CONNECTING FABRIC

From Big Medical Encyclopedia

CONNECTING FABRIC [textus connectivus (LNH)] — the fabric of an animal organism developing from a mesenchyma, which is carrying out basic and mechanical, trophic, protective and reparative functions. She makes more than 50% of the weight (weight) of a body, forms a basic framework (skeleton) and outside covers (derma), is a component of all bodies and fabrics, creates together with blood (see) and a lymph (see) internal environment of an organism, edges takes part in a metabolism in an organism (see. Internal environment of an organism ).

Page of t. for many years attracted interest of representatives of various medicobiological specialties. Classical researches of a structure, function C. of t., relationship between S.'s cells of t. and the blood in evolutionary aspect which were carried out by Russians and the Soviet scientists I. I. Mechnikov. A. A. Maximov, A. A. Zavarzin, A. A. Bogomolts and their pupils, t were the most important milestones in development of the doctrine about S. In studying of pathology of S. of t. works A. I. Struko-va and his pupils, A. V. Rusakov, etc.

the Structure

Feature of a structure of S. of t were of great importance. existence of well developed intercellular structures is (fibers and the main substance). Depending on cellular structure, a structure and properties of intercellular structures (see. Intercellular substance), their orientations S. of t. subdivide t into friable and dense not properly executed fibrous S., the dense issued fibrous S. of t. and connecting fabric with special properties. To friable not properly executed fibrous S. of t. carry: hypodermic cellulose (see. Hypodermic fatty tissue); the fabric filling layers between bodies and accompanying blood vessels and nerves, and also the fabric creating a stroma of parenchymatous bodies — intersticial, or interstitial, fabric. Dense not properly executed fibrous S. of t. the derma of skin is (see); the dense issued fibrous — sinews (see), sheaves (see), dense a fascia (see) and aponeuroses, capsules of internals, a bone tissue (see the Bone), cartilaginous tissue (see) all types (joint cartilages, intervertebral disks, costal cartilages, meniscuses, cartilages of a throat, a nose, an auricle, the hearing aid), the capsule of joints (see), valves of heart (see). Page of t. with special properties it is presented by reticular, elastic and fatty tissue (see. Fatty tissue, Reticular fabric). From S. of t. with special properties synovial and serous membranes, a submucosa of walls of hollow bodies, dentine and a pulp of tooth, the main substance of a cornea, a sclera, a choroid of an eye consist.

The most widespread type C. of t. the person and animals friable not properly executed fibrous S. of t is. It includes practically all types of the cells and intercellular structures meeting in other types C. of t.

Intercellular substance C. of t. it is presented by fibrous structures (collagenic, reticular and elastic fibers) and the main substance (an amorphous component of intercellular substance), in a cut cells and fibers are concluded.

In composition of collagenic fibers C. of t. collagen I of type enters (see Collagen). On diffraction patterns cross striation of collagenic fibers with periodokhm repetitions of 64 — 70 nanometers is visible (see fig. to St. Collagen, t. And, p. 126). On gistol. cuts during the use of survey methods of coloring collagenic fibers are painted by eosine in pink color. For selective identification of collagenic fibers usually use polikhromny methods of coloring (see Van-Gizona a method, Mallori methods, etc.). During the studying of properties of collagen the immunofluorescent method (see the Immunofluorescence) based on use of specific antiserums to collagen of different types was widely adopted.

Reticular fibers consist of collagen III of the type which is characterized by the high content of oxyproline (see Proline) and availability of cysteine (see). According to biochemical researches reticular fibers the content of carbohydrates, almost by 10 times distinguishes high (to 4%) the exceeding content of carbohydrates in collagenic fibers. The fine branching reticular fibers form gentle network and at impregnation are painted by silver salts (see Silverings methods) in black color, unlike collagenic fibers, to-rye get yellow or pale brown coloring. Later it was revealed that silver is besieged preferential in a surface layer of reticular fibers where it contacts their not collagenic (carbohydrate) component. Reticular fibers are painted also with the help CHIC reaction (see).

It is established also that kollagena of various genetic types, including kollagena of I and III types, are not tkanespetsifichny (i.e. they can be not connected with connecting fabric). Biol. the sense of such distribution of kollagen is not clear yet.

