Special Education

HEMOPOIETIC FACTORS AND BLOOD CELL PROLIFERATION AND DIFFERENTIATION: Blood cells are generally classified into three cell lineages: erythrocytes, granulocytes and megakaryocytes. In the bone marrow, pluripotent stem cells differentiate into either the lymphoid stem cell line, where they are further induced to differentiate into B- or T-derived lymphocytes, or the myeloid stem cell (CFU-GEMM) line, where they are further induced to become erythrocytes, granulocytes (neutrophils, eosinophils or basophils), macrophages or megakaryocytes (platelets). Proliferation and differentiation of blood cells in the bone marrow are regulated by hemopoietic factors. Hemopoietic factors include those that are continuously produced, such as EPO, G-CSF and thrombopoietin (TPO), and those that are produced on demand in response to inflammation and infection, such as IL-3, IL-11 and GM-CSF. In recent years the genes for hemopoietic factors which regulate erythrocytes and granulocytes have been cloned using the techniques of genetic engineering. In 1994 the gene for TPO was cloned. TPO acts specifically on megakaryocytes. PROLIFERATION AND DIFFERENTIATION OF ERYTHROCYTIC CELLS: The earliest cells destined to become erythrocytes which differentiate from the myeloid stem cells (CFU-GEMM) are early phase erythroblast progenitor cells called BFU-E cells. After the BFU-E cells have undergone several divisions, they differentiate into late phase erythroblast progenitor cells called CFU-E cells. After passing through the proerythroblast stage, the CFU-E cells become erythroblasts. Erythroblasts can be confirmed by light microscope as belonging to the erythroid cell line. Erythroblasts mature and become enucleated reticulocytes, which are then released from the bone marrow into the blood, thus becoming mature erythrocytes. Proliferation and differentiation of the erythroid progenitor cells are regulated by erythropoietin (EPO), which is primarily produced by the kidneys. In 1985 genomic DNA and cDNA for human EPO were cloned, and it was learned that the mature protein is a glycoprotein consisting of 165 amino acids and having a molecular weight of about 30,000. There is powerful evidence to suggest that EPO is produced by peritubular cells of the renal cortex. When the hematocrit drops for some reason and hypoxia occurs, the number of EPO-producing cells increases and EPO production rises in the kidneys. CFU-E cells are the main target cells for EPO. EPO receptors are expressed along