Erythropoiesis is the process of red blood cell production in the bone marrow. Mature red blood cells are derived from committed progenitor cells through mitotic division and maturation phases stimulated by erythropoietin. Key events in erythropoiesis include proliferation and differentiation of red blood cell precursors in the bone marrow, entry of mature red blood cells into circulation, and removal of aged red blood cells by the spleen. Proper red blood cell structure and function relies on normal hemoglobin synthesis, membrane integrity, and cellular energetics.
Platelet function tests.pptx 2.pptx finalAnupam Singh
This document summarizes platelet function testing. It discusses how platelets are formed from megakaryocytes in the bone marrow and circulate in the bloodstream. The major platelet function tests are platelet aggregometry, flow cytometry, and point-of-care tests like the impact cone and plate analyzer and thromboelastography. These tests are used to diagnose platelet disorders and monitor antiplatelet therapy. The document also briefly discusses platelet-derived microparticles and microRNAs, which can provide information about platelet activation and signaling.
This presentation is focused on diagnostic utility of Red blood cell indices which will be very useful for undergraduate and postgraduate of medical field.
Hb electrophoresis (principle materials and procedure)hussainshahid55
This document provides information on hemoglobin electrophoresis, including its definition, purpose, principles, procedures, materials, risks, results, factors that can affect the test, and applications. Hemoglobin electrophoresis is used to screen for and diagnose blood disorders by separating normal and abnormal hemoglobin types in blood based on their electrical charges. The procedure involves extracting hemoglobin from blood samples, running the samples through a gel or cellulose acetate strip using an electrical current, then staining and analyzing the strips to identify abnormal hemoglobin levels or variants that can indicate blood disorders.
Immunohistochemistry (IHC) is a highly sensitive method that allows the localization of antigen within a cell or a tissue with high resolution. The method is based on the use of a primary antibody that specifically binds to its complementary antigen. The bound antibody may then be visualized by a variety of methods such as colorimetric end points.
Hemoglobinopathies are disorders that affect the structure, function, or production of hemoglobin. The document discusses normal hemoglobin structure and composition, the genes that encode the globin chains, fetal hemoglobin development, classification of hemoglobinopathies including structural abnormalities and thalassemias, and details on sickle cell disease which results from a single nucleotide change causing valine to replace glutamic acid in the beta globin chain.
I have listed out the LE cells structure and Microscopical examinaton of LE CELLS, Difference between tart cells and le cells, clinical symptoms and diagnostic procedure.
The document discusses various methodologies for analyzing red blood cells (RBCs). It describes the erythrocyte sedimentation rate (ESR) test, which measures how quickly RBCs settle in plasma, and lists several methods for performing the test including the Wintrobe and Westergren methods. It also covers the osmotic fragility test, which examines RBC stability in hypotonic solutions, and erythrocyte indices, which provide information about average RBC size, hemoglobin content, and concentration by calculating mean corpuscular volume, hemoglobin, and hemoglobin concentration.
This document describes various abnormal red blood cell morphologies seen in different hematological conditions. It discusses ovalocytes seen in megaloblastic anemia, spherocytes in hereditary spherocytosis and membrane defects, elliptocytes associated with iron deficiency anemia and thalassemia, echinocytes in renal and liver diseases, burr cells and acanthocytes seen in various conditions. It also summarizes target cells, schistocytes, keratocytes, dacrocytes, sickle cells and other abnormal RBC shapes and their clinical associations.
Platelet function tests.pptx 2.pptx finalAnupam Singh
This document summarizes platelet function testing. It discusses how platelets are formed from megakaryocytes in the bone marrow and circulate in the bloodstream. The major platelet function tests are platelet aggregometry, flow cytometry, and point-of-care tests like the impact cone and plate analyzer and thromboelastography. These tests are used to diagnose platelet disorders and monitor antiplatelet therapy. The document also briefly discusses platelet-derived microparticles and microRNAs, which can provide information about platelet activation and signaling.
This presentation is focused on diagnostic utility of Red blood cell indices which will be very useful for undergraduate and postgraduate of medical field.
Hb electrophoresis (principle materials and procedure)hussainshahid55
This document provides information on hemoglobin electrophoresis, including its definition, purpose, principles, procedures, materials, risks, results, factors that can affect the test, and applications. Hemoglobin electrophoresis is used to screen for and diagnose blood disorders by separating normal and abnormal hemoglobin types in blood based on their electrical charges. The procedure involves extracting hemoglobin from blood samples, running the samples through a gel or cellulose acetate strip using an electrical current, then staining and analyzing the strips to identify abnormal hemoglobin levels or variants that can indicate blood disorders.
Immunohistochemistry (IHC) is a highly sensitive method that allows the localization of antigen within a cell or a tissue with high resolution. The method is based on the use of a primary antibody that specifically binds to its complementary antigen. The bound antibody may then be visualized by a variety of methods such as colorimetric end points.
Hemoglobinopathies are disorders that affect the structure, function, or production of hemoglobin. The document discusses normal hemoglobin structure and composition, the genes that encode the globin chains, fetal hemoglobin development, classification of hemoglobinopathies including structural abnormalities and thalassemias, and details on sickle cell disease which results from a single nucleotide change causing valine to replace glutamic acid in the beta globin chain.
I have listed out the LE cells structure and Microscopical examinaton of LE CELLS, Difference between tart cells and le cells, clinical symptoms and diagnostic procedure.
The document discusses various methodologies for analyzing red blood cells (RBCs). It describes the erythrocyte sedimentation rate (ESR) test, which measures how quickly RBCs settle in plasma, and lists several methods for performing the test including the Wintrobe and Westergren methods. It also covers the osmotic fragility test, which examines RBC stability in hypotonic solutions, and erythrocyte indices, which provide information about average RBC size, hemoglobin content, and concentration by calculating mean corpuscular volume, hemoglobin, and hemoglobin concentration.
This document describes various abnormal red blood cell morphologies seen in different hematological conditions. It discusses ovalocytes seen in megaloblastic anemia, spherocytes in hereditary spherocytosis and membrane defects, elliptocytes associated with iron deficiency anemia and thalassemia, echinocytes in renal and liver diseases, burr cells and acanthocytes seen in various conditions. It also summarizes target cells, schistocytes, keratocytes, dacrocytes, sickle cells and other abnormal RBC shapes and their clinical associations.
Challenges in interpreting serum protein electrophoresis. Requires an approach to recognize pattern within the various protein fractions & differentiate systemic inflammatory response from abnormal antibody production due to neoplastic disorders.Presence of M-band does not always correlate with plasma cell disorders but can be seen some lymphomas, chronic leukaemias, systemic amyloidosis hence need further ancillary tests for diagnosis of aetiology for the M-band.
This document discusses laboratory tests for serum iron, total iron binding capacity (TIBC), transferrin, ferritin, vitamin B12 and serum folate. It provides objectives, principles, methodologies, normal ranges and limitations for each test. The tests are useful in diagnosing iron deficiency anemia and vitamin deficiencies. Sample collection and handling factors that could impact results are also outlined.
This document discusses the erythrocyte sedimentation rate (ESR) test, including the objectives, principle, mechanism, factors affecting ESR, clinical significance, and methods of estimating ESR. ESR is a non-specific test that measures how far red blood cells fall in one hour, indicating inflammation. The rate depends on factors that promote or resist sedimentation and is affected by physiological conditions and test variables. An increased ESR may indicate infection, inflammation or disease while a decreased ESR can occur in certain blood disorders. Common estimation methods include Wintrobe's, Westergren's and automated techniques.
