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Erythrocytes, red blood cells (RBC), are the functional components of blood responsible for transporting gases and nutrients throughout the human body. Their unique shape and composition allow for these specialized cells to carry out their essential functions. The role of the erythrocyte is critical in investigating many disease processes in a variety of body systems. Their structure, function, physiology, preparation, microscopy, and clinical importance are the subject of this review article.
Erythrocytes are very sensitive to their surroundings, changing shape and reacting to their environment. In an ideal situation, the erythrocyte exists as a biconcave disc. When exposed to certain chemicals or compounds, the cell morphs in response. It has been proposed that this happens under two conditions: when the environment changes the phospholipid bilayer of the erythrocyte or when exposed to oxidants in the environment. For example, when red blood cells are depleted of their energy source, adenosine triphosphate (ATP), or when there is increased intracellular calcium, the cell develops an echinocyte shape. Also, when an erythrocyte swells with water, it becomes a stomatocyte. These changes occur because of how these situations manipulate the lipid bilayer membrane. Additionally, the red blood cell has an efficient way to convert hydrogen peroxide to water to prevent its protein degradation and lipid peroxidation abilities. In certain inherited conditions, the red blood cell is void of the enzymes needed to carry out this function and, therefore, suffers from the oxidative stress of its environment. This situation could lead to the formation of Heinz bodies or denatured hemoglobin, such as in patients with glucose-6-phosphate dehydrogenase deficiency. Other oxidative changes to the red blood cell occur in blood bank storage. There are reports that the ability of spectrin to bind actin with protein 4.1 during red blood cell storage decreases due to oxidative changes and loss of phospholipids in the in vitro environment.[1]