Biochemistry. Topic name: Blood.

This topic is biochemical properties of blood

1. Physiology of blood

2. Functions of blood Blood has three main functions: transport, protection, communication & regulation. Transport Blood transports the following substances: Gases, namely oxygen (O2) and carbon dioxide (CO2), between the lungs and rest of the body ( respiration function ) Nutrients from the digestive tract and storage sites to the rest of the body( nutritive function ) Waste products to be detoxified or removed by the liver and kidneys ( excretory function ) Hormones from the glands in which they are produced to their target cells ( humoral function) Heat to the skin so as to help regulate body temperature ( themoregulatory function)

3. Protection Blood has several roles in inflammation: Leukocytes, or white blood cells, destroy invading microorganisms and cancer cells Antibodies and other proteins destroy pathogenic substances (immune function) Platelet factors initiate blood clotting and help minimise blood loss (protection against loosing of blood) Regulation Blood helps regulate: pH by interacting with acids and bases Water balance by transferring water to and from tissues Ionic balance (homeostatic function) Communication Blood carry information over all body (communicative function)

4. COMPOSITION OF BLOOD Blood is that portion of the extracellular fluid volume that is confined to the blood vessels Blood is a normally liquid suspension of formed elements (cells and cell fragments) in plasma

5. Blood composition

6. Red blood cells Red blood cells (RBCs), also called erythrocytes are flexible and oval biconcave disks lack a cell nucleus and most organelles, in order to accommodate maximum space for hemoglobin

7. Hemoglobin iron-containing oxygen-transport metalloprotein in the red blood cells

8. Hemoglobin compounds Physiological: HbO 2 – ox y hemoglobin Hb – reduced hemoglobin HbCO 2 – carbhemoglobin Pathological: HbCO – carboxyhemoglobin MetHb - methemoglobin

9. Hemolysis

10. Types of hemolysis 1. Mechanical (in vivo when diluting tissues, in vitro when shaking blood in a test tube). 2. Thermal (in vivo for burns, in vitro for freezing and thawing or heating of blood) 3. Chemical (in vivo under the influence of chemicals, when inhaling vapors of volatile substances (acetone, benzene, ether, dichloroethane, chloroform), dissolving the shell of red blood cells, in vitro under the influence of acids, alkalis, heavy metals, etc.). 4 . Biological. Under the influence of factors of biological origin (hemolysins, snake venom, fungal venom, protozoa (molar plasmodium). 4a.Immune(biological) hemolysis-when transfusions of incompatible blood or in the presence of immune antibodies to red blood cells. 5. Osmotic resistance of red blood cells (ORE) - their stability in hypotonic solutions. 6 . Physiological- hemolysis of red blood cells that have completed their life span (in the liver, spleen, red bone marrow).

11. Osmotic resistance of red blood cells (ORE) - their stability in hypotonic solutions . Distinguish between: The minimum ORE is the concentration of the NaCl solution at which hemolysis begins (0.48-0.46%). Less stable ones are hemolysed . The maximum ORE . - the concentration of the NaCl solution in which all red blood cells are hemolysed (0.34—0.32%). Osmotic resistance of red blood cells depends on the degree of their maturity and shape. Young forms of red blood cells, coming from the bone marrow into the blood, are most resistant to hypotension.

12. White blood cells (WBCs), also called leukocytes

13. Blood groups or blood types

14. Immunologic properties of blood Presence of blood group systems were discovered by  Karl Landsteiner  during early experiments with blood transfusion in 1901 . Blood of all people we can divide for different groups(or types) according to presence or absence definite agglutinogens . The most important are erythrocite blood groups.

15. . A total of 35  human blood group systems  are now recognized by the  International Society of Blood Transfusion  (ISBT).  The two most important ones are  ABO  and the  Rh ( D ) antigen ; they determine someone's blood type  Erythrocite blood group systems

16. Blood group When red cells from an individual are mixed with plasma from another individual, an immune response (transfusion reaction) will occur, in which the red cells will clump together ( agglutinate) and hemolysis , releasing their hemoglobin. The antigens are called agglutinogens and are carried on the red cells in the blood as well as on cells in many other tissues. In red cells, they are glycosphingolipids that differ by only the last sugar in the carbohydrate chain that is attached to a membrane sphingolipid . There are more than 400 different blood group antigens that have been identified.

17. There are more than 400 different blood group antigens that have been identified. There are no two people with identical fingerprints so there are no two persons with identical antigenic set in blood.

