《红细胞与贫血》.pptxVIP

基础血 液 学红细胞与贫血Erythrocyte Anemia 夏 立 病理生理学教研室 lixia@ BLOOD Function Deliver O2 Remove metabolic wastes Transport hormones Protection from blood loss- platelets Prevent infection- antibodies and WBC Maintain temperature, pH, and fluid volume At a Glance Erythrocyte 7.5?m in dia, BiConcave（双凹状） Anucleate（无核）Cell Lack mitochondria (essentially no organelles) Hemoglobin （血红蛋白）transport respiratory gases adult males 12-16 g/dl adult women 11-15 g/dl Objectives recognizing the key components of Erythropoiesis (红细胞生成). understanding the general Structural Functional features of red blood cells (RBCs). -- Membrane of RBCs understanding the main Metabolic Pathways occurring in RBCs with reference to their relations to functions of RBCs. Recognizing changes occurring in Aging of RBCs. Identifying some of the main common Diseases of RBCs as implication of defects of RBCs. Blood Cell Production 1. Erythropoiesis Reticulocyte （网织红细胞） ( Ribosomal RNA stained with methylene blue) Reticulocyte no nucleus no organelles many polyribosomes larger than the mature RBC not concave Normally, 25 billion cells, which is 1% of circulating blood, are reticulocytes In severe anemia, many of these (3%) are released into the blood prematurely. 1. Erythropoiesis 骨髓红系定向细胞增殖及其最重要受体的理论模型 EPO：促红细胞生成素；GM-CSF：粒-巨核细胞集落刺激因子；IL3：白介素3； Transferrin: 转铁蛋白；Fibronectin:纤连蛋白 1. Erythropoiesis Too few RBCs leads to tissue hypoxia Regulation of Erythropoiesis 1. Erythropoiesis Hypoxia Inducible Factor (HIF) Regulation of Erythropoiesis 1. Erythropoiesis Erythropoietin (EPO（促红细胞生成素）) 34,000 Da, Glycoprotein Released by the kidney in response to hypoxia (hemorrhage（出血）, hemolytic（溶血）, iron deficiency or high altitudes) Regulation of Erythropoiesis 1. Erythropoiesis Regulation of Erythropoiesis 1. Erythropoiesis Erythropoietin (EPO) Direct stimulus for erythropoiesis More rapid maturation of committed bone marrow cells Increased circulating reticulocyte count in 1–2?days Regulation of Erythr