HEMATOPOEITIC NSOH FOFANG

MIA BIOS 2021

SYSTEM Edited by Laouna Fru

Supervised by Dr Dimitri
INTRODUCTION
The system concerned with blood, its components and its
functioning.
Blood is a specialized type of connective tissue, composed of
a matrix called plasma, in which its cellular components
(formed elements) bathe.
The study of the hematopoeitic system is known as
hematology.
FUNCTIONS OF BLOOD
Transport (respiratory gases,waste products, nutrients,
hormones, urea)
Regulation (pH and temperature)
Protection (clotting mechanisms, antibodies and
phagocytes.)
PROPERTIES OF BLOOD
•About 4 times as viscous as water
•Temperature slightly higher than body temp by C(38C)
•pH between 7.35-7.45(slightly alkaline),venous blood has a
low Ph than the arterial blood as venous blood has more co2
•Constitutes about 8% of body weight
•4-6L in adult males (4-5L in females)
•Osmotic pressure 25mmHg
BLOOD COMPONENTS 1
Liquid plasma which is the matrix; yellowish, 55% of blood
volume
Formed elements (cellular component)
BLOOD COMPONENTS 2
PLASMA
It is made up of:
The cells ( RBCs and the Buffy coat)
Water ( about 90%-92% of plasma)
Plasma proteins (60% being albumin,15% globulin,
15-20% fibrinogen and 2-4%)
Mineral Salts (Na, K, Ca, Mg, Cl, HP,,HC)
Nutrients(glucose,amino acids,fatty acids,vitamins
and minerals)
Hormones, enzymes
Gases and Waste products
BLOOD COMPONENTS 3
Role of Plasma
Due to 90% of it being water, it acts as a solvent.
Its protein content helps in maintaining oncotic
pressure (albumin)
Globulins aid in transport and in defense against
infections.
Fibrinogen and prothrombin play a big role in blood
clotting
Mineral salts aid in osmoregulation and acidobasic
regulation
It aids in channeling waste products to the kidney
BLOOD COMPONENTS 4
PLASMA
Points to note:
Plasma without the clotting factors is called Serum
which is colorless
Active plasma proteins are called Serines
Inactive plasma proteins are knowns as Zymogens
 BLOOD COMPONENTS
FORMED ELEMENTS
Formation of cellular components – Hemopoeisis
Takes place in red bone marrow by specialized cells- hemopoietic stem
cells
They make up about 0.05-0.1% of the marrow cell population
They can differentiate themselves into all the other types of blood cells
and can equally replenish themselves
They give rise to the blast cells
Blast cell Cellular component

proerythroblast erythroblast

myeloblast Neutrophile, monocytes

Lymphoblast lymphocytes

megakaryoblasts Platelets,
HEMOPOIETIC ORGANS
1. During embryonic life
The yolk sac, liver, spleen, lymph nodes, thymus, red
bone marrow
2. After birth
Red bone marrow found in the epiphysis of the long
bones and in flat bones
HEMOPOIESIS
Differentiation begins when they develop surface
receptors for specific stimulatory chemicals.
The process of differentiation usually includes a
decrease in the cell size and an increase in the
number of cells.
These chemicals make them commit to a particular
lineage, such that hemoblast production is stopped,
to ensure that differentiation occurs, and that
subsequent cell formation occurs in one of the three
pathways: Erythropoiesis, leukopoiesis and
thrombopoiesis
HEMOPOIESIS
HORMONAL STIMULATION
Erythropoietin: produced in the kidney, stimulates
the production of RBC precursors.
Thrombopoietin: stimulates the production og
thrombocytes
Cytokines: small glucoproteins that stimulate the
production of WBCs. The 2 most important are: IL
and CSFs
ERYTHROPOIESIS
 It is the process of red blood cell production
It normally generates about 2.5 million RBCs per
second (20 mL/day).
The sequence of cell trans-formations leading to
an erythrocyte is hemocytoblast → proerythroblast
→ erythroblast → normoblast → reticulocyte →
erythrocyte.
The proerythroblast is the first committed cell,
having receptors for the hormone erythropoietin
(EPO).
The reticulocyte is the last nucleated cell in the
lineage. Requires Fe, vits B9 and B12
 ERYTHROPOIESIS
It usually occurs within a duration of 7 days
Vit B12 is absorbed in the stomach with the help of intrinsic
factors
Erythropoeisis is stimulated by:
i. Hypoxia-decreased level of O2 in circulation
ii. Anaemia-reduced amount of healthy red blood cells
iii. Hormone stimulation ( erythropoietin)
Reticulocytes: immature RBCs (about 1-2% of
circulating RBCs, possess Hb, mitochondria,
endoplasmic reticulum and ribosomes) 72 hours
after their release, they become mature RBCs
LEUKOPOIESIS
From the primitive stem cell, leucopoiesis occurs
through three major pathways:
B cell progenitors, T cell progenitors, Granulocyte-
Monocyte colony forming units.
From these, the different types of WBCs develop
THROMBOPOIESIS
This is the process by which platelets, or
thrombocytes, are formed from giant cells called
megakaryoblasts, after having differentiated from
the hemocytoblast under the influence of a
hormone called thrombopoietin.
Mature platelets have a lifespan of about 10 days.
RED BLOOD CELLS
Biconcave disc-shape to maximize gaseous exchange and
increase flexibility
7-8 µm in diameter
About 90% of the cellular population
In males, 5-5.5 million/. In females, 4.5-5 million/
Anucleated
Possess Hb, 250 million Hb molecules/cell
 no mitochondria
RED BLOOD CELLS
HAEMOGLOBIN
Formed before the cell loses its nucleus and accounts for
about 33% of its weight.
Made of a globin protein which has 2α and 2B chains
Haem containing that can reversibly bind with
Different haemoglobin chains exist
types Blobin chain percentage

