BLOOD. PUMC Dept. of Anat. Hist. & Embry. 陈咏梅 YONG-MEI CHEN Dept. of Anatomy, Histology & Embryology Peking Union Medical College

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1 BLOOD PUMC Dept. of Anat. Hist. & Embry. 陈咏梅 YONG-MEI CHEN Dept. of Anatomy, Histology & Embryology Peking Union Medical College

2 Content Composition & functions of plasma PUMC Dept. of Anat. Hist. & Embry. Structure & functions of erythrocytes Classification, structure & functions of leukocytes Structure & functions of platelets Hemopoiesis

3 Blood smear Wright & Giemsa stain (azures)

4 Hemogram Blood female: /L Neutrophils Granular ~ Eosinophils Formed Leukocytes Basophils element /L Lymphocytes ~ 45% Agranular ~ Monocytes Platelets ( ) 10 9 /L Plasma ~ 55% male: /L Erythrocytes Hematocrit: 40-50% in men & 35-45% in women

5 I. Plasma: yellowish & translucent 1. Compositions:

6 Plasma proteins: albumin, α,β,γ-globulin clotting protein (prothrombin, fibrinogen, etc.) complement protein (C 1 -C 9 ) lipoproteins (chylomicrons, VLDL, LDL, HDL) 2. Functions: Transportation, regulation & defense 3. Serum:

7 II. Formed element: PUMC Dept. of Anat. Hist. & Embry. 1. Erythrocytes (Red Blood Cell, RBC) (1) Structure: 1) biconcave disc 2) d 7-8μm sectioned slide Histologic ruler

8 (1) Structure: PUMC Dept. of Anat. Hist. & Embry. 1) biconcave disc 2) d 7-8μm 3) acidophilic 4) no nucleus 5) no organelles 6) rich in hemoglobin 7) deformable membrane

9 Hemoglobin (Hb): globin + iron-containing heme HbA & HbF

10 RBC membrane proteins: PUMC Dept. of Anat. Hist. & Embry. a) Integral ~: Na + -K + pump, Ca 2+ pump, and glucose transport protein, band 3 protein, and glycophorins etc. Blood group ABO group Rh group hemolytic transfusion reaction

11 RBC membrane proteins: b) Peripheral ~: spectrin, actin, and ankyrin etc. serving as a membrane skeleton. PUMC Dept. of Anat. Hist. & Embry. RBC membrane is flexible & deformable

12 (2) Functions: O 2 transport and CO 2 transport Alveoli Cell in the tissue

13 (3) Normal value of erythrocytes PUMC Dept. of Anat. Hist. & Embry. Erythrocytes Hemoglobin male: /L female: /L male: g/l female: g/l

14 (4) Change of RBC 1) Physical adaptation: 2) Pathological changes: D > 9μm: macrocytes; D < 6μm: microcytes Anisocytosis

15 Anemia: RBC < /L, Hb < 100g/L eg: Iron-deficiency ~, Sickle cell ~, Mediterranean ~ etc.

16 (5) Osmotic equilibrium between RBC and plasma PUMC Dept. of Anat. Hist. & Embry. blood shadow or blood ghost

17 (6) Reticulocyte: 0.5~1.5% of RBC anucleate, contain some organelles, e.g.: rrna demonstrated by brilliant cresyl blue methods ( 煌焦油蓝 )

18 (7) Life span: about 120days PUMC Dept. of Anat. Hist. & Embry.

19 2. Leukocytes (White Blood Cell, WBC) Blood Inactive WBC PUMC Dept. of Anat. Hist. & Embry. diapedetis Active WBC

20 (1) Introduction: Neutrophils 50-70% Granular ~ Eosinophils 0.5-3% Leukocytes /L Agranular ~ 1) Granular leukocytes Basophils < 1% Lymphocytes 20-30% Monocytes 3-8% a. Azurophilic granules: staining purple, lysosomes b. Specific granules:

21 (1) Introduction: Neutrophils 50-70% Granular ~ Eosinophils 0.5-3% Leukocytes /L Agranular ~ 2) Agranular leukocytes a. Azurophilic granules 3) Life span: variable Basophils < 1% Lymphocytes 20-30% Monocytes 3-8%

22 (2) Classification: 1) Neutrophils: 12-15μm a. Structure: Nucleus: band-form or multilobed, 2-5 lobes PUMC Dept. of Anat. Hist. & Embry. Specific granules: neutrophilic ~: small, barely visible in LM, containing alkaline phosphatase, collagenase and lysozyme etc.

