Erythrocyte profile report

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Erythrocyte profile report
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Erythrocyte profile report
The erythrocytes also called the red blood cells are the cellular components of the blood,
many of which are in the blood circulation of the vertebrates. The erythrocyte gives the blood its
color, and they also carry the oxygen to the body tissues from the lungs. The mature erythrocyte
is biconcave, round and small in size and they appear to be dumbbell-shaped in their profile. The
erythrocyte is very flexible, and they assume the shape of a bell because it passes through tiny
vessels of the blood. They are covered with a cell membrane which is composed of proteins and
lipids, they lack a nucleus, but they contain hemoglobin which is a red iron-rich protein that is
responsible for binding oxygen
1
.
Figure 1 The Red erythrocytes or red blood cells
2
1
. Hoffman JF. Red blood cells, compasses and snap shots. Blood Cells, Molecules, and Diseases. 2018 Mar 21.
2
. Erythropoiesis: Formation of Red Blood Cells. (2016, December 17). Retrieved from http://www.interactive-
biology.com/3969/erythropoiesis-formation-of-red-blood-cells/
3
Figure 2 The Red erythrocytes or red blood cells
3
The red blood cells develop in adult bone marrow or the fetal liver via a process called
erythropoiesis. This process is stimulated by the erythropoietin, cytokine hormone, which is
produced by the kidney following the detection of reduced oxygen level circulation. The main
function of the erythrocytes is binding the oxygen through hemoglobin and carrying it to the
tissues of the body. The erythrocytes are also able to induce vasodilatation by mediating nitric
oxide (NO) bioactivity effects in the diseases such as sepsis and pulmonary hypertension. In
particular, the erythrocytes discharge S-nitrosothiols when hemoglobin particles are
deoxygenated, causing the smooth muscle in the vessels of the blood to relax and elevating the
flow of blood to oxygen-depleted tissues. The erythrocytes can likewise advance vasodilatation
by discharging ATP under states of shear pressure and initiate an insusceptible reaction when
they are lysed by pathogens
4
.
The erythrocytes also carry carbon dioxide which is a waste product in the process of
metabolism to the lungs where it is then excreted from the body. In many invertebrates, the
3
. Erythropoiesis: Formation of Red Blood Cells. (2016, December 17). Retrieved from http://www.interactive-
biology.com/3969/erythropoiesis-formation-of-red-blood-cells/
4
. Overmann J. Red Blood Cells. Interpretation of Equine Laboratory Diagnostics. 2017 Oct 5:113.
4
pigment for carrying the oxygen is carried in the plasma the mammalian erythrocyte is
additionally adjusted without a corethe measure of oxygen required by the cell for its digestion
is consequently low, and most oxygen conveyed can be liberated into the tissues. The biconcave
state of the cell permits oxygen trade at a steady rate over the most significant conceivable
territory
5
.
The erythrocytes develop in the bone marrow in different stages which starts from
hemocytoblast, which is a multi-potential cell in the mesenchyme which becomes norm oblast
(erythroblast) amid a development period of two to five days. The erythroblast is then gradually
filled with hemoglobin and its nucleus and particles in the cytoplasm, also known as
mitochondria, provide the cells its energy. In a late stage the reticulocyte cell turns into a wholly
developed red cell. The standard red cell in people lives 100 120 days. There are somewhere in
the range of 5.2 million red cells for every cubic millimeter of blood in the adult human
6
.
Human bone marrow
5
. Singh AK, Singh S, Garg G, Rizvi SI. Rapamycin mitigates erythrocyte membrane transport functions and oxidative
stress during aging in rats. Archives of physiology and biochemistry. 2018 Jan 1;124(1):45-53.
6
. Pretorius E, Oore-ofe O, Mbotwe S, Bester J. Erythrocytes and their role as health indicator: Using structure in a
patient-orientated precision medicine approach. Blood reviews. 2016 Jul 1;30(4):263-74.
