Blood

B

Red Blood Cells

Red blood cells make up almost 45 percent of the blood volume. Their primary function is to carry oxygen from the lungs to every cell in the body. Red blood cells are composed predominantly of a protein and iron compound, called hemoglobin, that captures oxygen molecules as the blood moves through the lungs, giving blood its red color. As blood passes through body tissues, hemoglobin then releases the oxygen to cells throughout the body. Red blood cells are so packed with hemoglobin that they lack many components, including a nucleus, found in other cells. Hemoglobin also takes up and releases nitric oxide, which plays an important role in regulating blood pressure.

The membrane, or outer layer, of the red blood cell is flexible, like a soap bubble, and is able to bend in many directions without breaking. This is important because the red blood cells must be able to pass through the tiniest blood vessels, the capillaries, to deliver oxygen wherever it is needed. The capillaries are so narrow that the red blood cells, normally shaped like a disk with a concave top and bottom, must bend and twist to maneuver single file through them.

C

Blood Type

There are several types of red blood cells and each person has red blood cells of just one type. Blood type is determined by the occurrence or absence of substances, known as recognition markers or antigens, on the surface of the red blood cell. Type A blood has just marker A on its red blood cells while type B has only marker B. If neither A nor B markers are present, the blood is type O. If both the A and B markers are present, the blood is type AB. Another marker, the Rh antigen (also known as the Rh factor), is present or absent regardless of the presence of A and B markers. If the Rh marker is present, the blood is said to be Rh positive, and if it is absent, the blood is Rh negative. The most common blood type is A positive—that is, blood that has an A marker and also an Rh marker. More than 20 additional red blood cell types have been discovered.

Blood typing is important for many medical reasons. If a person loses a lot of blood, that person may need a blood transfusion to replace some of the lost red blood cells. Since everyone makes antibodies against substances that are foreign, or not of their own body, transfused blood must be matched so as not to contain these substances. For example, a person who is blood type A positive will not make antibodies against the A or Rh markers, but will make antibodies against the B marker, which is not on that person’s own red blood cells. If blood containing the B marker (from types B positive, B negative, AB positive, or AB negative) is transfused into this person, then the transfused red blood cells will be rapidly destroyed by the patient’s anti-B antibodies. In this case, the transfusion will do the patient no good and may even result in serious harm. For a successful blood transfusion into an A positive blood type individual, blood that is type O negative, O positive, A negative, or A positive is needed because these blood types will not be attacked by the patient’s anti-B antibodies.

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D

White Blood Cells

White blood cells only make up about 1 percent of blood, but their small number belies their immense importance. They play a vital role in the body’s immune system—the primary defense mechanism against invading bacteria, viruses, fungi, and parasites. They often accomplish this goal through direct attack, which usually involves identifying the invading organism as foreign, attaching to it, and then destroying it. This process is referred to as phagocytosis.

White blood cells also produce antibodies, which are released into the circulating blood to target and attach to foreign organisms. After attachment, the antibody may neutralize the organism, or it may elicit help from other immune system cells to destroy the foreign substance. There are several varieties of white blood cells, including neutrophils, monocytes, and lymphocytes, all of which interact with one another and with plasma proteins and other cell types to form the complex and highly effective immune system.

E

Platelets and Clotting

The smallest cells in the blood are the platelets, which are designed for a single purpose—to begin the process of coagulation, or forming a clot, whenever a blood vessel is broken. As soon as an artery or vein is injured, the platelets in the area of the injury begin to clump together and stick to the edges of the cut. They also release messengers into the blood that perform a variety of functions: constricting the blood vessels to reduce bleeding, attracting more platelets to the area to enlarge the platelet plug, and initiating the work of plasma-based clotting factors, such as fibrinogen. Through a complex mechanism involving many steps and many clotting factors, the plasma protein fibrinogen is transformed into long, sticky threads of fibrin. Together, the platelets and the fibrin create an intertwined meshwork that forms a stable clot. This self-sealing aspect of the blood is crucial to survival.

IV

Production and Elimination of Blood Cells

Blood is produced in the bone marrow, a tissue in the central cavity inside almost all of the bones in the body. In infants, the marrow in most of the bones is actively involved in blood cell formation. By later adult life, active blood cell formation gradually ceases in the bones of the arms and legs and concentrates in the skull, spine, ribs, and pelvis.

Red blood cells, white blood cells, and platelets grow from a single precursor cell, known as a hematopoietic stem cell. Remarkably, experiments have suggested that as few as 10 stem cells can, in four weeks, multiply into 30 trillion red blood cells, 30 billion white blood cells, and 1.2 trillion platelets—enough to replace every blood cell in the body.

Red blood cells have the longest average life span of any of the cellular elements of blood. A red blood cell lives 100 to 120 days after being released from the marrow into the blood. Over that period of time, red blood cells gradually age. Spent cells are removed by the spleen and, to a lesser extent, by the liver. The spleen and the liver also remove any red blood cells that become damaged, regardless of their age. The body efficiently recycles many components of the damaged cells, including parts of the hemoglobin molecule, especially the iron contained within it.

The majority of white blood cells have a relatively short life span. They may survive only 18 to 36 hours after being released from the marrow. However, some of the white blood cells are responsible for maintaining what is called immunologic memory. These memory cells retain knowledge of what infectious organisms the body has previously been exposed to. If one of those organisms returns, the memory cells initiate an extremely rapid response designed to kill the foreign invader. Memory cells may live for years or even decades before dying.

Memory cells make immunizations possible. An immunization, also called a vaccination or an inoculation, is a method of using a vaccine to make the human body immune to certain diseases. A vaccine consists of an infectious agent that has been weakened or killed in the laboratory so that it cannot produce disease when injected into a person, but can spark the immune system to generate memory cells and antibodies specific for the infectious agent. If the infectious agent should ever invade that vaccinated person in the future, these memory cells will direct the cells of the immune system to target the invader before it has the opportunity to cause harm.

Platelets have a life span of seven to ten days in the blood. They either participate in clot formation during that time or, when they have reached the end of their lifetime, are eliminated by the spleen and, to a lesser extent, by the liver.

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