Abnormalities of the ECM Flashcards

1
Q

What is the Extracellula Matrix

A
  • Structural framework in which cells organize, move, and interact
  • Proveds sites for cell adhesion and a conduit for exchange of cell nutrients and wastes
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2
Q

What are some of the properties of teh ECM?

A
  • Dictates tissue architecture and organization
    • Has specific feature for each tissue/organ
      • bone, liver, brain, lung, intestine, skin, etc
  • Regulates or modifies many cell c\activities
  • Serves as a reservoir of growth factors and bioactive molecules
  • Constantly remodeling and changing
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3
Q

What processes are influenced by the ECM?

A
  • Play a major role in:
    • Embryogenesis
    • Fibrosis
    • Wound healing
    • Cell behvor
      • Morphogenesis, differentiation, adhesion, migration, apoptosis
    • Carcinogenesis
      • Tumor invasion nd metastasis
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4
Q

What are the components of the ECM

A
  • The “matrisome” conssts of over 300 different proteins
  • 3 categories:
    • Structural
    • Absorptive
    • Adhesive
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5
Q

What are teh structural components of the ECM?

A
  • Build the framework for cells to exist upon and within
  • Include:
    • Collagen - many types
    • Elastin - prominent where elasticity is needed
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6
Q

What are the collagen types?

A
  • at least 28 types
  • I - structural collagen of most tissues
    • Fibrous tissue, bone
  • II - major component of cartilage
  • IV - Basement membranes
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7
Q

What is Marfan Syndrome

A
  • Collagen Disorder
  • A mutation in the gene encoding fibrillin-1
    • Fibrillin-1 is a structural component of microfibrils and regulates formtion of elastic fibers
    • Elevated levels of TGF-beta also occur and contribute to the disease
  • Features include tall, slender build, disprportionally long fingers and toes, lsn dislocation , and Aortic weakening among others
    • Dr. Abraham Gordon Proposed in 1962 that Abraham Lincoln had Marfan Syndrome
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8
Q

What is Ehler-Danlos Syndrome?

A
  • A group of inherited connective tissue disorders characterized by defective collagen synthesis
    • Loose and very fragile skin
  • Dermatoporaxis is one variant of this condition
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9
Q

What are the Absorptive parts of the ECM

A
  • Absorb water and other soluble substances whibh bath surrounding cells
  • Major absoptive components:
    • Glycosaminoglycans (GAG)
    • Proteoglycans
  • Exert important osmotic pressures to help maintain water balance
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10
Q

What are Glycosaminoglycans?

A
  • Polysaccharides consisting of 4 main groups:
    • Hyaluronic acid
    • Heparan sulfate
    • Chondroitin/dermatan sulfate
    • Keratan sulfate
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11
Q

What are proteoglycans

A

proteins with GAG side-chains

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12
Q

What is Edema?

A
  • The excessive accumultion of fluid in the ECM or within body cavities
  • Vacious causes, one of which is a chang in concentrations or properties of absorptive molecules in the ECM
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13
Q

What is the Adhesive part of the ECM?

A
  • Sites of attachment for structural ECM components nd cells
  • Adhesive components:
    • Fibronectin
    • Laminin
    • Many others
  • Mediate interactions of fixed or mobile cells with the ECM
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14
Q

What is Fibronectin and what is its role in would healing?

A
  • A glycoprotein that attaches to integrins (cell membrane receptor proteins) as well as ECM prteins such as collagen, fibrin, and proteglycans
  • Critiacl for wound healing
    • provides binding sites for macrophages, endothelium, and fibroblasts during tissue repair and healing
    • Contributes to formation of the granulation tissue matrix
    • Can influence cel function and protein expression
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15
Q

What are the other roles of Fibrnectin besides wound healing?

A
  • Cell migration and differentiation during embryogenesis
  • Hemostasis - in conjuntion with fibrin
  • Carcinogenesis - may promote tumor growth nd survival
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16
Q

How can Fibronectin affect embryogenesis

A
  • Deficiency can lead to embryonic death or defects in neural and vascular development
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17
Q

What are the general patterns of injury?

A
  • Increased destruction
  • Decreased production
  • Excessive production
  • Deposition of abnormal substances
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18
Q

What is increased destruction of ECM?

A
  • ECM exists in a dynamic balane of production and degradation
    • Fibroblasts produce collagen
    • Matrix metalloproteinases among other enzymes degrade collagen
      • MMP 1 collagenase
  • Decreased ECM occurs when the balance of degradation exceeds production
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19
Q

What are causes of inceased destruction of ECM?

