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Toxicology - Coggle Diagram

- - - - arterial supply + portal circulation
        
        Receives large proportion of total CO
        
        due to portal circulation, first organ exposed to absorbed toxins
        
        multiple exposures to same toxin due to enterohepatic recyclying
    - - may result in activation of toxins
  - - - portal triad
        
        sinusoids
        
        hepatocytes
        
        central vein
    - - zone 1: lots of mitochondria
      - zone 2
      - Zone 3: highest CYP450 and lowest GSH expression
        
        most common site of toxicant injury
  - - - dead or dying cells release ALT or AST
    - - canalicular injury
        
        decreased bile volume or impaired secretion into bile, associated with increased bile salts and bilirubin in plasma
        
        toxicant mediated cholestasis can be transient or chronic
      - Cholangiodestructive injury
        
        toxin-induced destruction of bile ducts associated with increased ALP, bile salts and bilirubin in plasma
    - - imbalance between FA uptake and assimilation
        
        (progress to) Steatohepatits
    - - (progress to) Cirrhosis
    - - dilation of lumen
      - blocakade of lumen
      - destruction of endothelium
  - - - hepatocytes
        
        synergism withhepatitis virus infection
        
        hepatocellular carcinomas
        
        aflatoxin
      - bile duct cells
        
        cholangiocarcinomas
        
        dioxin
      - cells lining sinusoids
        
        angiosarcomas
        
        heavy metals
    - - plants
      - molds/fungi
      - heavy metals
      - human medications and foods
    - - fatty liver
      - hepatocyte death
      - immune response (type B ADR)
      - canalicular cholestasis)
      - cholangiodestructive cholestasis (bile duct damage)
      - sinusoidal disorders
      - fibrosis/cirrhosis
- - - - absorbed toxins (artery)
        
        Liver
      - inhaled toxins (nasopharynx)
        
        esophagus
        
        GI track
  - - - its the entry point for toxins and has extensive surface area
      - large blood supply and large proportion of the CO
      - High O2 concsumption and metabolic activity (helps xenobiotic metabolism)
      - intestines may be exposed to xenobiotic multiples times due to enterohepatic recyling
    - - GI motility (toxicant delivery)
      - gastric acid and enzymes (break down/activation of toxicants)
      - tight junctions (seperate external and internal environments)
      - extensive surface area
        
        not always a defense, just a fact that there are many "entry points"
      - enterocytes and microbes (toxicant breakdown)