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RBC removal
Removal
  • Some red blood cells will rupture within the blood vessels (aka, intravascular hemolysis), but most aging cells are removed and destroyed within the spleen (extravascular hemolysis).
  • Spleen removes malformed cells via two mechanisms:
    • The so-called splenic sieve mechanism traps rigid, unpliable cells in capillaries; cells burst, release contents that macrophage will phagocytose.
    • Splenic macrophages detect senescent cells, engulf in phagosome.
  • In both cases, red blood cell contents are released in splenic macrophage, and hemoglobin is dismantled:
    • Heme oxgenase, a macrophage enzyme, releases iron from hemoglobin;
Iron is then stored as ferritin and/or hemosiderin, or, Binds to transferrin for transport to the red bone marrow to be re-used in hemoglobin synthesis.
    • Porphyrin portion of hemoglobin is converted to bilirubin, which is later excreted in bile by the liver.
    • Globin, a protein substance, is broken into its amino acid components and added to the amino acid pool.

RBC removal

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Erythrokinetics
    • 1% of erythrocytes, aka, red blood cells, are removed and replaced every day.
    • The production of new red blood cells, called erythropoiesis, occurs in the red marrow of spongy bone.
    • Regulated by hypoxia, sensed by kidney.
    • On average, erythrocytes travel in the circulatory system for approximately 120 days; recall that they are responsible for oxygen and carbon dioxide transport.
    • Once they are no longer viable, splenic macrophages remove them via phagocytosis.