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The Journey of a Red Blood Cell

6 October 2017

Red Blood Cells (also known as Erythrocytes), are cellular components of blood. There are millions of them within the human body and their sole purpose is to carry oxygen from the lungs to tissues throughout the body, as well as carrying carbon dioxide to the lungs so it can be exhaled. The blood cell is characterised by a red colour due to the presence of hemoglobin, which is a protein that helps bind oxygen to the cell. 

The red blood cell goes through a complex journey through the body, going from a deoxygenated blood cell to an oxygenated blood cell, and entering the heart twice. Below, we’ve laid out the journey of a red blood cell in the human body:

Step 1 - Creation of the Red Blood Cell

The journey starts with the red cell being created inside the bone. In the bone marrow, it develops in several stages starting as a hemocytoblast, then becoming an erythroblast after 2 to 5 days of development. After filling with hemoglobin it becomes a reticulocyte, which then becomes a fully matured red blood cell. This will be of a specific blood type, determined by the presence or absence of certain antibodies - learn more about blood grouping products here.

Step 2 - The Red Blood Cell's Journey begins

After creation, the red blood cell starts travelling to the heart via capillaries. The blood cell is currently deoxygenated.

Step 3 - Entering the Heart

The deoxygenated red blood cell now makes its way to the vena cava within the heart, and is then pushed into the right atrium.

The right atrium then contracts, pushing the blood cell through the tricuspid into the right ventricle.

The right ventricle then contracts, pushing the red blood cell out of the heart through the semi lunar.

Step 4 - Entering the Lungs and Oxygenation

After leaving the heart, the red blood cell travels through the pulmonary artery to the lungs. There it picks up oxygen making the deoxygenated red blood cell now an oxygenated blood cell. The blood cell then makes it way back to the heart via the pulmonary vein into the left atrium.

Step 5 - Re-entering the heart

After entering the left atrium, which then contracts and pushes the blood cell through the bicuspid, the red blood cell then enters the left ventricle.

The left ventricle then contracts, pushing the red blood cell through the semi lunar, and out of the heart into the aorta.

Step 6 - Travelling around the body

Travelling through the aorta, the red blood cell goes into the kidneys trunk and other lower limbs, delivering oxygenated blood around the body. They typically last for 120 days before they die.

And that’s the whole process! Although this seems like a lengthy process, the whole thing takes less than a minute from start to finish, depending on the individual’s heart rate.

In some cases such as illnesses or blood loss following injury or childbirth, the body may have too few red blood cells to provide the oxygen required by the body's extremities. This is where a blood transfusion becomes vital.  At Lorne Laboratories all our blood grouping reagents and  red cell  products comply with the UK Red Book Standards to ensure safe blood transfusions.

Got questions about our products and how they impact the journey of the red blood cell? Email our team at Lorne Labs HQ  and we'll be happy to assist you. 

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The Life of a Red Blood Cell

July 8, 2011 at 11:24 am By Stanford Blood Center

By Billie Rubin, Hemoglobin’s Catabolic Cousin, reporting from the labs of Stanford Blood Center

Red blood cells (RBCs) are born in the bone marrow of our large bones at a rate of 2 million every second! Our bone marrow is like a heavy-duty erythropoietic ward.

And RBCs grow up fast. In about seven days they are ready to toss out their nucleus and DNA and leave the nest to spend all of their 120-day life span traveling down vast arterial highways and capillary byways. They get rid of their interior baggage so they can each carry over 250 million molecules of hemoglobin. While tossing out their DNA makes them beefier, it also limits them as they can’t reproduce or even repair themselves. It’s a wild life.

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The journey of a red blood cell By Maggie Doyle

The red blood cell's journey starts in the bone marrow, where after 7 days of maturation, it is released into the bloodstream. The production of red blood cells is controlled by the kidney releasing a chemical called erythropoietin (EPO), which is triggered by an O2 deficiency in the Kidney.

Once the red blood cell has matured, it can start doing the job it is created for. The red blood cell exists to carry oxygen throughout the bloodstream and body, which it does through hemoglobin; hemoglobin carries oxygen from the lungs to the body's tissues and returns carbon dioxide from the tissues back to the lungs. Hemoglobin is a protein found within red blood cells that is crucial to the red blood cell, it can also carry up to 4 oxygen molecules at a time.

Along the way, a red blood cell encounters many other things in the blood. White blood cells, which fight infections, are another crucial part of your body functions. Platelets are present to help clotting if the skin gets cut and one starts bleeding, so that the bleeding eventually stops. Plasma is a yellow-ish liquid responsible for carrying nutrients, hormones, proteins, etc. through the body. Hopefully it won't, but a red blood cell could also encounter blood-borne viruses such as HIV, AIDS, or hepatitis B.

The red blood cell is allowed to make this awesome journey because it is pumped by the heart muscle, which is so powerful that the red blood cell is able to travel all the way around the body. When oxygen depleted blood returns to the heart, it is then pumped to the lungs. After it has been oxygenated in the lungs, it is pumped back to the heart, and from there pumped to the rest of the body.

