THE FIRST TWO YEARS

LESSON OF A DOCTOR

ANATOMY
BIOCHEMISTRY
MICROBIOLOGY
PATHOLOGY
PHARMACOLOGY
 INTRODUCTIONS
ONLY

Anatomy: A brief
introduction
 Gross anatomy

 Microscopic anatomy

 Histopathology

 Studying anatomy

Anatomy is the identification and description of

the structures of living things. It is a branch of
biology and medicine.

The study of anatomy goes back over 2,000 years, to the Ancient Greeks. It
can be divided into three broad areas: Human anatomy, zootomy, or animal
anatomy, and phytotomy, which is plant anatomy.
Human anatomy is the study of the structures of the human body. An
understanding of anatomy is key to the practice of health and medicine.

The word “anatomy” comes from the Greek words “ana,” meaning “up,” and
“tome,” meaning “a cutting.” Studies of anatomy have traditionally depended
on cutting up, or dissection, but now, with imaging technology, it is
increasingly possible to see how a body is made up without dissection.

There are two ways of looking at anatomy: Gross, or macroscopic, anatomy

and microscopic anatomy.

Gross anatomy

Share on Pin terest Knowing about anatomy is key to understanding healthcare.

In medicine, gross anatomy, macro anatomy, or topographical anatomy refers
to the study of the biological structures that are visible to the naked eye.

The study of gross anatomy may involve dissection or noninvasive methods.

The aim is to collect data about the larger structures of organs and organ
systems.

In dissection, the scientist cuts open the human or animal cadaver is cut open
and examines its organs.

Endoscopy, inserting a tube with a camera at the end, might be used to study
structures within living animals. Endoscopy is performed either through the
mouth or through the rectum, so the gastrointestinal tract is often the primary
organ of interest.

There are also less invasive methods. For example, to study the blood
vessels of living animals or humans, the scientist may insert an opaque dye
into the animal that will highlight the circulatory system when imaging
technology, such as angiography.

Techniques such as magnetic resonance imaging (MRI), computed

tomography (CT), or x-ray also reveal information about the inside of a living
body.

Medical and dental students perform dissection as part of their practical work
in gross human anatomy during their studies. They may dissect a human
corpse.

Students of gross anatomy will need to learn about the major body systems.

Human body systems

There are 11 organ systems in the human body: http://www.innerbody.com/

  The integumentary system, meaning skin, hair, nails, and so on
 Skeletal system
 Muscular system
 Lymphatic system
 Respiratory system
 Digestive system
 Nervous system
 Endocrine system, which regulates hormone production
 Cardiovascular system
 Urinary system
 Reproductive systems

Although these systems have different names, they all work interdependently,
meaning they work together and depend on each other.

Microscopic anatomy
Share on Pin terest On a microscopic level, anatomy looks at cell structure and function.

Microscopic anatomy, also known as histology, is the study of cells and

tissues of animals, humans and plants that are too small to been seen with
the naked eye.

By looking at tissue under the microscope, we can learn about the

architecture of the cells, how they are put together, and how they relate to
each other.

For example, if a person has cancer, examining the tissue under the

microscope will reveal how the cancer cells are acting and how they affect
normal human tissue.
This commonly involves studying tissues and cells using histological
techniques such as sectioning and staining, and then looking at them under
an electron or light microscope.

Sectioning involves cutting tissue into very thin slices so they can be
examined. Histological stains are added to biological structures, such as
tissues, to add colors or to enhance colors so they can be more easily
distinguished when they are examined, especially if different structures are
next to each other.

Histology is vital for the understanding and advancement of medicine,

veterinary medicine, biology, and other aspects of life science.

Histology is used for:

Teaching: Histology slides are used in teaching labs to help students who are
learning about the microstructures of biological tissues.

Diagnosis: Tissue samples, or biopsies, are taken from patients and sent to
the lab for analysis by a histologist.

Forensic investigations: The microscopic study of biological tissues can

help explain why, for example, somebody unexpectedly died.

Autopsies: As in forensic investigations, biological tissues from deceased

people and animals can be analyzed, so that investigators may better
understand the causes of death.

Archeology: Biological samples from archeological sites can provide useful

data about what was going on in history or ancient history.

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Histopathology
Histotechnicians, also known as histology technicians, histology technologists,
biomedical scientists, medical scientists, or medical laboratory technicians,
work in histology laboratories.

These specialists use special skills to process samples of biological tissues

that may come from patients, from suspects if it is a forensic lab, or from
corpses. Using a series of techniques, they prepare tiny slices of tissue,
known as sections. They mount the slices on slides and add histology stains.
The slides are then examined by a histopathologist, or pathologist, for
analysis.

The skills of a histologist must be meticulous and precise to deliver top-quality

samples for examination under a microscope by histopathologist.

A pathologist is a medical doctor who has graduated from medical school and
then goes on to specialize in pathology through their residency. Residency
programs are required for all specialties, and for pathology, the training is an
additional four years.

They examine cells and tissues and interpret what they see, so that they or
others can use the data to decide on treatment for an illness, determine how
somebody was injured or died, and so on.
Histopathology is a sub-discipline of pathology. It is the microscopic study of
disease tissues and cells.

Studying anatomy
Most health-care related studies need training in gross anatomy and histology.
Paramedics, physical therapists, occupational therapists, medical doctors,
orthotists and prosthetists, and biological scientists all need a knowledge of
anatomy.

Some websites offer a “tour” of the human body which explains the different
organs and how they are made up. The National Institutes of Health offer a
range of resources about the different parts of the body.

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Biochemistry
From Wikipedia, the free encyclopedia
Jump to navigationJump to search
"Biological Chemistry" redirects here. For the journals, see Biochemistry
(journal) and Biological Chemistry (journal).
For the textbook by Lubert Stryer, see Biochemistry (Stryer).

Part of a series on

Biochemistry
 Key components

 Biomolecules
 Metabolism

 Index
 Outline

History of Biochemistry

 History

 Biochemistry
 Cell biology
 Bioinformatics
 Enzymology
 Genetics
 Immunology
 Molecular biology
 Plant biochemistry
 Structural biology

 Branches of biochemistry

 List of biochemists

Glossaries

 Glossary of biology
 Glossary of chemistry

Portals: Biochemistry

 v
  t
 e

Biochemistry, sometimes called biological chemistry, is the study of chemical

processes within and relating to living organisms.[1] Biochemical processes give rise to
the complexity of life.
For instance, in every living cell, there is a crucial biological process, called respiration.
This process is the conversion of glucose into a useful form of energy, which is ATP
(adenosine triphosphate). The study of biochemistry uncovers the numerous chemical
processes involved in converting glucose into carbon dioxide and water.
A sub-discipline of both biology and chemistry, biochemistry can be divided into three
fields: structural biology, enzymology and metabolism. Over the last decades of the 20th
century, biochemistry has become successful at explaining living processes through
these three disciplines. Almost all areas of the life sciences are being uncovered and
developed by biochemical methodology and research. [2] Biochemistry focuses on
understanding the chemical basis which allows biological molecules to give rise to the
processes that occur within living cells and between cells,[3] which in turn relates greatly
to the study and understanding of tissues and organs, as well as organism structure and
function.[4]
Biochemistry is closely related to molecular biology, the study of
the molecular mechanisms of biological phenomena.[5]
Much of biochemistry deals with the structures, functions, and interactions of
biological macromolecules, such as proteins, nucleic acids, carbohydrates, and lipids,
which provide the structure of cells and perform many of the functions associated with
life.[6] The chemistry of the cell also depends on the reactions of
smaller molecules and ions. These can be inorganic (for example, water and metal ions)
or organic (for example, the amino acids, which are used to synthesize proteins).[7] The
mechanisms by which cells harness energy from their environment via chemical
reactions are known as metabolism. The findings of biochemistry are applied primarily
in medicine, nutrition and agriculture. In medicine, biochemists investigate the causes
and cures of diseases.[8] In nutrition, they study how to maintain health and wellness and
study the effects of nutritional deficiencies.[9] In agriculture, biochemists
investigate soil and fertilizers. They also try to discover ways to improve crop cultivation,
crop storage, and pest control.

Contents

 1History
 2Starting materials: the chemical elements of life
 3Biomolecules
o 3.1Carbohydrates
o 3.2Lipids
o 3.3Proteins
 o 3.4Nucleic acids
 4Metabolism
o 4.1Carbohydrates as energy source
 4.1.1Glycolysis (anaerobic)
 4.1.2Aerobic
 4.1.3Gluconeogenesis
 5Relationship to other "molecular-scale" biological sciences
 6Extremophiles
 7See also
o 7.1Lists
o 7.2See also
 8Notes
 9References
o 9.1Cited literature
 10Further reading
 11External links

History[edit]
Main article: History of biochemistry

Gerty Cori and Carl Cori jointly won the Nobel Prize in 1947 for their discovery of the Cori cycle at RPMI.

At its broadest definition, biochemistry can be seen as a study of the components and
composition of living things and how they come together to become life. In this sense,
the history of biochemistry may therefore go back as far as the ancient Greeks.
[10]
 However, biochemistry as a specific scientific discipline began sometime in the 19th
century, or a little earlier, depending on which aspect of biochemistry is being focused
on. Some argued that the beginning of biochemistry may have been the discovery of the
first enzyme, diastase (now called amylase), in 1833 by Anselme Payen,[11] while others
considered Eduard Buchner's first demonstration of a complex biochemical
process alcoholic fermentation in cell-free extracts in 1897 to be the birth of
biochemistry.[12][13] Some might also point as its beginning to the influential 1842 work
by Justus von Liebig, Animal chemistry, or, Organic chemistry in its applications to
physiology and pathology, which presented a chemical theory of metabolism,[10] or even
earlier to the 18th century studies on fermentation and respiration by Antoine Lavoisier.
[14][15]
 Many other pioneers in the field who helped to uncover the layers of complexity of
biochemistry have been proclaimed founders of modern biochemistry. Emil Fischer,
who studied the chemistry of proteins,[16] and F. Gowland Hopkins, who studied enzymes
and the dynamic nature of biochemistry, represent two examples of early biochemists. [17]
The term "biochemistry" itself is derived from a combination of biology and chemistry. In
1877, Felix Hoppe-Seyler used the term (biochemie in German) as a synonym
for physiological chemistry in the foreword to the first issue of Zeitschrift für
Physiologische Chemie (Journal of Physiological Chemistry) where he argued for the
setting up of institutes dedicated to this field of study. [18][19] The German chemist Carl
Neuberg however is often cited to have coined the word in 1903, [20][21][22] while some
credited it to Franz Hofmeister.[23]

DNA structure (1D65)[24]

It was once generally believed that life and its materials had some essential property or
substance (often referred to as the "vital principle") distinct from any found in non-living
matter, and it was thought that only living beings could produce the molecules of life.
[25]
 Then, in 1828, Friedrich Wöhler published a paper on the synthesis of urea, proving
that organic compounds can be created artificially. [26] Since then, biochemistry has
advanced, especially since the mid-20th century, with the development of new
techniques such as chromatography, X-ray diffraction, dual polarisation
interferometry, NMR spectroscopy, radioisotopic labeling, electron
microscopy and molecular dynamics simulations. These techniques allowed for the
discovery and detailed analysis of many molecules and metabolic pathways of the cell,
such as glycolysis and the Krebs cycle (citric acid cycle), and led to an understanding of
biochemistry on a molecular level.
Another significant historic event in biochemistry is the discovery of the gene, and its
role in the transfer of information in the cell. In the 1950s, James D. Watson, Francis
Crick, Rosalind Franklin and Maurice Wilkins were instrumental in solving DNA structure
and suggesting its relationship with the genetic transfer of information. [27] In
1958, George Beadle and Edward Tatum received the Nobel Prize for work in fungi
showing that one gene produces one enzyme.[28] In 1988, Colin Pitchfork was the first
person convicted of murder with DNA evidence, which led to the growth of forensic
science.[29] More recently, Andrew Z. Fire and Craig C. Mello received the 2006 Nobel
Prize for discovering the role of RNA interference (RNAi), in the silencing of gene
expression.[30]

Starting materials: the chemical elements of life [edit]

The main elements that compose the human body shown from most abundant (by mass) to least abundant.

