The dead skin cells there should shed in a process called desquamation, but it is slowed by a number of factors: hormone fluctuations, sun exposure, vitamin deficiencies and aging.
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This lasts several weeks. The desquamation process usually begins on the face and progresses downward on the body. After the desquamation, the skin will be left with a sunburned appearance.
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Certain eye tissues, including the conjunctiva and cornea, may undergo pathological desquamation in diseases such as dry eye syndrome. The anatomy of the human eye makes desquamation of the lens impossible.
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Sloughing of the epidermis and exposure of the dermal layer clinically characterize moist desquamation. Outside of medical therapy, when moist desquamation is seen in the setting of nuclear warfare, the condition is generally thought to be fatal.
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Desquamation (skin peeling) can occur with severe mercury poisoning acquired by handling elemental mercury.
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Christmas Eye typically presents with a unilateral, irregular desquamation of the cornea with a well-demarcated border. The defect stains brightly with fluorescein. In the very early stages the desquamation may be patchy before progressing to involve up to 80% of the corneal surface.
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This desquamation may be a method for the sea cucumber to rid itself of metabolic waste.
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The rash starts fading within 3–4 days, followed by the desquamation of the rash, which lasts several weeks to a month. If the case of scarlet fever is uncomplicated, recovery from the fever and clinical symptoms, other than the process of desquamation, occurs in 5–10 days.
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Proteolysis of corneodesmosomes is required for desquamation, the shedding of corneocytes from the outer layer of the epidermis. This indicates a role for KLK7 in maintaining skin homeostasis. Both KLK5 and KLK14, other skin-expressed proteases, also cleave corneodesmosomal proteins. KLK5 is able to undergo autoactivation, as well as activating KLK7 and KLK14, suggesting a KLK skin cascade is responsible for coordinating desquamation.
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Desquamation, commonly called skin peeling, is the shedding of the outermost membrane or layer of a tissue, such as the skin. The term is .
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In the movie Austin Powers in Goldmember, the titular villain eats flakes of his own skin that have already peeled off on their own (desquamation).
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The infection tends to self-resolve so long as the fungal growth does not exceed inflammatory response and desquamation rate is sufficient. If immune response is insufficient, however, infection may progress to chronic inflammation.
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Desquamation, the process of cell shedding from the surface of the stratum corneum, balances proliferating keratinocytes that form in the stratum basale. These cells migrate through the epidermis towards the surface in a journey that takes approximately fourteen days.
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Corneocytes are terminally differentiated keratinocytes and compose most if not all of the stratum corneum, the outermost part of the epidermis. They are regularly replaced through desquamation and renewal from lower epidermal layers, making them an essential part of the skin barrier property.
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Desquamation of dunite boulder Spalling is a common mechanism of rock weathering, and occurs at the surface of a rock when there are large shear stresses under the surface. This form of mechanical weathering can be caused by freezing and thawing, unloading, thermal expansion and contraction, or salt deposition.
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The cause is uncertain, but it is thought to be caused by accumulation of epithelial squames and proliferation of chromogenic (i.e., color-producing) microorganisms. There may be an increase in keratin production or a decrease in normal desquamation (shedding of surface epithelial cells). Many people with BHT are heavy smokers.
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The sebum in vernix is produced in utero by the sebaceous glands around the 20th week of gestation. Vernix appears primarily in full term infants, while premature and postmature births generally do not display any. Postdates desquamation (flakey skin in babies born >42 weeks) is thought to be due to loss of vernix.
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For hair infections, fungal invasion begins at the hair shaft. Symptoms manifest from inflammatory reactions due to the fungal antigens. The rapid turnover of desquamation, or skin peeling, due to inflammation limits dermatophytoses, as the fungi are pushed out of the skin. Dermatophytoses rarely cause serious illness, as the fungi infection tends to be limited to the superficial skin.
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The dry gangrene is a result of vasoconstriction induced by the ergotamine-ergocristine alkaloids of the fungus. It affects the more poorly vascularized distal structures, such as the fingers and toes. Symptoms include desquamation or peeling, weak peripheral pulses, loss of peripheral sensation, edema and ultimately the death and loss of affected tissues. Vasoconstriction is treated with vasodilators.
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Lympho-epithelial Kazal-type related inhibitor 2 (LEKTI-2) is a protein encoded by the SPINK9 gene in humans. LEKTI-2 is an inhibitor of KLK5, a serine protease expressed in the epidermis and responsible for coordinating skin homeostasis and desquamation. SPINK9 is a member of a gene family cluster located on chromosome 5q33.1, which includes SPINK5 and SPINK6.