The lungs are an important part of the red blood cell's journey as well, because that is where red blood cells bring waste CO2 to be exhaled. The lungs are also where hemoglobin binds with oxygen as oxygen molecules enter the lungs.

The red blood cells travel through the body on its journey in veins and arteries. Veins are for blood towards the heart, and arteries are full of blood travelling away from the heart. The heart pumps blood out through the pulminary arteries and in through the vena cavas. Blood goes from the heart to the arteries, arteries to arterioles, and arterioles to capillaries. From the capillaries, the oxygen goes to the interstitial fluid and cells, while the deoxygenaged blood travels through veins and venues back to the heart, where the process restarts. Veins rely on muscle contraction to return blood to the heart, and many veins have valves that ensure blood can only travel one way.

Created with images by NIAID - "Malaria-infected Red Blood Cell"

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ISawTheScience

Science Through Stories

Journey of Red Blood Cell

Millions of red blood cells are created in our bone marrow each second. Built with iron-rich haemoglobin, they are able to bind and transport oxygen to every single cell in the human body. Unlike other human cells, a red blood cell lacks a nucleus, giving them the flexibility to squeeze through the tiniest blood capillaries in the human body. However, this comes at a price. Without a nucleus, a red blood cell only survives for about 100 to 120 days before being sent to the liver to be destroyed. Follow their short-lived but crucial journey through the human body in the video!

Written by Sharmin Taj Animation by Toh Bee Suan

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Journey of the Red Blood Cell

By William Aird

Is there any other cell type in the human body that must adapt to so many different environments? 120 days of treacherous navigation – as though on a rollercoaster ride – all without the benefit of a nucleus/other organelles to guide response and repair.

Impressive!

The complex journey of red bloods cells through microvascular networks

Tacc's stampede1 used to simulate and study dynamics of red blood cells.

If you think of the human body, microvascular networks composed of the smallest blood vessels are a central part of the body's function. They facilitate the exchange of essential nutrients and gasses between the blood stream and surrounding tissues, as well as regulate blood flow in individual organs.

While the behavior of blood cells flowing within single, straight vessels is a well-known problem, less is known about the individual cellular-scale events giving rise to blood behavior in microvascular networks. To better understand this, researchers Peter Balogh and Prosenjit Bagchi published a recent study in the Biophysical Journal . Bagchi resides in the Mechanical and Aerospace Engineering Department at Rutgers University, and Balogh is his PhD student.

To the researchers' knowledge, theirs is the first work to simulate and study red blood cells flowing in physiologically realistic microvascular networks, capturing both the highly complex vascular architecture as well as the 3D deformation and dynamics of each individual red blood cell.

Balogh and Bagchi developed and used a state-of-the-art simulation code to study the behavior of red blood cells as they flow and deform through microvascular networks. The code simulates 3D flows within complex geometries, and can model deformable cells, such as red blood cells, as well as rigid particles, such as inactivated platelets or some drug particles.

"Our research in microvascular networks is important because these vessels provide a very strong resistance to blood flow," said Bagchi. "How much energy the heart needs to pump blood, for example, is determined by these blood vessels. In addition, this is where many blood diseases take root. For example, for someone with sickle cell anemia, this is where the red blood cells get stuck and cause enormous pain."

One of the paper's findings involves the interaction between red blood cells and the vasculature within the regions where vessels bifurcate. They observed that as red blood cells flow through these vascular bifurcations, they frequently jam for very brief periods before proceeding downstream. Such behavior can cause the vascular resistance in the affected vessels to increase, temporarily, by several orders of magnitude.

There have been many attempts to understand blood flow in microvascular networks dating back to the 1800s and French physician and physiologist, Jean-Louis-Marie Poiseuille, whose interest in the circulation of blood led him to conduct a series of experiments on the flow of liquids in narrow tubes. He also formulated a mathematical expression for the non-turbulent flow of fluids in circular tubes.

Updating this research, Balogh and Bagchi use computation to enhance the understanding of blood flow in these networks. Like many other groups, they originally modelled capillary blood vessels as small, straight tubes and predicted their behavior.

"But if you look at the capillary-like vessels under the microscope, they are not straight tubes...they are very winding and continuously bifurcate and merge with each other," Bagchi said. "We realized that no one else had a computational tool to predict the flow of blood cells in these physiologically realistic networks."

"This is the first study to consider the complex network geometry in 3D and simultaneously resolve the cell details in 3D," Balogh said. "One of the underlying goals is to better understand what is occurring in these very small vessels in these complex geometries. We hope that by being able to model this next level of detail we can add to our understanding of what is actually occurring at the level of these very small vessels."

In terms of cancer research, this model may have tremendous implications. "This code is just the beginning of something really big," Bagchi said.

In the medical field today, there are advanced imaging systems that image the capillary network of blood vessels, but it's sometimes difficult for those imaging systems to predict the blood flow in every vessel simultaneously. "Now, we can take those images, put them into our computational model, and predict even the movement of each blood cell in every capillary vessel that is in the image," Bagchi said.

This is a huge benefit because the researchers can see whether the tissue is getting enough oxygen or not. In cancer research, angiogenesis -- the physiological process through which new blood vessels form from pre-existing vessels -- is dependent upon the tissue getting enough oxygen.