Elastic fibers, according to a submicroscopy, consist of amorphous protein — the elastin (see) making a core of elastic fiber, and microfibrils diameter apprx. 11 nanometers deprived of periodic striation, located on the periphery. Protein of microfibrils differs from elastin and is rather rich with polar amino acids. However in its structure there are no oxylysine and oxyproline characteristic of collagen. Content of carbohydrates is big — apprx. 5% that indicates the glikoproteidny nature of microfibrils. Elastic fibers usually do not come to light at survey coloring of cuts owing to the low content of polar amino acids. For their visualization use the selection methods of coloring, napr, orcein or resorcin-fuchsin.

Main substance C. of t. represents the semi-fluid viscous gel consisting of an intercellular lymph and so-called structural biopolymers — macromolecules of the proteins and polysaccharides forming various complex connections. The main substance of connecting fabric provides diffusion of oxygen and nutrients from capillaries in cells, products of cellular exchange in the opposite direction arrive.

In connecting fabric allocate three main types of cellular elements — fibroblasts, macrophages and mast cells.

Main cellular form C. of t. the person fibroblasts are, to-rye develop and cosecrete procollagen, pro-elastin and glikozaminoglikana, and also protein of the microfibrils which are a part of elastic fibers. Immunochemical it is proved that the same cell can synthesize collagen I and III of types at the same time. Morphologically distinguish the young fibroblasts capable to division and actively synthesizing proteins, including both procollagen, and low-active cells — the fibrocytes which lost ability to division. In young fibroblasts are strongly developed a granular cytoplasmic reticulum (see. Endoplasmic reticulum), Golgi's complex (see Golgi a complex) and other structures characteristic of secretory cells. Fibroblasts participate in healing of wounds, encapsulation of foreign bodys, processes of regeneration and many others physiological and patol. processes. At early stages of a wound repair they synthesize generally collagen III of type, and on late — the I type. On a nek-eye to data, fibroblasts can englobe and destroy collagen (in this case they carry the name of fibroklast), participating, thus, in S.'s reorganization t. Along with typical fibroblasts the so-called miofibroblasta occupying on functional and ultrastructures-nym to signs an intermediate position between fibroblasts and smooth muscle cells are allocated. Miofibroblasta provide a smykaniye of edges of wounds at their healing, promote a teething etc.

Concerning an origin of fibroblasts still there is no consensus. Consider that in the embryonal period they are differentiated directly from mezen-eshmny cells. There is an opinion that in the post-natal period, nr of regeneration of S. of t., a source of fibroblasts are the low-differentiated cells which are located along capillaries (pericytes or adventitious cells), i.e. fibroblasts are self-sustaining population. According to other point of view predecessors of one of populations of fibroblasts (short-lived) are localized in marrow. For invertebrates transformation of blood cells (amoebocides) into fibroblasts (desmoblast) is proved. However in general a gistogenetichesky number of fibroblasts is not defined yet. Experiences with various inductors, especially with the demineralized bone matrix, show that among fibroblasts there are cells capable to transformation in other types of mekhanotsit (chondroblasts, osteoblasts, reticular macrophages) synthesizing inherent to them kollagena. On the other hand, the marrowy fibroblasts showing osteogene in vivo properties in culture conditions out of an organism have the same ultrastructure and synthesize the same types of kollagen, as friable not properly executed fibrous S.'s fibroblasts of t. At the same time antigenic, metabolic and functional features of fibroblasts of various organ localization are revealed.

Page of t. it is rich with the macrophages (see) belonging to system of mononuclear phagocytes (see) and performing protective function. They englobe foreign debris, bacteria, the died cells. Macrophages actively participate in inflammatory and immune responses. Predecessors of macrophages are the hemopoietic stem cells which are localized in marrow (see).

In S. of t. the mast cells (see) containing heparin, a histamine and other biologically active agents, and also fatty, pigmental, plasmocytes and different types of leukocytes are localized (see Leukocytes, Pigment cells, Plasmocytes).

Universal distribution of friable not properly executed fibrous S. of t., its role in a trophicity of cells, protective processes causes participation of this fabric practically in all physiological and pathological reactions (phisiological and reparative regeneration, an inflammation, healing of wounds, sclerous processes, etc.) - For S. of t. with the expressed trophic (protective) function rather large number and a variety of cells, including leukocytes of blood is characteristic. In S. of t. preferential basic type intercellular structures prevail, and cells are presented only by fibroblasts or other mekhanotsita (cartilaginous cells, bone cells).

