Erythrocytes Flashcards

1
Q

Blood gas transport

A

Haemoglobin binds O2 in lungs (where PO2 is high) and unbinds it in tissues (where PO2 is low)

Hb moves CO2 in opposite direction

Cooperativity and chemical allosteric effects more O2 is bound in lungs and is deposited in tissues

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2
Q

Oxygen

A

Poorly soluble in plasma – normal arterial blood carries 70X more O2 on Haemoglobin (Hb in RBCs) than dissolved directly in plasma

Hb is needed to carry O2
Thus, it is possible for arterial PO2 to be normal but hypoxia to occur (b/c there is no Hb to carry O2)

Why you need O2:
Oxidative Respiration Produces More Energy

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3
Q

Oxygen delivery to tissues by Hb

A

Hb must bind O2 (to carry it to tissues)

Hb must ALSO RELEASE the O2

Binding of O2 to Hb must be weak enough to be reversible

There need to be mechanisms at the muscles for reducing O2 affinity

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4
Q

Haemoglobin

A

95% of dry weight of RBC

Each subunit has a small haem group (616 Da) + a large globin peptide (17,000 Da)
Haem is coloured, contains one Iron atom, and is site of O2 binding

picks up oxygen in lungs and releases it in tissues

haemoglobin has allosteric properties:
cooperativity

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5
Q

Haem group

A

Haem is a porphyrin ring
They are rigid, 2 dimensional, and highly coloured due to sharing of electrons
Hence red and blue colour
Not due to Iron

conjugated to iron ion
Ferrous (Fe2+)

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6
Q

Porphyrins

A

Naturally occurring heterocyclic compounds similar to this structure.

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7
Q

HbA vs HbF

A
Healthy Adults (HbA)
2 alpha subunits + 2 beta subunits (4 subunits = tetramer)
Also called “maternal Haemoglobin”

Foetal Haemoglobin (HbF)
2 alpha subunits + 2 gamma subunits
Adults have a small percentage of HbF
Binds O2 more strongly than HbA

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8
Q

CO2 & H+ affect O2 binding to Hb

A

the “Bohr effect” †
Increase blood carbon dioxide level —>  affinity of Hb for O2
Decrease blood pH —>  affinity of Hb for O2

b/c of carbonic anhydrase rxn

Increase blood carbon dioxide level —> decrease  blood pH

CO2 & H+ bind Hb but at a different site from O2

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9
Q

CO2 transport in blood

A

A) 10% as dissolved, B) 22% as carbamino, C) 68% as HCO3-

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10
Q

Curve shapes: myoglobin and haemoglobin

A

Myoglobin curve is hyperbolic in shape, whilst haemoglobin curve is sigmoidal (ie “S-shaped”)

Adult Haemoglobin curve (green) is S shaped.
This is b/c of cooperativity

Myoglobin curve (red) is exponential; not S shaped

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11
Q

Regulation of oxygen affinity

A

CO2 -> rightward shift (R)

H+ -> rightward shift

Cl- -> rightward shift

2,3-DPG -> R
Diphospho-glycerate
Bis-phospho-glycerate

Muscle activity encourages Hb to release O2

R (rightward shift)  affinity for O2

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12
Q

2,3-DPG

A

2,3 diphosphoglycerate
- OR 2,3 bis phosphoglycerate,

Binds to Hb

Lowers affinity of Hb for O2

2,3-DPG found in erythrocytes at 5 mM

Increase 2,3-DPG —> decrease affinity for O2

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13
Q

Breathing Controlled by O2, CO2, H+

A

Plasma O2 must drop precipitously before respiratory drive increases

Main driver to increase respiratory rate: H+ in CSF
Not H+ in blood
H+ in the blood is slow to get into the CSF, but
CO2 gas can get into the CSF, and
once CO2 is in CSF, it makes carbonic acid & H+

The response to CO2 is > the response to H+
because blood H+ is only based on signal from carotid arch.

Medullary receptors
sample from the interstitial and CSF fluid.

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14
Q

Erythrocytes

A

Red blood cells (RBCs)
“definitive” = mature

Biconcave disc

Anucleate, lack organelles

7 um diam, 2 um height

Contain haemoglobin

Red when oxygenated
Out of body O2

Survive ~120 days

Very flexible – fold and stack in blood vessels

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15
Q

Erythropoiesis: Locations

A

Erythropoiesis = development/production of RBCs

After birth: bone marrow only
After age 20: membranous bones only (e.g. vertebrae)

During embryogenesis:
Liver
Spleen
Lymph nodes
Yolk sac

Haematopoiesis = Haemopoiesis = devel blood cells

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16
Q

Development from stem cells

A

Multipotent Stem Cells -> Multipotent Progenitor Cells -> Lineage-committed Progenitor Cells -> Mature
Cells

17
Q

Erythropoietin (EPO)

A

A cytokine / hormone that drives erythropoiesis
Made in the kidney
In response to hypoxia in the kidney

Used medically to stimulate erythropoiesis
Risk of severe off target effects

Performance enhancing drug for athletes

18
Q

Reticulocytes

A

RBC precursor
Before complete extrusion of nucleus + organelles

Lasts for 2 days in blood
Then becomes definitive RBC

Reticulocyte count can be a diagnostic tool in anaemia
Indicator of bone marrow activity
High in haemolytic anaemias (homeostatic response)
Low when erythropoiesis is low
Machine counts cells and detects those with basophilic material (eg DNA) in them

19
Q

Methaemoglobinaemia

A

Hb cannot transport O2
Fe in haemoglobin is oxidized (Fe3+)
Instead of usual ferrous (Fe2+)

Due to:
Congenital globin mutations (Hb M)
Hereditary decrease of NADH
Toxic substances

20
Q

Carbon Monoxide Poisoning

A

Hb cannot transport O2
Due to:

CO Displaces O2 from Hb
O2 and CO have same binding site

Affinity for CO is 250X stronger
Low levels of CO can completely displace most O2
PO2 dissolved in blood remains normal
Lethal

blood turns bright red

Brain affected first = disorientation
Treatment: 95% O2 / 5% CO2 (drives Hb toward T config)

21
Q

Polycythaemias

A

Increase number of RBCs (PCV)
Viscosity of blood
“Clog” blood vessels

Physiologic polycythaemia
Due to living at high altitude
See lectures on respiration

Polycythaemia vera
Often asymptomatic
Risk of thrombotic events
No cure, treat with venesection
All ages,  with age
Possibly genetic ???
22
Q

Iron requirements for RBC production

A

65% of all iron in adult is in RBC haemoglobin

Fe stored intracellularly as Ferritin & Haemosiderin (30%)

Fe stored in reticulo endothelial system:
Liver, spleen, erythrocytes, bone marrow, macrophages/monocytes
depleting all iron from stores leads to anaemia (microcytic hypochromic)

Only small % dietary Iron absorbed
High Iron concentration in red meat
Iron loss ~1 mg/day
More for pregnancy, menstruation, peptic ulcers

Iron deficiency can —> iron deficient anaemia
Microcytic, hypochromic

23
Q

Vitamin B12 and Folic Acid

A

Important for rapidly dividing tissue
Essential for forming DNA (thymidine)
Nuclear maturation fails
RBCs, Skin, Gametogenesis

Deficiency causes megaloblastic anaemia (macrocytic)
Fragile cells

Caused by diet, malabsorption, ↑ utilization
Old age, vegan, institutions, famine
Pernicious anaemia (Intrinsic factor)
Pregnancy, haemolytic anaemia, lymphoma

Treated with vitamin
Oral folic acid
Intramuscular hydroxocobalamin