Red blood cells/Erythrocytes

Among the formed elements of blood RBCs is most predominant, occupy 40-45%of blood vol. (Hematocrit). No. of RBCS:
In normal man 5,200,000 300,000 In normal woman 4,700,000 300,000

Size & Shape of RBCS:

Circular, non-nucleated, biconcave discs. Mean diameter 7.8 m. Thickest at sides 2.5 m, thinner in center 1um or less. Area of central pallor corresponding to concavity.

 Bio concave shape increase the surface area greatly for the exchange of gases. The shape can be deformed temporarily as it squeezes through capillaries 6 m diameter, .Because the normal cell has a great excess of cell membrane for the quantity of material inside. So deformity does not rupture the cell (high elasticity, flexibility, pliable).

 Organelles of RBCs: Do not contain Nucleus, Mitochondria, Endoplasmic reticulum, Golgi apparatus and Ribosomes. Metabolic processes of RBCS: energy requirement decreases ,only 0.5% of a normal cell. Glucose is the only source ,transported into the cell interior by glucose transporter 1 (GLUT 1,faccilitated diffusion). 90% of glucose enters into anaerobic glycolysis. 10% of glucose is supplied to Hexose Monophosphate Shunt (HMP) pathway or pentose phosphate pathway. It produces NADPH which keeps Glutathion reductase in reduced form.
Deficiency of reduced Glutathion reductase leads to oxidative damage and loss of memb. pliabilityhemolysis. Certain drugs like primaquin decrease reduced Glutathion and cause hemolysis& hemoglobinuria.

 Energy is utilized in RBCS for

1- To drive Na/K pump which expels Na + out and carries K+ inside the cell& prevents hemolysis. 2-Keep reduced glutathione in reduced form. 3-To keep heme Fe in Fe++ form.

Ageing of RBCs:
Total life span 120 days. Lacks organelles for production of enzymes (proteins). Old RBCs loses pliability becomes spiculated, fragmentation and osmotic lysis. Old cells become coated by immunoglobulins more susceptible to phagocytosis.

Hemoglobin in the RBCS

Principal solid component of RBCS. Enzymes of RBCs.
Enzymes of anaerobic glycolysis. HMP enzymes Glutathione reductase. Carbonic anhydrase responsible for effective transport of CO2 by the RBCs. Catalyzes reaction H2O+ CO2 -------. H2 CO3---- H++HCO3-.

Oxygen carrying capacityof blood

Normally in male 15 grams of Hb /100ml of whole blood &14 grams of Hb /100ml of whole blood in females. Oxygen carrying capacity of Hemoglobin Each gram of Hb can carry 1.34ml of O2. So 100 mls of blood in males carries 1.34x15=20.01mls and in females1.34x14=18.76 or 19mls/100mls of blood.

Erythropoiesis
Proerythroblast or Pronormoblast:
round,14-20 m diameter, nucleus with many nucleoli, red purple chromatin & basophilic cytoplasm.

Basophilic erythroblast or Early normoblast:

Round,12-17 m diameter, nucleoli absent, rough chromatin.

Erythropoiesis
Polychromatic erythroblast or Intermediate normoblast:

Round,12-15 m diameter. nucleus smaller with coarse chromatin. Basophilic due to RNA and Hb synthesis starts at this stage & first traces appear around nucleus. No mitosis after this stage.

Erythropoiesis
Orthochromatic erythroblast or late normoblast:
round, 8-12 m diameter. Does not divide. Nucleus pyknotic. Due to more synthesis of Hb dull coppery staining of cytoplasm.

Erythropoiesis
Reticulocyte:
round or bioconcave disc, no nucleus, cytoplasm may show basophilic fragments (ER,mitochondria, golgi app. remenants). Normal no. is 1% (0.2---2%) in neonate 6% why? May pass to circulation by diapedesis---Squeezing through capillary pores. Brilliant cresyl blue stains the reticulum of reticulocyte. Reticulocytosis:in all conditions in which tissue hypoxia is present.

 Erythrocyte:
1-2 days are taken for disappearance of rest of the basophilia of reticulocyte.

Summary of changes during erythropoisis.

1) The cell size decreases 2) The cytoplasmic/nucleus size ratio increases. 3. The chromatin in the nucleus which was first regular and fine later becomes coarse and irregular and finally lost. 4) The nucleoli in primitive blast cells disappears. 5)The amount of RNA (ribosome& RER, basophilia) decreases

Regulation of erythropoiesis
The total mass of RBCs in circulatory system is regulated within narrow limits. Tissue oxygenation is the most essential regulator of red blood cell production
Any condition that causes decreased quantity of oxygen transported to the tissues (hypoxia) increases the rate of red cell production. After hemorrhage At high altitude: Partial pressure of oxygen in the air decreases ,insufficient oxygen is transported to the tissues. In chronic heart failure sluggish blood flow and poor oxygenation in prolong lung disease. Functional ability of the cell to transport oxygen to the tissues in relation to tissue demand for oxygen.

Erythropoietin
The principal stimulus for RBCs production is tissue hypoxia stimulates RBCs production in presence of erythropoietin. erythropoietin:

glycoprotein, mol. Wt. 34000. Principal hormone in blood to act on bone marrow when there is tissue hypoxia. 90% forms in the kidney 10% is formed by the liver Epinephrine, Norepinephrine and several prostaglandins stimulate its production. Loss of renal mass e.g. In chronic renal failure anemia. Reticulocyte count is indicative of rate of erythropoiesis or of bone marrow activity.

Effect of erythropoietin
When a person is exposed to low atmospheric pressure, within mins. erythropoietin begins to start and becomes max. within 24 hrs. But new RBCs appear in the circulation until about 5 days later. It stimulates the production of proerythroblast from hemopoietic stem cells in the bone marrow. Also speed up the maturation of proerythroblast into mature RBCs. Can increase the rate of erythropoiesis by 10 times of normal. A powerful mechanism.