Main articles: Composition of the human body and Dietary mineral

Around two dozen chemical elements are essential to various kinds of biological life.
Most rare elements on Earth are not needed by life (exceptions
being selenium and iodine)[citation needed], while a few common ones (aluminum and titanium)
are not used. Most organisms share element needs, but there are a few differences
between plants and animals. For example, ocean algae use bromine, but land plants
and animals seem to need none. All animals require sodium, but some plants do not.
Plants need boron and silicon, but animals may not (or may need ultra-small amounts).
Just six elements—carbon, hydrogen, nitrogen, oxygen, calcium and phosphorus—
make up almost 99% of the mass of living cells, including those in the human body
(see composition of the human body for a complete list). In addition to the six major
elements that compose most of the human body, humans require smaller amounts of
possibly 18 more.[31]

Biomolecules[edit]
Main article: Biomolecule
The four main classes of molecules in biochemistry (often called biomolecules)
are carbohydrates, lipids, proteins, and nucleic acids.[32] Many biological molecules
are polymers: in this terminology, monomers are relatively small macromolecules that
are linked together to create large macromolecules known as polymers. When
monomers are linked together to synthesize a biological polymer, they undergo a
process called dehydration synthesis. Different macromolecules can assemble in larger
complexes, often needed for biological activity.
Carbohydrates[edit]
Main articles: Carbohydrate, Monosaccharide, Disaccharide, and Polysaccharide
Carbohydrates

Glucose, a monosaccharide

A molecule of sucrose (glucose + fructose), a disaccharide

Amylose, a polysaccharide made up of several thousand glucose units

Two of the main functions of carbohydrates are energy storage and providing structure.
One of the common sugars known as glucose is carbohydrate, but not all carbohydrates
are sugars. There are more carbohydrates on Earth than any other known type of
biomolecule; they are used to store energy and genetic information, as well as play
important roles in cell to cell interactions and communications.
The simplest type of carbohydrate is a monosaccharide, which among other properties
contains carbon, hydrogen, and oxygen, mostly in a ratio of 1:2:1 (generalized formula
CnH2nOn, where n is at least 3). Glucose (C6H12O6) is one of the most important
carbohydrates; others include fructose (C6H12O6), the sugar commonly associated with
the sweet taste of fruits,[33][a] and deoxyribose (C5H10O4), a component of DNA. A
monosaccharide can switch between acyclic (open-chain) form and a cyclic form. The
open-chain form can be turned into a ring of carbon atoms bridged by an oxygen atom
created from the carbonyl group of one end and the hydroxyl group of another. The
cyclic molecule has a hemiacetal or hemiketal group, depending on whether the linear
form was an aldose or a ketose.[34]
In these cyclic forms, the ring usually has 5 or 6 atoms. These forms are
called furanoses and pyranoses, respectively—by analogy with furan and pyran, the
simplest compounds with the same carbon-oxygen ring (although they lack the carbon-
carbon double bonds of these two molecules). For example, the
aldohexose glucose may form a hemiacetal linkage between the hydroxyl on carbon 1
and the oxygen on carbon 4, yielding a molecule with a 5-membered ring,
called glucofuranose. The same reaction can take place between carbons 1 and 5 to
form a molecule with a 6-membered ring, called glucopyranose. Cyclic forms with a 7-
atom ring called heptoses are rare.
Two monosaccharides can be joined together by a glycosidic or ether bond into
a disaccharide through a dehydration reaction during which a molecule of water is
released. The reverse reaction in which the glycosidic bond of a disaccharide is broken
into two monosaccharides is termed hydrolysis. The best-known disaccharide
is sucrose or ordinary sugar, which consists of a glucose molecule and
a fructose molecule joined together. Another important disaccharide is lactose found in
milk, consisting of a glucose molecule and a galactose molecule. Lactose may be
hydrolysed by lactase, and deficiency in this enzyme results in lactose intolerance.
When a few (around three to six) monosaccharides are joined, it is called
an oligosaccharide (oligo- meaning "few"). These molecules tend to be used as markers
and signals, as well as having some other uses.[35] Many monosaccharides joined
together form a polysaccharide. They can be joined together in one long linear chain, or
they may be branched. Two of the most common polysaccharides
are cellulose and glycogen, both consisting of repeating
glucose monomers. Cellulose is an important structural component of plant's cell
walls and glycogen is used as a form of energy storage in animals.
Sugar can be characterized by having reducing or non-reducing ends. A reducing
end of a carbohydrate is a carbon atom that can be in equilibrium with the open-
chain aldehyde (aldose) or keto form (ketose). If the joining of monomers takes place at
such a carbon atom, the free hydroxy group of the pyranose or furanose form is
exchanged with an OH-side-chain of another sugar, yielding a full acetal. This prevents
opening of the chain to the aldehyde or keto form and renders the modified residue non-
reducing. Lactose contains a reducing end at its glucose moiety, whereas the galactose
moiety forms a full acetal with the C4-OH group of glucose. Saccharose does not have
a reducing end because of full acetal formation between the aldehyde carbon of glucose
(C1) and the keto carbon of fructose (C2).
Lipids[edit]
Main articles: Lipid, Glycerol, and Fatty acid
Structures of some common lipids. At the top are cholesterol and oleic acid.[36] The middle structure is
a triglyceride composed of oleoyl, stearoyl, and palmitoyl chains attached to a glycerol backbone. At the bottom
is the common phospholipid, phosphatidylcholine.[37]

Lipids comprise a diverse range of molecules and to some extent is a catchall for

relatively water-insoluble or nonpolar compounds of biological origin,
including waxes, fatty acids, fatty-acid derived phospholipids, sphingolipids, glycolipids,
and terpenoids (e.g., retinoids and steroids). Some lipids are linear, open-
chain aliphatic molecules, while others have ring structures. Some are aromatic (with a
cyclic [ring] and planar [flat] structure) while others are not. Some are flexible, while
others are rigid.
Lipids are usually made from one molecule of glycerol combined with other molecules.
In triglycerides, the main group of bulk lipids, there is one molecule of glycerol and
three fatty acids. Fatty acids are considered the monomer in that case, and may
be saturated (no double bonds in the carbon chain) or unsaturated (one or more double
bonds in the carbon chain).
Most lipids have some polar character in addition to being largely nonpolar. In general,
the bulk of their structure is nonpolar or hydrophobic ("water-fearing"), meaning that it
does not interact well with polar solvents like water. Another part of their structure is
polar or hydrophilic ("water-loving") and will tend to associate with polar solvents like
water. This makes them amphiphilic molecules (having both hydrophobic and
hydrophilic portions). In the case of cholesterol, the polar group is a mere –OH (hydroxyl
or alcohol). In the case of phospholipids, the polar groups are considerably larger and
more polar, as described below.
Lipids are an integral part of our daily diet. Most oils and milk products that we use for
cooking and eating like butter, cheese, ghee etc., are composed of fats. Vegetable
oils are rich in various polyunsaturated fatty acids (PUFA). Lipid-containing foods
undergo digestion within the body and are broken into fatty acids and glycerol, which
are the final degradation products of fats and lipids. Lipids, especially phospholipids, are
also used in various pharmaceutical products, either as co-solubilisers (e.g., in
parenteral infusions) or else as drug carrier components (e.g., in
a liposome or transfersome).
Proteins[edit]
Main articles: Protein and Amino acid

The general structure of an α-amino acid, with the amino group on the left and the carboxyl group on the right.

Proteins are very large molecules—macro-biopolymers—made from monomers

called amino acids. An amino acid consists of an alpha carbon atom attached to
an amino group, –NH2, a carboxylic acid group, –COOH (although these exist as –
NH3+ and –COO− under physiologic conditions), a simple hydrogen atom, and a side
chain commonly denoted as "–R". The side chain "R" is different for each amino acid of
which there are 20 standard ones. It is this "R" group that made each amino acid
different, and the properties of the side-chains greatly influence the overall three-
dimensional conformation of a protein. Some amino acids have functions by themselves
or in a modified form; for instance, glutamate functions as an
important neurotransmitter. Amino acids can be joined via a peptide bond. In
this dehydration synthesis, a water molecule is removed and the peptide bond connects
the nitrogen of one amino acid's amino group to the carbon of the other's carboxylic acid
group. The resulting molecule is called a dipeptide, and short stretches of amino acids
(usually, fewer than thirty) are called peptides or polypeptides. Longer stretches merit
the title proteins. As an example, the important blood serum protein albumin contains
585 amino acid residues.[38]

Generic amino acids (1) in neutral form, (2) as they exist physiologically, and (3) joined together as a dipeptide.
A schematic of hemoglobin. The red and blue ribbons represent the protein globin; the green structures are
the heme groups.

Proteins can have structural and/or functional roles. For instance, movements of the
proteins actin and myosin ultimately are responsible for the contraction of skeletal
muscle. One property many proteins have is that they specifically bind to a certain
molecule or class of molecules—they may be extremely selective in what they
bind. Antibodies are an example of proteins that attach to one specific type of molecule.
Antibodies are composed of heavy and light chains. Two heavy chains would be linked
to two light chains through disulfide linkages between their amino acids. Antibodies are
specific through variation based on differences in the N-terminal domain. [39]
The enzyme-linked immunosorbent assay (ELISA), which uses antibodies, is one of the
most sensitive tests modern medicine uses to detect various biomolecules. Probably the
most important proteins, however, are the enzymes. Virtually every reaction in a living
cell requires an enzyme to lower the activation energy of the reaction. These molecules
recognize specific reactant molecules called substrates; they then catalyze the reaction
between them. By lowering the activation energy, the enzyme speeds up that reaction
by a rate of 1011 or more; a reaction that would normally take over 3,000 years to
complete spontaneously might take less than a second with an enzyme. The enzyme
itself is not used up in the process and is free to catalyze the same reaction with a new
set of substrates. Using various modifiers, the activity of the enzyme can be regulated,
enabling control of the biochemistry of the cell as a whole. [citation needed]
The structure of proteins is traditionally described in a hierarchy of four levels.
The primary structure of a protein consists of its linear sequence of amino acids; for
instance, "alanine-glycine-tryptophan-serine-glutamate-asparagine-glycine-lysine-
…". Secondary structure is concerned with local morphology (morphology being the
study of structure). Some combinations of amino acids will tend to curl up in a coil called
an α-helix or into a sheet called a β-sheet; some α-helixes can be seen in the
hemoglobin schematic above. Tertiary structure is the entire three-dimensional shape of
the protein. This shape is determined by the sequence of amino acids. In fact, a single
change can change the entire structure. The alpha chain of hemoglobin contains 146
amino acid residues; substitution of the glutamate residue at position 6 with
a valine residue changes the behavior of hemoglobin so much that it results in sickle-
cell disease. Finally, quaternary structure is concerned with the structure of a protein
with multiple peptide subunits, like hemoglobin with its four subunits. Not all proteins
have more than one subunit.[40]
Examples of protein structures from the Protein Data Bank

Members of a protein family, as represented by the structures of the isomerase domains