Biochemistry

Features of chemical structure of S. of t. are connected with intercellular substance, a cut contains t, characteristic of S. so-called structural biopolymers: collagen (see), elastin (see), glikozaminoglikana (see Mucopolysaccharides) and structural glycoproteins, being representatives of glycoproteins (see).

Fibroblasts synthesize collagen in the form of the predecessor — procollagen, to-ry by means of secretory granules is removed in intercellular space. Here molecules of procollagen turn into molecules of tropocollagen, and from them there is an assembly of collagenic fibrilla.

At formation of elastic fibers there is also a synthesis of the predecessor — pro-elastin, to-ry turns in tropoelastin by eliminating of a trailer fragment. Lizinovy groups of four molecules of a tropoelastin «are sewed» together with the help of enzyme of a lysyloxidase and create thus desmozin (and from-desmozin), cross bonds therefore there is the elastin connecting molecules of pro-elastin. However formation of elastic fibers requires presence of microfibrils, to-rye are developed the first and perform function of the formoobrazovatelny framework filled by elastin. Both in collagen, and in elastin the number of cross bonds increases with age that leads to change of their biochemical properties.

Glikozaminoglikana of intercellular substance are presented by preferential acid glycoses-noglikanami, from to-rykh the major hyaluronic acids (see), and also the sulphated glikozaminoglikana (geparan-sulfate, chondroitin-4-sulfate, chondroitin-6-sulfate and dermatan-sulfate) are. Different types of S. of t. differ among themselves on type and quantity cosecreted glycose-minoglikanov.

Intercellular substance C. of t., including basal membranes, contains, except kollagen, elastin and glikozaminoglikan, several types of the structural glycoproteins identified by means of the high-allowing biochemical methods. Fibronectin, laminin and hondronektin, playing an important role in interactions between cells, between cells and the main substance and in the organization of the main substance belong to these glycoproteins. Quantitative ratios of biopolymers in separate kinds of S. of t. are very variable; there are also big differences of their supramolecular structural organization, of structure and a structure of units of the molecules belonging to various classes (e.g., to hondromukoida). Intercellular substance contains, besides, serum proteins, monomeric carbohydrates, amino acids, lipids, salts. Such kinds of S. of t., as the bone, dentine of teeth, are especially rich with phosphorus-calcium salts. Other chemical components C. of t. (e.g., nucleinic to - you) are the general for all cells of an organism.

An originality of a metabolism in S. of t. normal is defined by the synthesis of above-mentioned structural biopolymers of intercellular substance which is carried out by cells. Thus, biosynthesis and secretion of intercellular substance are the most important specific functions of cells of S. of t.; cells carry out these processes, generating necessary energy and utilizing low-molecular metabolites (free amino acids, monosaccharides, etc.). At the same time S.'s cells of t. take part in a catabolism of intercellular substance, a cut is in a condition of dynamic metabolic equilibrium at the level answering to functional, first of all mechanical, requirements to each kind of S. of t. The condition of intercellular substance is the major extracellular factor of regulation of metabolic activity of cells of S. of t. These cells have all necessary enzymes (see) as nonspecific character (e.g., enzymes of a cycle of tricarboxylic acids, glycolysis, oxidizing phosphorylation and other main metabolic ways, acid lysosomic hydrolases), and specific (e.g., the enzymes providing sulphation of glikozaminoglikan). In intercellular substance a number of the specific enzymes which are carrying out the final stages of biosynthesis and initial reactions of a catabolism of biopolymers of connecting fabric (about-kollagenendopeptidazy) works and hyaluronidases (see).

As S.'s cells of t. are not numerous in relation to the mass of intercellular substance, their metabolic activity is very high.

Various types C. of t. usually well regenerate in response to damage (see Regeneration) and at transplantation (see) that is very important, napr, at skin transplantations, marrow, etc. S.'s regeneration t. it is carried out thanks to presence of progenitors of the fibroblasts capable to proliferation.

