Cell Injury

Homeostasis

  • Steady state
  • Closely maintained
  • Stress on cells results in an attempt at adaptation

Adaptations to increased demand

Hyperplasia

  • Hyperplasia: Increase in cell number in response to external stimulus
  • Can be physiological or pathological
    • Physiological e.g. breast tissue in puberty, response after loss of tissue
    • Pathological - hormonally induced e.g. excess oestrogen → endometrial hypoplasia, hyperplasia of lymph nodes in response to infection
  • Reversed on withdrawal of stimulus
    • Cancer keeps growing on absence of stimulus
    • Hyperplastic tissue = risk site for development of cancer

Hypertrophy

  • Hypertropy: increase in cell size
  • Often occurs:
    • In conjunction with hyperplasia
    • In isolation in non-dividing cells (e.g. skeletal muscle)
    • In response to mechanical stress
  • Becomes pathological when heart/muscle can no longer function
    • Requires more blood supply etc. than it is supplied
    • Heart failure

Growth receptors

  • Stress growth factors lead to cell division
  • To increase cell division:
    • Produce more growth factors
    • Produce more growth factor receptors
  • Three categories of receptor:
    • Receptors with intrinsic tyrosine kinase activity
    • 7 transmembrane G protein coupled receptors
    • Receptors without intrinsic tyrosine kinase receptors

Cell cycle

  • Tightly controlled - checkpoints
  • Faulty cells may not perform function; may predispose to cancers
  • Each stage of the cell cycle is controlled by CDKs, which are activated by a specific cyclin

G1

  • Cells get bigger, increased protein synthesis
  • Cyclin D activates CDK4 which phosphorylates Rb
  • Rb is normally bound to E2F, stopping it from initiating cell division
  • When Rb is phosphorylated it is unable to bind to E2F, and E2F will initiate cell division
  • p53 can cause cell cycle arrest between G1 and S phase

S phase

  • E2F initiates DNA replication and increases levels of cyclin A
  • Cyclin A activates CDK2 – also promotes DNA replication
  • By end – cell contains 2 copies of genome

G2

  • Cell gets bigger, more protein synthesis
  • Main p53 checkpoint occurs at end of G2
    • Checks cell for mistakes
    • Pauses cell cycle and repair is attempted
      • Success → cycle continues
      • Fails → cell death
    • Important in cancer – if cells can avoid p53 they can keep dividing despite faults in DNA

M phase

  • Mitosis

Variations in cell cycle

  • Not all cells divide - some are terminally differentiated (neurons etc.)
    • Replicative senescence
  • Telomeres: caps which protect chromosome ends from degradation and fusion
    • Get smaller with each division - cells can only divide so many times

Atrophy

  • Atrophy: reduction in cell size
  • Can be physiological (e.g. embryological structures, post-menopausal uterus) or pathological (e.g. decreased workload, blocked blood supply, loss of innervation)

Mechanism

  • Reduced cellular components
  • Protein degradation
  • Some hormones promote degradation (thyroid hormone), others promote growth (insulin)