Chemiluminescence Immunoassay (CLIA) using Microplate luminometers provides a sensitive, high throughput, and economical way to quantitatively measure antigen in cell lysates, plasma, urine, saliva, tissue and culture media samples.
Chemiluminescence Immunoassay does not require long incubations and the addition of stopping reagents, as is the case in conventional colorimetric assays such as Enzyme-linked ImmunoSorbent Assays (ELISA).
Among various enzyme assays that employ light-emitting reactions, one of the most successful assays is the enhanced chemiluminescent immunoassay involving a horseradish peroxidase (HRP) labeled antibody or antigen and a mixture of chemiluminescent substrate, hydrogen peroxide, and enhancers.
In recent years, CLIA has become very popular in clinical chemistry and environmental analysis, due to its high sensitivity, wide dynamic range and complete automation. With the development and application of recombinant Ab (rAb) technology, markers and related techniques, solid-phase materials and improvements in automation, integration and miniaturization, CLIA has acquired an entirely new appearance.
Serum protein electrophoresis & their clinical importanceDr.M.Prasad Naidu
This document discusses serum proteins and electrophoresis techniques used to analyze them. It provides details on the major serum proteins - albumin and globulins - and their functions. Electrophoresis separates proteins based on their charge and size. Several electrophoresis methods are described, including agarose gel, SDS-PAGE, and capillary electrophoresis. Factors influencing electrophoresis results and common stains used are also outlined. The document concludes with descriptions of normal and abnormal serum protein electrophoresis patterns and their clinical significance.
This document provides information on interpreting histograms from cell counters. It discusses the principles of electronic impedance and optical light scatter cell counting methods. Histograms graphically represent cell population data based on cell size on the x-axis and cell number on the y-axis. Normal ranges are provided for red blood cell, platelet, and white blood cell histograms. Various flags that could appear are described, including possible causes such as platelet clumping, red blood cell agglutination, or extreme leukocytosis. Parameters for each cell type are also defined.
The document provides information about peripheral blood smear examination. It discusses how peripheral blood smears are an important diagnostic tool that provide information about hematologic disorders through examination of red blood cells, white blood cells, and platelets. It outlines the procedure for preparing, staining, and examining a peripheral blood smear under the microscope. Key things examined include red blood cell size, shape, color, and inclusions, as well as white blood cell and platelet counts, differentials, and morphologies. Common red blood cell abnormalities seen include microcytosis, macrocytosis, anisocytosis, poikilocytosis, hypochromasia, polychromasia, and inclusions.
Dr. S. Ismat Bukhari's document discusses G6PD deficiency, the most common enzyme deficiency worldwide. It affects over 200 million individuals, predominantly in areas like the Middle East, Africa, and Asia. G6PD deficiency is caused by mutations in the G6PD gene and results in inadequate protection of red blood cells from oxidative stress. This can lead to hemolysis, jaundice, and anemia, especially after exposure to oxidizing drugs or foods. The document outlines the inheritance, clinical manifestations, treatment, and screening of G6PD deficiency.
Serum protein electrophoresis is used to separate serum proteins into fractions based on their size and electrical charge. It has five major fractions: albumin, alpha1, alpha2, beta, and gamma globulins. Specific diseases and conditions cause abnormal patterns in the fractions. For example, liver disease decreases albumin levels while nephrotic syndrome increases alpha2 levels due to protein loss in the urine. The test is useful for identifying inflammatory states, immunodeficiencies, and monoclonal gammopathies.
This document discusses methods for determining fibrinogen levels. Fibrinogen is a blood coagulating protein synthesized by the liver and plays a key role in blood clotting. The document outlines several methods for measuring fibrinogen including physical-chemical methods, congealable protein methods, and immunology methods. It focuses on the fibrinogen activity test which works by measuring the clotting time after thrombin is added to a sample, with shorter clotting times indicating higher fibrinogen levels. The test procedure, reagents, calibration curve preparation, and clinical significance of fibrinogen levels are also summarized.
Autoimmune hemolytic anemia (or autoimmune haemolytic anaemia; AIHA) occurs when antibodies directed against the person's own red blood cells (RBCs) cause them to burst (lyse), leading to insufficient plasma concentration.
1. Erythrocyte sedimentation rate (ESR) measures the rate at which red blood cells settle in a tube of blood over one hour. It is a non-specific test used to detect inflammation.
2. ESR works by fibrinogen proteins adhering to red blood cells, neutralizing their negative charge and allowing them to stick together and fall faster as rouleaux. Conditions with elevated fibrinogen like infection, inflammation, and malignancy increase ESR.
3. ESR is measured using the Westergreen, Wintrobe, or automated methods. The Westergreen method is the reference standard. ESR values are interpreted based on age, sex and clinical context.
Hemolytic Anemia Investigation - By Mohan kumarSchin Dler
This document summarizes hemolytic anemia, including its causes, characteristics, laboratory tests used for evaluation, and specific types like hereditary spherocytosis, hereditary elliptocytosis, G6PD deficiency, sickle cell disease, and thalassemia. Key tests discussed are serum bilirubin, urine urobilinogen, fecal stercobilinogen, serum haptoglobin, LDH, reticulocyte count, and the Coombs test for immunohemolytic anemia. Causes of hemolytic anemia include blood loss, increased red blood cell destruction (hemolysis), and increased red blood cell production.
priciples and applications Immunohistochemistry Markos Tadele
This document provides an overview of immunohistochemistry (IHC), including the principle, general protocol, and key steps. IHC combines histology and immunology to identify specific tissue components using antigen-antibody reactions tagged with visible labels. The protocol involves fixing, embedding, sectioning tissues, performing antigen retrieval, incubating with primary/secondary antibodies, and visualizing the antigen-antibody complex through detection systems like peroxidase or fluorescence. Proper controls and interpretation by a pathologist are needed for accurate results.
Platelet function testing assesses platelet adhesion, activation, granule release and aggregation in response to agonists using light transmission platelet aggregometry (LTA) as the gold standard test. Abnormal LTA results can indicate defects in platelet adhesion receptors, activation and secretion, aggregation receptors, or the thromboxane pathway. The pattern of abnormal aggregation in response to different agonists helps localize the platelet function defect.
1. The document discusses the differentiation between myeloid leukemoid reaction, chronic myeloid leukemia (CML), and chronic neutrophilic leukemia (CNL).
2. Key differences include peripheral smear findings, bone marrow aspirate/biopsy pictures, LAP scores, cytogenetics, and immunophenotyping results.
3. A leukemoid reaction is secondary to an underlying cause and shows features of that cause, while CML and CNL are myeloproliferative neoplasms with distinct clinical features, lab findings, and disease progression.
This document discusses several red blood cell indices used to characterize anemias, including mean cell volume (MCV), mean cell hemoglobin (MCH), mean cell hemoglobin concentration (MCHC), and red cell distribution width (RDW). It provides details on how each index is calculated and interpreted, and examples of abnormal red blood cell morphologies seen in different types of anemias that would affect the index values.
cytochemical stains. CML versus Leukamoid. LAP score. NAP score. Hematology, Hematopathology. Lab technology. Pahology. Medical Laboratory. White cell stains
This document provides information on various cytochemical staining techniques used in hematology, including myeloperoxidase, esterase, alkaline phosphatase, acid phosphatase, Sudan black B, periodic acid Schiff, and Toluidine blue staining. It describes the principle, reagents, procedure, and interpretation for each stain. These stains are used to classify and diagnose different types of leukemia by identifying cellular enzymes and components in blood and bone marrow samples.
