RBC basics for dental and allied students

1. RBC:
DR.A.BEEULA
2nd YR PG
DEPT.OF ORAL PATHOLOGY
CHETTINAD DENTAL COLLEGE AND RI

2. CONTENT:
• DEFINITIONOF RBC
• FUNCTION MORPHOLOGY OF RBC
• NORMAL SIZE
• NORMAL SHAPE
• NORMALVALUES
• FUNCTIONSOF RBC
• NUTRITIONAL REQUIREMENTSOF RBC
• HEMOGLOBIN
• STRUCTURE
• FUNCTION
• O2 DISSOCIATIONCURVE
• PRODUCTIONOF RBC
• FORMATIONOF RBC
• METABOLIC PATHWAYS
• FATE OF RBC
• CONCLUSION
• REFERENCE

3. RBC –OTHER NAMES;
• RED BLOOD CELLS ALSO CALLED
• ERYTHROCYTES
• RED CELLS
• RED BLOOD CORPUSCLES
• HAEMATIDS
• [GREEK :’ERYTHROS’-”RED” AND ‘KYTOS’-”HOLLOW
VESSEL”,’CYTE’TRANSLATED AS “CELL” IN MODERN USAGE]

4. FUNCTIONAL MORPHOLOGY OF RBC:
• THE RED BLOOD CELLS(MATURE ERYTHROCYTES) FORM ONE OFTHE
IMPORTANT CONSTITUENT OFTHE CELLULAR ELEMENTS OFTHE
BLOOD
• EACH RBC LIKE ANY OTHER CELL INTHE BODY IS BOUNDED BY A CELL
MEMBRANE BUT IS NON NUCLEATED AND LACKSTHE USUAL CELL
ORGANELLES
• THE CYTOPLASM OFTHE RBC CONTAINS A SPECIAL PIGMENTED
PROTEIN CALLEDTHE HAEMOGLOBINWHICH FORMS 90% WEIGHT OF
ERYTHROCYTE.
• THE RED COLOUR OFTHE RBC ANDTHUS OFTHE BLOOD IS DUETOTHE
PRESENCE OF HAEMOGLOBIN.

5. NORMAL SIZE:
• DIAMETER OF EACH RBC IS 7.8MICROMETERS (RANGE 6.9-7.4 Um)
• THICKNESS OFTHE PERIPHERY IS 2 MICROMETERS AND INTHE CENTRE 1
Um
• SURFACE AREA OF EACH RBC IS ABOUNT 120-140uM2
• VOLUME IS ABOUT 80 CUBIC MICROMETERS (RANGE 78-86uM3)

7. NORMAL SHAPE:
• THE RED BLOOD CELLS ARE CIRCULAR,BICONCAVE,DISCS
• ADVANTAGE OF BICONCAVE SHAPE ARE:
• IT RENDERSTHE RED CELLS QUITE FLEXIBLE SOTHATTHEY CAN
PASSTHROUGH CAPILLARIESWHOSE MINIMUM DIAMETER IS 3.5uM
• THE BIOCANCAVITY PROVIDES GREATER SURFACE AREA AS
COMPAREDTOVOLUME WHICHALLOWS CONSIDERABLE ALTERATIONS IN
THE CELLVOLUME.THUSTHE RBC CANWITHSTAND CONSIDERABLE
CHANGES OF OSMOTIC PRESSURE,INTHISWAYTHE RBCs CAN RESIST
HAEMOLYSISTO CERTAIN EXTENT WHEN PLACED IN HYPOTONIC
SOLUTION.

8. CONT….
• GREATER SURFACE AREA ALLOWS EASY EXCHANGE OF O2 AND
CO2 AND RAPID DIFFUSION OF OTHER SUBSTANCES.

9. NORMAL COUNT
• AT BIRTH : 6-7MILLIONS/MM3
• IN ADULTS MALES:5-6.5MILLIONS/MM3(AVR 5.5MILLION/MM3)
• IN FEMALES:4.5 – 5.5 MILLION/MM3(AVR 4.8MILLION/MM3)
• CLINICALLYTHE COUNT OF 5 MILLION/MM3 IS CONSIDERED AS 100%.
• NOTE:-PERSONS IN HIGHALTITUDES HAVE GREATER NO.OF RBC

10. FUNCTIONS OF RBC:
• THE PRIMARY FUNCTION IS:
• CARRY OXYGEN FROMTHE LUNGSTO ALL CELLS THAT NEEDS
OXYGEN(FOR CELLULAR RESPIRATION)
• TO CARRYWASTE CARBONDIOXIDE FROM CELLS BACKTOTHE
LUNGS,WHERE IT IS REFORMED(DEHYDRATED)INTOTHE CARBON DIOXIDE
AND EXHALED.

