CELLULAR ADAPTATIONS TO
STRESS
Cells maintain their intracellular environment
within a narrow range of physiologic
parameters this is called normal homeostasis
When cells affected by physiologic stresses or
pathologic stimuli, they may injured or may
adapted to injury.
Cell injury are tow types:
1.Reversible when the injury is limited and cells
return to a stable baseline
2.Irreversible injury; when severe or persistent
stress results in death of the affected cells
Cell death has tow forms
1.Necrosis
2.Apoptosis
Adaptations :
Are reversible changes in the number, size,
phenotype, metabolic activity, or functions of
cells in response to changes in their
environment.
1. Physiologic adaptations
Responses of cells to normal stimulation by
hormones or endogenous chemical mediators.
2. Pathologic adaptations
Responses to stress that allow cells to
modulate their structure and function and
thus escape injury.
The principal adaptive responses are:
1.Hypertrophy
2.Hyperplasia
3.Atrophy
4.Metaplasia
1.Hypertrophy
An increase in the size of cells resulting in
increase in the size of the organ.
No new cells, just bigger cells.
Occur by an increased amount of structural
proteins and organelles.
Occurs in cells that are incapable of dividing.
Can be physiologic or pathologic.
Example physiologic hypertrophy :
1.Physiologic enlargement of the uterus
during pregnancy occurs as a consequence of
estrogen-stimulated smooth muscle
hypertrophy and smooth muscle hyperplasia .
2. Striated muscle cells in both the skeletal
muscle and the heart can undergo only
hypertrophy in response to increased demand.
Example of pathologic hypertrophy
1.Cardiac enlargement that occurs with
hypertension or aortic valve disease.
2.Hyperplasia
Characterized by an increase in cell number.
Is an adaptive response in cells that are
capable of replication.
Can be physiologic or pathologic.
The two types of physiologic hyperplasia are
(1) Hormonal hyperplasia:
e.g proliferation of the glandular epithelium of the
female breast at puberty and during pregnancy.
(2) Compensatory hyperplasia:
occurs when a portion of the tissue is removed,e.g
if liver is partially resected, remaining cells
eventually restoring the liver to its normal weight.
Pathologic hyperplasia:
Caused by excessive hormonal or growth
factor stimulation.
e.g; endometrial hyperplasia which occur
when balance between estrogen and
progesterone is disturbed which lead to
abnormal menstrual bleeding.
3.Atrophy
Shrinkage in the size of the cell by the loss of cell
substance, then the entire tissue or organ
diminishes in size.
Atrophy results from decreased protein synthesis
and increased protein degradation in cells.
Atrophic cells may have diminished function,
they are not dead.
Causes of atrophy:
1.decreased workload (e.g. immobilization of
a limb)
2.Loss of innervation
3. Diminished blood supply
4. Inadequate nutrition
5. Loss of endocrine stimulation
6.Aging (senile atrophy).
4.Metaplasia
Is a reversible change in which one adult cell
type (epithelial or mesenchymal) is replaced
by another adult cell type.
Metaplastic cells are better able to withstand
the adverse environment.
Arise by genetic "reprogramming" of stem
cells rather than transdifferentiation of
already differentiated cells.
May predispose to malignant transformation.
Examples of metaplasia:
1.squamous change that occurs in the ciliated
columnar respiratory epithelium in habitual
cigarette smokers .
2. Vitamin A deficiency may also induce
squamous metaplasia in the respiratory
epithelium.
3. Normal stratified squamous epithelium of
the lower esophagus may undergo metaplastic
transformation to gastric or intestinal-type
columnar epithelium due to acid effect.
