Session 1 Flashcards
What can severe changes in the environment of a cell lead to? (3)
Cell adaptation, injury or cell death
Degree of injury to cell following severe changes in environment depends on what? (3)
–Type of injury
–Severity of injury
–Type of tissue
How is the cell injury response part of a continuum?
Stimulus: Physiological –> Harmful
Response: Homeostasis –> Cellular Adaptation –> Cellular Injury –> Cell death
What kind of things can cause cell
injury? (7)
- Hypoxia
- Toxins
- Physical agents
- Radiation
- Micro-organisms
- Immune mechanisms
- Dietary insufficiency and deficiencies, dietary excess
Give examples of physical agents that can cause cell injury (4)
– Direct trauma
– Extremes of temperature
– Changes in pressure
– Electric currents
What is hypoxia?
Deficiency in the amount of oxygen reaching the tissues
Define cyanosis
A bluish discoloration of the skin due to poor circulation or inadequate oxygenation of the blood
- Caused by hypoxia.
What does frostbite most commonly affect?
Fingers, nose, toes
What can frostbite often result in?
Gangrene
What is cellulitis?
Inflammation of skin (subcutaneous connective tissue)
How can the worsening/improving of cellulitis be tracked?
Draw around affected area
What is the difference between hypoxia and ischaemia? Which is considered worse and why?
Hypoxia: Decreased oxygen supply
Ischaemia: Decreased blood supply
- Ischaemia deprives the cell of of oxygen but also many other things (e.g. sugars) that could impact metabolic processes.
What are the four main causes of hypoxia?
– Hypoxaemic hypoxia – arterial content of oxygen is low
• Reduced inspired p02
at altitude
• Reduced absorption secondary to lung disease
– Anaemic hypoxia – decreased ability of haemoglobin to carry oxygen
• Anaemia
• Carbon monoxide poisoning
– Ischaemic hypoxia - interruption to blood supply
• Blockage of a vessel
• Heart failure
– Histiocytic hypoxia – inability to utilise oxygen in cells due to disabled
oxidative phosphorylation enzymes
• Cyanide poisoning
Difference in sensitivity to hypoxia: brain vs skin
Neurones = few minutes Fibroblasts = few hours
What is urticaria?
Hives
How does the immune system damage the
body’s cells? (2)
• Hypersensitivity reactions - host tissue is
injured secondary to an overly vigorous
immune reaction, e.g. urticaria (= hives)
• Autoimmune reactions - immune system fails
to distinguish self from non-self e.g. Grave’s
disease of thyroid.
Which cell components are most
susceptible to injury? (4)
- Membranes
- Nucleus
- Proteins
- Mitochondria
Why do calcium and iron levels need to be controlled very carefully in the body?
They are very metabolically active (catalyse reactions).
What is happening at a molecular level in hypoxia? Reversible injury.
- Stop blood supply to group of cells.
- Mitochondria will use up the supplies they have.
- Oxidative phosphorylation slowly dwindles.
- Decreased production of ATP.
- Sodium pumps are dependant on ATP –> will grind to a halt.
- Sodium rushes into the cell followed by water and calcium (Ca also from ER and mitochondria) and there is a potassium efflux –> cellular swelling, loss of microvili, blebs, ER swelling, myelin figures.
- Revert to anaerobic respiration (glycolysis) which causes a drop in glycogen and the cells pH –> latter leads to clumping of chromatin.
- Ribosomes are kept at the ER using energy, without ATP, they are dislocated, proteins cannot be made –> in hepatic cells this means that apolipoproteins cannot be made and lipids can’t be metabolised –> lipid deposition in liver cells –> fatty liver (this end result in the liver can also be a consequence of alcohol abuse)
What is happening at a molecular level in prolonged hypoxia? Irreversible injury.
- Difficult to say why but likely to be due to the high influx of calcium into the cell (from extracellular, mitochondria and ER).
Calcium activates many enzymes:
- ATPase: Decreased ATP
- Phopholipase: Decreased phospholipids (attacks membranes)
- Proteases: Disruption of me membrane and cytoskeleton proteins (skeleton of cell starts to break down and it changes shape)
- Increases activity of endonuclease: Nuclear chromatin damage (breaks down DNA)
Why can different insults result in the same damage?
Sequence of events for other insults may be different
but as the cell has a limited responses to injury,
outcome often similar.
Two types of injury that damage membranes primarily
- Extreme cold (e.g. frostbite)
- Free radicals
- What is a free radical?
- What else is it often to referred to as?
- Comment on its reactivity.
- Single unpaired electron in an outer orbit
- Reactive oxygen species
- High reactivity: an unstable configuration hence react with other molecules, often producing further free radicals
What are the three free radicals that are of particular biological significance in cells?