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Tissue reactions have a threshold of irradiation under which they do not appear and above which they typically appear. Fractionation of dose, dose rate, the application of antioxidants and other factors may affect the precise threshold at which a tissue reaction occurs. Tissue reactions include skin reactions (epilation, erythema, moist desquamation), cataracts, circulatory disease, and other conditions.
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The CrB score on the day of clinical appraisal significantly correlated with the number 6f days of treatment needed for remission. These results were in keeping with the hypothesis that eosinophils cause desquamation of respiratory epithelial cells resulting in prolongation of asthmatic attacks. Observation of CrB seemed to be useful as a marker of duration of asthmatic attacks.
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As one of the precursor proteins of the cornified cell envelope, involucrin is markedly increased in inflammatory skin diseases such as psoriasis Lamellar ichthyosis involves a decrease in expression of involucrin. This decrease could contribute to the altered desquamation process seen in the disease, since the clinical improvement associated with retinoid treatment is accompanied by increased expression of involucrin.
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Desquamation and formation of the cornified envelope are both required for the maintenance of skin homeostasis. A failure to correctly regulate these processes leads to the development of skin disorders. Cells of the stratum corneum contain a dense network of keratin, a protein that helps keep the skin hydrated by preventing water evaporation. These cells can also absorb water, further aiding in hydration.
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Treatment is by reassurance, as the condition is benign, and then by correction of any predisposing factors. This may be cessation of smoking or cessation/substitution of implicated medications or mouthwashes. Generally direct measures to return the tongue to its normal appearance involve improving oral hygiene, especially scraping or brushing the tongue before sleep. This promotes desquamation of the hyperparakeratotic papillae.
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Acute radiodermatitis occurs when an "erythema dose" of ionizing radiation is given to the skin, after which visible erythema appears up to 24 hours after. Radiation dermatitis generally manifests within a few weeks after the start of radiotherapy. Acute radiodermatitis, while presenting as red patches, may sometimes also present with desquamation or blistering. Erythema may occur at a dose of 2 Gy radiation or greater.
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Those junctions disintegrate as corneocytes migrate toward the surface of the skin and result in desquamation. At the same time, as those loosened junctions encounter more hydration, they will expand and connect together, forming potential entry pores for microorganisms. The stratum corneum can absorb three times its weight in water but if its water content drops below 10% it no longer remains pliable and cracks.
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Alternative splicing results in multiple transcript variants encoding the same protein. KLK5 has been suggested to regulate cell shedding (desquamation) in conjunction with KLK7 and KLK14, given its ability to degrade proteins which form the extracellular component of cell junctions in the stratum corneum. It is proposed that KLK5 regulates this process since it is able to self-activate in addition to activating KLK7 and KLK14.
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Repeat episodes of mouth ulcers can be indicative of an immunodeficiency, signaling low levels of immunoglobulin in the oral mucous membranes. Chemotherapy, HIV, and mononucleosis are all causes of immunodeficiency/immunosuppression with which oral ulcers may become a common manifestation. Autoimmunity is also a cause of oral ulceration. Mucous membrane pemphigoid, an autoimmune reaction to the epithelial basement membrane, causes desquamation/ulceration of the oral mucosa.
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Seborrheic dermatitis is a skin disorder where inflammation and desquamation occurs in areas of the body with a high density of sebaceous glands, particularly the face and trunk. The dandruff form does not result in inflammation and is restricted to the scalp. Although 'M. sympodialis has been reported as an agent of seborrhoeic dermatitis and dandruff, other species including M. furfur and M. globosa are more commonly associated with the disorder.
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Corneodesmosin is a protein that in humans is encoded by the CDSN gene. This gene encodes a protein found in corneodesmosomes, which localize to human epidermis and other cornified squamous epithelia. During maturation of the cornified layers, the protein undergoes a series of cleavages, which are thought to be required for desquamation. The gene is located in the major histocompatibility complex (MHC) class I region on chromosome 6.
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Kallikreins are a subgroup of serine proteases, enzymes capable of cleaving peptide bonds in proteins. In humans, plasma kallikrein (KLKB1) has no known paralogue, while tissue kallikrein-related peptidases (KLKs) encode a family of fifteen closely related serine proteases. These genes are localised to chromosome 19q13, forming the largest contiguous cluster of proteases within the human genome. Kallikreins are responsible for the coordination of various physiological functions including blood pressure, semen liquefaction and skin desquamation.
