Free radicals and cellular injury

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Free radicals and cellular injury

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Amino acid metabolism
Nitrogen and urea cycle
Hartnup disease
Ornithine transcarbamylase deficiency
Maple syrup urine disease
Homocystinuria
Phenylketonuria (NORD)
Abetalipoproteinemia
Hypertriglyceridemia
Hyperlipidemia
Vitamin B12 deficiency
Nucleotide metabolism
Cholesterol metabolism
Disorders of amino acid metabolism: Pathology review
Purine and pyrimidine synthesis and metabolism disorders: Pathology review
Adenosine deaminase deficiency
Severe combined immunodeficiency
Gout
Diabetes mellitus: Pathology review
Physiological changes during exercise
Endocrine system anatomy and physiology
Glucagon
Insulin
Fats and lipids
Lipid-lowering medications: Fibrates
Lipid-lowering medications: Statins
Free radicals and cellular injury
Ischemia
Hypoxia
Atrophy, aplasia, and hypoplasia
Hyperplasia and hypertrophy
Metaplasia and dysplasia
Oncogenes and tumor suppressor genes
Anorexia nervosa
Bulimia nervosa
Eating disorders: Pathology review
Vitamin K deficiency
Vitamin D deficiency
Excess Vitamin A
Excess Vitamin D
Folate (Vitamin B9) deficiency
Niacin (Vitamin B3) deficiency
Vitamin C deficiency
Wernicke-Korsakoff syndrome
Beriberi
Iodine deficiency
Zinc deficiency
Marasmus
Kwashiorkor
Fat-soluble vitamin deficiency and toxicity: Pathology review
Zinc deficiency and protein-energy malnutrition: Pathology review
Water-soluble vitamin deficiency and toxicity: B1-B7: Pathology review
Familial adenomatous polyposis
Azoles
Echinocandins
Miscellaneous antifungal medications
Miscellaneous cell wall synthesis inhibitors
Cell wall synthesis inhibitors: Cephalosporins
Protein synthesis inhibitors: Aminoglycosides
Mycobacterium tuberculosis (Tuberculosis)
Tuberculosis: Pathology review
Anatomy of the leg
Dementia with Lewy bodies
Bones of the cranium
Anatomy of the cranial base
Anatomy of the orbit
Anatomy of the eye
Anatomy of the nose and paranasal sinuses
Anatomy of the oral cavity
Anatomy of the temporomandibular joint and muscles of mastication
Muscles of the face and scalp
Anatomy of the salivary glands
Nerves and vessels of the face and scalp
Anatomy of the tongue
Anatomy of the pterygopalatine (sphenopalatine) fossa
Anatomy of the inner ear
Anatomy of the infratemporal fossa
Anatomy of the external and middle ear
Anatomy clinical correlates: Skull, face and scalp
Anatomy clinical correlates: Ear
Anatomy clinical correlates: Eye
Anatomy clinical correlates: Temporal regions, oral cavity and nose
Gallbladder histology
Esophagus histology
Stomach histology
Small intestine histology
Colon histology
Liver histology
Pancreas histology
Laxatives and cathartics
Antidiarrheals
Acid reducing medications
Esophageal disorders: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Inflammatory bowel disease: Pathology review
Malabsorption syndromes: Pathology review
Diverticular disease: Pathology review
Appendicitis: Pathology review
Gastrointestinal bleeding: Pathology review
Colorectal polyps and cancer: Pathology review
Pancreatitis: Pathology review
Gallbladder disorders: Pathology review
Jaundice: Pathology review
Viral hepatitis: Pathology review
Cirrhosis: Pathology review
Hepatitis A and Hepatitis E virus
Hepatitis D virus
Hepatitis C virus
Adrenocorticotropic hormone
Growth hormone and somatostatin
Oxytocin and prolactin
Antidiuretic hormone
Thyroid hormones
Synthesis of adrenocortical hormones
Cortisol
Cyanotic congenital heart defects: Pathology review

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Electrons in an atom are present in spaces called orbitals, and each orbital can fit different pairs of electrons.

Now free radicals are molecules with only one electron, or an unpaired electron, in their outer orbital.

Free radicals have a habit of stealing electrons from any molecule they come across to make themselves stable and it’s what causes all the trouble and potentially can cause cellular injury.

Now, a free radical is formed when any molecule gains or loses an electron.

In the body, free radicals can be generated physiologically, which means as a part of normal metabolic processes; or pathologically, which is due to some disease.  

A major physiological source of free radicals is cellular respiration, which is also called oxidative phosphorylation.

Oxidative phosphorylation is the process of making ATP by donating electrons to complexes embedded within the inner mitochondrial membrane.

Together, they form the electron transport chain, which pass electrons from complex to complex, and finally to oxygen, creating a proton gradient that will be used to make ATP.

The final step of this process involves a molecule called cytochrome c oxidase, sometimes known as complex IV, which transfers electrons to oxygen.

Normally, when oxygen gets four electrons, it gets converted into water.

But when oxygen doesn’t get all four electrons, then it will have unpaired electrons in its orbital, giving rise to free radicals.

Since these are formed from oxygen, they’re collectively called reactive oxygen species, or simply ROS.

Okay so if oxygen is given one electron, it becomes superoxide (O2−) If it gets two electrons, it becomes hydrogen peroxide, or H2O2, and then 3 electrons, it’s the hydroxyl radical (OH.).

There are also pathological conditions where free radicals can be generated.

First, they can be produced during inflammation by phagocytes like macrophages and neutrophils.

When a pathogen invades the body, the phagocyte gobbles up the pathogen forming a phagolysosome.

These phagocytes also have an enzyme called NADPH oxidase, which gets activated by the lysosomal enzymes, causing NADPH to undergo oxidation, and lose two of its electrons.

Nearby oxygen molecules can grab these electrons to form superoxide ions.

Another enzyme, superoxide dismutase, can take these ions and combine them with hydrogen ions to form hydrogen peroxide.

This process of producing superoxide ions and hydrogen peroxide is called the respiratory burst.

Phagocytes also have a type of nitric oxide synthase, which is an enzyme that produces nitric oxide, which helps to kill the pathogen.

But what nitric oxide also does is that, it reacts with superoxide ions to form peroxynitrite free radical (ONOO—). These ions and molecules destroy pathogens by breaking down their cell membranes and damaging their proteins. 

Another way free radicals can be generated is through exposure to ionising radiations like ultraviolet light or X-rays.

When the radiation hits the water in the tissues, it knocks off an electron from water, converting it into hydroxyl radical.

Free radicals can also be generated when there’s a build up of metals like copper or iron in the body.

For example, hemochromatosis is a condition where unusually high amounts of iron are absorbed.

All this extra iron, undergoes the Fenton reaction, where molecules of iron 2+ are oxidized by hydrogen peroxide, producing iron 3+ and the hydroxyl radical and hydroxide ion as byproducts; now, iron 3+ can be reduced back to iron 2+ via hydrogen peroxide again, creating a peroxide radical and a proton, and then the cycle repeats, like an endless loop.

So, over time, free radicals formed as a result of the Fenton reaction slowly damage cells in various organs, and that can cause cell death and then lead to tissue fibrosis