Ingested proteins are usually broken up into single amino acids or dipeptides in
the small intestine and then absorbed. They can then be joined to form new proteins.
Intermediate products of glycolysis, the citric acid cycle, and the pentose phosphate
pathway can be used to form all twenty amino acids, and most bacteria and plants
possess all the necessary enzymes to synthesize them. Humans and other mammals,
however, can synthesize only half of them. They cannot
synthesize isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan,
and valine. Because they must be ingested, these are the essential amino acids.
Mammals do possess the enzymes to
synthesize alanine, asparagine, aspartate, cysteine, glutamate, glutamine, glycine, proli
ne, serine, and tyrosine, the nonessential amino acids. While they can
synthesize arginine and histidine, they cannot produce it in sufficient amounts for young,
growing animals, and so these are often considered essential amino acids.
If the amino group is removed from an amino acid, it leaves behind a carbon skeleton
called an α-keto acid. Enzymes called transaminases can easily transfer the amino
group from one amino acid (making it an α-keto acid) to another α-keto acid (making it
an amino acid). This is important in the biosynthesis of amino acids, as for many of the
pathways, intermediates from other biochemical pathways are converted to the α-keto
acid skeleton, and then an amino group is added, often via transamination. The amino
acids may then be linked together to form a protein.
A similar process is used to break down proteins. It is first hydrolyzed into its component
amino acids. Free ammonia (NH3), existing as the ammonium ion (NH4+) in blood, is
toxic to life forms. A suitable method for excreting it must therefore exist. Different
tactics have evolved in different animals, depending on the animals'
needs. Unicellular organisms simply release the ammonia into the environment.
Likewise, bony fish can release the ammonia into the water where it is quickly diluted. In
general, mammals convert the ammonia into urea, via the urea cycle.
In order to determine whether two proteins are related, or in other words to decide
whether they are homologous or not, scientists use sequence-comparison methods.
Methods like sequence alignments and structural alignments are powerful tools that
help scientists identify homologies between related molecules. The relevance of finding
homologies among proteins goes beyond forming an evolutionary pattern of protein
families. By finding how similar two protein sequences are, we acquire knowledge about
their structure and therefore their function.
Nucleic acids[edit]
Main articles: Nucleic acid, DNA, RNA, and Nucleotide

The structure of deoxyribonucleic acid (DNA), the picture shows the monomers being put together.

Nucleic acids, so-called because of their prevalence in cellular nuclei, is the generic

name of the family of biopolymers. They are complex, high-molecular-weight
biochemical macromolecules that can convey genetic information in all living cells and
viruses.[2] The monomers are called nucleotides, and each consists of three
components: a nitrogenous heterocyclic base (either a purine or a pyrimidine), a
pentose sugar, and a phosphate group.[41]

Structural elements of common nucleic acid constituents. Because they contain at least one phosphate group,
the compounds marked nucleoside monophosphate, nucleoside diphosphate and nucleoside triphosphate are
all nucleotides (not simply phosphate-lacking nucleosides).

The most common nucleic acids are deoxyribonucleic acid (DNA) and ribonucleic

acid (RNA). The phosphate group and the sugar of each nucleotide bond with each
other to form the backbone of the nucleic acid, while the sequence of nitrogenous bases
stores the information. The most common nitrogenous bases
are adenine, cytosine, guanine, thymine, and uracil. The nitrogenous bases of each
strand of a nucleic acid will form hydrogen bonds with certain other nitrogenous bases
in a complementary strand of nucleic acid (similar to a zipper). Adenine binds with
thymine and uracil, thymine binds only with adenine, and cytosine and guanine can bind
only with one another.
Aside from the genetic material of the cell, nucleic acids often play a role as second
messengers, as well as forming the base molecule for adenosine triphosphate (ATP),
the primary energy-carrier molecule found in all living organisms. Also, the nitrogenous
bases possible in the two nucleic acids are different: adenine, cytosine, and guanine
occur in both RNA and DNA, while thymine occurs only in DNA and uracil occurs in
RNA.

Metabolism[edit]
Carbohydrates as energy source[edit]
Main article: Carbohydrate metabolism
Glucose is an energy source in most life forms. For instance, polysaccharides are
broken down into their monomers by enzymes (glycogen phosphorylase removes
glucose residues from glycogen, a polysaccharide). Disaccharides like lactose or
sucrose are cleaved into their two component monosaccharides.
Glycolysis (anaerobic)[edit]
 Glucose
G6P
F6P
F1,6BP
GADP
DHAP
1,3BPG
3PG
2PG
PEP
Pyruvate
HK
PGI
PFK
ALDO
TPI
GAPDH
PGK
PGM
ENO
PK
Glycolysis

The metabolic pathway of glycolysis converts glucose to pyruvate by via a series of intermediate metabolites.    Each

chemical modification is performed by a different enzyme.    Steps 1 and 3 consume ATP and    steps 7 and 10 produce
ATP. Since steps 6–10 occur twice per glucose molecule, this leads to a net production of ATP.

Glucose is mainly metabolized by a very important ten-step pathway called glycolysis,

the net result of which is to break down one molecule of glucose into two molecules
of pyruvate. This also produces a net two molecules of ATP, the energy currency of
cells, along with two reducing equivalents of converting NAD+ (nicotinamide adenine
dinucleotide: oxidized form) to NADH (nicotinamide adenine dinucleotide: reduced
form). This does not require oxygen; if no oxygen is available (or the cell cannot use
oxygen), the NAD is restored by converting the pyruvate to lactate (lactic acid) (e.g., in
humans) or to ethanol plus carbon dioxide (e.g., in yeast). Other monosaccharides like
galactose and fructose can be converted into intermediates of the glycolytic pathway. [42]
Aerobic[edit]
In aerobic cells with sufficient oxygen, as in most human cells, the pyruvate is further
metabolized. It is irreversibly converted to acetyl-CoA, giving off one carbon atom as the
waste product carbon dioxide, generating another reducing equivalent as NADH. The
two molecules acetyl-CoA (from one molecule of glucose) then enter the citric acid
cycle, producing two molecules of ATP, six more NADH molecules and two reduced
(ubi)quinones (via FADH2 as enzyme-bound cofactor), and releasing the remaining carbon
atoms as carbon dioxide. The produced NADH and quinol molecules then feed into the
enzyme complexes of the respiratory chain, an electron transport system transferring
the electrons ultimately to oxygen and conserving the released energy in the form of a
proton gradient over a membrane (inner mitochondrial membrane in eukaryotes). Thus,
oxygen is reduced to water and the original electron acceptors NAD + and quinone are
regenerated. This is why humans breathe in oxygen and breathe out carbon dioxide.
The energy released from transferring the electrons from high-energy states in NADH
and quinol is conserved first as proton gradient and converted to ATP via ATP
synthase. This generates an additional 28 molecules of ATP (24 from the 8 NADH + 4
from the 2 quinols), totaling to 32 molecules of ATP conserved per degraded glucose
(two from glycolysis + two from the citrate cycle). [43] It is clear that using oxygen to
completely oxidize glucose provides an organism with far more energy than any
oxygen-independent metabolic feature, and this is thought to be the reason why
complex life appeared only after Earth's atmosphere accumulated large amounts of
oxygen.
Gluconeogenesis[edit]
Main article: Gluconeogenesis
In vertebrates, vigorously contracting skeletal muscles (during weightlifting or sprinting,
for example) do not receive enough oxygen to meet the energy demand, and so they
shift to anaerobic metabolism, converting glucose to lactate. The combination of
glucose from noncarbohydrates origin, such as fat and proteins. This only happens
when glycogen supplies in the liver are worn out. The pathway is a crucial reversal
of glycolysis from pyruvate to glucose and can utilize many sources like amino acids,
glycerol and Krebs Cycle. Large scale protein and fat catabolism usually occur when
those suffer from starvation or certain endocrine disorders. [44] The liver regenerates the
glucose, using a process called gluconeogenesis. This process is not quite the opposite
of glycolysis, and actually requires three times the amount of energy gained from
glycolysis (six molecules of ATP are used, compared to the two gained in glycolysis).
Analogous to the above reactions, the glucose produced can then undergo glycolysis in
tissues that need energy, be stored as glycogen (or starch in plants), or be converted to
other monosaccharides or joined into di- or oligosaccharides. The combined pathways
of glycolysis during exercise, lactate's crossing via the bloodstream to the liver,
subsequent gluconeogenesis and release of glucose into the bloodstream is called
the Cori cycle.[45]

Relationship to other "molecular-scale" biological

sciences[edit]
Schematic relationship between biochemistry, genetics, and molecular biology.

Researchers in biochemistry use specific techniques native to biochemistry, but

increasingly combine these with techniques and ideas developed in the fields
of genetics, molecular biology, and biophysics. There is not a defined line between
these disciplines. Biochemistry studies the chemistry required for biological activity of
molecules, molecular biology studies their biological activity, genetics studies their
heredity, which happens to be carried by their genome. This is shown in the following
schematic that depicts one possible view of the relationships between the fields:

 Biochemistry is the study of the chemical substances and vital processes

occurring in live organisms. Biochemists focus heavily on the role, function, and
structure of biomolecules. The study of the chemistry behind biological processes
and the synthesis of biologically active molecules are examples of biochemistry..
Biochemistry studies life at the atomic and molecular level.
 Genetics is the study of the effect of genetic differences in organisms. This can
often be inferred by the absence of a normal component (e.g. one gene). The study
of "mutants" – organisms that lack one or more functional components with respect
to the so-called "wild type" or normal phenotype. Genetic interactions (epistasis) can
often confound simple interpretations of such "knockout" studies.
 Molecular biology is the study of molecular underpinnings of the processes
of replication, transcription, translation, and cell function. The central dogma of
molecular biology where genetic material is transcribed into RNA and then
translated into protein, despite being oversimplified, still provides a good starting
point for understanding the field. The picture has been revised in light of emerging
novel roles for RNA. Molecular Biology studies life at the molecular and cellular level
 'Chemical biology' seeks to develop new tools based on small molecules that
allow minimal perturbation of biological systems while providing detailed information
about their function. Further, chemical biology employs biological systems to create
non-natural hybrids between biomolecules and synthetic devices (for example
emptied viral capsids that can deliver gene therapy or drug molecules).
Extremophiles[edit]
Extremophiles are microorganisms that live in extreme conditions, some of which may
provide some exceptions or variations on some of the natural laws cited above. For
example, in July 2019, a scientific study of Kidd Mine in Canada discovered sulfur-
breathing organisms that live 7900 feet below the surface and absorb sulfur instead of
oxygen to facilitate cellular respiration. These organisms are also remarkable due to
eating rocks such as pyrite as their regular food source. [46][47][48]
The DNA polymerase of the thermophile bacteria Thermus aquaticus, extracted in 1968
and named Taq polymerase, is a biochemical DNA replicator resistant to relative high
temperatures (50-80 °C), which has allowed molecular biologists to ease complications
in the PCR (Polymerase Chain Reaction) method.

Microbiology
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An agar plate streaked with microorganisms

Microbiology (from Greek μῑκρος, mīkros, "small"; βίος, bios, "life"; and -λογία, -logia) is

the study of microorganisms, those being unicellular (single cell), multicellular (cell
colony), or acellular (lacking cells).[1][2] Microbiology encompasses numerous sub-
disciplines including virology, bacteriology, protistology, mycology, immunology
and parasitology.
Eukaryotic microorganisms possess membrane-bound organelles and
include fungi and protists, whereas prokaryotic organisms—all of which are
microorganisms—are conventionally classified as lacking membrane-bound organelles
and include Bacteria and Archaea.[3][4] Microbiologists traditionally relied on culture,
staining, and microscopy. However, less than 1% of the microorganisms present in
common environments can be cultured in isolation using current means.
[5]
 Microbiologists often rely on molecular biology tools such as DNA sequence based
identification, for example the 16S rRNA gene sequence used for bacteria identification.
Viruses have been variably classified as organisms, [6] as they have been considered
either as very simple microorganisms or very complex molecules. Prions, never
 considered as microorganisms, have been investigated by virologists, however, as the
clinical effects traced to them were originally presumed due to chronic viral infections,
and virologists took search—discovering "infectious proteins".
The existence of microorganisms was predicted many centuries before they were first
observed, for example by the Jains in India and by Marcus Terentius Varro in ancient
Rome. The first recorded microscope observation was of the fruiting bodies of moulds,
by Robert Hooke in 1666, but the Jesuit priest Athanasius Kircher was likely the first to
see microbes, which he mentioned observing in milk and putrid material in
1658. Antonie van Leeuwenhoek is considered a father of microbiology as he observed
and experimented with microscopic organisms in the 1670s, using
simple microscopes of his own design. Scientific microbiology developed in the 19th
century through the work of Louis Pasteur and in medical microbiology Robert Koch.