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Chemotherapy-induced acral erythema is reddening, swelling, numbness and desquamation (skin sloughing or peeling) on palms of the hands and soles of the feet (and, occasionally, on the knees, elbows, and elsewhere) that can occur after chemotherapy in patients with cancer. Hand-foot syndrome is also rarely seen in sickle-cell disease. These skin changes usually are well demarcated. Acral erythema typically disappears within a few weeks after discontinuation of the offending drug.
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In the past, the disorder was nearly always fatal, whether due to dehydration, infection (sepsis), restricted breathing due to the plating, or other related causes. The most common cause of death was systemic infection, and sufferers rarely survived for more than a few days. However, improved neonatal intensive care and early treatment with oral retinoids, such as the drug Isotretinoin, may improve survival. Early oral retinoid therapy has been shown to soften scales and encourage desquamation.
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O. viverrini invades the bile ducts and, rarely, the gall bladder and pancreatic duct. Heavy infection can produce problems such as fibrosis in the liver, gall bladder and bile ducts. Pathological effects on the bile ducts including inflammation, epithelial desquamation, goblet cell metaplasia, epithelial and adenomatous hyperplasia and periductal fibrosis collectively promote cholangiocarcinoma. Though it is not immediately life-threatening, cancer develops after 30–40 years, and the ensuing death is rapid—within 3–6 months of diagnosis.
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A slowly oxidised plug of metallic uranium can sometimes resemble an onion subjected to desquamation. The main hazard however arises from the pyrophoric character of actinide metals which can spontaneously ignite when their specific area is high. This property, along with these elements inherent toxicity and (for some to a lesser extent) radioactivity, make them dangerous to handle in metallic form under air. Therefore, they are often handled under an inert atmosphere (nitrogen or argon) inside an anaerobic glovebox.
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Besides peripheral neuropathy (presenting as paresthesia or itching, burning or pain) and discoloration, swelling (edema) and desquamation may occur.Since mercury blocks the degradation pathway of catecholamines, epinephrine excess causes profuse sweating (diaphora), tachycardia, salivation and elevated blood pressure. Mercury is suggested to inactivate S-adenosyl-methionine, which is necessary for catecholamine catabolism by catechol-o-methyl transferase.Affected children may show red cheeks and nose, red (erythematous) lips, loss of hair, teeth, and nails, transient rashes, hypotonia and photophobia.
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When inhaled, virus will attach to glycoprotein receptors containing sialic acid on ciliated epithelial cells of the respiratory epithelium. The respiratory replication will result in loss of ciliary activity, mucus accumulation, necrosis and desquamation, causing respiratory distress, râles and asphyxia. Local virus replication will result in viremia, spreading the infection into other tissues and organs. Other respiratory diseases of chickens (Mycoplasma gallisepticum, avian infectious laryngotracheitis (Gallid alphaherpesvirus 1), Newcastle disease (avian paramyxovirus 1), Avian metapneumovirus infection may be confused clinically to infectious bronchitis.
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Progesterone has an anti-proliferative effect on mucosa and accelerates desquamation. It causes a menstrual-like cycle in the vocal fold epithelium and a drying out of the mucosa with a reduction in secretions of the glandular epithelium. Progesterone has a diuretic effect and decreases capillary permeability, thus trapping the extracellular fluid out of the capillaries and causing tissue congestion. Testosterone, an androgen secreted by the testes, will cause changes in the cartilages and musculature of the larynx for males during puberty.
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Exfoliating slabs of granite, on Half Dome in Yosemite National Park, USA Exfoliating granite is a granite undergoing exfoliation, or onion skin weathering (desquamation). The external delaminated layers of granite are gradually produced by the cyclic variations of temperature at the surface of the rock in a process also called spalling. Frost and ice expansion in the joints during the winter accelerate the alteration process while the most unstable loosen external layers are removed by gravity assisted by runoff water.
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Pathological effects on the bile ducts include inflammation, epithelial desquamation, goblet-cell metaplasia, epithelial and adenomatous hyperplasia, and periductal fibrosis. The collective effects in addition to specific parasite secretion and the host's immune reactions account for the development of cholangiocarcinoma. The infection is not immediately life-threatening; cancer develops after 30–40 years, but death occurs very fast, within 3–6 months of diagnosis. Medical care and loss of wages caused by O. viverrini in Laos and in Thailand costs about million annually, primarily in northeast Thailand.
