Blood

Vessels

Hemopoiesis

Artery

large diameter

mainly elastic tissue and smooth tissue to withstand high pressure

Arteriole

Thick smooth muscle to control degree of constriction with little elastic connective tissue; also has sympathetic innervation, chemical sensitivity and circulating hormones

Capillary

3um diameter, thin walled and extensive network

only 1 cell thick and maximum area, no carrier mediated transport (apart from blood brain barrier) so only diffusion

Venule

20um diameter

made of endothelium and fibrous tissue

Vein

larger diameter

less tissue and muscle so have high compliance and act as volume reservoirs

Slow velocity

hydrostatic pressure drops throughout the capillary so contenets can be forced out when hydrostatic pressure is greater tehan osmotic pressure. Protein controls hydrostatic pressure and osmotic pressure is constant

exchange occurs by diffusion, bulk flow and transcytosis; they branch extensively to bring blood with ing the reach of every essential cell

Components

Cellular

Red blood cell

Plasma

blood is a specialised connective tissue and makes 25% of extracellular fluid

plasma contains albumin, fibrinogen, immunoglobulins, lipisd, hormones, vitamins, and salts

discoid shape

loose nucleus and no mitochondria and ER

cytoskeleton

contain haemoglobin, binds oxygen in haem group

the cell forms spectrin tetramers which are linked to a complex of actin, tropomyosin and protein 4.1

both ends of actin are capped to stop growth

Spectrin is a large dimeric protein consisting of spectrin alpha and beta

the numerous cytoskeleton makes the cell very flexible

Neutophils

Old people

rbcs only live for 4 moths

but as people age they become stiffer and lose membrane flexibility

they are fragile and more likely to rupture; they are engulfed by scavenging macrophages spleen-liver-lymph nodes and bone marrow

Lifecycle

a senescent is taken up by a phagocyte and broken down into globin, heme and iron

heme is converted to bilirubin

bilirubin is toxic and causes brain damage but cannot be removed from the body

so hepatocytes turn bilirubin and glucoronic acid with of UDP-glucoronyl transferase into bilirubin diglucoronide (conjugated bilirubin)

this is water soluble and is expelled into the intestine

the ineterndothelial slit is a tiny hole, and only healthy rbcs can move through it but old abnormal cells cannot and are engulfed by macrophage

Pathology

membrane cytoskeleton defects

Elliptocytosis: AD, EPB41, SPTA1, or SPTB genes

EPB41: encodes 4.1, SPTA1 and SPTB encode a, b –spectrins

Spherocytosis: AD spectrin deficiency

Metabolic defects

Glucose 6phosphate dehydrogenase (G6PD) deficiency

Pyruvate kinase deficiency

Haemoglobin defects

a- and b-globin chain defects

they have no mitochondria so cannot fully convert sugars

Sickle cell

due to mutation in haemoglobin chain beta-2, point mutation at amino acid 6 (glutamic to valine)

this changes negatively charged amino acid to a hydrophobic, changing the shape which means they are taken out by the spleen

beta-Thalassemia`

Unpaired a-chains aggregate and damage the membrane

Extravascular haemolysis

Inadequate haemoglobin and small rbc

develops if no b globin adn excessive a globin

the abnormal shapes are detected by the spleen and removes them, the lack of rbcs can lead to skeletal deformities

Embryo

Primitive wave

yolk sac is primary site of blood cell formation

yolk sac is extra embryonic

first trimester yields nucleated rbcs

Definitive wave

split into hepatosplenothymic phase and medullolymphatic phase

in second trimester, hematopoietic stem cells migrate via liver and spleen to seed these tissues

these tissues continues haemopoiesis

bone marrow is major site of blood cell production by 20 weeks production and increases in third trimester

Children

in hildren all bone marrow is red

red bone marrow contains stem cells involved in haematopoiesis

Adults

red marrow only found in torso and skull, the rest is yellow bone marrow

yellow bone marrow contains adipose tissue and is inert

yellow bone marrow can turn into red when there is continuous increased haemopoietic demand

the spleen and and liver are also capable of producing blood cells and are the main sites of extramedulllary haemopoiesis

