Atrophy

DEFINITION
decrease in size and weight (or function, clinically) of a tissue/organ
due to decrease in size and number of its constituent parenchymal cells
CAUSES
Loss/interruption of trophic signals:

Decreased hormonal stimulation of

hormone-responsive tissue

Dennervation of muscle

The activities of many cells depend on

signals triggered by chemical
mediators (e.g., hormonal or
neuromuscular transmission), which
place functional demands on them. If
the source of the signal is removed
(e.g., via ablation of an endocrine
gland or denervation), cells dependent
on that stimulus will atrophy.
If the anterior pituitary is surgically
resected or lost to ischemia (e.g.,
Sheehan syndrome), deficiency of
TSH, ACTH and FSH results in atrophy
of the thyroid, adrenal cortex and
ovaries, respectively.
Physiological atrophy of breast and
uterus following menopause, when
estrogen stimulation is diminished
Skeletal muscle atrophy following
lower motor neuron loss in
Amyotrophic lateral sclerosis; nerve
section as in spinal cord injuries;
poliomyelitis

Decreased workload/functional
demand-Disuse atrophy

Skeletal muscle in plaster cast

Decreased blood supply

Cerebral atrophy due to

atherosclerosis of CA
Cerebral atrophy in Alzheimer's
disease
Atrophy of brain and heart in aging
(senile atrophy)
Although total cessation of oxygen
perfusion results in cell death, partial
ischemia is often compatible with cell
viability.
Atrophic kidney in renal artery
atheroscelrosis

Decreased nutrition

Calorie deprivation in
marasmus/kwarshiokor
As a result of utilization of skeletal

muscle proteins as source of energy

after other reserves have been
depleted.
Increased pressure/compression

Atrophy of renal cortex and medulla in

hydronephrosis (increased luminal
pressure of backed up urine
compresses vessels in medulla and
cortex)
Compression atrophy of exocrine
glands in cystic fibrosis (thick
pancreatic duct secretions occlude
duct lumens, causing increased
luminal back pressure, resulting in
atrophy and damage)
Enlarging benign tumor/cyst/aneurysm
can cause atrophy of surrounding
uninvolved tissues.(erosion of spine by
tumor in nerve root, erosion of skull by
meningioma, erosion of sternum by
arch of aorta aneurysm)
Decubitis ulcers/pressure ulcers/bed
sores (When soft tissues are
compressed between bony
prominences and contact surfaces,
microvascular occlusion with tissue
ischemia and hypoxia occurs)
Atrophy of hepatocytes in the center
of the liver lobule, in congestive heart
failure (poor venous return from the
liver increases the pressure within
hepatic sinusoids)
Pressure exerted causes the blood
supply to compromise, resulting in
ischemic/hypoxic changes??

Persistent cell injury caused by chronic Atrophy of gastric mucosa, associated

inflammation associated with
with chronic gastritis
bacterial/viral infections
Small intestinal villous atrophy
accompanying the chronic
inflammation of celiac disease
Chronic disease like AIDS/Cancer

Generalised atrophy of many tissues;

[emaciation and anaemia referred to
as cachexia seen in cancer and
severely ill patients.]
(often due to decreased calorie intake
and alterations in cytokines and other
mediators)

Idiopathic atrophies

Myopathies
testicular atrophy?

MECHANISMS
SHRINKAGE OF CELLS (by reduction in cytosol and number of organelles
through Autophagy[formation of autophagic vacuoles-fusion with primary
lysosomes=autophagolysosomes->enzymatic degradation]..[lipid peroxidation
of cell membranes-undigested stored as residual bodies, e.g. Lipofuscin, brown
tissue discoloration/brown atrophy, normal age-related finding)
LOSS OF CELLS by PCD/apoptosis
PROTEIN CATABOLISM-decreased protein synthesis (wasting
syndrome?/catabolic state?) and increased protein degradation (ubiquitinproteasome pathway)