The
Physiology of Transport Substances in the Blood (Sodium) By Professor Marcel Uluitu, M.D. Ph.D. Co-Authored by Diana Popa (Uluitu), M.D. Department of Microbiolgy, Immunology
and Molecular Genetics [Editor’s Note: This paper is presented as Part I of a
series of chapters from the new book “The Physiology of Transport Substances in
the Blood (Sodium)”; subsequent chapters will be featured in upcoming issues of
this Journal. This segment features Chapter One (of six chapters) and Section 1
of Chapter Two] MOTTO: Preface: General mechanisms
regulating functions: Body unity,
control and coordination of its functions are achieved by means of nervous,
humoral and physico-chemical mechanisms. The humoral mechanism regulating the functions of the
body recognizes the transport of substances as a means by which it provides for
the needs of every tissue metabolic activity, synthesis of own substances,catabolites removal, etc. The humoral pathway is enabled as
a result of the analysis by the nervous system of the internal environment,
through feedback mechanisms, of the level of normal concentrations of
constituents of the body and their balance within the three spaces, including
nutriments, new compounds synthesized in some specific tissues, catabolites,
etc. Humoral pathway activation mechanisms depend on the role of these
substances in the economy of the body (composition, physico-chemical structure,
functional role, the energy structure of the body, etc.). The physico-chemical pathway includes the body
composition and the circulating and structural substances which interact by
means of trace energy and have significance in the processes of transport in
the blood. The physico-chemical route of regulation depends on the composition
and structural-functional lability of proteins. These substances are in
constant motion, ensuring a local and global uniformity. Transport of substances in plasma is in a state of
trace energy interaction ionic, electrostatic interactions, Van der Waals
forces, hydrogen bonds, Disorders in the substance transport mechanisms in the
blood generate a special pathology whose recognized causes are deficiencies
(anemia ,acidosis, etc.) ,genetic disorders (Wilson’s disease involving
Cu),endocrine diseases involving Ca ,abnormal excitability neuromuscular
disorder, behavioral-type constitutional disorders (involving the transport of
sodium).
The
General Structure of the Body. Transport
of Substances in the Blood. Sodium is a chemical element in Group I
of the periodic table. Very widespread in Nature, it is at the same time the
monovalent cation best represented in the blood. It is extensively studied in
both kingdoms because of its association with multiple processes. It is associated with metabolic and enzymatic
processes acting as cell activator. It is mainly involved in the cell membrane
functions. It is an extra cellular cation and is present more especially in
blood. In the excitable cells, the action potential is also identified under
the Name of sodium potential. It is an activator of the heart, in vitro. It has
an important role in the electrical manifestations of the excitable membranes
of cells; neurons, cell rods, excitoconductor cardiac tissue, etc. At the synapse level it acts in
conjunction with acetylcholine. A seriously low concentration of sodium is not
compatible with life. Sodium blood homeostasis is assured by a very complex
regulatory system starting with food intake and continuing with transport in
the blood, sodium distribution, and elimination by the kidney, the digestive
tract, the skin, etc. Such mechanisms are nervously and hormonally regulated
(adrenal cortical, natriuretic hormone), osmoregulatory mechanisms, mechanisms of cellular and molecular emergency. In case of
acute intake increased, sodium is retained temporarily in the connective
tissues, interstitial tissue and fatty tissue in order to maintain sodium
concentration. In the cell membranes, it works through
sodium ion channels interacting with the anionic sites of the proteins in their
structure. Thus, the information conveyed by the cation depends on the local
ion concentration and on the size of their ionic radii, varying according to the
number of hydrating water molecules. Its action can be antagonised in the ion
pore region of the Na channel, by neurotoxines. The regulation of sodium activity in
the blood depends on its interaction with proteins. Sodium chemical activity
determines the capacity of response of nervous structures by the generation of
an action potential. The fraction of chemically active sodium in the blood
highlights the role of physical and chemical interactions in the body.
