Theme: Blood and body fluids

Lecture: Red blood cells

Okpanachi O. Alfred
Neuro-endocrine Physiologist
 Lecture outline
• Red blood cells: Characteristics and functions
• Erythropoiesis and its Regulation
• Requirements for RBC synthesis and
Destruction of RBC; Jaundice or icterus
• Formation of Hemoglobin/steps and iron
metabolism
• Blood tests: RBC count , Blood indices,
Hemoglobin, Osmotic fragility of RBC
RED BLOOD CELLS
 Characteristics
• Are nonnucleated “cells”
• Biconcave discs of diameter about 7.8 micrometers and
thickness of 2.5
• Great excess of cell membrane and shape can change
remarkably
• Average lifespan of RBC is about 120 days.
• Old RBCs are destroyed in reticuloendothelial system.
• The destruction occurs mainly in the capillaries of red
pulp of spleen.
• Destroyed RBCs are fragmented and hemoglobin is
released and phagocytized by macrophages of the body.
 Red Blood Cells functions

• Oxygen transport
• Hemoglobin transport
• Transport of carbon dioxide
Presence of carbonic anhydrase enzyme

CO2 + H2O ↔ H2CO3 ↔ H+ + HCO3−

• Control of pH
 Erythropoiesis; where?????
Fetus 1 to 3 months - Yolk sac
3 to 6 months - Liver
spleen
lymph nodes
last three months- Red bone
marrow

Post natal Red bone marrow

Organs involved in Erythropoiesis
 Synthesis of RBC: overview
• Manufactured by erythropoiesis
– Committed cell: will form a specific cell type
– Erythroblasts undergo rapid mitosis
– Reticulocytes enter blood stream (2% of blood)
Erythropoiesis: regulation
Feedback control of RBC synthesis: summary
Formation of Red Blood Cells:
requirements

EPO

Iron

Folic Acid

Vitamin B
12
HEMOGLOBIN
 Hb: structure
• GLOBIN : composed by four polypeptide
chains
• HEME: composed by ringlike no protein
pigment. It is bound to each of the four
chains
• Fe2+ : located at the center of each heme ring,
that combine in reversible way with ONE
oxygen molecule
Hemoglobin in the Erythrocytes
 Formation of Hemoglobin/steps

I. 2 succinyl-CoA + 2 glycine Pyrrole molecule

II. 4 pyrrole protoporphyrin IX

III. Protoporphyrin IX + Fe++ heme

IV. Heme + polypeptide chain Hb chain (α or β)

V. 2 α chains + 2 β chains Hemoglobin A

 Hemoglobin chains
• Different types: alpha, beta, gamma and delta
chains.
• The most common Hb is Hemoglobin A
• The type of hemoglobin chain determines the
binding affinity for oxygen molecule
• Abnormalities of the chains alter the physical
characteristics/functions
IRON METABOLISM
 Total quantity of iron
4-5 grams

Iron in Stored Ferritin

Hemoglobin 15-30%
65%

Transferrin (bound
for transport)
0.1%
 IRON METABOLISM

INGESTION EXCRETION

ABSORPTION
IRON INGESTION

• Feces
LOSS • Menstruation

ABSORPTION TRANSPORT

LIVER STORAGE
 Jaundice or icterus
• Condition characterized by yellow coloration of
the skin, mucous membrane and deeper tissues
due to increased bilirubin level in blood.
• Normal bilirubin (Total bilirubin) content in
plasma is 0.5 to 1.5 mg/dL.
• When it exceeds 1mg/dL, the condition is called
hyperbilirubinemia.
• When Serum bilirubin level increases above 2
mg/dL, jaundice occurs
 Erythrocytes: summary
• Destruction (3 - 4 months)
• Trapped in spleen and destroyed by
macrophages
• Globin is recycled into amino acids
• Iron is used to make new RBC’s
• Rest of heme group converted to bilirubin
• Bilirubin appears in urine and feces
 Anemia: types and causes
• Pernicious anemia: due to deficit of B12
• Hypochromic anemia: Blood loss
• Aplastic anemia: bone marrow aplasia
• Hemolytic anemias: abnormal rate of
hemolisis
 Blood tests: RBC count
• RBC count ranges between 4 and 5.5
million/cu mm of blood.
• Adult males- 5 million/cu mm and Adult
females- 4.5 million/cu mm.
 Hemoglobin
• Average hemoglobin (Hb) content in blood is 14
to 16 g/dL. The value varies depending upon
the age and sex of the individual.
• At birth : 25 g/dL
• After 3rd month : 20 g/dL
• After 1 year : 17 g/dL
• From puberty onwards : 14 to 16 g/dL
• In adult males : 15 g/dL
• In adult females : 14.5 g/dL
 Blood indices
• Blood indices are the calculations derived from RBC
count, hemoglobin content of blood and PCV.
• Blood indices help in diagnosis of the type of
anemia.
1. Mean corpuscular volume (MCV).
2. Mean corpuscular hemoglobin (MCH).
3. Mean corpuscular hemoglobin concentration
(MCHC).
4. Color Index (CI).
 Fragility test
• Measures the resistance of erythrocytes in
hypotonic saline solution. It is done by using
sodium chloride solution at different
concentrations from 1.2% to 0.2%.
• One drop of blood is added to each tube with
solution at different concentration.
• The sodium chloride solution and the blood in
each tube are mixed well.
• Results will be analyzed looking for signs of
hemolisis
Osmotic fragility of RBC: principle
 Required reading
• GUYTON HALL. TEXTBOOK OF MEDICAL
PHYSIOLOGY
. MEDICAL PHYSIOLOGY by Ganong