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Cell damage

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Cell damage can occur as a result of an adverse stimulus which disrupts the normal homeostasis of affected cells Among other causes, this can be due to physical, chemical, infectious, biological, nutritional or immunological factors Cell damage can be reversible or irreversible Depending on the extent of injury, the cellular response may be adaptive and where possible, homeostasis is restored Cell death occurs when the severity of the injury exceeds the cell’s ability to repair itself Cell death is relative to both the length of exposure to a harmful stimulus and the severity of the damage caused Cell death may occur by necrosis or apoptosis


  • 1 Causes
  • 2 Targets
  • 3 Types of damage
    • 31 Sub-lethal reversible
      • 311 Cellular swelling
      • 312 Fatty change
    • 32 Lethal
      • 321 Necrosis
      • 322 Apoptosis
  • 4 Repair
    • 41 Regeneration
    • 42 Replacement
  • 5 Biochemical changes in cellular injury
  • 6 DNA damage and repair
    • 61 DNA damage
    • 62 Repair of DNA damages
  • 7 See also
  • 8 References


  • Physical agents such as heat or radiation can damage a cell by literally cooking or coagulating their contents
  • Impaired nutrient supply, such as lack of oxygen or glucose, or impaired production of adenosine triphosphate ATP may deprive the cell of essential materials needed to survive


The most notable components of the cell that are targets of cell damage are the DNA and the cell membrane

  • DNA damage:In human cells, both normal metabolic activities and environmental factors such as ultraviolet light and other radiations can cause DNA damage, resulting in as many as one million individual molecular lesions per cell per day
  • Membrane damage:damage to the cell membrane disturbs the state of cell electrolytes, eg calcium, which when constantly increased, induces apoptosis

Types of damage

Some cell damage can be reversed once the stress is removed or if compensatory cellular changes occur Full function may return to cells but in some cases a degree of injury will remain

Sub-lethal reversible

Cellular swelling

Cellular swelling or cloudy swelling may occur due to cellular hypoxia, which damages the sodium-potassium membrane pump; it is reversible when the cause is eliminated Cellular swelling is the first manifestation of almost all forms of injury to cells When it affects many cells in an organ, it causes some pallor, increased turgor, and increase in weight of the organ On microscopic examination, small clear vacuoles may be seen within the cytoplasm; these represent distended and pinched-off segments of the endoplasmic reticulum This pattern of non-lethal injury is sometimes called hydropic change or vacuolar degeneration Hydropic degeneration is a severe form of cloudy swelling It occurs with hypokalemia due to vomiting or diarrhea

The ultrastructural changes of reversible cell injury include:

  • Blebbing
  • Blunting
  • distortion of microvilli
  • loosening of intercellular attachments
  • mitochondrial changes
  • dilation of the endoplasmic reticulum

Fatty change

The cell has been damaged and is unable to adequately metabolize fat Small vacuoles of fat accumulate and become dispersed within cytoplasm Mild fatty change may have no effect on cell function; however more severe fatty change can impair cellular function In the liver, the enlargement of hepatocytes due to fatty change may compress adjacent bile canaliculi, leading to cholestasis Depending on the cause and severity of the lipid accumulation, fatty change is generally reversible Fatty Change is also known as fatty degeneration, fatty metamorphosis, or fatty steatosis



Necrosis is characterised by cytoplasmic swelling, irreversible damage to the plasma membrane, and organelle breakdown leading to cell death The stages of cellular necrosis include pyknosis; clumping of chromosomes and shrinking of the nucleus of the cell, karyorrhexis; fragmentation of the nucleus and break up of the chromatin into unstructured granules, and karyolysis; dissolution of the cell nucleus Cytosolic components that leak through the damaged plasma membrane into the extracellular space can incur an inflammatory response

There are six types of necrosis:

  • Coagulative necrosis
  • Liquefactive necrosis
  • Caseous necrosis
  • Fat necrosis
  • Fibroid necrosis
  • Gangrenous necrosis


