ERYTHROPOIESIS

-Abhay kumar
HAEMOPOIESIS & ERYTHROPOIESIS

● Haemopoiesis or Hematopoiesis is the process of origin,

development and maturation of all the blood cells.

● Erythropoiesis is the process of the origin, development and

maturation of erythrocytes.
SITE OF ERYTHROPOIESIS

Intrauterine life

Occurs in three stage

☆Mesoblastic Stage

● During first 2 months

● Site of RBC production yolk sac
SITE OF ERYTHROPOIESIS (Cont.)

☆Hepatic Stage
● Third month of intra-uterine life.
● Liver is the main organ that produces RBC.
● Spleen and lymphoid organs are also involved in erythropoiesis.

☆Myeloid Stage

During the last three months of intrauterine life, RBCs are produced from
the red bone marrow and liver.
SITE OF ERYTHROPOIESIS (Cont.)

In children (Occurs up to 20 years )

● All bones with red marrow (mainly)

● Liver
● Spleen
SITE OF ERYTHROPOIESIS (Cont.)

In adults (Occurs after age of 18 to 20 years)

● Happens due to red bone marrow which includes ends of long

bones like humerus and femur, skull, vertebrae, ribs, sternum
and pelvis.

● If marrow gets destroyed, then liver and spleen again become

important site of blood formation.
Stage of Erythropoiesis Haemocytoblast (Stem cell)

Proerythroblast

Early normoblast 7 days

Intermediate normoblast

Late normoblast

Reticulocyte
2 days
Erythrocyte
Regulation of Erythropoiesis
Regulation of
Erythropoiesis

General factor Special Maturation Factors

1. Dietary factor
Hypoxia 2. Castle’s Intrinsic factor (IF)
3. Extrinsic factor
General Factors - Hypoxia

● Hypoxia means lack of oxygen at tissue level. It is the most potent

stimulus for the production of RBCs. Hypoxia cause stimulation of the
bone marrow.
● Erythropoietin production reaches its peak within 24 hour of hypoxic
simulation.
● Mode of Action : Causes early differentiation of erythropoietin sensitive
stem cells in the bone marrow into proerythroblast and subsequently
to mature RBCs. Thus, increasing RBC count in 2-3 days.
Factor affecting Erythropoietin production

Factor affecting Erythropoietin production

Increase Decrease
● Haemorrhage ● Oestrogen
● High altitude ● Protein deficiency
● Hormones
○ Thyroxine
○ Androgens
 Special Maturation Factor
(Factor responsible for the final maturation of RBCs)

Special Maturation Factor

Dietary Factors Castle’s Intrinsic Factor (IF) Extrinsic Factor

● Proteins ● Produced by the parietal
● Iron, Manganese, Copper, (Oxyntic cell of the
Cobalt, Nickel stomach)
● CIF helps in absorption of
vitamin B12 from ileum
● These are present in
certain foods and are
essentially vitamin
B12 and folic acid
 Clinical Conditions

Anaemia: It is a clinical condition in which the oxygen carrying capacity of blood

is reduced.
It is characterized by reduction in the number of RBCs less than 4 million/ul or
their content of haemoglobin less than 12 gm/dL or both.

Grading
Mild Anaemia: Haemoglobin 8-12 gm/dL .
Moderate Anaemia: Haemoglobin 5-8 gm/dL .
Severe Anaemia: Haemoglobin less than 5 gm/dL .
Various ways to classify anemia

Various ways to classify anemia

Ethological(Whitby’s classification) Morphology(Wintrobe’s classification)

● Haemorrhagic ->Blood loss ● Size of RBC
● Dietary Deficiencies
● Dyshaemopoiesis -> X rays radiation
● Haemolytic Anaemia -> Excess destruction of RBC
 Few others examples of Anaemia

● Pernicious Anaemia
○ Due to lack of intrinsic factor.
○ Result in failure of Absorption of B12
● Folic Acid Deficiency Anaemia
○ Due to deficiency of folic Acid.
● Iron Deficiency of Anaemia
○ Commonest in India.
○ Due to inadequate dosage of iron.
Thank you