This document discusses various staining techniques used in cytology, including both routine and special stains. It provides details on the principles, procedures, and applications of stains such as May-Grunwald Giemsa, Diff-Quik, Papanicolaou, hematoxylin and eosin, periodic acid Schiff, mucicarmine, Alcian blue, Oil red O, Congo red, Feulgen, and Ziehl-Neelsen. The stains are used to demonstrate cellular and extracellular components, identify infectious organisms, and examine DNA content. Proper staining allows visualization of structures like glycogen, mucin, lipids, amyloid, and acid-fast bacteria under the microscope.
1. Red blood cells (erythrocytes) constitute 99% of blood cells and function to transport oxygen to tissues and carbon dioxide from tissues to the lungs.
2. Erythrocytes contain hemoglobin which gives blood its red color and allows for oxygen transport. They are biconcave discs that are able to deform to pass through small blood vessels.
3. The erythrocyte membrane is selectively permeable and regulates ion content. It contains proteins, lipids, and carbohydrates that maintain the biconcave shape and cellular integrity of erythrocytes.
The red blood cell membrane consists of 50% protein, 20% phospholipid, 20% cholesterol, and 10% carbohydrate. It has three basic components: a lipid bilayer, integral membrane proteins, and a membrane cytoskeleton. The cytoskeleton is formed by structural proteins including spectrin, actin, ankyrin, and proteins 4.1 and 4.2. It interacts with the lipid bilayer and maintains the biconcave shape of red blood cells. Defects in membrane proteins can cause hereditary disorders like hereditary spherocytosis or elliptocytosis, which are inherited hemolytic anemias.
Challenges in interpreting serum protein electrophoresis. Requires an approach to recognize pattern within the various protein fractions & differentiate systemic inflammatory response from abnormal antibody production due to neoplastic disorders.Presence of M-band does not always correlate with plasma cell disorders but can be seen some lymphomas, chronic leukaemias, systemic amyloidosis hence need further ancillary tests for diagnosis of aetiology for the M-band.
This document discusses laboratory tests for serum iron, total iron binding capacity (TIBC), transferrin, ferritin, vitamin B12 and serum folate. It provides objectives, principles, methodologies, normal ranges and limitations for each test. The tests are useful in diagnosing iron deficiency anemia and vitamin deficiencies. Sample collection and handling factors that could impact results are also outlined.
This document discusses the erythrocyte sedimentation rate (ESR) test, including the objectives, principle, mechanism, factors affecting ESR, clinical significance, and methods of estimating ESR. ESR is a non-specific test that measures how far red blood cells fall in one hour, indicating inflammation. The rate depends on factors that promote or resist sedimentation and is affected by physiological conditions and test variables. An increased ESR may indicate infection, inflammation or disease while a decreased ESR can occur in certain blood disorders. Common estimation methods include Wintrobe's, Westergren's and automated techniques.
Chemiluminescence Immunoassay (CLIA) using Microplate luminometers provides a sensitive, high throughput, and economical way to quantitatively measure antigen in cell lysates, plasma, urine, saliva, tissue and culture media samples.
Chemiluminescence Immunoassay does not require long incubations and the addition of stopping reagents, as is the case in conventional colorimetric assays such as Enzyme-linked ImmunoSorbent Assays (ELISA).
Among various enzyme assays that employ light-emitting reactions, one of the most successful assays is the enhanced chemiluminescent immunoassay involving a horseradish peroxidase (HRP) labeled antibody or antigen and a mixture of chemiluminescent substrate, hydrogen peroxide, and enhancers.
In recent years, CLIA has become very popular in clinical chemistry and environmental analysis, due to its high sensitivity, wide dynamic range and complete automation. With the development and application of recombinant Ab (rAb) technology, markers and related techniques, solid-phase materials and improvements in automation, integration and miniaturization, CLIA has acquired an entirely new appearance.
Serum protein electrophoresis & their clinical importanceDr.M.Prasad Naidu
This document discusses serum proteins and electrophoresis techniques used to analyze them. It provides details on the major serum proteins - albumin and globulins - and their functions. Electrophoresis separates proteins based on their charge and size. Several electrophoresis methods are described, including agarose gel, SDS-PAGE, and capillary electrophoresis. Factors influencing electrophoresis results and common stains used are also outlined. The document concludes with descriptions of normal and abnormal serum protein electrophoresis patterns and their clinical significance.
This document provides information on interpreting histograms from cell counters. It discusses the principles of electronic impedance and optical light scatter cell counting methods. Histograms graphically represent cell population data based on cell size on the x-axis and cell number on the y-axis. Normal ranges are provided for red blood cell, platelet, and white blood cell histograms. Various flags that could appear are described, including possible causes such as platelet clumping, red blood cell agglutination, or extreme leukocytosis. Parameters for each cell type are also defined.
The document provides information about peripheral blood smear examination. It discusses how peripheral blood smears are an important diagnostic tool that provide information about hematologic disorders through examination of red blood cells, white blood cells, and platelets. It outlines the procedure for preparing, staining, and examining a peripheral blood smear under the microscope. Key things examined include red blood cell size, shape, color, and inclusions, as well as white blood cell and platelet counts, differentials, and morphologies. Common red blood cell abnormalities seen include microcytosis, macrocytosis, anisocytosis, poikilocytosis, hypochromasia, polychromasia, and inclusions.
Dr. S. Ismat Bukhari's document discusses G6PD deficiency, the most common enzyme deficiency worldwide. It affects over 200 million individuals, predominantly in areas like the Middle East, Africa, and Asia. G6PD deficiency is caused by mutations in the G6PD gene and results in inadequate protection of red blood cells from oxidative stress. This can lead to hemolysis, jaundice, and anemia, especially after exposure to oxidizing drugs or foods. The document outlines the inheritance, clinical manifestations, treatment, and screening of G6PD deficiency.
Serum protein electrophoresis is used to separate serum proteins into fractions based on their size and electrical charge. It has five major fractions: albumin, alpha1, alpha2, beta, and gamma globulins. Specific diseases and conditions cause abnormal patterns in the fractions. For example, liver disease decreases albumin levels while nephrotic syndrome increases alpha2 levels due to protein loss in the urine. The test is useful for identifying inflammatory states, immunodeficiencies, and monoclonal gammopathies.
This document discusses methods for determining fibrinogen levels. Fibrinogen is a blood coagulating protein synthesized by the liver and plays a key role in blood clotting. The document outlines several methods for measuring fibrinogen including physical-chemical methods, congealable protein methods, and immunology methods. It focuses on the fibrinogen activity test which works by measuring the clotting time after thrombin is added to a sample, with shorter clotting times indicating higher fibrinogen levels. The test procedure, reagents, calibration curve preparation, and clinical significance of fibrinogen levels are also summarized.
Autoimmune hemolytic anemia (or autoimmune haemolytic anaemia; AIHA) occurs when antibodies directed against the person's own red blood cells (RBCs) cause them to burst (lyse), leading to insufficient plasma concentration.
1. Erythrocyte sedimentation rate (ESR) measures the rate at which red blood cells settle in a tube of blood over one hour. It is a non-specific test used to detect inflammation.
2. ESR works by fibrinogen proteins adhering to red blood cells, neutralizing their negative charge and allowing them to stick together and fall faster as rouleaux. Conditions with elevated fibrinogen like infection, inflammation, and malignancy increase ESR.
3. ESR is measured using the Westergreen, Wintrobe, or automated methods. The Westergreen method is the reference standard. ESR values are interpreted based on age, sex and clinical context.