Determination of total blood sodium with classical methods (physical, chemical,
etc.) after removal of macromolecular organic compounds has the same value as
the basic analysis of the composition of living organisms. It is a sort of
"Chemical anatomy." The physiological role of Na+ can be
established only by determining its chemically active form while maintaining
the full composition of plasma. There are multiple interactions among plasma
constituents. Despite the small energy values of such interactions, their
number is particularly important. The method for determining the chemical
activity of blood Na+ described in this monograph has as the
reference system the energy of interaction, E, between serotonin (5-hydroxitriptamin = 5HT) and the
polyanion heparin (Natural components of blood). If there is Na+ in
the solution, whose interaction with heparin is accomplished by energy EE, the interaction 5HT-heparin no longer takes place and 5HT
goes out of the dialysis pouch In the normal groups of both species
studied, there are subjects in which the chemical activity of cations (Na+
up to 95%) antagonizes the interaction between heparin and 5HT, the latter
leaving the dialysis pouch. Prof. Alexandre Monnier (biophysicist
at the Sorbonne) said that throughout his entire life he strongly believed that
Na+ is circulating in the blood in a state of interaction with
proteins, but he never had a method to prove it. The statement is repeated in a
letter presented in facsimile. Individuals in whom Na+
antagonizes the reaction heparin/5HT present with increased neuro-muscle hyper
excitability expressed in the form of behavior disorders of a constitutional
type in humans, state of alert on EEG, poor concentrated attention, good
distributive attention, disorders in the regulation of the cardiac-homodynamic
function, while rats are prone to audiogenic convulsions, hyper mobility in
open areas, exaggerated intake of Nail, mineral-corticoid function deficiency. The body can be divided into
interdependent compartments in point of transport mechanisms: INTRAVASCULARLY,
INTERSTITIAL ENDOCELULAR. This division suggests the existence of two major
types of transport of substances: transport of the substance within the same
space (blood, interstitial, intracellular) and another transport between the
three COMPARTMENTS, across separator walls consisting of semi permeable
membranes and epithelia. The intravascular space communicates through capillary
walls with the interstitial space and the latter with the endocellular space
through cell membranes. Transmembrane transport, well-studied in both living
and artificial membranes takes place under multiple influences: blood pressure,
osmotic pressure and colloid osmotic pressure, concentration gradients,
electrochemical gradients, etc. The term "space" includes
multiple interdependent structures, having close embryonic origin. The
embryonic origin of interdependence is preserved by the chemical composition
whose origin is the secretion of macromolecules in the cells of every
compartment. Macromolecules are secreted by vascular endothelial cells and by
other host tissues as well. Thus, a local, complex functional
structure is created. The structure acts in an integrated manner. This phenomenon
is known to organize and include the three spaces. In each of the three
anatomical structures the three spaces communicate among them. The chemical
composition of the compartments is maintained constant within the general
concepts of "internal medium" and "homeostasis". In this
context, the segment medium is maintained constant by the transport of
substances between the compartments. The substances in the three spaces have
oligoenergetic interaction. The complex connection between compartments is mediated
by semipermeable mentioned structures. The knowledge of the physical and
physico-chemical force enables a more precise understanding of the fundamental
state of structural elements and their functions. The following will deal with
transport processes, mainly in the blood, with particular focus on the
relationships between transport of Na+ in the blood and functional
status of the excitable and unexcitable structures. Chapter 2: The
Blood-Vascular Space
The
vascular tree is made up of the arteries, the capillaries and the veins. The
vascular wall (artery) is made up of three layers: the outer layer - tunica
adventitia, the second layer - tunica media, consisting of elastic and smooth
muscle fibers and, finally, tunica intima. Typically, the capillary wall is
made up of only a unicellular layer of endothelial cells which is surrounded by
a basement membrane on the outer side. At this level exchanges are taking place
between blood and the extra vascular space. It is an active physical and
