Chapter 2: Cell Death Flashcards
What are the main causes of necrosis?
Loss of oxygen supply (ischemia), exposure to microbial toxins, burns, and other forms of chemical and physical injury
How is necrosis characterized?
Denaturation of cellular proteins, leakage of cellular contents through damaged membranes, local inflammation, and enzymatic digestion of the lethally injured cell
What are two examples of the different types of DAMPs that are released from injured cells?
ATP (released from damaged mitochondria), uric acid (a breakdown product of DNA)
What is the purpose of the DAMPs that are released from injured cells?
They are recognized by receptors present in macrophages and most other cell types and trigger phagocytosis of the debris and the production of cytokines that induce inflammation
What is the basis for blood tests that detect tissue-specific cellular injury?
Necrosis-associated leakage of intracellular proteins through damaged plasma membranes and ultimately into the circulation
The necrotic cell may have a glassy homogenous appearance relative to normal cells. This is mainly as a result of what?
The loss of glycogen particles
In necrosis, dead cells may be replaced by large whorled phospholipid precipitates known as what?
Myelin figures
What is karyolysis?
When the basophilia of the chromatin fades
What is pyknosis?
Nuclear shrinkage and increased basophilia
What is karyorrhexis?
The pyknotic nucleus undergoes fragmentation
What nuclear change occurs in both necrosis and apoptosis?
Pyknosis
Why does karyolysis occur?
It reflects the loss of DNA because of enzymatic degradation by endonucleases
What two phenomena consistently characterize irreversibility?
The inability to reverse mitochondrial dysfunction and profound disturbances in membrane function
What is coagulative necrosis?
A form of necrosis in which the architecture of dead tissue is preserved for a span of at least some days
How are coagulative necrotic cells broken down?
By the action of lysosomal enzymes derived from infiltrating leukocytes
What is an example of something that may lead to coagulative necrosis?
Ischemia caused by obstruction in a vessel in all organs except the brain
What is a localized area of coagulative necrosis called?
An infarct
What is liquefactive necrosis characterized by?
The digestion of the dead cells resulting in transformation of the tissue into a vicious liquid
When is liquefactive necrosis seen?
In focal bacterial or occasionally fungal infections because the microbes stimulate the accumulation of leukocytes and the liberation of enzymes from these cells
Why is the necrotic tissue in liquefactive necrosis frequently creamy yellow?
Because of the presence of leukocytes (called pus)
Hypoxic death of cells within the CNS manifests as what?
Liquefactive necrosis
What is gangrenous necrosis?
A term usually applied to a limb (generally the lower leg) that has lost its blood supply and has undergone necrosis (typically coagulative necrosis)
When bacterial infection is superimposed in gangrenous necrosis, what do you get?
Wet gangrene
What is caseous necrosis?
It is encountered most often in foci of tuberculous infection
What is fat necrosis referring to?
Focal areas of fat destruction, typically resulting from release of activated pancreatic lipases into the substance of the pancreas and the peritoneal cavity
When does fat necrosis occur?
Acute pancreatitis
What occurs during acute pancreatitis?
Pancreatic enzymes leak out of the damaged acinar cells and liquefy the membranes of fat cells in the peritoneum, releasing triglyceride esters that are split by pancreatic lipases
On histologic examination, what does fat necrosis look like?
The necrotic areas contain the shadowy outlines of necrotic fat cells, basophilic calcium deposits, and an inflammatory reaction
What is fibrinoid necrosis?
A special form of vascular damage usually seen in immune reactions involving blood vessels
When does fibrinoid necrosis typically occur?
When complexes of antigens and antibodies are deposited in the walls of arteries; the immunologically mediated vasculitis syndromes
What does the wall of a fibrinoid necrotic artery look like?
It shows a circumferential bright pink area of necrosis with inflammation
If necrotic cells and cellular debris are not promptly destroyed and reabsorbed, what happens?
They provide a nidus for the deposition of calcium salts and other minerals, and thus become calcified (dystrophic calcification)
Although the “point of no return” at which the damage becomes irreversible and progresses to necrosis is still largely undefined, two phenomena consistently characterize irreversibility. What are they?
severe mitochondrial damage with depletion of ATP and rupture of lysosomal and plasma membranes
What are the 5 different causes of physiological apoptosis?
1) the removal of supernumerarary cell during development 2)involution of hormone-dependent tissues 3)cell turnover in proliferating cell populations 4) elimination of potentially harmful self-reactive lymphocytes 5) death of host cells that have served their useful purpose such as neutrophils in acute inflammatory response
What are 4 pathological causes of apoptosis?
1) DNA damage 2) accumulation of misfolded proteins 3) during certain infections, particularly viral infection like HIV 4) pathologic atrophy in parenchymal organs after duct obstruction