Group three

Lecturer: Mr. Ngam Leslie

School: MPHIH
Topic: Fate and destruction of Erythrocytes

Group members: KONGFON AMOS W

MANGWI COLLETTE
NKEKEKANG VERA N
YENGO RUPHINE SHIE
JENELLE NKWENTI
KEN LARYNCE
CLOTILD LAISINLA
WALTERS NGU

Introduction

The first person to describe erythrocytes was the young Dutch biologist Jan
Swammerdam who had used her early microscope to study the blood of a frog in
1658.
Erythrocytes commonly known as red blood cells are by far the most
common formed element. That is a single drop of blood contains millions of
erythrocytes and thousands of leukocytes in which they mature and develop in a
proses erythropoiesis. Specifically males have about 5.4million red blood cells
and females have approximately 4.8million. Infact, red blood cells are estimated
to make up about 25% of total cells in the body with a mean diameter with about
7-8 micro meters. The primary functions of erythrocytes are to pick up inhaled
oxygen from the lungs and transport it to the body tissues and also to pick up
some carbon dioxide in tissues and transport it to the lungs as exhalation.
Although leukocytes leave the blood vessels to perform their defensive functions
and movement of red blood cells from blood vessels is abnormal.

Shape and structure of Erythrocytes

As red blood cells mature in the red bone marrow, it extrudes that is sends
out its nucleus and most of its other organelles. During the first or second day in
the circulation, an immature erythrocytes (reticulocytes) comprises 1-2% of the
erythrocytes counts which provides a rough estimates of red blood cells
production. These immature reticulocytes primarily consist of networks of
ribosomes which are quickly shed and mature to produce circulating
erythrocytes which have fewer internal cellular structural components and they
rely of anaerobic respiration or they lack a mitochondria. This is;
- Because they do not utilize any of the oxygen they are transporting and so
can deliver its all body tissues.
- Also because they lack an endoplasmic reticula and cannot synthesis
protein.

Shape
 Erythrocytes are biconcave disk that is they are plump at their periphery and
thin at the center and thus enable them to change their shape to squeeze through
capillaries with the aid of a protein spectrin which is a cytoskeletal protein
element. The biconcave shape also provides a greater surface area across which
gas exchange can occur relative to its volume.

Properties of Erythrocytes

Hemoglobin is a coloring matter of red blood cells. It’s a chromo protein

forming 95% of dry weight red blood cells and 30-35% of wet weight.
This is a large molecule made up of proteins and iron. It consists of four
folded chains of a protein called globin. Therefore, each hemoglobin molecules
can transport four oxygen molecules. Thus an individual erythrocyte may
contain about 300million hemoglobin molecules which can bind and transport
up to 1.2billion oxygen molecules.
In the lungs hemoglobin picks up oxygen which binds to the iron ions
forming oxyhemoglobin. The bright red oxygenated hemoglobin travels to the
body tissues and releases some oxygen molecules known as deoxyhemoglobin
which becomes dark red in color and is sometimes referred to as reduced
hemoglobin. In patients with insufficient hemoglobin. The tissues may not
receive enough sufficient oxygen resulting to anemia thus a patient percent
saturation is normally monitored using a device known as a pulse oximeter
which is applied to the tip of a patient finger. The normal pulse rate ranges from
95-100%. Lower percentage reflects hypoxemia.
Hemoglobin
- At birth: 25g/dl
- After 3 months: 20g/dl
- After 1 year: 17g/dl
- Puberty on wards 14-16g/dl
Factors necessary for hemoglobin formation

Erythrocytes is produced in the bone marrow for this production to occur, a

number of raw materials must be present in adequate amounts. This includes the
same nutrients that are essential in the production and maintenance of any cell
such as glucose, lipids and amino acids. Erythrocyte requires several elements:

a. Iron
Each hemoglobin molecules contains an ion of trace mineral iron. These
heme irons can be gotten from animal foods such as meat, poultry and fish and
non-heme iron can be gotten plant foods. upon absorption iron becomes part of
the body’s total iron pool which is then stored in the bone marrow liver and
spleen. The red bone marrow, liver and spleen stores this iron in the protein
compound ferritin and hemosiderin then known as Ferro protein transports the
iron across cell plasma membrane and is stored in tissue fluids where to enter
the blood, and stimulches the production of erythrocytes in the red marrow.
b. Zinc
The trace mineral element zinc function as a co-enzyme that facilitates
the synthesis of heme portion of hemoglobin.
c. Vitamins
 Vitamins like vitamin C, Riboflavin, Nicotinic acid etc. (folate) and
vitamins B2 functions as a co-enzyme to facilitate DNA synthesis and new
cells including erythrocytes.