The team is also working on modeling targeted drug delivery, particularly for cancer. In this approach nanoparticles are used to carry drugs and target the specific location of the disease. For example, if someone has cancer in the liver or pancreas, then those specific organs are targeted. Targeted drug delivery allows increased dose of the drug so other organs don't get damaged and the side effects are minimized.

"The size and shape of these nanoparticles determine the efficiency of how they get transported through the blood vessels," Bagchi said. "We think the architecture of these capillary networks will determine how well these particles are delivered. The architecture varies from organ to organ. The computational code we developed helps us understand how the architecture of these capillary networks affects the transport of these nanoparticles in different organs."

This research used computational simulations to answer questions like: How accurately can a researcher capture the details of every blood cell in complex geometries? How can this be accomplished in 3D? How do you take into account the many interactions between these blood cells and vessels?

"In order to do this, we need large computing resources," Bagchi said. "My group has been working on this problem using XSEDE resources from the Texas Advanced Computing Center. We used Stampede1 to develop our simulation technique, and soon we will be moving to Stampede2 because we'll be doing even larger simulations. We are using Ranch to store terabytes of our simulation data."

The eXtreme Science and Engineering Discovery Environment (XSEDE) is a National Science Foundation-funded virtual organization that integrates and coordinates the sharing of advanced digital services -- including supercomputers and high-end visualization and data analysis resources -- with researchers nationally to support science. Stampede1, Stampede2, and Ranch are XSEDE-allocated resources.

The simulations reported in the paper took a few weeks of continuous simulation and resulted in terabytes of data.

In terms of how this research will help the medical community, Bagchi said: "Based on an image of capillary blood vessels in a tumor, we can simulate it in 3D and predict the distribution of blood flow and nanoparticle drugs inside the tumor vasculature, and, perhaps, determine the optimum size, shape and other properties of nanoparticles for most effective delivery," Bagchi said. "This is something we'll be looking at in the future."

• Hypertension
• Blood Clots
• Lung Cancer
• Heart Disease
• Brain Tumor
• Sickle Cell Anemia
• White blood cell
• Blood vessel
• Blood pressure
• Coronary circulation
• Bone marrow

Story Source:

Materials provided by University of Texas at Austin, Texas Advanced Computing Center . Original written by Faith Singer-Villalobos. Note: Content may be edited for style and length.

Journal Reference :

• Peter Balogh, Prosenjit Bagchi. Direct Numerical Simulation of Cellular-Scale Blood Flow in 3D Microvascular Networks . Biophysical Journal , 2017; 113 (12): 2815 DOI: 10.1016/j.bpj.2017.10.020

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Welcome to Charlesbridge!

The Circulatory Story

By: Mary K. Corcoran / Illustrated by: Jef Czekaj

Hop a ride with a red blood cell!

Simple, humorous text and comic illustrations explain the basics of the circulatory system - the systemic, pulmonary, and coronary circuits. Readers follow a red blood cell on its journey through the body, and in the process learn how the body combats disease, performs gas exchanges, and fights plaque.

If you like this book, you’ll enjoy these: The Quest to Digest Science Stunts

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Mary Corcoran, author

Mary Corcoran grew up in Mount Vernon, New York. Camping trips with her large family were a great opportunity for a young girl fascinated by the natural world and interested in the sciences.

Mary studied Biology at the City University of New York-Lehman College and did her student teaching at the Bronx High School of Science. After working as a Student Conservation Association volunteer at Acadia National Park in Maine and at Badlands National Park in South Dakota, Mary moved to Colorado Springs and dedicated her life to teaching science.

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Jef Czekaj, illustrator

Jef Czekaj is a cartoonist, musician, and poster artist who lives and works in Somerville, Massachusetts. His adventure comic strip, Grandpa and Julie: Shark Hunters , is read by over a million children monthly in Spanish and English in Nickelodeon Magazine . A Zeric-award-winning collection of the first 3 years of this strip has been collected in a book of the same name (Top Shelf). His self-published comic Hypertruck has been called "the funniest indie-obsessed subcultural screed ever photocopied" by the Seattle Stranger .

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• A Junior Library Guild Selection

Booklist Showing why "it's great to circulate," the author and illustrator of The Quest to Digest (2006) take young readers on an equally engaging ride through the heart, lungs, arteries, veins, capillaries, and back again. In the big, labeled cartoon illustrations a small, green Shmoo-like creature rides a red blood cell down a river of plasma ("YEE HAW!"), "passes gas" to a body cell in exchange for a bag of CO2, sits back to watch as white blood cells and platelets race to a skinned knee, then threateningly wards off a cheeseburger and other fatty, arterial plaque-causing foods. Corcoran's breezy commentary lays out the whole 60,000-mile system in easy-to-understand terms, giving readers a chance to add words like erythrocyte , leukocyte , and sino-atrial node to their personal lexicons and closing with well-chosen books and Web sites to spur further investigation. An irresistible invitation to go with the flow.