Apoptosis is the programmed cell death of superfluous or potentially harmful cells in the body It is an energy dependent process mediated by proteolytic enzymes called caspases, which trigger cell death through the cleaving of specific proteins in the cytoplasm and nucleus The dying cells shrink and condense into apoptotic bodies The cell surface is altered so as to display properties which lead to rapid phagocytosis by macrophages or neighbouring cells Unlike necrotic cell death, neighbouring cells are not damaged by apoptosis as cytosolic products are safely isolated by membranes prior to undergoing phagocytosis In the average adult between 50 and 70 billion cells die each day due to apoptosis Inhibition of apoptosis can result in a number of cancers, autoimmune diseases, inflammatory diseases, and viral infections Hyperactive apoptosis can lead to neurodegenerative diseases, hematologic diseases, and tissue damage


When a cell is damaged the body will try to repair or replace the cell to continue normal functions If a cell dies the body will remove it and replace it with another functioning cell, or fill the gap with connective tissue to provide structural support for the remaining cells The motto of the repair process is to fill a gap caused by the damaged cells to regain structural continuity Normal cells try to regenerate the damaged cells but this cannot always happen Asexual reproduction is what repairs cells


Regeneration of parenchyma cells, or the functional cells, of an organism The body can make more cells to replace the damaged cells keeping the organ or tissue intact and fully functional


When a cell cannot be regenerated the body will replace it with stromal connective tissue to maintain tissue/organ function Stromal cells are the cells that support the parenchymal cells in any organ Fibroblasts, immune cells, pericytes, and inflammatory cells are the most common types of stromal cells

Biochemical changes in cellular injury

ATP adenosine triphosphate depletion is a common biological alteration that occurs with cellular injury This change can happen despite the inciting agent of the cell damage A reduction in intracellular ATP can have a number of functional and morphologic consequences during cell injury These effects include:

  • Failure of the ATP dependent pumps Na+
    pump and Ca2+
    pump, resulting in a net influx of Na+
    and Ca2+
    ions and osmotic swelling
  • ATP-depleted cells begin to undertake anaerobic metabolism to derive energy from glycogen which is known as 'glycogenolysis'
  • A consequent decrease in the intracellular pH of the cell arises, which mediates harmful enzymatic processes
  • Early clumping of nuclear chromatin then occurs, known as 'pyknosis', and leads to eventual cell death

DNA damage and repair

DNA damage

DNA damage or RNA damage in the case of some virus genomes appears to be a fundamental problem for life As noted by Haynes, the subunits of DNA are not endowed with any peculiar kind of quantum mechanical stability, and thus DNA is vulnerable to all the "chemical horrors" that might befall any such molecule in a warm aqueous medium These chemical horrors are DNA damages that include various types of modification of the DNA bases, single- and double-strand breaks, and inter-strand cross-links see DNA damage naturally occurring DNA damages are distinct from mutations although both are errors in the DNA Whereas DNA damages are abnormal chemical and structural alterations, mutations ordinarily involve the normal four bases in new arrangements Mutations can be replicated, and thus inherited when the DNA replicates In contrast, DNA damages are altered structures that cannot, themselves, be replicated

Several different repair processes can remove DNA damages see chart in DNA repair However, those DNA damages that remain un-repaired can have detrimental consequences DNA damages may block replication or gene transcription These blockages can lead to cell death In multicellular organisms, cell death in response to DNA damage may occur by a programmed process, apoptosis Alternatively, when a DNA polymerase replicates a template strand containing a damaged site, it may inaccurately bypass the damage and, as a consequence, introduce an incorrect base leading to a mutation Experimentally, mutation rates increase substantially in cells defective in DNA mismatch repair or in Homologous recombinational repair HRR

In both prokaryotes and eukaryotes, DNA genomes are vulnerable to attack by reactive chemicals naturally produced in the intracellular environment and by agents from external sources An important internal source of DNA damage in both prokaryotes and eukaryotes is reactive oxygen species ROS formed as byproducts of normal aerobic metabolism For eukaryotes, oxidative reactions are a major source of DNA damage see DNA damage naturally occurring and Sedelnikova et al In humans, about 10,000 oxidative DNA damages occur per cell per day In the rat, which has a higher metabolic rate than humans, about 100,000 oxidative DNA damages occur per cell per day In aerobically growing bacteria, ROS appear to be a major source of DNA damage, as indicated by the observation that 89% of spontaneously occurring base substitution mutations are caused by introduction of ROS-induced single-strand damages followed by error-prone replication past these damages Oxidative DNA damages usually involve only one of the DNA strands at any damaged site, but about 1–2% of damages involve both strands The double-strand damages include double-strand breaks DSBs and inter-strand crosslinks For humans, the estimated average number of endogenous DNA DSBs per cell occurring at each cell generation is about 50 This level of formation of DSBs likely reflects the natural level of damages caused, in large part, by ROS produced by active metabolism

