'Red blood cells' are the most common type of
blood cell and the
vertebrate body's principal means of delivering
oxygen from the
lungs or
gills to body tissues via the
blood.
Red blood cells are also known as 'RBCs', 'haematids', or 'erythrocytes' (from
Greek ''erythros'' for "red" and ''kytos'' for "hollow", with ''cyte'' nowadays translated as "cell"). A 'schistocyte' is a red blood cell undergoing fragmentation, or a fragmented part of a red blood cell.
Vertebrate erythrocytes
Erythrocytes consist mainly of
hemoglobin, a complex
molecule containing
heme groups whose
iron atoms temporarily link to oxygen molecules in the lungs or gills and release them throughout the body. Oxygen can easily
diffuse through the red blood cell's
cell membrane. Hemoglobin also carries some of the waste product
carbon dioxide back from the tissues. (In humans, less than 2% of the total oxygen, and most of the carbon dioxide, is held in solution in the
blood plasma). A related compound,
myoglobin, acts to store oxygen in
muscle cells.
The color of erythrocytes is due to the heme group of hemoglobin. The
blood plasma alone is straw-colored, but the red blood cells change color depending on the state of the hemoglobin: when combined with oxygen the resulting oxyhemoglobin is scarlet, and when oxygen has been released the resulting deoxyhemoglobin is darker, appearing bluish through the human skin because of the biochromes of human skin.
Pulse oximetry takes advantage of this color change to directly measure the
arterial blood
oxygen saturation using
colorimetric techniques.
The sequestration of oxygen-carrying proteins inside cells (rather than having them dissolved in body fluid) was an important step in the
evolution of
vertebrates; it allows for less
viscous blood and higher concentrations of oxygen.
Mammalian erythrocytes
Erythrocytes in
mammals are ''anucleate'' when mature, meaning that they lack a
cell nucleus and thus have no
DNA. In comparison, the erythrocytes of nearly all other
vertebrates have nuclei; the only known exception is
salamanders of the ''
Batrachoseps'' genus.
[1]} Mammalian erythrocytes also lose their other
organelles including their
mitochondria and produce energy by
fermentation, via
glycolysis of
glucose followed by
lactic acid production. Furthermore, red cells do not have an
insulin receptor and thus glucose uptake is not regulated by
insulin.
As a result of the lack of nucleus and organelles, the cells cannot produce new structural or repair proteins or
enzymes and their lifespan is limited.
Mammalian erythrocytes are
biconcave disks: flattened and depressed in the center, with a dumbbell-shaped cross section. This shape (as well as the loss of organelles and nucleus) optimizes the cell for the exchange of oxygen with its surroundings. The cells are flexible so as to fit through tiny
capillaries, where they release their oxygen load. Erythrocytes are circular, except in the
camel family
Camelidae, where they are oval.
In large blood vessels, red blood cells sometimes occur as a stack, flat side next to flat side. This is known as ''rouleaux formation'', and it occurs more often if the levels of certain serum proteins are elevated, as for instance during
inflammation.
The
spleen acts as a reservoir of red blood cells, but this effect is somewhat limited in humans. In some other mammals such as
dogs and
horses, the spleen sequesters large numbers of red blood cells which are dumped into the blood during times of exertion stress, yielding a higher oxygen transport capacity.

Erythrocytes: (a) seen from surface; (b) in profile, forming rouleaux; (c) rendered spherical by water; (d) rendered crenate by salt. (c) and (d) do not normally occur in the body.
Human erythrocytes
The diameter of a typical human erythrocyte disk is
6–8 µm, much smaller than most other
human cells. A typical erythrocyte contains about 270 million hemoglobin molecules, with each carrying four heme groups.
Adult humans have roughly
2–3 × 1013 red blood cells at any given time (women have about 4 to 5 million erythrocytes per
microliter (cubic millimeter) of blood and men about 5 to 6 million; people living at high altitudes with low oxygen tension will have more). Red blood cells are thus much more common than the other blood particles: There are about 4,000–11,000
white blood cells and about 150,000–400,000
platelets in each microliter of human blood. The red blood cells store collectively about 3.5 grams of
iron, more than five times the iron stored by all the other tissues combined.