Paperback ISBN: 978-1-58089-209-4

E-book ISBN: 978-1-60734-180-2 PDF

Ages: 8-12 Page count: 44 8  1 / 2 x 11

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Roughwood Primary School

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Story mapping in science – A journey of a red blood cell

Following on from our learning all about the heart, this week the children have been investigating the journey of a Red blood cell. To help support our understanding further, the children have been creatively story mapping their own narrative account of the journey. Everyone has thoroughly enjoyed using their own imagination of ways to help them to remember the whole process.

Well done Y6, the finished pieces look fantastic.

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Early Career Scientists’ Guide to the Red Blood Cell – Don’t Panic!

Anna bogdanova.

1 Red Blood Cell Research Group, Institute of Veterinary Physiology, Vetsuisse Faculty and the Zurich Center for Integrative Human Physiology (ZIHP), University of Zurich, Zurich, Switzerland

Lars Kaestner

2 Theoretical Medicine and Biosciences, Saarland University, Homburg, Germany

3 Experimental Physics, Saarland University, Saarbrücken, Germany

Associated Data

The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding authors.

Why should we take interest in studying red blood cells? This mini review attempts to answer this question and highlights the problems that authors find most appealing in this dynamic research area. It addresses the early career scientists who are just starting their independent journey and facing tough times. Despite unlimited access to information, the exponential development of computational and intellectual powers, and the seemingly endless possibilities open to talented and ambitious early career researchers, they soon realize that the pressure of imminent competition for financial support is hard. They have to hit deadlines, produce data, publish, report, teach, manage, lead groups, and remain loving family members at the same time. Are these countless hardships worth it? We think they are. Despite centuries of research, red blood cells remain a mysterious and fascinating study objects. These cells bring together experts within the family of the European Red Cell Society and beyond. We all share our joy for the unknown and excitement in understanding how red cells function and what they tell us about the microenvironments and macroenvironments they live in. This review is an invitation to our colleagues to join us on our quest.

With Inspiration and in Memory of Douglas Adams and His Ultimate Hitchhiker’s Guide to the Galaxy ( Adams, 1996 )

Red blood cells have power over us, no doubt. Making up over 50% of our cells (2 × 10 13 cells), these cells provide us with energy to live, think, and create ( Bianconi et al., 2013 ; Lew and Tiffert, 2017 ). Each day, we lose 1.7 × 10 11 cells and make the same number anew ( Lew and Tiffert, 2017 ). However, the deeper we delve into the red blood cell universe, the humbler we feel, as we still have no ultimate answer to “the Question of Life, the Universe, and Everything.”

Are all the 1.7 × 10 11 cells we produced today the same? Do they differ from the cells we made yesterday when we went hiking in the mountains or were swimming in the lake? How do the heat waves associated with climate change affect these cells? How does microgravity affect them when, e.g., hitchhiking through the galaxy? How do the cells change as we get older and older with the increasing life expectancy?

Do the red cells produced today pass away on the same day and from the same cause? For humans, the causes of death and lifespan of individual cells seem to be somewhat random ( Kaestner and Minetti, 2017 ), and the investigations to be done are complex, as we cannot trace the life cycle of each individual cell back as detectives do. We do not know exactly what forces red blood cells to die and how they exactly cease to exist. Some of us acknowledge oxidation-induced clustering of band 3 proteins in the membrane as a signal that tags cells with antibodies against these clusters as “labeled for removal” ( Lutz, 2012 ; Lutz and Bogdanova, 2013 ). Others describe red cell death as an “apoptosis-like” process and call it eryptosis ( Lang et al., 2006 , 2008 ). The “Nomenclature Committee on Cell Death,” specializing in terminology, warns us for translation of the process as well as the word “eryptosis” to the way the enucleated cells pass away ( Galluzzi et al., 2018 ). Is there one or more than one way to die? This question remains unclear and must still be resolved.

What do we need to learn about red blood cells? As in Adams’ novels, experts and early career scientists witness dynamic developments in the field that leave us both excited and thrilled. We seem to know much about the major function of red blood cells, which is gas transport, but there is much more to what these cells are doing. This makes it difficult to limit the number of ultimate questions to just one ( Figure 1 ).

A schematic of the Red Blood Cell Universe as the authors see it, including a list of ultimate questions.

There are more than 100 years of evidence for the active participation of red blood cells in blood coagulation ( Duke, 1983 ; Andrews and Low, 1999 ; Steffen et al., 2011 ; Byrnes and Wolberg, 2017 ). This concept, however, did not mature enough to enter the textbooks. How many million years will it take?

There are some indications that red blood cells may sense the changes in plasma levels of hormones, such as insulin ( Pedersen et al., 1982 ; Zhang et al., 2015 ), catecholamines ( Hasan et al., 2017 ) and cortisol ( Farese and Plager, 1962 ), sex hormones ( Koefoed and Brahm, 1994 ), and erythropoietin ( Trial et al., 2001 ; Mihov et al., 2009 ). If so, what happens to the cells as hormones interact with the receptors on the red blood cell membrane or cytosolic components?