Contents

 1History
 2The birth of bacteriology
 3Branches
 4Applications
 5See also
 6References
 7Further reading
 8External links

History[edit]
See also: Proto-microbiologists (pre-1670s)

Avicenna hypothesized the existence of microorganisms.

The existence of microorganisms was hypothesized for many centuries before their
actual discovery. The existence of unseen microbiological life was postulated
by Jainism which is based on Mahavira’s teachings as early as 6th century BCE.[7] Paul
Dundas notes that Mahavira asserted the existence of unseen microbiological creatures
living in earth, water, air and fire. [8] Jain scriptures describe nigodas which are sub-
microscopic creatures living in large clusters and having a very short life, said to
pervade every part of the universe, even in tissues of plants and flesh of animals.
[9]
 The Roman Marcus Terentius Varro made references to microbes when he warned
against locating a homestead in the vicinity of swamps "because there are bred certain
minute creatures which cannot be seen by the eyes, which float in the air and enter the
body through the mouth and nose and thereby cause serious diseases." [10]
In the golden age of Islamic civilization, Iranian scientists hypothesized the existence of
microorganisms, such as Avicenna in his book The Canon of Medicine, Ibn Zuhr (also
known as Avenzoar) who discovered scabies mites, and Al-Razi who gave the earliest
known description of smallpox in his book The Virtuous Life (al-Hawi).[11]
In 1546, Girolamo Fracastoro proposed that epidemic diseases were caused by
transferable seedlike entities that could transmit infection by direct or indirect contact, or
vehicle transmission.[12]

Antonie van Leeuwenhoek, often cited as the first to experiment with microorganisms.[13][14][15][16]

Van Leeuwenhoek's microscopes by Henry Baker[17]

Martinus Beijerinck, the founding father of the Delft School of Microbiology, in his laboratory. Beijerinck is often
considered as a founder of virology, environmental microbiology, and industrial microbiology.[18]

In 1676, Antonie van Leeuwenhoek, who lived most of his life in Delft, Holland,
observed bacteria and other microorganisms using a single-lens microscope of his own
design.[19][2] He is considered a father of microbiology as he pioneered the use of simple
single-lensed microscopes of his own design.[19] While Van Leeuwenhoek is often cited
as the first to observe microbes, Robert Hooke made his first recorded microscopic
observation, of the fruiting bodies of moulds, in 1665.[20] It has, however, been suggested
that a Jesuit priest called Athanasius Kircher was the first to observe microorganisms.[21]
Kircher was among the first to design magic lanterns for projection purposes, so he
must have been well acquainted with the properties of lenses. [21] He wrote "Concerning
the wonderful structure of things in nature, investigated by Microscope" in 1646, stating
"who would believe that vinegar and milk abound with an innumerable multitude of
worms." He also noted that putrid material is full of innumerable creeping animalcules.
He published his Scrutinium Pestis (Examination of the Plague) in 1658, stating
correctly that the disease was caused by microbes, though what he saw was most likely
red or white blood cells rather than the plague agent itself. [21]

The birth of bacteriology[edit]

Innovative laboratory glassware and experimental methods developed by Louis Pasteur and other biologists
contributed to the young field of bacteriology in the late 19th century.

The field of bacteriology (later a subdiscipline of microbiology) was founded in the 19th

century by Ferdinand Cohn, a botanist whose studies on algae and photosynthetic
bacteria led him to describe several bacteria including Bacillus and Beggiatoa. Cohn
was also the first to formulate a scheme for the taxonomic classification of bacteria, and
to discover endospores.[22] Louis Pasteur and Robert Koch were contemporaries of
Cohn, and are often considered to be the fathers of modern microbiology [21] and medical
microbiology, respectively.[23] Pasteur is most famous for his series of experiments
designed to disprove the then widely held theory of spontaneous generation, thereby
solidifying microbiology's identity as a biological science. [24] One of his students, Adrien
Certes, is considered the founder of marine microbiology. [25] Pasteur also designed
methods for food preservation (pasteurization) and vaccines against several diseases
such as anthrax, fowl cholera and rabies.[2] Koch is best known for his contributions to
the germ theory of disease, proving that specific diseases were caused by specific
pathogenic microorganisms. He developed a series of criteria that have become known
as the Koch's postulates. Koch was one of the first scientists to focus on the isolation
of bacteria in pure culture resulting in his description of several novel bacteria
including Mycobacterium tuberculosis, the causative agent of tuberculosis.[2]
While Pasteur and Koch are often considered the founders of microbiology, their work
did not accurately reflect the true diversity of the microbial world because of their
exclusive focus on microorganisms having direct medical relevance. It was not until the
late 19th century and the work of Martinus Beijerinck and Sergei Winogradsky that the
true breadth of microbiology was revealed.[2] Beijerinck made two major contributions to
microbiology: the discovery of viruses and the development of enrichment
culture techniques.[26] While his work on the tobacco mosaic virus established the basic
principles of virology, it was his development of enrichment culturing that had the most
immediate impact on microbiology by allowing for the cultivation of a wide range of
microbes with wildly different physiologies. Winogradsky was the first to develop the
concept of chemolithotrophy and to thereby reveal the essential role played by
microorganisms in geochemical processes.[27] He was responsible for the first isolation
and description of both nitrifying and nitrogen-fixing bacteria.[2] French-Canadian
microbiologist Felix d'Herelle co-discovered bacteriophages in 1917 and was one of the
earliest applied microbiologists.[28]
Joseph Lister was the first to use phenol disinfectant on the open wounds of patients. [29]

Branches[edit]

A university food microbiology laboratory

Main article: Branches of microbiology

The branches of microbiology can be classified into applied sciences, or divided
according to taxonomy, as is the case
with bacteriology, mycology, protozoology, virology and phycology. There is
considerable overlap between the specific branches of microbiology with each other and
with other disciplines, and certain aspects of these branches can extend beyond the
traditional scope of microbiology[30][31] A pure research branch of microbiology is
termed cellular microbiology.

Applications[edit]
While some fear microbes due to the association of some microbes with various human
diseases, many microbes are also responsible for numerous beneficial processes such
as industrial fermentation (e.g. the production of alcohol, vinegar and dairy
products), antibiotic production and act as molecular vehicles to transfer DNA to
complex organisms such as plants and animals. Scientists have also exploited their
knowledge of microbes to produce biotechnologically important enzymes such as Taq
polymerase,[32] reporter genes for use in other genetic systems and novel molecular
biology techniques such as the yeast two-hybrid system.[citation needed]
Bacteria can be used for the industrial production of amino acids. Corynebacterium
glutamicum is one of the most important bacterial species with an annual production of
more than two million tons of amino acids, mainly L-glutamate and L-lysine. [33] Since
some bacteria have the ability to synthesize antibiotics, they are used for medicinal
purposes, such as Streptomyces to make aminoglycoside antibiotics.[34]
A variety of biopolymers, such as polysaccharides, polyesters, and polyamides, are produced by
microorganisms. Microorganisms are used for the biotechnological production of biopolymers with
tailored properties suitable for high-value medical application such as tissue engineering and drug
delivery. Microorganisms are for example used for the biosynthesis
of xanthan, alginate, cellulose, cyanophycin, poly(gamma-glutamic acid), levan, hyaluronic acid,
organic acids, oligosaccharides polysaccharide and polyhydroxyalkanoates.[35]
Microorganisms are beneficial for microbial biodegradation or bioremediation of domestic,
agricultural and industrial wastes and subsurface pollution in soils, sediments and marine
environments. The ability of each microorganism to degrade toxic waste depends on the nature of
each contaminant. Since sites typically have multiple pollutant types, the most effective approach
to microbial biodegradation is to use a mixture of bacterial and fungal species and strains, each
specific to the biodegradation of one or more types of contaminants.[36]
Symbiotic microbial communities confer benefits to their human and animal hosts health including
aiding digestion, producing beneficial vitamins and amino acids, and suppressing pathogenic
microbes. Some benefit may be conferred by eating fermented foods, probiotics (bacteria potentially
beneficial to the digestive system) or prebiotics (substances consumed to promote the growth of
probiotic microorganisms).[37][38] The ways the microbiome influences human and animal health, as
well as methods to influence the microbiome are active areas of research. [39]
Research has suggested that microorganisms could be useful in the treatment of cancer. Various
strains of non-pathogenic clostridia can infiltrate and replicate within solid tumors. Clostridial vectors
can be safely administered and their potential to deliver therapeutic proteins has been demonstrated
in a variety of preclinical models.[40]

See also
Pathology
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"Pathobiology" redirects here. For the journal, see Karger Publishers. For other uses,
see Pathology (disambiguation).

Pathology

A pathologist examines a tissue section for evidence of cancerous cells

while a surgeon observes.

Focus Disease

Subdivisions Anatomical pathology, clinical

pathology, dermatopathology, forensic
pathology, hematopathology, histopathology, mol
ecular pathology, surgical pathology

Significant diseas All infectious and organic diseases and
es physiological disorders

Significant tests All medical diagnostic tests,

particular biopsy, blood analysis, dissection, and
other applications of medical microscopy

Specialist Pathologist

Glossary Glossary of medicine

 Pathology is the study of the causes and effects of disease or injury. The
word pathology also refers to the study of disease in general, incorporating a wide
range of bioscience research fields and medical practices. However, when used in the
context of modern medical treatment, the term is often used in a more narrow fashion to
refer to processes and tests which fall within the contemporary medical field of "general
pathology", an area which includes a number of distinct but inter-related medical
specialties that diagnose disease, mostly through analysis of tissue, cell, and body
fluid samples. Idiomatically, "a pathology" may also refer to the predicted or actual
progression of particular diseases (as in the statement "the many different forms
of cancer have diverse pathologies"), and the affix pathy is sometimes used to indicate
a state of disease in cases of both physical ailment (as in cardiomyopathy)
and psychological conditions (such as psychopathy).[1] A physician practicing pathology
is called a pathologist.
As a field of general inquiry and research, pathology addresses four components of
disease: cause, mechanisms of development (pathogenesis), structural alterations of
cells (morphologic changes), and the consequences of changes (clinical
manifestations).[2] In common medical practice, general pathology is mostly concerned
with analyzing known clinical abnormalities that are markers or precursors for
both infectious and non-infectious disease, and is conducted by experts in one of two
major specialties, anatomical pathology and clinical pathology. Further divisions in
specialty exist on the basis of the involved sample types (comparing, for
example, cytopathology, hematopathology, and histopathology), organs (as in renal
pathology), and physiological systems (oral pathology), as well as on the basis of the
focus of the examination (as with forensic pathology).
Pathology is a significant field in modern medical diagnosis and medical research.

