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Summary Medical Biochemistry and Pathophysiology: Pathophysiology Section - Biomedical Sciences, minor Patient-Oriented Research, University of Amsterdam$4.98
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Summary Medical Biochemistry and Pathophysiology: Pathophysiology Section - Biomedical Sciences, minor Patient-Oriented Research, University of Amsterdam
Summary of lectures of Medical Biochemistry and Pathophysiology, part Pathophysiology. Biomedical Sciences, minor Patient-Oriented Research, University of Amsterdam. The summary is written in English, since the entire course is taught in English and the exam is also in English.
Atherosclerosis, metabolism and nuclear receptors – De Vries
Atherosclerosis = formation of lesion (=plaque) in blood vessels, consisting of dead cells, cholesterol,
cholesteryl esters, triglycerides, macrophages, smooth muscle cells, crystallized calcium > narrowing
vessels
Atherosclerosis is the underlying pathology of myocardial and cerebral infarction
When there are high LDL levels in the blood circulation:
- Monocytes are attracted by endothelial cells to clean up LDL
- Monocytes (in blood) go into tissue and become macrophages (=monocytes in tissue)
- LDL is a little oxidized by radical oxygen species (ROS)
- Macrophages can take up oxidized LDL
- Macrophages cannot handle all the LDL and become ‘foam cells’
- Macrophages secrete cytokines > inflammation and attraction of more monocytes
- Macrophages also secrete growth factors > smooth muscle cells (SMCs) differentiate and can
now migrate to endothelial cells > enlarge the lesion
, Multi-factorial disease and treatment:
- Environment: smoking, diet, lack of exercise > can be prevented
- Risk factors:
High cholesterol (LDL) > statins (to decrease cholesterol synthesis and upregulate LDL
receptors)
Low HDL
Hypertension > multiple drugs
Diabetes > insulin (in Diabetes type I)
- Genetic components
Familiar Hypercholesterolemia (FH) > LDL receptor gene mutation
Tangier disease > ABCA1 receptor defect
‘Genetic predisposition’ > multiple genes
Acute myocardial infarction: atherosclerosis in coronary artery > plaque rupture > formation of
thrombus that can obstruct the coronary artery, which results in decreased or no blood flow = infarction
Cells involved in atherosclerosis: monocytes/macrophages, T cells, endothelial cells, smooth muscle
cells
Treatment of atherosclerosis: stent in coronary artery > metal thing in which a balloon can be pumped
up to widen narrowed or obstructed vessels (angioplasty) (stent ensures that the vessel remains open)
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