12. HEMOGLOBIN STRUCTURE OF HB
 FUNCTION OF HB
 NORMALVALUES
 OXYGEN DISSOCIATION
CURVE
 BOHR EFFECT

13. HEMOGLOBIN
• HEMOGLOBIN ISTHE RED BLOOD PIGMENT,EXCLUSIVELY FOUND IN
ERYTHROCYTES
• GREEK:ERYTHROSE-RED
• KYTOS-HALLOWVESSEL

14. STRUCTURE OF HB:
• HEMOGLOBIN (MOL.WGT:64,450)IS A CONJUCATED PROTEIN
CONTAINING GLOBIN-THE APO PROTEIN PART ANDTHE HEME-THE
NON PROTEIN PART(PROSTHEIC GROUP)
• “TETRAMERIC ALLOSTERIN PROTEIN”

15. STRUCTURE OF GLOBIN:
• GLOBIN CONSISTS OF FOUR POLYPEPTIDES CHAIN OFTWO DIFFERENT
PRIMARY STRUCTURES(MONOMERIC UNIT)
• THE COMMON FORM OF ADULT HEMOGLOBIN(HBA1) IS MADE UP OFTWO
ALPHA CHAINS,AND TWO BETA CHAINS’SOME AUTHOURS CONSIDER
HB.CONSISTS OFTWO IDENTICAL DIMERS-ALPHA BETA 1,ALPHA BETA 2
• EACH ALPHA CHAIN CONTAINS 141 AMINO ACIDS
• BETA CHAIN CONTAINS 146 AMINO ACIDS
• HBA1 HASTOTAL OF 574 AMINO ACIDS

17. STRUCTURE OF HEME:
• THE CHARACTERISTIC RED COLOUR OF HEMOGLOBIN IS DUETO HEME.
• IT HAS A PORPHYRIN MOLECULES NAMELY”PROTOPORPHYRIN IX”,WITH
IRONS AT CENTER
• THIS CONSISTS OF 4 PYRROLE RINGS
• 4METHYL
• 2 PROPIONYL
• 2VINYL GROUP

19. FUNCTION OF HEMOGLOBIN:
• DELIVERY OF OXYGENTOTHE LUNGSTOTHETISSUES
• TRANSPORT OF CO2 AND PROTONS FROMTISSUETO LUNGS FOR
EXPIRATION AND EXCREATION

21. OXYGEN DISSOCIATION CURVE:
• THE BINDING ABILITY OF HBWITH O2 AT DIFFERENT PARTIAL PRESSURE
OF OXYGEN(PO2) CAN BE MEASURED BY A GRAPHIC REPRESENTATION
KNOWN AS O2 DISSOCIATION CURVE.

23. BINDING OF O2TO HB:
• ONE MOLECULE OF HBWILL BINDTO 4 MOLECULES OF O2
COOPERATIVE BINDING OF O2TO HB;
BINDING OF O2TO ONE HEME INCREASESTHE BINDING OF O2
TO OTHER HEME

24. BOHR EFFECT
• THE BINDING OF OXYGENTO HB DECREASES WITH INCREASINH H+
CONCENTRATION(LOW PH)
(OR)
• WHENTHE HB.IS EXPOSEDTO INCREASED PARTIAL PRESSURE OF CO2
(PCO2)
• IT IS DUETOTHE CHANGE IN AFFINITY OF O2TO HB
• IT CAUSES SHIFT INTHE O2 DISSOCIATION CURVETOTHE RIGHT

26. FUNCTIONS OF RED PIGMENT INTHE RBC:
• RED PIGMENT OF RBC IS HAEMOGLOBIN(IRON CONTAINING PIGMENT)
• THIS IS RESPONSIBLE FORTHETRANSFER OF GASES(O2
AND CO2)ACROSS CELLS.

