Types of dystrophy - an area of research in biology and medicine. Pathological processes are associated with abnormal metabolism at the cellular level, which leads to a violation of the integrity of organic structures. In tissues, cells, chemical compounds are generated that are not inherent in these localizations. A rather voluminous classification system has been developed, and for each type, doctors are studying the causes of the phenomenon and possible ways to deal with it.
Categories and Groups
The classification of the types of dystrophies is based on the morphology of the cellular level and the features of its change. Parenchymal, mesenchymal and combined cases are distinguished. Assessing the nuances of metabolic processes, pathology is considered lipidosis, dysproteinosis, or due to a violation of reactions involving minerals, carbohydrates. The case may be local or generalized - the second, of course, is more difficult.
Considering the different types of dystrophies, scientists introduced a classification into groups based on the origin of the pathology. The disease can be inherited, but you can get it after birth.
Morphology and genetics
Different types of dystrophies have specific features and differences. The pathology is explained by the ability of substances to pass into others similar in structure to them. A classic example is carbohydrates, which under certain conditions transform into fatty structures. Cells, tissues can become the area of localization of some chemical compounds. This process is called infiltration and is also important in the framework of the morphogenesis of dystrophy. There are two options for infiltrates. In the first case, some compound enters in excess in a cell that is actively involved in biochemical processes. The limit is approaching, the structure cannot cope with the processing of the compound. The second type of phenomenon is a decrease in the activity of the cell structure, which cannot cope with the normal volume of the compounds entering it.
In the morphogenesis of different types of dystrophies, an important aspect is decomposition, that is, the phenomenon of decay of structures within tissues and cells. Lipid and protein complexes present in organelle membranes are destroyed. Normally, in the membrane, fatty, protein elements are connected, and are not visible during microscopic examination, but after the decomposition of the complex they can be seen in a specific study.
The last feature is improper synthesis, in which the cell becomes a localization area for the production of abnormal compounds that are not required for the body to function properly. So, amyloidosis is accompanied by the generation of a protein structure from which amyloid emerges. Against the backdrop of chronic alcoholism, hepatic cells generate protein elements - the basis for the formation of alcoholic hyaline.
Pathology: manifested by violations
Different types of muscular dystrophy, mesenchymal, carbohydrate and other types, lead to certain malfunctions of the functionality of organic tissues. Disorders can develop in one of two ways: functionality weakens or work features change, traits are formed that are not inherent in cellular structures normally.
A classic example of the phenomenon: with renal pathologies in urine, protein elements are detected, the generation of which is associated precisely with dystrophic processes. With hepatic dystrophy, the results of the samples change, and with cardiac dystrophy, the tones of the organ.
Parenchymal dystrophies
Three types of phenomena are distinguished in this category; for the division into categories, the structures involved in the process are evaluated. So, dystrophy can develop a carbohydrate type, with the participation of proteins or lipids. Each of them has its own unique features.
Protein Dystrophies
This term refers to pathological processes associated with abnormally occurring protein metabolic reactions. Such are usually localized within the cells. There are the following types of protein parenchymal dystrophies: horny, hydropic, drop hyaline and granular.
Granular is especially interesting. This variety is easily identified within the framework of histological examination: protein grains are clearly visible. Such a pathology is often localized in the kidneys, heart, liver, called dull swelling. The name reflects microscopic manifestations - the organs seem to be slightly enlarged, but in the section they are dull and cloudy. It seems as if the tissue was scalded with boiling water. This type of dystrophy is found depending on several factors, and it is customary to divide the causes into infectious and poisoning.
Granular renal dystrophy is common. A favorable course and outcome are possible if the cause is identified and eliminated in time - gradually the tubular epithelium normalizes its qualities. With prolonged aggressive influence, the processes progress, it is impossible to reverse them, dystrophic changes become the area of localization of necrotic processes. This is often observed if the patient is in contact with renal poisons.
Granular dystrophy: in the heart and liver
If this type of dystrophy develops in the heart, the organ slightly increases, and the myocardium becomes flabby, visually when cut, it is similar to boiled meat. Histological analysis shows basophilia. Myocardial waves react differently to eosin, hematoxylin. Some elements due to hematoxylin get a lilac hue, others due to eosin become bright blue.