Repair of DNA damages

Five major pathways are employed in repairing different types of DNA damages These five pathways are nucleotide excision repair, base excision repair, mismatch repair, non-homologous end joining and homologous recombinational repair HRR see chart in DNA repair and reference Only HRR can accurately repair double strand damages, such as DSBs The HRR pathway requires that a second homologous chromosome be available to allow recovery of the information lost by the first chromosome due to the double-strand damage

DNA damage appears to play a key role in mammalian aging, and an adequate level of DNA repair promotes longevity see DNA damage theory of aging and reference In addition, an increased incidence of DNA damage and/or reduced DNA repair cause an increased risk of cancer see Cancer, Carcinogenesis and Neoplasm and reference Furthermore, the ability of HRR to accurately and efficiently repair double-strand DNA damages likely played a key role in the evolution of sexual reproduction see Evolution of sexual reproduction and reference In extant eukaryotes, HRR during meiosis provides the major benefit of maintaining fertility

See also

  • Cellular adaptation


  1. ^ a b Cobb, J P; et al 1996 "Mechanisms of cell injury and death" British Journal of Anaesthesia doi:101093/bja/7713 
  2. ^ a b Wolf, Ronni; et al 2011 Emergency Dermatology Cambridge University Press pp 1–10 ISBN 9780521717335 
  3. ^ Klaassen, CD, Ed:Casarett and Doull's Toxicology:The Basic Science of Poisons Sixth Edition, McGraw-Hill, 2007
  4. ^ Lodish H, Berk A, Matsudaira P, Kaiser CA, Krieger M, Scott MP, Zipursky SL, Darnell J 2004 Molecular Biology of the Cell, WH Freeman:New York, NY 5th ed, p 963
  5. ^ Hayes, AW, Ed:Principles and Methods of Toxicology Fourth Edition, Raven Press, New York, 2001 and 5th edition 2008
  6. ^ "Cellular Swelling" Humpathcom-Human Pathology Humpathcom, 30 Jan 2006 Web 21 Mar 2013
  7. ^ Festjens, Nele; Vanden Berghe, Tom; Vandenabeele, Peter 2006-09-01 "Necrosis, a well-orchestrated form of cell demise:Signalling cascades, important mediators and concomitant immune response" Biochimica et Biophysica Acta BBA - Bioenergetics Mitochondria:from Molecular Insight to Physiology and Pathology 1757 9–10:1371–1387 doi:101016/jbbabio200606014 
  8. ^ "Medical Definition of PYKNOSIS" wwwmerriam-webstercom Retrieved 2016-04-16 
  9. ^ a b Proskuryakov, Sergey Y a; Konoplyannikov, Anatoli G; Gabai, Vladimir L 2003-02-01 "Necrosis:a specific form of programmed cell death" Experimental Cell Research 283 1:1–16 doi:101016/S0014-48270200027-7 PMID 12565815 
  10. ^ "What Is Necrosis - Definition & Types - Video & Lesson Transcript | Studycom" Studycom Retrieved 2016-04-16 
  11. ^ a b Alberts, Bruce; Johnson, Alexander; Lewis, Julian; Raff, Martin; Roberts, Keith; Walter, Peter 2002-01-01 Molecular Biology of the Cell 4th ed Garland Science ISBN 0815332181 
  12. ^ Hardman, J G; Limburd, L E; Gilman, A G, eds 2000 Goodman & Gilman's The Pharmacological Basis of Therapeutics 10th ed New York:McGraw-Hill ISBN 0-07-135469-7 
  13. ^ Chien, S; Toledo-Pereyra, L, eds 2008 "'Metabolic Management - Organ Procurement and Preservation For Transplantation" Landes Bioscience Springer, New York Retrieved 11 April 2016 