Contents

 1History
o 1.1Etymology
 2General pathology
o 2.1Anatomical pathology
 2.1.1Cytopathology
 2.1.2Dermatopathology
 2.1.3Forensic pathology
 2.1.4Histopathology
 2.1.5Neuropathology
 2.1.6Pulmonary pathology
 2.1.7Renal pathology
 2.1.8Surgical pathology
o 2.2Clinical pathology
 2.2.1Hematopathology
o 2.3Molecular pathology
o 2.4Oral and maxillofacial pathology
 3Medical training and accreditation
 4Overlap with other diagnostic medicine
 5Psychopathology
 6Non-humans
o 6.1Veterinary pathology
o 6.2Plant pathology
 7See also
 8References
 9External links

History[edit]
Main article: History of medicine

The advent of the microscope was one of the major developments in the history of pathology. Here researchers
at the Centers for Disease Control in 1978 examine cultures containing Legionella pneumophila, the pathogen
responsible for Legionnaire's disease.

The study of pathology, including the detailed examination of the body, including
dissection and inquiry into specific maladies, dates back to antiquity. Rudimentary
understanding of many conditions was present in most early societies and is attested to
in the records of the earliest historical societies, including those of the Middle
East, India, and China.[3] By the Hellenic period of ancient Greece, a concerted causal
study of disease was underway (see Medicine in ancient Greece), with many notable
early physicians (such as Hippocrates, for whom the modern Hippocratic Oath is
named) having developed methods of diagnosis and prognosis for a number of
diseases. The medical practices of the Romans and those of the Byzantines continued
from these Greek roots, but, as with many areas of scientific inquiry, growth in
understanding of medicine stagnated some after the Classical Era, but continued to
slowly develop throughout numerous cultures. Notably, many advances were made in
the medieval era of Islam (see Medicine in medieval Islam), during which numerous
texts of complex pathologies were developed, also based on the Greek tradition. [4] Even
so, growth in complex understanding of disease mostly languished until knowledge and
experimentation again began to proliferate in the Renaissance, Enlightenment,
and Baroque eras, following the resurgence of the empirical method at new centers of
scholarship. By the 17th century, the study of rudimentary microscopy was underway
and examination of tissues had led British Royal Society member Robert Hooke to coin
the word "cell", setting the stage for later germ theory.
Modern pathology began to develop as a distinct field of inquiry during the 19th Century
through natural philosophers and physicians that studied disease and the informal study
of what they termed “pathological anatomy” or “morbid anatomy”. However, pathology
as a formal area of specialty was not fully developed until the late 19th and early 20th
centuries, with the advent of detailed study of microbiology. In the 19th century,
physicians had begun to understand that disease-causing pathogens, or "germs" (a
catch-all for disease-causing, or pathogenic, microbes, such
as bacteria, viruses, fungi, amoebae, molds, protists, and prions) existed and were
capable of reproduction and multiplication, replacing earlier beliefs in humors or even
spiritual agents, that had dominated for much of the previous 1,500 years in European
medicine. With the new understanding of causative agents, physicians began to
compare the characteristics of one germ's symptoms as they developed within an
affected individual to another germ's characteristics and symptoms. This approach led
to the foundational understanding that diseases are able to replicate themselves, and
that they can have many profound and varied effects on the human host. To determine
causes of diseases, medical experts used the most common and widely accepted
assumptions or symptoms of their times, a general principal of approach that persists
into modern medicine.[5][6]
Modern medicine was particularly advanced by further developments of the microscope
to analyze tissues, to which Rudolf Virchow gave a significant contribution, leading to a
slew of research developments. By the late 1920s to early 1930s pathology was
deemed a medical specialty.[7] Combined with developments in the understanding of
general physiology, by the beginning of the 20th century, the study of pathology had
begun to split into a number of distinct fields, resulting in the development of a large
number of modern specialties within pathology and related disciplines of diagnostic
medicine.
Etymology[edit]
The terms pathology comes from the Ancient Greek roots of pathos (πάθος), meaning
"experience" or "suffering" and -logia (-λογία), "study of".

General pathology[edit]

A modern pathology lab at the Services Institute of Medical Sciences

The modern practice of pathology is divided into a number of subdisciplines within the
discrete but deeply interconnected aims of biological research and medical
practice. Biomedical research into disease incorporates the work of a vast variety of life
science specialists, whereas, in most parts of the world, to be licensed to practice
pathology as a medical specialty, one has to complete medical school and secure a
license to practice medicine. Structurally, the study of disease is divided into many
different fields that study or diagnose markers for disease using methods and
technologies particular to specific scales, organs, and tissue types. The information in
this section mostly concerns pathology as it regards common medical practice in these
systems, but each of these specialties is also the subject of voluminous pathology
research as regards the disease pathways of specific pathogens and disorders that
affect the tissues of these discrete organs or structures. (See also Gross pathology).
Anatomical pathology[edit]
Main article: Anatomical pathology
Anatomical pathology (Commonwealth) or anatomic pathology (United States) is a
medical specialty that is concerned with the diagnosis of disease based on
the gross, microscopic, chemical, immunologic and molecular examination of organs,
tissues, and whole bodies (as in a general examination or an autopsy). Anatomical
pathology is itself divided into subfields, the main divisions being surgical
pathology, cytopathology, and forensic pathology. Anatomical pathology is one of two
main divisions of the medical practice of pathology, the other being clinical pathology,
the diagnosis of disease through the laboratory analysis of bodily fluids and tissues.
Sometimes, pathologists practice both anatomical and clinical pathology, a combination
known as general pathology.
Cytopathology[edit]
Main article: Cytopathology

A bone marrow smear from a case of erythroleukemia. The large cell in the top center is an
abnormal erythroblast: it is multinucleated, with megaloblastoid nuclear chromatin This is diagnostic of
erythroleukemia.

Cytopathology (sometimes referred to as "cytology") is a branch of pathology that

studies and diagnoses diseases on the cellular level. It is usually used to aid in the
diagnosis of cancer, but also helps in the diagnosis of certain infectious diseases and
other inflammatory conditions as well as thyroid lesions, diseases involving sterile body
cavities (peritoneal, pleural, and cerebrospinal), and a wide range of other body sites.
Cytopathology is generally used on samples of free cells or tissue fragments (in contrast
to histopathology, which studies whole tissues) and cytopathologic tests are sometimes
called smear tests because the samples may be smeared across a glass microscope
slide for subsequent staining and microscopic examination. However, cytology samples
may be prepared in other ways, including cytocentrifugation.
Dermatopathology[edit]
Main article: Dermatopathology

A malignant melanoma can often be suspected from sight, but confirmation of the diagnosis or outright removal
requires an excisional biopsy.

Dermatopathology is a subspecialty of anatomic pathology that focuses on the skin and

the rest of the integumentary system as an organ. It is unique, in that there are two
paths a physician can take to obtain the specialization. All general pathologists and
general dermatologists train in the pathology of the skin, so the
term dermatopathologist denotes either of these who has reached a certainly level of
accreditation and experience; in the US, either a general pathologist or
a dermatologist[8] can undergo a 1 to 2 year fellowship in the field of dermatopathology.
The completion of this fellowship allows one to take a subspecialty board examination,
and becomes a board certified dermatopathologist. Dermatologists are able to
recognize most skin diseases based on their appearances, anatomic distributions, and
behavior. Sometimes, however, those criteria do not lead to a conclusive diagnosis, and
a skin biopsy is taken to be examined under the microscope using usual histological
tests. In some cases, additional specialized testing needs to be performed on biopsies,
including immunofluorescence, immunohistochemistry, electron microscopy, flow
cytometry, and molecular-pathologic analysis.[9] One of the greatest challenges of
dermatopathology is its scope. More than 1500 different disorders of the skin exist,
including cutaneous eruptions ("rashes") and neoplasms. Therefore,
dermatopathologists must maintain a broad base of knowledge in clinical dermatology,
and be familiar with several other specialty areas in Medicine.
Forensic pathology[edit]
Main article: Forensic pathology
Pathologist performing a human dissection of the abdominal and thoracic organs in an autopsy room

Forensic pathology focuses on determining the cause of death by post-mortem

examination of a corpse or partial remains. An autopsy is typically performed by a
coroner or medical examiner, often during criminal investigations; in this
role, coroners and medical examiners are also frequently asked to confirm the identity
of a corpse. The requirements for becoming a licensed practitioner of forensic pathology
varies from country to country (and even within a given nation [10]) but typically a minimal
requirement is a medical doctorate with a specialty in general or anatomical pathology
with subsequent study in forensic medicine. The methods forensic scientists use to
determine death include examination of tissue specimens to identify the presence or
absence of natural disease and other microscopic findings, interpretations
of toxicology on body tissues and fluids to determine the chemical cause of overdoses,
poisonings or other cases involving toxic agents, and examinations of physical trauma.
Forensic pathology is a major component in the trans-disciplinary field of forensic
science.
Histopathology[edit]
Main article: Histopathology

An instance of diagnosis via histopathology, this high-magnification micrograph of a section of cardiac tissue

reveals advanced cardiac amyloidosis. This sample was attained through an autopsy.

Histopathology refers to the microscopic examination of various forms of human tissue.

Specifically, in clinical medicine, histopathology refers to the examination of a biopsy or
surgical specimen by a pathologist, after the specimen has been processed and
histological sections have been placed onto glass slides. [11] This contrasts with the
methods of cytopathology, which uses free cells or tissue fragments. Histopathological
examination of tissues starts with surgery, biopsy, or autopsy. The tissue is removed
from the body of an organism and then placed in a fixative that stabilizes the tissues to
prevent decay. The most common fixative is formalin, although frozen section fixing is
also common.[12] To see the tissue under a microscope, the sections are stained with one
or more pigments. The aim of staining is to reveal cellular components; counterstains
are used to provide contrast. Histochemistry refers to the science of using chemical
reactions between laboratory chemicals and components within tissue. The histological
slides are then interpreted diagnostically and the resulting pathology report describes
the histological findings and the opinion of the pathologist. In the case of cancer, this
represents the tissue diagnosis required for most treatment protocols.
Neuropathology[edit]
Main article: Neuropathology

This coronal cross-section of a brain reveals a significant arteriovenous malformation that occupies much of

the parietal lobe.

Neuropathology is the study of disease of nervous system tissue, usually in the form of
either surgical biopsies or sometimes whole brains in the case of autopsy.
Neuropathology is a subspecialty of anatomic pathology, neurology, and neurosurgery.
In many English-speaking countries, neuropathology is considered a subfield of
anatomical pathology. A physician who specializes in neuropathology, usually by
completing a fellowship after a residency in anatomical or general pathology, is called a
neuropathologist. In day-to-day clinical practice, a neuropathologist is a consultant for
other physicians. If a disease of the nervous system is suspected, and the diagnosis
cannot be made by less invasive methods, a biopsy of nervous tissue is taken from the
brain or spinal cord to aid in diagnosis. Biopsy is usually requested after a mass is
detected by medical imaging. With autopsies, the principal work of the neuropathologist
is to help in the post-mortem diagnosis of various conditions that affect the central
nervous system. Biopsies can also consist of the skin. Epidermal nerve fiber density
testing (ENFD) is a more recently developed neuropathology test in which a punch skin
biopsy is taken to identify small fiber neuropathies by analyzing the nerve fibers of the
skin. This test is becoming available in select labs as well as many universities; it
replaces the traditional nerve biopsy test as less invasive.
Pulmonary pathology[edit]
Main article: Pulmonary pathology
Pulmonary pathology is a subspecialty of anatomic (and especially surgical) pathology
that deals with diagnosis and characterization of neoplastic and non-neoplastic
diseases of the lungs and thoracic pleura. Diagnostic specimens are often obtained
via bronchoscopic transbronchial biopsy, CT-guided percutaneous biopsy, or video-
assisted thoracic surgery. These tests can be necessary to diagnose between
infection, inflammation, or fibrotic conditions.
Renal pathology[edit]
Main article: Renal pathology

This tissue cross-section demonstrates the gross pathology of polycystic kidneys.