Erythrocytes live up to 120 days in circulation after which the worn out
cells are removed by a type of myeloid macrophage called macrophage located
primarily in the bone marrow, spleen and liver. The component of the degraded
erythrocytes hemoglobin are further processed as follows

- Globin : this is the protein portion of hemoglobin which is broken-down

in to amino-acids which can be sent back into the bone marrow to be used
in the product of new erythrocytes hemoglobin that is phagocytized is
broken down in the circulate releasing alpha and beta chains which is
removed from circulation by the kidneys.

- Iron contained in the heme portion of hemoglobin may be stored in the

liver or spleen primarily in the form of ferritin or hemosiderin or carried
through the blood stream by transferring to the red bone marrow for
recycling into new erythrocytes.

- The non-iron portion of heme is degraded into waste product biliverdin

which is a green pigment and then into anther waste product bilirubin a
yellow pigment. Bilirubin binds to albumin and travels into the blood then
to the liver which is used to manufacture bile a compound released into
the intestines to help emulsify dietary fats.

Fate of erythrocytes

When the cell becomes older (120 days), the cell membrane becomes
more fragile. The diameter of the capillaries is less or equal to that of the
red blood cells. Younger red blood cells can pass through the capillaries
easily. However, because of the fragile nature, the older cells are
destroyed while trying to squeeze through the capillaries. This destruction
occurs mainly in the capillaries of the pulp of the spleen because the
diameter of splenic capillaries is very small. So the spleen is called
graveyard of red blood cells. Destroyed red blood cells are fragmented
and hemoglobin is released from the fragmented parts. Hemoglobin is
phagocytized by macrophages of the body particularly the microphage
present in liver (Kupffer cells), spleen and bone marrow. Hemoglobin is
degraded into iron, globin and porphyrin. Iron combines with the proteins
called apoferrtin to form ferritin which is stored in the body and reused
later. Globin enters the depot for later use. The diagram below explains
the fate of erythrocytes:
 Destruction of RBCs (in the spleen)

Release of hemoglobin

Iron globin porphyrin

Aproferritin

Ferritin protein pool bilirubin

Stored and released stored and released excreted

Porphyrin is degraded into bilirubin which is excreted by the liver through the
bile. Daily, 10% of RBCs are destroyed in normal young adults. It causes the
release of about 0.6g\dl of hemoglobin into the plasma. From this, 0.9-1.5g/dl
bilirubin is formed.

Destruction of erythrocyte:
As in the development, the erythrocytes develop in the bone marrow,
which is the sponge. Like tissue inside your bones the body normally destroys
old or faulty red blood cells in the spleed or other parts of your body through a
process called hemolysis. Hemolytic anemia therefore occurs when you have a
low number of RBC due to too much hemolysis in the body. Increase in RBC
counts is known as polycythemia.

What is hemolytic anemia

This is a disorder in which RBC’s are destroyed faster than they can be
made the destruction of RBC is called hemolysis RBC than carry oxygen to all
part of your body. If you have lower than normal amount of RBC’s you’ll have
anemia which makes your blood to be unable to bring enough oxygen to all your
tissues and organs and without oxygen your body can’t work well as it should.

Hemolytic anemia is of two types that is; Inherited and Acquired

Hemolytic Anemia.

1. Inherited Hemolytic Anemia

With this type, parents pass the genes for the condition unto their
children. The two main causes are Sickle cell anemia and Thalassemia.
This condition produces RBCs that do not live long as normal RBCs.

2. Acquired Hemolytic Anemia

This type of anemia, you are not born with a certain condition. The body
produces normal RBCs but they are later destroyed and may happen
because of;
  Certain infections which is either viral or bacterial.
 Medicines like Penicillin, Antimalarial drugs.
 Blood cancers.
 Auto Immune disorders.

Symptoms of Hemolytic Anemia

 Abnormal paleness or lack of color of the skin.

 Yellowish skin, eyes, mouth.
 Fever.
 Weakness.
 Dizziness .
 Confusion.

Diagnosis

It can be diagnosed based on your symptoms, medical history and physical

exam. The health care provider may order the following tests;
 Complete blood count.
 Urine test: to check for hemoglobin (protein in RBC) and iron.
 Bone marrow aspiration or biopsy which involves taking a small sample
of bone marrow fluid (aspiration) to check for the number, size and
maturity of blood cells or abnormal cells.

Treatment

The treatment plan will be based on:

 Your age, overall health and medical history.

 How sick you are.
 Cause of the disease.
 How well you handle certain medicines.

Other treatments may include:

 Blood transfusion.
 Corticosteroid medicines.
 Treatment to strengthen your immune system using IV globulins.

In more severe cases, the following may be needed;

 Surgery to remove the spleen.
 Medicine to reduce the strength of your immune system that is Immuno-
suppresive therapy is used.