5
Figure 3 The Human Bone Marrow
7
Despite the fact that red cells are round in shape, a little extent is oval in the ordinary
individual, and in particular innate states, a greater extent might be oval. A few sicknesses
likewise show red cells of unusual shape, for example, crescent-shaped in sickle cell anemia,
elliptical in pernicious anemia, and with projections giving a prickly appearance in the inherited
issue, acanthocytosis. The number of red cells and the measure of hemoglobin change among
various people and under different conditions; the number is higher, for instance, in people who
inhabit high heights and in the infection polycythemia
8
. During childbirth the red cell tally is
7
. Erythropoiesis: Formation of Red Blood Cells. (2016, December 17). Retrieved from http://www.interactive-
biology.com/3969/erythropoiesis-formation-of-red-blood-cells/
8
. Singh AK, Singh S, Garg G, Rizvi SI. Rapamycin mitigates erythrocyte membrane transport functions and oxidative
stress during aging in rats. Archives of physiology and biochemistry. 2018 Jan 1;124(1):45-53.
6
high; it falls not long after birth and step by step ascends to the adult level at adolescence. As a
result of the powerlessness of red blood cells or erythrocytes to separation to renew their
numbers, the old burst cells must be supplanted by entirely new cells. They meet their
destruction since they don't have the standard specific intracellular hardware, which controls cell
development and repair, prompting a short life expectancy of 120 days
9
.
This short life expectancy requires the procedure erythropoiesis, which is the
development of red platelets. All platelets are shaped in the bone marrow. This is the erythrocyte
industrial facility, which is the delicate, very basement tissue that fills the interior holes of bones.
Erythropoiesis
The differentiation and development of the erythrocytes are depicted by the figure below.
The development takes place in the bone marrow extra-sinusoidal stoma, and it starts with the
pluripotent stem cells which can generate erythrocytes as well as white blood cells or the
leukocytes
10
.
9
. Lloyd JA. An Introduction to Erythropoiesis Approaches. In Erythropoiesis 2018 (pp. 1-10). Humana Press, New
York, NY.
10
. Nandakumar SK, Ulirsch JC, Sankaran VG. Advances in understanding erythropoiesis: evolving perspectives. British
journal of haematology. 2016 Apr 1;173(2):206-18.
7
Figure 3The differentiation and development of the erythrocytes
11
After the primitive stem cells undergo division process, one of its daughter cells remains
pluripotent and undifferentiated so as the marrow stem cells depletion doesn’t take place
regularly. The activity of erythropoietin in the bone marrow is under the influence of hormones,
decreasing or increasing according to circulating the erythropoietin level (it is produced in the
cortical area of the kidney and is secreted in the bloodstream). The red blood cell progenitor
usually shows growing erythropoietin sensitivity via the stage of proerythroblast. The
proerythroblast stage results to irreversibly maturation sequence which leads to blood cells
formation
12
.
11
. Erythropoiesis: Development and... (PDF Download Available). (n.d.). Retrieved from
https://www.researchgate.net/publication/236096782_Erythropoiesis_Development_and_Differentiation
12
. Yamamoto ML, Clark TA, Gee SL, Kang JA, Schweitzer AC, Wickrema A, Conboy JG. Alternative pre-mRNA
splicing switches modulate gene expression in late erythropoiesis. Blood. 2009 Apr 2;113(14):3363-70.
8
Figure 4 Relationship between the time course maturation and differentiation of erythrocytes in
the bone marrow and the proliferative potential of progenitor cells, sensitivity to erythropoietin
influence, accumulation of mRNA for globin chains and the buildup of cellular hemoglobin
13
The mRNAs for the different globin chains of hemoglobin show up and increment in an
amount in the proerythroblast and erythroblast stages, and this is trailed by the blend and
gathering of hemoglobin. By the late erythroblast and norm oblast stages, the combination of
hemoglobin represents over 95 percent of all protein amalgamation happening in the cells
14
.
Hemoglobin blend is deduced in the reticulocyte arrange and is joined by the progressive
disintegration of inner cell structure (counting the loss of the core) and leftover nucleic acids.
Late reticulocytes leave the bone marrow and enter the circulating blood; whereas in the
following hours they lose their granulation, and are changed into the biconcave plates
13
. Erythropoiesis: Development and... (PDF Download Available). (n.d.). Retrieved from
https://www.researchgate.net/publication/236096782_Erythropoiesis_Development_and_Differentiation
14
. Hirono A, Kanno H, Miwa S, Beutler E. Chapter 182: Pyruvate Kinase Deficiency and Other Enzymopathies of the
Erythrocyte. Valle D, Beaudet AL, Vogelstein B, et al, eds. The Online Metabolic and Molecular Bases of
Inherited Disease.