27. • RBC(HB) HEME GROUP + O2(REVERSIBILY)
• EG.IN ALVEOLI OFTHE LUNGS,HB HAS HIGHAFFINITY FOR O2
• IN LOW O2 ENVIRONMENT(EG.MUSCLES)WERE,HB CHARACTERISTICS
CHANGE IN SUCH AWAYTHAT ITS ABILITYTO BIND O2 DECREASES
MARKEDLYTHUS RELEASING O2
• IN SUM,HB INTHE RED BLOOD CELLS PICKS UP O2 FROMTHE AIR SPACE
INTHE AIR SAC OFTHE LUNGSWHERE O2 IS ABUUNDENT,AND RELEASES
O2WHERE O2 CONC.IS LOW.

28. DOES RED BLOOD CELLS ARE ALIVE?
• THE CELL WITHOUT ANY NUCLEUS AND MITOCHONDRIA WILL NOT BE ALIVE.
• SO,RED BLOOD CELLS ARE ALIVE
?

29. ANSWER: YES
• THE ENERGY NEEDS AREVERY LOW FORTHETRANPORTATION OF O2
TO ALL PARTS OFTHE BODY.
• THIS ENERGY ARE OBTAINED SOLELY BY”GLYCOLYSIS”
• [1 MOLECULE OF GLUCOSEYIELDS-2 MOLECULES OF ATP BY ONE
ANAEROBC GLYCOLYTIC PATHWAY]

30. NUTRITION REQUIREMENT FOR RBC:
• HOWTO INCREASE RED BLOOD CELL COUNT???

31. INCORPORATE IRON RICH FOOD INYOUR
DIET:
• BEANS/LEGUMES
• LENTILS
• GREEN LEAFYVEGETABLES
• DRIED FRUITS INCLUDING PRUNES
• MEAT LIVER,KIDNEY
• EGGYOLK
• RED MEAT
• DRIED RAISINS

32. GET MORE COPPER
• ACCESSTHE CHEMICAL FORM OF IRON NECESSARY FOR RED BLOOD
CELLS DURINGTHE PROCESS OF IRON METABOLISM
• POULTRY MEATS
• SHELLFISH
• LIVER
• WHOLE GRAIN
• CHOCOLATE
• BEANS,CHERRIES
• NUTS

33. GET ENOUGH FOLIC ACID!
• CEREALS
• BREAD
• LEAFYVEGETABLES
• PEAS
• BEANS
• NUTS

34. TAKEVITAMIN A(RETINOL)
• VIT A SUPPORTS STEM CELL DEVELOPMENT OF RBC INTHE BONE MARROW
BY ENSURINFTHAT DEVELOPING RBC ACCESS ENOUGH IRON REQUIEDTO
PROCESS HB.
• SWEET POTATOES
• CARROTS
• SWEET RED PEPPERS
• FRUITS-APRICOT.WATERMELON,GRAOE.PLUMS

35. GETYOURVITAMIN C,
• PRODUCES SYNERGISTIC EFFECT,THIS BOOSTSTHE ABILITY OFTHE
BODYTO ABSORB MORE ION,INCREASING RED BLOOD CELL
PRODUCTION.

36. AJWA DATES
• BEST NATURAL SOURCE OF ESSENTIALVITAMINS AND MINERALS SUCH
AS,IRON,MG.VIT-B AND DIETRY FIBERS
• DAILYTAKE 7 AJWA DATES+1 CUPWARM MILK FOR 1 OR 2WEEKS

37. PLUMS
• POTASSIUM AND ION IN PLUMS ARE BEST FOR RED BLOOD FORMATION
• DAILYTAKE 10 FRESH PLUMS AND REMOVETHE SEEDS AND BLEND
THEM IN A BLENDER WITH ONE GLASS OFWATER. FILTER IT ANDTAKE IT
ON AN EMPTY STOMACH EARLY INTHE MORNING AND ALSO EVENING.
• WITH IN ONE MONTHYOUR RBC COUNT BOOSTS UP NATURALLY

