RED BLOOD CELLS (RBC)

RBC basics for dental and allied students

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

2. CONTENT: DEFINITION OF RBC FUNCTION MORPHOLOGY OF RBC NORMAL SIZE NORMAL SHAPE NORMAL VALUES FUNCTIONS OF RBC NUTRITIONAL REQUIREMENTS OF RBC HEMOGLOBIN STRUCTURE FUNCTION O2 DISSOCIATION CURVE PRODUCTION OF RBC FORMATION OF 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 OF THE IMPORTANT CONSTITUENT OF THE CELLULAR ELEMENTS OF THE BLOOD EACH RBC LIKE ANY OTHER CELL IN THE BODY IS BOUNDED BY A CELL MEMBRANE BUT IS NON NUCLEATED AND LACKS THE USUAL CELL ORGANELLES THE CYTOPLASM OF THE RBC CONTAINS A SPECIAL PIGMENTED PROTEIN CALLED THE HAEMOGLOBIN WHICH FORMS 90% WEIGHT OF ERYTHROCYTE. THE RED COLOUR OF THE RBC AND THUS OF THE BLOOD IS DUE TO THE PRESENCE OF HAEMOGLOBIN.

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

6. NORMAL SHAPE: THE RED BLOOD CELLS ARE CIRCULAR,BICONCAVE,DISCS ADVANTAGE OF BICONCAVE SHAPE ARE: IT RENDERS THE RED CELLS QUITE FLEXIBLE SO THAT THEY CAN PASS THROUGH CAPILLARIES WHOSE MINIMUM DIAMETER IS 3.5uM THE BIOCANCAVITY PROVIDES GREATER SURFACE AREA AS COMPARED TO VOLUME WHICH ALLOWS CONSIDERABLE ALTERATIONS IN THE CELL VOLUME.THUS THE RBC CAN WITHSTAND CONSIDERABLE CHANGES OF OSMOTIC PRESSURE,IN THIS WAY THE RBCs CAN RESIST HAEMOLYSIS TO CERTAIN EXTENT WHEN PLACED IN HYPOTONIC SOLUTION.

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

8. 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) CLINICALLY THE COUNT OF 5 MILLION/MM3 IS CONSIDERED AS 100%. NOTE:-PERSONS IN HIGH ALTITUDES HAVE GREATER NO.OF RBC

9. FUNCTIONS OF RBC: THE PRIMARY FUNCTION IS: CARRY OXYGEN FROM THE LUNGS TO ALL CELLS THAT NEEDS OXYGEN(FOR CELLULAR RESPIRATION) TO CARRY WASTE CARBONDIOXIDE FROM CELLS BACK TO THE LUNGS,WHERE IT IS REFORMED(DEHYDRATED)INTO THE CARBON DIOXIDE AND EXHALED.

10. HEMOGLOBIN STRUCTURE OF HB FUNCTION OF HB NORMAL VALUES OXYGEN DISSOCIATION CURVE BOHR EFFECT

11. HEMOGLOBIN HEMOGLOBIN IS THE RED BLOOD PIGMENT,EXCLUSIVELY FOUND IN ERYTHROCYTES GREEK:ERYTHROSE-RED KYTOS-HALLOW VESSEL

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

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

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

15. FUNCTION OF HEMOGLOBIN: DELIVERY OF OXYGEN TO THE LUNGS TO THE TISSUES TRANSPORT OF CO2 AND PROTONS FROM TISSUE TO LUNGS FOR EXPIRATION AND EXCREATION

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

17. BINDING OF O2 TO HB: ONE MOLECULE OF HB WILL BIND TO 4 MOLECULES OF O2 COOPERATIVE BINDING OF O2 TO HB; BINDING OF O2 TO ONE HEME INCREASES THE BINDING OF O2 TO OTHER HEME

18. BOHR EFFECT THE BINDING OF OXYGEN TO HB DECREASES WITH INCREASINH H+ CONCENTRATION(LOW PH) (OR) WHEN THE HB.IS EXPOSED TO INCREASED PARTIAL PRESSURE OF CO2 (PCO2) IT IS DUE TO THE CHANGE IN AFFINITY OF O2 TO HB IT CAUSES SHIFT IN THE O2 DISSOCIATION CURVE TO THE RIGHT

19. FUNCTIONS OF RED PIGMENT IN THE RBC: RED PIGMENT OF RBC IS HAEMOGLOBIN(IRON CONTAINING PIGMENT) THIS IS RESPONSIBLE FOR THE TRANSFER OF GASES(O2 AND CO2)ACROSS CELLS.

