44.1 Blood cells Flashcards
Why do red blood cells stain pink in H&E staining?
Haemoglobin is a basic protein, so binds to acidic dyes - the pink colour isn’t to do with the haemoglobin itself but rather the eosin staining
What is the average size of a red blood cell?
7 microns (more specifically 7.5um)
What does a red blood cell lack?
Red blood cells have no nucleus, no DNA and no organelles
How can white blood cells be distinguished from all the red blood cells?
WBCs contain nucleic acids which show up purple under H&E staining - RBCs do not so just stain pink
How is the shape of a RBC maintained?
- Specific shape affected by water content (osmotic effects of solutes)
- Maintained mostly by cytoskeleton
- > spectrin
- > ankyrin
- > other membrane proteins
What are discocytes?
A normal mature red blood cell with a biconcave disc structure
What are stomatocytes?
Red blood cells that are slightly more ‘blown up’ than normal discocytes, have a central ‘slit-like’ appearance under a microscope (rather than central paler circle, the shape is a slit)
Often seen in alcoholic liver disease
What are echinocytes?
Also known as burr cells, a type of red blood cell that has an unusual cell membrane causing many evenly-spaced spiky projections to be present
Sometimes appear as an artefact of staining and putting on to a slide, but can also be an indicator of disease
Why is it beneficial that erythrocytes can deform?
Because it allows them to pass through arterioles and capillaries - RBC diameter is around 7um, whereas capillary diameter can be about 5um
They tend to stay in the centre of vessels (this is helped by their biconcave shape) - circumference of vessel is often plasma-dense
Why is it difficult to make artificial substitutes for blood?
Because of its natural visco-elastic properties
How does viscosity of blood change with velocity and why?
As velocity INCREASES, viscosity DECREASES
- Blood flow in small vessels is low (1mm/s) causing a high viscosity
- This is due to the formation of rouleaux (the adherence of RBCs to each other and vessel walls, allowed through discoid shape)
- RBCs appear more rigid as shear forces (planar forces that occur in fluids due to bodies moving past each other) no longer enough to cause deformation
When is the rouleaux effect even more noticeable?
- If membrane is more rigid (e.g. in spectrin defects)
- When erythrocytes are older/more aged (aggregate formation increases with age and decreased sialic acid conc in RBC reduces the negative charge, making the formation of a rouleaux more likely)
- If there are inclusions inside cells (e.g. sickle cells in sickle cell anaemia)
- Why does sickle cell anaemia cause painful episodes?
- This is because the shape of the RBCs make them more likely to form a rouleaux (shape is caused by mutation in a gene that helps to form haemoglobin, recessive)
- These cause blockages in small vessels (capillaries most often)
- The blockages lead to vascular occlusions, restricting flow of oxygen and nutrients to certain areas that will them cause painful crises
What are the benefits of a RBC being anucleate?
- Better SA:Vol ratio, allows about 25% more surface area than is spherical which improves gas exchange
- Improves deformability to fit through capillaries which often have diameters smaller than that of the RBC
- Less work for the heart as a pump, as the heart pumps approx. 3kg of erythrocytes per min, 40% of that mass would be nucleus
- > saves about 1 to 1.5 tons per day
What are the disadvantages of a RBC being anucleate?
- No further protein synthesis or repair, so cells will wear out with a lifespan of approx. 120 days
-> this means that an efficient new cell replacement system is needed and a constant turnover of new RBCs (erythropoiesis) - Cell can’t adapt to different conditions, they are terminally differentiated and highly specialised, e.g. cannot respond to high altitudes/low pO2
( - The same goes for blood platelets/thrombocytes)
What are the words for RBC and platelet production?
RBC: erythropoiesis
Platelet/thrombocyte: thrombopoiesis
What is the normal turnover time for a RBC?
120 days
IMPORTANT, IS ON SPEC
How do RBCs synthesis ATP?
No mitochondria, so only use anaerobic respiration
-> rely heavily upon blood glucose
Why do RBCs need ATP?
- No large energy requirement
- ATP only really needed for membrane-asscoates ATP-dependant Na+/K+ ion exchanger
- > maintains concentrations of ions both in plasma and the RBC
What are the plasma and RBC concentrations of sodium and potassium ions?
Plasma: - Na+ 140mM - K+ 3.5-5mM RBC: - Na+ 6mM - K+ approx. 100-140mM
- What concentration of extracellular potassium ions causes hyperkalaemia and how can this occur?
Conc: 7 mM
Caused by RBC lysis (which is in turn caused by high osmotic pressure/hypotonic solutions), which releases a high amount of potassium ions due to the high intracellular concentration
What are the three components of a RBC?
