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Immunology + Pathology > Healing and repair > Flashcards

Healing and repair Flashcards

1
Q

How can tissues heal

A

Regeneration
Repair

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2
Q

When is it regeneration or repair

A

Depends on severity and location of tissue damage

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3
Q

What is regeneration

A

Replacement with functional, differentiated cells

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4
Q

What is repair

A

Production of a fibrous scar and changes in tissue structure

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5
Q

What cells are involved in healing and repair

A

Labile cells ​
-Normal state is active cell division​
-Rapid regeneration​

Stable cells ​
-Variable rates of regeneration​
-Proliferation in response to injury​

Permanent cells ​
-Unable to divide​
-Unable to regenerate​

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6
Q

What are the 4 stages of healing

A

Coagulation
Inflammation
Proliferation
Maturation

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7
Q

What occurs in the coagulation stage

A

Clot formation arises through coagulation cascade​

Occurs in parallel with fibrinolytic system ​

Involves platelets weaved together by fibrin​

Mitosis of labile and stable cells (e.g., epithelial cells)​

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8
Q

What does the inflammation phase consist of

A

Innate immune cell recruitment to site​

Immune cells phagocytose and degrade infectious agent (or damaged cells) - antigen presentation

Stimulation of cells to start tissue repair/regeneration​

Fibroblasts – fibrosis ​

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9
Q

What is involved in the proliferation phase

A

Can be early and late phase​

Formation of granulation tissue (rich in collagen)​

Growth factors are essential​

Fibroblasts are key players​

Angiogenesis (formation of new blood vessels)​

Myofibroblasts help healing

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10
Q

What happens in the proliferation phase

A

First phase – rich in vasculature​
-Mix of (newly formed) capillaries, immune cells, fibroblasts ​
-Capillaries are “leaky”​

Second phase – rich in collagen (called fibrous granulation tissue) ​
-Capillaries regress​
-Mature fibroblasts create collagen​

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11
Q

What is the matrix metalloproteinases

A

Produced by different immune cells​

Extracellular matrix (ECM) made of protein fibres (mainly collagen) ​

ECM re-modeled by matrix metalloproteinases (MMPs)​

Help cellular migration ​

Aid the process of angiogenesis​

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12
Q

What are growth factors

A

Signaling molecules​

Promote or inhibit cell growth and/or cell differentiation ​

Bind receptors on cell surfaces​

Homeostatic production = balance in health​

Alteration in this balance = dysregulated cellular proliferation

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13
Q

When are growth factors produced

A

Growth factors can be produced by cells as an “effector” response following: ​

Microbial recognition ​

Cytokine signalling​

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14
Q

What is angiogenesis

A

Formation of new capillaries ​

Formed from existing vasculature by: ​
-Sprouting ​
-Splitting​

Process driven by vascular endothelial growth factor (VEGF)​

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15
Q

What is fibrosis

A

Deposition of collagen and formation of fibrous connective tissue (second phase)​

A process driven by fibroblasts ​

Substantial or repeated damage (e.g., chronic inflammation) ​

Macrophages control fibroblast function (through different subsets – M1 and M2)​

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16
Q

What are the difference between macrophages

A

M1 – pro-inflammatory​

M2 – anti-inflammatory​

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17
Q

Which macrophages drive fibrosis and angiogenesis

A

M2

18
Q

What is the final stage of healing and it’s properties

A

Maturation phase: ​

Disorganized granulation tissue remodeled by remaining cells​

Collagen fibers are cross linked ​

Re-epithelization​

Regain of tensile strength​

Fibrous scar remains (in repair)​

Tissue remodeling required

19
Q

What is the process of bone formation

A

osteoblastogenesis

20
Q

After how many years do we get a new skeleton

A

10 - bone remodelling

21
Q

When is formation and resorption of bone in equilibrium

A

When you are healthy

22
Q

Where do osteoclasts differentiate from

A

macrophages

23
Q

What does RANKL stand for

A

Receptor Activator of Nuclear Factor Kappa-B Ligand

24
Q

What produces RANKL

A

osteoblasts

25
Q

What does uncontrolled production of RANKL stimulate

A

bone resorption

26
Q

What does RANKL activate

A

RANK on osteoclasts

27
Q

What secretes OPG

A

Osteoblasts

28
Q

What does OPG stand for

A

Osteoprotogerin

29
Q

What does OPG do

A

Inhibits RANKL function ultimately controlling bone resorption

30
Q

What is required to have healthy bone remodeling

A

Balance between RANKL/OPG ratio

31
Q

In the healing of hard tissues what occurs first

A

(Coagulation) formation of a Hematoma

32
Q

What is a hematoma

A

Blood clot within the tissue/bone

33
Q

What occurs during the inflammation stage of healing hard tissues

A

Recruitment of immune cells​

Removal of debris/dying tissue​

Cells produce soluble mediators to drive later healing responses​

34
Q

When is granulation tissue formed

A

Proliferation phase

35
Q

What is a callus

A

Woven bone forming a temporary scoffold for new bone development (essentially soft bone)

36
Q

When healing hard tissues what occurs in the proliferation phase

A

Formation of granulation tissue (similar to soft tissue)​

Granulation tissue becomes the fibrocartilage callus –soft bone​

Composed of osteoblasts, fibroblasts and chondrocytes​

Granulation tissue is ossified​

37
Q

What replaces woven bone

A

coritcal

38
Q

What does the maturation stage of healing fractures consist of

A

Osteoclasts and osteoblasts remodel the bone callus​

Cortical replaces woven bone ​

Takes between months and years – may never fully repair​

Angiogenesis essential in bone regeneration and repair​

39
Q

What is regeneration vs repair

A

Soft vs hard tissues

40
Q

What occurs in periodontitis to have bone loss

A

Imbalanced process of osteoblasts and osteoclasts secreting OPG and RANKL

Immunology + Pathology (11 decks)

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