Anemia Flashcards
What is hematopoiesis?
- formation of blood cellular components
- derived from hematopoietic stem cells
- largely controlled by feedback mechanism (cytokines)
What is Erythropoiesis?
- the process which produces red blood cells
- which is the development from erythropoietic stem cell to mature red blood cell
- it is stimulated by decreased O2 in circulation which is detected by the kidneys which then secretes the hormone erythropoietin
Erythropoiesis through out life?
Which organs does it happen in?
- fetal
- occurs in yolk sac, liver and spleen
- At ~7 months moves to the BM and hepatic production decreases during the 3rd trimester and ceases soon after birth - child
- active bone marrow is present in all skeleton - adult
- active bone marrow is present in axial skeleton (head and trunk of vertebrae)
Erythropoiesis process?
- pluripotent hematopoietic stem cell
- proerythroblast
- erythroblast
- loses nucleus + some organelles
> processes above happen in bone marrow - reticulocyte
- spends 3 days in marrow, 1 day in blood
- loses remaining organelles - erythrocyte
- lifespan aprox. 120 days (90 in an infant)
> processes above happen in blood
Physiology of erythropoiesis?
Erythropoietin > hormone produced in the kidney
- Induces erythroid progenitor cells to differentiate into proerythroblasts
- Brings about expansion of the erythroid marrow and an increase in red cell production
Requirements for erythropiesis?
- Metals: Iron, cobalt, Mn.
- Vitamins: Vit B12, Folic acid, Vitamin C, Vitamin E Vit B6, Riboflavin.
- Amino acids
- Hormones: Erythropoietin, Androgens, Thyroxin
Structure of a normal erythrocyte?
Typically, without a nucleus.
Contain the pigment hemoglobin
Shape: Biconcave disks
Size:
~Diameter of 7.8um.
Thickness of 2.5um at the edge and 1um at the center
Volume: 90-95 m
Form: Flexible, deformable, elastic
Structure of RBC membrane?
- outer membrane
- hydrophilic : glycolipids, glycoprotein, proteins - inner layer
- hydrophilic : proteins - central layer
- hydrophobic : proteins, cholesterol, phospholipids
RBC membrane function?
Maintain structure and contain the contents of the red cell- chiefly, hemoglobin.
Maintain cellular functions in transport of salts and nutrients.
Avoid adhesion to self and vascular wall
Deformability, metabolism, senescence
Provides cellular shape
What is hemoglobin?
iron containing oxygen transporting metalloprotein
2 parts of hemoglobin?
- Globin
Consists of 4 polypeptide chains:
Two alpha chains
Two beta chains - Heme
Flat ring molecule with 4 pyrrole ring.
Single Fe2+ ion at centre of each pyrrole ring.
Without iron ring – Porphyrin Ring.
Hemoglobin function?
- Delivery of oxygen from the lungs to the tissues
- Transport of CO2 and protons from tissue to lungs for expiration and excretion
How does Hb work?
- One molecule of hb will bind to 4 molecules of O2
- Cooperative binding of O2 to hb: binding of O2 to one heme increases the binding of O2 to other heme
Bohr effect of hemoglobin?
- Haemoglobin’s lower affinity for oxygen secondary to increases in partial pressure of carbon dioxide and/or decreased blood pH.
- This lower affinity, in turn, enhances the unloading of oxygen into tissues to meet the oxygen demand of the tissue.
- It causes shift in the O2 dissociation curve to the right
Describe the oxyhemoglobin dissociation curve?
- right shift
- increase pCO2, H+, temp, DPG, decrease pH, sulf-Hb, HbSS > decrease O2 affinity so increase O2 unloading - left shift
- decrease pCO2, H+, temp, DPG, increase pH, decrease phosphate, met-Hb, CO-Hb, fetal-Hb > increase O2 affinity sp decrease O2 unloading
What is globin switch?
Fate of the RBC?
- RBCs normally circulate an average of 120days before being destroyed
- Once the red cell membrane becomes fragile, the cell ruptures
Where do RBCs self destruct?
- Many of the red cells self destruct in the spleen
- Squeeze through the red pulp
> Space between the structural trabeculae are only 3 umeters wide, in comparison with the 8-umeter diameter of the red cell