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Pathology Exam 1: Wound Healing
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Terms in this set (27)
Regeneration and 3 regenerative capacity types
• Replace tissue with itself
• Type 1: Labile tissues
• Type 2: Stabile tissues
• Type 3: Permanent tissues
Repair and phases
• Replace tissue with a fibrous scar
• Phase 1: Granulation tissue
Labile Tissues
• Continuously cycling
• Intestines (crypts), skin (basal layer), bone marrow (hematopoietic stem cell, CD34)
Stable Tissues
• Quiescent, but reenter cell cycle
• Regeneration of liver by compensatory hyperplasia.
• Each hepatocyte produces additional cells and then reenters quiescence.
• Kidney
Permanent Tissues
• Lack significant regenerative potential
• Myocardium, skeletal muscle, neurons
Granulation tissue and 3 cell types
• Fibroblasts = deposit type III collagen
• Capillaries = provide nutrients
• Myofibroblasts = contract wound
Scar formation
• Type III collagen replaced by Type 1
• Collagenase removes type III collagen requiring zinc as cofactor
Collagen Types
• Type I: Bone. Strong.
• Type 2: Cartilage.
• Type 3: Vessels, granulation tissue, embryonic tissue. Pliable.
• Type 4: Basement membrane.
TGF-α
• Transforming growth factor
• Epithelial and fibroblast growth factor
TGF-B
• Transforming growth factor
• Fibroblast growth factor
• Inhibits inflammation
PDGF
• Platelet Derived growth factor
• Endothelium, smooth muscle, fibroblast GF
FGF
• Fibroblast growth factor
• Angiogenesis, skeletal development
VEGF
• Angiogenesis
Cutaneous healing types
• Primary intention = wound edges brought together
• Secondary intention = granulation fills defect. Scar. Slight contraction of wound (myofibroblasts).
Delayed wound healing
• Infection = most common cause
• Vitamin C (hydroxylation), copper (lysyl oxidase), zinc deficiency (collagenase)
• Foreign body, ischemia, diabetes, malnutrition
Dehiscence
• Rupture of wound
Hypertrophic scar
• Excess production of scar tissue localized to the wound
• Type 1 collagen
Keloid
• Excess production of scar tissue out of proportion of wound
• Type III collagen
• Genetic (african americans)
• Earlobes, face, upper extremities
EGF
• Epidermal growth factor
• Cause keratinocytes in skin to perliforate
HGF
• Hepatocyte growth factor
Cicatrix (another name)
• Scar
Components of Extracellular Matrix
• Basement membrane = type 4 collagen
• Interstitial Matrix = fibrillar collagens. Less organized
Cutaneous wound healing phases
• Inflammation = clot formation and chemotaxis
• Proliferation = re-epithlialization, granulation, provisional matrix
• Maturation = collagen matrix, wound contraction
Most important fibrogenic agent
• TGF-B
• Fibroblast migration and proliferation
• Increased synthesis of collagen and fibronectin
• Decreased degradation of ECM by metalloproteinases
Tissue Remodeling
• ECM synthesis and degradation
• Matrix Metalloproteinases (MMPs) = need zink. Degrade ECM. Stimulated by PDGF, EGF, IL-1/TNF. Inhibited by TGF-B, Steroids
• Tissue inhibitors of MMPs = TIMPS
Desmoid Tumors
• Excess Fibrous tissue.
• Aggressive fibromatosous.
Buruli Ulcer
• By mycobacterium ulcerans
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