Renal pathology is a subspecialty of anatomic pathology that deals with the diagnosis
and characterization of disease of the kidneys. In a medical setting, renal pathologists
work closely with nephrologists and transplant surgeons, who typically obtain diagnostic
specimens via percutaneous renal biopsy. The renal pathologist must synthesize
findings from traditional microscope histology, electron microscopy,
and immunofluorescence to obtain a definitive diagnosis. Medical renal diseases may
affect the glomerulus, the tubules and interstitium, the vessels, or a combination of
these compartments.
Surgical pathology[edit]
Main article: Surgical pathology

Brain biopsy under stereotaxy. A small part of the tumor is taken via a needle with a vacuum system.

Surgical pathology is one of the primary areas of practice for most anatomical
pathologists. Surgical pathology involves the gross and microscopic examination of
surgical specimens, as well as biopsies submitted by surgeons and non-surgeons such
as general internists, medical subspecialists, dermatologists, and interventional
radiologists. Often an excised tissue sample is the best and most definitive evidence of
disease (or lack thereof) in cases where tissue is surgically removed from a patient.
These determinations are usually accomplished by a combination of gross (i.e.,
macroscopic) and histologic (i.e., microscopic) examination of the tissue, and may
involve evaluations of molecular properties of the tissue by immunohistochemistry or
other laboratory tests.
There are two major types of specimens submitted for surgical pathology analysis:
biopsies and surgical resections. A biopsy is a small piece of tissue removed primarily
for surgical pathology analysis, most often in order to render a definitive diagnosis.
Types of biopsies include core biopsies, which are obtained through the use of large-
bore needles, sometimes under the guidance of radiological techniques such
as ultrasound, CT scan, or magnetic resonance imaging. Incisional biopsies are
obtained through diagnostic surgical procedures that remove part of a suspicious lesion,
whereas excisional biopsies remove the entire lesion, and are similar to therapeutic
surgical resections. Excisional biopsies of skin lesions and gastrointestinal polyps are
very common. The pathologist's interpretation of a biopsy is critical to establishing the
diagnosis of a benign or malignant tumor, and can differentiate between different types
and grades of cancer, as well as determining the activity of specific molecular pathways
in the tumor. Surgical resection specimens are obtained by the therapeutic surgical
removal of an entire diseased area or organ (and occasionally multiple organs). These
procedures are often intended as definitive surgical treatment of a disease in which the
diagnosis is already known or strongly suspected, but pathological analysis of these
specimens remains important in confirming the previous diagnosis.
Clinical pathology[edit]
Main article: Clinical pathology
Clinical pathology is a medical specialty that is concerned with the diagnosis of disease
based on the laboratory analysis of bodily fluids such as blood and urine, as well as
tissues, using the tools of chemistry, clinical microbiology, hematology and molecular
pathology. Clinical pathologists work in close collaboration with medical technologists,
hospital administrations, and referring physicians. Clinical pathologists learn to
administer a number of visual and microscopic tests and an especially large variety of
tests of the biophysical properties of tissue samples involving automated
analysers and cultures. Sometimes the general term "laboratory medicine specialist" is
used to refer to those working in clinical pathology, including medical doctors, Ph.D.s
and doctors of pharmacology.[13] Immunopathology, the study of an organism's immune
response to infection, is sometimes considered to fall within the domain of clinical
pathology.[14]
Hematopathology[edit]
Main article: Hematopathology

Clinical chemistry: an automated blood chemistry analyzer

Hematopathology is the study of diseases of blood cells (including constituents such
as white blood cells, red blood cells, and platelets) and the tissues, and organs
comprising the hematopoietic system. The term hematopoietic system refers to tissues
and organs that produce and/or primarily host hematopoietic cells and includes bone
marrow, the lymph nodes, thymus, spleen, and other lymphoid tissues. In the United
States, hematopathology is a board certified subspecialty (licensed under the American
Board of Pathology) practiced by those physicians who have completed a general
pathology residency (anatomic, clinical, or combined) and an additional year of
fellowship training in hematology. The hematopathologist reviews biopsies of lymph
nodes, bone marrows and other tissues involved by an infiltrate of cells of the
hematopoietic system. In addition, the hematopathologist may be in charge of flow
cytometric and/or molecular hematopathology studies.
Molecular pathology[edit]
Main article: Molecular pathology
Molecular pathology is focused upon the study and diagnosis of disease through the
examination of molecules within organs, tissues or bodily fluids.[15] Molecular pathology is
multidisciplinary by nature and shares some aspects of practice with both anatomic
pathology and clinical pathology, molecular
biology, biochemistry, proteomics and genetics. It is often applied in a context that is as
much scientific as directly medical and encompasses the development of molecular and
genetic approaches to the diagnosis and classification of human diseases, the design
and validation of predictive biomarkers for treatment response and disease progression,
and the susceptibility of individuals of different genetic constitution to particular
disorders. The crossover between molecular pathology and epidemiology is
represented by a related field "molecular pathological epidemiology". [16] Molecular
pathology is commonly used in diagnosis of cancer and infectious diseases. Molecular
Pathology is primarily used to detect cancers such as melanoma, brainstem glioma,
brain tumors as well as many other types of cancer and infectious diseases.
[17]
 Techniques are numerous but include quantitative polymerase chain reaction (qPCR),
multiplex PCR, DNA microarray, in situ hybridization, DNA sequencing, antibody based
immunofluorescence tissue assays, molecular profiling of pathogens, and analysis of
bacterial genes for antimicrobial resistance.[18] Techniques used are based on analyzing
samples of DNA and RNA. Pathology is widely used for gene therapy and disease
diagnosis.[19]
Oral and maxillofacial pathology[edit]
Main article: Oral and maxillofacial pathology
Many conditions, such as this case of geographic tongue, can be diagnosed partly on gross examination, but
may be confirmed with tissue pathology.

Oral and Maxillofacial Pathology is one of nine dental specialties recognized by

the American Dental Association, and is sometimes considered a specialty of both
dentistry and pathology.[20] Oral Pathologists must complete three years of post doctoral
training in an accredited program and subsequently obtain diplomate status from the
American Board of Oral and Maxillofacial Pathology. The specialty focuses on the
diagnosis, clinical management and investigation of diseases that affect the oral cavity
and surrounding maxillofacial structures including but not limited to odontogenic,
infectious, epithelial, salivary gland, bone and soft tissue pathologies. It also significantly
intersects with the field of dental pathology. Although concerned with a broad variety of
diseases of the oral cavity, they have roles distinct from otorhinolaryngologists ("ear,
nose, and throat" specialists), and speech pathologists, the latter of which helps
diagnose many neurological or neuromuscular conditions relevant to speech
phonology or swallowing. Owing to the availability of the oral cavity to non-invasive
examination, many conditions in the study of oral disease can be diagnosed, or at least
suspected, from gross examination, but biopsies, cell smears, and other tissue analysis
remain important diagnostic tools in oral pathology.

Medical training and accreditation[edit]

An anatomical pathology instructor uses a microscope with multiple eyepieces to instruct students in diagnostic
microscopy.

Becoming a pathologist generally requires specialty-training after medical school, but

individual nations vary some in the medical licensing required of pathologists. In the
United States, pathologists are physicians (D.O. or M.D.) who have completed a four-
year undergraduate program, four years of medical school training, and three to four
years of postgraduate training in the form of a pathology residency. Training may be
within two primary specialties, as recognized by the American Board of
Pathology: anatomical Pathology and clinical Pathology, each of which requires
separate board certification. The American Osteopathic Board of Pathology also
recognizes four primary specialties: anatomic pathology, dermatopathology, forensic
pathology, and laboratory medicine. Pathologists may pursue specialised fellowship
training within one or more subspecialties of either anatomical or clinical pathology.
Some of these subspecialties permit additional board certification, while others do not. [21]
In the United Kingdom, pathologists are physicians licensed by the UK General Medical
Council. The training to become a pathologist is under the oversight of the Royal
College of Pathologists. After four to six years of undergraduate medical study, trainees
proceed to a two-year foundation program. Full-time training in histopathology currently
lasts between five and five and a half years and includes specialist training in surgical
pathology, cytopathology, and autopsy pathology. It is also possible to take a Royal
College of Pathologists diploma in forensic pathology, dermatopathology, or
cytopathology, recognising additional specialist training and expertise and to get
specialist accreditation in forensic pathology, pediatric pathology, and neuropathology.
All postgraduate medical training and education in the UK is overseen by the General
Medical Council.
In France, pathology is separated into two distinct specialties, anatomical pathology,
and clinical pathology. Residencies for both lasts four years. Residency in anatomical
pathology is open to physicians only, while clinical pathology is open to both physicians
and pharmacists. At the end of the second year of clinical pathology residency,
residents can choose between general clinical pathology and a specialization in one of
the disciplines, but they can not practice anatomical pathology, nor can anatomical
pathology residents practice clinical pathology.[14][22]

Overlap with other diagnostic medicine [edit]

Main articles: Diagnostic medicine, Oncology, Infectious disease, and Medical imaging
Though separate fields in terms of medical practice, a number of areas of inquiry in
medicine and medical science either overlap greatly with general pathology, work in
tandem with it, or contribute significantly to the understanding of the pathology of a
given disease or its course in an individual. As a significant portion of all general
pathology practice is concerned with cancer, the practice of oncology makes extensive
use of both anatomical and clinical pathology in diagnosis and treatment. [23] In particular,
biopsy, resection, and blood tests are all examples of pathology work that is essential
for the diagnoses of many kinds of cancer and for the staging of cancerous masses. In
a similar fashion, the tissue and blood analysis techniques of general pathology are of
central significance to the investigation of serious infectious disease and as such inform
significantly upon the fields of epidemiology, etiology, immunology, and parasitology.
General pathology methods are of great importance to biomedical research into
disease, wherein they are sometimes referred to as "experimental" or "investigative"
pathology.
Medical imaging is the generating of visual representations of the interior of a body for
clinical analysis and medical intervention. Medical imaging reveals details
of internal physiology that help medical professionals plan appropriate treatments for
tissue infection and trauma. Medical imaging is also central in supplying
the biometric data necessary to establish baseline features
of anatomy and physiology so as to increase the accuracy with which early or fine-detail
abnormalities are detected. These diagnostic techniques are often performed in
combination with general pathology procedures and are themselves often essential to
developing new understanding of the pathogenesis of a given disease and tracking the
progress of disease in specific medical cases. Examples of important subdivisions in
medical imaging include radiology (which uses the imaging technologies of X-
ray radiography) magnetic resonance imaging, medical ultrasonography (or
ultrasound), endoscopy, elastography, tactile imaging, thermography, medical
photography, nuclear medicine and functional imaging techniques such as positron
emission tomography. Though they do not strictly relay images, readings from
diagnostics tests involving electroencephalography, magnetoencephalography,
and electrocardiography often give hints as to the state and function of certain tissues in
the brain and heart respectively.

Psychopathology[edit]
Main article: Psychopathology
Psychopathology is the study of mental illness, particularly of severe disorders.
Informed heavily by both psychology and neurology, its purpose is to classify mental
illness, elucidate its underlying causes, and guide clinical psychiatric treatment
accordingly. Although diagnosis and classification of mental norms and disorders is
largely the purview of psychiatry—the results of which are guidelines such as
the Diagnostic and Statistical Manual of Mental Disorders, which attempt to classify
mental disease mostly on behavioural evidence, though not without controversy [24][25][26]—
the field is also heavily, and increasingly, informed upon by neuroscience and other of
the biological cognitive sciences. Mental or social disorders or behaviours seen as
generally unhealthy or excessive in a given individual, to the point where they cause
harm or severe disruption to the sufferer's lifestyle, are often called "pathological"
(e.g., pathological gambling or pathological liar).

Non-humans[edit]

This field post-mortem of a ewe has revealed lesions consistent with acute haemolytic pneumonia, possibly

due to Pasteurella haemolytica.