18. System Антигены % распределение групп крови АВО A 1 , A 2 , A 3 , A 4 , A 5 , A z , A , B 1 , B 2 , B 3 , B W , B X , H, O 0 - 40 А - 39 В - 15 АВ - 6 MNSs M, M 1 , M 2 , M a , M c , M k , M v , M g , Mi a , Mur, Mt a , N, N 2 , Ny a , S, St a , Sul , Sj , S 2 , s, U, Tm, Hu , He, Hil , V w , V r , Ri a , Cl a M - 33 N - 19 MN - 48 P P 1 , P 2 , P k P 1 - 79 P 2 - 21 P k p Rh C, C w , C u , Ce s , Ce , ce , CE, D, D u , D w , E, E u , E w , E t , c, cE , d, e, e , LW Rh + 85 Rh - 15 Lu Lu a , Lu b Lu a -0,1 Lu b -92,4 Lu ab -7,5 Le Le a , Le b , Le c , Le d Le a Le b Le c Le d K K, k, Kp a , Kp b , Js a , Js b Kk -0,2 Kk -9, 8 kk-90 Fy Fy a , Fy b Fy a -17 Fy b -34 Fy ab -49 Jk Jk a ,Jk b Jk a -25 Jk b -25 Jk ab -50 Di Di a , Di b Di a Di b Yt Yt a , Yt b Yt a -91,9 Yt b -0,2 Yt ab -7,9 Ii I, i I-99,98 i-0,02 Au Au a , Au b Au a -82 Au b -8 Bx Bx Bx+ 0,03 Bx-99,97 Xg Xg a Xg a + 63 M , 89 F Xg а -37 M , 11 F Bu a Bu a Bu a + 0,1 Bu a –99,9 Do Do a Do a + 66 Do a - 34

19. K. Landsteiner and Y. Yansky (1901) The A and B antigens are the most important of the different blood group antigens; They are inherited and are the basis for dividing individuals into the four blood groups: O, A, B, and AB . In neonatal life , we quickly develop antibodies against the antigens that are not present on our red cells, and these antibodies, called agglutinins (  and  ) , are carried in plasma. ABO antigens

20. Antigens of the ABO group Antigens are glycosphingolipids on the surface of erythrocytes . The H antigen that is present in individuals with type O blood . The A antigen (type A blood ) has a terminal N- acetylgalactosamine (NAG). The B antigen (type B blood ) has a terminal galactose (Gal). Cer = ceramide; Fuc = fucose; Gal = galatose; Glu = glucose. H antigen A antigen B antigen

21. The ABO system

22. The distribution of people among the four groups:

23. Agglutionation of the erythrocytes occurs when agglutinogens of the donor (the individual who supplies the blood) are combined with the same agglutinins of the recipient – A plus  , or B plus  .  If a unit of incompatible blood is  transfused  between a  donor  and recipient, a severe  acute hemolytic reaction  with  hemolysis  (RBC destruction),  renal failure  and  shock  is likely to occur, and death is a possibility. ( Hemotrasfusion shock ) Hemagglutination

24. The best transfusion of blood is the transfusion of blood the same group Main principles of blood transfusion Transfusion blood should not contain identical agglutinogens of the donor to identical agglutinins of the recipient Two main exceptions of blood transfusion: The donor agglutinins are diluted when small volumes of blood are transfused. This is the so called the rule of dilution . The small volume is 200 to 500 ml of blood.

25. Two main exceptions of blood transfusion:

26. Type O individuals are called “universal donors” because their red cells carry neither A nor B antigens. Their plasma will agglutinate recipient red cells of types A, B, and AB, but in a transfusion, the donated plasma will normally be diluted by the donor’s plasma Blood group AB  individuals have both A and B antigens on the surface of their RBCs, and their  blood plasma  does not contain any antibodies against either A or B antigen. Therefore, an individual with type AB blood can receive blood from any group (with AB being preferable), but cannot donate blood to any group other than AB. They are known as universal recipients .

27. Determination of blood group

28. R h system K. Landsteiner and A. Wiener (19 37 ) Rhesus factor ( Rh factor) Rh-positive group Rh-negative group of blood Within the Rh system, the C, D , and E antigens are most important. They are found only in red cells. D is the most antigenic component , and the presence or absence of D is designated as “Rh-positive” or “Rh-negative,” respectively.

29. Rhesus system Under normal circumstances, human plasma does not contain anti- Rh antibodies(agglutinins). However, if an Rh - person received Rh + blood the body starts to make anti- Rh anti-bodies that will remain in the blood. If a second transfusion of Rh + blood is given later, the previously formed antibodies will react against the donated blood and a severe reaction may occur ( rhesus conflict).

30. This ( rhesus conflict) can occur also when Rh + fetal blood mixes with the circulation of an Rh – mother. When an Rh - mother carries an Rh + fetus and small amounts of fetal blood mix with maternal blood during delivery, the mother may develop significant levels of anti- Rh antibodies in her plasma. During the next pregnancy, the mother’s Rh agglutinins cross the placenta into the fetus and can cause severe hemolytic disease in the fetus.

31. Hemotransfusion

32. Rules for hemotransfusion 1. Determination blood group belonging (donor & recepient ) ABO & Rh systems 2. Cross test 3. Biological test 15ml of donors blood(streamly) (wait 3 min), 3 times 4. Hemotransfution

33. Good bye!