Sangele si elementele figurate

Difuzia (miscarea aleatorie a moleculelor unei substante din zonele cu concentratie mare
in zonele cu concentratie mica) nu este suficient de rapida pentru a asigura necesitatile
metabolice ale celulelor, in cazul unor distante mari (de exemplu o distanta de cateva
celule). De aceea organismele multicelulare au dezvoltat alte mecanisme pentru a
transporta rapid molecule pe distante lungi, intre celule interne si suprafata corpului si
intre diversele tesuturi si organe ale corpului. In lumea animala acest rol il are sistemul
circulator, alcatuit din sange, sistemul vascular (sistemul de vase interconectate prin care
circula sangele) si inima (pompa care determina curgerea sangelui). Impreuna, inima si
vasele sangvine formeaza sistemul cardiovascular.

Sangele
Sangele este constituit dintr-o componenta lichida, plasma sangvina si o componenta
solida, reprezentata de elementele figurate. Sangele indeplineste doua functii majore:
transportul in organism al: oxigenului si dioxidului de carbon, moleculelor nutritive, ioni
(Na+, Ca2+, HCO3-, etc), produsilor de excretie (uree, bilirubina, etc), hormoni si
apararea organismului, proces in care sunt implicate toate celulele albe ale sangelui.

Plasma sangvina contine apa (in proportie de peste 90%) in care sunt dizolvate substante
anorganice (in special ioni) si substante organice (proteine, substante nutritive, produsi de
metabolism, hormoni, etc). Plasma sangvina din care au fost indepartate proteinele de
coagulare reprezinta serul. Elementele figurate se pot clasifica in: celule rosii sau
hematii/eritrocite, celule albe (leucocite) si plachete sangvine sau trombocite.

Hematiile
Sunt cele mai numeroase elemente figurate, in jur de 4.8 x 106/mm3 la femei si 5.5 x
106/mm3 la barbati. Aceste valori pot varia in functie de factori precum starea de
sanatate, varsta, altitudine (peruvienii care traiesc la altitudini de peste 5.400 m pot avea
pana la 8.3 x 106 hematii/mm3. Sunt celule anucleate, cu forma de disc biconcav. RBC
se dezvolta in hematopoieza din celule progenitoare eritroide. Pe parcursul procesului de
maturare, celulele produc hemoglobina pana ce aceasta ajunge sa reprezite 90% din
greutatea uscata a celulei. Celulele se matureaza in apropierea unui macrofag care va
ingera nucleul eritrocitului. Eritrocitele mature nu se divid (sunt celule diferentiate
terminal). Traiesc aproximativ 120 zile, dupa care sunt distruse de celule fagocitare din
ficat si splina. In fiecare secunda, in organismul uman sanatos, mor aproximativ
3.000.000 hematii. Majoritatea fierului din structura hemoglobinei este reciclat iar
gruparea hem a hemoglobinei este degradata si formeaza pigmentii biliari (bilirubina,
biliverdina). Celulele rosii sunt responsabile cu transportul oxigenului si dioxidului de
carbon in organism. Transportul oxigenului: molecula de hemoglobina este constituita
din 4 polipeptide (doua lanturi alfa si doua lanturi beta) fiecare dintre acestea fiind atasata
la o grupare prostetica, denumita grupare hem. Fiecare grupare hem contine un atom de
fier care va lega o molecula de oxigen si se va forma oxihemoglobina. Reactia este
reversibila.

In conditii de temperatura scazuta, pH ridicat si presiune crescuta a oxigenului,

conditii care se regasesc in capilarele din plamani se formeaza oxihemoglobina. Sangele
care transporta oxigenul (sangele arterial) are o culoare rosu deschis, prezentei datorita
oxihemoglobinei. La nivelul tesuturilor, temperatura creste, pH scade, iar presiunea
oxigenului este scazuta si in aceste conditii, hemoglobina elibereaza oxigenul si leaga
CO2. Din acest motiv, sangele venos are o culoare rosu inchis. Transportul CO2: dioxidul
de carbon se combina cu apa si formeaza acidul carbonic care disociaza in protoni si
anioni bicaronat. 95% din CO2 generat in tesuturi este transportat de hematii. Gazul
patrunde si iese din celule probabil prin difuzie prin canale din membrana plasmatica. In
interiorul celulei aproximativ 50% din cantitatea de CO2 se leaga la hemoglobina (la alt
situs decat cel de legare al oxigenului), iar restul este convertit in ioni bicarbonat care ies
din celula si protoni (H+) care se leaga de partea proteica a hemoglobinei (in acest fel pH
nu este modificat). Doar 5% din cantitatea de CO2 din tesuturi este dizolvat si transportat
direct in plasma. Scaderea numarului de hematii sub limita normala poarta denumirea de
anemie. Anemia poate reprezenta insa si o scadere a cantitatii de hemoglobina din
hematii. Cel mai adesea, principala cauza a anemiei o reprezinta un aport alimentar de
fier insuficient. Cresterea numarului de celule rosii peste valoarea normala poarta
denumirea de policitemie.

