I.Introduction II.Cell types III.Glycemia IV.Blood types BLOOD (Haima, Sanquis) MAIN FUNCTIONS OF BLOOD 1.Exchange of O2 and CO2 2.Exchange of nutritions and metabolic waste 3.Transport of hormones, enzymes etc. 4.Thermoregulation 5.Buffering the pH 6.Immune functions 7.Mainteining the blood pressure Výsledek obrázku pro hematopoiesis https://www.news-medical.net/life-sciences/What-is-Hematopoiesis.aspx Number of blood elements Erythrocytes Leukocytes Hemoglobin Hematocrit 4,3 - 5,3.106/ml 4 - 9.103/ml 14 – 18g/100ml 0,39 – 0,49 3,8 – 4,8.106/ml 12 – 16g/100ml 0,35 – 0,43 PCV DETECTION: Heparinized tube - plug Centrifugation 3 min / 12 000 RPM Height of the red cell column in a tube after centrifugation related to the total volume of blood 0,39 – 0,49 0,35 – 0,43 http://www.eclinpath.com/hematology/tests/hematocrit / 14 – 18 g/100 ml 12 – 16 g/100 ml Transport of O2 and CO2 Buffering the blood pH Hemolysis: Globin – cleaved to the aminoacids Hem – Fe3+ - transferin – hemosiderin – feritin - biliverdin – bilirubin - bile DETECTION: Drop of 0.1 M HCl + 20 ul Blood = acidic (brown) chlorhemin Dilution with dH2O in Sahli´s visual hemometer/colormeter —Blood glucose level —Hypoglycemia – hypoglycemic shock (reversible) —Normal level - 3,9 – 5,6 mM (70 – 110 mg/1OO ml) —Hyperglycemia – diabetes mellitus — —discovery of insulin 1921 – Banting a Best (Nobel price) — —Insulin-dependent and -independent cells — —1. Autoregulation —2. Hormonal regulation insulin vs. — glukagon, adrenalin — somatotropin (pituitary gland) — glucocorticoids (e.g. cortisol) —3. CNS regulation Výsledek obrázku pro pankreas langerhans > PhysioEx manual Effect of insulin on glucose uptake and metabolism. Insulin binds to its receptor (1) which in turn starts many protein activation cascades (2). These include: translocation of Glut-4 transporter to the plasma membrane and influx of glucose (3), glycogen synthesis (4), glycolysis (5) and fatty acid synthesis (6). http://en.wikipedia.org/skins-1.5/common/images/magnify-clip.png Výsledek obrázku pro insulin function https://www.rudymawer.com/blog/insulin-sensitivity-the-ultimate-guide/ Acute diabetic syndrome DMI (7 %, juvenile) Ketoacidotic coma - lack of glucose in insulin-dependent cells – alternative source of energy – overproduction of KETONS (hydroxybutyrate, aceton) – ACIDIC blood Kusmauls breething, excessive urination) – ketons overcome blood-brain barriere – failure of brain centres – COMA Micro- and macroangiopaties - imbalanced glycemia – hyperglycemia – glucose binds to hemoglobin = glycated hemoglobin – increased viscosity of blood – plaques – ischemia - first microcapilaries e.g. retina, kidney; later leg veins —Indicator on the strip of glucometer (spectrophotometer) —Glucose and indicator react and the colour of indicator changes —Intenzity of colour change is in direct proportion to the concentration of glucose Výsledek obrázku pro glucometer https://www.accu-chek.cz/ —Starving glycemia —1g glucose/1kg weight —2 hours after glycemia hyperglycemia Healthy person I.AB0 II.Rh III.MHC/HLA BLOOD GROUPS Blood groups —Immunohematology — —Antigen = aglutinogen —(protein(glycan) on cellular surface) —Antibody = aglutinin —(protein produced by B-lymfocytes) — Aglutinogen + aglutinin = aglutination Ag Ab clusters System ABO 1.1901 Landsteiner (A,B,0) 2.A,B antigens are common in all the microorganisms ERYTHROCYTE glycosfingolipide/ glycoprotein Fucose N-acetylglukosamin galactose N-acetylgalaktosamin Group A Group B H antigen = group 0 (Mumbai antigen = h Ag) Detection of ABO on glass — CR 41 % 14 % 7 % 38 % — Most N Europe SE Asia mid Europe Indians, Africans — World 32 % 22% 5 % 41 % Anti A anti B 0 A B AB Clonal selection 1.Hematopoietic stem cell 2.Imature B lymfocytes with different Ag R 3.Those, who react with body Ag are removed by apoptosis (in bone marrow) 4.Other clones mature and leave marrow 5.React with foreing Ag – activate 6.Proliferate and produce Ab 7. — Those, who have not meet the appropriate Ag yet, are in G0 and circulate Clonal selection of lymphocytes: 1) A hematopoietic stem cell undergoes differentiation and genetic rearrangement to produce 2) immature lymphocytes with many different antigen receptors. Those that bind to 3) antigens from the body's own tissues are destroyed, while the rest mature into 4) inactive lymphocytes. Most of these will never encounter a matching 5) foreign antigen, but those that do are activated and produce 6) many clones of themselves. Principle of elimination of auto-immune clones of B-lymfocytes Rh factor (in tube detection) —1940 – Landsteiner — - Immunized the rabbits by the blood of Macacus Rhesus — - Rh incompatibility mother Rh- and child Rh+ — — Genotype Fenotype —CcDdEe - D - Rh+ … 85 % — - d - Rh- … 15 % — —DETECTION: 500 ml of physiolog. solution + 10 ul blood —Centrifugation (1OOO RPM/3 min) – add 100 ul of physiol. solution to the pellet) —1 drop of anti-D Ab + 1 drop of erytrocytes, 10´/RT – Centrifugation (1000 RPM/1 min) Other blood systems ÒMN system (Ss), P system, Lewis, Duffy ÒHLA/MHC system (leukocytes) – 1960 (10 Ag) — — — —Transfúze – AB0, Rh (křížový test) — — —Transplantation – AB0, Rh — heart, liver - 5/10 HLA Ag — kidney – 7/10 HLA Ag — b. marrow – 10/10 HLA Ag Small test — 1.Which hormones increase glycemia? 2.What is the insulin signaling? 3.How proceeds hemolysis (hemoglobin decomposition)? 4.Is there anti-B Ab in the blood of person with blood group O?