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The uterovaginal canal or genital canal, forms in the third month of the development of the urogenital system. The lower part of the canal is blocked off by a plate of tissue, the vaginal plate. This tissue develops and lengthens during the third to fifth months and the lower part of the vaginal canal is formed by a process of desquamation or cell shedding. The end of the vaginal canal is blocked off by an endodermal membrane which separates the opening from the vestibule.
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Skin plaques start to appear as reddened areas of inflammation, thus often leading to the mistaken diagnosis of Atopic Dermatitis. Following inflammation, the red areas start keratinization, eventually forming the definitive plaques that appear brownish, dry and scaled. Following quite a precise temporal pattern of evolution, the keratinized plaques last for weeks or months, eventually leading to periods of desquamation that leads to the uncovering of "normal" skin. Then, a new cycle usually begins, leaving a variable number of days of delay between the cycles.
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These disulfide bonds force the molecule into a rigid conformation that enables the protein to interact with a target protease via an extended beta-sheet. All domains (excepting 1, 2 and 15) contain an arginine at P1, indicating trypsin-like proteases are the likely targets. In the epidermis, LEKTI is implicated in the regulation of desquamation via its ability to selectively inhibit KLK5, KLK7 and KLK14. Recombinant full length LEKTI inhibits the exogenous serine proteases trypsin, plasmin, subtilisin A, cathepsin G and human neutrophil elastase.
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The face, however, is usually flushed, most prominently in the cheeks, with a ring of paleness around the mouth. After the rash spreads, it becomes more pronounced in creases in the skin, such as the skin folds in the inguinal and axillary regions of the body. Also in those areas, Pastia's Lines may appear: petechiae arranged in a linear pattern. Within 1 week of onset, the rash begins to fade followed by a longer process of desquamation, or shedding of the outer layer of skin.
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The first reported case of seaweed dermatitis was from 1958 in Hawaii on Oahu island. About 125 people who had been swimming in the sea get suffered from symptoms like itching, burning, blisters, rash and desquamation. The causative substance of this seaweed dermatitis was not known till 1968 when people in Okinawa, Japan, suffered from the same symptoms as the people in Hawaii. After researchers took samples in 1973 from Lyngbya majuscula they found out that this was the causative agent of the dermatitis.
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Netherton syndrome is an autosomal recessive disorder associated with mutations in the SPINK5 gene, which encodes the serine protease inhibitor lympho-epithelial Kazal-type-related inhibitor (LEKTI). These mutations result in a dysfunctional protein that has a reduced capacity to inhibit serine proteases expressed in the skin. Potential endogenous targets of LEKTI include KLK5, KLK7 and KLK14. These enzymes are involved in various aspects of epidermal remodelling, including desquamation, PAR-2 activation and degradation of lipid hydrolases, suggesting a potential mechanism for the development of atopic manifestations characteristic of Netherton syndrome.
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Moist desquamation is a description of the clinical pattern seen as a consequence of radiation exposure where the skin thins and then begins to weep because of loss of integrity of the epithelial barrier and decreased oncotic pressure. Typically this occurs at doses of 15–20 Gray, far higher than any diagnostic scan and more typical of levels seen in radiotherapy or deployment of nuclear armament. Historically, this was a common phenomenon in Hiroshima and Nagasaki during World War II with the atomic bomb attacks from the United States.Huda, W. Review of Radiologic Physics.
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The course of infection varies between each case, and may be determined by several factors including: "the anatomic location, the degree of skin moisture, the dynamics of skin growth and desquamation, the speed and extent of the inflammatory response, and the infecting species." The ring shape of dermatophyte lesions result from outward growth of the fungi. The fungi spread in a centrifugal pattern in the stratum corneum, which is the outermost keratinized layer of the skin. For nail infections, the growth initiates through the lateral or superficial nail plates, then continues throughout the nail.
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Similar to KLKB1, three tissue kallikreins KLK1, KLK2 and KLK12 also participate in regulation of blood pressure via the activation of bradykinin. KLK2, KLK3, KLK4, KLK5 and KLK14 are expressed in the prostate and are thought to be responsible for regulating semen liquefaction through hydrolysis of seminogelin. Desquamation of the skin is likely controlled by KLK5, KLK7 and KLK14, which are expressed in the outermost layer of the epidermis and cleave cellular adhesion proteins. Additionally, KLK6 and KLK8 are associated with neuronal plasticity in the central nervous system.
