Erythrocytes: Creation, Function and Destruction Flashcards
Describe the breakdown of the blood volume.
- 70kg adult = ~5L blood volume.
- 40% cells
- 60% plasma
- This is expressed as ‘packed cell volume’ or ‘haematocrit’ - typically 0.4 or 40%.
What is the ratio of red blood cells to white blood cells.
- Red blood cells are 500x more numerous that white blood cells - approximately 2.4x1013.
What is the replacement rate of red blood cells? Why?
Red blood cells need to replace 1% per day to make up for the expected lifespan of 100-120 days.
Describe the structure of red blood cells and relate this to function.
- Red blood cells are subjected to high pressures and squeezed thorugh narrow capillaries every minute.
- Biconcave disc
- No nucleus
- Pliable, high surface area / volume
- Bag of Hb and enzymes for glycolysis
- Unable to divide or make new proteins
- Able to maintain membrane integrity and prevent oxidation
- Main functions:
- O2 and CO2 transport, acid/base balance
Describe the formation of blood.
- Embryological stem cells form blood islands in the yolk sac.
- Cells migrate to the liver, then the spleen, then the bone marrow in the fetus.
- At birth, marrow is widely distributed retreating to axial skeleton by adulthood.
What are the constituents of bone marrow stroma?
- Fibroblasts
- Macrophages
- Endothelium
- Fat cells
What are the growth factors of bone marrow?
- Interleukin 3
- Erythropoietin (EPO- RBCs)
- Androgens
- Thyroxine
- Growth hormone
What is reticulin?
Remnants of mRNA left once the nucleus of a maturing RBC has been extruded. It is removed by the spleen in 1-2 days.
When and why would it be useful to measure reticulocytes?
- It is a useful measure of marrow response to anaemia or treatment (eg. 5-10 fold rise).
- Stained by new methylene blue on slide or on automated count.
How much iron should an adult have?
Where is this iron in the body?
- Adults have 3000-5000mg of iron
- 2/3 is in Hb
How is iron content in the body maintained?
- Daily diet contains 10-20mg of which 1-2mg are absorbed in ferrous form - higher need in pregnancy / blood loss.
- Fe2+ transported into duodenal enterocytes (small intestine absorptive cells).
- Hepcidin regulates iron absorption and release from macrophages:
- Increase in inflammatory disease = less available iron.
- Body has no mechanism to excrete iron.
How is iron lost?
- Menstrual loss
- Minor trauma
- Gi - ~1ml blood per day
- Blood sampling
- Very small amounts in urine / skin shedding
How is iron transported?
- Transferrin is responsible for the transport and recycling of iron.
- Transferrin receptors are increased in iron defficiency.
What is ferritin?
Insoluble form of iron storage. This is a good measure of the body’s iron stores.
Describe the body’s folic acid / folate need.
- Daily requirement 0.1mg
- ~0.25mg in diet - green veg and fruit
- Absorbed in upper small intestine
- Liver stores 10-20mg ie. only 100-200 days
- Deficiency can be due to:
- Poor intake
- Absorption
- Increased need
Describe the body’s B12 / cobalamin need.
- Daily requirement = 1µg.
- Diet may contain 5µg but all in animal derived products.
- Gastric parietal cells produce ‘intrinsic factor’ - binds B12.
- Atrophic gastritis - cannot produce intrinsic factor so B12 cannot be absorbed even if dietary intake is sufficient.
- B12 absorbed in terminal ileum.
- Transported on transcobalamin II via portal circulation to the liver.
- Dietary defecit in vegans or pernicious anaemia - antibodies to intrinsic factor associated with gastric atrophy.