Leucocitele (celulele albe)

Sunt mult mai putin numeroase decat hematiile (4000-8000 /mm3). Sunt celule nucleate
care participa la apararea imuna a organismului. In functie de prezenta sau absenta
granulatiilor din citoplasma se clasifica in celule fara granulatii (limfocite si monocite) si
granulocite (celule cu granulatii): neutrofile, eozinofile si bazofile.

Limfocite
Toate limfocitele sunt produse in maduva osoasa (un organ limfoid primar). Daca devin
imunocompetente in maduva osoasa se numesc limfocite B (sintetizeaza anticorpi si
limfokine) iar daca devin imunocompetente in timus (un alt organ limfoid primar), se
numesc limfocite T (sintetizeaza doar limfokine). Exista mai multe tipuri de limfocite T,
cele mai comune fiind:

 limfocitele T inflamatorii care recruteaza macrofage si neutrofile la situsul unei

infectii sau al unei leziuni tisulare;
 limfocite T citotoxica (CTL) care ucid celule infectate cu virusuri si (probabil)
celule tumorale
 celule T helper - stimuleaza producerea de anticorpi de catre limfocitele B.

Monocite
Monocitele circula prin sangele periferic inainte de a emigra in tesuturi unde se
transforma in macrofage. In functie de organul in care sunt localizate au denumiri
specifice. Astfel macrofagele din ficat se numesc celule Kupfer, in creier se numesc
celule microgliale, in os - osteoclaste, etc. Macrofagele sunt celule mari, fagocitare care
inglobeaza materiale straine organismului sau celule si fragmente de celule ale
organismului.

Neutrofile
Neutrofilele sunt elemente sangvine care raspund la semnale chemotactice si parasesc
capilarele printr-un proces complex care implica marginatia celulelor (apropierea de
endoteliul vaselor sangvine), atasarea la peretele vasului si iesirea din capilar prin spatiul
dintre celulele endoteliale (proces denumit extravazare sau diapedeza). Migrarea este
determinata de mai multi factori: substante produse de microorganisme, semnale emise
de celule participante la procesul inflamator, etc. De exemplu, interleukina 1 (IL-1) este
eliberata de macrofage in caz de infectii sau leziuni tisulare; histamina este produsa de
bazofilele circulante, celule mastocite si plachete sangvine si are ca efect dilatarea
capilarelor si a venelor. Neutrofilele sunt cele mai abundente celule albe. La nivelul
tesuturilor infectate, neutrofilele anihileaza organismele invadatoare (ex. bacterii) si apoi
le ingera prin fagocitoza. Acest proces are loc in permanenta chiar si la persoanele
sanatoase. Neutofilele tin sub control populatiile de bacterii comensale existente in mod
normal in organismul uman in colon, cavitatea bucala sau la nivelul gatului. In cazuri
patologice, cand numarul de neutrofile scade (radiatii, chemoterapie, stress), aceste
bacterii scapa de sub control, prolifereaza excesiv si apar infectiile oportuniste.

Eozinofile
Numarul de eozinofile este in mod normal cuprins intre 0 si 450/mm3. Numarul lor creste
in anumite boli, in special in cazul parazitozelor, mai ales in cazul parazitilor mari.
Granulele eozinofilelor contin substante citotoxice, care sunt eliberate asupra parazitului.
Printre substantele din granule se numara proteina bazica majora (MBP - major basic
protein), proteine cationice, peroxidaza, arilsulfataza B, fosfolipaza D si histaminaza.
Acest amestec este capabil sa distruga membranele parazitului.