HbA (adult) 2A, 2B 5

Hb (adult) 2A, 2D 2-3

HbF 2A, 2Y 2

Embryonic hemoglobin 2A, 2E <1

 RED BLOOD CELLS
HAEMOGLOBIN
Abnormal Hb, HbS, causes a hereditary disease called Sickle cell anemia
Affects mainly the black race
In HbS, glutamate is replaced by Valine on the B chain, precisely position
6
This results in the formation of long elongated crystals low in Oxygen
The cell thus acquires a sickle shape
Hematocrit: percentage of RBCs in blood expressed as
volume of RBCs/ blood volume x 100%
 RED BLOOD CELLS
HAEMOLYSIS AND THE FATE OF HAEMOGLOBIN
Haemolysis is the destruction of RBCs and it takes place in the spleen and
liver
RBCs have a life span of about 120 days at a rate of 2 million n/ second
Haem is broken down into and biliverdin.
Biliverdin is converted into bilirubin which is passed out in faeces
Fe is transferred to the liver via transferrins and stored as ferritin for
recycling
Globin is recycled
RED BLOOD CELLS
PATHOLOGIES
1. Anicytosis: variation in RBC size
2. Poikilocytosis: variation in RBC shape
3. Drepanocytosis: sickle-shaped RBC
4. Polycthermia: increase >7 million RBCs/
1. Megaloblastic anemia: deficiency in B9 and B12
2. Microcytic anemia: deficiency in iron
3. Applastic anemia: major decrease in RBC and
haemoglobin production
4. Haemolytic anemia: deficiency due to massive
destruction of RBCs
BUFFY COAT
Less than 1% of total blood volume
Made of leukocytes and platelets
Leukocytes:
These are the WBCs
There are 5000 -10000 /mm3 blood. (>10,000=
leukocytosis; <5000= Leukopenia)
Two major classes of leucocytes :granulocytes and
agranulocytes.
Granulocytes: those with many granules in their cytoplasm
(neutrophils, eosinophils and basophils)
Agranulocytes: those with no granules in their
cytoplasm(monocytes and lymphocytes).
 NEUTROPHILS
Most populated WBCs (60-70%)
Nucleus possesses 3-5 lobes
Leave blood vessels through diapedesis in instances of
infection
Their cytoplasm has fine red granules possessing defensive
chemicals( , oxidants, defensins) and enzymes
Increase in bacterial responses
Defense by phagocytosis of bacteria
 EOSINOPHILES
Constitute about 2-4% of total WBCs
Have large orange granules in
cytoplasm
Increase during allergic responses,
parasitic infections and diseases of the
spleen
Phagocytize antibody-antigen complexes
They destroy parasitic worms
The largest polynuclear leucocytes
 BASOPHILS
Constitute about 0.5-1% of total WBC population
Have large deep blue granules containing heparin,
histamine and serotonins
Their release triggers the allergic response and the
inflammatory response
In tissue, they are known as mast cells
Histamine is a vasodilator
Heparin is an anti-coagulant
 LYMPHOCYTES
Constitute about 25-33% of the total WBC count
Uninucleated
Three classes exist depending on the size: small, medium,
large
Serve in immune memory and secrete antibodies
Coordinate most of the other cells in the immune system
Present antigens to other cells of the immune system
Destroy cancer cells, viruses and other foreign bodies
 MONOCYTES
Constitute about 3-8% of the total WBC count
Uninucleated, kidney shaped nucleus
In tissues, they differentiate into macrophages
Main role is to phagocytize foreign bodies
Increase in viral and inflammatory responses
They are the largest leucocyte
 PLATELETS/ THROMBOCYTES
They are not cells but fragments of larger cells called
megakaryoblasts
About 150,000 to 400,000 of them per mm3 of blood.
(<130,000= thrombocytopenia; >360,000= thrombocytosis
Are capable of amoeboid movements.
Secrete procoagulants, or clotting factors (promote blood
clotting) vasoconstrictors, (cause vascular spasms in broken
vessels).
Form temporary platelet plugs to stop bleeding.
Dissolve blood clots that have outlasted their usefulness
Secrete chemicals that attract neutrophils and
monocytes to sites of inflammation.
Secrete growth factors that stimulate mitosis in
fibroblasts and smooth muscle and help to maintain the
linings of blood vessels.
HAEMOSTASIS/ BLOOD
CLOTTING
These are mechanisms put in place by the
body in bid to reduce blood loss when a vessel
is destroyed.
Divided into : Primary and Secondary
hemostasis.
PRIMARY HAEMOSTASIS
1.) VASCULAR SPASM
Immediately there’s lesion to the wall of a blood vessel,
vasospasm (vasoconstriction) occurs.
This could be due to two main mechanisms: Constriction of
the muscles in the wall of the blood vessel, or secretion of
serotonin and thromboxane A2 by the platelets
Vasoconstriction reduces the lumen of the blood vessel, which
favours the other two aspects of the coagulation cascade
PRIMARY HAEMOSTASIS
2.) PLATELET PLUG FORMATION
The platelet plug is an agglomeration of platelets that bind to
the walls of the blood vessel, constituting a tentative clot.
The wall of the normal blood vessel is smooth, and coated with
prostacyclin, which repels platelets.
However when the vessel walls are breached, the underlying
connective tissue is exposed, thus favouring the formation of
the platelet plug.
Processes involved in the formation of a
platelet plug: Platelet activation, aggregation,
adhesion to the blood vessels
The platelet plug could stay in place for 48 -
72 hours, during which the formation of the
final clot occurs.
SECONDARY HEMOSTASIS
The formation of the clot is a complex process, which could
occur either by the intrinsic or the extrinsic pathway.
Clot formations occur with the aid of plasma proteins called
clotting factors.
12 clotting factors exist
Vitamin K dependent factors are
X, IX, VII, II
Clotting factor origin mechanism functions
Fibrinogen I liver both Fibrin precursor

