2. Hemoglobin DR QAZI IMTIAZ RASOOL

3. OBJECTIVES 1.Describe the structure of hemoglobin molecule 2.Describe synthesis of hemoglobin in brief. 3.List the functions of hemoglobin. 4.Enlist various types of normal and abnormal hemoglobin’s.

4. Hemoglobin 1. if the body had to depend upon dissolved O 2 in the plasma to supply O 2 to the cells 2.The heart would have to pump 140 l/min instead of 4-6 l/min. 3. RBC have nuclei during early stages of development mature to make room for Hb

5. HB historical facts 1.1 st protein to be crystallized (1849); 2.1 st to be associated with a specific physiological function (1875); 3.1 st proteins to have its molecular weight (64,500) determined correctly (1920s); 4.2 nd protein having its 3-D structure determined (1969) 5.. Hb: A protein that you can “ see ” with your naked eyes!

6. Synthesis: following R essential 1.1 st class proteins – milk, fish, egg, soyabean etc. 2. Metals – iron and sulphur.------copper+calcium 3. Vitamin B12 (Folic acid).-------cobalt 4. Porphyrin compound

7. Synthesis 1.- Erythroblasts, =65% ---7days—intermediate normoblast stage - Reticulocyte stage=35% ------2 days 2. Haem synthesis in the mitochondria. 3. Globin synthesis in the polyribosomes 4. Although synthesis occur separately within developing red cell precursors, their rates R coordinated for Hb assembly.

8. Haemoglobin Chemistry: It is a chromo protein, mol:wt. 64000 1.Single RBC contains about 270 million HB molecules. Each RBC can hold about 1 billion mol of O 2. Hb = 1/3 of the weight of RBC 2. Heme = porphyrin ring + Fe 2 non-protein (pigment) –Source of iron in body –Iron – held in organic lattice –Each iron holds 1 mol O 2 3. Adult Hb Globin = 2 α + 2β chains each with its own haem group i.e. α 1 β 1 and α 2 β 2

9. Structure of Heme 1.a protoporphyrin ring with an iron atom at its centre starts from a cyclic tetrapyrrole i.e. consists of 4 mol; of pyrrole ( mol:wt1600 X 4). 2. - imparts a red color 3. -R, -methyl (M), -vinyl (V) - proprionate (Pr) groups Pyrrole ring

10. Porphyrin Ring 1

11. Iron distribution

12. Iron 1.Food: Fe 3+ absorbable Fe 2+ `Gastric juice (gastroferrin)+ vit C reduces 2.Absorbed in duodenum 3.Fe 2+ plasma level 10-35  mol/l 4. Apoferritin (mucosa) 5.Transferrin ( Fe 3+ ; plasma; β 1 -globulin), 6.Ferritin; spleen, liver, bone marrow; plasma ferritin, 7.hemosiderin 8.There is no physiological mechanism for the excretion of excess iron

13. Iron metabolism 1.Iron is indipensable for life (either in heme or non-heme form essential for oxygen transport, electron transfer, DNA synthesis, etc.) 2.Iron is insoluble ([Fe] cannot exceed 10 -17 ) 3. Iron is potentially toxic (unless appropriately chelated, Fe plays a key role in the formation of oxygen radicals)

14. 1st : Haem synthesis

15. GENETIC ROLE 1.Humans normally carry 8 functional globin genes, arranged in 2 duplicate gene clusters: 2.These genes code for 6 different types of globin chains: α,β,γ,δ,ε,ζ,. 3.2 α (each with141 amino acids) 6. 2 β each - 146

16. siagetypesnameRegionTime embryonic  Gower I Gower II Yolk Sac 3 weeks of Gestation embryonic (  2  2 ) Portland Yolk-Sac 5 wks Gestation fetal, higher affinity to O 2  Hb F Liver & spleen6-30 wks Gestation adult, 2.5% Hb  Hb B Liver 30 wks Gestation adult Hb  Hb A B.M At Birth

17. Normal Hb in adult blood Hb AHb A 2 Hb F structurea2b2a2b2 a2d2a2d2 a2g2a2g2 Normal %96-98 %1.5-3.2 %0.5-0.8 % HbA IC : glycated Hb – important marker of long- term diabetes compensation

19. Haemoglobin catabolism 1.Destruction - life span- 120 days. 2. removed extravascularly by macrophages of the reticuloendothelial system (RES), - specially in the bone marrow - but also in the liver and spleen. 3. cell metabolism deteriorates as enzymes R degraded and not replaced, makes it non viable, but the exact reason why the red cells die is obscure.