Hemolytic Anemia Investigation - By Mohan kumarSchin Dler
This document summarizes hemolytic anemia, including its causes, characteristics, laboratory tests used for evaluation, and specific types like hereditary spherocytosis, hereditary elliptocytosis, G6PD deficiency, sickle cell disease, and thalassemia. Key tests discussed are serum bilirubin, urine urobilinogen, fecal stercobilinogen, serum haptoglobin, LDH, reticulocyte count, and the Coombs test for immunohemolytic anemia. Causes of hemolytic anemia include blood loss, increased red blood cell destruction (hemolysis), and increased red blood cell production.
priciples and applications Immunohistochemistry Markos Tadele
This document provides an overview of immunohistochemistry (IHC), including the principle, general protocol, and key steps. IHC combines histology and immunology to identify specific tissue components using antigen-antibody reactions tagged with visible labels. The protocol involves fixing, embedding, sectioning tissues, performing antigen retrieval, incubating with primary/secondary antibodies, and visualizing the antigen-antibody complex through detection systems like peroxidase or fluorescence. Proper controls and interpretation by a pathologist are needed for accurate results.
Platelet function testing assesses platelet adhesion, activation, granule release and aggregation in response to agonists using light transmission platelet aggregometry (LTA) as the gold standard test. Abnormal LTA results can indicate defects in platelet adhesion receptors, activation and secretion, aggregation receptors, or the thromboxane pathway. The pattern of abnormal aggregation in response to different agonists helps localize the platelet function defect.
1. The document discusses the differentiation between myeloid leukemoid reaction, chronic myeloid leukemia (CML), and chronic neutrophilic leukemia (CNL).
2. Key differences include peripheral smear findings, bone marrow aspirate/biopsy pictures, LAP scores, cytogenetics, and immunophenotyping results.
3. A leukemoid reaction is secondary to an underlying cause and shows features of that cause, while CML and CNL are myeloproliferative neoplasms with distinct clinical features, lab findings, and disease progression.
This document discusses several red blood cell indices used to characterize anemias, including mean cell volume (MCV), mean cell hemoglobin (MCH), mean cell hemoglobin concentration (MCHC), and red cell distribution width (RDW). It provides details on how each index is calculated and interpreted, and examples of abnormal red blood cell morphologies seen in different types of anemias that would affect the index values.
cytochemical stains. CML versus Leukamoid. LAP score. NAP score. Hematology, Hematopathology. Lab technology. Pahology. Medical Laboratory. White cell stains
This document provides information on various cytochemical staining techniques used in hematology, including myeloperoxidase, esterase, alkaline phosphatase, acid phosphatase, Sudan black B, periodic acid Schiff, and Toluidine blue staining. It describes the principle, reagents, procedure, and interpretation for each stain. These stains are used to classify and diagnose different types of leukemia by identifying cellular enzymes and components in blood and bone marrow samples.
This document discusses various staining techniques used in cytology, including both routine and special stains. It provides details on the principles, procedures, and applications of stains such as May-Grunwald Giemsa, Diff-Quik, Papanicolaou, hematoxylin and eosin, periodic acid Schiff, mucicarmine, Alcian blue, Oil red O, Congo red, Feulgen, and Ziehl-Neelsen. The stains are used to demonstrate cellular and extracellular components, identify infectious organisms, and examine DNA content. Proper staining allows visualization of structures like glycogen, mucin, lipids, amyloid, and acid-fast bacteria under the microscope.
1. Red blood cells (erythrocytes) constitute 99% of blood cells and function to transport oxygen to tissues and carbon dioxide from tissues to the lungs.
2. Erythrocytes contain hemoglobin which gives blood its red color and allows for oxygen transport. They are biconcave discs that are able to deform to pass through small blood vessels.
3. The erythrocyte membrane is selectively permeable and regulates ion content. It contains proteins, lipids, and carbohydrates that maintain the biconcave shape and cellular integrity of erythrocytes.
The red blood cell membrane consists of 50% protein, 20% phospholipid, 20% cholesterol, and 10% carbohydrate. It has three basic components: a lipid bilayer, integral membrane proteins, and a membrane cytoskeleton. The cytoskeleton is formed by structural proteins including spectrin, actin, ankyrin, and proteins 4.1 and 4.2. It interacts with the lipid bilayer and maintains the biconcave shape of red blood cells. Defects in membrane proteins can cause hereditary disorders like hereditary spherocytosis or elliptocytosis, which are inherited hemolytic anemias.
Red blood cells have a lifespan of around 120 days, during which they circulate through the body before being destroyed. There are three main phases to their life: production in the bone marrow, release into circulation, and eventual destruction. Their production requires nutrients like iron, vitamins, amino acids, and hormones. Maintaining the proper balance of production and destruction is critical for red blood cell homeostasis.
normal and abnormalities in red blood cellRfa Mohd
This document provides information on various types of red blood cell morphologies seen on blood smears, including normal and abnormal shapes and inclusions. It describes normocytic and normochromic red blood cells as well as variations such as microcytic, macrocytic, poikilocytes (variations in shape), anisocytosis (variation in size), and polychromasia (variation in color). Specific abnormal red blood cells and inclusions are defined such as sickle cells, target cells, Howell-Jolly bodies, basophilic stippling, malaria parasites, and reticulocytes. Causes and disorders are provided for each abnormal finding.
Blood functions to transport oxygen, nutrients, waste, hormones, and more throughout the body. It is composed of plasma and formed elements including erythrocytes, leukocytes, and thrombocytes. Erythrocytes carry oxygen to tissues via hemoglobin and have a normal lifespan of 100-120 days before being recycled. The erythrocyte sedimentation rate is a common test measuring the rate at which red blood cells sediment in one hour, indicating inflammation.
Erythropoiesis is the process where red blood cells are produced. It occurs in multiple stages starting with stem cells in the bone marrow that differentiate into erythroid progenitor cells and progress through normoblast stages as the cells take up hemoglobin and lose their nuclei to become reticulocytes and then mature red blood cells. Key regulators of erythropoiesis include erythropoietin, iron, vitamin B12 and folic acid which promote red blood cell production and maturation. Hypoxia is the main stimulant for increased erythropoietin secretion from the kidneys which then acts to accelerate the production of red blood cells from progenitor cells in the bone marrow.
Multiple myeloma is characterized by neoplastic proliferation of plasma cells producing monoclonal immunoglobulin. It commonly affects elderly individuals and presents with bone disease, anemia, infections and renal failure. Diagnosis involves finding monoclonal proteins in serum or urine and plasma cell infiltration in bone marrow. Treatment aims to improve quality of life and may include chemotherapy, stem cell transplant, supportive care and management of complications.
Liposomes are spherical vesicles composed of phospholipid bilayers that can encapsulate aqueous solutions. They can be used to deliver both hydrophilic and hydrophobic drug molecules by encapsulating them within the aqueous interior or embedding them within the phospholipid membrane respectively. Liposomes offer several advantages for drug delivery such as protecting drugs, altering pharmacokinetics and biodistribution, and promoting targeted drug delivery. However, liposomal drug formulations also present challenges including high production costs, stability issues, and the potential for new side effects. Ongoing research continues to aim to optimize liposome design and composition to improve drug encapsulation and release properties.
This document provides an overview of a seminar presentation on blood. It discusses the composition of blood including plasma, red blood cells, white blood cells, and platelets. It also describes the formation and maturation of blood cells through hematopoiesis and the specific processes of erythropoiesis, leukopoiesis, and thrombopoiesis. Additionally, it covers the functions, properties, and role of blood in the body.