  14. ^ Haynes RH 1988 Biological context of DNA repair In:Friedberg EC & Hanawalt PC editors, Mechanisms and Consequences of DNA Damage Processing, John Wiley & Sons Canada, Limited, 1988 pp 577-584 ISBN 0471502693, 9780471502692
  15. ^ a b Bernstein, C; Bernstein, H; Payne, CM; Garewal, H 2002 "DNA repair/pro-apoptotic dual-role proteins in five major DNA repair pathways:fail-safe protection against carcinogenesis" Mutat Res 511 2:145–178 doi:101016/s1383-57420200009-1 PMID 12052432 
  16. ^ Narayanan, L; Fritzell, JA; Baker, SM; Liskay, RM; Glazer, PM 1997 "Elevated levels of mutation in multiple tissues of mice deficient in the DNA mismatch repair gene Pms2" Proc Natl Acad Sci U S A 94 7:3122–3127 doi:101073/pnas9473122 PMC 20332  PMID 9096356 
  17. ^ Hegan, DC; Narayanan, L; Jirik, FR; Edelmann, W; Liskay, RM; Glazer, PM 2006 "Differing patterns of genetic instability in mice deficient in the mismatch repair genes Pms2, Mlh1, Msh2, Msh3 and Msh6" Carcinogenesis 27 12:2402–2408 doi:101093/carcin/bgl079 PMC 2612936  PMID 16728433 
  18. ^ Tutt, AN; van Oostrom, CT; Ross, GM; van Steeg, H; Ashworth, A 2002 "Disruption of Brca2 increases the spontaneous mutation rate in vivo:synergism with ionizing radiation" EMBO Rep 3 3:255–260 doi:101093/embo-reports/kvf037 PMC 1084010  PMID 11850397 
  19. ^ Sedelnikova, OA; Redon, CE; Dickey, JS; Nakamura, AJ; Georgakilas, AG; Bonner, WM 2010 "Role of oxidatively induced DNA lesions in human pathogenesis" Mutat Res 704 1–3:152–159 doi:101016/jmrrev200912005 PMC 3074954  PMID 20060490 
  20. ^ Ames, BN; Shigenaga, MK; Hagen, TM September 1993 "Oxidants, antioxidants, and the degenerative diseases of aging" Proc Natl Acad Sci USA 90:7915–22 doi:101073/pnas90177915 PMC 47258  PMID 8367443 
  21. ^ Sakai, A; Nakanishi, M; Yoshiyama, K; Maki, H 2006 "Impact of reactive oxygen species on spontaneous mutagenesis in Escherichia coli" Genes Cells 11 7:767–778 doi:101111/j1365-2443200600982x PMID 16824196 
  22. ^ Massie, HR; Samis, HV; Baird, MB 1972 "The kinetics of degradation of DNA and RNA by H2O2" Biochim Biophys Acta 272 4:539–548 doi:101016/0005-27877290509-6 PMID 5065779 
  23. ^ Vilenchik, MM; Knudson, AG 2003 "Endogenous DNA double-strand breaks:production, fidelity of repair, and induction of cancer" Proc Natl Acad Sci U S A 100 22:12871–12876 doi:101073/pnas2135498100 PMC 240711  PMID 14566050 
  24. ^ a b Bernstein H, Payne CM, Bernstein C, Garewal H, Dvorak K 2008 Cancer and aging as consequences of un-repaired DNA damage In:New Research on DNA Damages Editors:Honoka Kimura and Aoi Suzuki Nova Science Publishers, Inc, New York, Chapter 1, pp 1-47 open access, but read only https://wwwnovapublisherscom/catalog/product_infophpproducts_id=43247 ISBN 1604565810 ISBN 978-1604565812
  25. ^ a b Harris Bernstein, Carol Bernstein and Richard E Michod 2011 Meiosis as an Evolutionary Adaptation for DNA Repair Chapter 19 in DNA Repair Inna Kruman editor InTech Open Publisher DOI:105772/25117 http://wwwintechopencom/books/dna-repair/meiosis-as-an-evolutionary-adaptation-for-dna-repair

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