20. MACROPHAGE HEMOGLOBIN BREAKDOWN

21. HB breakdown haemoglobin haem protoporphyrin iron Bilirubin (free) CO Expired air transferrin erythroblast Bilirubin glucuronides Stercobilin(ogen) Urobilin(ogen) Urine Liver conjugation faeces globin Amino acids Enterohepatic cir

22. FUNCTIONS 1. - combines reversibly with O 2 to form oxy-HB (HbO 2 ). 2. combines + CO 2 and transports 30% of total as (carbamino-HB ) 3. Acts as a buffer 4. forms typical haem crystals with NaCl and glacial acetic acid which is useful in diagnosis of blood sample (man or animal). 5. combines with other gases like CO, H 2 S ( poisoning,death) 6.Nitric oxide (NO) binds to Hb, NO causing vasodilation to ↑ blood flow and O 2 delivery

23. Normal values 1.At birth: 23 gm% 2.Falls to 10.5gm% by 3 month (breast feed no iron) 3.Rises gradually to 12.5 rises at 1 year of age. 4.Males: 14 – 18 gm% 5.Females: 12 – 15 gm % females: 12 – 15 gm%

25. Differences Hemoglobin & Myoglobin 1.Found in Blood 2.Composed of 4 Heme and 4 Globin chains 3.Carrier of Oxygen and Carbon dioxide 4.Higher Oxygen affinity 1.Found in Heart and skeletal muscles 2.Composed of 1 Heme and 1 Globin chain 3.Reservoir and Carrier of Oxygen 4.Lesser Oxygen affinity

26. deoxyHb deoxyMb Myoglobin and Hb Structure     oxyHb (HbO 2 ) O2O2 O2O2 O2O2 O2O2 Glu6  Val6 oxyMb (MbO 2 )O2O2

29. CLASSIFICATION of ANEMIAS Deficiency of Hb in the blood caused by either: RBC Count or Hb in the RBCs 1.Hemorrhagic anemiahemorrhagic anemia 2.Aplastic anemiaaplastic anemia 3.Megaloblastic anemiamegaloblastic anemia 4.Pernicious anemiapernicious anemia 5.Hemolytic anemiahemolytic anemia 6.Sickle cell anemiasickle cell anemia 7.Iron deficiency anemiairon deficiency anemia 8.Secondary anemia (renal)secondary anemia (renal)

30. Anemia – reduced O 2 carrying capacity of the blood Insufficient hemoglobin content in RBCs: Iron Deficiency - inadequate intake or absorption of iron. Pernicious - dietary deficiency of Vitamin B 12 or inadequate production of intrinsic factor for absorption of Vitamin B 12.

31. Abnormal hemoglobin –Sickle Cell - one amino acid in the 287 forming the beta chains is wrong. In low O 2 conditions the beta chains form stiff rods which cause RBCs to sickle blocking small vessels.

32. Hb S CAUSE: 1.This disease is caused by a mutation in Hb. (Abnormal polypeptides due to substitution of amino acids) 1.Supression of synthesis of polypeptide chains. 2.Occurs in 0.3 to 1 % of west african & american black people 3.Valine is substituted for glutamic acid at 6 position of beta chain.

33. Red blood cells from sickle cell anemia patients: become sickle-shaped only in the deoxygenated state!

34. Thalassemia 1.Defect in the synthesis of either α & β 2.If the body doesn't produce enough of either proteins, the RBC cannot carry sufficient O 2. 3.- is anemia in early childhood and lasts throughout life.

35. Porphyria 1.abnormalities in the chemical steps production of heme 2.It is characterized by extreme sensitivity to light ( expo- sure to sunlight causes vesicular erythema ), -reddish-brown urine, - reddish-brown teeth, and ulcers which destroy cartilage and bone, 3.causing the deformation of the nose, ears, and fingers. Mental aberrations such as hysteria, manic-depressive psychosis, and delirium,

36. Hemoglobine derivates unable to transport CO 2 1.Methemoglobin: contains Fe 3 instead of Fe 2 (e.g. nitrate/nitrite containing food or water) 2.Carboxyhemoglobin– CO poisoning, smokers (cherry red colour) 3.Sulfhemoglobin – green