10. Carriage of O2 in the blood Flashcards

1
Q

What is the purpose of the cardiovascular system?

A

Supply oxygen and metabolic fuel e.g. glucose to tissues and to take away the waste product of metabolism i.e. CO2

To maintain defences against invading microorganisms

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2
Q

Why is the simple carriage of oxygen a problem?

How do we overcome this?

A

Because O2 is a powerful oxidising agent
Most organic molecules are damaged by too high a concentration of O2

Erythrocytes are specific for this task

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3
Q

Define and describe ‘oxidation’

A

The loss of electrons

Oxidising agents e.g. molecular O2 are ‘electron hungry’ so when they combine with other atoms or electrons they remove the electrons from the oxidised molecule

Oxidation simplifies the electronic structure of the substrate and hence, decreases the free energy of the system

This releases energy - most often in the form of heat

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4
Q

Define and describe ‘reduction’

A

The gain/adding of electrons

Involves the building of molecules from simpler ones

Normally requires energy

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5
Q

Describe O2 as an oxidising agent

A

Powerful oxidising agent

One O2 molecules takes 4 electrons from an organic substrate

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6
Q

Describe erythrocytes

Describe the breakdown of erythrocytes and how this occurs

A

Contains Hb - contains about 270 million Hb molecules

Bioconcave disks

Volume of about 80 cubic microns

Have no nuclei - SO they cannot synthesise any RNA and hence, cannot divide or repair themselves and so have a limited lifetime of about 120 days

Have no mitochondria - SO cannot use any of the O2 that they carry

Ageing RBC undergoes changes in it’s plasma membrane which makes it susceptible to recognition by phagocytes and subsequent phagocytosis in the spleen, liver and bone marrow

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7
Q

Describe why RBCs require ATP and how they form this

A

Require ATP to maintain sodium pumps in their cell membranes and for ion pumping operations

Produce ATP by glycolysis - glucose to pyruvate and pyruvate to lactic acid

SO they have a naturally low pH

RBCs have a separate uptake of glucose system to other cells in the body - not regulated by insulin

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8
Q

Describe Hb and why it is unique

Explain why Hb is able to do this

A

Unique because it can combine rapidly and reversibly with O2 without becoming oxidised

SO it can release the O2 to tissues when required

This is due to the presence of the iron atom and its special properties - ferrous iron atom has 6 unpaired electrons and hence, can form bonds with 6 electrons from other atoms

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9
Q

Describe the effect that oxygen has on RBCs

A

RBCs are progressively damaged by the O2 they carry

Hb is converted to methaemaglobin (oxidised Hb)
Other enzymes become oxidised and inactive

Cells are also damaged by having to bend to get through the smallest capillaries

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10
Q

What are reticulocytes? Describe these

A

Just before and after leaving the bone marrow, immature erythrocytes are known as reticulocytes

These comprise about 1-2% of the circulating erythrocytes in a normal person - they change into erythrocytes about a day after entering the circulation

They have this name due to the reticular (mesh-like) network of ribosomal RNA that becomes visible under a microscope with certain stains e.g. methylene blue

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11
Q

Describe the ferrous iron that is present in Hb

A

Has 6 unpaired electrons - can form bonds with 6 electrons from other atoms

4 bonding orbitals are in a plane and 2 stick out above and below the plane

The 4 in the same plane are held tight by 4 covalent bonds to nitrogen atoms in a porphyrin ring
5th electron is bonded to histidine amino acid under the plane
This leaves a single 6th ferrous electron able to form a bond

In Hb O2 forms a weak reversible bond with the 6th ferrous electron

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12
Q

Describe the structure of human Hb

A

Made up of four polypeptide subunits
Each subunit has a haem prosthetic group attached
The four polypeptide chains are bound to each other by salt bridges, hydrogen bonds and hydrophobic interactions

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13
Q

Describe what is meant by ‘steric hindrance’ and how this relates to Hb

A

Steric hindrance is the stopping of a chemical reaction due to the structure of the molecules

The 3D folding of the Hb subunits creates a steric hindrance so O2 cannot get close enough to iron to remove it’s electrons

In Hb, O2 meets iron in the Fe++ state and does not remove the 6th electron completely
This means that it does not leave iron in the Fe+++ form (ferric state)
This is due to the steric hindrance

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14
Q

What is the impact of steric hindrance in Hb?

A

Steric hindrance in Hb results in the formation of a resonance structure where O2 is weakly bonded to iron but does not oxidise it

This is dependent on the pO2 in solution e.g. when the pO2 is high (lungs) the O2 can bind and form this oxyhaemoglobin resonance structure

If the steric hindrance is not correct then O2 does oxidise the iron to it’s ferric state - Hb with ferric iron is called methaemoglobin and cannot carry O2

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15
Q

Describe methaemoglobin and it’s significance

A

The formation of methaemoglobin is another reason with RBCs have a limited lifespan - once this forms in aged cells, the cells become full of it and need to be replaced

A small amount of methaemoglobin is formed whenever the RBCs pass through the lungs

In young cells, most of this can be converted back to Hb by the NADH dependent enzyme methaemoglobin reductase inside the cell but in ageing cells, the amount of methaemaglobin increases (possibly because NADH levels decrease)

One signal that an erythrocyte should be removed from circulation is an increased concentration of methaemoglobin in the cell - causes antigen markers on the surface of the cell to change and this change is detected by cells in the liver and the spleen, which remove the exhausted erythrocytes

