regulation of erythropoiesis dr ghulam mustafa regulation of erythropoiesis importance factors...
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Regulation of Erythropoiesis
Dr Ghulam Mustafa
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Regulation of Erythropoiesis Importance Factors affecting Erythropoiesis
Tissue Oxygenation Anemia, High Altitudes, Cardiac failure, Resp Problem ERYTHROPOITEN
VitaminsMetalsProteinsHormonesOther factors/Conditions
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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
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Factors affecting Erythropoiesis
1. Tissue Oxygenation
2. Vitamins
3. Metals
4. Proteins
5. Hormones
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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
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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?
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Lung diseases:Failure of oxygen absorption in LungsBlood carries less OxygenTissue hypoxiaResult?
All conditions have one common problem
HYPOXIA
ERYTHROPOIETIN
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Erythropoietin
Glycoprotein Mol weight 34000 Sites of production
KidneysLiverBrain, Uterus
If Erythropoiten production reducedEffect of Hypoxia?
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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?
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Formation of Erythropoiten Erythrogenin – Renal Erythropoitic factor Erythropoitinogen
Alpha globulinSubstrate for Erythropoiten
Stimulants of Erythrogenin HypoxiacAMP NADHemosylates
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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
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Recombinant Erythropoiten
Anemia – Renal Failure Blood doping
Erythropoiten - AthletesRunning – Increase Oxygen demandBreathlessnessERYTHROPOITEN – Increase RBC’sLess dyspnea
DNA Recombinant Technique
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2. Vitamins
Vit B12 & Folic acid
Essential for formation of thymidine triphosphate
Essential building block of DNA
Diminished DNAFailure of nuclear maturation
Inadequate Erythropoiesis
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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
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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
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3. Proteins
Adequate protein diet essential
Formation of Globin
Protein deficiency
Kwashiorkor
Prisoners
Protein losing Enteropathies
Renal disease- Proteinuria
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4. Hormones
Testosterone
Growth hormone
Thyroid hormone
Cortisol
Adrenocorticotrophic hormone ACTH
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5. Other Conditions Stimulating Erythropoiesis Exercise Excitement Menstruation Pregnancy Menopause
More RBC Count in fetal lifeHbF – Binds more oxygen
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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
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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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If you complain about your transport
system, What about them?
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