Cell Injury

Presented
By
Ahmed El-Rashedy
Professor & Previous Head
of Pathology Department
Al-Azhar University

Prof. Dr. Ahmed Elrashedy

Cell Injury
Def.: A sequence of events occurring in the living cells or
tissues after their exposure to the stimulus.
Course: Usually reversible (i.e. returns to normal). When
the stimulus persists or being severe from the start, the
cell injury will be irreversible.
Causes:
1. Hypoxia: Lack in O2 pressure & supply occurring in:
Anemia.
Ischemia.
Carbon monoxide poisoning.
Cardio-respiratory failure (Shock).

Prof. Dr. Ahmed Elrashedy

2. Physical agents:
Mechanical trauma or crush injury.
Extremes of temperature (excess heat or severe coldness).
Irradiation whether ionizing (cobalt, gamma) or non-ionizing
(X-, ultraviolet) rays.
Electric shock.
3. Chemical agents:
Air pollutants & hydrocarbons.
Hypertonic solutions.
Poisons: Cyanide, Mercury, Arsenic.
Insecticides.
Fungicides.
Industrial vapors or fibers (Asbestos, silica).
Drugs: Narcotics.

Prof. Dr. Ahmed Elrashedy

4.Micro-organisms(viable agents):
Bacteria.
Viruses.
Fungi.
Parasites.
Rickettsia.
5. Immunologic disorders:
Hypersensitivity to a foreign protein (injectable,
ingestible, inhaler).
Hypersensitivity to a self- antigen as extrusion of
eye lens protein or sperm head protein in obstructed
epididymis.

Prof. Dr. Ahmed Elrashedy

6. Genetic diseases:
Sickle cell anemia: production of Hb-S instead
of Hb-A.
Downs syndrome (Mongolism): aberration in
chromosome no; 21.
7. Nutritional disorders:
Hyper- or Hypo- vitaminosis A & D.
Protein-Calorie deficiency: Marasmic baby
(Kwashiorkor's disease).
Fat-rich
diet
intake:
Obesity
&
atherosclerosis.

Prof. Dr. Ahmed Elrashedy

Types of cell injury:

1.Cell adaptations: Hyperplasia, Hypertrophy,

Metaplasia, Dysplasia.
2.Reversible injury: Degenerations (Hydropic
degeneration, fatty change and hyaline change).
3.Irreversible injury: Cell death and necrosis.
Mechanisms of cell Injury:
1.Hypoxic injury.
2.O2 free radical-mediated injury.

3.Viral injury.

Prof. Dr. Ahmed Elrashedy

O2 free Radicals
Def.: They are chemicals characterized by the presence of a
single unpaired electron on the outer orbital layer of their
atom.
Significance:
They are unstable & liable to enter in oxidative reactions
with organic & inorganic chemicals found in the cell &
organeller membranes & nucleic acids.
Synthesis:
1. Absorption of radiant energy.
2.Oxidative reactions in the normal metabolism.
3.Enzymatic metabolism of the exogenous chemicals or
drugs.

Prof. Dr. Ahmed Elrashedy

Types:
1.Superoxide ion .
2.Hydrogen peroxide.
3.Hydroxyl group.
4.Organic free radicals formed by oxidative reactions.
Effects:
1.Lipid peroxidation & membrane damage.
2.Protein breakdown.
3.DNA damage.
Removal ( Inactivation): through
1.Antioxidants: as
Vitamins (E, C, folic acid),
Selenium,
Amino acids &
serum proteins (ceruloplasmin & transferrin).

Prof. Dr. Ahmed Elrashedy

2. Enzymes: as
Catalase: changes hydrogen peroxide into water.
Superoxide dismutase: converts superoxide into water.
Glutathione peroxidase: causes reduction of glutathione by
removal of H2 from its SH-group.
Examples of cell injury mediated by O2 free Radicals
1.Ageing process with production of O2 free radicals that cause
lipid peroxidation & membrane damage.
2.Exposure to high concentration of O2 & ozone.
3.Chemical injury: e.g. Carbon tetrachloride poisoning.
4.Irradiation with release of O2 free radicals due to tissue lysis.
5.Inflammation with tissue damage.
6.Microbial killing with production of O2 free radicals.
7.Atherosclerosis.
8.Carcinogenesis.



Prof. Dr. Ahmed Elrashedy