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Path Lecture 1
Cell Degeneration & Death
38
Veterinary Medicine
Not Applicable
02/08/2017

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Term
What is the difference between apoptosis, cell degeneration and oncosis/necrosis?
Definition
Apoptosis: programmed cell death NOT arising from cell degeneration. This is not damaging to surrounding tissue

Cell Degeneration: cell damage (can result from changes in environment, metabolic activity etc) which can, in theory, be repaired

Necrosis: degeneration which cannot be repaired, resulting in death of the cell. This is damaging to surrounding tissue
Term
Explain the phrase "malfunctioning cells will not necessarily result in a malfunctioning organ, or cause disease to the animal as a whole"
Definition
-some aspects of structure & function are redundant, so altered structure/function may not affect the tissue/animal health

-many physiologic feedback loops are self-correcting
Term
Can necrosis occur in a dead animal?
Definition
no, cell death is then called autolysis
Term
What is putrefaction?
Definition
bacterial lysis & fermentation of tissue in a dead animal
Term
What factors may contribute to how a normal cell responds to an injurious stimulus (e.g. lack of oxygen)
Definition
-type of injury
-duration of injury
-severity of stimulus
-type of cell

e.g. bone cell lack of O2 less impact than brain cell lack of O2
Term
What are intracellular inclusions?
Definition
Accumulations of molecules in a cell, which can result from a change in metabolic pathways, phagocytosis, normal function (e.g. hepatocytes), aging cells etc
Term
True or False

Metabolically active cells are often more susceptible to injury than non-active cells
Definition
True

-constant import/export of molecules, synthesis of product etc
-sublethal injury can lead to accumulation of products
Term
What might cause a product/molecule to accumulate in a cell in large amounts?
Definition
-increased production
-decreased excretion/secretion
-decreased consumption within the cell
-reduced metabolism/processing of a precursor (so the precursor accumulates)
-increased uptake from ECF
-loss of enzyme function to degrade substances (e.g. phagocytic molecule that has poor enzyme function)
Term
What are the categories of intracellular material? (6)
Definition
-normal molecules that are present in excess e.g. protein

-foreign substances e.g. carbon from smoke inhallation

-pigments (e.g. bilirubin, lipofuscin)

-metal ions

-Calcium in necrotic cells

-microbial structures (baterial/viral/protistain)
Term
Describe the pathogenesis of hepatic lipidosis
Definition
Lipid metabolism requires: enzymes, ATP, CHO metabolites

Excretion requires: synthesis of apoprotein & lipoprotein

Sublethal injury -> disruption of metabolic pathway, fatty acids or TG's accumulate in cytoplasm -> Hepatic lipidosis
Term
Who would you describe a fatty liver?
Definition
Gross: enlarged, yellow, greasy

Microscopic: lots of fat vesicles
Term
How can cell death be characterized?
Definition
physiological vs pathological
cell morphology - necrosis vs apoptosis
Term
What is the difference between physiologic cell death & pathologic cell death?
Definition
Physiologic = apoptosis (programmed cell death)
Term
Skin cells maturing and dying is an example of (physiologic/pathologic) cell death
Definition
physiologic
Term
Name some causes of cell injury/death...
Definition
-hypoxia
-ischemia
-loss of mmb integrity
-Fas ligand binding to Fas receptor (induces apoptosis)
Term
What are the phases of apoptosis?
Definition
1. Signalling (transmembrane or intracellular. e.g. FAS binding to its receptor

2. Integration
-pro vs anti apoptotic factors are contrasted, outcome of cell is determined

3. Execution
Caspases mediate the process, with a bioamplification of apoptotic factors. Nucleus shrinks, cytoplasm & organelles form blebs -> apoptotic bodies

4. Membrane flipping
-apoptotic bodies preset signals on the mmb surface to promote their own phagocytosis
Term
Key characteristics of apoptosis
Definition
-orchestrated
-does not induce inflammation
-cellular contents do not leak into extracellular compartment
-well controlled, mediated by enzymes
Term
What enzymes regulate apoptosis?
Definition
caspases

(Cysteine-Aspartic residues)
Term
True or False

Apoptosis is a non-inflammatory process which does not require ATP to proceed
Definition
false - ATP is required
Term
What is the correlation between chronic high blood calcium, and the parathyroid gland?
Definition
chronic high Ca leads to atrophy of the parathyroid via apoptosis
Term
What are the four main mechanisms of cell injury?
Definition
-depletion of ATP
-damage to nucleic acids (especially DNA)
-interference with protein synthesis
-injury to cell membranes
Term
Why do injured cells accumulate calcium, and what is the significance?
Definition
Cell injury = membrane damage = large amounts of calcium enter = enzyme activate

ATPase uses up ATP
Phospholipase & protease further reduce membrane integrity
Endonuclease causes damage to nucleus chromatin
Term
What is white muscle disease?
Definition
calcification of necrotic tissue (calcium accumulates in dead muscle cells)
Term
True or False

The transition from degneration to necrosis is visible fairly quickly after cells have passed the "point of no return"
Definition
False

6-8hrs before you can see necrosis microscopically
Term
What are the trademark microscopic signs of necrosis? (3)
Definition
hypereosinophilia
homogenous cytoplasm
nuclear changes (pyknosis, karyorrhexis, karyolysis)
Term
What cells will be more severely affected by ischemia, cells in Zone 1, 2 or 3 surrounding the portal triad?
Definition
Zone 3
-farthest away from the blood supply

BUT if it were an issue of toxicity in the blood, they would be exposed to the toxin last, and would exhibit signs of toxicity last
Term
What is pyknosis
Definition
shrunken, dark blue (hyperchromatic) nucleus
Term
What is karyorrhexis
Definition
fragmented nucleus
Term
What is karyolysis
Definition
dissolution/fading of nucleus (caused by DNAses / endonucleases)
Term
Compare necrosis vs apoptosis
Definition
Swell / Shrink
Liquify or coagulation / blebbing
Membrane fragment/intact
ATP depleted/requires ATP
Disorganized / organized
Contents leak / contained
Inflammation / no inflammation
Term
What are some of the ways necrotic tissue can appear (grossly)
Definition
Coagulation Necrosis: looks similar to normal structure, pale/swollen/friable

Liquefactive Necrosis: loss of stucture, pale, liquid

Caseation Necrosis: structure lost, dry/cheeselike/friable
Term
What causes liquifaction necrosis
Definition
leukocytes or bacteria release enzymes which break down cells -> liquify

may leave a hollow cavity behind (esp in brain)
Term
Why is the brain prone to liquefaction necrosis?
Definition
less capable of regeneration or scarring vs other tissues
Term
True or False

Macrophages in particular are prone to causing liquification of dead tissue
Definition
false

more likely to see caseation necrosis b.c. dont ahve lytic enzymes
Term
Hyperadenalcorticism will cause persistent ______ which increses stores of _____ in hepatocytes
Definition
hyperglycemia

glycogen
Term
What do hepatocytes with glycogen inclusions look like?
Definition
cytoplasm looks moth-eaten
Term
How does the colour of a renal infarct change over the course of several days
Definition
Initially: very pale (no blood)
24h: red as blood seeps into affected tissue

From there, low pH bc of liquifying cells = RBCs broken down = bilirubin (yellow/green) and hemosiderin (brown) released

Breakdown process starts around 36h and may take days depending on how big the infarct is
Term
What is a "watershed zone"?
Definition
where 2 arterial fields overlap (regions between 2 arterial supplies)
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