Peripheral Blood Prof. Dr. Xiaoxun Xie

* a specialized form of C.T. * a circulating tissue * as a transporting medium * a total volume about 5 liters in health adult INTRODUCTION

Components of blood * Formed elements------blood cells (45%) * Intercellular substance------plasma (55%) Erythrocytes Leukocytes Platelets H 2 O ( 90% ) Plasma proteins: albumin, globulin, fibrinogen, etc. Others:

血液的组成 centrifugation ( 离心 ) plasma Leukocytes + Platelets Erythrocyte (Red blood cell) anticoagulant (heparin)

血块、血清 —Serum —Clotting without anticoagulant

Mature Erythrocyte * biconcave disc shape, providing greater surface area; * no nucleus and organelles; * Hemoglobin ( Hb ); * deformability. Blood smear SEM

* not fully mature RBC * 0.5  1% of a total number of RBC * no nucleus * ribosomal RNA remnants (netlike structure) * remaining Hb synthesis * Clinic significance Reticulocyte

* Function of mature erythrocytes: gaseous transport * lifespan of erythrocytes: 120 days * Size: 7.5 ~8.5µm (diameter) * Number: Male: 4.2~5.5×10 12 / L (Hb: 120~150g/L) Female: 3.5~5.0 ×10 12 / L (Hb: 105~135g/L)

Pathological conditions Number Size Shape Hb Anemia Erythrocytosis SpherocytosisSpherocytosis; Sickle cell anemiaSickle cell anemia Thalassemia （地中海贫血） Large / small cell anemia

Sickle-cell anemia is a painful disease in which RBCs become crescent shaped due to inheritance of an abnormal type of hemoglobin. Sickled RBCs break down, releasing hemoglobin into the circulation.

Normal RBC Sickled RBC

Typically, the affected RBCs are small, spherically shaped, and lack the light centers seen in normal RBCs. Spherocytosis

General characteristic of leukocytes * spherical shape * posses nuclei * presence of organelles * a total number less than that of erythrocytes * exhibiting amoeboid movement * involving in body defenses and immunity

Classification *Granular leukocytes neutrophils 50  70% eosinophils 0.5  3% basophils 0  1% *Agranular leukocytes lymphocytes 20  30% monocytes 3  8%

Neutrophil Size : 10  12 µm (diameter) Morphology nucleus ： highly morphonuclear rod-like 2-3 lobulated 4-5 lobulated young old cytoplasm ： specific granules: 80%, small azurophilic granules: 20%, lysosome Neutrophils

中性粒细胞 （血涂片）Neutrophils Lobulated nuclei Rod-like nucleus azurophilic granules * fine, uniform * evenly distributed * pink staining Charateristics of specific granules:

Specific granules (80%, samll) contain: * alkaline phosphatase * phagocytin * lysozyme Azurophilic G. (large, less) containing: * acid phosphatase * Peroxidase Neutrophil (EM)

Size: 10  12 µm (diameter) LM: - usually bilobed nucleus - eosinophilic granules * strong eosinophilia (reddish) * coarse and refractile * uniform size and evenly distributed Eosinophils Characteristic

（电镜） Eosinophilic granules ( primary lysosomes ) which contain substances: * acid phosphatase * aryl sulphatase * Peroxidase * histaminase nucleus Eosinophilic granules with crystalloid in the center (EM)

Size: 10  12 µm (diameter) LM: nucleus: lobulated; S or irregular; obscured outline cytoplasm: basophilic granules * variable size * uneven distribution * strong basophilia Characteristic Basophil

Basophil (EM) Basophilic granules contain: * heparin * leukotriene * histamine nucleus

Neutrophils: * ruffled membrane movement * chemetaxis * phagocytosis Eosinophils: anti-parasite; anti-allergy Basophils: * anticoagulation; * involving in allergic response Function of granular leukocytes

Size: 14  20 µm (diameter) Nucleus: large, eccentric, light staining, deep indentation, horseshoe cytoplasm ： abundant ， gray-blue staining, weak basophilia, numerous pink-purple granules (azurophilic G) Monocyte

Small pseudopodia, microvillus, mitochondrion RER, Lysosomes (azurophilic granule) contain: * Peroxidase * Acid phoshpatase * Lysozyme ( EM 模式图） nucleus Monocyte under EM

Function of monocyte - differentiate into macrophages. - phagocytose - immune response - give rise to osteoclasts, which are able to dissolve bone.

Size: 6  20 µm (diameter), small / medium / large nucleus ： a round, densely stained nucleus cytoplasm: a relatively small amount of cytoplasm, pale basophilic (?) some azurophilic granules Lymphocyte

* a large number of free ribosomes, * a few mitochondria, and other organelles * exhibiting small cytoplasmic projections in the surface of cells. (EM 模式图） nucleus Lymphocyte under EM

Function of Lymphocytes: T LC: cellular immunity B LC: plasma cells humoral immunity

Blood Platelets (thrombocytes) fragments of megakaryocytes no nucleus cytoplasm: two zones: - outer hyalomere hardly stains, cytoskeletal f. ( actin & myosin) - inner granulomer * bluish staining granule * Some other organelles

Function of Platelets body's first line of defense to prevent blood loss. secretion of chemical platelet factors into the blood plasma. fibrinogen fibrin Blood cells +fibrils (insoluble protein) clot

CellDiameter (µm ) Population number Lifespan (day) Erythrocyte7.53.5~5.0 ×1012/ L120 Platelet32- 4 ×1012 /µl4-6 Monocyte173-8% of WBClong Lymphocyte % of WBCvariable Neutrophil % of WBC1-4 Eosinophi % of WBC1-4 Basophil % of WBC1-4 Peripheral Blood Cells

Slides review

Summary table. Erythrocyte & leukocyte Erythrocyte(mature) Leukocyte Number Size Shape Nucleus Organelle HB Granules Function Lifespan biconcave disc sphere non present