III.

Composition of Blood

About 55 percent of the blood is composed of a liquid known as plasma. The rest of the blood is made of three major types of cells: red blood cells (also known as erythrocytes), white blood cells (leukocytes), and platelets (thrombocytes).

A.

Plasma

Plasma consists predominantly of water and salts. The kidneys carefully maintain the salt concentration in plasma because small changes in its concentration will cause cells in the body to function improperly. In extreme conditions this can result in seizures, coma, or even death. The pH of plasma, the common measurement of the plasma’s acidity, is also carefully controlled by the kidneys within the neutral range of 6.8 to 7.7. Plasma also contains other small molecules, including vitamins, minerals, nutrients, and waste products. The concentrations of all of these molecules must be carefully regulated.

Plasma is usually yellow in color due to proteins dissolved in it. However, after a person eats a fatty meal, that person’s plasma temporarily develops a milky color as the blood carries the ingested fats from the intestines to other organs of the body.

Plasma carries a large number of important proteins, including albumin, gamma globulin, and clotting factors. Albumin is the main protein in blood. It helps regulate the water content of tissues and blood. Gamma globulin is composed of tens of thousands of unique antibody molecules. Antibodies neutralize or help destroy infectious organisms. Each antibody is designed to target one specific invading organism. For example, chicken pox antibody will target chicken pox virus, but will leave an influenza virus unharmed. Clotting factors, such as fibrinogen, are involved in forming blood clots that seal leaks after an injury. Plasma that has had the clotting factors removed is called serum. Both serum and plasma are easy to store and have many medical uses.

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.

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.