23 b. Functions: Chemotaxis: Phagocytosis and destruction of microorganisms, especially bacteria. Pus & pyocyte

24 2) Eosinophils: 12-15μm a. Structure: Nucleus: bilobed PUMC Dept. of Anat. Hist. & Embry. Specific granules: Eosinophilic ~: staining orange-pink, large, elongated, crystalline core, refractile, and containing major basic protein, histaminase, myeloperoxidase, etc.

25 b. Functions: Chemotaxis: Phagocytosis of Ag-Ab-complexes and destruction of parasites.

26 3) Basophils: 12-15μm a. Structure: Nucleus: lobed, S-shaped, or irregular, often masked by the overlying specific granules

27 Specific granules: Basophilic ~: metachromasia, staining blue purple and containing heparin, histamin, PUMC Dept. of Anat. Hist. & Embry. eosinophil chemotactic factor of anaphylaxis (ECF-A). Leukotriene b. Functions: mediating the allergic reactions.

28 4) Lymphocytes: a. Structure: Small lymphocytes: 6-8μm, nucleus: cytoplasm 9:1 Deeply-stained spherical nucleus, sometimes with an indentation, located eccentrically; cytoplasm is basophilic, sky-blue, contains fine azurophilic granules.

29 Medium-sized lymphocytes: 9-12μm Large lymphocytes: 13-18μm PUMC Dept. of Anat. Hist. & Embry. b. Classification and functions: B-Lymphocytes: 20-30%, responsible for humoral immunity T-Lymphocytes: 70-80%, responsible for cell-mediated immunity Natural killer cells:

30 5) Monocytes: 12-20μm a. Structure: oval, kidney- or horseshoe-shaped nucleus, eccentric position; cytoplasm is basophilic, bluishgray, and contains fine azurophilic granules. PUMC Dept. of Anat. Hist. & Embry. b. Functions: Precursor cells of the mononuclear phagocyte system

31 3. Platelets: (Thrombocytes) 2-4μm (1) Structure: often in clumps 1) anucleate, biconvex round or ovoid discs.

32 2) Hyalomere: peripheral clear zone dense tubular system PUMC Dept. of Anat. Hist. & Embry. open canalicular system microtubules 3) Granulomere: central darker zone α, λ, δ granules

33 (2) Functions: promote blood clotting & controlling hemorrhage thrombocytopenic purpura PUMC Dept. of Anat. Hist. & Embry. (3) Life span: ~ 10 days.

34 Hemopoiesis (Blood Cell Formation) I. Hemopoietic Organ: 1. Mesoblastic phase: york sac 2. Hepatic phase: 3. Splenic phase: 4. Myeloid phase: bone marrow

35 Red Bone Marrow Yellow Bone Marrow RBM YBM

36 Structure of Red Bone Marrow: (1) Stroma: reticular tissue (2) Hemopoietic cord: hemopoietic cells & macrophages (3) Sinusoids:

37 pluripotential hemopoietic stem cells PUMC Dept. of Anat. Hist. & Embry. progenitor cells (committed stem cells) colony-forming cells (CFC) or colony-forming units (CFU). precursor cells (blasts) colony-stimulating factors (CSF), growth factors or hematopoietins, e.g.: Erythropoietin (EPO), G-CSF, GM-CSF etc

38 Monoblast Myeloblast

39

40 II. Erythropoiesis ~7d Major morphological changes: PUMC Dept. of Anat. Hist. & Embry. (1) Cell volume: (2) Cytoplasm: basophilic acidophilic (3) Nucleus: disappear nucleoli: disappear chromatin condensation

41 III. Granulopoiesis ~11d Granules PUMC Dept. of Anat. Hist. & Embry.

42 IV. Thrombopoiesis Megakaryoblast Promegakaryocyte Megakaryocyte Platelet