Red blood cells are famous because they are widely used as a perfect cell model for studying cell membranes ( Agre and Parker, 1989 ; Bernhardt and Ellory, 2003 ; Yawata, 2003 ). Earlier, all cells looked the same to the observers, and their properties were studied “en masse” e.g. using radioactive isotopes, rubbing cells between two plates to examine their viscosity and deformability, by inflating or deflating them, and by applying all possible approaches to whole blood samples. Mean volume and hemoglobin content values were assigned to them. Only desperate experts, such as Marcel Bessis, were photographing red blood cells for their beauty and turning their appearance into art by means of scanning electron microscopy ( Bessis, 1974 ). If we want to study cells of similar densities and, eventually, ages, we may apply centrifugal force to produce fractions of such cells ( Figure 2 ). Everyone that has once done such an experiment appreciates that each red cell has a certain density and joins one, but not the other group of cells of certain density, producing a striped pattern in centrifuged samples. Why certain densities are favored and others avoided is a question that needs answering. Our current understanding of red blood cell shapes includes their individual appearance and properties, their dynamic shape transitions, and their “shape memory” ( Fischer, 2004 ; Tomaiuolo, 2014 ; Lanotte et al., 2016 ; Cordasco and Bagchi, 2017 ; Kihm et al., 2018 ). These studies make use of cellular and molecular biophysics, sophisticated in vivo imaging techniques for microfluidic channels and even blood vessels, and a great deal of artificial intelligence – even coming close to “Deep Thought,” the supercomputer in Adams’ story – but there is one crucial difference: patients do not have a million years to wait for the answer.

Red blood cells may have different densities, as shown on this continuous Percoll density gradient, but some densities are favored, and others are mysteriously abandoned.

Most red blood cell researchers are deeply devoted to developing novel tools that may reveal so far unnoticed sides of cells we all like to study. Benefits are include protein profiling of red blood cells using omics approaches ( Nemkov et al., 2018 ). Technologies use stem cells for production and manipulation of red blood cells ( Hansen et al., 2019 ). We may follow red blood cells running through the blood vessels of living hosts ( Hertz et al., 2019 ; Slovinski et al., 2019 ) and model and evaluate responses of red blood cells to mechanical shear forces – the ones they are exposed to in our microvasculature ( Lizarralde Iragorri et al., 2018 ; Moura et al., 2019 ). We can detect electric currents that ions mediate passing through red blood cell membranes in hundreds of individual cells at the same time ( Rotordam et al., 2019 ). As progress in research is fast, sometimes careful examination of the possible pitfalls and sources of artifacts is required ( Minetti et al., 2013 ).

There is even more to explore in the universe of pathophysiology. For some patients, we do not have an answer as to what causes a red blood cell defect and only know the symptoms. Even when the molecular cause of the disease is clear, the links between the defective protein (a mismatch in amino acid composition or a dysregulated production program) and disease severity are often unknown. This is the case for sickle cell disease, hereditary spherocytosis, and Gardos channelopathy, just to name a few examples. Some patients get scientists involved into a thrilling quest for the actual cause of disease, those that were identified by hematologists as carriers of “idiopathic hemolytic anemia.” New tools are currently in development that will enable the diagnosis of “newly identified” diseases ( Kaestner and Bianchi, 2020 ).

Even more mysterious cases are described when defects in red blood cells come along with neurodegenerative symptoms. One such disease was named “acanthocytosis” (from the Greek word “acantha,” meaning “thorn”) because of the spiked thorny appearance of red blood cells ( De Franceschi et al., 2014 ; Adjobo-Hermans et al., 2015 ). In fact, neurons and erythroid progenitor cells in the bone marrow were recently shown to share common gene regulatory pathways defining their fate and properties ( Kinney et al., 2019 ).

The heart and blood also have much in common ( Kaestner, 2013 ). The mortality of patients with myocardial infarction (acute coronary syndrome) and those undergoing valve replacement surgery may be predicted based on the degree of variance in red blood cell shapes and sizes ( Ghaffari et al., 2016 ; Duchnowski et al., 2017 ; Abrahan et al., 2018 ). Furthermore, red blood cells were recently shown to function as actors, not passive witnesses, in cardiovascular diseases, contributing to the regulation of redox state and vascular tone and activating protective or disruptive signaling cascades in the myocardium and blood vessels ( Pernow et al., 2019 ). Can red blood cells be regarded as deputies for other organs of our body, such as the brain and the heart?

One more exciting and rapidly developing area aims at revolutionizing blood donations and transfusions. Instead of relying on people readily offering their blood for the others to use, researchers are producing, so far in very small amounts, red blood cells of the type needed for each individual patient in a test tube ( Shah et al., 2014 ; Hawksworth et al., 2018 ). However, it will take some time until cell culture can upscale to provide enough red blood cells for transfusion. Therefore, before this happens, we still have to rely on blood donations and do our best to improve the red blood cell storage conditions ( D’Alessandro and Seghatchian, 2017 ) and to manage and reduce damage of cells during lesions ( Yoshida et al., 2019 ). Furthermore, each patient may decide in the future to use his/her own red blood cells as transport containers to deliver toxic drugs to the location in the body where they are supposed to act without poisoning the host ( Villa et al., 2016 ; Sun et al., 2017 ). Nature itself has chosen to modify components of red blood cells to protect hosts from Plasmodium infection causing a deadly disease that claimed over 400 000 lives in 2018 alone, malaria ( Weatherall, 2008 ; Timmann et al., 2012 ; Malaria Genomic Epidemiology et al., 2015 ). This evolutionary selection has taken ages to occur and may now be of use to the development of protective strategies for the human population, as the spread of Plasmodium further to the north will follow the increase in atmospheric temperatures.

