cell injury and death Flashcards
what are the 9 causes of cell injury
- physical agents
- infectious agents
- immunologic dysfuntion
- genetic derangements
- nutritional imbalances
- workload imbalances
- chemicals, drugs, and toxins
- aging
- 0xygen and energy deprivation
cell injury
physical agents
- heat, cold, radiation, electric shock
- may directly rupture cells, damage their blood supply, denature cell proteins, create free radicals, or damage DNA
cell injury
infectious agents
- viruses, prions, bacteria, rickettsiae, protozoan, metazoan parasites
- damage cells by directly invading the cells or producing toxins, or the damage may be due to the inflammatory reaction they induce
cell injury
immunologic dysfunction
failure to respond to infectious agents and other antigens as a result of congenital or acquired immunodeficiencies; autoimmune dieases; hypersensitivity reactions
cell injury
genetic derangements
- mutations
- cause a wide spectrum of abnormalities, from gross defects that are incompatible with life, to subtle variations in susceptibililty to other diseases; hypersensitivity reactions
cell injury
nutritional imbalances
include decreased food intake (starvation) excessive ingestion of calories leading to obesity, and deficiencies or excessive intake (toxicity) of vitamins and minerals
cell injury
workload imbalances
due to excess or deficiencies of either physical activity or hormonal secretion and often cause apoptosis, atrophy or hypertrophy/hyperplasia
cell injury
chemicals, drugs, and toxins
act by a variety of different mechanisms to lead to cell injury
cell injury
aging
aged cells may suffer a lifetime of DNA damage and/or accumulation of cellular debris that interfaces with normal cell functions
how long does it take to notice microscopic changes associated with cell injury
6-12 hrs
how long does it take to notice gross changes associated with cell injury
hours-days
what are the 5 mechanisms of cell injury
- depletion of ATP and decreased ATP synthesis
- mitochondrial damage
- influx of intracellular calcium and loss of calcium homeostasis
- accumulation of oxygen-derived free radicals (oxidative stress)
- defects in membrane permeability/membrane injury
what occurs when there is a depletion of ATP and decreased ATP synthesis
- the plasma membrane NaK ATPase pump fails and Na enters the cell and water follows leading to cell swelling and dilation of the RER
- failute of the Ca pump causes excess calcium to enter the cell; that damages a number of systems by increased enzyme activity
- if cells switch to glycolysis, glycogen is depleted and lactic acid and inorganic phosphates accumulate which decreases intracellular pH, resulting in decreased activity of some cellular enzymes
- as ATP depletion continues, ribosomes detach from the RER leading to decreased protein synthesis
- protein misfolding occurs leading to further cell injury
what occurs during mitochondrial damage
- cell injury causes formation of the mitochondrial permeability transition that ultimately interferes with mitochonrial oxidative phosphorylation
- following injury, mitochondria can leak cytochrome c into the cytosol that may trigger apoptosis
what occurs when there is an influx of intracellular calcium and loss of calcium homeostasis
- activation of phospholipase A
- breaks down the normal phospholipids of the inner mitochondrial membrane and other cell membranes
- generates arachidonic acid (substrate for many lipid mediators of inflammation)
- activation of proteases that cause cytoskeleton and membrane damage
- ATPases
- endonucleases that degrade chromatin
what occurs when there is accumulation of oxygen-derived free radicals (oxidative stress)
- free radicals can damage lipids, proteins, and nucleic acids
- normally free radicals are scavenged, but when there is an excess of production or decreased removal then oxidative stress occurs
- free radical damage occurs with chemical and radiation injury, ischemia, microbial killing by neutrophils and macrophages, and cellular aging
- once formed, free radicals damage tissues by: lipid peroxidation of membranes; oxidative modification of proteins; DNA damage
- cells have multiple mechanisms to remove or neutralize free radicals (antioxidants, iron and copper binding proteins, free radical-scavening enzyme systems)