Cell Injury (Drake) Flashcards
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Apoptosis
Programmed cell death (physiological or pathological)
Single cells
Requires ATP
No loss of membrane integrity
Little release of cell contents (apart from extrusion-planned)
Little inflammation
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Causes of Necrosis
(1) ischemia
(2) mitochondrial poisoning
(3) membrane damage agents (ROS, bacterial enzymes)
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Sequence of events for cell death in ischemia
1) Decreased blood flow
2) Decreased oxygen
3) Decreased ATP
4) Decreased Na/K pump (increased cytoplasmic Na+ and Ca++)
5) Loss of mitochondrial electron transport function
6) Loss of inner mitochondrial membrane integrity
7) Lysosomes degrade cell constituents
PROCESS IS REVERSIBLE UNTIL LOSS OF INNER MITOCHONDRIAL MEMBRANE INTEGRITY
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Consequences of ischemia
Decreased oxidative phosphorylation –> decreased ATP –>
(1) ER swelling Cell swelling (decreased Na+ pump activity)
(2) clumping of nuclear chromatin
(3) decreased protein synthesis and increased lipid deposition
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Role of increased cytosolic Calcium in cell injury
activation of cellular enzymes–>
(1) membrane damage (due to phospholipases and proteases)
(2) nuclear damage (due to endonucleases)
(3) decreased ATP (due to ATPase activity)
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Clinical conditions leading to necrosis
Ischemia and hypoxia
Ischemia reperfusion injury
Inflammation and infections
Chemical injury
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Stages of apoptosis
- Signaling stage - Initiation (generate activated initiator caspase from procaspases)
- Effector stage - Death pathway engaged (caspase cascade generates effector caspases)
- Terminal stage - Cell death. Morphologic changes. (endonucleases digest DNA, cytoskeleton broken apart)
- Phagocytosis of apoptotic cell
Necrosis
Occurs in many adjacent cells
Passive response
Does not require ATP
Disruption of organalle fxn
Release of cell contents
Strong inflammatory rxn
Always pathological
What are all initiators of necrosis associated with?
Decreased ATP
How can you tell if a tissue is undergoing necrosis?
Released intracellular proteins enter the blood and are measured as markers of tissue damage (eg liver enzymes; cardiac enzymes and proteins).
Where does the intrinsic pathway of apoptosis occur?
Mitochondria
Molecules involved in intrinsic pathway of apoptosis
1) Bcl2 (regulator): sits on membrane of mitochondria and binds Bax/Bac to keep it from forming mitochondrial pores; is anti-apoptotic
2) Bax/Bac (effector): forms pore in mitochondrial outer membrane; is pro-apoptotic
3) BH3 (sensor): when cell wants to undergo apoptosis, BH3 binds to Bcl2, freeing Bax/Bac to form mitochondrial pores; is pro-apoptotic
After mitochondrial pore is formed in intrinisc pathway of apoptosis, what happens?
Cytochrome C and other proteins released into cytoplasm –> initiates formation of caspase complex called apoptosome –> caspase pathway that leads to apoptosis
Extrinsic pathway of apoptosis
Fas death receptor present on all cells binds Fas ligand on killer T cell –> aggregate –> adaptor protein FADD attracts procaspase (forming DISC complex) –> initiate effector caspase cascade –> apoptosis
Terminal stage of apoptosis
Executioner caspases: activate endonucleases (DNA fragmentation), degrade microfilaments (cytoplasmic blebbing), proteolyse lamin (nuclear blebbing)
Transglutaminase inside cell does protein cross-linking