Understanding red cell morphology - a short guide

NOTE Use existing red cell biconcave disk, with the following accompanying text: The function of red cell is to safely transport haemoglobin between lungs and tissues. This function requires the different elements of red cell structure to work together. Each of these elements may be affected by inherited or acquired disease - each in turn can cause abnormal morphological appearances. NOTE Now we have these pieces of text that ideally act as buttons or have attached buttons “click for more” leading to a more detailed page.

1. Red cell formation: The bone marrow generates uniformly sized mature erythrocytes, but the cells can make extra (or fewer) divisions according to physiological or pathological circumstances – this may affect red cell size or uniformity. 2. Haemoglobin: To collect oxygen in the lungs and gives it up within tissues the four chains of the haemoglobin molecules have a complex interaction – changes to the haemoglobin molecule can affect its solubility or stability leading to characteristic morphological change. 3. Cytoskeleton and membrane: The baseline state of the red cell is a biconcave disk - this allows optimal gas exchange, the cell flexes to form other shapes in fast blood-flow, or when navigating small capillaries. Changes or damage to cytoskeleton or membrane can significantly affect shape. 4. Metabolism: The red cell has no mitochondria, so has limited power to generate or protection from oxidative damage. In conditions of cell stress or if enzyme deficiency further limits metabolism the cell is even more vulnerable.