Changes of a metabolism in S. of t. in ontogenesis are shown by shifts of quantitative ratios of structural biopolymers (decrease in content of elastin, glikozamino-glycanes, in particular hyaluronic to - t), change of properties of macromolecules (reduction of extractibility of collagen due to development of system inside - and intermolecular cross bonds, decrease in elasticity of elastin), reduction of number of cellular forms, the general delay of metabolic processes, regenerations. These changes of S. of t. play an essential role in genesis of aging (see the Old age, aging). Nek-rye from acquired diseases of S. of t., napr, atherosclerosis (see) and an osteoarthrosis (see Arthroses), find accurate age dependence in this connection in many cases it is difficult to draw a clear boundary between S.'s pathology of t. and its age changes.

Biochemical methods of a research of disbolism in S. of t. are based on definition in blood, urine and biopsy material of concentration of specific metabolites of biopolymers C. of t. (oxyproline, oxylysine), biopolymers or fragments of their molecules (gli-kozaminoglikan, glycoproteins, peptides of procollagen), activity of specific enzymes (spilled - hydroxylases, collagenases, hyaluronidases). Also methods of studying of exchange reactions in cultures of cells and synthesis of biopolymers on utilization of radioactive precursors are used, e.g., to identification it glikozaminoglika-is new the most specific autoradiographic methods (see the Autoradiography) reckon with use of marked predecessors (radio sulfate, a 3H-fukoza, etc.).

Physiology

S. of t. represents complete fiziol. system what a number of factors testifies to: its universal prevalence in an organism in the form of numerous specialized versions; a large number and a variety of the making elements having the general mezenkhimny origin; structurally functional polymorphism of separate elements within one version (e.g., the kollagenoblasta relating to fibroblasts, sokratitelny miofibroblasta, fibroklasta; the erythrophages relating to macrophages, haemo siderophages, necrophages, kollagenofag; various molecular types of collagen, etc.); high ductility (adaptogennost) of S. of t., expressed in proliferation and migration at the right time of the cells having a reserve from the low-differentiated cells and also in functional heterogeneity, i.e. complementarity and duplication of the same functions by different elements (functional switching, owing to performance by one elements different, sometimes opposite functions).

The listed properties C. of t. provide its main functions — basic and mechanical, trophic (metabolic), protective, reparative (plastic) and morphogenetic, the defining homeostasis of an organism and its adaptation to the changing external and internal conditions of life activity. In implementation of functions C. of t. the majority of its cellular and extracellular elements participates, and not summing of functions of these elements, but their close interaction resulting in new quality takes place. It, naturally, does not exclude the leading role of separate elements in implementation of each specific function.

Basic and mechanical function is shown that S. of t. is a framework of a body (bone), internals (stroma), muscles (a fascia, etc.), vessels (adventitia) and even separate cells (reticular fibers). Such mechanical characteristic of S. of t., as durability, is caused by preferential collagenic fibers and structural glycoproteins, elasticity — elastic fibers, viscosity and elasto-plastic properties — proteoglycans and glycoproteins, contractility — mio-fibroblasts.

Trophic (metabolic) function C. of t. is defined by the fact that, being a component of internal environment of an organism, it together with taking place in it circulatory and limf, capillaries provides other fabrics with nutrients. Vascular and fabric permeability, ion-exchange properties and filtering are caused generally by features of proteoglycans and glycoproteins, and the important regulating impact on these functions is exerted by the biological active agents cosecreted and deposited by mast cells, and also macrophages, lymphocytes and fibroblasts. Other substances of these cells influence metabolism of cells of S. of t., endothelium, epithelium and muscular tissue. Lipoblasts of S. of t actively participate in lipidic exchange., and in pigmental — pigmental. Data on participation of macrophages (histiocytes) of S. of t are obtained. in a water salt metabolism.

Protective (barrier) function C. of t. is implemented in creation of an outside mechanical barrier of an organism (skin), bodies (serous covers, capsules), groups of cells (stroma), and also in nonspecific protection (phagocytal activity of macrophages, fibroblasts), an immune response (macrophages, lymphocytes, plasmocytes), antineoplastic protection (lymphocytes, macrophages, proteoglycans). In the conditions of pathology protective function C. of t. it is shown by an inflammation, encapsulation of foreign bodys.

