BLOOD

PHYSIOLOGY
LECTURE 5
Plasma (cont.)
Blood cells
 PLASMA - COMPOSITION
• Water 90%
• Other substances 10%
• Inorganic substances 1%
• ions
• minerals
• Organic substances 9%
• carbohydrates
• fats
• proteins: albumin, globulins, fibrinogen
• other substances: urea, polypeptides, NH3, uric acid,
creatin, creatinin, billirubin
 PLASMA PROTEINS
• Normal values = 6 – 8 g/dl (60 – 80 g/l)
• Plasma proteins fractions (by electrophoresis)
• albumines = 50 - 60%
• α- 1 globulines = 4,2 – 7,2% (4%)
• α- 2 globulines = 6,8 – 12% (8%)
• β - globulines = 9,3 – 15% (12%)
• γ - globuline = 13 – 23% (16%)
 PLASMA PROTEINS
Roles
1) Tissue nutrition
2) Transport:
• Hormones (e.g. transcortin binds cortisol)
• Vitamins (e.g. transcobalamines bind vitamin B12)
• Minerals (e.g. transferrin binds iron)
• Fats (e.g. apoproteins transport lipids ⇒ lipoproteins),
• Drugs, metabolites
3) Enzymes
4) Hormones
5) Blood clotting and fibrinolysis
6) Body defense (Ig, complement)
7) ABB (protein buffer system)
8) Major factor which causes plasma oncotic pressure
 ONCOTIC PRESSURE
Oncotic pressure (ΠΠp)
= caused by solved proteins in plasma, especially albumins
Πp = 5.54 x A (g%) + 1.43 x G (g%)
Normal values = 25-30 mmHg

Importance: for fluid exchanges through the capillary membrane

Ph = 35 mmHg Ph = 15 mmHg
Ph> Πp Πp = 25 mmHg Ph< Πp

Arteriolar end Venous end

FILTRATION REABSORPTION
 PLASMA PROTEINS
• Hyperproteinemia (> 80g/l)
- ↑ Ig (after vaccination, plasmocitoma)
- dehydration (severe diarrhea, vomiting)
• Hypoproteinemia (< 60g/l):
- reduced synthesis (e.g. chronic liver diseases)
- reduced dietary intake
- reduced absorption (gastro-intestinal disturbances)
- digestive, renal loss, hemorrhages

• In hypoproteinemia
⇒reduced oncotic pressure
⇒alterations of capilarry fluids exchange
⇒edema
 HEMATOPOIESIS
= the process of replenishment of blood cells (RBC, WBC, PLT)
• all formed elements of the blood are derived from a single population
of stem cells located in the red bone marrow
• in children, nearly all marrow is red bone marrow
• in adults, red marrow is confined to the ribs, pelvis, sternum,
vertebrae, proximal femur and humerus
• Red bone marrow – made up
• Hematopoietic cells (30-70%)
• Stromal cells, fat cells, fibrocytes, extracellular connective tissue,
sinusoidal and vascular spaces
 HEMATOPOIESIS
PSC
Hematopoietic cells – 3 groups:
1. Pluripotent stem cells (PSC)
• the precursor cells from which
all RBC, WBC, PLT are
derived
2. Committed stem cells
• derive from PSC
• 2 types:
• myeloid →
– erythrocytes
– most leukocytes
(neutrophils,
eosinophils, basophils,
monocytes)
– platelets
• lymphoid → lymphocytes
3. Cell lines: from immature to the
final mature stage
RED BLOOD CELLS
(ERITHROCYTES)
 ERYTHROCITES: MORPHOLOGICAL
AND FUNCTIONAL CHARACTERISTICS
1. RBC count
= 4–5.5 mil/mm3
2. Shape of E
- Biconcave discs
- Provide a big area on small volumes
3. Size of E
- MCD (mean corpuscular diameter)
= 6.8 – 7.7µm;
- MCT (mean corpuscular thickness)
= 1.7 – 2.5 (2) µm;
4. Color of E
- Red, due to E HB (hemoglobin)
- The normal colored E = normochromic
5. Content
- No nucleus
- Lot of HB in cytoplasm
 ERYTHROCITES: MORPHOLOGICAL
AND FUNCTIONAL CHARACTERISTICS