- Haemoglobin
- Enzymes for metabolising glucose
- Ions (mostly potassium, maintains ion gradient for other processes)
- What are some properties of haemoglobin in RBCs?
- Globular protein
- 2 alpha subunits, 2 beta subunits
- Around 650 million molecules per cell
- Haem prosthetic group, one Fe2+ per haem group
- > this is about 2/3s of the body’s iron
- > RBCs maintain reducing conditions (therefore no oxidative phosphorylation/mitochondria, achieved through the presence of glucose) to prevent iron from oxidising to Fe3+ which would form methaemoglobin
- Haemoglobin allows the transport of O2 and CO2 (see later flashcards)
What glycolytic intermediate has a particular effect within RBCs and what is it?
- 2,3-biphosphoglycerate (2,3-BPG, used to be called 2,3-DPG)
- Produced by an erythrocyte enzyme
- Shifts dissociation curve to unload O2 from HbO2 (oxyhaemoglobin)
- > this is due to the fact that if ion pump activity increases it indicates that nearby tissues are respiring, more ATP is needed to maintain action of pumps so more of 2,3-BPG is produced as respiratory/glycolytic intermediate (and this is main energy source for RBC), encourages RBC to unload oxygen at respiring tissue
What is and what is the importance of the pentose phosphate pathway/shunt?
- Alternate pathway to glycolysis that involves NADPH
- Pathway uses G6PDH (glucose-6-phosphate dehydrogenase, X-linked enzyme)
- > deficiency (caused by eating too many broad beans (Favism, linked to the Mediterranean region) or by the now-obsolete anti-malaria drug Pamaquine, both are examples of oxidative stressors) results in serious haemolytic crises/anaemia
- Generation of NADPH slows accumulation of oxidised proteins that are associated with erythrocyte aging
- > maintains glutathione, a cysteine-containing tripeptide, in a reduced state
- Allows RBCs to remain in reduced conditions and therefore live longer
- What is crenation?
This is where cells shrink because they are in hypertonic solutions (e.g. water potential of cell > water potential of surrounding solution), so water travels out of the cell, causing them to shrink in size/the membranes to become noticeably crumbled under a microscope
What are the different types of solutions?
- Hypertonic (water potential lower than that of the cell, >300 mOsmoles)
- Isotonic (water potential same as that of the cell, around 300 mOsmoles)
- Hypotonic (water potential higher than that of the cell, around <300 mOsmoles)
What are RBCs ghosts and what do they indicate?
Red blood cells without any contents (e.g. only the membrane remains)
- Indicator of disease (e.g. haemolytic anaemia) or hypotonic solutions
- Can be created in vitro, useful for discovering the presence of the phospholipid bilayer
What is osmolarity?
Another word for the osmotic concentration, i.e. the concentration of a solution expressed as the total number of solute particles per litre (osmotically active particles need to be counted, include ions in this)
What are the features of an RBC membrane?
- Semi-permeable
- Allows water to permeate through the presence of aquaporins (does mean that cells will lyse if not in a isotonic solution)
- Band 3 complex, allows attachment to glycoproteins extracellularly (these are involved in blood group determination) and the cytoskeleton of ankyrin and various spectrins internally
How do RBCs ‘age’?
Through the accumulation of oxidised proteins/oxidation products, lifespan prolonged by pentose phosphate shunt but still limited to a turnover rate of around 120 days
How can erythrocyte lifespan be shortened?
- Through an abnormal shape
- > haemoglobin mutation, results in thalassaemia and sickle cell anaemia amongst others
- > cytoskeletal proteins are altered through mutations, results in hereditary spherocytosis
- Through RBC clearance mechanisms being accelerated
- > old RBCs are broken down in the spleen and the liver
- > this can be caused by autoimmune diseases (causing the RBCs to be covered in antibodies, triggering phagocytosis by macrophages) or if the macrophages are too active due to a disorder
Where are RBCs broken down?
By macrophages in the liver and the spleen
- In the liver, the specific hepatocytes/stellate (star-shaped) macrophages are known as Kupffer cells, and line the sinusoids
What effect does the sickle shape of RBCs in sickle cell anaemia have?
- Causes a drastic rearrangement of membrane proteins which signals to macrophages that they should be broken down
- > broken down at a faster rate than possible for the liver to deal with, resulting in a build up of bilirubin and jaundice
- Shape of cells makes them more likely to aggregate/form rouleaux, these block capillaries and cause vascular occlusions/painful crises