The liver with this pathology is slightly larger than normal sizes. If you cut organic tissue, the shade seems like clay. With histological analysis, protein grains can be established, but their presence will not be constant. It is important to evaluate the integrity of the beam structure. Proteins are characterized by separation into hepatocytes, due to which the condition was called discomplexation of liver beams.
Hyaline droplet
This form is often localized in the kidneys, liver. Visually, changes in the organ cannot be noticed, when examined under a microscope in the cell cytoplasm, protein drops can be detected. Dystrophy causes cell death due to coagulation necrosis. In the kidneys, pathology is usually formed due to the nephrotic syndrome, characteristic of various diseases. Often, the syndrome accompanies nephropathy, amyloidosis. Nephrocytic dystrophy is characterized by pronounced infiltration, since the glomerular filter is characterized by an abundance of pores. This soon leads to decomposition, disruption of the nephrocyte apparatus responsible for protein reabsorption.
Hepatic dystrophy of this type is characteristic of patients suffering from alcoholism, hepatitis for this reason. Somewhat less dystrophy is detected against a background of cholestasis, cirrhosis. Hyaline-like elements were called alcoholic hyaline. Such structures - mesh or in the form of blocks, are perinuclear. Dystrophy to a greater extent is due to improperly occurring synthesis reactions than to other processes. Alcohol hyaline defines a whole range of biochemical reactions inside the liver and outside this organ. Chemotactic qualities are characteristic of it, which determines leukotaxis. Mostly dystrophic foci are surrounded by polymorphonuclear leukocytes. Their presence is one of the typical signs of hepatitis due to addiction to alcohol.
Hydropic Dystrophy
With this form of the disease, the organs visually remain normal, but with a detailed examination under a microscope, vacuoles can be found in the cell cytoplasm, which gradually becomes the cause of balloon dystrophy, cell death. Such a pathology is often localized in the liver, kidneys, less often - the skin.
Cytoplasm swelling, vacuole formation is accompanied by a displacement of the cell nucleus to the membrane, the color weakens. Such a pathology is characteristic of patients suffering from nephrotic syndrome. The epithelium covering the tubules of the kidneys becomes an area of localization of pathological processes due to a malfunction of the enzyme system and membranes. Normally, these systems are responsible for re-absorption of fluids, proteins.
Nephrocytic hydropic dystrophy proceeds with severe infiltration, decomposition. The sodium-potassium basal labyrinth of ATP suffers, through which the reverse absorption of liquid, sodium occurs.
In the liver, pathology is usually diagnosed in patients with viral hepatitis. The reason is reproductive viral activity, which knocks down normal processes of synthesis in cells.
Lipids
There are several types of fatty degeneration, and the division into categories is associated with the biological and chemical nuances of the process. It is customary to differentiate fats into two types: labile, whose volumes throughout the course of human life are constantly being corrected, and stable, which enter into cell membranes. To identify fatty structures resort to dyes (Sudan, scarlet, osmic acid, Nile blue). Identifying the causes of dystrophy, it was found that most often a pathological condition develops due to poisoning or infection. Chronic poisoning is most often alcoholic, somewhat less often - drug, endocrine. The latter is characteristic of patients with diabetes. The area of localization of dystrophic processes is the myocardium, kidney, and liver.
Most often in clinical practice, one has to deal with a type of fatty degeneration localized in the liver. With this pathology, neutral fat is half formed by hepatocytes. There are three stages of the condition: fatty liver, organ with mesenchymal response, fibrosis and cirrhosis. The reason for the accumulation of fatty structures in the liver is a violation of enzymatic reactions at a certain lipid metabolism step. This is possible if the cell receives too many fatty compounds, the hepatocyte actively synthesizes such substances, due to which there are not enough enzymes for the normal functioning of the system. The cause of dystrophy can be a prolonged effect of toxic compounds, due to which the oxidation of substances is inhibited, as well as a lack of amino acids, without which it is impossible to produce lipoproteins, phospholipids.