38. RED GRAPES
• CURES BLOOD DISORDERS WHICH CAUSES LOW RBC AND IS AVERY
GOOD PURIFIER OF BLOOD.
• IT FLUSHES OUT HARMFULTOXINS FROMTHE BODY
• TAKE 100GRAMS OF RED GRAPES OR 1 CUP FRESH RED GRAPE JUICE
FOR 1 MONTH

39. MANGOES
• MANGOES ARE AWONDERFULLY HEALTHY ADDITIONTHAT ARE RICH IN
VIT-A ,DIETRY FIBERS AND ANTIOXIDANTS,IT IS ALSO A GOOD SOURCE
OF B COMPLEX –WHICH CONVERTS FOOD INTO ENERGY
• ADD 1 OR 2 MANGO PULP IN FRESH COW MILKWITH 1TEASPOON OF
GINFER JUICE MIXWELL.COOL IT AND DRINK

40. LYCHEE
• LYCHEE HAS AVERY GOOD AMOUNT OF MINERALS LIKE POTASSIUM
AND COPPER
• COPPER IN LYCHEE HELPS IN PRODUCTION OF RBC
• EATING 2 LYCHEES AFTER EVERY 6 HRS DAILY IS ONETHE BEST FOOD
TIPTO PRODUCE NEW BLOOD CELLS(RBC AND PLATELETS)

41. DRIED APPLE WITH HONEY
• CUT ONE MEDIUM SIZE APPLE INTO SLICES IN A PLATE AND COVERTHE
PLATE WITH A COOTON CLOTH PIECE.LEAVE IT OVERNIGHT AT ROOM
TEMPERATURE.
• NEXT MORNING APPLE SLICES BECOME BROWN NOW DIPTHEM IN
HONEY AND EAT SLICESWITH A GLASS OFWARM MILK.
• WITH IN ONE MONTHYOU CAN BOOSTYOUR LOW RBC COUNT
NATURALLY

42. POMEGRANATE JUICE
• 1 GLASS OF APPLE JUICE
• 2TABLESPOONS LEMON JUICE COOK FOR 2 OR 3 HRS
• 2TABLESPOON MINT JUICE
• ¼ CUP OF POMEGRANATE JUICE MAKE A SYRUP
• 1KG NATURAL SUGAR
• THIS AGICAL HOME MADE SYRUPWILL IMPROVEYOUR RED BLOOD CELLS
AND HB LEVEL IN A FEW DAYS

43. PRODUCTION OF RBC
• INTHE EARLY WEEKS OF EMBRYONIC LIFE-NUCLEATED RBCs ARE
PRODUCED INTHEYOLK SAC
• DURING MIDDLETRIMESTER OF GESTATION-LIVER ISTHE MAIN SOURCE
OF PRODUCTION OF RBCs ,BUT RESONABLE NUMBERS ARE ALSO
PRODUCED INTHE SPLEEN AND LYMPH NODES
• THEN,LAST MONTH OR SO OF GESTATION AND AFTER BIRTH-RBCs
PRODUCED EXCLUSIVELY INTHE BONE MARROW

45. • THE BONE MARROW OF ESSENTIALLY ALL BONES PRODUCES RED
CELLS UNTIL A PERSON IS 5YRS OLD
• THE MARROW OFTHE LONG BONES ,EXCEPT FORTHE PROXIMAL
PORTIONS OFTHE HUMERI ANDTIBIEA,BECOMES QUITE FATTY AND
PRODUCE NO MORE RBCs AFTER ABOUT AGE 20YRS
• AFTER 20YRS-RBCs CONTINUETO BE PRODUCED INTHE
MEMBERABOUS BONES,SUCH ASTHEVERTEBRAE,STERNUM,RIBS AND
ILIA

47. REGULATION OF RBC:

48. ERYTHROPOISIS:

50. METABOLISM OF RBC
• TWO MAIN METABOLISM INVOLVED:
• GLYCOLYSIS
• PENTOSE PHOSPHATE PATHWAY
• RAPOPORT LUBERING PATHWAY

51. GLYCOLYSIS PATHWAY:
• ALSO CALLED EMBDEN-MEYERHOF PATHWAY
• DEFN:
• GLYCOLYSIS IS DEFINED ASTHE SEQUENCE OF REACTIONS CONVERTIG
GLUCOSETO PYRUVATE OR LACTATE WITHTHE PRODUCTION OF ATP
• PRODUCTION OF ATP IN GLYCOLYSIS
• AEROBI=3-4
• ANAEROBIC=2

