Cell Responses to Stress , Adaptation, Injury, Death - Dobson (Ch2) Flashcards
Etiology
Cause
Hypertrophy
Increased size in cells due to increased demand
= increased synthesis of cell proteins and myofilaments
Hyperplasia
Increased number of cells due to higher demand
Metaplasia
The increase in cells differentiated to new role (Change in phenotype), usually when a cell is sensitive to stress and replaced by a cell not as sensitive
Due to Chronic irritation
Reversible
What causes autophagy
Low nutrients
What can cause calcification or intracellular accumulations
Metabolic changes from genetically or acquired
Or Chronic Injury
what causes either the physiologic or pathological hypertrophy to activate
TGF-B, ,IGF-1, (a-adrenergic agonist, endthelin, angiotensin = vasoconstriction)
What are the factors activated for Physiologic Hyperplasia
= exercise induced
(PI3K/AKT pathway)
= (uterus grows when pregnant)
What are the factors activated in pathologic Hyperplasia
G-protein receptors and their pathway
What TF are activated to make more myosin and muscle proteins
GATA4, NFAT, MEF2
Cardiac hypertrophy usually is associated with what
Increased ANP production
Physiologic Hyperplasia
H or GFs needed in higher amount after damage or resection, so it can have normal function
(Breasts during puberty, adrenal gland)
Hormonal hyperplasia
Glands like breast growth
Compensatory hyperplasia
Liver
Pathologic Hyperplasia
Excessive H or GFs on target cells due to that cell not responding well
(Endometrial - E does not decrease like it should in period cycle and endometrium continues to grow, Prostate - T continuously stimulating growth)
Physiologic Atrophy
Embryologic and normal things
Pathologic Atrophy
Low workload X innervation X BF Low nutrition or high TNF X endocrine stimulation (endometrium, breasts, vagina) Pressure on the tissue (tumor or bone)
Ex of metaplasia
Columnar to squamous epithelium in the respiratory track (irrigation like smoking, low VIT A, GERD), bile duct, pancreatic duct, salivary glands
Squamous metaplasia can cause what consequence
Low protection, mucus secretion, ciliary actions
Can lead to malignancy
For Cartilage or adipose or bone in muscles and other tissues = CT metaplasia
Bone formation in muscle (metaplasia) called what
Myositis Ossificans
How does metaplasia happen
Reprogramming or stem cells in tissues or mesenchyme cells that are undifferentiated
Hallmarks for reversible cell injury
- Cell swelling (ion changes)
- Reduced oxidative phosphorylation (low ATP storages)
- Altered mitochondria and cytoskeleton
- Light microscopy sees fatty change and swelled cells
Necrosis uses what to die
Lysosomes and cleaned up by inflammation
Necrosis and apoptosis physiologic and pathologic
Necrosis is always pathologic
Apoptosis is both
Necrosis nucleus
Apoptosis nucleus
N : Pyknosis = shrink, Karyorrhexis = fragmentation, Karyolysis = endonuclease degrade and it fades
A : Fragmentation to nucleosomes
What is seen in reversible cell injury
Lowered cell function
Ultra structural changes (mito, PM, ER, Nuclear changes)
What is seen in irreversible cell
- Biochemical alterations
2 . Ultra structural changes - Light microscopic changes
- Gross morphological changes
What is seen in necrotic cell
- High eosinophilia
- Glassy looking
- Myelin figures (phospholipid masses)
- Calcification
Coagulative necrosis
No digestion of cells (only denature proteins)
Ischemia due to obstructed vessel = all organs (except brain)
- if localized = infarct
Liquefaction necrosis
Digests cells - liquid, pus (creamy yellow)
Bacteria or fungal infection
CNS (brain)
Gangrenous Necrosis
Lowe limbs usually from coagulative necrosis, can undergo liquefactive necrosis is bacteria infects it
Caseous necrosis
TB ad fungal infection
= cheese Iike
= Lysed cells, granular debri = granuloma
Fat necrosis
Fat destruction, released pancreatic enzymes (lipases)
Calcium deposits
Fibrinoid necrosis
Immune reactions in BVs
Fibrinoids (fibrin leaks out)
In low ATP levels like from hypoxia
Body depends on anaerobic glycolysis from glycogen stores = lactic acid
Irreversible Mitochondrial and lysosomal damage causes
Necrosis
3 things that happen when there is mitochondrial damage
- Mitochondrial permeability transition pore = X membrane potential —> X oxphos —> X ATP (Cyclophilin D + Ca+2 causes this, targeted in transplantation)
- ROS
- Proteins leak inside —> apoptosis intrinsic pathway
Increased CA+ 2 into cell causes what 3 things
- Mitochondrial permeability transition pore
- Activate ATPase, Protease, Phosphilipases, endonuclease
- Activate caspases
How are ROS (free radicals also removed)
Add to H2O—-> O2 and H2O2
- Catalase
- SODs
- Glutathione peroxidase (makes GSSG)
Which VIT are anti oxidants
E and A, C, glutathione
What metals can cause ROS
Iron and copper
What can you measure in blood to see if there is necrosis in
- Liver
- Liver by bile duct epithelium
- Cardiac myocardium
- Transaminase
- Alkaline phosphate
- Troponin
Low ATP due to hypoxia or ischemia =
CA+ into the cell = changes and damage
What stimulates new BVs to form
Hypoxia - induce blue factor -1
Restoring O2 to ischemic tissues can do what
