- The formed elements of blood are erythrocytes, leukocytes and platelets. They are suspended in an aqueous solution (plasma) and have several specialized functions such as transport of oxygen, destruction of external agents, and clotting of blood. Plasma which is allowed to clot yields serum. Most biochemical tests are done on serum. To obtain plasma, blood must be taken into a test tube containing an anticoagulant.
- Plasma contains many proteins broadly classified into albumin and globulins (predominantly immunoglobulins). Albumin functions as a major transport protein for several ligands - trace metals, hormones, bilirubin, and free fatty acids.
- Other proteins are more specialized: they bind specific ligands, e.g. ceruloplasmin binds Cu2+, and thyroid binding globulin (TBG) binds thyroid hormones.
- Immunoglobulins are unique molecules that participate in the defense against antigens that may enter or attempt to enter the body. They have a common structure and five classes of immunoglobulin exist with different protective functions.
- Changes in the concentration of plasma proteins give important clinical information. A characteristic pattern with decreased albumin, transthyretin and transferrin and increased α1-antitrypsin, fibrinogen and C-reactive protein indicates the acute phase response.
- Serum and urine protein electrophoresis is an important way of identifying the presence of monoclonal immunoglobulins.
|
- Compare and contrast plasma and serum and discuss the different types of blood samples taken for laboratory tests.
- Discuss the transport role of serum albumin.
- Describe the core structure of immunoglobulins and different roles played in immunity by different classes of immunoglobulins.
- How does acute phase reaction affect the results of blood tests?
- Characterize Wilson's disease.
- How is hemoglobin handled if erythrocytes become disrupted?
|
Anderson KC, Shaughnessy JD, Barlogie B, Harousseau JL, Roodman GD. Multiple Myeloma. Hematology. American Society of Hematology Education Program Book 2002;214-240. (Full text available at www.asheducationbook.org)
Full article
|
| El-Youssef M. Wilson's Disease. Mayo Clin Proc 2003;78:1126-1136.
|
| Hayashi T, Hideshima T, Anderson KC. Novel therapies for multiple myeloma. Br J Haematol 2003;120:10-17.
Full article
|
| Lewis SM, Bain B, Bates I, eds. Practical Haematology 9th Ed. London: Churchill Livingston; 2001.
Full article
|
| Pepys MB, Hirschfield GM. C-reactive protein: a critical update. J Clin Invest 2003;111:1805-1812. (full text available at www.jci.org)
Full article
|
|
