Repair and Regeneration
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What are the 2 forms of healing?
Regeneration and repair
What is healing by regeneration?
Cells replaced by like cells and tissue regains function
What is healing by repair?
Cells cannot be replaced by like cells and so fibrosis and scarring occur. There is a loss of specialised function.
What are the characteristics of labile cell populations?
High turnover Active stem cell population Excellent regenerative capacity
Name a location where labile cell populations are found
Epithelia
What are the characteristics of quiescent cell populations?
Low turnover Good regenerative capacity Turnover can massively increase if required
Name two locations where quiescent cell populations are found
Liver Renal tubules
What are the characteristics of permanent cell populations?
Zero turnover Zero regenerative capacity Long life span
Which condition observes a collapse of reticular framework in the liver?
Cirrhosis
What are the characteristics of stem cells
A prolonged self renewal An asymmetric replication Crucial to regeneration
When does repair occur?
When the normal structure cannot be replaced
What are the consequences of healing by repair?
Functional
What are the characteristics of healing by repair?
Basic stereotyped pathological process Repair of specialised tissue by formation of fibrous scar Granulation tissue in abundance
What are the three components of granulation tissues?
New capillary loops Phagocytic cells (Neutrophils and macrophages) Myofibroblasts
What are the steps of new vessel formation?
Endothelial cell proliferation Buds Canalisation New vessels
What is the function of phagocytes in granulation tissue?
Remove dead/damaged tissue
What is the function of myofibriblasts in granulation tissue?
Synthesis collagen and ECM
What 3 categories can oesophageal peptic ulcers be grouped into?
Intrinsic diseases Extrinsic diseases Functional
What is the pathophysiology of intrinsic forms of oesophageal peptic ulcers?
Narrow the lumen through inflammation, fibrosis or neoplasia
What is the pathophysiology of extrinsic forms of oesophageal peptic ulcers?
Compromise the lumen by direct invasion or lymph node enlargement
What is the pathophysiology of functional forms of oesophageal peptic ulcers?
Disrupt oesophageal peristalsis Lower oesophageal sphincter function Both via affects on smooth muscle and it’s innervation
What are some causes of oesophageal peptic ulcers?
Acid Infectious Congenital Drug induced Autoimmune Iatrogenic Radiation
As vascularity and cellularity of granulation tissue decrease, what increases?
Collagen ECM Wound strength
What are some local factors inhibiting healing?
Infection Haematoma Foreign bodies Mechanical stress Blood supply