A
  • Excessive MMP activity
    • associated with various condition, including vascular disease, neoplasia, skin and musculoskeletal disorders
  • Inflammation
    • Lysosomal enzymes are released into the ECM
      • Excessive amounts of MMPs
        • Collagenaes and elastases
    • Oxygen free radicals and cytokines damage ECM
  • Immunologic reactions
    • Immunologic activation of inflammatory responses
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20
Q

Increased destruction of ECM

A
  • Morphology:
    • Gross:
      • Corresponds to the different types of necrosis
    • Histologic:
      • Collagen is swollen, uniformly eosinophilic, fragmented or absent
      • Inflammation is usually present
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21
Q

What causes decreased production of ECM?

A
  • Most cases occur as inheited diseases of collagen formation
    • Collagen dysplasias
  • Nutritional deficienceis can influence ECM production
    • Vit C is a critical element for collagen formation and maintenance
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22
Q

What is the morphology of decreased production of ECM?

A
  • Gross:
    • skin is very distensible and fragile
    • Tears in the skin
  • Histiologic:
    • No abdormlities in some cases
    • Collagen of variable size and shape
    • Abnormal collagen organization
23
Q

What is excessive production of ECM?

A
  • Predominantly associated with healing in irreversibly dmaged tissue
    • Fibrosis and scar formation
  • Excessive fibrosis can interfere with tissue and organ funtion
    • Can have major detrimental effects when located in criical tissues
24
Q

What are causes of excessive ECM production?

A
  • Upregulation of collagen-producing cells
    • predominately fibroblasts
    • a shift in ECM homeostasis or a metabolic problem
  • Any stimulus resulting in irreversibly damaged tissue
    • Tissue is replaced by collagen as part of healing
25
Q

What is the morphology of Excessive ECM production?

A
  • Gross:
    • Dense, white fibrous tissue replacing normal tissue
    • Abnormal relationships between tissues and organs
      • Excessive fibrosis can interfere with organ function
  • Histologic:
    • Densely packed collagen
    • Initially increased fibroblasts
    • Later mainly collage with few fibroblasts
26
Q

What substances are depsited in the ECM?

A
  • Abnormal substances can be deposited in both normal and abnormal ECM
  • Common substances:
    • Amyloid
    • Calcium
    • Iron
    • Excessive collagen
27
Q

What is Amyloid

A
  • Amyloid is a chemically diverse protein that has a ß - plated sheet conformation
  • Composition:
    • 95% fibrillar proteins
    • 5% other proteins
      • Serum amyloid P protein
      • Proteoglycans
      • Glycosaminoglycans
28
Q

What are the common forms of Amyloid?

A
  • Over 30 biochemically distinct forms of disease-associated amyloid havebeen described
  • Most common forms:
    • Amyloid Light Chain (AL) protein
      • ​consists of immunoglobulin light chains
    • Amyloid-Associated (AA) protein
      • This is deried from serum AA produced by the liver
    • Aß amyloid:
      • ​A fragment derived from amyloid precursor protein (AAP)
29
Q

Why is Amyloid deposited?

A
  • Amyloid deposition occurs due to abnormal folding of amyloid proteins
  • Deposition is usually due to:
    • Normal proteins that have tendency to misfold when produced in excess
    • Abnormal proteins formed due to mutations
30
Q

Why does Amyloid accumulate?

A
  • Misfolded amyloid can NOT be degraded and accumulated extracellularly in ECM
    • May be a defect in normal degrdative processes
    • May be an abnormal protein that can’t be degraded
31
Q

What is the morphology of deposited Amyloid?

A
  • Gross:
    • Deposition can occur either locally or systemically
    • Affected organs are enlarged, firm and discolored
    • Detectable with Lugol’s iodine and sulfuric acid
  • Histologic:
    • Eosinophilic, acellular, amorphous, fibrillar extracellular protein that displces normal tissue components
      • Some types can be intracellular as well
    • Stains with Congo Red dye
      • Produces apple-green fluorescence with polarized light
32
Q

What syndromes have been characterized by Amyloid deposition?

A
  • Primary amyloidosis
  • Secondary (reactive) amyloidosis
  • Amyloidosis of aging
  • Endcrine amyloidosis
  • Familial amyloidosis
33
Q

What is Primary Amyloidosis?