chemical space separated by a cellular layer and an extra cellular layer having
a restrictive selective action for interstitial and blood components. For every
organ and tissue there are structural and functional features of the
capillaries that control the local exchanges. 2.2. Blood. Blood is
the circulating tissue that irrigates all body cells. It circulates in a closed
system at variable speed given by the activity of heart pump, the elasticity of
vessels and size variations in different parts of the tree. Blood is composed
of a cell system (red cell, white blood cells, platelets) associated with
respiratory functions, antimicrobial defense, haemostasis and a liquid
intercellular system where the cells are floating – the plasma. Between the
dissolved substances in the blood there are chemical, physical interactions
resulting in the particular distribution of such substances. One should note
leukocytes and platelets contain 5-60 times more amino acids than plasma and
erythrocytes. Serotonin is also virtually wholly carried on platelets (219,220) The blood tissue communicates with the
extra vascular interstitial space and through it with all body cells,
sustaining them and participating in the regulation of their function. In their
turn they affect the biochemical composition and physico-chemical properties of
the blood. This maintains the chemical and physiological homeostasis of the
inner medium within limits compatible with life. Blood plays a key role through
its circulating function as a transporter and participates alongside the
nervous system to maintaining, adjusting and adapting the body functions. The total volume of blood is 5.5 liters
in adults, of which 3.5 liters (55%) is represented by plasma, and 45% of
volume contains blood cells (haematocrit). The volume of blood varies with sex,
age. The haematocrit varies with physical effort, environment temperature,
altitude, age of pregnancy, etc. The color of blood is red, with shades
depending on its gas content and Nature: oxygen, carbon dioxide, carbon oxide-
accidentally. Density varies with gender (1061 in men and 1057 in women)
consistent with haematocrit values. Viscosity, the resistance against the flow
by friction with the neighboring areas of blood components and the vascular
wall has values of 4.7 to 4.4 in men and in women, respectively. 2.3. Blood plasma Plasma represents the liquid phase of
the blood. It is a transparent, slightly yellow solution wherein blood cells
are floating. It is a complex solution with heterogeneous composition of
inorganic and organic substances which are interacting among themselves, with
the solvent (water) and the vascular wall and their components. The solvent and
the compounds with low molecular weight are in balance with the substances of
the same kind in the extra vascular space. 2.3.1. Composition of plasma
2.3.2.1. Temperature Organs with intense metabolic activity
(permanently or occasionally) have intense thermo genesis and efferent blood
temperature is higher. This increase in temperature affects the stability of
plasma solution and therefore the physical properties of plasma. Blood
temperature is also variable (37.7 C - 40 C) in various organs, depending on
the intensity of the metabolic processes specific to their function (liver,
brain) or on functional requirements (muscles). 2.3.2.2. Density and viscosity. The lower density of plasma (1027) is
due to the protein. It is low in hypoproteinemia (hepatitis, nephropathy with
intense albuminuria, inanition, consumptive diseases). Viscosity is defined by 2.3.2.3. Osmotic pressure It is a colligative property (68)
representing the force that the particles of the solvite are exerting on the
vessel wall. The chemical composition of blood varies between certain limits in
different regions in point of concentration of protein, gas (O, CO, etc.) H,
various electrolytes, some catabolites resulting from the tissues activity, etc Another property of a colligative
solution depends on the concentration
of particles in the solution. This property is the "freezing point"
or "cryoscopy point."
Osmotic pressure varies with the
intensity of tissue metabolism. It is 6.7 atmospheres (matching cryoscopic
point is 0.560 C) and is given by the concentration of particulate
substances (dissociated plus non dissociated) in plasma: Na, K, Ca, glucose,
etc.. Under normal circumstances this is given, up to
90% by Na. Osmotic pressure is a condition for cell division in the processes
of excitability.
The plasma colloid osmotic pressure
(PCO) is produced, in addition to the substances mentioned by dissolved
proteins. They do not pass through the capillary membrane. Plasma protein
content is 2 -3 times higher than the interstitial content (7-8 gm vs. 2-3 gm).