9
commonplace of developing erythrocytes and finish differentiation and development from
foundational microorganism to the red blood cells which takes from 7 to 10 days
15
.
Due to its exceedingly separated express, the mature erythrocyte is unequipped to
promoting multiplication. In people, the typical life expectancy is 120 days. As there are 5 billion
red platelets in each cubic centimeter of blood, a couple of straightforward computations rapidly
uncover that in an ordinary adult, the separation and development of 3 million erythrocytes are
finished each second. An apparent extent of the body's vitality and assets is persistently devoured
to help erythropoietic movement. This distinct difference is a glaring difference from other
profoundly separated cells, for example, those of muscle and nerve, whose expansion stops not
long after birth
16
.
Results
The erythrocyte is formed in the bone marrow from the hemopoietic stem cells. The cells
are partially differentiated and are called erythropoietic bone marrow cells. When the erythrocyte
is manufactured the cells undergo some development phases until the mature erythrocytes are
released into the bloodstream. The last maturation stage requires two vital vitamins that are folic
15
. Cortese-Krott MM, Kelm M. Endothelial nitric oxide synthase in red blood cells: key to a new erythrocrine
function?. Redox biology. 2014 Jan 1;2:251-8.
16
. Litwack G. Erythropoietin. Academic Press; 2017 Jul 1.
10
acid and vitamin B12. The development process from the erythropoietic bone marrow cells to
mature erythrocytes takes about seven days
17
.
The red blood cells are produced by a stimulus known as hypoxia which is the low state
of oxygen. However, the stimulus cannot be enough to trigger the production of erythrocytes
unless the erythropoietin hormone is circulating within the bloodstream. The erythropoietin
hormone is produced primarily by kidneys. Many erythrocytes self-destruct instead of being
removed actively from the circulation and are destroyed
18
. This process occurs primarily in the
spleen.
When the erythrocytes rupture, the hemoglobin is then released to the process of
circulation. The process is done primarily by bone marrow, macrophages in the spleen and the
Kupfer cells of the liver. These macrophages discharge iron which is conveyed by transferring
deep down the bone marrow where it can be reused for the generation of new erythrocytes. The
17
. Revin VV, Gromova NV, Revina ES, Mel’nikova NA, Balykova LA, Solomadin IN, Tychkov AY, Revina NV,
Gromova OY, Anashkina IV, Yakushkin VA. Study of the structure, oxygen-transporting functions, and ionic
composition of erythrocytes at vascular diseases. BioMed Research International. 2015;2015.
18
. Kodali SK, Williams MR, Smith CR, Svensson LG, Webb JG, Makkar RR, Fontana GP, Dewey TM, Thourani VH,
Pichard AD, Fischbein M. Two-year outcomes after transcatheter or surgical aortic-valve replacement. New
England Journal of Medicine. 2012 May 3;366(18):1686-95.
11
rest of the porphyrin part of the hemoglobin is changed over to bilirubin by the macrophages.
The hepatocytes or the liver cells take up the bilirubin, conjugate it and discharge it in the bile
19
.
Discussion
Hematopoietic stem cell transplantation
The steps involved in Hematopoietic stem cell transplantation
Figure 5 Hematopoietic stem cell transplantation process
20
Hematopoietic stem cell transplantation is quickly evolving method that provides a
possible cure for hematologic cancers (myeloma, lymphomas, leukemias) and many other
19
. de Back DZ, Kostova EB, van Kraaij M, van den Berg TK, Van Bruggen R. Of macrophages and red blood cells; a
complex love story. Frontiers in physiology. 2014 Jan 30;5:9.
20
Weissman I. Hematopoietic stem cells, regenerative medicine, and leukemogenesis. Thomas’ Hematopoietic Cell
Transplantation, Fifth Edition. 2015:25-57.
12
hematologic illnesses (such as myelodysplasia, aplastic anemia, primary immunodeficiency).
Hematopoietic stem cell transplantation is also used sometimes for solid tumors, for example,
germ cell tumors that usually respond to chemotherapy
21
.
The Hematopoietic stem cell transplantation usually contributes to the cure by replacing
the abnormal bone marrow with a bone marrow that is normal in nonmalignant hematologic
disorders, and also by restoring the bone marrow after cancer treatments. Hematopoietic stem
cell transplantation may also be allogeneic or autologous. The stem cells may be harvested from
the Umbilical cord blood, peripheral blood, and bone marrow
22
.