- OH• (hydroxyl): the most dangerous
- O2- (superoxide)
- H2O2 (hydrogen peroxide)
How are free radicals produced?
- (Need free radicals to stay alive) Normal metabolic reactions: e.g. oxidative phosphorylation.
- Inflammation: oxidative burst of neutrophils (used as part of phagocytosis).
- Radiation, H20 -> OH radical (dangerous).
- Contact with unbound metals within the body: iron
(by Fenton reaction) and copper. - Drugs and chemicals: e.g., in the liver during
metabolism of paracetamol or carbon tetrachloride
by P450 system.
Where are free radicals made from oxidative phosphorylation stored and why?
Stored away in mitochondria –> avoid damage.
What is the damage in haemachromatosis caused by?
Damage caused by the high amounts of free radicals produced by the excess of iron.
What is the damage in Wilson’s disease caused by?
Damage caused by the high amounts of free radicals produced by the excess of copper.
How does the body control free radicals?
- Anti-oxidant system: donate electrons to the
free radical – vitamins A, C and E (ACE System). - Metal carrier and storage proteins sequester iron and copper (transferrin for iron and ceruloplasmin for copper).
- Enzymes that neutralise free radicals.
Name three enzymes that neutralise free radicals
– Superoxide dismutase
– Catalase
– Glutathione peroxidase
What is oxidative imbalance?
If the number of free radicals overwhelms the anti-oxidant system. Leads to injury of cells by free radicals.
How do free radicals injure cells?
Most important target are lipids in cell membranes.
– Cause lipid peroxidation. – This leads to generation of further free radicals → autocatalytic chain reaction.
• Also oxidise proteins, carbohydrates and DNA
– These molecules become bent out of shape, broken or cross-linked
- Mutagenic DNA - protein can’t be transcribed or may be a carcinogenic mutation.
What is lipid peroxidation?
Radical takes an electron from an atom in the lipid membrane which then takes an electron from its neighbouring atom -> chain reaction down the membrane -> membrane disruption that can lead to cell death.
Describe a protection system against free radicals found in all living organisms.
- Heat shock proteins
• In cell injury heat shock response aims to ‘mend’
mis-folded proteins and maintain cell viability.
What are heat shock proteins?
- Lab: increased cells environmental temperature.
- Cells stopped producing all their normal proteins and instead produced this group of proteins: heat shock proteins.
- These proteins however are produced in response to any njury to the cell.
What are heat shock proteins also known as?
Unfoldases or chaperonins.
Give an example of a heat shock protein.
Ubiquitin
Changes to cell appearance in hypoxia (3)
- Cytoplasmic changes.
- Nuclear changes.
- Abnormal cellular accumulations (e.g fat in hepatocytes).
Appearance of injured cell under light microscope.
Injured: Appear pale and swollen because membranes disrupted and sodium and water are able to rush into the cell.
Appearance of dead cell under light microscope (4)
- Eosinophylic cytoplasms (pink, deeply stained) because proteins have denatured/coagulated.
- Pyknosis: nucleus shrinks and becomes very dark, irreversible condensation of chromatin.
- Karyorrhexis: less common, nucleus breaks into smaller fragments.
- Karyolysis: dissolution of cell nucleus.
Appearance of a cell undergoing reversible injury from hypoxia under an electron microscope. (8)
- Generalised swelling
- Blebs: cytoskeleton being broken down by proteases activated by calcium leading to loss of shape
- Lysosomal membrane subject to leakiness
- Autophagy by lysosomes
- Clumping of nuclear chromatin
- ER swelling
- Dispersion of ribosomes
- Mitochondrial swelling
Appearance of a cell undergoing irreversible injury from hypoxia under an electron microscope. (6)
- Rupture of lysosomes and autolysis
- Nucleus: pyknosis, karyolysis or karyorrhexis
- Defects in cell membrane (visible holes)
- Myelin figures (disrupted cell membrane/lipid fixation)
- Lysis of ER
- Mitochondrial swelling
How to tell apart an injured cell from a dead cell?
- Test for function rather than appearance.
- Dye exclusion test: any cells with dye in them at the end are considered to be dead.
Define oncosis
Oncosis: cell death with swelling, the spectrum of
changes that occur in injured cells prior to death.
Define necrosis
Necrosis: in a living organism the morphologic
changes that occur after a cell has been dead some
time.
- Seen after 12-24 hours.
What are the two main types of necrosis?
Name two other special types.
Main:
- Coagulative
- Liquefactive (colliquitive)
Two other special types:
– Caseous
– Fat necrosis