About 1-2% of people’s Hb is methaemoglobin - a higher percentage of this can be due to genetic causes or due to exposure to various chemicals - known as mehaemoglobinemia

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16
Q

Describe the different subunits of Hb

A

Several forms of Hb subunit globin e.g. alpha, beta
Each form has a slightly different amino acid sequence
All subunits contain the haem group but the amount of steric hindrance varies depending on the particular mix of subunits in the molecule
Folding of the subunits and the ability of O2 to bind to them is altered by other factors such as pH and CO2

17
Q

Describe the subunits present in adult Hb

A

Normally made up of two alpha subunits and two beta subunits - HbA

18
Q

Describe the subunits present in foetal Hb

A

Two gamma subunits

This has a higher affinity for O2 than adult Hb and can hence remove it from the placental blood

19
Q

Describe the effect of mutations in Hb and two common diseases this results in

A

Mutations in the genes for Hb protein in humans can result in a group of hereditary diseases

These are termed the haemoglobinopathies

Most common are sickle cell anaemia and thalassaemia

20
Q

Briefly describe the Hb changes in SCA

A

When foetal Hb is switched off after birth, instead of producing normal HbA, HbS is produced

HbS contains mutant form of one of the beta subunits

This is because a valine replaces a glutamine in the 6th position of the beta chain of globin

21
Q

Briefly describe the Hb changes in thalassaemia

A

Inherited autosomal recessive blood disease

Genetic defect - could be either mutation or deletion which results in a reduced rate of synthesis of one of the globin chains that make up Hb

Reduced rate results in abnormal Hb which causes the disease

22
Q

What is the oxygen/Hb dissociation curve?

A

This is the curve that relates the oxygen binding to Hb to the partial pressure of O2

23
Q

Explain the shape of the curve

A

The progressive binding of O2 to the four subunits of Hb is the reason for the characteristic shape of this curve

The curve is S shaped

Flat curve at a high pO2
This means that Hb is more than 90% saturated by O2 over a wide range of pO2 in the lungs
This ranges from pO2 of 70mmHg to >100mmHg

Steep curve at medium and low pO2
This means that Hb releases large amounts of O2 for a small decrease in pO2 over the range of 20-40mmHg (remember that the purpose of Hb is to release the O2)

24
Q

What factors affect the oxygen/Hb curve?

A

Heat

PH

25
Q

Describe the impact of heat/lack of heat on oxygen/Hb curve

A

Heavily metabolising tissue heats up
Heat moves the Hb curve to the right and so unloads more O2 at any given partial pressure

Slowly metabolising tissue is colder than normal
Cold moves the Hb curve sharply to the left
A cold limb may become hypoxic and feel fatigued even if well perfused

26
Q

Describe the impact of heat on the oxygen/Hb curve and what this is called

A

Heavily metabolising tissue generates more CO2 and so the tissue becomes more acidic

Lower pH moves the curve to the right

This pH driven shift is called the Bohr shift

27
Q

What is myoglobin? Describe it’s role in the body

A

This is a form of Hb found in muscle
It is a single subunit
Mb has a greater affinity for O2 than Hb - SO O2 is transferred to MbO2 as blood passes through muscle capillaries
Hence, Mb forms a ‘buffer store’ of O2 in muscle

NB. When myoglobin is released from damaged muscle tissue, this process is called rhabdomyolysis and the released Mb is filtered by the kidneys – it is toxic to the renal tubular epithelium so may cause acute renal failure

28
Q

Why is carbon monoxide toxic?

A

It has a greater affinity for Hb than O2

Blood leaving the lungs will hence contain mostly carboxyhaemoglobin and the person will die from hypoxia

29
Q

What is haematocrit?

A

This is the percentage of blood that is red blood cells – normally about 45%

The amount of O2 that is carried is dependent on the haematocrit

30
Q

How is the haematocrit level regulated?

A

Haematocrit is controlled by a hormone erythropoietin (EPO)

EPO is continually released from the kidney and the liver
It stimulates the production of red blood cells in the bone marrow
When the kidney is hypoxic, EPO secretion is increased SO negative feedback loop

EPO is also used as a therapeutic agent to treat anaemia resulting from chronic kidney disease, chemotherapy and radiation and other critical diseases such as heart failure

31
Q

Explain how CO2 is transported in the blood

A

Red blood cells also carry CO2 back to the lungs

Although CO2 is very water soluble, this solubility is not enough to carry all the CO2 generated by the body back to the lungs

The RBCs convert the CO2 to bicarbonate via the enzyme carbonic anhydrase

Most of the bicarbonate that is formed is expelled into the plasma and carried in the venous blood to the lungs

As the bicarbonate diffuses out, Cl- ions diffuse into the RBC to maintain electrical neutrality

In the lungs, the bicarbonate re-enters the RBC and is converted back to CO2 and then released into the alveoli

Cl- leaves the RBC to balance the electrical charge of the HCO3- entering the cell

CO2 can also be carried to the lungs as carbaminohaemoglobin – CO2 binds to oxyhaemoglobin and displaces O2 in acid conditions

In the lungs, the high partial pressure of O2 and low pH displaces the CO2 and haemoglobin and oxyhaemoglobin is reformed

OVERALL most CO2 is carried back to the lungs in the form of bicarbonate, not as a dissolved gas