Although the vast majority of lab work and research in pathology concerns the
development of disease in humans, pathology is of significance throughout the
biological sciences. Two main catch-all fields exist to represent most complex
organisms capable of serving as host to a pathogen or other form of disease: veterinary
pathology (concerned with all non-human species of kingdom of Animalia)
and phytopathology, which studies disease in plants.
Veterinary pathology[edit]
Main articles: Veterinary pathology and Animal testing
Veterinary pathology covers a vast array of species, but with a significantly smaller
number of practitioners, so understanding of disease in non-human animals, especially
as regards veterinary practice, varies considerably by species. Nonetheless, significant
amounts of pathology research are conducted on animals, for two primary reasons: 1)
The origins of diseases are typically zoonotic in nature, and many infectious pathogens
have animal vectors and, as such, understanding the mechanisms of action for these
pathogens in non-human hosts is essential to the understanding and application
of epidemiology and 2) those animals that share physiological and genetic traits with
humans can be used as surrogates for the study of the disease and potential
treatments[27] as well as the effects of various synthetic products. For this reason, as well
as their roles as livestock and companion animals, mammals generally have the largest
body of research in veterinary pathology. Animal testing remains a controversial
practice, even in cases where it is used to research treatment for human disease. [28] As
in human medical pathology, the practice of veterinary pathology is customarily divided
into the two main fields of anatomical and clinical pathology.

A tobacco plant infected with the tobacco mosaic virus

Plant pathology[edit]
Main article: Plant pathology
Although the pathogens and their mechanics differ greatly from those of animals, plants
are subject to a wide variety of diseases, including those caused
by fungi, oomycetes, bacteria, viruses, viroids, virus-like
organisms, phytoplasmas, protozoa, nematodes and parasitic plants. Damage caused
by insects, mites, vertebrate, and other small herbivores is not considered a part of the
domain of plant pathology. The field is connected to plant disease epidemiology and
especially concerned with the horticulture of species that are of high importance to
the human diet or other human utility.
Pharmacology
From Wikipedia, the free encyclopedia
Jump to navigationJump to search
This article is about the science. For the book type ("a pharmacology"), see Materia
medica. For the journal, see Pharmacology (journal).

Pharmacology

Diagrammatic representation of organ bath used for studying the effect

of isolated tissues

MeSH Unique ID D010600

Pharmacology is a branch of medicine and pharmaceutical sciences which is

concerned with the study of drug or medication action,[1] where a drug can be broadly or
narrowly defined as any man-made, natural, or endogenous (from within the body)
molecule which exerts a biochemical or physiological effect on the cell, tissue, organ, or
organism (sometimes the word pharmacon is used as a term to encompass
these endogenous and exogenous bioactive species). More specifically, it is the study
of the interactions that occur between a living organism and chemicals that affect
normal or abnormal biochemical function. If substances have medicinal properties, they
are considered pharmaceuticals.
The field encompasses drug composition and properties, synthesis and drug design,
molecular and cellular mechanisms, organ/systems mechanisms, signal
transduction/cellular communication, molecular diagnostics, interactions, chemical
biology, therapy, and medical applications and antipathogenic capabilities. The two
main areas of pharmacology are pharmacodynamics and pharmacokinetics.
Pharmacodynamics studies the effects of a drug on biological systems, and
pharmacokinetics studies the effects of biological systems on a drug. In broad terms,
pharmacodynamics discusses the chemicals with biological receptors, and
pharmacokinetics discusses the absorption, distribution, metabolism, and excretion
(ADME) of chemicals from the biological systems.
 Pharmacology is not synonymous with pharmacy and the two terms are frequently
confused. Pharmacology, a biomedical science, deals with the research, discovery, and
characterization of chemicals which show biological effects and the elucidation of
cellular and organismal function in relation to these chemicals. In contrast, pharmacy, a
health services profession, is concerned with the application of the principles learned
from pharmacology in its clinical settings; whether it be in a dispensing or clinical care
role. In either field, the primary contrast between the two is their distinctions between
direct-patient care, pharmacy practice, and the science-oriented research field, driven
by pharmacology.

Contents

 1Etymology
 2History
 3Divisions
o 3.1Systems of the body
o 3.2Clinical practice and drug discovery
 3.2.1Drug discovery
o 3.3Wider contexts
o 3.4Emerging fields
 4Theory of pharmacology
o 4.1Systems, receptors and ligands
o 4.2Pharmacology
o 4.3Pharmacokinetics
 5Administration, drug policy and safety
o 5.1Drug policy
 6Societies and education
o 6.1Societies and administration
o 6.2Education
 7See also
 8References
 9External links
 10Further reading

Etymology[edit]
The word "pharmacology" is derived from Greek φάρμακον, pharmakon, "drug, poison,
(paranormal)|-λογία, -logia "study of", "knowledge of"[2][3] (cf. the etymology of  pharmacy).
Pharmakon is related to pharmakos, the ritualistic sacrifice or exile of a
human scapegoat or victim in Ancient Greek religion.

History[edit]
Main articles: List of drugs by year of discovery and History of pharmacy
Naturally derived opium from opium poppies has been used as a drug since before 1100 BCE. [4]

Opium's major active constituent, morphine, was first isolated in 1804 and is now known to act as an opioid
agonist.[5][6]

The origins of clinical pharmacology date back to the Middle Ages,

with pharmacognosy and Avicenna's The Canon of Medicine, Peter of
Spain's Commentary on Isaac, and John of St Amand's Commentary on the Antedotary
of Nicholas.[7] Early pharmacology focused on herbalism and natural substances, mainly
plant extracts. Medicines were compiled in books called pharmacopoeias. Crude
drugs have been used since prehistory as a preparation of substances from natural
sources. However, the active ingredient of crude drugs are not purified and the
substance is adulterated with other substances.
Traditional medicine varies between cultures and may be specific to a particular culture,
such as in traditional Chinese, Mongolian, Tibetan and Korean medicine. However
much of this has since been regarded as pseudoscience. Pharmacological substances
known as entheogens may have spiritual and religious use and historical context.
In the 17th century, the English physician Nicholas Culpeper translated and used
pharmacological texts. Culpeper detailed plants and the conditions they could treat. In
the 18th century, much of clinical pharmacology was established by the work of William
Withering.[8] Pharmacology as a scientific discipline did not further advance until the mid-
19th century amid the great biomedical resurgence of that period. [9] Before the second
half of the nineteenth century, the remarkable potency and specificity of the actions of
drugs such as morphine, quinine and digitalis were explained vaguely and with
reference to extraordinary chemical powers and affinities to certain organs or tissues.
[10]
 The first pharmacology department was set up by Rudolf Buchheim in 1847, in
recognition of the need to understand how therapeutic drugs and poisons produced
their effects.[9] Subsequently, the first pharmacology department in England was set up
in 1905 at University College London.
Pharmacology developed in the 19th century as a biomedical science that applied the
principles of scientific experimentation to therapeutic contexts. [11] The advancement of
research techniques propelled pharmacological research and understanding. The
development of the organ bath preparation, where tissue samples are connected to
recording devices, such as a myograph, and physiological responses are recorded after
drug application, allowed analysis of drugs' effects on tissues. The development of
the ligand binding assay in 1945 allowed quantification of the binding affinity of drugs at
chemical targets.[12] Modern pharmacologists use techniques from genetics, molecular
biology, biochemistry, and other advanced tools to transform information about
molecular mechanisms and targets into therapies directed against disease, defects or
pathogens, and create methods for preventative care, diagnostics, and
ultimately personalized medicine.

Divisions[edit]
The discipline of pharmacology can be divided into many sub disciplines each with a
specific focus.
Systems of the body[edit]

A variety of topics involved with pharmacology, including neuropharmacology, renal pharmacology,

human metabolism, intracellular metabolism, and intracellular regulation

Pharmacology can also focus on specific systems comprising the body. Divisions

related to bodily systems study the effects of drugs in different systems of the body.
These include neuropharmacology, in the central and peripheral nervous
systems; immunopharmacology in the immune system. Other divisions
include cardiovascular, renal and endocrine pharmacology. Psychopharmacology is the
study of the use of drugs that affect the psyche, mind and behavior (e.g.
antidepressants) in treating mental disorders (e.g. depression). [13][14] It incorporates
approaches and techniques from neuropharmacology, animal behavior and behavioral
neuroscience, and is interested in the behavioral and neurobiological mechanisms of
action of psychoactive drugs.[citation needed] The related field
of neuropsychopharmacology focuses on the effects of drugs at the overlap between
the nervous system and the psyche.
Pharmacometabolomics, also known as pharmacometabonomics, is a field which stems
from metabolomics, the quantification and analysis of metabolites produced by the
body.[15][16] It refers to the direct measurement of metabolites in an individual's bodily
fluids, in order to predict or evaluate the metabolism of pharmaceutical compounds, and
to better understand the pharmacokinetic profile of a drug. [15][16] Pharmacometabolomics
can be applied to measure metabolite levels following the administration of a drug, in
order to monitor the effects of the drug on metabolic
pathways. Pharmacomicrobiomics studies the effect of microbiome variations on drug
disposition, action, and toxicity.[17] Pharmacomicrobiomics is concerned with the
interaction between drugs and the gut microbiome. Pharmacogenomics is the
application of genomic technologies to drug discovery and further characterization of
drugs related to an organism's entire genome.[citation needed] For pharmacology regarding
individual genes, pharmacogenetics studies how genetic variation gives rise to differing
responses to drugs.[citation needed] Pharmacoepigenetics studies the
underlying epigenetic marking patterns that lead to variation in an individual's response
to medical treatment.[18]
Clinical practice and drug discovery[edit]
Main articles: Drug development and Drug Discovery Hit to Lead

A toxicologist working in a lab

Pharmacology can be applied within clinical sciences. Clinical pharmacology is the

basic science of pharmacology focusing on the application of pharmacological principles
and methods in the medical clinic and towards patient care and outcomes. [citation needed] An
example of this is posology, which is the study of how medicines are dosed. [citation needed]
Pharmacology is closely related to toxicology. Both pharmacology and toxicology are
scientific disciplines that focus on understanding the properties and actions of
chemicals.[19] However, pharmacology emphasizes the therapeutic effects of chemicals,
usually drugs or compounds that could become drugs, whereas toxicology is the study
of chemical's adverse effects and risk assessment. [19]
Pharmacological knowledge is used to
advise pharmacotherapy in medicine and pharmacy.
Drug discovery[edit]
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Drug discovery is the field of study concerned with creating new drugs. It encompasses
the subfields of drug design and development.[citation needed] Drug discovery starts with drug
design, which is the inventive process of finding new drugs.[20] In the most basic sense,
this involves the design of molecules that are complementary in shape and charge to a
given biomolecular target.[citation needed] After a lead compound has been identified through
drug discovery, drug development involves bringing the drug to the market. [citation needed] Drug
discovery is related to pharmacoeconomics, which is the sub-discipline of health
economics that considers the value of drugs[21][22] Pharmacoeconomics evaluates the cost
and benefits of drugs in order to guide optimal healthcare resource allocation. [citation
needed]
 The techniques used for the discovery, formulation, manufacturing and quality
control of drugs discovery is studied by pharmaceutical engineering, a branch
of engineering.[23] Safety pharmacology specialises in detecting and investigating
potential undesirable effects of drugs.[citation needed]