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Prognosis is generally poor. If a patient survives, recovery may be prompt and complete, or protracted with sequelae, such as orchitis, hepatitis, uveitis, parotitis, desquamation or alopecia. Importantly, MARV is known to be able to persist in some survivors and to either reactivate and cause a secondary bout of MVD or to be transmitted via sperm, causing secondary cases of infection and disease. Of the 252 people who contracted Marburg during the 2004–2005 outbreak of a particularly virulent serotype in Angola, 227 died, for a case fatality rate of 90%.
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Transient increased bowel frequency, diarrhoea, constipation or minor rectal bleeding, may also occur. Acute and subacute side effects usually resolve over a matter of days or a few weeks. In the case of permanent (seed) brachytherapy for prostate cancer, there is a small chance that some seeds may migrate out of the treatment region into the bladder or urethra and be passed in the urine. Brachytherapy for skin cancer may result in a shedding of the outer layers of skin (desquamation) around the area of treatment in the weeks following therapy, which typically heals in 5–8 weeks.
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In rabbits receiving 250 mg/kg of technical-grade ethion for 21 days, the dermal exposure lead to increased cases of erythema and desquamation. It also lead to inhibition of brain acetylcholinesterase at 1 mg/kg/day and the NOAEL was determined to be 0.8 mg/kg/day. In guinea pigs, ethion als lead to slight erythema, that cleared in 48 hours, and it was determined that the compound was not a skin sensitizer. In a study determining the LD50 of ethion, 80 male and 60 female adult rats were dermally exposed to ethion dissolved in xylene.
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The body is divided into four sections (head (H) (10% of a person's skin); arms (A) (20%); trunk (T) (30%); legs (L) (40%)). Each of these areas is scored by itself, and then the four scores are combined into the final PASI. For each section, the percent of area of skin involved, is estimated and then transformed into a grade from 0 to 6: Within each area, the severity is estimated by three clinical signs: erythema (redness), induration (thickness) and desquamation (scaling). Severity parameters are measured on a scale of 0 to 4, from none to maximum.
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Chlorhexidine is rarely associated with other issues like overgrowth of enterobacteria in persons with leukemia, desquamation and irritation of oral mucosa, salivary gland pain and swelling, and hypersensitivity reactions including anaphylaxis. A randomized clinical trial conducted in Rabat university in Morocco found better results in plaque inhibition when chlorohexidine with alcohol base 0.12% was used, when compared to an alcohol free 0.1% chlorhexidine mouthrinse. Chlorhexidine mouthrinses increase staining score of teeth over a period of time. Hexetidine also has anti-plaque, analgesic, astringent and anti-malodor properties but is considered as an inferior alternative to Chlorhexidine.
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Corneocytes are keratinocytes in their last stage of differentiation. Keratinocytes in the stratum basale of the epidermis will multiply through cell division and migrate toward the skin surface. During that migration keratinocytes will undergo multiple stages of differentiation to finally become corneocytes once they reach the stratum corneum. As corneocytes are continually eliminated through desquamation or through rubbing, skin washing or detergents they are also continually formed through keratinocyte differentiation. Corneocytes, also referred to as squames (from Latin squama, meaning a “thin flake” or “scales”) are terminally differentiated, anucleated cells of keratinocyte lineage that constitute the majority of stratum corneum, the outermost layer of the epidermis.
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Common symptoms of mercury poisoning include peripheral neuropathy, presenting as paresthesia or itching, burning, pain, or even a sensation that resembles small insects crawling on or under the skin (formication); skin discoloration (pink cheeks, fingertips and toes); swelling; and desquamation (shedding or peeling of skin). Mercury irreversibly inhibits selenium-dependent enzymes (see below) and may also inactivate S-adenosyl-methionine, which is necessary for catecholamine catabolism by catechol-O-methyl transferase. Due to the body's inability to degrade catecholamines (e.g. epinephrine), a person suffering from mercury poisoning may experience profuse sweating, tachycardia (persistently faster-than-normal heart beat), increased salivation, and hypertension (high blood pressure).
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Pastia's sign, Pastia lines, or Thompson's sign is a clinical sign in which pink or red lines formed of confluent petechiae are found in skin creases, particularly the crease in the antecubital fossa, the soft depression on the inside of the arm; the folding crease divides this fossa where the forearm meets the (upper) arm (the biceps, triceps, humerus section of the upper extremity); the inside of the elbow (the inside flexor depression (fossa) of the elbow. It occurs in patients with scarlet fever prior to the appearance of the rash and persists as pigmented lines after desquamation. The sign is named after the Romanian physician Constantin Chessec Pastia (1883–1926).