Reparative (plastic) function C. of t. consists in elimination of defects of fabric (healing of wounds, ulcers etc.), the organizations and revascularizations of blood clots and necroses, replaceable regeneration of parenchymatous bodies, and in all cases all cellular and intercellular elements participate in close interaction. Special value has the interaction of macrophages and fibroblasts, fibroblasts and collagenic fibers regulating the reparative growth of connecting fabric.

Morphogenetic function C. of t. it is most expressed in the embryonal and post-natal periods, and also at regeneration. According to Reddi (A. Reddi, 1976) and D. A. Lebedeva (1979), it is shown by influence of cells of S. of t. (lymphocytes, mast cells, fibroblasts), gliko-zaminoglikan and especially collagen of different types on a differentiation of epithelial and muscular tissue, on growth of vessels. Besides, S. of t. is, apparently, a source of the so-called position information providing very tectonics, i.e. their formation, specific to bodies and fabrics.

Thus, S. of t. it is necessary to carry to difficult fiziol. to the systems which are characterized by hierarchy in the organization and management, focus of functions, existence of information communication between a large number of diverse elements and their interaction on the basis of straight lines and feed-backs. Special importance is gained by a research of management processes and mechanisms of an autoregulyation in such system. Regulation of functions, metabolism and cellular structure of S. of t. it is carried out by the central regulatory systems (neurosomatic, neurovegetative, endocrine), humoral system of physiologically active agents (mediators), the interstitial regulatory system based on cooperative intercellular interaction, intracellular regulation. Kazh - yes I from higher systems control subordinate.

Nervous control is carried out in the usual reflex way though action a so-called axon reflexes is not excluded (see). An important role is played by the receptor opened by B. I. Lavrentyev (1946) dichotomizing vascular and fabric. In V. G. Yeliseyev's researches (1961), A. M. Chernukh, etc. (1975), I.P. Wheat (1978), BB. 3. Arentda (1980) numerous data on change of vascular and fabric permeability, cellular composition of blood and S. of t are obtained., metabolism of cells, immunobiol. S.'s reactivity of t., inflammatory reaction and growth of granulyatsionny fabric at irritation of various departments of a brain, section of nerves, excitement or blockade of a sympathetic or parasympathetic nervous system.

The facts about action are saved up for S. by t. hormones of a hypophysis, bark of adrenal glands, pancreas, thyroid, parathyroid and gonads. In particular, AKTG, glucocorticoids and hormones of a thyroid gland oppress proliferation of fibroblasts, detain development of granulyatsionny fabric (see), somatotropic hormone has opposite effect, testosterone stimulates synthesis of glikozamino-glycanes etc. On S. of t. vitamins, especially the redoxon regulating biosynthesis of collagen, and also microelements exert impact (The SI, Fe, Zn, etc.). By data A. M. The seamy side (1979), importance, especially at an inflammation, has the regulating role of humoral mediator systems — systems of a complement (see), kallikrein-kinin system (see Kinina), Hageman's factors (see. Hemorrhagic diathesis), numerous mediators of an inflammation, etc.

At the fabric and cellular levels the leading role is played by the interstitial regulatory system based on intercellular interactions and relationship between cells and intercellular components C. of t. Interaction of cells and other elements C. of t. under control of the central mechanisms provides regulation of number, qualitative structure and intensity of functions of each of cell populations, coordinates their activity and integrates all system C. of t. in a single whole, causing its adaptation at fiziol. shifts and patol. processes.

All cells of S. of t. are local korotkodistantny regulators of the microenvironment (a functional element, the residential district or the region). This role is carried out thanks to the available feed-back between cells of one look (intra population interaction), other cells of S. of t. (interpopulation interaction), parenchymatous cells, intercellular components and microcirculator bed.

Interaction between cells (cellular regulation) is carried out in several ways, one of to-rykh is interaction by means of soluble mediators (lymphokines, monokin — mediators of macrophages, fibrokin — mediators of fibroblasts, labrokin — mediators of mast cells). All mediators divide on circulating in blood (Hageman's factor, substances of system of a complement, kallikrein-kinin system, etc.) and local (derivatives arachidonic to - you, the substances emitted by mast cells, etc.), synthesized in insignificant quantities, and also into the specific, having special receptors on target cells, and nonspecific (prostaglandins, cyclic nucleotides, a lysozyme, fibronectin, acid hydrolases, neutral proteases, etc.). Besides, cells interact among themselves by direct intercellular contacts when the effector substance which is closely connected with a cell membrane «is directly shown» to a target cell; posredstvokhm insoluble, so-called firm, mediators (collagen, structural glycoproteins, proteoglycans), to-rye in addition to a structural role render the major information reguli-ruyushchee influence on cells of a parenchyma and S. of t., and also by means of decomposition products of cells and collagen (peptides, amino acids, RNA, DNA, nucleotides, phospholipids, etc.).

