Bone Marrow - Wikipedia, The Free Encyclopedia

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Bone marrowFrom Wikipedia, the free encyclopedia



Bone marrow

A simplified illustration of cells in bone marrowDetails

Latin Medulla ossium

Identifiers

MeSH D001853 (https://www.nlm.nih.gov/cgi/mesh/2011/MB_cgi?mode=&term=Bone+Marrow)

TA A13.1.01.001(http://www.unifr.ch/ifaa/Public/EntryPage/TA98%20Tree/Entity%20TA98%20EN/13.1.01.001%20Entity%20TA98%20EN.htm)

FMA 9608 (http://fme.biostr.washington.edu/FME/index.jsp?fmaid=9608)Anatomical terminology

Bone marrow is the flexible tissue in the interior of bones. In humans, red blood cells are produced by cores of bone marrowin the heads of long bones in a process known as hematopoiesis. On average, bone marrow constitutes 4% of the total bodymass of humans in an adult weighing 65 kilograms (143lb), bone marrow typically accounts for approximately 2.6 kilograms(5.7lb). The hematopoietic component of bone marrow produces approximately 500 billion blood cells per day, which use thebone marrow vasculature as a conduit to the body's systemic circulation.[1] Bone marrow is also a key component of thelymphatic system, producing the lymphocytes that support the body's immune system.[2]

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Bone marrow transplants can be conducted to treat severe diseases of the bone marrow, including certain forms of cancersuch as leukemia. Additionally, bone marrow stem cells have been successfully transformed into functional neural cells,[3] andcan also potentially be used to treat illnesses such as inflammatory bowel disease.[4]

Contents

1 Structure1.1 Types1.2 Stroma1.3 Cellular components

2 Function2.1 Mesenchymal stem cells2.2 Bone marrow barrier2.3 Lymphatic role2.4 Compartmentalization

3 Society and culture4 Clinical significance

4.1 Disease4.2 Examination4.3 Donation and transplantation

4.3.1 Harvesting

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A femoral head with a cortexof cortical bone and medulla oftrabecular bone. Both red bonemarrow and a central focus ofyellow bone marrow are visible.

5 Fossil record6 See also7 References8 Further reading

Structure

Types

The two types of bone marrow are "red marrow" (Latin: medulla ossium rubra), which consistsmainly of hematopoietic tissue, and "yellow marrow" (Latin: medulla ossium flava), which ismainly made up of fat cells. Red blood cells, platelets, and most white blood cells arise in redmarrow. Both types of bone marrow contain numerous blood vessels and capillaries. At birth,all bone marrow is red. With age, more and more of it is converted to the yellow type onlyaround half of adult bone marrow is red. Red marrow is found mainly in the flat bones, such asthe pelvis, sternum, cranium, ribs, vertebrae and scapulae, and in the cancellous ("spongy")material at the epiphyseal ends of long bones such as the femur and humerus. Yellow marrowis found in the medullary cavity, the hollow interior of the middle portion of long bones. Incases of severe blood loss, the body can convert yellow marrow back to red marrow toincrease blood cell production.

Stroma

The stroma of the bone marrow is all tissue not directly involved in the marrow's primary function of hematopoiesis. Yellow

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The stroma of the bone marrow is all tissue not directly involved in the marrow's primary function of hematopoiesis. Yellowbone marrow makes up the majority of bone marrow stroma, in addition to smaller concentrations of stromal cells located inthe red bone marrow. Though not as active as parenchymal red marrow, stroma is indirectly involved in hematopoiesis, since itprovides the hematopoietic microenvironment that facilitates hematopoiesis by the parenchymal cells. For instance, theygenerate colony stimulating factors, which have a significant effect on hematopoiesis. Cell types that constitute the bonemarrow stroma include:

fibroblasts (reticular connective tissue)macrophages, which contribute especially to red blood cell production, as they deliver iron for hemoglobin production.adipocytesosteoblastsosteoclastsendothelial cells, which form the sinusoids. These derive from endothelial stem cells, which are also present in the bonemarrow.[5]

Cellular components

Cellular constitution of the red bone marrow parenchyma[6]

Group Cell type AveragefractionReference

range

Myeloblasts 0.9% 0.2-1.5

Promyelocytes 3.3% 2.1-4.1

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Hematopoietic precursorcells: promyelocyte in thecenter, twometamyelocytes next to itand band cells from a bonemarrow aspirate.