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In some families autosomal dominant inheritance and point mutations in the TGFBI gene encoding keratoepithelin have been identified, but according to the International Committee for Classification of Corneal Diseases (IC3D) the available data still does not merit a confident inclusion of EBMD in the group of corneal dystrophies. In view of this, the more accurate designation of the disease is possibly not dystrophy but corneal degeneration. The main pathological feature of the disease is thickened, multilaminar and disfigured basement membrane of corneal epithelium. The change in the structure affects the epithelium, some cells of which may become entrapped in the rugged membrane and fail to migrate to the surface where they should undergo desquamation.
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Trichophyton verrucosum is thought to have evolved from a soil-dwelling ancestor that migrated to its contemporary cattle host, losing many features that it previously required for survival in soil habitats through genetic drift, such as vitamin prototrophy, urease activity, and the ability to perforate hair. Infection is characterized by 10–50 mm patches of hair loss, desquamation, and formation of thick crusts. Trichophyton verrucosum is endemic in cattle, and almost exclusively the fungus that is isolated from cattle with ringworm, with younger cattle being more prone to infection due to their skin having higher pH, and having weaker immune systems. Infection in cattle peaks in fall and winter due to the overcrowded, cramped facilities of cattle-housing facilities.
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As a stratified squamous epithelium, the epidermis is maintained by cell division within the stratum basale. Differentiating cells delaminate from the basement membrane and are displaced outward through the epidermal layers, undergoing multiple stages of differentiation until, in the stratum corneum, losing their nucleus and fusing to squamous sheets, which are eventually shed from the surface (desquamation). Differentiated keratinocytes secrete keratin proteins, which contribute to the formation of an extracellular matrix that is an integral part of the skin barrier function. In normal skin, the rate of keratinocyte production equals the rate of loss, taking about two weeks for a cell to journey from the stratum basale to the top of the stratum granulosum, and an additional four weeks to cross the stratum corneum.
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High-frequency treatment uses low-current high-frequency alternating currents, delivered via a glass electrode.Jeanine Connor, Sheila Godfrey, Gil Milsom, BTEC National Beauty Therapy Sciences, Publisher Heinemann, 2004, , , 381 pages (page 197) Because the high frequency current converts some of the oxygen in the air into ozone, the treatment has a germicidal action, and is also drying and warming.Susan Cressy, The beauty therapy fact file, Edition 4, Publisher Heinemann, 2004, , , Length 469 pages (page 153) Consequently, the treatment is used to aid healing and also to help desquamation (the skin's natural exfoliation) and stimulate sweat and sebaceous glands. At up to 250,000 Hz frequency, the hollow glass electrode behaves like a glow discharge tube and is sometime called a "violet ray" or "violet wand" (though the colour depends on the gas in the glass).
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Cecil J. Doyle and six other ships picked up the remaining survivors. After the rescue, Marks' plane was sunk by Cecil J. Doyle as it could not be recovered. Many of the survivors were injured, and all suffered from lack of food and water (leading to dehydration and hypernatremia; some found rations, such as Spam and crackers, among the debris of the Indianapolis), exposure to the elements (dehydration from the hot sun during the day and hypothermia at night, as well as severe desquamation due to continued exposure to salt water and bunker oil), and shark attacks, while some killed themselves or other survivors in various states of delirium and hallucinations.In Harm's Way: The Sinking of the USS Indianapolis and the Extraordinary Story of Its Survivors Only 316 of the nearly 900 men set adrift after the sinking survived.
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After fat (lipid) accumulation and when stimulated by inflammation, endothelial cells become activated, which is characterized by the expression of molecules such as E-selectin, VCAM-1 and ICAM-1, which stimulate the adhesion of immune cells. Additionally, transcription factors, which are substances which act to increase the production of proteins within cells, become activated; specifically AP-1 and NF-κB, leading to increased expression of cytokines such as IL-1, TNFα and IFNγ, which promotes inflammation. This state of endothelial cells promotes accumulation of lipids and lipoproteins in the intima, leading to atherosclerosis, and the subsequent recruitment of white blood cells and platelets, as well as proliferation of smooth muscle cells, leading to the formation of a fatty streak. The lesions formed in the intima, and persistent inflammation lead to desquamation of endothelium, which disrupts the endothelial barrier, leading to injury and consequent dysfunction.
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