Regulation of Erythropoiesis Dr Ghulam Mustafa Regulation of Erythropoiesis Importance Factors...
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Transcript of Regulation of Erythropoiesis Dr Ghulam Mustafa Regulation of Erythropoiesis Importance Factors...
Regulation of Erythropoiesis
Dr Ghulam Mustafa
Regulation of Erythropoiesis Importance Factors affecting Erythropoiesis
Tissue Oxygenation Anemia, High Altitudes, Cardiac failure, Resp Problem ERYTHROPOITEN
VitaminsMetalsProteinsHormonesOther factors/Conditions
Normal RBC Count
Importance:
Must Not fall
To supply oxygen from lungs to tissues
Must Not rise
Blood viscosity may increase
May impede blood flow
Factors affecting Erythropoiesis
1. Tissue Oxygenation
2. Vitamins
3. Metals
4. Proteins
5. Hormones
1. Tissue Oxygenation – Most
Important Regulator of Erythropoiesis ANY CONDITION Decrease Tissue
Oxygenation Increase Erythropoiesis
Anemia
Immediately Increase RBCs production
Bone marrow destruction:
Hyperplasia of remaining cells
Increase production of RBCs
High altitudes:Partial pressure of oxygen in air lessDecrease in oxygen transport to tissuesTissue hypoxiaResult?
Cardiac FailureInefficient pumping by heartDecreased blood flow to peripheral vesselsTissue hypoxiaResult?
Lung diseases:Failure of oxygen absorption in LungsBlood carries less OxygenTissue hypoxiaResult?
All conditions have one common problem
HYPOXIA
ERYTHROPOIETIN
Erythropoietin
Glycoprotein Mol weight 34000 Sites of production
KidneysLiverBrain, Uterus
If Erythropoiten production reducedEffect of Hypoxia?
Stimulants of Erythropoiten production:
RENAL MECHANISMAnemic blood to kidney
Less oxygen supplied
Renal tubular cells - High O2 consuming
Stimulates production of Erythropoiten
NON RENAL MECHANISM
Hypoxia in other parts – Non renal sensorNor epinephrine, epinephrine, prostaglandins
In Renal failure?
Formation of Erythropoiten Erythrogenin – Renal Erythropoitic factor Erythropoitinogen
Alpha globulinSubstrate for Erythropoiten
Stimulants of Erythrogenin HypoxiacAMP NADHemosylates
Role of EP in Erythropoiesis
Formed in response to Hypoxia within minutes
RBC production in 5 days
Erythropoiten
Stimulates Proerythroblasts formation
Causes cells to pass through various stages
of Erythropoiesis rapidly
Recombinant Erythropoiten
Anemia – Renal Failure Blood doping
Erythropoiten - AthletesRunning – Increase Oxygen demandBreathlessnessERYTHROPOITEN – Increase RBC’sLess dyspnea
DNA Recombinant Technique
2. Vitamins
Vit B12 & Folic acid
Essential for formation of thymidine triphosphate
Essential building block of DNA
Diminished DNAFailure of nuclear maturation
Inadequate Erythropoiesis
Vitamin C Potentiate the effect of Folic acid Also helpful in Iron
Absorption Reducing Ferric to ferrous form
Pyridoxine: Coenzyme for condensation of Glycine and
succinyl-CoA
Riboflavin and Pantothenic acid Heme formation Cell growth and division
2. Minerals Iron Copper
CeruloplasminNecessary for Iron transfer from storage sites
Bone marrow, Liver and Spleen
CobaltForms a part of Vitamin B12
Nickel and Manganese
3. Proteins
Adequate protein diet essential
Formation of Globin
Protein deficiency
Kwashiorkor
Prisoners
Protein losing Enteropathies
Renal disease- Proteinuria
4. Hormones
Testosterone
Growth hormone
Thyroid hormone
Cortisol
Adrenocorticotrophic hormone ACTH
5. Other Conditions Stimulating Erythropoiesis Exercise Excitement Menstruation Pregnancy Menopause
More RBC Count in fetal lifeHbF – Binds more oxygen
Regulation of Erythropoiesis Importance
Factors affecting Erythropoiesis
1 Tissue Oxygenation
Anemia, High Altitudes, Cardiac failure, Resp Problem
ERYTHROPOITEN
Site of production
Stimulants for production
Mechanism of production
Role in Erythropoiesis
2 VitaminsVit B12 and Folic acidPyridoxineVitamin CRiboflavin and Pantothenic acid
3 Metals Iron, Cu, Co, Ni, Mn
4 Proteins5 Hormones
GH, TH, CORTISOL, TESTOSTERONE, ACTH
5 Other conditions affecting…..
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