BIOKIMIA DARAH

MODUL SIRKULASI & RESPIRASI

Blood, Plasma, Serum :

Blood : 8 % dari Berat badan orang dewasa
pH : 7.35 7.45
RBC, WBC, platelets, Proteins, substrat organic dan inrganic
Plasma : 3 L
Water , solutes
Serum : clear
Blood cells & fibrins

Elektrofosesis

Show differences in plasma proteins

Paper electrophoresis, Celluse acetasa electrophoresis and gel

electrophoresis

Sel darah merah (RBC)

4.5 6.0 Juta / L, Ht 40 5- %

4.0 4.5 Juta/ L, Ht 35 45%

Sintesis sel darah merah :

Bone marrow/ Sum sum tulang

Eritropoietin ( glycoprotein), Insulin like GF, Interleukin, etc.

Struktur membrane eritrosit

Lipid bilayer : protein, lipid & karbohidrat

Integral & peripheral protein membrane

Golongan darah :

Membran Erytrosit

Define blood tipe (antigens)

A, B, AB, O grup
Goda

Group Substances

Antibodies

Anti- B

Anti- A

AB (Uniersal
Recipient)

A,B

O (universal donor)

ABO Group substances :

Minor blood groups : Rh and MN

Rh Factors (important in transfusion)

Rh + & Rh -

Sel Darah Putih

5000 8000/ L Darah

Granulosit/ PMN (neutrophil, eusinofil dan basophil) , Monosit dan

limfosit.

Neutrofil :
Immune system (inflammation)
glikolisis dan HMP Shunt
protease dan proteinase (hidrolisis protein)
Myeloper oksidase, NADPH-Oksidase, Lisosim, etc (fagositosis)

Basofil, Eusinofil dan monosit:

Basofil hipersensitivitas (Anticoagulan Heparin, Histamin, etc)
Eusinofil reaksi alergi,infeksi parasite
Monosit prekusor makrofag (immune respons in fagositosis)

Limfosit :
B- Limfosit dan T- Limfosit

Sistem imun :
network of organs (spleen, thymus, bone marrow, tonsils, lymph nodes)
and cells (neutrophil, monosit, limfosit)

Respon Immune :
1. Innate (inborn) immune response
2. Adaptive immune response

Innate immune respose :

first line defence
cepat, non-spesifik respons
Neutrofil dan monosit
NK cells

Adaptive immune response :

2nd line defence
lambat, spesifitas respons >>
Memori (future infection)
1. Humoral immune response
2. T-Cell mediated immune response

Humoral immune response :

1. B-Limfosit
2. Binding antigen B-cells Plasma cells/ clones immunoglobulin
apoptosis
3. immunoglobulin + Ag Elimination
4. B-cells remains (memory cells)

T-cell mediated immune respose :

MHC (Major Histocompatibility complex) Class I, Class II
APC (Antigen presenting cells)
HLA (Human Leucocyte Antigen)

NK Cells (Natural Killer cells)

Innate immune response
killed cells lack of MHC proetin

Cytokines : di produksi oleh T-Limfosit

intraselular mediator pada respon imun
inflamasi, perbaikan jaringan, hemopoiesis dan kanker.

Interleukin (ILs) : 20 IL
diproduksi oleh T-Limfosit, APCs, Makrofag, NK cells, Monosit, Mast cell, basophil,
eusinofil, epithelial sell dan lainnya.
Perannya unutk pertumbuhan dan proliferasi T-cell dan B-Cell.

IL-4 penting pada alergi.

Interferons (IFNs) :
Glikoprotein molekul
viral infection
IFN (, , )
di produksi oleh : limfosit, makrofag, monosit, fibroblast dan epithelial
sel.

Other important Fx of IFNs

TNFs ( Tumor Ncrotizing Factors) :

diaktivasi oleh ; makrofag, Monosit, APCs, T-Cells, B-Cells, NK cells,
Endothelial cells.

Chemokines (CKs)

Sistem Komplemen
membantu peran sistem imun
di produksi di Liver
aktivasi : Ag-Ab complex, CRP, Neutrophil & plasma protease.

Platelets (trombosit)

Platelets level :
sintesis di sutul
Thrombopoietin
Membran sel : canalicular system
Receptor Kolagen, Fibrinogen dan Von Willbrands Factor
Organel Sub selular : Granule (Adenine Nucleotides, ADP, ATP, Serotonin,
clotting factor (V &XIII), PDGF, Protein C inhibitor, platelet factor IV,
thromboxane A2.

Fx : Hemostasis
a. Agregasi platelet
b. Blood clotting
c. Chemotaxis
d. Vasokonstriksi
e. Tissue repair

p.d

Int
ag pla ak

t
g
se rega elet (-)
pr cret tio
os io n &
ta n o
sik
lin f
.

Blood Clotting
covers injured area
stop further leakage

Inactive zymogen form

active form

Jalur ekstrinsik & Jalur Intrinsik

Jalur Ekstrinsik
Or Tissue Factor pathway.
Faktor

III (Tissue Factor)

Faktor

VII (-carboxygluthamyl residues)

Jalur Intrinsik

Faktor VIII, IX, XI, XII.

HMWK (High molecular weight kininigen), Prekalikrein, Kalikrein (non

factor component).

Final common pathway

Prothrombin (factor II), Fibrinogen (factor I), factor v & factor XIII

Blood Clotting Regulation :

Protein inhibitor complex

a. Anti thrombin III (AT III) ; spesifik inhibitor Thrombin & Xa
b. Anti convertin : inhibitor jalur extrinsic (TF-VIIa-Ca2+-Xa complex)

Fibrinolisis :

Medical Importance :
1.

Hemphilia Disease (defisiensi factor VIII) spontaneous bleeding

2.

Anticoagulants : Heparin, Hirudin, Chelating Agents (EDTA, Fluoride,

Citrate, oxalate, etc), Warfarin & di cumarol.

3.

Urokinase, Streptokinase & recombinant t-PA

4.

Aspirin

5.

Anti hemostatic (coagulation) compounds of insect saliva.

Hemophilia Disease :

Plasma Enzim :

Non protein nitrogenous substance (Urea, Uric acid, Creatinin

Karbohidrat (Glukosa, fruktosa dan sugar acid)

Lipids (TG, Cholesterol & asam lemak bebas)

Asam organic : piruvat, laktat, asetoasetat, suksinat, malat, dll

Vitamin

Hormon

Inorganic constituent : Anion & Kation.

TERIMA KASIH