The universe of red blood cells spreads far beyond the cells that function in Homo sapiens . In agreement with the Hitchhiker’s Guide, we have learned much about RBCs in the true rulers of the Earth, mice. These furry fellows give us a chance to study the mechanisms of diseases and to design new therapies for mice and humans. Our knowledge of the red blood cells in other species, including our pets and other tamed and wild, warm- and cold-blooded creatures that attend veterinary clinics from time to time, is rather fragmentary and requires more attention ( Figure 1 ).

The ultimate “Answer to the Ultimate Question of Life, the Universe, and Everything” may only be given as we keep working and using our brains along with artificial intelligence. The next edition of “The Guide to Red Blood Cells” is on the way, and the motto for the early career scientists in the area stands as stated by Adams: “Don’t Panic.”

Data Availability Statement

Author contributions.

All authors listed have made a substantial, direct and intellectual contribution to the work, and approved it for publication.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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What Are Red Blood Cells?

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Red Blood Cells

Red blood cells have the important job of carrying oxygen all over the body. These cells, which float in your blood , begin their journey in the lungs, where they pick up oxygen from the air you breathe. Then they travel to the heart, which pumps out the blood, delivering oxygen to all parts of your body.

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Solar eclipse 2024: Follow the path of totality

Solar eclipse, worried about eclipse damage to your eyes don't panic.

Geoff Brumfiel

Nell Greenfieldboyce

Junior Espejo looks through eclipse glasses being handed out by NASA in Houlton, Maine. Used correctly, eclipse glasses prevent eye damage. Joe Raedle/Getty Images hide caption

Junior Espejo looks through eclipse glasses being handed out by NASA in Houlton, Maine. Used correctly, eclipse glasses prevent eye damage.

Tens of millions of Americans will have spent the day staring at a total solar eclipse, and at least a few of them may become worried that they inadvertently damaged their eyes.

But experts say there's no need to panic — the vast majority of eclipse viewers are probably fine. And even if somebody did strain their eyes, the effects could be temporary.

During the 2017 total solar eclipse it's estimated that 150 million Americans viewed the event. There were around 100 documented cases of eye damage across all of America and Canada, according to Ralph Chou, an expert on eclipse eye safety with the University of Waterloo in Canada.

Far more people turned up in emergency rooms worried that they'd damaged their eyes. Many complained of watery eyes or blurred vision, but in most cases they were fine, according to Avnish Deobhakta, an ophthalmologist at the New York Eye and Ear Infirmary of Mount Sinai, one of the largest eye hospitals in the nation.

The reason it's hard to do real damage is simple — the human eye has evolved to avoid staring directly at the sun.

"It's so bright that we're not actually capable of looking at it without either tearing or sort of not really feeling comfortable staring at this ball of light," Deobhakta says.

Shots - Health News

Here's what it looks like when you fry your eye in an eclipse.

In the rare case that someone does damage their eyes, that damage usually shows up as a blurry spot in the field of vision , hours or up to a day after watching the eclipse. In about half of cases, the problem fixes itself, but permanent damage can sometimes occur.

Anticipating the post-eclipse ocular anxiety, at least one eye clinic in Buffalo, N.Y., is offering free eye checks immediately after the eclipse on April 8.

It's always a good idea to get your eyes checked, whether or not there's an eclipse. So if you're worried at all, go ahead and use the opportunity to schedule your annual exam.

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April 11, 2024

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Anemia may contribute to higher female mortality during heart surgery

by Weill Cornell Medical College

Women are at higher risk of death when undergoing heart bypass surgery than men. Researchers at Weill Cornell Medicine have determined that this disparity is mediated, to a large extent, by intraoperative anemia—the loss of red blood cells during surgery.

The study , published in the Journal of the American College of Cardiology , suggests that strategies for minimizing anemia that occurs during this procedure could lead to better outcomes for women with cardiovascular disease .

This study set out to discover why women are less likely to survive coronary artery bypass grafting , a surgical procedure for restoring blood flow to the heart. The team, led by senior author Dr. Mario Gaudino, the Stephen and Suzanne Weiss Professor in Cardiothoracic Surgery at Weill Cornell Medicine, analyzed information obtained from the Society of Thoracic Surgeons Adult Cardiac Surgery Database on more than one million patients. Dr. Lamia Harik, a fellow in Cardiothoracic Surgery Research at Weill Cornell Medicine, was the first author of the paper.

They examined patient demographics (such as age and ethnicity), risk factors (including disease severity, previous heart attacks, and the co-occurrence of other health conditions), and surgical data (including the time spent on the bypass machine and the volume of the components of blood, such as red blood cells).