Bazofile
Bazofilele sunt celule nefagocitare care, atunci cand sunt activate elibereaza numerosi
compusi din granulele bazofile din citoplasma lor. Joaca un rol major in raspunsurile
alergice, in special in cazul reactiilor hipersenzitive de tip I. Bazofilele sunt implicate in
raspunsul anafilactic. Anafilaxia este o reactie de hipersensibilitate specifica, care apare
la a doua expunere la acelesi antigen. Forma cea mai grava este socul anafilactic. O buna
definitie clinica a reactiei anafilactice tine cont de prezenta a doua manifestari severe:
dificultatea respiratorie (prin edem laringian sau criza de astm) si hipotensiunea. Numarul
bazofilelor creste si in timpul infectiilor. Granulele contin o serie de mediatori: histamina,
serotonina, prostaglandine si leukotriene, cu rol de a creste fluxul sangvin in zona lezata.

Plachete sangvine
Plachetele sunt fragmente de celule produse din megacariocite si sunt implicate in
procesul de coagulare. In cazul lezarii unui vas de sange, plachetele sangvine se dispun
intr-o retea de fibrina insolubila formand cheagul sangvin. In mod normal sunt in numar
de 150.000-350.000 / mm3. Numarul lor este reglat prin mecanisme homeostatice
(feedback negativ). Atunci cand numarul plachetelor scade sub 50.000 apar probleme de
coagulare

Blood and figurative elements

 Diffusion (random motion of molecules of a substance in areas with high
concentration in areas with low concentrations) is not fast enough to ensure the metabolic
needs of cells, in case of large distances (eg a distance of several cells). Therefore
multicellular organisms have developed other mechanisms to transport molecules over
long distances quickly, between internal and surface cells of the body and between
various tissues and organs of the body. In the animal world this role he has circulatory
system, consisting of blood, vascular system (the system of interconnected vessels by
circulating blood) and heart (the pump determine blood flow). Together, heart and blood
vessels form the cardiovascular system.

Blood
Blood consists of a liquid component, blood plasma and a solid component, represented
by figurative elements. Blood fulfills two major functions: transportation of the body:
oxygen and carbon dioxide molecules, nutrients, ions (Na +, Ca2 +, HCO3-, etc.)
produced by excretion (urea, bilirubin, etc.), hormones and defend the body, a process in
involving all white blood cells

Blood plasma contains water (at a rate of over 90%) that are dissolved inorganic
substances (especially ions) and organic substances (proteins, nutrients, metabolic
byproducts, hormones, etc.). Blood plasma from which clotting proteins have been
removed is serum. Figurative elements may be classified as follows: red blood cells or
red / red blood cells, white blood cells (WBC) and platelets in blood or platelets.

Red blood cells

Figurative elements are the most numerous, about 4.8 x 106/mm3 to 5.5 x
106/mm3 to women and men. These values may vary depending on factors such as health
status, age, altitude (peruvienii living at altitudes above 5400 m can be up to 8.3 x 106
hematii/mm3. They are anucleate cells with biconcave disc shape. RBC grow in
haematopoiesis from the erythroid progenitor cells. In the process of maturation, the cells
produce hemoglobin until it reaches its reprezite 90% of cell dry weight. matureaza cells
are near a macrophage will ingest eritrocitului nucleus. erythrocytes couples do not
divide (are terminal differentiated cells). I live about 120 days after they are destroyed by
phagocytic cells of liver and spleen. In every second, in the human body healthy red
blood cells die around 3,000,000. Most of the iron in hemoglobin is recycled and the
group structure of hemoglobin hem is degraded and form bile pigments (bilirubin,
biliverdina). red cells are responsible for the transport of oxygen and carbon dioxide in
the body. oxygen transport: hemoglobin molecule consists of 4 polypeptides (two alpha
chains and two beta chains) each of which is prostetica attached to a group, called
assembly hem. Each group contains one atom of iron hem to connect one molecule of
oxygen and will form oxihemoglobina. The reaction is reversible.

    In conditions of low temperature, high pH and high oxygen pressure, conditions
that are found in capillaries in the lungs are formed oxihemoglobina. The blood that
carries oxygen (arterial blood) has a bright red color, owing oxihemoglobinei. In tissues,
the temperature increases, pH decreases and the oxygen pressure is low in these
conditions, the hemoglobin releases oxygen and CO2 connects. Therefore, venous blood
is dark red. Transport CO2: carbon dioxide combines with water and form carbonic acid
which dissociates into protons and anions bicaronat. 95% of CO2 generated in the tissues
is carried by red blood cells. The gas enters and exits the cell probably by diffusion
through plasma membrane channels. Inside the cell, approximately 50% of CO2 binds to
hemoglobin (in other than the binding site on oxygen) and the remainder is converted to
bicarbonate ions leaving the cell and protons (H +) which is tied to the protein
hemoglobin (In this way pH is not changed). Only 5% of CO2 in the tissues is dissolved
and transported directly into the plasma. The drop below the normal number of red blood
cells called anemia. And anemia may be but a drop in the amount of hemoglobin in red
blood cells. Most often, the main cause of anemia is an inadequate intake of dietary iron.
Increasing the number of red blood cells than normal value is called the polycythaemia