A
  • Usually associated wih immunological dyshomeostasis and deposition of AL protein
  • Most commonly associated with plasma cell neoplasia
    • Neoplastic cells produce excessive amounts of immunoglobulin and immunoglobulin light chains
34
Q

What is Secondary Amyloidosis

A
  • Usually associated with chronic inflammation and tissue destruction with deposition of AA protein
  • Cytokines and cell damage associated with chronic inflammation increases production of SAA
  • Abnormal breakdown of SAA or structural abnormalities in the SAA results in deposition in teh ECM
  • Most common form in domestic animals
35
Q

What is amyloidosis of aging?

A
  • Deposition of Aß amyloid can occur in the brain (neurons and neurovascular tissue) of old dogs
    • this type s characteristic of Alzheimer’s disease of humans
  • Deposition less often occurs in the heart, GI tract and lungs of old dogs
36
Q

What is Endocrine Amyloiosis?

A
  • Amyloid is deposited in teh pancreas (islets) of cats
    • Amyloid protein is derived from a norml product of pancreatic islet ß cells
      • Islet amyloid polypeptide
  • Amyloid deposition can result in Type I diabetes mellitus
  • Also occurs in some non-human primates and humans
37
Q

What is Familial Amyloidosis?

A
  • Systemic deposition of AA amyloid occurs specifically in some breeds of dogs and cats
    • Abyssinian and Siamese cats
    • Shar-pei dogs
  • Hereditary
    • SAA may be abnormal
    • There may be some chronic inflammatory component in some cases
  • Kidney and liver are most commonly affected
38
Q

What is Calcification?

A
  • Calcium deposition can occur in either normal or abnormal ECM
  • “Mineralization”
39
Q

What causes calcification?

A
  • Mineralization can occur due to 2 basic prcesses
    • Dystrophic mineralization
    • Metastatic mineralization
40
Q

What is Dystrophic Calcification?

A
  • This process occurs in necrotic tissue
  • Calcium binds to damaged membrane phospholipids and initiates calcium crystal formation
    • Cell can no longer prevent calcium influx into the cytosol
  • A reflection of local tissue damage and NOT a systemic disturbance in calcium homeostasis
41
Q

What are common locations for Dystrophic calcification?

A
  • Heart
  • Skeletal muscle
  • Inflammatory lesions
    • Granulomas
  • Skin
    • Calcinosis cutis associated with hyperadrenocorticism
42
Q

What is Metastatic calcification?

A
  • This occurs in normal, viable tissue
  • It is a reflection of calcium dyshomeostass
    • mainly occurs secondarily to hypercalcemia
  • Calcification is initiated by local alkaliniity and alterations in collagen structure
  • Often systemic
43
Q

What are common metastatic calcification situations?

A
  • Renal failure
  • Vit D toxicity
  • Pseudohyperparathyroidism
    • paraneoplastic condition associated with PTH-like protein
  • Neoplastic bone destruction
44
Q

What is the morphology of cacification?

A
  • Gross:
    • Gritty and white deposits in tissue
  • Histologic:
    • Purple material that either incorporates into normal structures or disrupts the normal morphology of the tissue
45
Q

What are some ECM-associated Disease?

A
  • Epidermolysis bullosa
  • Collagen defects
  • Muscular dystophies
  • Osteoarthritis and intervertebral disk disease
  • Vascular disease
  • Neoplasia
  • Diabetes mellitus
  • Chondrodysplasia
46
Q

What is Epidermolysis bullosa?

A
  • A group of conditions characterized by skin fragility and blistering
    • Causes include abnormal collagen type VII, keratin, laminin, and integrins
47
Q

What collagen defects are ECM-associated disease?

A
  • Osteogenesis imperfecta
    • Abnormal Type I collagen
  • Ehlers-Danlos Syndrome
    • Defects in collagen or metalloproteinases
48
Q

How are muscular dystrophies ECM associated?

A
  • Defects in laminin
  • Defects in Type VI collagen
  • decreased dystrophin levels
49
Q

How is Osteoarthritis and intervertebral disk disease ECM-associated?

A
  • Degeneration of multiple matrix components
50
Q

Which Vascular diseases are ECM-associated?

A
  • Atherosclerosis and aneuryms
51
Q

What parts of Neoplasia are ECM associated?

A
  • Invasion
  • Angiogenesis
  • metastasis
52
Q

How is Diabetes Mellitus ECM associated?

A
  • Excessive collagen glycation and cross-linking and stiffening
53
Q

How is Chodrodysplasia ECM-associated?

A
  • Abnormal Type II collagen