The drug discovery cycle

Development of medication is a vital concern to medicine, but also has

strong economical and political implications. To protect the consumer and prevent
abuse, many governments regulate the manufacture, sale, and administration of
medication. In the United States, the main body that regulates pharmaceuticals is
the Food and Drug Administration; they enforce standards set by the United States
Pharmacopoeia. In the European Union, the main body that regulates pharmaceuticals
is the EMA, and they enforce standards set by the European Pharmacopoeia.
The metabolic stability and the reactivity of a library of candidate drug compounds have
to be assessed for drug metabolism and toxicological studies. Many methods have
been proposed for quantitative predictions in drug metabolism; one example of a recent
computational method is SPORCalc.[24] A slight alteration to the chemical structure of a
medicinal compound could alter its medicinal properties, depending on how the
alteration relates to the structure of the substrate or receptor site on which it acts: this is
called the structural activity relationship (SAR). When a useful activity has been
identified, chemists will make many similar compounds called analogues, to try to
maximize the desired medicinal effect(s). This can take anywhere from a few years to a
decade or more, and is very expensive.[25] One must also determine how safe the
medicine is to consume, its stability in the human body and the best form for delivery to
the desired organ system, such as tablet or aerosol. After extensive testing, which can
take up to six years, the new medicine is ready for marketing and selling. [25]
Because of these long timescales, and because out of every 5000 potential new
medicines typically only one will ever reach the open market, this is an expensive way
of doing things, often costing over 1 billion dollars. To recoup this outlay pharmaceutical
companies may do a number of things:[25]

 Carefully research the demand for their potential new product before spending an
outlay of company funds.[25]
 Obtain a patent on the new medicine preventing other companies from producing
that medicine for a certain allocation of time.[25]
The inverse benefit law describes the relationship between a drugs therapeutic benefits
and its marketing.
When designing drugs, the placebo effect must be considered to assess the drug's true
therapeutic value.
Drug development uses techniques from medicinal chemistry to chemically design
drugs. This overlaps with the biological approach of finding targets and physiological
effects.
Wider contexts[edit]
Pharmacology can be studied in relation to wider contexts than the physiology of
individuals. For example, pharmacoepidemiology concerns the variations of the effects
of drugs in or between populations, it is the bridge between clinical
pharmacology and epidemiology.[26][27] Pharmacoenvironmentology or environmental
pharmacology is the study of the effects of used pharmaceuticals and personal care
products (PPCPs) on the environment after their elimination from the body. [28] Human
health and ecology are intimately related so environmental pharmacology studies the
environmental effect of drugs and pharmaceuticals and personal care products in the
environment.[citation needed]
Drugs may also have ethnocultural importance, so ethnopharmacology studies the
ethnic and cultural aspects of pharmacology.[citation needed]
Emerging fields[edit]
Photopharmacology is an emerging approach in medicine in which drugs are activated
and deactivated with light. The energy of light is used to change for shape and chemical
properties of the drug, resulting in different biological activity. [29] This is done to ultimately
achieve control when and where drugs are active in a reversible manner, to
prevent side effects and pollution of drugs into the environment. [30][31]

Theory of pharmacology[edit]
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A trio of dose response curves. Dose response curves are studied extensively in pharmacology

The study of chemicals requires intimate knowledge of the biological system affected.
With the knowledge of cell biology and biochemistry increasing, the field of
pharmacology has also changed substantially. It has become possible, through
molecular analysis of receptors, to design chemicals that act on specific cellular
signaling or metabolic pathways by affecting sites directly on cell-surface receptors
(which modulate and mediate cellular signaling pathways controlling cellular function).
Chemicals can have pharmacologically relevant properties and
effects. Pharmacokinetics describes the effect of the body on the chemical (e.g. half-
life and volume of distribution), and pharmacodynamics describes the chemical's effect
on the body (desired or toxic).
Systems, receptors and ligands[edit]
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Main articles: Ligand (biochemistry), List of drugs, and Neurotransmitter

The cholinergic synapse. Targets in synapses can be modulated with pharmacological agents. In this
case, cholinergics (such as muscarine) and anticholinergics (such as atropine) target receptors; transporter
inhibitors (such as hemicholinium) target membrane transport proteins and anticholinesterases (such as sarin)
target enzymes

Pharmacology is typically studied with respect to particular systems, for example

endogenous neurotransmitter systems. The major systems studied in pharmacology
can be categorised by their ligands and
include acetylcholine, adrenaline, glutamate, GABA, dopamine, histamine, serotonin, ca
nnabinoid and opioid.
Molecular targets in pharmacology include receptors, enzymes and membrane transport
proteins. Enzymes can be targeted with enzyme inhibitors. Receptors are typically
categorised based on structure and function. Major receptor types studied in
pharmacology include G protein coupled receptors, ligand gated ion
channels and receptor tyrosine kinases.
Pharmacology[edit]
This section needs expansion. You
 can help by adding to it. (July 2019)

Main article: Pharmacodynamics
Pharmacodynamics is defined as how the body reacts to the drugs. Pharmacology
models include the Hill equation, Cheng-Prusoff equation and Schild regression.
Pharmacodynamics theory often investigates the binding affinity of ligands to their
receptors.
Medication is said to have a narrow or wide therapeutic index, certain safety
factor or therapeutic window. This describes the ratio of desired effect to toxic effect. A
compound with a narrow therapeutic index (close to one) exerts its desired effect at a
dose close to its toxic dose. A compound with a wide therapeutic index (greater than
five) exerts its desired effect at a dose substantially below its toxic dose. Those with a
narrow margin are more difficult to dose and administer, and may require therapeutic
drug monitoring (examples are warfarin,
some antiepileptics, aminoglycoside antibiotics). Most anti-cancer drugs have a narrow
therapeutic margin: toxic side-effects are almost always encountered at doses used to
kill tumors.
The effect of drugs can be described with Loewe additivity.[clarification needed]
Pharmacokinetics[edit]
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Main article: Pharmacokinetics
Pharmacokinetics is the study of the bodily absorption, distribution, metabolism, and
excretion of drugs.[32]
When describing the pharmacokinetic properties of the chemical that is the active
ingredient or active pharmaceutical ingredient (API), pharmacologists are often
interested in L-ADME:

 Liberation – How is the API disintegrated (for solid oral forms (breaking down into
smaller particles), dispersed, or dissolved from the medication?
 Absorption – How is the API absorbed (through the skin, the intestine, the oral
mucosa)?
 Distribution – How does the API spread through the organism?
 Metabolism – Is the API converted chemically inside the body, and into which
substances. Are these active (as well)? Could they be toxic?
 Excretion – How is the API excreted (through the bile, urine, breath, skin)?
Drug metabolism is assessed in pharmacokinetics and is important in drug research
and prescribing.

Administration, drug policy and safety[edit]

Drug policy[edit]
Main article: Drug policy
In the United States, the Food and Drug Administration (FDA) is responsible for creating
guidelines for the approval and use of drugs. The FDA requires that all approved drugs
fulfill two requirements:

1. The drug must be found to be effective against the disease for which it is seeking
approval (where 'effective' means only that the drug performed better than
placebo or competitors in at least two trials).
2. The drug must meet safety criteria by being subject to animal and controlled
human testing.
Gaining FDA approval usually takes several years. Testing done on animals must be
extensive and must include several species to help in the evaluation of both the
effectiveness and toxicity of the drug. The dosage of any drug approved for use is
intended to fall within a range in which the drug produces a therapeutic effect or desired
outcome.[33]
The safety and effectiveness of prescription drugs in the U.S. are regulated by the
federal Prescription Drug Marketing Act of 1987.
The Medicines and Healthcare products Regulatory Agency (MHRA) has a similar role
in the UK.
Medicare Part D is a prescription drug plan in the U.S.
The Prescription Drug Marketing Act (PDMA) is an act related to drug policy.
Prescription drugs are drugs regulated by legislation.

Societies and education[edit]

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Societies and administration[edit]

The International Union of Basic and Clinical Pharmacology, Federation of European
Pharmacological Societies and European Association for Clinical Pharmacology and
Therapeutics are organisations representing standardisation and regulation of clinical
and scientific pharmacology.
Systems for medical classification of drugs with pharmaceutical codes have been
developed. These include the National Drug Code (NDC), administered by Food and
Drug Administration.;[34] Drug Identification Number (DIN), administered by Health
Canada under the Food and Drugs Act; Hong Kong Drug Registration, administered by
the Pharmaceutical Service of the Department of Health (Hong Kong) and National
Pharmaceutical Product Index in South Africa. Hierarchical systems have also been
developed, including the Anatomical Therapeutic Chemical Classification System (AT,
or ATC/DDD), administered by World Health Organization; Generic Product
Identifier (GPI), a hierarchical classification number published by MediSpan
and SNOMED, C axis. Ingredients of drugs have been categorised by Unique Ingredient
Identifier.
Education[edit]
Main article: Medical education
The study of pharmacology overlaps with biomedical sciences and is the study of the
effects of drugs on living organisms. Pharmacological research can lead to new drug
discoveries, and promote a better understanding of human physiology. Students of
pharmacology must have a detailed working knowledge of aspects in physiology,
pathology, and chemistry. Modern pharmacology is interdisciplinary and relates to
biophysical and computational sciences, and analytical chemistry. A pharmacist needs
to be well-equipped with knowledge on pharmacology for application in pharmacy
practice and pharmaceutical research. Whereas, pharmacologists usually work in a
laboratory setting. Pharmacological research is important in academic research
(medical and non-medical), private industrial positions, science writing, scientific patents
and law, consultation, biotech and pharmaceutical employment, the alcohol industry,
food industry, forensics/law enforcement, public health, and environmental/ecological
sciences. Pharmacology is often taught to pharmacy and medicine students as part of
a Medical School curriculum.

Being a final-year medical student: What is

it like?
Day in the Life
08/10/2018
What's it like to be a final-year medical student?
Dr. Christine Thang, David Geffen School of Medicine at UCLA (DGSOM) class of 2015,
answers this question.

You’ll explore and develop during clinical rotations.

At the end of the third year, medical students plan clinical rotations for the final year.
DGSOM requires 30 weeks of clinical experiences, and students choose the rotations that
will best prepare them for residencies and future careers. Dr. Thang says rotation year
presents an opportunity for exploration and development.
"It gives you time to explore. You can go to different hospitals in the LA area and experience
a variety of hospital settings. Or you can do rotations away from LA, which helps students if
they want to explore a new city or if they want to go back East. There is lots of flexibility to
plan your schedule and [tailor] it to what you want to do after you graduate."

You’ll receive career-specific mentoring.

Students choose rotations based on their interests and career advice from faculty mentors; the
DGSOM matches medical students and faculty mentors during the third year.
Dr. Thang specially requested her mentor because he was involved in her chosen career path.
She had also worked with him before, so she knew he understood what she wanted to
achieve.
Dr. Christine Thang

You’ll get more involved with patients.

According to Dr. Thang, students get even more involved with patients during the final year
of medical school.  
"The patient looks at you as the person who answers their questions. There's so much to learn
in the third year, but in the fourth year, you are surprised at how much you have learned in
taking care of patients. You are expected to be in the hospital longer ... As a final-year
medical student, you have more autonomy and independence, but not completely without
residents and attendings guiding you along the way. There's a lot of great training in the
fourth year, and you learn how to be efficient and manage your time — skills that you need
for residency."

You’ll experience the final year in waves.

Dr. Thang says the fourth year of medical school comes in waves. The year starts on an
academic note as students take the USMLE Step 2 exam. After that, the year takes a clinical
turn as students complete rotations and apply to residency programs.
By Match Day in March, clinical rotations wind down and many students travel, spend time
with family and friends, get married, or even participate in global health rotations.
"I went to Bangkok, Thailand, for my global health rotation. I was at an academic hospital
and was surprised at the similarities. I had patients to care for and the healthcare teams were
the same ... [W]e practiced evidence-based medicine, but I got to see how healthcare is
delivered in a foreign country and experience a different culture," she says.
To summarize, the final year of medical school is a satisfying mix of learning, preparing for
residency, and celebrating years of hard work and accomplishment.
by Kyleigh Roessner