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Regenerasi Sel dan

Penyembuhan Luka
dr. Sari Eka Pratiwi
Departemen Patologi Anatomi
Program Studi Pendidikan Dokter
Fakultas Kedokteran Universitas Tanjungpura
2014
Sebelum Mulai, kita senam dulu

Inflammation
Stimulus

Tissue Reaction Repair

Cell
Chemical
Vascular

Causes
Physical agents
Mechanical
Thermal
Chemicals & drugs
Microbiologic agents
Immunologic reactions
Radiation
Repair & Regeneration
Repair : process of recovering the damaged
tissue :
Initial tissue cells
Other cells

Regeneration : process of recovering by
initial tissue cells
Regeneration
Two processes :

Proliferation of surviving cells
Migration of surviving cells

Three groups of cells
Labile cells
Stable cells
Permanent cells
Role of the extracellular
matrix in regeneration
and repair. Liver
regeneration with
restoration of normal
tissue after injury
requires an intact cellular
matrix. If the matrix is
damaged the injury is
repaired by fibrous tissue
deposition and scar
formation.
Mechanisms
regulating cell
populations

Signaling Cell Growth
Healing Processes
Induction of an inflammatory process
Proliferation and migration of parenchymal
and connective tissue cells
Angiogenesis and granulation tissue
Synthesis of ECM proteins and collagen
deposition
Tissue remodelling
Wound contraction
Acquisition of wound strength
Wound healing
Superficial regeneration

Deep repair

Healing Processes

The main components :

- ANGIOGENESIS
- SCAR FORMATION
ANGIOGENESIS
Definition :
The process of blood vessel formation in adult
or NEOVASCULARIZATION


Mechanisms :
- Angiogenesis from Endothelial Precursor Cells
- Angiogenesis from Pre-Existing Vessels
- Growth Factors and Receptors Involved in
Angiogenesis
- ECM Proteins as Regulators of Angiogenesis
Angiogenesis by mobilization of endothelial precursor cells
(EPCs) from the bone marrow and from preexisting vessels
(capillary growth).
Two patterns of healing
Healing by first intention
(primary union = repair perprimam)

Healing by second intention
(secondary union = repair persekundam)
Healing of skin ulcers. A, Pressure ulcer of the skin, commonly found in diabetic patients. The
histologic slides show: B, a skin ulcer with a large gap between the edges of the lesion; C, a
thin layer of epidermal re-epithelialization and extensive granulation tissue formation in the
dermis; and D, continuing re-epithelialization of the epidermis and wound contraction
A, Granulation tissue showing numerous blood vessels, edema, and a loose ECM containing
occasional inflammatory cells. Collagen is stained blue by the trichrome stain; minimal mature
collagen can be seen at this point. B, Trichrome stain of mature scar, showing dense collagen,
with only scattered vascular channels.
Multiple roles of macrophages in wound healing. Macrophages participate in wound
debridement, have antimicrobial activity, stimulate chemotaxis and the activation of
inflammatory cells and fibroblasts, promote angiogenesis, and stimulate matrix remodeling
and synthesis. ROS, reactive oxygen species
SCAR FORMATION
Processes of Scar Formation :

1. Emigration and Proliferation of
Fibroblast in the site of injury

2. Deposition of ECM

3. Tissue Remodeling
Scar Formation
Net collagen depends on increased
collagen synthesis and decreased
degradation

Scar compossed of spindle-shaped
fibroblasts, dense collagen, fragments
of elastic tissue and ECM components

Vascular regression --- pale, avascular
scar
Tissue Remodeling
Granulation tissue to Scar --- involves
transitions in the composition of The
ECM

The Balance between ECM synthesis and
degradation results in remodeling of
the connective tissue framework

Keloid. A, Excess collagen deposition in the skin forming a raised scar known as keloid. B,
Note the thick connective tissue deposition in the dermis
Development of fibrosis in chronic inflammation. The persistent stimulus of chronic
inflammation activates macrophages and lymphocytes, leading to the production of growth
factors and cytokines, which increase the synthesis of collagen. Deposition of collagen is
enhanced by decreased activity of metalloproteinases.
THANK YOU
Tugas
Kelainan melanosit
Benign epithelial tumor
Premalignant and Malignant Epidermal
Tumors
Chronic Inflammatory Dermatoses
Infeksi virus dan jamur

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