Blood is composed of cellular components called formed elements (red blood cells, white blood cells, and platelets) suspended in plasma. Red blood cells transport oxygen and carbon dioxide throughout the body. White blood cells help fight infection and disease. Platelets help control bleeding by initiating blood clotting. The bone marrow produces new blood cells through the process of hematopoiesis to replenish aging and damaged cells.
This document discusses cleaning validation in the pharmaceutical industry. It begins by defining cleaning validation and outlining regulatory requirements for cleaning. Key factors in developing a cleaning validation protocol are then summarized, including the product being cleaned, equipment, facilities, cleaning methods, cleaning agents, and sampling and testing. The document stresses that cleaning validation ensures removal of residues and contaminants to meet purity standards for safety. It provides an overview of considerations for each validation factor to help establish effective cleaning procedures.
This document discusses cells, tissues, and organs. It begins by defining the goals of describing plant and animal cell structures and functions, differences between plant and animal cells, and specialized cell structures. Diagrams of liver and leaf cells show key structures. Plant cells have cell walls and chloroplasts while animal cells do not. Descriptions of red blood, muscle, ciliated, xylem, and root hair cell structures and functions are provided. Tissues are groups of similar cells performing shared functions, while organs are groups of tissues working together. Organ systems are groups of organs coordinating related functions.
This document discusses cleaning validation which is important to prevent contamination that could affect product safety and quality. It outlines the purpose, importance and levels of cleaning validation. Key aspects covered include developing a master validation plan, defining appropriate cleaning procedures and sampling methods, establishing acceptance criteria, and using validated analytical methods. The conclusion emphasizes that cleaning procedures must be validated to ensure they are reliable and reproducible.
Cleaning validation is required by regulatory agencies to ensure equipment is cleaned properly between product batches. It provides documented evidence that cleaning procedures consistently reduce residues to acceptable limits. The objective is to verify cleaning removes product, degradation products, preservatives, and potential contaminants. Acceptance criteria include limits for detectable residues and microbial counts. Common sampling methods are swabbing, rinsing, and placebo batches to test cleaned equipment.
This presentation discusses using resealed erythrocytes as drug carriers. Erythrocytes are attractive carriers as they are biocompatible and can carry a broad spectrum of drugs while avoiding toxicity. Drugs can be loaded into erythrocytes through hypotonic lysis or endocytosis methods. Loaded erythrocytes are then resealed and characterized. They provide benefits like prolonged drug release and targeting to specific sites. Applications include delivering enzymes, drugs, and targeting the liver or reticuloendothelial system. Resealed erythrocytes show potential as a drug delivery system.
The document discusses key aspects of cleaning validation including:
1. Cleaning validation is defined as the process of removing contaminants from equipment and monitoring equipment cleanliness for subsequent manufacturing.
2. The purpose of cleaning validation is to ensure product integrity, prevent cross contamination, and allow for equipment reuse in compliance with regulations.
3. Critical parameters that impact cleaning include cleaning agents, methods, times, temperatures, and establishing worst case scenarios for validation.
This document discusses erythropoiesis, the process of red blood cell formation. It outlines the stages of erythropoiesis from pluripotent hematopoietic stem cells to mature red blood cells, including proerythroblasts, basophilic erythroblasts, polychromatophilic erythroblasts, orthochromatic erythroblasts, reticulocytes, and mature red blood cells. It also describes the key factors that regulate erythropoiesis, particularly erythropoietin produced by the kidneys in response to tissue oxygen levels. Vitamin B12 and folic acid also support red blood cell formation.
Aseptic / sterile - “ A state of control attained by using an aseptic work area and performing activities in a manner that precludes microbiological contamination of the exposed sterile product”
Validation of aseptic process should be designed to provide assurance through appropriate testing that all phases and activities of the process remain sterile and it is controlled within the predetermined parameters.
Drug product, container, and closure are subject to sterilization separately, and then brought together.
Erythrocytes, or red blood cells, can be used as carriers for drugs and other molecules. They contain hemoglobin which gives blood its red color and allows for oxygen transport. Various methods can be used to entrap drugs inside erythrocytes, including osmotic lysis and electrical breakdown. Loaded erythrocytes undergo characterization to assess drug content, release kinetics, and effects on cell integrity. Erythrocytes show promise for targeted drug delivery to tissues like the liver and spleen, as well as for extended release of payloads over time.
This document discusses the use of erythrocytes (red blood cells) as drug delivery carriers. It describes how erythrocytes can be loaded with drugs through various methods like hypotonic lysis, dialysis, and electroencapsulation. Loaded erythrocytes are then resealed to form drug-loaded carrier erythrocytes. Erythrocytes offer benefits as carriers including biocompatibility, long circulation times, and the ability to encapsulate large drug volumes. However, limitations include potential drug leakage and an inability to target non-phagocytic tissues. The document reviews various loading methods and their efficiencies.
Red blood cells are produced through erythropoiesis in the bone marrow. This process takes about 7 days and involves the differentiation of multipotential stem cells into proerythroblasts, normoblasts, reticulocytes, and then mature erythrocytes. Erythropoietin, produced mainly in the kidneys in response to tissue hypoxia, stimulates red blood cell production. Iron is essential for hemoglobin synthesis and a deficiency can lead to microcytic anemia. Vitamin B12 and folic acid are also required for red blood cell maturation and deficiencies can cause megaloblastic anemia.
This document provides an overview of a lecture on blood and hematopoiesis. It discusses the composition of blood including the different cell types. It covers topics like hemopoiesis, erythropoiesis, classification of anemias, hemoglobin and related disorders, white blood cells, blood coagulation, and some common blood diseases. The key cell types discussed in more detail include erythrocytes, neutrophils, eosinophils, basophils, and their roles in the immune response. Common blood disorders like sickle cell anemia and thalassemia are also summarized.
The document discusses the process of erythropoiesis, or red blood cell formation, including the regulation of erythropoiesis through erythropoietin (EPO) production and feedback loops to control hemoglobin levels. It describes the multi-step differentiation process from hematopoietic stem cells in bone marrow to mature red blood cells, and the roles of the liver and kidney in producing EPO at different developmental stages. The document also outlines the metabolic pathways in red blood cells, their lifespan of around 120 days before removal by the spleen, and the breakdown of hemoglobin into bilirubin to be processed and excreted by the liver and intest
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(1) Red blood cells (RBCs) transport oxygen and carbon dioxide throughout the body via hemoglobin.
(2) RBCs are biconcave disks that allow for flexibility and efficient gas exchange. Their normal size is 7.2 micrometers in diameter.
(3) RBCs lack a nucleus and organelles. They have a lifespan of around 120 days before being destroyed and recycled by the spleen and liver.
The document summarizes the key components and functions of blood. It describes the formation of blood cells including erythrocytes, leukocytes and platelets through hematopoiesis. It discusses the roles of iron, vitamin B12 and folate in erythropoiesis. The functions of hemoglobin and the structural differences between oxyhemoglobin and deoxyhemoglobin are also summarized.
This document provides an overview of red blood cell structure and physiology. It discusses that blood volume is calculated based on weight, and lists the functions of blood. It describes hematopoiesis, the process of blood cell formation, and focuses on erythropoiesis, the development of red blood cells. Key aspects of red blood cell structure are summarized, including the lipid bilayer membrane, cytoskeleton, integral and peripheral proteins. Hemoglobin, its structure and function in oxygen transport, is also explained. Iron metabolism and the role of hepcidin are briefly covered.