Variations Examples

Number ↓ E number = anemia

↑ E number = polycytemia
Shape Irregular shapes, bizarre = poikilocytes
spherical E = spherocytes
moon-shape E = drepanocytes
Size Φ ↓ = microcytes
Φ ↑ > 9µm (10-12) = macrocytes (megalocyte)
↑ Φ and ↓ thickness = flat erythrocytes
Color pale, weak colored = hypochromic E
strong colored = hyperchromic E
e.g. Hereditary spherocytosis
 ERYTHROCYTES STRUCTURE
Erythrocytes membrane:
membrane
- surface antigens (ABO blood groups) and membrane receptors

Composition:
• 60% water
• 33-35% HB
• 5-7% other substances:
• 2% enzymes
• ionic pumps
 HEMOGLOBIN PHYSIOLOGY
HB = iron containing protein
• 4 heme groups (each has 1 Fe2+: binds O2, CO)
• binds and release O2
• 4 globin chains (polypeptidic) arranged in pairs
• binds and release CO2
HB functions
• O2 transportation - oxyhemoglobin (HbO2)
• CO2 transportation - carbhemoglobin (HbCO2)
 ERYTHROCYTES NORMAL VALUES

RBC = 99% of the blood cell mass (1% = WBC, PT)

• RBC count
• 4.9±0.7 mil/mm3 (males);
• 4.3±0.6 mil/mm3 (females)
• Hemoglobin concentration (HGB)
• 15±2 g% (males);
• 13±2 g% (females)
• Hematocrit (HCT) = the proportion, by volume, expressed
as a percentage, of the blood that consists of RBC
• 45±7% (males);
• 42±5% (females);
 RED BLOOD CELLS LIFE CYCLE
1. Generation of RBC (erythropoiesis)
• in red bone marrow (BM)
• from PSC to immature elements → 5 – 7 days
• substances required for erythropoiesis
• proteins
• minerals: iron, copper, cobalt, zinc
• vitamines: B12, folic acid, B6, C
2. Circulating RBC
• mature RBC circulate in blood and accomplish their
functions →100-120 days
3. Destroying compartment
• within spleen, liver and BM
• old and morpho-functional changed erythrocytes
Normal erythrocytes

Macrocytosis Microcytosis
Hyperchromia Hypochromia
↓ ↓

(vitamin B12 (Fe deficiency)

deficiency)
REGULATION OF ERYTHROPOIESIS

Erythropoietin
- glycoprotein synthesized by
kidneys (90%)
- erythropoietin synthesis depends
on tissue concentration of O2
- hypoxia – stimulator
- hyperoxia - inhibitor
-Effects:
- activation of erythropoiesis
 PHYSIOLOGICAL HEMOLYSIS
Hemolysis = RBC distruction
• destruction of RBC membrane ⇒ release of Hb ⇒
⇒ globine → destroyed
⇒ Fe2+ → stored in red bone marrow
⇒ heme → biliverdin
• biliverdin → indirect bilirubin (IB) – transported in blood
• IB → conjugated in liver → direct bilirubin (DB) – in bile
• in intestine →urobilinogen →stercobilin

- Total Bilirubin = 1mg%

- ↑Value ⇒ yellow color of
skin and mucosa (jaundice)
 RBC FUNCTIONS
1. O2 and CO2 transport
In the lungs: In the tissues:

- O2 binding on Hb - O2 releasing from HbO2

- CO2 releasing from HbCO2 - CO2 binding⇒ HbCO2

2. Maintaining of blood acid-base balance

• RBC contain hemoglobin buffer systems