Myelopoieticcells

Neutrophilic myelocytes 12.7% 8.2-15.7

Eosinophilic myelocytes 0.8% 0.2-1.3

Neutrophilic metamyelocytes 15.9% 9.6-24.6

Eosinophilic metamyelocytes 1.2% 0.4-2.2

Neutrophilic band cells 12.4% 9.5-15.3

Eosinophilic band cells 0.9% 0.2-2.4

Segmented neutrophils 7.4% 6.0-12.0

Segmented eosinophils 0.5% 0.0-1.3

Segmented basophils and mast cells 0.1% 0.0-0.2

Erythropoieticcells

Pronormoblasts 0.6% 0.2-1.3

Basophilic normoblasts 1.4% 0.5-2.4

Polychromatic normoblasts 21.6% 17.9-29.2

Orthochromatic normoblast 2.0% 0.4-4.6

Other celltypes

Megakaryocytes < 0.1% 0.0-0.4

Plasma cells 1.3% 0.4-3.9

Reticular cells 0.3% 0.0-0.9

Lymphocytes 16.2% 11.1-23.2

Monocytes 0.3% 0.0-0.8

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In addition, the bone marrow contains hematopoietic stem cells, which give rise to the three classes of blood cells that arefound in the circulation: white blood cells (leukocytes), red blood cells (erythrocytes), and platelets (thrombocytes).[5]

Function

Mesenchymal stem cells

The bone marrow stroma contains mesenchymal stem cells (MSCs),[5] also known as marrow stromal cells. These aremultipotent stem cells that can differentiate into a variety of cell types. MSCs have been shown to differentiate, in vitro or invivo, into osteoblasts, chondrocytes, myocytes, adipocytes and beta-pancreatic islets cells.

Bone marrow barrier

The blood vessels of the bone marrow constitute a barrier, inhibiting immature blood cells from leaving the marrow. Onlymature blood cells contain the membrane proteins, such as aquaporin and glycophorin, that are required to attach to and passthe blood vessel endothelium.[7] Hematopoietic stem cells may also cross the bone marrow barrier, and may thus be harvestedfrom blood.

Lymphatic role

The red bone marrow is a key element of the lymphatic system, being one of the primary lymphoid organs that generatelymphocytes from immature hematopoietic progenitor cells.[2] The bone marrow and thymus constitute the primary lymphoidtissues involved in the production and early selection of lymphocytes. Furthermore, bone marrow performs a valve-like functionto prevent the backflow of lymphatic fluid in the lymphatic system.

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Compartmentalization

Biological compartmentalization is evident within the bone marrow, in that certain cell types tend to aggregate in specificareas. For instance, erythrocytes, macrophages, and their precursors tend to gather around blood vessels, while granulocytesgather at the borders of the bone marrow.[5]

Society and culture

Animal bone marrow has been used in cuisine worldwide for millennia.

Clinical significance

Disease

The normal bone marrow architecture can be damaged or displaced by aplastic anemia, malignancies such as multiple myeloma,or infections such as tuberculosis, leading to a decrease in the production of blood cells and blood platelets. The bone marrowcan also be affected by various forms of leukemia, which attacks its hematologic progenitor cells.[8] Furthermore, exposure toradiation or chemotherapy will kill many of the rapidly dividing cells of the bone marrow, and will therefore result in adepressed immune system. Many of the symptoms of radiation poisoning are due to damage sustained by the bone marrow cells.

To diagnose diseases involving the bone marrow, a bone marrow aspiration is sometimes performed. This typically involves usinga hollow needle to acquire a sample of red bone marrow from the crest of the ilium under general or local anesthesia.[9]

Examination

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A Wright's-stained bonemarrow aspiratesmear from apatient withleukemia.

A bone marrow harvest inprogress.

Bone marrow examination is the pathologic analysis of samples of bone marrow obtained via biopsy andbone marrow aspiration. Bone marrow examination is used in the diagnosis of a number of conditions,including leukemia, multiple myeloma, anemia, and pancytopenia. The bone marrow produces the cellularelements of the blood, including platelets, red blood cells and white blood cells. While much informationcan be gleaned by testing the blood itself (drawn from a vein by phlebotomy), it is sometimes necessary toexamine the source of the blood cells in the bone marrow to obtain more information on hematopoiesisthis is the role of bone marrow aspiration and biopsy.

The ratio between myeloid series and erythroid cells is relevant to bone marrow function, and also todiseases of the bone marrow and peripheral blood, such as leukemia and anemia. The normal myeloid-to-erythroid ratio is around 3:1 this ratio may increase in myelogenous leukemias, decrease in polycythemias,and reverse in cases of thalassemia.[10]

Donation and transplantation

In a bone marrow transplant, hematopoietic stem cells are removed from a person and infused intoanother person (allogenic) or into the same person at a later time (autologous). If the donor andrecipient are compatible, these infused cells will then travel to the bone marrow and initiate bloodcell production. Transplantation from one person to another is conducted for the treatment ofsevere bone marrow diseases, such as congenital defects, autoimmune diseases or malignancies. Thepatient's own marrow is first killed off with drugs or radiation, and then the new stem cells areintroduced. Before radiation therapy or chemotherapy in cases of cancer, some of the patient'shematopoietic stem cells are sometimes harvested and later infused back when the therapy isfinished to restore the immune system.[11]