This document provides an overview of red blood cell structure and physiology. It discusses that blood volume is calculated based on weight, and lists the functions of blood. It describes hematopoiesis, the process of blood cell formation, and focuses on erythropoiesis, the development of red blood cells. Key aspects of red blood cell structure are summarized, including the lipid bilayer membrane, cytoskeleton, integral and peripheral proteins. Hemoglobin structure and function in oxygen transport is also covered. The roles of erythropoietin and iron metabolism in red blood cell production are highlighted.
Erythropoiesis is the process of red blood cell production that occurs in multiple stages within the bone marrow. It begins with pluripotent stem cells that differentiate into erythroid progenitor cells and progress through normoblast stages as the cells take on hemoglobin and lose their nuclei to become reticulocytes and finally mature red blood cells. Key regulators of erythropoiesis include erythropoietin, which is produced mainly in the kidneys in response to hypoxia and promotes red blood cell production, and various vitamins and minerals that support cell maturation and hemoglobin synthesis.
Erythropoiesis is the process of red blood cell formation that occurs in bone marrow. It involves stem cells maturing through several stages over 7-9 days to become reticulocytes and then erythrocytes. The cytoplasm changes color as maturation occurs and cell size decreases as the nucleus is lost. Erythropoietin produced by kidneys is the major hormonal regulator of erythropoiesis, stimulating stem cell development and red blood cell maturation. A variety of nutritional and environmental factors can also influence erythropoiesis.
This document provides a summary of key information about blood:
1. Blood is composed of plasma and cellular elements including red blood cells, white blood cells, and platelets. Red blood cells contain hemoglobin which gives blood its red color and allows it to carry oxygen.
2. The main functions of blood are to transport oxygen, carbon dioxide, nutrients, hormones and waste products throughout the body, to fight infections through white blood cells, and to regulate pH, temperature, water content and pressure.
3. Blood groups are classified by the presence or absence of antigens on red blood cells. The main blood group systems are ABO and Rh factor. Compatible blood types are required for safe blood transfusions.
Blood is considered a connective tissue because it has a matrix. ... Blood Tissue: Blood is a connective tissue that has a fluid matrix, called plasma, and no fibers. Erythrocytes (red blood cells), the predominant cell type, are involved in the transport of oxygen and carbon dioxide.
RBCs are biconcave disks that are 62.5% water, 35% hemoglobin, and 2.5% other substances. Their membrane is composed of a lipid bilayer and integral proteins like band-3 and glycophorins. The membrane skeleton, made of spectrin and ankyrin, maintains the biconcave shape and anchors the lipid bilayer. RBCs primarily use glucose through the Embden-Meyerhoff pathway to generate ATP for metabolism. Erythropoiesis occurs in three stages - the mesoblastic, hepatic, and medullary stages - and is influenced by hormones, nutrients, and other environmental factors.
RBCs are biconcave disks that are 62.5% water, 35% hemoglobin, and 2.5% other substances. Their membrane is composed of a lipid bilayer and integral proteins like band-3 and glycophorins. The membrane skeleton, made of spectrin and ankyrin, maintains the biconcave shape and anchors the lipid bilayer. RBCs primarily use glucose through the Embden-Meyerhoff pathway to generate ATP for metabolism. Erythropoiesis occurs in three stages - the mesoblastic, hepatic, and medullary stages - and is regulated by factors like erythropoietin and nutrients.
This document provides an overview of a seminar on blood and blood disorders presented by Dr. Venisha Pandita. It begins with an introduction to blood, its characteristics and composition. It describes the main components of blood including plasma proteins, red blood cells, white blood cells, platelets, and hemoglobin. It discusses the processes of hematopoiesis and hemostasis. The document then covers common blood disorders like anemia, thrombocytopenia, and leukemia. It concludes with references cited.
Blood and lymph are the two main body fluids. Blood consists of plasma, red blood cells, white blood cells, and platelets. Lymph circulates within lymphatic vessels. The document discusses the composition, functions, and formation of blood cells through hematopoiesis. Hematopoietic stem cells in bone marrow give rise to myeloid cells like red blood cells and platelets, and lymphoid cells like lymphocytes. The stages of erythropoiesis and hemoglobin synthesis are described. Anemia results from low red blood cell count, hemoglobin, or hematocrit, and can be classified by cell morphology or etiology.
Erythropoiesis is the process of red blood cell formation. It occurs in the yolk sac in embryos, the liver and spleen in fetuses, and the red bone marrow after birth. Factors that affect erythropoiesis include oxygen supply, the state of hematopoietic organs like the bone marrow and liver, hormones, and diet. Erythropoietin is the key hormone that stimulates erythropoiesis by acting on stem cells in the bone marrow to speed up red blood cell development.
Hemoglobin is synthesized in proerythroblasts and reticulocytes through a process involving succinyl-CoA, glycine, protoporphyrin IX, iron, and globin chains. Each hemoglobin molecule binds four oxygen molecules and transports them throughout the body. Hemoglobin is then broken down, with iron recycled and bilirubin produced and excreted. Abnormal hemoglobins can cause conditions like sickle cell anemia. Jaundice results from high bilirubin levels causing a yellowish skin color.
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2. Erythropoiesis (RBC production)
Mature erythrocytes are derived
from committed erythroid proginator
cells through a series of mitotic divisions and
maturation phases.
Erythropoietin, a humoral agent produced
mainly by the kidneys stimulates
erythropoiesis by acting on committed stem
cells to induce proliferation and differentiation
of erythrocytes in the bone marrow.
3. Erythropoiesis
Tissue hypoxia (lack of oxygen) is the
main stimulus for erythropoietin production.
Nucleated red cell precursors in the bone
marrow are collectively called normoblasts
or erythroblasts.
RBCs that have matured to the non-
nucleated stage gain entry to the
peripheral blood. Once the cells have lost
their nuclei they are called erythrocytes.
4. Erythropoiesis
Young erythrocytes that contain residual
RNA are called reticulocytes.
Bone marrow normoblast proliferation and
maturation occurs in an orderly and well
defined sequence.
The process involves a gradual decrease in
cell size, condensation and eventual expulsion
of the nucleus, and an increase in hemoglobin
production.
5. Basic blood cell maturation
Nearly all hematopoietic cells mature in the manner shown
below. For RBCs the nucleus is eventually extruded and the
cytoplasm increase correlates with hemoglobin increase.
6. Erythropoiesis
For efficient red cell production, 85% or more of
the erythroid activity must have a balanced
incorporation of heme and globin to form
hemoglobin.
The immature nucleated RBC must have an adequate
supply of iron‚ as well as normal production of porphyrin
and globin polypeptide chains‚ for adequate synthesis of
hemoglobin.
Folic acid and vitamin B12‚ are also needed inadequate
amounts to maintain proliferation and differentiation.
Defects may occur at any stage of development and
this leads to the death of the cell.
7. Erythropoiesis
Normally 1-15% of the RBCs die during maturation.
Ineffective erythropoiesis occurs when there is a
failure to deliver the appropriate number of
erythrocytes to the peripheral blood.
Normoblasts normally spend 4-7 days
proliferating and maturing in the bone
marrow.
The stages of maturation from the most
immature to the most mature are:
15. Erythropoiesis
Reticulocytes are released from the bone
marrow into the peripheral blood where they
mature into erythrocytes , usually within 24
hours.
It is rare to see more than 1% reticulocytes in
the peripheral smear from an adult , but
common in healthy newborns.
They can be visualized more easily by staining with
new methylene blue which allows for visualization of
the remnants of the ribosomes on the endoplasmic
reticulum.
