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Tissue Renewal (Cell Cycle (Checkpoints (p53 dependent mechanisms (Delay…
Tissue Renewal
Cell Cycle
stimulated by
integrins
growth factors
EGF=Epidermal Growth Factor
TGF- α = Transformaing Growth Factor α
HGF=Hepatocyte Growth Factor
PDGF=Platelet-Derived Growth Factor
VEGF=Vascular Endothelial Growth Factor
FGF=Fibroblast Growth Factor
TGF-β = Transforming Growth Factor β
Cytokines
Checkpoints
G1/S transition
Restriction point
p53 dependent mechanisms
Delay cycle and trigger repair
Apoptosis
Senesence
G2/M
cyclins and (CDKs=cyclin-dependent kinases)
CDK inhibitors
p21
p16
(RB=Retinoblastoma) protein
healing process
Regeneration
完全復原(Complete restitution)
residual cells
tissue stem cells
Compensatory growth
hyperplasia
哺乳類
Wnt/β-catenin pathway
肝臟
paracrine effects
HGF, IL-6
Connective tissue deposition
scar formation
嚴重傷害
持續傷害
無法完全restitution
Fibrosis
collagen嚴重deposition
TGF-β
Chronic inflammation
Infarction(梗塞)
有機化(Organization)
Inflammatory exudate
造成沾黏
Cutaneous Wound Healing
Inflammation
clot
Proliferation
Granulation tissue
chronic inflammation
Hallmark of tissue repair
Maturation
Tissue remodeling
Healing by
primary union (first intention)
乾淨無疤
secondary union (secondary intention)
骯髒有疤
granulation tissue
攣縮(contracture)
Extracellular Matrix (ECM)
framework
polarity
造成migration
angiogenesis
產生growth factors
by fibroblasts and macrophages
cytokines
chemokines
Growth Factors
Epidermal Growth Factor (EGF)
EGFR
肺癌
大腸癌
HER-2
乳癌
Vascular Endothelial Growth Factor (VEGF)
Angiogenesis (VEGF-A)
舊有衍生
Vasodilation
NO
Degradation
basement membrane
Migration
Proliferation
Maturation
Recruitment
Suppression
EPCs=Endothelial Precursor Cells
Vasculogenesis (VEGF-B)
無中生有
Lymphangiogenesis (VEGF-C)
啟動機制:Hypoxia
Transforming Growth Factor β (TGF-β)
Multiple and often opposing effects
Growth inhibitor for most epithelial cells
Variable effects on mesenchymal cells
invasion
metastasis
A potent fibrogenic agent
Fibrosis
Strong anti-inflammatory effect
IL-17-producing T cells
Cytokines
發炎和免疫反應
TNF and IL-1
傷口治癒
TNF and IL-6
肝臟再生
Repair
結構derangements
regeneration + scar formation
可能造成dysfunction
Tissue Proliferative Activity
Labile Tissues
持續分裂
上皮細胞
骨髓
Stable Tissues
quiescent
傷口復原
淋巴球
子宮、消化道平滑肌
肝臟細胞
Permanent Tissues
不分裂
中樞神經
骨骼肌、心肌
scar formation
Stem Cells
self-renewal
Stochastic differentiation
Obligatory asymmetric replication
Types
全能性幹細胞(Totipotent stem cells)
多功能性幹細胞(Pluripotent stem cells)
Embryonic stem cells
Repopulate or construct
Introducing and functionally integrating
Immunologic rejection (HLA)
iPS cells=Induced pluripotent stem cells
Reproductive cloning
但會產生oncogenes
多潛能性幹細胞(Multipotent stem cells)
Lineage committed stem cells
Tissue stem cells
niche
組成 mesenchymal cells 和 endothelial cells
adult stem cell 密集處
adult/somatic stem cell
labile tissues 和 stable tissues 裡面
Transit amplifying cells
Progenitor cells
Transdifferentiation
Tissue Homeostasis
Bone Marrow
HSC=Hematopoietic stem cells
臍帶血
peripheral blood
注射cytokine取得
MSC=Marrow stromal cells=Mesenchymal stem cells
受傷嚴重才有
Liver
Oval cells
bipotential progenitors
在肝臟再生受阻時活化
惡性腫瘤
canals of Hering
Brain
Cornea
Skin
Wnt pathway (+)
bone morphogenetic protein (BMP) system (-)
Intestinal Epithelium
Skeletal and Cardiac Muscle
Signals
Mechanism
Autocrine Signaling
Paracrine Signaling
Endocrine Signaling
Synaptic Signaling
Signal Transduction Pathway
gene expression
Receptors~intrinsic tyrosine kinase activity
有
大部分growth factor
無
G-protein-coupled receptors
Steroid hormone receptors
在nucleus
Transcription Factor
DNA-binding domains
Post-translational modifications (rapid)
Heterodimerization
最快
Phosphorylation
Release of inhibition
Release from membranes
Pathologic Aspects
無法形成granulation tissue 或 scar
Wound dehiscence (rupture)
腹部手術
Ulceration
Inadequate vascularization
Contraction
Contracture
Adhesion
形成太多
肥厚性疤痕=Hypertrophic scars
蟹足腫=Keloids
蕈狀肉芽=Exuberant granulation (proud flesh)
纖維狀=Desmoids (aggressive fibromatosis)
Control of Cell Proliferation
影響細胞數量的因素
proliferation
differentiation
apoptosis
Growth factor stimuli
ECM integrity
Stem cell maturation