1-Causes of Cell Injury
The causes of cell injury range from the external gross physical violence of an automobile accident tointernal endogenous causes, such as a subtle genetic mutation causing
Hypoxia is a deficiency of oxygen, which causes cell injury by reducing aerobicoxidative respiration. Hypoxia is an extremely important and common cause of cell injury and celldeath.
Physical agents capable of causing cell injury include mechanical trauma, extremesof temperature (burns and deep cold), sudden changes in atmospheric pressure, radiation, andelectric shock.
Chemical Agents and Drugs.
The list of chemicals that may produce cell injury defiescompilation. Simple chemicals such as glucose or salt in hypertonic concentrations may causecell injury directly or by deranging electrolyte homeostasis of cells.
These agentsrange from the submicroscopic viruses to the large tapeworms. In between are the rickettsiae,bacteria, fungi, and higher forms of parasites
Although the immune systemserves an essential function in defense against infectious pathogens, immune reactions may, in fact,cause cell injury
The genetic injury may result in a defect as severe as thecongenital malformations associated with Down syndrome, caused by a chromosomal abnormality,or as subtle as the decreased life of red blood cells caused by a single amino acid substitution inhemoglobin S in sickle cell anemia
Nutritional imbalances continueto be major causes of cell injury. Protein-calorie deficiencies cause an appalling number of deaths,chiefly among underprivileged populations.
Physical Agents e.g.. trauma, thermal injury
Chemical Agents e.g. poisons, environmental pollutants and drugs
Infectious Diseases caused by protozoa, bacteria, viruses
Inherited diseases- inborn errors of metabolism
Mechanisms of Cell Injury
Two mechanisms serve as useful models:
fatty change is generally a reversible form of sublethal injury whereas the effects of hypoxiadepend on the severity, duration and on the vulnerability of the cell
Accumulation of fat in hepatocytes depends on rate of fat synthesis, catabolism and on thesynthesis and export of lipoproteins.
Alcohol increases triglycyeride synthesis and reduces fatty acid catabolism
Malnutrition impairs protein synthesis and therefore reduces lipoprotein synthesis
Interruption of oxidative phosphorylation within mitochondria- depletion of ATP
Progressive loss of membrane functional integrity
Increased cytosolic calcium