16. Erythropoiesis
Mature RBCs have a lifespan of 100-120
days and senescent RBCs are removed by
the spleen.
3 areas of RBC structure/metabolism are
crucial for normal erythrocyte maturation,
survival and function:
The RBC membrane
Hemoglobin structure and function
Cellular energetics
17. Erythropoiesis
Defects or problems associated with any of these will
result in impaired RBC survival.
The RBC must be flexible in order to squeeze
through the capillaries of the spleen. Flexibility is a
property of the membrane and the fluidity of the cells
content.
Any decrease in flexibility results in a decrease in
RBC deformability and a decrease in RBC survival in
passage through the spleen.
18. The RBC membrane
The RBC membrane is a semi-
permeable lipid bilayer supported by a
protein cytoskeleton (contains both
integral and peripheral proteins). Since
the mature cells lack enzymes and
cellular organelles necessary to
synthesize new lipid or protein,
extensive damage cannot be repaired
and the cell will be culled in the spleen.
19. The RBC membrane
The constituents of the RBC membrane
include:
Phospholipids- exchange between phospholipids
in the membrane and the plasma may occur.
Since the fatty acid content of the diet and the
plasma are correlated, changes in the diet may
have an effect on the fatty acid composition of the
phospholipids in the RBC membrane and may
result in decreased RBC survival.
20. The RBC membrane
Cholesterol- membrane cholesterol exists in free
equilibrium with plasma cholesterol. Therefore, an
increase in free plasma cholesterol results in an
accumulation in cholesterol on the RBC
membrane.
RBCs appear distorted and result in the formation of
target cells, and acanthocytes.
An increase in the cholesterol to phospholipid ratio
results in an increased microviscosity of the cell
membrane resulting in a membrane that is less
deformable and therefore, there is a decreased RBC
survival time.
23. The RBC membrane
RBC membrane proteins- 10 major and over 200
minor proteins are asymmetrically organized in the
membrane.
Integral proteins- many carry RBC antigens and act as
receptors or are transport proteins. Glycophorins are the
major integral membrane proteins.
Located in the membrane are cationic pumps. The RBC
maintains its volume and water homeostasis by controlling
the intracellular concentrations of Na+ and K+ via these
cationic pumps which require ATP. ATP is also required in
the Ca++ pump system that prevents excessive
intracellular build-up of Ca++.
In ATP depleted cells there is an intracellular build-up of
Na+ and Ca++ and a loss of K+ and water. This leads to
dehydrated, rigid cells that are culled by the spleen.
24. The RBC membrane
Any abnormality that increases membrane permeability or
alters cationic transport may lead to decreased RBC
survival.
The major peripheral protein is spectrin and it binds with
other peripheral proteins such as actin to form a skeleton
of microfilaments on the inner surface of the membrane.
This strengthens the membrane and gives it its elastic
properties.
For spectrin to participate in this interaction, it must be
phosphorylated by a protein kinase that requires ATP.
Thus, a decrease in ATP leads to decreased
phosphorylation of spectrin which leads to a loss in
membrane deformability and a decreased RBC survival
time.
26. Hemoglobin Structure and
Function
Hemoglobin occupies 33% of the RBC
volume and 90-95% of the dry weight.
65% of the hemoglobin synthesis occurs in
the nucleated stages of RBC maturation
and 35% during the reticulocyte stage.
Normal hemoglobin consists of 4 heme
groups which contain a protoporphyrin ring
plus iron and globin which is a tetramer of
2 pairs of polypeptide chains.
28. Hemoglobin Structure and
Function
Normal hemoglobin production is dependent upon
3 processes: Adequate iron delivery and supply,
adequate synthesis of protoporphyrins and
adequate globin synthesis.
Iron delivery and supply:
iron is delivered to the RBC precursor by transferrin. It
goes to the mitochondria where it is inserted into
protoporphyrin to form heme.
Synthesis of protoporphyrin:
Begins in the mitochondria where glycine + succinyl CoA
→ delta aminolevulenic acid ( ALA). This is the rate
limiting step.
In the cytoplasm 2 ALA → prophobilinogen (PBG)
29. Hemoglobin Structure and
Function
4 prophobilinogen (PBG) → uroporphyrinogen I and III
(UPG I and III). Only type III is used. Type I represents a
dead-end pathway. PBG deaminase and UPG cosynthase
are both required for UPG III synthesis. UPG I synthesis
requires only PBG deaminase. In the absence of UPG
cosynthase large amounts of UPG I accumulate in the
RBCs , bone marrow, and urine causing a condition called
congenital erythropoietic porphyria.
Decarboxylation of UPG III → coproporphyrinogen III
(CPG III). This moves to the mitochondria.
In the mitochondria CPG III → protoporphyrin IX
Fe is added to form ferroprotoporphyrin IX= HEME
32. Hemoglobin Structure and
Function
Since porphyrinogens are readily oxidized to form
porphyrins excess formation of porphyrins can occur if any
of the normal enzymatic steps in heme synthesis is
blocked. Metabolic disorders in which this occurs are
called porphyrias. There are 2 categories of porphyrias:
inherited and acquired
Inherited
Erythropoietic porphyria - results from
excessive production of porphyrins in the bone
marrow.
Hepatic porphyria - results from excessive
production of porphyrins in the liver.
Acquired
Lead intoxication - interferes with
protoporphyrin synthesis
Chronic alcoholic liver disease
33. Hemoglobin Structure and
Function
Globin Synthesis
In the yolk sac the embryonic hemoglobins epsilon and
zeta are produced.
In the fetus and the adult 4 types of hemoglobin chains
may be formed: alpha ( α), beta (β ), gamma ( γ), and delta
( δ).
Normal hemoglobin's contain 4 globin chains.
Hemoglobin (hgb) F= α2 γ2 and is the predominant hgb
formed during liver and bone marrow erythropoiesis in the
fetus. A normal, full term baby has 50-85% hgbF.
Near the end of the first year of life, normal adult levels are
reached. All adult normal hgbs are formed as tetramers
containing 2 α chains + 2 non-α chains. Normal adult
RBCs contain:
34. Hemoglobin Structure and
Function
92-95% hgb A=α2β2
3-5% hgb Ac= glycosylated α2β2
2-3% hgb A2= α2δ2
1-2% hgb F (fetal hgb)= α2γ2
Each globin chain links with heme to form hgb= 4
globin + 4 heme.
The precise order of the amino acids is critical for
hgb structure and function.
An adequate amount of globin synthesis is also
important. A decreased production in 1 chain results
in thalassemia (discussed later).
36. Hemoglobin Structure and
Function
Hemoglobin synthesis is regulated by several
mechanisms:
The regulation of globin chain synthesis. The rate of
globin synthesis is directly related to the rate of heme
synthesis because heme stimulates globin synthesis by
inactivating an inhibitor of globin translation.
Negative feedback of heme. High concentrations of
heme prevent the mitochondrial import of the first
enzyme in heme synthesis, ALA synthase (ALAS).
The concentration of iron. An iron responsive element-
binding protein (IRE-BP) binds to mRNA iron response
elements (IRE) to to affect the translation of the mRNA
for ALAS, ferritin (discussed later), and transferrin
receptors (discussed later).
37. Hemoglobin Structure and
Function
The affinity of IRE-BP for IRE is determined by
the amount of cellular iron.
When iron levels are low, there is a high binding
affinity which acts to inhibit the translation of ALAS
mRNA resulting in a decrease in heme synthesis.