Peripheral blood has to a great extent supplanted bone marrow as a wellspring of
foundational microorganisms, particularly in autologous Hematopoietic stem cell transplantation,
since undifferentiated cell gather is simpler and neutrophil and platelet tallies recoup speedier.
Umbilical cord Hematopoietic stem cell transplantation has been limited mainly to youngsters
because there are excessively few undifferentiated organisms in umbilical line blood for an adult.
A potential future wellspring of immature microorganisms is instigated by pluripotent
21
. Koniarczyk HL, Ferraro C, Miceli T. Hematopoietic Stem Cell Transplantation for Multiple Myeloma. InSeminars in
oncology nursing 2017 Aug 1 (Vol. 33, No. 3, pp. 265-278). WB Saunders.
22
. van Laar JM, Farge D, Sont JK, Naraghi K, Marjanovic Z, Larghero J, Schuerwegh AJ, Marijt EW, Vonk MC,
Schattenberg AV, Matucci-Cerinic M. Autologous hematopoietic stem cell transplantation vs intravenous pulse
cyclophosphamide in diffuse cutaneous systemic sclerosis: a randomized clinical trial. Jama. 2014 Jun
25;311(24):2490-8.
13
foundational microorganisms (specific cells are taken from adults and reinvented to act like
undifferentiated organisms)
23
.
There are no contraindications to autologous Hematopoietic stem cell transplantation.
Contraindications to allogeneic Hematopoietic stem cell transplantation are relative and
incorporate age > 50, past Hematopoietic stem cell transplantation, and huge co morbidities.
Allogeneic HSC transplantation is restricted mainly by the absence of
histocompatiblebenefactors
24
. An HLA-indistinguishable kin contributor is perfect, trailed by an
HLA-coordinated kin benefactor. Since just a single fourth of patients have such a kind
benefactor, jumbled related or coordinated disconnected givers (distinguished through universal
registries) are regularly utilized. Nonetheless, long-term ailment free survival rates might be
23
. Wagner Jr JE, Brunstein CG, Boitano AE, DeFor TE, McKenna D, Sumstad D, Blazar BR, Tolar J, Le C, Jones J,
Cooke MP. Phase I/II trial of StemRegenin-1 expanded umbilical cord blood hematopoietic stem cells supports
testing as a stand-alone graft. Cell stem cell. 2016 Jan 7;18(1):144-55.
24
. Forman SJ, Kalos M, June CH. Adoptive Tcell Therapy for Malignancy in the Setting of Hematopoietic Cell
Transplantation. Thomas’ Hematopoietic Cell Transplantation, Fifth Edition. 2016 Jan 1:826-38.
14
lower than those with HLA-indistinguishable kin contributors
25
.
Figure 6 Chemotherapy process
26
References
25
. Weissman I. Hematopoietic stem cells, regenerative medicine, and leukemogenesis. Thomas’ Hematopoietic Cell
Transplantation, Fifth Edition. 2015:25-57.
26
. Koniarczyk HL, Ferraro C, Miceli T. Hematopoietic Stem Cell Transplantation for Multiple Myeloma. InSeminars in
oncology nursing 2017 Aug 1 (Vol. 33, No. 3, pp. 265-278). WB Saunders.
15
Chemaly RF, Ullmann AJ, Stoelben S, Richard MP, Bornhäuser M, Groth C, Einsele H, Silverman
M, Mullane KM, Brown J, Nowak H. Letermovir for cytomegalovirus prophylaxis in
hematopoietic-cell transplantation. New England Journal of Medicine. 2014 May
8;370(19):1781-9.
Cortese-Krott MM, Kelm M. Endothelial nitric oxide synthase in red blood cells: key to a new
erythrocrine function?. Redox biology. 2014 Jan 1;2:251-8.
de Back DZ, Kostova EB, van Kraaij M, van den Berg TK, Van Bruggen R. Of macrophages and
red blood cells; a complex love story. Frontiers in physiology. 2014 Jan 30;5:9.
DeBaun MR, Gordon M, McKinstry RC, Noetzel MJ, White DA, Sarnaik SA, Meier ER, Howard
TH, Majumdar S, Inusa BP, Telfer PT. Controlled trial of transfusions for silent cerebral
infarcts in sickle cell anemia. New England Journal of Medicine. 2014 Aug 21;371(8):699-
710.