Leukocytes (white cells)

Are much less numerous than red blood cells (4000-8000 / mm3). Are nucleated cells
that participate in immune defense of the body. Depending on the presence or absence of
granulations in the cytoplasm of cells are classified without granulations (lymphocytes
and monocytes) and granulocytes (cells with grain): neutrophils, eosinophils and
basophils.

Lymphocytes

All lymphocytes are produced in the bone (a primary lymphoid organ). If you are
immunocompetent lymphocytes in the bone marrow are called B (synthesize antibodies
and limfokine) and if they become immunocompetent in thymus (another primary
lymphoid organ), are called T lymphocytes (synthesize only limfokine). There are several
types of T lymphocytes, the most common being:

• inflammatory T cells and macrophages recruiting neutrophils to the site of an infection

or tissue damage;

• cytotoxic T lymphocyte (CTL) that kill cells infected with viruses and (probably) tumor
cells

• T-helper cells - stimulates production of antibodies by B lymphocytes

Monocytes

Monocytes circulating in peripheral blood before emigrating in tissues where they

transform into macrophages. Depending on the organ in which they are located have
specific names. Thus liver macrophages are called Kupfer cells in the brain are called
microgliale cells in bone - osteoclast, etc.. Macrophages are large cells, which includes
materials phagocytic cells and foreign body or fragments of cells in the body.
Neutrophil

Neutrophils are blood components that respond to chemotactic signals and leave the
capillaries by a process which involves marginatia cells (blood vessels near the
endothelium), attach to the vessel wall and exit through the space between the capillary
endothelial cells (a process called extravasation or diapedeza). Migration is determined
by several factors: substance produced by microorganisms, cell signals involved in
inflammation, etc.. For example, interleukin 1 (IL-1) is released by macrophages in case
of infection or tissue damage, histamine is produced by circulating basophils, mastocite
cells and blood platelets and results in dilated capillaries and veins. Neutrophils are the
most abundant white cells. In infected tissues, neutrophils annihilate the invading
organisms (eg bacteria) and then ingest them by phagocytosis. This process takes place
permanently even healthy persons. Neutofilele keep control existing populations of
commensal bacteria normally in the human body in the colon, oral cavity or neck. In
pathological cases, when the number of neutrophils decreases (radiation, chemotherapy,
stress), these bacteria out of control, proliferating excessive and opportunistic infections
occur.
Eosinophils
Eosinophils is usually between 0 and 450/mm3. Their number increases in
certain diseases, especially if parazitozelor, especially if large parasites. Eosinophil
granules contain cytotoxic substances, which are issued on the parasite. Among the
substances in grains include major basic protein (MBP - major basic protein), cationic
protein, peroxidase, arilsulfataza B, phospholipase D and histaminaza. This mixture is
able to destroy the parasite membranes.
Basophils

Nefagocitare basophils are cells which are activated when issued numerous compounds
in their cytoplasm granules of basophils. Play a major role in allergic answers, especially
in the case of type I hypersensitive reactions basophils are involved in the anaphylactic
response. Anaphylaxis is a specific hypersensitivity reaction, which occurs at the second
exposure to antigen acelesi. Most severe form is anaphylactic shock. A good clinical
definition of anaphylactic reaction you account for the presence of two severe events:
respiratory difficulty (with laryngeal edema or asthma attack) and hypotension. Basophils
increase in number during infection. The granules contain a number of mediators:
histamine, serotonin, prostaglandin and leukotriene, the role of increased blood flow to
the injured.
Blood platelets
Platelets are cell fragments produced from megacariocite and are involved in coagulation.
If damage to a blood vessel, blood platelets to have a network of insoluble fibrin blood
clot forming. Normally they are in number of 150.000-350.000 / mm3. Their number is
regulated by homeostatic mechanisms (negative feedback). When platelets fall below
50,000 coagulation problems
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