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Under physiological stresses or pathological stimuli (“ injury ”), cells can undergo adaptation to achieve a new steady state that would be compatible with their viability in the new environment. If the injury is too severe (“irreversible injury ”), the affected cells die. When cells are injured , one of two patterns will generally result: reversible cell injury leading to adaptation of the cells and tissue, or irreversible cell injury leading to cell death and tissue damage. When cells adapt to injury , their adaptive changes can be atrophy, hypertrophy, hyperplasia, or metaplasia.