Bone

haematopoietic stem cells occupy a well protected niche, since bone marrow is a high calorie source

bone provides shelter from harmful irradiation , protection from UV light is an evolutionarily conserved feature of haematopoietic niche

studies have shown that most fish kidney cells that make stem cells have a layer above them of melanocytes for protection

Haemopoiesis

Stem cells

only 0.05% of total haematopoietic cells are stem cells

they can self-renew, differentiate into range of lineages and perform slow replication

totipotent can differentiate into all cells, pluri can differentiate into the 3 germ layers (but not extra embryonic tissues), and multi can differentiate to all cell types in one particular lineage

they can divide into 2 daughter cells (symmetric cell division) and also divide wherre one remains a stem cells and other differentiates

multipotent stem cells become myeloid progenitor

myeloid erythroblast to erythroid CFO

Erythroid CFO to primitive then mature progenitor

progenitor to proerythroblast

reticulocyte

formed from polychromatophilic erythroblast

they have no nucleus, th ebenefit of no nucleues is more likely to fit through narrow spaces which could otherwise damage it rather than pack more in and the methylene blue stains a network of strands in cytoplasm (RNA)

they are slightly larger than erythrocutes

proerythroblast to basophilic erythroblast

basophilic erythroblast to polychromatophilic erythroblast

orthochromatic erythoblast shrink and the nucleus goes to the cell membraen and is then ejected and taken up by the macrophage

reticulocyte to red blood cell

erythroblastic island

these are clusters of cells if the differentiation sequence with a macrophage centre

the nuclei are taken up by the macrophage

macrophages also deliver iron for the cells for haemoglobin production

Control

TPO

Made by liver

platelets bind to it so little reaches teh bone marrow

means they receive less signal to make platelets so platelet number is self regulating

EPO

made by kidney adn little by liver

released in response to decrease in oxygen, interleukin proteins and CSF-E maturation is stimulated by B12 and folic acid; haemoglobin production by Fe, Cu, Zn, Co, vitamin C

34kD glycoprotein, 165 amino acids long, acts as a hormone

control

its gene contains an oxygen sensor regions

binds hypoxia-inducible factor 2, so it detects this factor which regulates breakdown of hypoxia inducible factor and can result in congenital polycythaemia

EPO binds to dimerised erythropoietin receptor and induces binding of cytosolic STAT5 protein to JAK2 (STAT5 becomes phosphorylated and homodimerises)

phosphorylated STAT5 homodimer translocates into nucleus and after binding to DNA it activates transcription of genes for erythropoiesis

Thrombopoiesis

they are both phagocytes and granulocytes

have a single, multilobed nucleus

make up 50-80% of circulating leukocytes and circulate for about 8 hours, form first line of defence

contain primary (azurophilic) granules which contain elastase defensins and myeloperoxidases, and smaller secondary granules which contain lysozyme, lactoferin, gelatinase adn other proteases

Eosinophils

stained with eosin

mainly kill parasites that cannot be digested

bind to antibody coated parasites, degranulate and dissolve the cell surface membrane

granules contain

eosinophil peroxidase which binds to microorganism and facilitates killing

major basic protein binds and disrupts membrane of parasites and causes basophils to release histamine by Ca2+ dependent mechanism

eosinophil catitonic protein neutralises heparin and causes fragmentation of parasites

eosinophil derived neurotoxin secretes protein with ribonuclease and antiviral activity

Basophils

involved in acute inflammatory response

important in allergy and hypersensitivity (secrete heparin and heparin)

