Lecture 7: Blood Disorders Flashcards

1
Q

What are the processes involved in the formation of capillaries and lymphatics?

A
  • Vasculogenesis: formation of blood vessels from precursor cells (angioblasts) or endothelial progenitor cells
  • Angiogenesis: sprouting and branching of new blood vessels from pre-existing ones, typically in response to physiological or pathological stimuli.
  • Lymphangiogenesis: formation of new lymphatic vessels from lymphatic endothelial progenitor cells, similar to angiogenesis but specific to lymphatic vessels.
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2
Q

What is arterogenesis, and how does it relate to the formation of arteries?

A
  • Small arterioles or collateral arteries remodel and enlarge to form mature arteries, often in response to changes in blood flow or ischemic conditions.
  • Involves the structural adaptation of existing vessels rather than de novo formation.
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3
Q

What processes are involved in vein formation?

A
  • Vasculogenesis and angiogenesis, similar to the formation of capillaries and arteries.
  • However, the specific mechanisms and regulatory factors governing vein development may differ from those of arteries.
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4
Q

What is angiogenesis, and when does it occur?

A
  • The process of forming new blood vessels from pre-existing ones, typically occurring in response to various physiological or pathological stimuli.
  • Can occcur as a result of trauma, embolism (blockage of arteries), neoplasia (tumor growth), diabetes, or during the regeneration of tissues such as the endometrium after menstruation or in instances of normal growth.
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5
Q

How do cancers form their own blood vessels through angiogenesis?

A
  • Cancers induce angiogenesis to create new blood vessels that supply nutrients and oxygen to support tumor growth.
  • Tumor cells release signaling molecules called angiogenic factors, such as vascular endothelial growth factor (VEGF),
    • These signaling molecules stimulate nearby blood vessels to sprout and grow toward the tumor.
    • This process allows tumors to establish a network of blood vessels, enabling their sustained growth and metastasis
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6
Q

What is the role of endothelial cells in blood vessel formation?

A

Grow in an ordered manner and participate in processes like sprouting or intussusceptive growth to generate new vessels.

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7
Q

What marker do endothelial cells contain, and what is its significance?

A

CD34 marker

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8
Q

What is sprouting in angiogenesis?

A
  • A single capillary generates a sprout of solid endothelium that grows outward.
  • This sprout eventually forms a lumen, resulting in the formation of two capillaries.
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9
Q

Describe the steps involved in sprouting angiogenesis.

A
  • Endothelial cells respond to cues → extending filopodia, similar to fibroblast cells.
  • Fibroblast cells search for suitable places and substrates to grow upon → formation of new blood vessels.
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10
Q

What is intussusceptive angiogenesis?

A
  • A single capillary develops a growth down its center.
  • This growth eventually forms a lumen → splitting of the capillary into two.
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11
Q

What is the stimulus for angiogenesis?

A
  • Ischemia (lack of blood supply to tissues)
  • Often occurs in growing tissues that outstrip their blood supply or in areas where blood flow is compromised.
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12
Q

How does ischemia lead to angiogenesis?

A

Ischemia in growing tissues → reduction of oxygen supply → hypoxia

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13
Q

How does hypoxia regulate gene expression?

A
  • Hypoxia → stimulates the expression of genes that encode pro-angiogenic factors → formation of new blood vessels to restore oxygen delivery to the affected tissues
  • When oxygen is plentiful, these genes are typically inactive.
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14
Q

What role does EPO play in response to hypoxia?

A
  • Hypoxia stimulates the synthesis of erythropoietin (EPO) in the kidneys.
  • EPO is released into the bloodstream and travels to the bone marrow, where it promotes RBC production
  • EPO can stimulate the growth of endothelial cells → angiogenesis
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15
Q

What transcription factors are involved in regulating gene expression in response to hypoxia?

A

HIF-α and HIF-β

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16
Q

How does oxygen availability affect the stability of HIF complexes?

A
  • High oxygen levels: part of the HIF-αβ complex is targeted for destruction.
  • Hypoxia: HIF-α is stabilized → form a complex with HIF-β → regulate gene expression related to angiogenesis
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17
Q

What is the role of VEGF in angiogenesis?

A
  • Vascular endothelial growth factor
  • It acts as a growth factor that binds to its receptor, which is a receptor tyrosine kinase.
  • This binding stimulates endothelial cells to proliferate and form new blood vessels.
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18
Q

Where is the receptor for VEGF typically found, and what does this imply about VEGF’s action?

A
  • The receptor for VEGF is primarily found on endothelial cells.
  • Indicates that VEGF selectively promotes the growth and function of endothelial cells, driving angiogenesis specifically in areas where new blood vessel formation is needed, such as in ischemic tissues.
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19
Q

What happens to HIF-α in normal oxygenation conditions?

A
  • Oxygen binds to a factor called von Hippel-Lindau protein (VHLp).
  • Once oxygenated, VHLp becomes oxidized and binds to HIF-α.
  • The VHLp-HIF-α complex is targeted to the proteasome for degradation.
  • RESULT: Switching off angiogenesis.
20
Q

How does hypoxia affect the interaction between VHLp and HIF-α?