When iron levels are sufficient, the binding affinity is
low, thus allowing translation of ALAS mRNA and
stimulation of heme synthesis.
39. Hemoglobin Structure and
Function
If either heme or globin synthesis is impaired, iron
accumulates in the RBC. This RBC is then called
a siderocyte and the iron can be visualized using a
Prussian blue stain.
When protoporphyrin synthesis is impaired,
mitochondria become encrusted with iron. This is
visible as a ring around the nucleus of the RBC
precursor when stained with Prussian blue and the
cell is called a ringed sideroblast.
42. Hemoglobin Structure and
Function
Hemoglobin function
The primary function of hgb is gas transport. The
molecule is capable of a considerable amount of
allosteric movement as it loads and unloads O2.
This is due to the multichain structure of the
molecule.
In unloading the space between the chains widens and
2,3 diphosphoglycerate (DPG) binds. This is the T
(tense) form of hgb and it is called deoxyhgb. It has a
lower affinity for O2, so O2 unloads from the hbg.
When hgb loads O2 and becomes oxyhgb the chains are
pulled together, expelling 2,3 DPG. This is the R
(relaxed) form of hgb. It has a higher affinity for O2, so O2
binds to or loads onto the hgb.
44. Hemoglobin Structure and
Function
Binding and dissociation of O2 are not directly
proportional to the O2 concentration. Note the
hgb-O2 dissociation curve below:
45. Hemoglobin Structure and
Function
The sigmoid curve permits a significant amount of O2
delivery with a small drop in O2 tension.
O2 affinity of hgb is expressed as the partial (P)O2 (in mm
Hg) at which hgb is 50% saturated with O2.
Increased O2 affinity means that hgb does not readily give
up itsO2.
Decreased O2 affinity means that hgb releases the O2 more
readily.
Normally the partial O2 pressure in the lungs is 100 mm.
and the hgb is 100 saturated with O2. In tissues the
partial pressure is 40mm. and the hgb is 75% saturated
with O2. Therefore 25% of the O2 is delivered to the
tissues
46. Hemoglobin Structure and
Function
In hypoxia there is a compensatory shift to the
right in the dissociation graph. This is mediated
by an increase in 2,3 DPG and results in
decreased hgb affinity for O2 and increased O2
delivery to the tissues. Therefore the RBCs are
more efficient in O2 delivery.
A patient suffering from anemia due to blood loss
may compensate by shifting the O2 dissociation
curve.
A shift to the right also occurs in acidosis and when
the body temperature is increased.
48. Hemoglobin Structure and
Function
A shift to the left in the O2 dissociation curve
results in decreased O2 delivery to the tissues.
This occurs in alkalosis
When there are increased quantities of abnormal
hemoglobins such as methgb and carboxyhgb
When there is an increase in hgb F which has a
higher affinity for O2 than does hgb A or
When a patient has received multiple transfusions
with 2,3 DPG depleted blood.
50. Comparison of an O2 dissociation curve at
normal pH and with acidosis or alkalosis
51. Hemoglobin Structure and
Function
Inherited abnormalities in hgb may result in either type of
shift and can have profound effects on the RBCs ability
to provide the tissues with O2. Acquired abnormal hgbs
of clinical importance are those that have been altered
post- translationally to produce hgbs that are unable to
transport or deliver O2 and they include:
Carboxyhgb - CO replaces O2 and binds 200X tighter than
O2.
This may be seen with heavy smokers
Methgb - occurs when iron is oxidized to the +3 (ferric)
state. In order for hgb to carry O2 the iron must be in the
+2 (ferrous) state. In the body, normally~ 2% is formed
and reducing systems prevent an increase beyond that.
Increases above 2% can occur with the ingestion of
strong oxidant drugs or
As a result of enzyme deficiency.
52. Hemoglobin Structure and
Function
Methgb can be reduced by treatment with
methylene blue or ascorbic acid.
Sulfhgb - occurs when the sulfur content of the blood
increases due to ingestion of sulfur containing drugs
or to chronic constipation. Unlike 1 and 2 this is an
irreversible change of hgb.
53. Cellular Energetics
Maintenance of hgb function requires active
RBC metabolic pathways for ATP production.
ATP is required for:
Maintaining hgb in the reduced form
Membrane integrity and deformability
Maintaining the RBC intracellular volume
Producing adequate amounts of NADH, NADPH,
and GSH
RBCs generate energy almost exclusively
from the anaerobic breakdown of glucose- 4
metabolic pathways are important for
maintaining cellular energetics.
54. Cellular Energetics
Glycolysis- generates 90% of the required ATP-
the breakdown of 1 glucose generates 2 ATP and
2NADH.
Hexose monophosphate shunt (pentose
phosphate shunt) - 5- 10% of the glucose is
metabolized this way. It produces NADPH and
GSH which protect the RBC from oxidative injury.
If the concentrations of these are too low, the globin will
denature and precipitate in the cell. This is seen as
Heinz bodies which attach to the membrane causing
membrane damage and RBC destruction.
55. Cellular Energetics
Inherited defects in the pathway result in the formation of
Heinz bodies with subsequent extravascular hemolysis.
Heinz bodies can only be seen with a supravital stain such
as new ethylene blue.
The most common deficiency is Glucose-6-Phosphate
Dehydrogenase deficiency.
Methgb Reeducate Pathway- maintains iron in the
reduced functional state. There are 2 pathways,
the NADH and the NADPH reductase pathways.
They are dependent upon NADH and NADPH
respectively. In the absence of the enzymes or
NADH and NADPH, methgb, which can't transport
O2, is formed.
57. Cellular Energetics
Leubering-Rapoport shunt - causes the
accumulation of 2,3 DPG which is
important in decreasing the hgb affinity for
O2 during O2 unloading.
58. Erythrocyte kinetics
The normal erythrocyte concentration varies
with age, sex, and geographic location.
There is a high RBC count at birth which
decreases until the age of 2-3 months where
physiologic anemia is seen due to low levels of
erythropoietin production.
The RBC count will then gradually increase until
adult levels are reached at about 14 years of age.
Males have higher RBC counts because
testosterone stimulates erythropoietin production.
59. Erythrocyte kinetics
Individuals living at high altitudes have increased
RBC levels because of the decreased partial
pressure of O2 at high altitudes which leads to
decreased O2 saturation.
A decrease in RBC mass and therefore, a
decrease in hemoglobin concentration results
in tissue hypoxia and can lead to anemia.
Anemia is not necessarily a diagnosis in itself,
but is a clinical sign of many different
pathologies.
60. Erythrocyte kinetics
An increase in RBC mass is called
polycythemia and it may lead to an
increase in blood viscosity.
Polycythemia may be relative or absolute
Relative polycythemia occurs with a decreased
plasma volume. This occurs with dehydration.
Absolute polycythemia results from an actual
increase in RBC mass. This may occur in
disorders that prevent adequate tissue
oxygenation such as:
61. Erythrocyte kinetics
High affinity hemoglobins
Pulmonary disorders
Occasionally this is due to a primary defect resulting
in an unregulated proliferation of RBCs
(polycythemia vera)
62. Erythrocyte destruction
RBC destruction is normally the result of
senescsnce.
Each day ~ 1% of the RBCs are removed and
replaced.
RBC aging is characterized by decreased
glycolytic enzyme activity which leads to
decreased energy production and subsequent loss
of deformability and membrane integrity.
90% of aged RBC production is extravascular and
occurs mainly in the spleen, with a small amount
occurring in the liver and bone marrow.
5-10% of RBC destruction is intravascular,
occurring in the lumen of the blood vessels