Owing to close interrelation of all elements C. of t. at impact on any of them of external or internal stimuluses, including pathogenic, inevitably there is a reaction chain therefore S. of t. reacts to an irritant as complete system. In case of slight attachments the chain reaction directed to adaptation leads to recovery of a homeostasis (see); at strong or frequent influences, at extensive damages the consecutive chain of regulatory mechanisms creates inflammatory, regenerator and fibrous processes. Breakdown of regulatory mechanisms at the different levels leads to disturbance or a perversion of the main functions C. of t., to permanent dystrophic processes, circulatory disturbance, hron. to an inflammation, the progressing sclerosis or not healing wounds.

Changes of connecting fabric at various pathological processes

At disturbance of numerous homeostatic functions C. of t. in it develop various patol. processes, among to-rykh the special place the mesenchymal proteinaceous dystrophy (see) which is characterized mukoidnsh by swelling, fibrinoid transformation and a hyalinosis borrows. In intercellular substance C. of t. there is an accumulation of proteins and polysaccharides in connection with increase in vascular permeability, swelling, and then destruction of fibrous structures and education in sites of disintegration of S. of t. fibrinoid — proteinaceous polisakharidnogo the kokhmpleks occluding fibrinogen/fibrin. Formation of fibrinoid creates conditions for formation of a hyalin. Possibly and perversion of synthesis of fibrous proteins S.'s cells of t., when instead of collagenic proteins are formed amyloid therefore the amyloidosis develops (see).

Disorder of exchange of glycoproteins leads t to S.'s sliming., to development of mucous dystrophy (see). Mesenchymal fatty dystrophy (see) — accumulation in S. of t. lipids, especially cholesterol — it is observed at lipidoses (see). At various diseases and patol. states in S. of t. many endogenous pigments collect: accumulation of hemosiderin conducts to the general or local hemosiderosis (see), to hemochromatosis (see), accumulation of porphyrines — to porphyrias (see), melanin — to a melanoderma (see the Melanosis, skin). Page of t. is surprised at disturbances of exchange of mineral substances, especially calcium that is the cornerstone of development of calcifications (see); at the same time both acid glikozaminoglikana, and elastic fibers C. of t become a matrix of loss of salts of calcium. In intercellular substance C. of t. salts uric to - you, napr can drop out, at gout (see).

Extreme expression of dystrophic changes of S. of t. its necrosis is (see). More often it has character coagulative, fibrinoid, is more rare than a kollikvatsionny necrosis. S.'s death t. comes after death of parenchymatous elements of bodies and fabrics.

As S. of t. and microcompasses - an even bed microcirculation, followed by the accruing hypoxia represent the uniform exchange and transport environment, disturbance of blood circulation, especially, conducts to a plasmorrhagia and hypostasis (see) S. t., and also to hemorrhages, from to-rykh diapedetic hemorrhages most often meet (see).

In edematization of S. of t. the large role is played by a lymphostasis (see); at long lymphogenous hypostasis of S. of t. subjected it gatsya to a sclerosis (see) as a result of increase at a hypoxia of collagen-producing function of fibroblasts. At acute ischemia of fabrics in connection with thrombosis or a vascular embolism after death of parenchymatous cells also elements C. of t are exposed to a necrosis.

Page of t. is directly involved in development of an inflammation (see), a cut is considered as vascular and mesenchymal reaction to damage (exudation of plasma in fabric, emigration of blood cells, formation of exudate and inflammatory infiltrate). Preferential localization of inflammatory reaction in S. of t. allows to speak about an interstitial inflammation, a cut can be exudative or productive. A specific place among forms of a productive inflammation is held by the granulomatosis (see Granulomatoses) which is result of coupled reaction of cells of system of mononuclear phagocytes (see), polymorphonuclear leukocytes, lymphocytes and S.'s fibroblasts of t. in response to a persistent irritant in an organism. Granulomas (see the Granuloma) in S. of t. are most frequent at acute inf. diseases (belly, sypny typhus) and chronic (tuberculosis, brucellosis, leprosy, etc.). In the outcome hron. inflammations the sclerosis develops, the amount of interstitial fabric increases; at the same time activation fibroblasts is mediated by system of mediators, first of all lymphokines (see Mediators of cellular immunity) and monokinam.

