Hematocrit also called PCV (Packed cell volume)

3 levels- RBC, buffy coat (WBC & PLT), plasma (Water/ Solute , Plasma protein, O2, CO2, NO,
Electrolytes, Enzymes, Nutrients, Hormones, Metabolic waste products- lactate, uric acid,
creatinine)
Plasma protein: Albumin (60%), Globulins- alpha and beta + gama
Alpha and beta globulin- transport proteins- transferrin, thyroxin binding globulin (TBG)
Gama globulin- antibodies

Erythropoiesis- Red blood cell formation

Increased erythropoiesis by Hypoxia

Fe3+ Iron absorption in duodenum > Duodenol cytochrome B (DCYTB) Ferrous reductase enzyme
Fe3+ to Fe2+ > Divalent metal transporter 1 (DVMT1) take Fe2+ into intestinal cell > Inside
intestinal cell, Fe2+ bind with ferritin, multiple ferritin bind together called Hemosiderin > Some
ferritin drop the Fe2 at Ferroportin transporter to outside the cell with Hephaesten enzyme covert
Fe2+ to Fe3+ into the blood.

In blood, Fe3+ bind to transferrin protein (transporter protein) to be brought to bone marrow,
spleen, liver for the Fe3+ usage.

In liver, Fe3+ storage, produce Hepcidin protein (regulate/ control Ferroportin). HFE protein at liver
regulate Hepcidin.
*Hemochromatosis disease- absent of HFE protein, no Hepcidin, no Ferroportin regulation, Iron
accumulation.

Vitamin B12, Folic acid (FA) in stomach > duodenum absorption to blood stream. Folic acid
transported via intestinal cell easily. However, VitB12 required protein intrinsic factor in stomach
to bind VitB12 transport to ileum. In ileum receptor bind intrinsic factor+VitB12, then VitB12
released into the blood circulation bind to protein Transcobalamin I and II.

In kidney has EPO gene (erythropoietin hormone), HIF (hypoxia inducible factor, transcription
factor)). If hypoxia detected, HIF bind to EPO gene to produce EPO to form more RBC to transport
O2 to tissues. Thus, in adequate oxygenation, HIF will be coated by enzyme to prevent binding
with EPO gene.

In bone marrow, has stem cells called haemocytoblast (has others name too). Haemocytoblast has
2 different lineage (Myeloid and Lymphoid). Myeloid divides to 3 lineage (PLT, RBC, WBC). EPO will
drive myeloid to produce RBC only (myeloid > proerythroblast > basophilic erythroblast >
polychromatic erythroblast > orthochromatic erythroblast > reticulocytes (after ejected nucleus
and organelles) > pushed out to blood vessels to be matured to > Erythrocytes

*Basophilic erythroblast is blue color cause of ribosome and mRNA.

*Polychromatic erythroblast is blue + red color cause not all ribosome was synthesized by protein
and not all mRNA was translated to protein, red color cause of some red hemoglobin produced.
*Orthochromatic erythroblast enriched by red hemoglobin with some blue due to some mRNA left
Nucleus and organelles will gradually condense and ejected from the erythroblast, and destroyed
by macrophages.
Erythrocytes got no mitochondria, thus, it won’t utilize the O2 and it mainly transport O2, CO2.

*Mitochondria loves to take pyruvate utilize O2 to make ATP

*Bone marrow capillaries are sinusoidal
(3 types of capillaries: sinusoidal, fenestrated, continuous)

DNA > mRNA > Protein > Hemoglobin.

DNA > mRNA called transcription
mRNA > Protein called translation
Hemoglobin- Heme + Globin
Heme made from carbohydrates, fats, amino acids

*RBC recipe: Iron, VitB12, FA, Carbs, Fats, Amino acids

*VitB12, FA is essential for DNA maturation and nucleus condensation. If deficiency, nucleus will
not be condensed, the RBC will be huge (macrocytic/ megaloblastic). Needed during translation
from basophilic > polychromatic and polychromatic > orthochromatic
*Iron essential for haemoglobin production, if no iron, no heme, RBC become small (microcytic)