The contribution of proteins to promote PCO is unequal as shown in Table 3.
At the level of capillaries, local forces are acting
that create a slight pressure imbalance according to Table. 4
The solubility of proteins depends on
their Nature and chemical structure, the solution pH, the degree of ionization,
the ionic composition of the environment (salt concentration and Nature of
salts), the dielectric constant of the environment, the ionic composition of
the environment, including the type of side groups of protein. The role of the
solvent: water is bound by polar interactions to the ionized groups and by the
hydrogen bond to the peptidic bond. Water binding is minimal at the izoelectric
pH of proteins. Electrolytes in low concentration favor
protein solubilisation and stabilize the solution. If the electric charges on
the protein molecules are neutralized by the addition of salts, proteins
precipitate by salefier (178). Electrolytes in high concentration destroy the
water interaction with the protein molecule and separate them. Non-electrolytes
may also dehydrate macromolecules through interaction with water and decrease
the solubility of proteins through a process of pseudo-hyper concentration. The ability of electrolytes to influence water
dissolving power follows Hofmeister's liotropic series. (52): The solubility of the proteins
increases in solutions with high a dielectric constant (52) and in the presence
of dipole ions. An important role is also played by the attraction and
repulsion forces existing on the surface of molecules in solution. In the two
segments, arterial and venous, there occur composition changes of water,
electrolytes, various other molecules that can cross the capillary wall as well
as a result of loading with catabolites and other products of local secretion.
Also at this level, there occur variations in the concentration of
macromolecules retained by the capillary wall, as, for example, the increase by
20% of the concentration of protein in
the blood during the formation of primary glomerular ultra filtrate. H-ions
concentration increases in venous plasma. 2.3.3.2. Physical factors of plasma stability. There are many physical conditions of stability. Among them one could list
Brownian motion, continuous flow of blood, rheology factors depending on the
type of blood flow in vessels, etc. The flow of a liquid through a closed
system of straight, cylindrical tubes is laminar. The liquid is moving in
parallel, immiscible layers alongside the vessel wall. Otherwise, the layers
are mixed, form whirling areas where plasma is shaken. In these areas the lumen
of the vessels is altered naturally (the valvular cardiovascular blood
pressure, fast-growing areas of vascular bed, and under conditions of temporary
exertion of some organs in the precapllary region), or in pathological
conditions. An important physical factor is represented by the large specific
surface of the solvite substances (relative to the surface, the particle size
with an average of 3.5 mμ of a gram of substance). The surface grows even
larger as a result of hydration (178). 2.3.4. Plasma functions (78, 136) are listed only: B) - the body's defense mechanism and the immune response.
The folding of the polypeptide chain is
conditioned by the amino acid composition and the distribution of polar and
unpolar groups (Table No. 11). They control the folding of protein molecules
(160124,15,16,17). Hydrophobic sites are accommodated
inside of the molecule thus avoiding contact with water and creating globulin
structures. Hydrophilic polar side chains are distributed on the external
surface where they can interact with water and other polar molecules. The
hydrogen bond is important in keeping together the various segments of the folding
molecule. The additional covalent bonds between the chains and
disulfuric bridges contribute to the stabilization of the three-dimensional
structure of the extra cellular proteins. Molecular specificity results from
the interactions between their various structural elements and the molecules in
their environment. They are based, in addition to covalent bonds, on hydrogen
bonds, phosphate bonds, saline bonds, etc.The distribution of various atoms on
the surface of the molecule, makes each protein unique and able to interact
with specific molecular and other surfaces and with some smaller molecules. Each protein has different segments that are repeated
in the macromolecule. The polypeptides, in the solution, take a unique spatial
arrangement as a result of noncovalent interactions in the protein so that its
energy could be minimal. Noncovalent bonds are established very quickly with no
catalysts and they are effective by aggregation. Inside the protein molecule
there is a dielectric environment which favors interactions, is associating to
reduce contact with water, forming a large number of contacts unpolar. 2.3.5.2. The structure of the protein. Inter-atom
measurements of distances and angular values connecting the amino acids in the
polypeptide chain established the following primary characteristic of