Prothrombin II liver both Thrombin precursor

Tissue thromboplastin III tissues ext Activates factor VII
Ca 2+ IV diet both Activates factor VII; together with factor X, it
forms prothrombin activator
Proaccelerin V liver both
Proconvertin VII liver ext Activates factor X
Anti-haemophiliac A factor platelets int Activates factor X
VIII
Anti-haemophiliac B factor liver int Activates factor VIII
IX
Thrombokinase X liver both Together wit factor V, forms prothrombin activator

Plasma thromboplastin XI liver int Activates factor IX

Hageman factor XII liver int Activates factor XI
Fibrin stabilizing factor XIII Liver, platelets both Stabilizes clot
FIBRINOLYSIS

When a clot has already served its purpose, it is destroyed by

a process called fibrinolysis.
This is considered by many authors as the third stage in
hemostasis.
 BLOOD GROUPS
They are anti genes present on the cell membrane of our redblood
cells.
Our plasma contains substances called antibodies that are produced
against non cell antigenes.
If the RBC from the donor and plasma antibody(recipient) are not the
same a condition called hemolysis will occur.
However, this result is due to agglutination.
It is an inherited phenotypic trait determined by the prescence or
absence of antigenes present on RBC surface.
BLOOD TYPES: ABO SYSTEM
TYPE A- ANTIGEN A
TYPE B-ANTIGENB
TYPE AB-ANTIGEN A AND B
TYPE O-NO ANTIGEN
Shortly after birth, human beings spontaneously
develop antibodies contrary to the antigen
expressed by its phenotype.
 RHESUS FACTOR
Inherited phenotypic traits.
When these antigens are present the individual is said to be
Rhesus +ve and vice versa.
Rhesus antibodies do not form spontaneously but will when
stimulated a second time.
The initial exposition is harmless however the RH- is sensitised.
During the following exposition, severe hemolysis occurs due to
the destruction of RBC by antibodies of the plasma.
ERYTHROBLASTOSIS
FOETALIS
Hemolytic diseases of the new born when a Rh- mother
becomes pregnant for the second time of a Rh + child.
IgG crosses the placenta and causes hemolysis of foetal
blood.
It can be prevented with RhoGAMM which is administered
to mothers after sensitisation.