A
  • VHLp is not oxidized → change in its structure.
  • This structural change prevents VHLp from dragging HIF-α to the proteasome for degradation
  • The HIF-α and HIF-β proteins dimerize due to a domain in their structure.
  • This dimerization exposes a nuclear localization signal (NLS), allowing the complex to enter the nucleus.
  • Once in the nucleus, the HIF complex acts as a DNA binding protein, specifically binding to sequences in the DNA.
  • RESULT: HIF complex increases the transcription of VEGF, leading to the growth of endothelial cells and promoting angiogenesis.
21
Q

What is the primary reason for arteriogenesis to occur?

A
  • Obstruction of blood flow in an artery
  • This obstruction can result from various factors such as embolism (e.g., blood clot), stenosis due to atherosclerosis, or narrowing of the artery.
22
Q

How does arteriogenesis occur?

A
  • Development of new arteries from pre-existing collateral arterioles.
  • These collateral arterioles, also known as anatomizing arterioles, form small channels called anastomoses that connect two larger channels.
23
Q

What happens when a blockage is introduced into the system?

A

Blood flow shifts from the main arteries to the anastomosing arterioles, bypassing the obstructed area.

24
Q

What is the immediate stimulus for arteriogenesis, and how does it affect endothelial cells?

A
  • Mechanical stress
  • Increased shear stress acting on the endothelium lining the arterioles [increased blood flow in the anastomosing arterioles]
25
Q

What happens when a liquid is moved across a cell?

A

When a liquid is moved across a cell, it generates force or shear stress.

25
Q

How is a cell held together in response to shear stress?

A

Matrix consisting of cytoskeletal proteins spanning from the membrane to substrates.

26
Q

How do endothelial cells respond to shear stress in culture?

A
  • Aligning themselves in the direction of flow.
  • They are anchored to adhesion sites, which creates tension within the cells.
27
Q

How is shear stress detected by endothelial cells?

A
  • Stretching of the plasma membrane.
  • This mechanical stimulus is transmitted into the cell interior via the cytoskeleton.
28
Q

What is cytopenia?

A

Deficiency or lack of cells in the blood.

29
Q

What is anemia?

A

Lack of erythrocytes, resulting in reduced oxygen-carrying capacity in the blood.

30
Q

What are some types of anemia?

A
  • Aplastic anemia: Characterized by too few cells being produced.
  • Iron deficiency anemia: Results from a defect in hemoglobin.
  • Pernicious anemia: Caused by vitamin B12 deficiency.
31
Q

How does anemia affect the body?

A

Paleness (pallor) and fatigue.

32
Q

What are some possible causes of anemia?

A
  • Bleeding
  • Defects in hemoglobin synthesis or hematopoiesis
  • Destruction of normal red blood cells
  • Conditions like leukemia.
33
Q

What causes anemia in leukemias and related conditions?

A
  • In leukemias and related conditions, anemia is primarily due to the failure of erythropoiesis
  • Malignant cells associated with these conditions can disrupt normal hematopoiesis → decrease in the production of red blood cells.
34
Q

How does this affect platelets and white blood cells?

A

Reductions in platelet and white blood cell counts → thrombocytopenia (low platelet count) and neutropenia (low white blood cell count).

35
Q

What are cytopenias?

A

Conditions characterized by a reduction in the number of blood cells

36
Q

What is leukopenia?

A

Decrease in the number of WBCs in the blood.

37
Q

What are some types of leukopenia?

A
  • Pancytopenia: Reduction in the number of all types of blood cells, including red blood cells, white blood cells, and platelets.
  • Neutropenia: Reduction specifically in the number of neutrophils, a type of white blood cell, while other blood cell types remain normal.
38
Q

Why are neutropenia and thrombocytopenia important?

A
  • Neutropenia increases susceptibility to infections [neutrophils play a critical role in the body’s immune response against bacterial infections]
  • Thrombocytopenia leads to a decreased number of platelets, which are essential for blood clotting.
    • Increases the risk of bleeding and can lead to disorders of hemostasis, impairing the body’s ability to stop bleeding.
39
Q

What happens in leukemia?

A
  • Type of cancer where abnormal cells, usually white blood cells, are produced in the bone marrow.
  • Abnormal leukemia stem cells occupy the bone marrow niches, disrupting normal cell production and leading to symptoms akin to bone marrow failure.
40
Q

What are the symptoms of leukemia?

A

Bone marrow failure and may include anemia (low red blood cells), thrombocytopenia (low platelets), and leukopenia (low white blood cells).

41
Q

What happens to the abnormal cells in leukemia?

A
  • Abnormal cells proliferate in the bone marrow and can spill over into the bloodstream.
  • However, once in circulation, they often do not divide further.
42
Q

What is neoplasia?

A

Abnormal growth of cells, which can occur in cancerous conditions like leukemia.

43
Q

What happens in lymphomas?

A

Cancers that originate in the lymph nodes, where abnormal cells proliferate.

44
Q

How do lymphoma cells spread?

A

Lymphoma cells can spread to other lymph nodes, causing their dysfunction, and to other tissues, including the bone marrow.

45
Q

What are the symptoms of lymphomas?

A

Symptoms arise from the disruption of lymph node function and infiltration into other tissues, leading to various manifestations depending on the affected areas.