Crunching the numbers, Dr. Gaudino and his team previously confirmed that women had higher mortality associated with the procedure than men: 2.8 percent versus 1.7 percent, a nearly 50 percent difference. Now, using sophisticated statistical analyses to assess all the possible variables, the researchers found that a substantial portion of this enhanced risk—38 percent—could be attributed to severe intraoperative anemia.

This depletion of red blood cells is an inevitable side effect of using blood-diluting fluids to prime the heart-lung bypass machine that takes over the job of pumping blood throughout the body during surgery. Women may be even more susceptible to the effects of intraoperative anemia because they tend to arrive in surgery with lower red blood cell counts and have smaller body size compared to their male counterparts.

The study does not establish that intraoperative anemia is causing greater female mortality, but the two factors are associated. It suggests that clinicians and researchers should consider interventions to prevent or minimize severe intraoperative anemia, which can lead to dangerously reduced oxygen delivery to the body's tissues, including the heart.

Using heart-lung bypass machines with shorter circuits, for example, would limit the volume of blood-diluting solution needed to run the pump. Randomized trials to assess whether methods for curtailing anemia could improve outcomes for women undergoing heart bypass surgery are "urgently needed," wrote Dr. Gaudino, who is also a cardiovascular surgeon at NewYork-Presbyterian/Weill Cornell Medical Center.

10.1001/jamasurg.2022.8156

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Middle East latest: US 'moving additional assets' to region amid fears of Iran attack on Israel

Washington officials expect Iran to attack Israel in retaliation to a strike on its embassy in Syria - as the US says it will not be drawn into any wider war and Tehran suggests its response will be non-escalatory. Listen to our latest podcast on how tensions are rising in the region.

Friday 12 April 2024 20:03, UK

• Israel-Hamas war
• Iran's threat of attack is real and viable, White House says
• US 'moving additional assets' to Middle East
• Iran attack on Israel expected in coming days - reports
• Tehran 'telling US' it will avoid major escalation
• Number of Palestinians killed by Israel in Gaza rises to 33,634, health ministry says
• Dominic Waghorn:  Risk of bigger war rising - but Biden knows he can't blink
• Alex Crawford report : Yemeni fishermen face threat of Houthi attack - but on Gaza they are firmly behind the militants
• Live reporting by Jess Sharp and (earlier)  Niamh Lynch

Around 40 rocket launches have been identified crossing from Lebanon, the Israeli military has said. 

In a Telegram post, the Israel Defence Forces said some rockets were intercepted, and the rest fell in open areas. 

It also confirmed two Hezbollah explosive drones that had entered Israeli territory from Lebanon had been intercepted. 

"Over the last few hours, the IDF struck in a number of locations in southern Lebanon in order to remove a threat," it added. 

Israel and the Lebanese militant group Hezbollah have regularly exchanged fire across the border since the war in Gaza erupted last year. 

Throughout the day, we have been reporting on the threat of an Iranian attack on Israel. 

The US has warned the threat is "real" and "viable" and, in the last few moments, an American defence official has confirmed "additional assets" are being moved to the Middle East as a result. 

Our security and defence analyst Michael Clarke has said it is "quite likely" Iran will attack, and the US has been given signals all day that it could be "imminent". 

He added he is "fairly sure" Iran will not let go of the deadly strike on its embassy in Syria - which is what sparked the threat of an attack in the first place. 

"The United States is pretty clear now that something is about to happen, maybe tonight, maybe tomorrow, but it won't be much further than that, and it might be quite big," Prof Clarke said.

He explained that the US has said it is more likely Iran will launch a direct attack on Israel, and the Iranians do have missiles with the capability to do so.

Israel has made it very clear it will hit back if Iran decides to attack, and Prof Clarke said some Israelis would "almost like that to happen" so they could attack some of Iran's nuclear facilities. 

You can watch his full analysis below...  

The US is "moving additional assets" to the Middle East, a defence official has told Sky News. 

The move will "bolster regional deterrence efforts and increase force protection for US forces", the official said. 

Our US correspondent Mark Stone said no further details have been provided. 

"That means more military hardware is being moved or will be moved to the region to do two things - try to deter Iran from taking any massive action and also to protect existing American forces that are in the region," he said. 

"I think the consensus among experts is that the Iranian will respond, but they will almost certainly respond against Israel directly rather than any American military in the region. 

"Nevertheless, what that response will look like and what it will mean in terms of an Israeli response, we don't know yet." 

The announcement comes after the White House said it changed its force posture in the region amid threats of an Iranian attack on Israel. 

Fears of an escalating situation in the Middle East have grown in recent days after Iran threatened to attack Israel. 

But how is Iran involved in the conflict - and why is it threatening to attack Israel? 

Firstly, Iran is the biggest backer of Hamas, having provided weapons and training to the militant group in previous years. 

It also backs Hezbollah in Lebanon and the Houthis in Yemen - both of which have been involved in attacks on Israel since the war in Gaza erupted last year. 

Historically, Israel and Iran have been arch enemies, with both countries allegedly behind a long series of attacks on each other's interests. 