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Bone marrow stem cells can be induced to become neural cells to treat neurological illnesses,[3] and can also potentially be usedfor the treatment of other illnesses, such as inflammatory bowel disease.[4] In 2013, following a clinical trial, scientistsproposed that bone marrow transplantation could be used to treat HIV in conjunction with antiretroviral drugs[12][13] however,it was later found that HIV remained in the bodies of the test subjects.[14]

Harvesting

The stem cells are typically harvested directly from the red marrow in the iliac crest, often under general anesthesia. Theprocedure is minimally invasive and does not require stitches afterwards. Depending on the donor's health and reaction to theprocedure, the actual harvesting can be an outpatient procedure, or can require 12 days of recovery in the hospital.[15]

Another option is to administer certain drugs that stimulate the release of stem cells from the bone marrow into circulatingblood.[16] An intravenous catheter is inserted into the donor's arm, and the stem cells are then filtered out of the blood. Thisprocedure is similar to that used in blood or platelet donation. In adults, bone marrow may also be taken from the sternum,while the tibia is often used when taking samples from infants.[9] In newborns, stem cells may be retrieved from the umbilicalcord.[17]

Fossil record

The earliest fossilised evidence of bone marrow was discovered in 2014 in Eusthenopteron, a lobe-finned fish which livedduring the Devonian period approximately 370 million years ago.[18] Scientists from Uppsala University and the EuropeanSynchrotron Radiation Facility used X-ray synchrotron microtomography to study the fossilised interior of the skeleton'shumerus, finding organised tubular structures akin to modern vertebrate bone marrow.[18] Eusthenopteron is closely related tothe early tetrapods, which ultimately evolved into the land-dwelling mammals and lizards of the present day.[18]

http://en.wikipedia.org/wiki/Lizardhttp://en.wikipedia.org/wiki/Humerushttp://en.wikipedia.org/wiki/European_Synchrotron_Radiation_Facilityhttp://en.wikipedia.org/wiki/Mammalhttp://en.wikipedia.org/wiki/HIVhttp://en.wikipedia.org/wiki/Peripheral_venous_catheterhttp://en.wikipedia.org/wiki/Tibiahttp://en.wikipedia.org/wiki/Antiretroviralhttp://en.wikipedia.org/wiki/Outpatient_surgeryhttp://en.wikipedia.org/wiki/Tetrapodhttp://en.wikipedia.org/wiki/General_anesthesiahttp://en.wikipedia.org/wiki/Devonianhttp://en.wikipedia.org/wiki/Uppsala_Universityhttp://en.wikipedia.org/wiki/Eusthenopteronhttp://en.wikipedia.org/wiki/Iliac_cresthttp://en.wikipedia.org/wiki/Umbilical_cordhttp://en.wikipedia.org/wiki/Lobe-finned_fishhttp://en.wikipedia.org/wiki/X-ray_microtomographyhttp://en.wikipedia.org/wiki/Inflammatory_bowel_diseasehttp://en.wikipedia.org/wiki/Human_sternumhttp://en.wikipedia.org/wiki/Intravenous_therapy



Bone marrow may have firstevolved in Eusthenopteron, aspecies of prehistoric fish

with close links to earlytetrapods.

See also

National Marrow Donor Program, a nonprofit organization that operates a registry ofvolunteer hematopoietic cell donors and umbilical cord blood units in the United StatesGift of Life Bone Marrow Foundation, an American bone marrow transplantation registry

References

1. Vunjak-Novakovic, G. Tandon, N. Godier, A. Maidhof, R. Marsano, A. Martens, T. P. Radisic, M.(2010). "Challenges in Cardiac Tissue Engineering". Tissue Engineering Part B: Reviews 16 (2): 169.doi:10.1089/ten.teb.2009.0352 (https://dx.doi.org/10.1089%2Ften.teb.2009.0352).

2. The Lymphatic System (http://allonhealth.com/health-news/par-lymphatic-system.htm).Allonhealth.com. Retrieved 5 December 2011.

3. "Antibody Transforms Stem Cells Directly Into Brain Cells"(http://www.sciencedaily.com/releases/2013/04/130422154756.htm). Science Daily. 22 April 2013.Retrieved 24 April 2013.

4. "Research Supports Promise of Cell Therapy for Bowel Disease" (http://www.wakehealth.edu/News-Releases/2013/Research_Supports_Promise_of_Cell_Therapy_for_Bowel_Disease.htm). WakeForest Baptist Medical Center. 28 February 2013. Retrieved 5 March 2013.

