SUMMARY
INTEGRATED
BIOMEDICAL SCIENCES
Claire Snel
Master Biomedical Sciences
Year 1
,Inhoudsopgave
Lecture 1 – Introduction & History of (interdisciplinarity) in biomedical sciences ............................. 2
Lecture 2 – Core concepts and processes in immunology ............................................................... 8
Innate immune system .................................................................................................................... 9
Adaptive immune system ................................................................................................................12
Lecture 3 – Core concepts and processes in neurobiology ............................................................. 18
Lecture 4 – Core concepts and processes in infectious diseases ................................................... 27
Viral infections ...............................................................................................................................27
Bacterial infections.........................................................................................................................29
Parasite/ protozoa ..........................................................................................................................31
Fungi and yeast ..............................................................................................................................31
How to treat pathogenic infections?.................................................................................................34
Lecture 5 – Technique to determine adaptive immune responses ................................................... 36
Part 1 – Flow cytometry: technique ..................................................................................................37
Part 2 – Flow cytometry: determining T-cell responses ......................................................................38
Part 3 – ELISA technique .................................................................................................................40
Lecture 6 – Research techniques neurobiology ............................................................................. 44
Lecture 7 – Outbreak policies and interventions ............................................................................ 49
International public health (AMR = antimicrobial resistance)) ............................................................53
Lecture 8 – Research techniques infectious diseases .................................................................... 56
Lecture 9 – Measles – the infectious disease that targets immunity and brain ................................. 65
Lecture 10 – Biostatistics and epidemiology 1 ............................................................................... 70
Lecture 11 – Biostatistics and epidemiology 2 ............................................................................... 74
Applied biostatistics knowledge clips........................................................................................... 77
Lecture 12 – Innovations in biomedical sciences ........................................................................... 83
Lecture 13 – Ethics in research ..................................................................................................... 92
Lecture 14 – Biomedical sciences in dialogue ............................................................................... 96
1
,Lecture 1 – Introduction & History of (interdisciplinarity)
in biomedical sciences
Ø Integration of di-erent biomedical disciplines
Ø Definition of biomedical sciences
o Biomedicine is a branch of medical science that applies biological and
physiological principles to clinical practice
o There is no universally agreed upon definition of ‘biomedicine’, it is often
conceptualized as the search for therapeutic/ medical innovations on the
laboratory
Ø Scientific revolution started 17th century > the body works as a machine
o Boerhave > hydraulic system - fluids
o Harvey > heart is a pump
o Corvisart > introduction percussion (early 19th century), is stethoscope
nowadays
§ There was resistance (late 19the century) from the use of these
instruments
§ We now see that still: medical innovation comes with resistance
o Von liebig – laboratory
o Virchow – cellular pathology
o Ernst abbe – microscope improvement
Laboratory revolution:
- Koch Postulate! – to establish a causal relationship between a microbe and a disease
o Foundation of biomedicine
1. The microorganism must be found in abundance in all organisms su-ering from
the disease but should not be found in healthy organisms
2. The microorganism must be isolated from a diseased organism and grown in
culture
3. The cultured microorganism should cause disease when introduced into a
healthy organism
4. The microorganism must be re-isolated from the inoculated, disease
experimental host and identified as being identical to the original specific
causative agent
- Pasteur – micro-organisms, pasteurization and rabies vaccine
- Fleming – discovered first antibiotic penicillin (1928)
Biomedicine increasingly came to signify ‘modern medicine’
Ø Biomedicine became the dominant research field of treating diseases
Ø Biomedical paradigm/ biomedicalization
o The biomedical model of medical care is the medical model used in most
western healthcare settings, and is built on the perception that a state of health
is defined purely in the absence of disease
2
, Biomedicine as practice
1. Diagnosis, etiology (cause/ origin of disease), interventions
o Increasingly focused on metrics/ numbers (cholesterol, genes etc.) rather than
symptoms
2. Clinical trials/ meta-analysis (proof of interventions)
o Integration of hospitals and patients into the biomedical enterprise >
development of RCT
3. Risk and enhancement
o Hormone replacement therapy, started o- as therapy for severe symptoms of
menopause, to become a preferred treatment to keep the skin of
postmenopausal woman supple (flexible)
§ This is also what we see with biomedicalization, we move beyond the
domain of disease
Reductionism
- A metaphor that can show that we can break down parts of the body and that we then
can research these parts apart from each other
- Definitions of di-erent disciplines:
o Ontological claim: a whole organism is nothing more than the sum of its part
o Epistemological claim: organism is best explained by reference to (in terms of) its
parts
o Methodological claim: organism is best investigated by its parts
- We now try to isolate things we want to study > this is not in line with the start at the
evolution where we wanted to see the body as whole system
- We more and more realize how everything is connected
- For a lot of the solutions that are made up > they don’t work in practice, because the
body is a changing thing
Evidence based medicine
Ø A systematic approach to medicine in which doctors and other health care professionals
use the best available scientific evidence from clinical research to help make decisions
about the care of individual patients
Ø Using RCTs, adding meta-analysis results
Ø Problems:
o Based on statistics on healthy people, but most of the patients that are seen are
not young healthy
o A lot of research is pushed by companies (pharmaceutical) which have their own
interest (they will prioritize research in their interest)
o By increasing power (more people in trial) we can identify statistical significance,
but we have the question whether its biomedically relevant
Crisis in evidence based medicine?
