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Jai Ganesh

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Blood Plasma

Blood Plasma

Gist

Plasma is the liquid portion of blood. About 55% of our blood is plasma, and the remaining 45% are red blood cells, white blood cells and platelets that are suspended in the plasma. Plasma is about 92% water.

Plasma carries water, salts, and enzymes. The main role of plasma is to take nutrients, hormones, and proteins to the parts of the body that need it. Cells also put their waste products into the plasma. The plasma then helps remove this waste from the body.

Summary

Plasma, the liquid portion of blood. Plasma serves as a transport medium for delivering nutrients to the cells of the various organs of the body and for transporting waste products derived from cellular metabolism to the kidneys, liver, and lungs for excretion. It is also a transport system for blood cells, and it plays a critical role in maintaining normal blood pressure. Plasma helps to distribute heat throughout the body and to maintain homeostasis, or biological stability, including acid-base balance in the blood and body.

Blood is made up of multiple components, including red blood cells, white blood cells, platelets, and plasma.

Plasma is derived when all the blood cells—red blood cells (erythrocytes), white blood cells (leukocytes), and platelets (thrombocytes)—are separated from whole blood. The remaining straw-coloured fluid is 90–92 percent water, but it contains critical solutes necessary for sustaining health and life. Important constituents include electrolytes such as sodium, potassium, chloride, bicarbonate, magnesium, and calcium. In addition, there are trace amounts of other substances, including amino acids, vitamins, organic acids, pigments, and enzymes. Hormones such as insulin, corticosteroids, and thyroxine are secreted into the blood by the endocrine system. Plasma concentrations of hormones must be carefully regulated for good health. Nitrogenous wastes (e.g., urea and creatinine) transported to the kidney for excretion increase markedly with renal failure.

Plasma contains 6–8 percent proteins. One critical group is the coagulation proteins and their inhibitors, synthesized primarily in the liver. When blood clotting is activated, fibrinogen circulating in the blood is converted to fibrin, which in turn helps to form a stable blood clot at the site of vascular disruption. Coagulation inhibitor proteins help to prevent abnormal coagulation (hypercoagulability) and to resolve clots after they are formed. When plasma is allowed to clot, fibrinogen converts to fibrin, trapping the cellular elements of blood. The resulting liquid, devoid of cells and fibrinogen, is called serum. Biochemical testing of plasma and serum is an important part of modern clinical diagnosis and treatment monitoring. High or low concentrations of glucose in the plasma or serum help to confirm serious disorders such as diabetes mellitus and hypoglycemia. Substances secreted into the plasma by cancers may indicate an occult malignancy; for instance, an increased concentration of prostate-specific antigen (PSA) in a middle-aged asymptomatic man may indicate undiagnosed prostate cancer.

Serum albumin, another protein synthesized by the liver, constitutes approximately 60 percent of all of the plasma proteins. It is very important in maintaining osmotic pressure in the blood vessels; it is also an important carrier protein for a number of substances, including hormones. Other proteins called alpha and beta globulins transport lipids such as cholesterol as well as steroid hormones, sugar, and iron.

The gamma globulins, or immunoglobulins, are an important class of proteins that are secreted by B lymphocytes of the immune system. They include most of the body’s supply of protective antibodies produced in response to specific viral or bacterial antigens. Cytokines are proteins synthesized by cells of various organs and by cells found in the immune system and bone marrow in order to maintain normal blood cell formation (hematopoiesis) and regulate inflammation. For example, one cytokine called erythropoietin, synthesized by specialized kidney cells, stimulates bone marrow blood progenitor cells to produce red blood cells. Other cytokines stimulate the production of white blood cells and platelets. Another protein system in the plasma, called complement, is important in mediating appropriate immune and inflammatory responses to a variety of infectious agents.

The electrolytes and acid-base system found in the plasma are finely regulated. For example, potassium is normally present in plasma in a concentration of only 4 milliequivalents per litre. A slight rise in plasma potassium (to 6–7 milliequivalents per litre) can result in death. Likewise, sodium, chloride, bicarbonate, calcium, and magnesium levels in the plasma must be precisely maintained within a narrow range. Smaller molecules such as sodium, potassium, glucose, and calcium are primarily responsible for the concentration of dissolved particles in the plasma. However, it is the concentration of much larger proteins (especially albumin) on either side of semipermeable membranes such as the endothelial cells lining the capillaries that creates crucial pressure gradients necessary to maintain the correct amount of water within the intravascular compartment and, therefore, to regulate the volume of circulating blood. So, for example, patients who have kidney dysfunction or low plasma protein concentrations (especially low albumin) may develop a migration of water from the vascular space into the tissue spaces, causing edema (swelling) and congestion in the extremities and vital organs, including the lungs.

Details

Blood plasma is a light amber-colored liquid component of blood in which blood cells are absent, but which contains proteins and other constituents of whole blood in suspension. It makes up about 55% of the body's total blood volume. It is the intravascular part of extracellular fluid (all body fluid outside cells). It is mostly water (up to 95% by volume), and contains important dissolved proteins (6–8%; e.g., serum albumins, globulins, and fibrinogen), glucose, clotting factors, electrolytes,  hormones, carbon dioxide (plasma being the main medium for excretory product transportation), and oxygen. It plays a vital role in an intravascular osmotic effect that keeps electrolyte concentration balanced and protects the body from infection and other blood-related disorders.