Liver pathology: features
In specialized publications you can find many tables devoted to the types of dystrophy that reveal the nuances of the development of pathological processes, the features of their onset, and the factors that provoke violations. An analysis of such sources allows us to identify the main cases leading to hepatic fatty degeneration. In many patients, an increased content of fatty acids is detected in the blood serum. This is typical for diabetics, alcoholics and people suffering from excess weight. Ethanol, phosphorus and other toxic substances affect hepatocytes, which provokes degeneration.
A pathological condition can develop due to malnutrition, lack of protein structures in products, against the background of violations in the digestive tract. Genetic enzyme defects that regulate lipid metabolism can contribute. In this case, inherited lipidosis is diagnosed.
Alcohol and diabetes
Among all cases of fatty degeneration, about half develop due to the use of ethanol. This substance mobilizes the fatty structures contained in the depot, activates synthesis in hepatocytes, esterification into triglycerides, lowers the level of oxidation, and the release of lipoproteins. On the background of alcohol intake, the permeability of cell membranes decreases, since cholesterol production is activated. With alcohol intoxication, hepatic deposits are common, focal. With diffuse obesity, the liver becomes larger in size, acquires a yellow tint, sagging. A possible outcome is hepatic steatosis. Its probability depends on the responsibility of the patient: with absolute withdrawal, after a couple of weeks (sometimes twice as long), fat completely disappears from the liver. The progress of steatosis leads to cirrhosis.
Up to 75% of diabetics suffer from hepatic fatty degeneration. This is rare in children, adolescents, young people. In addition, there is a dependence on weight, the level of ketoacidosis. Hepatic steatosis in diabetes is explained by the active involvement of fatty structures from the depot with transfer to the liver. At the same time, phospholipid production processes and oxidative reactions are knocked down. Lipolysis is enhanced by a lack of insulin, an antilipolytic hormone. The circulatory system increases the content of fatty acids, the liver actively generates lipoproteins, but lacks apoprotein, so the incoming acids are not absorbed, and excess masses turn into triglycerides. Diabetic hepatic steatosis is often associated with overweight, and dystrophy is activated due to the abundance of carbohydrates and fats supplied with food.
Carbohydrates and pathology
Several types of carbohydrate dystrophies are known. There are hereditary pathologies associated with abnormally occurring reactions involving glycogen. In this case, the body lacks the enzyme (or it does not exist at all), which is responsible for glycogen deposition. A pathological condition is considered an accumulation disease. Six varieties associated with a shortage of six types of enzymes have been identified and studied.
Sometimes carbohydrate dystrophies due to improperly occurring metabolic reactions of glycoproteins are detected. Inside the cells, in the space between them, mucoids, mucins accumulate, and mucous dystrophy appears.
To identify the case as belonging to a certain type, to determine the type of mixed dystrophy, if the process is complex, resort to the study of cells under a microscope. Analyzes help detect the generation of mucus and a change in its chemical, physical qualities. Cells capable of secreting substances die, desquamate, glandular ducts obstructed by mucus. As a result, a cyst is formed.
Mesenchymal pathological processes
There are several types of stromal-vascular dystrophies, caused, as a rule, by an improperly flowing connective tissue metabolism. Typically, these are found in the vascular wall, stroma in the histion, formed by the microvasculature and connective tissue elements nearby with the inclusion of nerve fibers. Among the developmental mechanisms, the most important is improper trophism, disruption of the transport system. Often, several types of mesenchymal dystrophy, capable of passing between themselves, are immediately revealed in a patient.
The features of dystrophy in the case of dysproteinosis are most clearly expressed. Connective tissue disorganization is caused by destruction, sometimes by the generation of an abnormal protein. All types of mesenchymal dystrophy are currently being actively studied, but certain discoveries in this area have yet to be made. Very often dystrophy is detected against the background of autoimmune conditions. The heavier they are, the more pronounced dystrophy.
A problem known to all
There is one type of dystrophy, the name of which everyone and everyone has heard. This problem does not scare people in vain - it is widespread, it can lead to irreversible consequences. It's about retinal dystrophy. The types of this pathological condition are acquired and hereditary. The first option with timely started therapy can be cured, the second cannot be corrected.