Tensions between the two nations have been increasingly stretched since Israel entered Gaza following the 7 October Hamas attacks. 

But, they became incredibly high last week after an attack on the Iranian embassy in Syria. 

That's why Iran is threatening to attack Israel. 

Two generals and seven members of the Iranian Revolutionary Guard were killed in the strike in Damascus, which Tehran has blamed on Israel. 

The US military has said it also believes Israel was behind the attack. 

However, Israel has not publicly commented on the airstrike. 

Iran has been warned by the US not to use the embassy attack as a pretext to escalate the situation in the region. 

Israeli officials have met a US CENTCOM commander today to discuss the military's readiness for "defensive and offensive operations". 

Israel's defence minister Yoav Gallant met General Michael Erik Kurilla at Hatzor airbase this afternoon. 

"We are prepared in defence, also on the ground, also in the air, we are in close cooperation with neighbours and friends in order to prevent a harm to Israel, and we will know how to respond," Mr Gallant said after the meeting.

General Kurilla then met the Israeli military's chief of general staff Lieutenant General Herzi Halevi. 

In a post on X, the Israel Defence Forces said the pair "completed a comprehensive situational assessment with IDF officials on the IDF's readiness for defensive and offensive operations in all scenarios". 

"The IDF continues to monitor closely what is happening in Iran and different arenas, constantly preparing to deal with existing and potential threats in coordination with the United States Armed Forces," Lt Gen Halevi said. 

Yesterday, Israel's military said it's prepared to defend the country and strike back if Iran retaliates for a deadly airstrike on the Iranian Consulate in Syria.

None of the United Nation's planned humanitarian missions to northern Gaza has been allowed to enter the besieged region today, officials have said. 

The UN Office for the Coordination of Humanitarian Affairs in the occupied Palestinian territory (OCHA) has said its assistance was blocked by Israeli authorities... 

Israel has been under increasing international pressure to help curb the humanitarian crisis in Gaza by letting aid into the enclave. 

Earlier today, the Israeli military said the first trucks carrying food aid entered Gaza through a newly opened northern crossing point. 

It said the trucks were inspected at the Kerem Shalom crossing point on the border with Egypt before moving north to cross.

It was not made clear who was supplying the trucks. 

Poland has urged citizens not to travel to Israel, the Palestinian territories and Lebanon. 

In travel guidance published today, Poland's foreign ministry warned "significant restrictions in air traffic" could occur due to a military escalation. 

"It cannot be ruled out that there will be a sudden escalation of military operations, which would cause significant difficulties in leaving these three countries," it said. 

"Any escalation may lead to significant restrictions in air traffic and the inability to cross land border crossings."

The Israeli-occupied Palestinian territories consist of the Gaza Strip and the West Bank. 

The warning comes amid threats of a retaliatory attack by Iran, who blames Israel for a deadly strike on its embassy in Syria last week.

At least three other countries have also recently updated their travel advice amid the threat, including France, Russia and India.

Motorcyclists in Tel Aviv have been taking part in a Ride for Hope today in support of hostages kidnapped in the 7 October attack.

Benjamin Netanyahu is coming under increasing pressure to help bring home the more than 100 hostages still being held in Gaza.  

Hamas militants took around 250 hostages during the 7 October attacks. 

Around half of the hostages were released in a November cease-fire.

Waterborne diseases are spreading in Gaza due to a lack of clean water and rising temperatures, the United Nations humanitarian coordinator in Gaza has said today. 

"It is becoming very hot there," Jamie McGoldrick told reporters via video link from Jerusalem. 

"People are getting much less water than they need, and as a result, there have been waterborne diseases due to lack of safe and clean water and the disruption of the sanitation systems."

"We have to find a way in the months ahead of how we can have a better supply of water into the areas where people are currently crowded at the moment," he said.

Contaminated water and poor sanitation are linked to diseases such as cholera, diarrhoea, dysentery and hepatitis A, according to the World Health Organization (WHO)

Since mid-October, the WHO has recorded more than 345,000 cases of diarrhoea, including more than 105,000 in children under five. 

By Mark Stone , US correspondent

Confirmation from the White House has changed its force posture in the Middle East is significant but shouldn't come as a surprise.

The National Security Council spokesman, Admiral John Kirby, would not be drawn on what the changes look like.

Iran has been open about its pledge to retaliate for the killing of a top Iranian general at the country's consulate in Damascus, Syria on 1 April.

Mr Kirby said that threat was "a public and credible threat", adding that the US is in "constant communications with Israel about how they can defend themselves".

In a phone call with reporters, including Sky News, he added: "We are doing all we can… we are watching closely…" and he said that President Biden is "being briefed multiple times a day. We will take seriously our commitment to the self-defence of Israel."

Mr Kirby said the US "deem[s] the threat to be real and viable and credible", adding that America is "making sure they [Israel] have what they need to defend themselves. It would be imprudent if we didn't take a look at our own posture in the region."

He would not address questions on whether America would use its own assets to shoot down any Iranian drones or missiles that could be fired towards Israel, either directly from Iran or by Iranian proxies in the region.

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• April 11, 2024

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