Monocytes

largest leucocyte

new monocytes circulate in blood for a few hours before migrating to tissue and turning into macrophages

the macrophages derived monocytes are more efficient phagocytic cells than neutrophils

lymphocytes

can be T, B or natural killer

thye contain large cytoplasmic granules with suffated or carboxylated acidic proteins like heparin

they are similar to mast cells in connective tissues since they express IgE receptors but differ in expression of c-kit receptors and CD49b

basophilia is an increase in basophils and causes acute hypersensitivity reactions, viral infections and chronic inflammatory conditions

non-phagocytic that defend against larger parasites

kidney shaped nucleus and contain fine strands of chromatin

account for 20-40% of total leukocytes

small lymphocyte

nucleus is densely stained with round or pointer shape and occupies majority of cellso cytoplasm is thin basophilic rim

represent 97% of circulating lymphocytes

Large lymphocyte

have large slightly indented nucleus surrounded by pale cytoplasm, sometimes with primary granules

Kapp et al (2018)

melanocytes protect haemopoietic stem and progenitor cells in zebrafish larvae from DNA damage by UV

melanocytes form an umbrella overs HSPCs and protects them

the protection was also found in other fish and the mechanism is evolutionary conserved

Haemostasis

Phases

Primary

reduction o blood flow

formation of a temporary plug in wall of damaged vessel

due to interaction of platelets and blood vessels

Secondary

Conservation of soluble fibrinogen to insuluble fibrin, strengthens initial haemostatic plug

Fibrinolysis

breakdown of fibrin plug after repair of wound

Clotting

platelets

small membrane bound packets of granular cytoplasm (clotting proteins and cytokines) with no nucleus

Circulating platelets are 1-4um in diameter and 0.5-1 um thick discoids

they contain mitochondria adn SER and are produced by pinching off and shredding of megakarocytes (polyploidy cells)

Megakaryocytes are derived from a multipotent progenitor in bone marrow which becomes lineage restricted to megakarocyte production

inactive platelet is smooth and discoid shape but an active platelet is spiny and sphaeric

membrane

the alpha granule

proteins with haemostatic function like fibrinogen, thrombospondin, and plasminogen

growth factors like PDGF, TGF alpha and beta

microbicidal proteins like thrombocidins and kinocidins

the granulomere is the central portion of platelet (containing granules and lysosomes) and hyalomere is the peripheral microtubules and microfilaments

cytoskeleton during platelet chagne

Components

Filamin binds actin filament to neighbouring filament

gelsolin cuts actin filaments and their ends

Profilin and Arp2/3 polymerises actin

elevated calcium levels

gelsolin levels increase this fragments existing filaments

cofilin activity increase and filamin decrease, this changes cell/platelet shape

this change means platelet becomes rounder and larger

then elevated PPI

Arp2/3 and profilin increase resulting in filamin assembly

this changes platelet shape

They have an invaginate membrane system, and many receptors like GP2b-CP3a, GP1b and alpha2beta1 integrin

glycocalyx surface coat that contains glycoproteins that help adhesion adn aggregation

coagulation factor receptors, like coagulation factor I is fibrinogen and V, VIII, X, XI, XII, XIII enhance coagulation

PDGF (platelt derived growth factor) acts as mitogen for fibroblasts and chemokine for neutrophils

5-HT (serotonin) and Thromboxane helps vasoconstriction

Vasoconstriction

following injiry blood vessels constrict under a neurogenic response

this restricts blood flow to the area

Plug formation

break in endothelial lining which exposes collagen

platelts adhere to collagen, but adhesion requires vWf and factor VIII which act as a bridge between platelet and membrane

return to normal

there is a release of platelets factors after contraction which further exposes basal membrane and collagen

adhesion triggers change from discoid to irregular shape to adhere to other platelets

receptors for ADP, collagen and thrombin increase on membrane; ADP and thromboxane A2 acts as platelet chemoattractants

platelet activation causes release of vasoconstrictors like A2 adn 5-HT

endothelium produces vWF and BM

also releases PGI2 (prostacyclin) to inhibit platelt aggregation and causes vasodilation

binding and extravasation of immune cells and synthesises tissue factor

nitric oxide inhibits platelt activation and promotes vasodilation by raising cGMP levels

fibrinin slowly dissolved by plasmin causing clot to dissolve

Calcium

it is an important secondary messenger for activation

phospholipid turned into arachidonic acif by phospholipase; then into endoperoxides (PGG2 and PGH2) by cyclo-oxygenase