20. RBC(HB) HEME GROUP + O2(REVERSIBILY) EG.IN ALVEOLI OF THE LUNGS,HB HAS HIGH AFFINITY FOR O2 IN LOW O2 ENVIRONMENT(EG.MUSCLES)WERE,HB CHARACTERISTICS CHANGE IN SUCH A WAY THAT ITS ABILITY TO BIND O2 DECREASES MARKEDLY THUS RELEASING O2 IN SUM,HB IN THE RED BLOOD CELLS PICKS UP O2 FROM THE AIR SPACE IN THE AIR SAC OF THE LUNGS WHERE O2 IS ABUUNDENT,AND RELEASES O2 WHERE O2 CONC.IS LOW.

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

22. ANSWER: YES THE ENERGY NEEDS ARE VERY LOW FOR THE TRANPORTATION OF O2 TO ALL PARTS OF THE BODY. THIS ENERGY ARE OBTAINED SOLELY BY”GLYCOLYSIS” [1 MOLECULE OF GLUCOSE YIELDS-2 MOLECULES OF ATP BY ONE ANAEROBC GLYCOLYTIC PATHWAY]

23. NUTRITION REQUIREMENT FOR RBC: HOW TO INCREASE RED BLOOD CELL COUNT???

24. INCORPORATE IRON RICH FOOD IN YOUR DIET: BEANS/LEGUMES LENTILS GREEN LEAFY VEGETABLES DRIED FRUITS INCLUDING PRUNES MEAT LIVER,KIDNEY EGG YOLK RED MEAT DRIED RAISINS

25. GET MORE COPPER ACCESS THE CHEMICAL FORM OF IRON NECESSARY FOR RED BLOOD CELLS DURING THE PROCESS OF IRON METABOLISM POULTRY MEATS SHELLFISH LIVER WHOLE GRAIN CHOCOLATE BEANS,CHERRIES NUTS

26. GET ENOUGH FOLIC ACID! CEREALS BREAD LEAFY VEGETABLES PEAS BEANS NUTS

27. TAKE VITAMIN A(RETINOL) VIT A SUPPORTS STEM CELL DEVELOPMENT OF RBC IN THE BONE MARROW BY ENSURINF THAT DEVELOPING RBC ACCESS ENOUGH IRON REQUIED TO PROCESS HB. SWEET POTATOES CARROTS SWEET RED PEPPERS FRUITS-APRICOT.WATERMELON,GRAOE.PLUMS

28. GET YOUR VITAMIN C, PRODUCES SYNERGISTIC EFFECT,THIS BOOSTS THE ABILITY OF THE BODY TO ABSORB MORE ION,INCREASING RED BLOOD CELL PRODUCTION.

29. AJWA DATES BEST NATURAL SOURCE OF ESSENTIAL VITAMINS AND MINERALS SUCH AS,IRON,MG.VIT-B AND DIETRY FIBERS DAILY TAKE 7 AJWA DATES+1 CUP WARM MILK FOR 1 OR 2 WEEKS

30. PLUMS POTASSIUM AND ION IN PLUMS ARE BEST FOR RED BLOOD FORMATION DAILY TAKE 10 FRESH PLUMS AND REMOVE THE SEEDS AND BLEND THEM IN A BLENDER WITH ONE GLASS OF WATER. FILTER IT AND TAKE IT ON AN EMPTY STOMACH EARLY IN THE MORNING AND ALSO EVENING. WITH IN ONE MONTH YOUR RBC COUNT BOOSTS UP NATURALLY

31. RED GRAPES CURES BLOOD DISORDERS WHICH CAUSES LOW RBC AND IS A VERY GOOD PURIFIER OF BLOOD. IT FLUSHES OUT HARMFUL TOXINS FROM THE BODY TAKE 100GRAMS OF RED GRAPES OR 1 CUP FRESH RED GRAPE JUICE FOR 1 MONTH

32. MANGOES MANGOES ARE A WONDERFULLY HEALTHY ADDITION THAT 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 MILK WITH 1 TEASPOON OF GINFER JUICE MIX WELL.COOL IT AND DRINK

33. LYCHEE LYCHEE HAS A VERY 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 ONE THE BEST FOOD TIP TO PRODUCE NEW BLOOD CELLS(RBC AND PLATELETS)

34. DRIED APPLE WITH HONEY CUT ONE MEDIUM SIZE APPLE INTO SLICES IN A PLATE AND COVER THE PLATE WITH A COOTON CLOTH PIECE.LEAVE IT OVERNIGHT AT ROOM TEMPERATURE. NEXT MORNING APPLE SLICES BECOME BROWN NOW DIP THEM IN HONEY AND EAT SLICES WITH A GLASS OF WARM MILK. WITH IN ONE MONTH YOU CAN BOOST YOUR LOW RBC COUNT NATURALLY