structure:
The residue of proline prevents the - spinning, and the chain is bent at an angle of 130. The residue glycocol (no side chain) confers fexibility
interrupts the structure , and changes slightly the chain direction. Other amino
acids: valine, isoleucine, treonine induce steric disturbances. Serine forms
hydrogen bonds at alcoholic group and prevents the helix stability. Cysteine
creates disulphur briges and a rigid polypeptide chain, hindering formation of
the helix. The - structure has the shape of a folded sheet. In this
structure the maximum of hydrogen bonds is achieved between CO and NH. The
hydrogen bonds are intercatenary and polypeptides are arranged in the shape of
sheets. The most stable configuration is the structure with antiparallel chains (chains are directed from the
"N" terminal to the C terminal and the other vice versa). Radicals "R" are arranged on alternating
sides of the polypeptide chain. Between sheets there are hydrogen bonds
connecting the "R" groups. Distances between the sheets are 5.7 and
3.5 Ǻ
alternatively. The structures are frequent in globular proteins, especially in immunoglobulins.
A simple - structure is formed of a polypeptide chain bent on itself, forming two antiparallel segments identified as the -tower. 2.3.5.2.3. Tertiary structure. This includes the secondary structures as spatial
units: domain and motifs. The packaging is noncovalent and by carbon
interactions between the radicals "R" at C of the structure, or unorganized. The bonds are determined as follows: (1)
hydrogen bonds between the OH groups of the amino acid residue tironyl,
tirosyl, with amide groups of glutamyl and asparaginyl (2) ionic bonds between
radicals with negative charge of lisinyl, arginyl, histidyl with and without
polar radical charge (3) hydrophilic interaction between the residue unpolar
amino acids valine, leucine, isoleucine, alanine, phenylalanine (4) links
between the cysteine residue distant covalent regions of the molecule. A polypeptide chain adopts the configurations and until it satisfies all
the affinity of radicals "R" under steric conditions influences when
the final conformation results, the best possible compromise of stable energy
and space. Therefore, the decisive factor to obtain the tertiary conformation
given is again its genetically induced primary structure whose primary
spontaneous structure depends on the chemical composition. The plasma globular
proteins have on polar groups on their surface. The unpolar radicals are
included within the protein molecule. The organization of the "domains" is a
structural intermediate form between the secondary and tertiary structures.
Because of this, it is identified as "secondary superstructure" or
"superstructure domain." Domain "is a continuous piece of the
primary structure of polypeptide chain, packed up as a functional entity with
its own secondary and tertiary structure. The "domains" are part of
the less organized part of the chain, allowing flexible dynamic segments of
their field. "Domains" are packagings of -helix and - sheet, forming globular compact units. It contains a number
of 50 - 350 amino acid residues. Protein may be constituted in a domain or more
connected with each other through long chains of open polypeptides. Through
these connections large molecules are formed, identified as “protein ensembles”
or “protein complexes” in which the subunits are linked with a large number of
noncovalent bonds. In the extra cellular environment they are often stabilized
by disulphur bridges. So a "domain" of protein appears as a basic
core of a protein which is composed mainly of a - sheet,-helix or both. These structures allow long hydrogen bonds
that stabilize the inside of the molecule where water has no access to form
hydrogen bonds with the oxygen or polar carbon with the hydrogen of peptide
bond. Proteins can be formed through recombination of pre-existing polypeptides
"domains" with supramolecular structures of complex type enzyme,
protein filaments, membranes, etc. Domains are the underlying structure of
proteins diversification. They are the basis of "analogous" proteins
(different proteins with similar functions) and of "homologous"
proteins (similar proteins with different functions). 2.3.5.2.4. Quaternary structure. The assembling of the protomers to oligomers is
accomplished only when the contact areas are complementary and have a large number
of atoms, and the bonds are close to the level where the Van der Waals are
active. The protomers of homologue proteins of different species do not
associate although they contain the information to be decoded. The interaction
capacity explains the formation of supramolecular structures. Perturbation of a
protomer annihilates the oligomer function. 2.3.5.3. Electric charge of proteins. (a) in an alkaline environment H+ is
released, so it acts as an acid (see also acid-basic equilibrium): In both cases a reaction of neutralization is
described, with formation of salts: Na-protein ate, in the first case (178, 68),
protein clorhydrate (macrocation) in the second case.