Blood plasma is separated from the blood by blood fractionation containing an anticoagulant in a centrifuge until the blood cells fall to the bottom of the tube. The blood plasma is then poured or drawn off. For point-of-care testing applications, plasma can be extracted from whole blood via filtration or via agglutination to allow for rapid testing of specific biomarkers. Blood plasma has a density of approximately 1,025 kg/m^3 (1.025 g/ml). Blood serum is blood plasma without clotting factors. Plasmapheresis is a medical therapy that involves blood plasma extraction, treatment, and reintegration.

Fresh frozen plasma is on the WHO Model List of Essential Medicines, the most important medications needed in a basic health system. It is of critical importance in the treatment of many types of trauma which result in blood loss, and is therefore kept stocked universally in all medical facilities capable of treating trauma (e.g., trauma centers, hospitals, and ambulances) or that pose a risk of patient blood loss such as surgical suite facilities.

Volume

Blood plasma volume may be expanded by or drained to extravascular fluid when there are changes in Starling forces across capillary walls. For example, when blood pressure drops in circulatory shock, Starling forces drive fluid into the interstitium, causing third spacing.

Standing still for a prolonged period will cause an increase in transcapillary hydrostatic pressure. As a result, approximately 12% of blood plasma volume will cross into the extravascular compartment. This plasma shift causes an increase in hematocrit, serum total protein, blood viscosity and, as a result of increased concentration of coagulation factors, it causes orthostatic hypercoagulability.

Plasma proteins:

Albumins

Serum albumins are the most common plasma proteins, and they are responsible for maintaining the osmotic pressure of the blood. Without albumins, the consistency of blood would be closer to that of water. The increased viscosity of blood prevents fluid from entering the bloodstream from outside the capillaries. Albumins are produced in the liver, assuming the absence of a hepatocellular deficiency.

Globulins

The second most common type of protein in the blood plasma are globulins. Important globulins include immunoglobins which are important for the immune system and transport hormones and other compounds around the body. There are three main types of globulins. Alpha-1 and Alpha-2 globulins are formed in the liver and play an important role in mineral transport and the inhibition of blood coagulation. An example of beta globulin found in blood plasma includes low-density lipoproteins (LDL) which are responsible for transporting fat to the cells for steroid and membrane synthesis. Gamma globulin, better known as immunoglobulins, are produced by plasma B cells, and provides the human body with a defense system against invading pathogens and other immune diseases.

Fibrinogen

Fibrinogen proteins make up most of the remaining proteins in the blood. Fibrinogens are responsible for clotting blood to help prevent blood loss.

Color

Plasma is normally yellow due to bilirubin, carotenoids, hemoglobin, and transferrin. In abnormal cases, plasma can have varying shades of orange, green, or brown. The green color can be due to ceruloplasmin or sulfhemoglobin. The latter may form due to medicines that are able to form sulfonamides once ingested. A dark brown or reddish color can appear due to hemolysis, in which methemoglobin is released from broken blood cells. Plasma is normally relatively transparent, but sometimes it can be opaque. Opaqueness is typically due to elevated content of lipids like cholesterol and triglycerides.

Plasma donation

Plasma as a blood product prepared from blood donations is used in blood transfusions, typically as fresh frozen plasma (FFP) or Plasma Frozen within 24 hours after phlebotomy (PF24). When donating whole blood or packed red blood cell (PRBC) transfusions, O- is the most desirable and is considered a "universal donor," since it has neither A nor B antigens and can be safely transfused to most recipients. Type AB+ is the "universal recipient" type for PRBC donations. However, for plasma the situation is somewhat reversed. Blood donation centers will sometimes collect only plasma from AB donors through apheresis, as their plasma does not contain the antibodies that may cross react with recipient antigens. As such, AB is often considered the "universal donor" for plasma. Special programs exist just to cater to the male AB plasma donor, because of concerns about transfusion related acute lung injury (TRALI) and female donors who may have higher leukocyte antibodies. However, some studies show an increased risk of TRALI despite increased leukocyte antibodies in women who have been pregnant.

Synthetic blood plasma

Simulated body fluid (SBF) is a solution having a similar ion concentration to that of human blood plasma. SBF is normally used for the surface modification of metallic implants, and more recently in gene delivery application.

Additional Information

Blood plasma is the yellow liquid part of blood. In normal blood, the blood cells are suspended in the plasma.

Plasma makes up about 55% of the total blood volume. It is mostly water (90% by volume) and contains dissolved proteins, glucose, clotting factors, mineral ions, hormones and carbon dioxide. Plasma is the transport medium for excretion.

In hospitals, blood plasma is extracted to either for medical therapy (plasmapheresis) or diagnostics tests (clinical chemistry, immunology,…) : an anti-coagulant stops the blood clotting. Then tubes of blood are spun very fast in a centrifuge. The blood cells go to the bottom of the tubes. The plasma is poured into another container.

Blood serum is blood plasma without fibrinogen or the other clotting factors (that is, whole blood minus both the cells and the clotting factors).

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