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

36. PRODUCTION OF RBC IN THE EARLY WEEKS OF EMBRYONIC LIFE-NUCLEATED RBCs ARE PRODUCED IN THE YOLK SAC DURING MIDDLE TRIMESTER OF GESTATION-LIVER IS THE MAIN SOURCE OF PRODUCTION OF RBCs ,BUT RESONABLE NUMBERS ARE ALSO PRODUCED IN THE SPLEEN AND LYMPH NODES THEN,LAST MONTH OR SO OF GESTATION AND AFTER BIRTH-RBCs PRODUCED EXCLUSIVELY IN THE BONE MARROW

37. THE BONE MARROW OF ESSENTIALLY ALL BONES PRODUCES RED CELLS UNTIL A PERSON IS 5 YRS OLD THE MARROW OF THE LONG BONES ,EXCEPT FOR THE PROXIMAL PORTIONS OF THE HUMERI AND TIBIEA,BECOMES QUITE FATTY AND PRODUCE NO MORE RBCs AFTER ABOUT AGE 20 YRS AFTER 20YRS-RBCs CONTINUE TO BE PRODUCED IN THE MEMBERABOUS BONES,SUCH AS THE VERTEBRAE,STERNUM,RIBS AND ILIA

38. REGULATION OF RBC:

39. ERYTHROPOISIS:

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

41. GLYCOLYSIS PATHWAY: ALSO CALLED EMBDEN-MEYERHOF PATHWAY DEFN: GLYCOLYSIS IS DEFINED AS THE SEQUENCE OF REACTIONS CONVERTIG GLUCOSE TO PYRUVATE OR LACTATE WITH THE PRODUCTION OF ATP PRODUCTION OF ATP IN GLYCOLYSIS AEROBI=3-4 ANAEROBIC=2

42. RAPOPORT LUBERING PATHWAY IT IS AN SUPPLEMENTARY PATHWAY TO GLYCOYSIS IT IS CONSERNED WITH THE SYNTHESIS OF 2,3 BPG IN THE RBC 1,3 BPG IN GLYCOLYSIS IS CONVERTED TO 2,3 BPG BY THE ENZYME BISPHOSPHOGLYCERATE MUTASE

43. SIGNIFICANCE OF 2,3BPG A SHUNT PATHWAY FOR GLYCOLYSIS OXYHEMOGLOBIN UNLOADS MORE O2 TO THE TISSUE

44. HMP SHUNT ALSO CALLED AS PENTOSE PHOSPHATE PATHWAY(PPP) THIS IS AN ALTERNATIVE PATHWAY TO GLCOLYSIS AND TCA CYCLE FOR THE OXIDATION OF GLUCOSE IT IS CONCERNED WITH THE BIOSYNTHESIS OF PENTOSES AND NADPH

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

46. IMPORTANT OF NADPH: ANTIOXIDENT REACTION SPECIAL FUNCTION: IT MAINTAINS THE INTEGRITY OF RBC MEMBRANE TO KEEP THE FE+ ION OG HB IN THE REDUCED STATE SO THAT ACCUMULATION OF METHEMOGLOBIN IS PREVENTED

47. GLUCOSE 6 PHOSPHATE DEHYDROGENASE DEFICIENCY: IT IS A SEX LINKED TRAIT IT IS THE FIRST ENZYME IN THE HMP SHUT PATHWAY,PRODUCES NADPH THIS DEFICIENCY LEADS TO REDUCED PRODUCTION OF NADPH ,ENDING IN ACUTE HEMOLYTIC ANAEMIA

48. FATE OF RBC WHEN RBCs ARE DELIVERED FROM THE BONE MARROW INTO THE CIRCULATORY SYSTEM,THEY NORMALLY CIRCULATE AN AVERAGE OF 120DAYS BEFORE BEING DESTROYED ONCE THE RED CELL MEMBRANE BECOMES FRAGILE,THE CELL RUPUTRES DURING PASSAGE THROUGH SOME TIGHT SPOT OF THE CIRULATION MANY OF THE RED CELLS SELF DESTRUCT IN THE SPLEEN ,WHERE THEY SQUEEZE THROUGH THE RED PULP OF THE SPLEEN

49. THERE,THE SPACE BETWEEN THE STRUCTURAL TRABECULAE OF THE RED PUPL,ARE ONLY 3 MICROMETERS WIDE,IN COMPARISON WITH THE 8-MICROMETER DIAMETER OF THE RED CELL WHEN THE SPLEEN IS REMOVED,THE NUMBER OF OLD ABNORMAL RED CELLS CIRCULATION IN THE BLOOD INCREASES CONIDERABLY

50. 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 KURANA THEORITICAL PHYSIOLOGY[CHAPTER 6] ONLINE WEBSITES-IMAGES

51. THANK YOU………………………………….  HAVE A NICE DAY