- If reversible : repair
2. If irreversible : make cells die (ischemia- reperfusion injury)
ischemia- reperfusion injury how does this happen
Increasing O2 to damaged Mitochondria causes accumulation of ROS
Inflammation (from blood coming again)
CA+ increases more inside cell due to damaged mito
Cyanide
Inhibits cytochrome oxidase = X oxidative phosphorylation
What do you see in apoptosis
- Cell shrinks
- Chromatin condensation
- Cytoplasmic blebs + apoptotic bodies
- M that phagocytose (lysosomes)
4 things causing apoptosis
- DNA damage
- Protein accumulation
- Infection like certain viruses
- Duct obstruction causing atrophy
Intrinsic Apoptosis
- Mitochondria gets more permeable by inhibited Bcl-2 (from BAX/BAK activation)
- Cytochrome c released to cytoplasm binding to Apaf (apopsome) activating caspase 9
* BH3= sensor activating this entire process when cell has stress*
Over-expression of Bcl-2
B- cell lymphoma
Extrinsic Apoptosis
- FAs —> FasL (death receptor on PM, CD95, TNF1)
- Activates FADD
- Activates caspase 8 + 10
Caspases executing apoptosis
3 and 6 activated by both pathways
Necroptosis
NO caspase = like necrosis
Programmed cell death = like apoptosis
= uses TNF and TNFR1, activating RIP1, RIP3, caspase 8 is not activated
Pyroptosis
Programmed cell death with IL1 (fever) released
= IL1 activated inflammasome
What is dysfunctional causing accumulation of something:
- CF
- Familial hyperlipidemia
- Tay-Sachs
- a-1-antitrypsin deficiency
- Crentzfeldt-Jacob
- Alzheimer’s
- CF : CFTR
- Familial hyperlipidemia : LDL receptor
- Tay-Sachs : Hexosaminidase B subunit (X lysosomal enzyme)
- a-1-antitrypsin deficiency : a1-antitrypsin (apoptosis in liver, emphysema in lungs)
- Crentzfeldt-Jacob : prions (misfolded PrPsc in neurons)
- Alzheimer’s : AB peptide
3 features of autophagy
- Double membrane
- Lysosomes
- Sequestering vacuoles
* *** usually during low nutrition
What can caused by uncontrolled autophage
IBS (Crohns)
Cancers
Neurodegenerative disorders
Steatosis
Fatty change : accumulation of TAGs in parenchymal cells due to DM, toxins, low protein diet, obesity, alcohol
(LIVER, heart, muscle, kidney)
Atherosclerosis
accumulation of cholesterol in M and muscle cells on BVs
Xanthomas
accumulation of cholesterol in M on skin and tendons
Cholesterolosis
accumulation of cholesterol in GB lamina Propria
Niemann- Pick disease , Type C
cholesterol trafficking enzyme mutation = accumulation cholesterol in many organs in lysosomes*
Proteinuria and what accumulates
Loss of protein is high and this increases tubules in kidney to reabsorb proteins that go into the tubular epithelium
Russell bodies
Are seen when protein is accumulated inside a cell especially immunoglobulins
A1-antitrypsin
Is mutated accumulated protein causing either apoptosis(liver) or emphysema (lungs)
Neurofibrillary tangles
Cytoskeleton accumulation can be seen in Alzheimer’s
Hyaline in DM and HTN
Arteriolar wall in kidney become hyalinized
Where can glycogen accumulation in DM
Kidney tubular epithelium, liver cells, B cells of Langerhans, heart muscle cells
Coal workers pneumoconiosis
Carbon accumulation in lung M and stay there can cause emphysema
Exogenous pigment
Carbon (anthracosis)
Tattoo ink
Endogenous pigment
- Lipofuscin (lipids and phospholipids + protein from poly-sat lipids)
= liver and heart gaining or cachexia - Melanin
- Alkaptonuria (defect in protein metabolism = black color)
4 .Hemosiderin : gold brown pigment
** usually lysosomal problem**
Dystrophic Calcification
In necrotic areas
Organ dysfunction
Metastatic Calcification
Normal tissues with hypercalcemia
(Can increase dystrophic calcification)
1. High PTH
2. High bone resorption (cancer, pager disease)
3. VIT D disorders (Williams D in infants)
4. Renal failure (cant excrete Phosphate —> secondary hyperparathyroidism)
What can increase life
Low caloric intake = low IGF-1 and high sirtuins
2 types of DAMPs released during necrosis
ATP : from damaged mitochondria
Uric Acid : broken down DNA
which receptors have the FasL
T-cells and CTLs
Extrinic pathwya inhibited by
FLIP
Ferroptosis
Iron dependent pathway for cell death due to lipid peroxidation from Glutathione being overwhelmed
increase in ROS and leakage of enzymes and proteins happens in what
and lowered ATP
necrosis
Lipid peroxidation causes what
membrane damage
Protein modification causes what
Breakdown or misfolding of proteins
what immune cells make ROS
N and M
low O2 does what MILD
lowered ATP from ox phos
X NA pump
NA and H2O influx
swelling (Reversible)
low O2 does what SEVERE
influx of Ca and mito swelling
rupture lysosomes and PM
which cells can undergo hypreplasia
only cells that can do replication (quiescent cells in G0 state)
Amyloid accumulation most likley in
heart
Gaucher cells
from in Gaucher Disease in BM
M cells that accumulate glucocerebroside (mutated glucocerebrosidase
lysosomal storage disease
Lipofusin accumulates in what cells mostly
heart
Asbestos body
Ferruginous body (cell with Fe and Ca)
what drug acts to increse sirtuins
Rapamycin
Sirituins does what
activate DNA repair enzymes
adaptation to caloric restriction (low caloric intake = lower ROS made)