Hemoglobin: Ahmad Sh. Silmi MSC Haematology, FIBMS
Hemoglobin: Ahmad Sh. Silmi MSC Haematology, FIBMS
Concentration of 2,3-DPG
H+ ion concentration (pH)
CO2 in red blood cells
Structure of Hb
Hb-oxygen dissociation curve
Right shift (easy oxygen delivery)
High 2,3-DPG
High H+
High CO2
HbS
2. H2CO3 H+ + HCO3
(CO2)
• Carbon dioxide diffuses freely into the red cell where the
presence of the enzyme carbonic anhydrase facilitates
reaction 1.
• The H+ liberated in reaction 2 is accepted by deoxygenated
hemoglobin, a process facilitated by the Bohr effect.
• The bicarbonate formed in this sequence of reactions diffuses
freely across the red cell membrane and a portion is
exchanged with plasma Cl-, a phenomenon called the
"chloride shift." the bicarbonate is carried in plasma to the
lungs where ventilation keeps the pCO2 low, resulting in
reversal of the above reactions and excretion of CO2 in the
expired air.
• About 70% of tissue carbon dioxide is processed in this way.
Of the remaining 30%, 5% is carried in simple solution and
25% is bound to the N-terminal amino groups of
deoxygenated hemoglobin, forming carbaminohemoglobin.
Methemoglobinemia
• In order to bind oxygen reversibly, the iron in the
heme moiety of hemoglobin must be maintained
in the reduced (ferrous) state despite exposure
to a variety of endogenous and exogenous
oxidizing agents.