................................................................................36 d. T cell subsets.................................................................................................................... 39 e. Regulatory T cells and Memory T Cells.......................................................................... 41 f. NK T cells......................................................................................................................... 44 2 7. B cell mediated immunity.................................................................................................... 45 a. B cell activation – cytokines and signal transduction ...................................................... 46 b. Epitope recognition and immunoglobulin production ..................................................... 48 c. Maturation of B lymphocytes........................................................................................... 49 d. Maturation of the antibody response................................................................................ 51 e. Biologic process initiated by antibody: opsonization, complement fixation, antibody dependent cell mediated cytotoxicity................................................................................... 52 f. IgE mediated immediate and late phase reactions........................................................... 54 g. Immune complexes – immunologic properties and mechanisms of clearance................ 55 8. Other immune and inflammatory mechanisms.................................................................... 56 a. Natural killer cells, their CD markers and functions........................................................ 56 b. Lymphokine activated killer cells and their effects ......................................................... 57 c. Basophil mediated inflammatory states ........................................................................... 58 d. Kinin mediated inflammation .......................................................................................... 60 e. Arachidonic acid metabolites inflammation .................................................................... 61 f. Cytokines/chemokines and their receptors....................................................................... 63 g. Growth factors ................................................................................................................ 65 9. Receptor Ligand interactions in immune functioning—signal transduction resulting from receptor ligand interaction - genetic polymorphisms............................................................... 65 10. Immunologic Memory ....................................................................................................... 69 C. Mucosal Immunity .................................................................................................................. 73 1. Adaptive Immunity .............................................................................................................