- The evidence based “quality mark” has been misappropriated by vested interests
- The volume of evidence, especially clinical guidelines, has become unmanageable
- Statistically significant benefits may be marginal in clinical practice
- Inflexible rules and technology driven prompts may produce care that is management
driven rather than patient centered
- Evidence based guidelines often map poorly to individuals, and complex multimorbidity
3
INTEGRATED
BIOMEDICAL SCIENCES
Claire Snel
Master Biomedical Sciences
Year 1
,Inhoudsopgave
Lecture 1 – Introduction & History of (interdisciplinarity) in biomedical sciences ............................. 2
Lecture 2 – Core concepts and processes in immunology ............................................................... 8
Innate immune system .................................................................................................................... 9
Adaptive immune system ................................................................................................................12
Lecture 3 – Core concepts and processes in neurobiology ............................................................. 18
Lecture 4 – Core concepts and processes in infectious diseases ................................................... 27
Viral infections ...............................................................................................................................27
Bacterial infections.........................................................................................................................29
Parasite/ protozoa ..........................................................................................................................31
Fungi and yeast ..............................................................................................................................31
How to treat pathogenic infections?.................................................................................................34
Lecture 5 – Technique to determine adaptive immune responses ................................................... 36
Part 1 – Flow cytometry: technique ..................................................................................................37
Part 2 – Flow cytometry: determining T-cell responses ......................................................................38
Part 3 – ELISA technique .................................................................................................................40
Lecture 6 – Research techniques neurobiology ............................................................................. 44
Lecture 7 – Outbreak policies and interventions ............................................................................ 49
International public health (AMR = antimicrobial resistance)) ............................................................53
Lecture 8 – Research techniques infectious diseases .................................................................... 56
Lecture 9 – Measles – the infectious disease that targets immunity and brain ................................. 65
Lecture 10 – Biostatistics and epidemiology 1 ............................................................................... 70
Lecture 11 – Biostatistics and epidemiology 2 ............................................................................... 74
Applied biostatistics knowledge clips........................................................................................... 77
Lecture 12 – Innovations in biomedical sciences ........................................................................... 83
Lecture 13 – Ethics in research ..................................................................................................... 92
Lecture 14 – Biomedical sciences in dialogue ............................................................................... 96
1
,Lecture 1 – Introduction & History of (interdisciplinarity)
in biomedical sciences
Ø Integration of di-erent biomedical disciplines
Ø Definition of biomedical sciences
o Biomedicine is a branch of medical science that applies biological and
physiological principles to clinical practice
o There is no universally agreed upon definition of ‘biomedicine’, it is often
conceptualized as the search for therapeutic/ medical innovations on the
laboratory
Ø Scientific revolution started 17th century > the body works as a machine
o Boerhave > hydraulic system - fluids
o Harvey > heart is a pump
o Corvisart > introduction percussion (early 19th century), is stethoscope
nowadays
§ There was resistance (late 19the century) from the use of these
instruments
§ We now see that still: medical innovation comes with resistance
o Von liebig – laboratory
o Virchow – cellular pathology
o Ernst abbe – microscope improvement
Laboratory revolution:
- Koch Postulate! – to establish a causal relationship between a microbe and a disease
o Foundation of biomedicine
1. The microorganism must be found in abundance in all organisms su-ering from
the disease but should not be found in healthy organisms
2. The microorganism must be isolated from a diseased organism and grown in
culture
3. The cultured microorganism should cause disease when introduced into a
healthy organism
4. The microorganism must be re-isolated from the inoculated, disease
experimental host and identified as being identical to the original specific
causative agent
- Pasteur – micro-organisms, pasteurization and rabies vaccine
- Fleming – discovered first antibiotic penicillin (1928)
Biomedicine increasingly came to signify ‘modern medicine’
Ø Biomedicine became the dominant research field of treating diseases
Ø Biomedical paradigm/ biomedicalization
o The biomedical model of medical care is the medical model used in most
western healthcare settings, and is built on the perception that a state of health
is defined purely in the absence of disease
2
, Biomedicine as practice
1. Diagnosis, etiology (cause/ origin of disease), interventions
o Increasingly focused on metrics/ numbers (cholesterol, genes etc.) rather than
symptoms
2. Clinical trials/ meta-analysis (proof of interventions)
o Integration of hospitals and patients into the biomedical enterprise >
development of RCT
3. Risk and enhancement
o Hormone replacement therapy, started o- as therapy for severe symptoms of
menopause, to become a preferred treatment to keep the skin of
postmenopausal woman supple (flexible)
§ This is also what we see with biomedicalization, we move beyond the
domain of disease
Reductionism
- A metaphor that can show that we can break down parts of the body and that we then
can research these parts apart from each other
- Definitions of di-erent disciplines:
o Ontological claim: a whole organism is nothing more than the sum of its part
o Epistemological claim: organism is best explained by reference to (in terms of) its
parts
o Methodological claim: organism is best investigated by its parts
- We now try to isolate things we want to study > this is not in line with the start at the
evolution where we wanted to see the body as whole system
- We more and more realize how everything is connected
- For a lot of the solutions that are made up > they don’t work in practice, because the
body is a changing thing
Evidence based medicine
Ø A systematic approach to medicine in which doctors and other health care professionals
use the best available scientific evidence from clinical research to help make decisions
about the care of individual patients
Ø Using RCTs, adding meta-analysis results
Ø Problems:
o Based on statistics on healthy people, but most of the patients that are seen are
not young healthy
o A lot of research is pushed by companies (pharmaceutical) which have their own
interest (they will prioritize research in their interest)
o By increasing power (more people in trial) we can identify statistical significance,
but we have the question whether its biomedically relevant
Crisis in evidence based medicine?
- The evidence based “quality mark” has been misappropriated by vested interests
- The volume of evidence, especially clinical guidelines, has become unmanageable
- Statistically significant benefits may be marginal in clinical practice
- Inflexible rules and technology driven prompts may produce care that is management
driven rather than patient centered
- Evidence based guidelines often map poorly to individuals, and complex multimorbidity
3