these turn into Thromboxae A2 by thromboxane synthase

thromboxane suppresses cAMP synthase which elevates ca2+ levels

endothelial cells release tissue factor which binds factor VIIa, which converts factor X into Xa, andVon Willebrand factor binds to Gp1B platelet receptor which helps collagen attachment

fibrinogen in plasma binds to activated integrin receptors to bridge platelets, and thrombin acts on fibrinogen to cleave fibrinopeptides adn form fibrin monomer which aggregates to form the clot (Factor XIII crosslinks monomers)

plasminogen converted to plasmin by tissue plasminogen activator

info on powerpoint (slide 26)

it is the formation of platelets in bone marrow

Earliest precursor

earliest precursor to platelets is identified in bone marrow by colony assay is CFU

IL-3, Epo and GM-CSF are important in commitment to CFU-Meg

Thrombopoietin produced by kidney and liver is important in stimulation of megakaryocyte differentiation and proliferation

Main processes

Proliferation

Megakartocytic cells undergo endomitosis (nuclei undergo multiple mitotic divisions, but not cytoplasmic division)

This produces very large cytoplasmic volume from platelets bud

Maturation

Formation of secretory granules

formation of demarcation membrane system which produces a large SA of membrane which is needed for platelet shedding

Circulation

release of protoplatelet packages

large cytoplasmic fragments undergo further fragmentation to form individual platelets

ends with phagocytosis of nuclei and remaining cytoplasm

each megakaryocyte produces 1000-3000 platelets per lifetime which survive up to 12 days in circulation

maturation and platelet release is regulated by thrombopoietin

pressure reservoir

despite there being no blood flow during diastole there is blood flow in capillaries

the driving force for this continuous flow is provided by elastic properties of the walls

in systole a greater volume of blood flows into arteries from heart than leaves(because of resistance) so teh elastic expadns to store this excess blood so there is pressure energy in stretched walls

in diastole the stretched walls recoil which exerts pressure on blood which pushes it downstream

they determine ho wmuch blood is reaching the tissues

major resistance

small radius offers resistance to flow

this resistnace maintains flow to end organs

converts pulsatile systolic-to-diastolic pressure swings in arteries into non-fluctuating pressure in capillaries

if blood pressure was not reduced for capillaries, tehy would be damaged by it

flwo rate is identical through all levels of circulatoy system and equal to cardiac output but branching of capillaries changes cross sectional aria so resistnace changes so actual velocity also changes

velocity varies throughout vascular tree and is inversely proportional to total cross sectional area of all vessels at a given level

it is much slower than arterioles adn venules and is because it needs to maximise time available for gas exchange

valves

only peripheral veins (not central veins)

skeletal muscle can contract to push when they relax the valves shut to prevent blood falling

Flow

Pressure gradient

blood pressure is the force exerted by blood against a vessel wall and depends on its volume and compliance

mean arterial pressure is main driving force

pressure controls distribution of blood to organs and arterioles change diameter which controls flow into tissues

Resistance

resistance is directly proportional to blood viscosity and vessel length and inversely proportional to radius

however we assume viscosity and length should be similar

total peripheral resistacne is the combined resistance of all organs and blood vessels adn arterioles adn small arteries make up 60% of it

click to edit

Flow rate

it is directly proportional to pressure gradient and indirectly proportional to vascular resistance

at left ventricle is 100mHg and at right ventricle it is 15mmHg which creates the gradient

it is pressure divided by resistance

it is affected by many factors and is integrated into Poiseuille's Law

normally laminar but cholesterol creates turbulent flow

Pressure

Starling's Force is when fluid flows across capillaries which creates pressure that pushes contents into the tissue

bulk flow

it is the difference in hydrostatic and colloid osmotic pressures between plasma and interstitial fluid

Many pressures like capillary blood pressure, plasma colloid osmotic pressure, interstitial fluid hydrostatic pressure, interstitial fluid colloid osmotic pressure

it determines whether contents are pulled or pushed, so at one point htere will be a point of no net movement