By Adrian C Bateman; Norman Carr
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Extra resources for The Flesh and bones of pathology
Example text
Important in immune reactions, this pathway is triggered by the binding of ligands to death receptors such as Fas expressed on the surface of the cell. The initial caspase to be activated is caspase 8. Second is the intrinsic (mitochondrial) pathway. The key stage is an increase in permeability of the mitochondrial membrane, releasing cytochrome c into the cytoplasm. Mitochondrial permeability is controlled by the Bcl-2 family of proteins. The initiator caspase in this pathway is caspase 9. Execution.
The new endothelial cells are derived from two sources: n sprouting from preexisting vessels adjacent to the injury n endothelial precursor cells derived from the bone marrow; these cells are mobilized from the marrow and circulate to the site of injury, where they migrate into the tissues. New arterioles and venules are formed as the proliferating capil laries become surrounded by pericytes and smooth muscle cells. The fibroblasts and myofibroblasts produce matrix materi als, in particular the collagen that will provide the strength of the scar.
Hyperviscosity of the blood occurs in some conditions, for example in polycythaemia and hypergammaglobulinaemia. It predisposes to thrombosis and impairs flow through stenotic vessels. Vascular steal occurs when a stenotic artery allows sufficient flow at rest, but when blood flow increases to neighbouring territories as a result of increased demand, the flow of blood through the narrowed vessel becomes inadequate (Fig. 3). The other arteries are said to ‘steal’ the blood from the narrowed artery as blood is diverted through them.