Page of t. and a microcirculator bed are the place of immune responses of hypersensitivity of the immediate and slowed-down type (see the Allergy), to-rye are morphologically shown in the form of an inflammation of this or that look.

Reparative regeneration of S. of t. at damage of fabrics comes down to education young, rich with vessels and undifferentiated hematogenous and gistiogenny cells of S. of t., the granulyatsionny fabric which received the name. Further this fabric ripens: among cells fibroblasts, sintezir prevailuyushchy collagen and acid glikozaminoglikana, fibers form, vessels are differentiated. Process comes to the end with coarse-fibered S.'s education with t. Process of reparative regeneration of S. of t. it can be perverted that is expressed in a delay of maturing of S. of t. or its excess education. It is observed, e.g., at keloids (see). To disturbances of reparative regeneration of S. of t. it is necessary to carry also its metaplasia in cartilaginous and bone fabrics that meets in postoperative hems (see the Hem), walls of large arteries at atherosclerosis (see) and arteritis (see), in the begun to live tuberculous focuses (see Tuberculosis).

The peculiar adaptive process connected with S.'s regeneration in t., it is possible to consider the organization (see the Organization in pathology), in process the cut occurs substitution by connecting fabric of sites of a necrosis and trombotichesky masses, encapsulation and a wound repair (see Wounds, wounds).

Patol. the processes developing in S. of t., reflect disturbance of the general (neurohumoral) and local (cellular) regulation of its homeostatic functions. Disturbance of local regulation leads to dissociation of cellular relationship in S. t., therefore there is a disintegration of components of S. of t. as basis of its pathology. The special place in S.'s pathology of t. occupy the diseases of system character connected with disturbances of an immunological homeostasis or disbolism. S.'s defeat t. at these diseases reflects insolvency of one or several of its functions: trophic, protective, reparative.

Systemic primary lesions of S. of t. the acquired character, connected preferential with disturbances of an immunogenesis, characterize group of diffusion diseases of S. of t., to-rye call also collagenic diseases (see). Enter into this group rheumatism (see), a system lupus erythematosus (see), a pseudorheumatism (see), Bekhterev's disease (see Bekhterev a disease), a system scleroderma (see), a nodular periarteritis (see the Periarteritis nodular), a dermatomyositis (see) and a polymiositis (see the Miositis), Shegren's syndrome (see Shegren a syndrome). Morfol. a basis of these diseases is the system progressing S.'s disorganization t. in the form of mucoid swelling, fibrinoid changes, cellular reactions, a sclerosis and a hyalinosis.

Systemic primary lesions of S. of t. inborn and hereditary character, the t connected with malformations S. and exchange disturbances, take place at nek-ry hereditary diseases (see), muko-polisakharidoza (see), a syndrome Mar fan (see Marfan a syndrome), an imperfect desmogenez of Rusakov (see Desmogenez imperfect).

Local primary disturbances of S. of t. as acquired, and inborn character are presented by big group of diseases and patol. states: a palmar fibromatosis (see. Dyupyuitrena contracture ), lyuksation of joints, keloid, achondroplasia, fibroelastosis of an endocardium, nonspecific aortoarteriit, or Takayasu's disease (cm. Takayasu syndrome ), temporal arteritis, or Horton's disease (see. Arteritis giant-cell ), etc.

Secondary defeats of S. of t. at diseases are various; it S.'s defeats t. (fibrosis and cirrhosis of bodies, a granulomatosis, an amyloidosis, etc.) at infections, a hypertension, atherosclerosis, dust pulmonary diseases, endocrine diseases, etc.



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B. I. Starostin, H. G. Hrushchov; V. V. Vinogradov, A. B. Shekhter (fiziol.), V. V. Serov (patol.), L. I. Slutsky (biochemical).

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