Life cycle
The process by which red blood cells are produced is called
erythropoiesis. Erythrocytes are continuously being produced in the red
bone marrow of large bones, at a rate of about 2 million per second. (In the
embryo, the
liver is the main site of red blood cell production.) The production can be stimulated by the
hormone erythropoietin (EPO), synthesised by the kidney; which is used for
doping in sports. Just before and after leaving the bone marrow, they are known as
reticulocytes which comprise about 1% of circulating red blood cells. Erythrocytes develop from committed stem cells through reticulocytes to mature erythrocytes in about 7 days and live a total of about 120 days. The erythrocyte undergoes changes in its plasma membrane making it susceptible to recognition and subsequent phagocytosis in the spleen, liver and bone marrow. Much of the important breakdown products are recirculated in the body. The heme constituent of hemoglobin are broken down into Fe3+ and biliverdin. The biliverdin is reduced to bilirubin, which is released into the plasma and recirculated to the liver bound to albumin. The iron is released into the plasma to be recirculated by a carrier protein called transferrin. Almost all old erythrocytes are removed from the circulation before they are old enough to hemolyze. Hemolyzed hemoglobin is bound to a protein in plasma called haptoglobin which is not excreted by the kidney.
Surface proteins
There are two main types of
proteins on the surface:
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Band 3
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Glycophorins such as
glycophorin C
The
blood types of humans are due to variations in surface
glycoproteins of erythrocytes.
Separation and blood doping
Red blood cells can be separated from
blood plasma by
centrifugation. During
plasma donation, the red blood cells are pumped back into the body right away, and the plasma is collected. Some athletes have tried to improve their performance by
blood doping: first about 1 litre of their blood is extracted, then the red blood cells are isolated, frozen and stored, to be reinjected shortly before the competition. (Red blood cells can be conserved for 5 weeks at −79 °C.) This practice is hard to detect but may endanger the human
cardiovascular system which is not equipped to deal with blood of the resulting higher
viscosity.
Diseases and diagnostic tools

Affected by
Sickle-cell disease, red blood cells alter shape and threaten to damage internal organs.
Blood diseases involving the red blood cells include:
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Anemias (or anaemias) are diseases characterized by low oxygen transport capacity of the blood, because of low red cell count or some abnormality of the red blood cells or the hemoglobin.
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Iron deficiency anemia is the most common anemia; it occurs when the dietary intake or absorption of
iron is insufficient, and hemoglobin, which contains iron, cannot be formed
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★
Sickle-cell disease is a genetic disease that results in abnormal hemoglobin molecules. When these release their oxygen load in the tissues, they become insoluble, leading to mis-shaped red blood cells. These sickle shaped red cells are rigid and cause blood vessel blockage, pain, strokes, and other tissue damage.
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Thalassemia is a genetic disease that results in the production of an abnormal ratio of hemoglobin subunits.
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Spherocytosis is a genetic disease that causes a defect in the red blood cell's
cytoskeleton, causing the red blood cells to be small, sphere-shaped, and fragile instead of donut-shaped and flexible.
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Pernicious anemia is an
autoimmune disease wherein the body lacks
intrinsic factor, required to absorb
vitamin B12 from food. Vitamin B12 is needed for the production of hemoglobin.
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Aplastic anemia is caused by the inability of the
bone marrow to produce blood cells.
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Pure red cell aplasia is caused by the inability of the bone marrow to produce only red blood cells.
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Hemolysis is the general term for excessive breakdown of red blood cells. It can have several causes.
★ The
malaria parasite spends part of its life-cycle in red blood cells, feeds on their hemoglobin and then breaks them apart, causing fever. Both
sickle-cell disease and
thalassemia are more common in malaria areas, because these mutations convey some protection against the parasite.
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Polycythemias (or erythrocytoses) are diseases characterized by a surplus of red blood cells. The increased viscosity of the blood can cause a number of symptoms.
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★ In
polycythemia vera the increased number of red blood cells results from an abnormality in the bone marrow.
★ Several
microangiopathic diseases, including
disseminated intravascular coagulation and
thrombotic microangiopathies, present with
pathognomonic (diagnostic) RBC fragments called schistocytes. These pathologies generate
fibrin strands that sever RBCs as they try to move past a
thrombus.
Several
blood tests involve red blood cells, including the ''RBC count'' (the number of red blood cells per volume of blood) and the
hematocrit (percentage of blood volume occupied by red blood cells). The
blood type needs to be determined to prepare for a
blood transfusion or an
organ transplantation.
History
In
1658, the
Dutch biologist
Jan Swammerdam was the first to describe red blood cells. He had used an early
microscope.
References
1. W. D. Cohen. The cytomorphic system of anucleate non-mammalian erythrocytes. ''Protoplasma'', vol 113 no 1, February 1982
External links
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''Blood Groups and Red Cell Antigens'' by Laura Dean. Searchable and downloadable online textbook in the public domain.
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Database of vertebrate erythrocyte sizes.