Erythropoiesis: Formation of Red Blood Cells. (2016, December 17). Retrieved from
http://www.interactive-biology.com/3969/erythropoiesis-formation-of-red-blood-
cells/
Erythropoiesis: Development and... (PDF Download Available). (n.d.). Retrieved from
https://www.researchgate.net/publication/236096782_Erythropoiesis_Development_and
_Differentiation
Forman SJ, Kalos M, June CH. Adoptive Tcell Therapy for Malignancy in the Setting of
Hematopoietic Cell Transplantation. Thomas’ Hematopoietic Cell Transplantation, Fifth
Edition. 2016 Jan 1:826-38.
16
Hirono A, Kanno H, Miwa S, Beutler E. Chapter 182: Pyruvate Kinase Deficiency and Other
Enzymopathies of the Erythrocyte. Valle D, Beaudet AL, Vogelstein B, et al, eds. The Online
Metabolic and Molecular Bases of Inherited Disease.
Hoffman JF. Red blood cells, compasses and snap shots. Blood Cells, Molecules, and Diseases. 2018
Mar 21.
Kodali SK, Williams MR, Smith CR, Svensson LG, Webb JG, Makkar RR, Fontana GP, Dewey
TM, Thourani VH, Pichard AD, Fischbein M. Two-year outcomes after transcatheter or
surgical aortic-valve replacement. New England Journal of Medicine. 2012 May
3;366(18):1686-95.
Koniarczyk HL, Ferraro C, Miceli T. Hematopoietic Stem Cell Transplantation for Multiple
Myeloma. InSeminars in oncology nursing 2017 Aug 1 (Vol. 33, No. 3, pp. 265-278). WB
Saunders.
Litwack G. Erythropoietin. Academic Press; 2017 Jul 1.
Lloyd JA. An Introduction to Erythropoiesis Approaches. InErythropoiesis 2018 (pp. 1-10). Humana
Press, New York, NY.
Nandakumar SK, Ulirsch JC, Sankaran VG. Advances in understanding erythropoiesis: evolving
perspectives. British journal of haematology. 2016 Apr 1;173(2):206-18.
Overmann J. Red Blood Cells. Interpretation of Equine Laboratory Diagnostics. 2017 Oct 5:113.
Pretorius E, Oore-ofe O, Mbotwe S, Bester J. Erythrocytes and their role as health indicator: Using
structure in a patient-orientated precision medicine approach. Blood reviews. 2016 Jul
1;30(4):263-74.
Revin VV, Gromova NV, Revina ES, Mel’nikova NA, Balykova LA, Solomadin IN, Tychkov AY,
Revina NV, Gromova OY, Anashkina IV, Yakushkin VA. Study of the structure, oxygen-
17
transporting functions, and ionic composition of erythrocytes at vascular diseases. BioMed
Research International. 2015;2015.
Singh AK, Singh S, Garg G, Rizvi SI. Rapamycin mitigates erythrocyte membrane transport
functions and oxidative stress during aging in rats. Archives of physiology and biochemistry.
2018 Jan 1;124(1):45-53.
van Laar JM, Farge D, Sont JK, Naraghi K, Marjanovic Z, Larghero J, Schuerwegh AJ, Marijt EW,
Vonk MC, Schattenberg AV, Matucci-Cerinic M. Autologous hematopoietic stem cell
transplantation vs intravenous pulse cyclophosphamide in diffuse cutaneous systemic
sclerosis: a randomized clinical trial. Jama. 2014 Jun 25;311(24):2490-8.
Wagner Jr JE, Brunstein CG, Boitano AE, DeFor TE, McKenna D, Sumstad D, Blazar BR, Tolar J,
Le C, Jones J, Cooke MP. Phase I/II trial of StemRegenin-1 expanded umbilical cord blood
hematopoietic stem cells supports testing as a stand-alone graft. Cell stem cell. 2016 Jan
7;18(1):144-55.
Weissman I. Hematopoietic stem cells, regenerative medicine, and leukemogenesis. Thomas’
Hematopoietic Cell Transplantation, Fifth Edition. 2015:25-57.
Yamamoto ML, Clark TA, Gee SL, Kang JA, Schweitzer AC, Wickrema A, Conboy JG. Alternative
pre-mRNA splicing switches modulate gene expression in late erythropoiesis. Blood. 2009
Apr 2;113(14):3363-70.

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