Electrophoresis in a liquid phase
(Moving boundary electrophoresis Tselios). It was used by us as well for research activity. It requires a
Tisselius apparatus. It is using 1 -2 ml of blood serum that is diluted with 2
ml.buffer Michaelis-Wideman, pH = 7, 4, ionic strength = 0.118. First, it is
dialyzed in buffer at 40 C for three hours. Dialysis continues for a
second time for another hour after changing the buffer. Direct current of 150
volts is used. Two photographic exposures of the two branches of the
device are performed, upward and downward, after 45 min. and 75 min. migration.
One calculates the mobility (fig. 1) of the fractions obtained, with the
equation: Figure 1.Electrophoretic mobility (=cm/V)of three plasma protein fractions
of normal children and children with behavioral constitutioNal disorders and
transport of Na in the ionic state. (230)
Different proteins have different ways to change the
variations of pH. The adsorbents can be very different, and eluents infinitely
increase the technical possibilities. Ion exchange resins (Dowex 1 and Dowex
50) have ion charges on the surface of the calcium phosphate gel type. The
cellulose ion exchange has ionizing groups with affinity for many proteins. The
covalent bonds allow cellulose stability ionizing groups. An example of the
group is DEAE cellulose and carboxymethyl cellulose, an ion exchanger for basic
proteins. Phosphorilate cellulose (P cellulose) and sulfoethyl cellulose
(SE-cellulose) are cationic exchangers with stronger acidic groups that retain
the negative charges to very low pH. Other derivatives are guanetidil cellulose
(G-cellulose) for very high pH, triethylaminocellulose anionic exchanger, sefadex is an ion exchanger with cross-links.
Chromatography with molecular sieve or gel filtration uses sefadex, gel of
granulated polyacrilamid, agar and agarose. So this is a way of sifting
molecules by size, along with electrochemical separation. The more sensitive
methods used for detecting and dosing are the radioimmunologic (RIA) and the
immunoenzymologic ones (ELISA).
2.3.5.7. Classification of plasma proteins 2.3.5.7.1 Electrophoresis classification.
Table 6 the percentage content of prostetic groups in
certain plasma proteins (132)
One notes the better expressed transporter role of
proteins with sugars as a dominant group, the transport of lipids belonging
more especially to lipoproteins. [The remainder of Chapter Two will be
featured in the upcoming September-October issue of this Journal.] Professor Marcel Uluitu, M.D. Ph.D. began his
scientific activity in Physiology in 1953 at the Professor Uluitu has also investigated
cerebral tissue excitability, studying the structure modification of the
protein macromolecules, and the physiological and pathopysiological processes
in which are involved Sodium and Lithium. He implemented an original method for
physical and chemical processes which involve the chemic active sodium, in
normal processes and in the cerebral excitability dysfunctions, in human and in
experimental model (animal). These results of this work gave him the chance to
outline the chapter herein relating to the physiology of substances transport
in the blood. This is based on the physical and chemical interaction between
blood components. His papers are included in the
collections of the U.S. National Library of Medicine and the U.S. National
Institute of Health. He is a member of the Dr. Diana Popa (Uluitu) is a
researcher in the Department of Microbiolgy, Immunology and Molecular Genetics
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