54. RAPOPORT LUBERING PATHWAY
• IT IS AN SUPPLEMENTARY PATHWAYTO GLYCOYSIS
• IT IS CONSERNED WITHTHE SYNTHESIS OF 2,3 BPG INTHE RBC
• 1,3 BPG IN GLYCOLYSIS IS CONVERTEDTO 2,3 BPG BYTHE ENZYME
BISPHOSPHOGLYCERATE MUTASE

56. SIGNIFICANCE OF 2,3BPG
• A SHUNT PATHWAY FOR GLYCOLYSIS
• OXYHEMOGLOBIN UNLOADS MORE O2TOTHETISSUE

57. HMP SHUNT
• ALSO CALLED AS PENTOSE PHOSPHATE PATHWAY(PPP)
• THIS IS AN ALTERNATIVE PATHWAYTO GLCOLYSISANDTCA CYCLE FOR
THE OXIDATION OF GLUCOSE
• IT IS CONCERNED WITHTHE BIOSYNTHESIS OF PENTOSES AND NADPH

59. IMPORTANCE OF PENTOSES:
• HEXOSES ARE CONVERTED INTO PENTOSES,MOST IMPORTANT BEING
RIBOSE 5-PHOSPHATE
• USEFUL FORTHE SYNTHESIS OF NUCLEIC ACID(RNA AND DNA)
• AND MANY NUCLEOTIDES SUCH AS ATP,NADP,COA….

60. IMPORTANT OF NADPH:
• ANTIOXIDENT REACTION
• SPECIAL FUNCTION:
• IT MAINTAINSTHE INTEGRITY OF RBC MEMBRANE
• TO KEEPTHE FE+ ION OG HB INTHE REDUCED STATE SO
THAT ACCUMULATION OF METHEMOGLOBIN IS PREVENTED

61. GLUCOSE 6 PHOSPHATE DEHYDROGENASE
DEFICIENCY:
• IT IS A SEX LINKEDTRAIT
• IT ISTHE FIRST ENZYME INTHE HMP SHUT PATHWAY,PRODUCES
NADPH
• THIS DEFICIENCY LEADSTO REDUCED PRODUCTION OF NADPH
,ENDING IN ACUTE HEMOLYTIC ANAEMIA

62. FATE OF RBC
• WHEN RBCs ARE DELIVERED FROMTHE BONE MARROW INTOTHE
CIRCULATORY SYSTEM,THEY NORMALLY CIRCULATE AN AVERAGE OF
120DAYS BEFORE BEING DESTROYED
• ONCETHE RED CELL MEMBRANE BECOMES FRAGILE,THE CELL RUPUTRES
DURING PASSAGETHROUGH SOMETIGHT SPOT OFTHE CIRULATION
• MANY OFTHE RED CELLS SELF DESTRUCT INTHE SPLEEN ,WHERETHEY
SQUEEZETHROUGHTHE RED PULP OFTHE SPLEEN

63. • THERE,THE SPACE BETWEENTHE STRUCTURALTRABECULAE OFTHE
RED PUPL,ARE ONLY 3 MICROMETERS WIDE,IN COMPARISON WITHTHE
8-MICROMETER DIAMETER OFTHE RED CELL
• WHENTHE SPLEEN IS REMOVED,THE NUMBER OF OLD ABNORMAL RED
CELLS CIRCULATION INTHE BLOOD INCREASES CONIDERABLY

66. REFERENCES:
• GUYTON BOOK OF CLINICAL PHYSIOLOGY[CHAPTER-32)
• ESSENTIALS OF BIOCHEMISTRY-
SATHYANARAYANAN,CHAKRAPANI[CHAPTER 11,12,13]
• DE GRUCHYS CLINICAL HEMTOLOGY[CHAPTER 1 AND 2]
• INDHU KURANATHEORITICAL PHYSIOLOGY[CHAPTER 6]
• ONLINEWEBSITES-IMAGES

67. THANKYOU………………………………….
HAVE A NICE DAY