5. Raphael Rubin and David S. Strayer (2007). Rubin's Pathology: Clinicopathologic Foundations ofMedicine (http://books.google.co.uk/books/about/Rubin_s_Pathology.html?id=kD9VZ267wDEC&redir_esc=y). Lippincott Williams & Wilkins. p.90. ISBN0-7817-9516-8.

http://en.wikipedia.org/wiki/International_Standard_Book_Numberhttp://en.wikipedia.org/wiki/File:Eusthenopteron_BW.jpghttp://en.wikipedia.org/wiki/Tetrapodhttp://en.wikipedia.org/wiki/Wake_Forest_Baptist_Medical_Centerhttp://en.wikipedia.org/wiki/Gift_of_Life_Bone_Marrow_Foundationhttp://en.wikipedia.org/wiki/Digital_object_identifierhttp://allonhealth.com/health-news/par-lymphatic-system.htmhttp://en.wikipedia.org/wiki/National_Marrow_Donor_Programhttp://books.google.co.uk/books/about/Rubin_s_Pathology.html?id=kD9VZ267wDEC&redir_esc=yhttp://dx.doi.org/10.1089%2Ften.teb.2009.0352http://www.wakehealth.edu/News-Releases/2013/Research_Supports_Promise_of_Cell_Therapy_for_Bowel_Disease.htmhttp://en.wikipedia.org/wiki/Eusthenopteronhttp://www.sciencedaily.com/releases/2013/04/130422154756.htmhttp://en.wikipedia.org/wiki/Special:BookSources/0-7817-9516-8



6. Appendix A:IV(http://www.msd.com.mx/secure/ebooks/WintrobesClinicalHematology/sid4266054.html) inWintrobe's clinical hematology (9th edition). Philadelphia: Lea & Febiger (1993).

7. "The Red Cell Membrane: structure and pathologies" (http://www.acbd.monash.org/docs/red-cell-membrane.pdf) (PDF). Australian Centre for Blood Diseases/Monash University. Retrieved24 January 2015.

8. "Human acute myeloid leukemia is organized as a hierarchy that originates from a primitivehematopoietic cell" (http://www.nature.com/nm/journal/v3/n7/abs/nm0797-730.html). Nature.1997. Retrieved 9 November 2012.

9. "Bone Marrow Aspiration and Biopsy"(http://www.labtestsonline.org.uk/understanding/analytes/bone-marrow/tab/sample). Lab TestsOnline UK. Retrieved 16 February 2013.

10. "Definition: 'M:E Ratio' " (http://www.medilexicon.com/medicaldictionary.php?t=75938). Stedman'sMedical Dictionary via MediLexicon.com. 2006. Retrieved 20 December 2012.

11. "Bone marrow transplantation" (http://www.uptodate.com/contents/bone-marrow-transplantation-stem-cell-transplantation-beyond-the-basics). UpToDate.com. Retrieved 12 April 2014.

12. "Bone marrow 'frees men of HIV drugs' " (http://www.bbc.co.uk/news/health-23132561). BBC. 3July 2013. Retrieved 3 July 2013.

13. "Stem-Cell Transplants Erase HIV In Two Men" (http://www.popsci.com/science/article/2013-07/stem-cell-transplants-erase-hiv-two-men). PopSci. 3 July 2013. Retrieved 3 July 2013.

14. "HIV Returns in Two Men Thought 'Cured' by Bone Marrow Transplants"(http://rhrealitycheck.org/article/2013/12/10/hiv-returns-in-two-men-thought-cured-by-bone-marrow-transplants/). RH Reality Check. 10 December 2013. Retrieved 10 December 2013.

http://www.medilexicon.com/medicaldictionary.php?t=75938http://www.popsci.com/science/article/2013-07/stem-cell-transplants-erase-hiv-two-menhttp://en.wikipedia.org/wiki/Monash_Universityhttp://www.labtestsonline.org.uk/understanding/analytes/bone-marrow/tab/samplehttp://www.bbc.co.uk/news/health-23132561http://www.msd.com.mx/secure/ebooks/WintrobesClinicalHematology/sid4266054.htmlhttp://www.nature.com/nm/journal/v3/n7/abs/nm0797-730.htmlhttp://www.uptodate.com/contents/bone-marrow-transplantation-stem-cell-transplantation-beyond-the-basicshttp://rhrealitycheck.org/article/2013/12/10/hiv-returns-in-two-men-thought-cured-by-bone-marrow-transplants/http://www.acbd.monash.org/docs/red-cell-membrane.pdf



WikimediaCommons hasmedia related toBone marrow.

Further reading

Nature Bone Marrow Transplantation (http://www.nature.com/bmt/index.html) (NaturePublishing Group) specialist scientific journal with articles on bone marrow biology and clinicaluses.Cooper, B (2011). "The origins of bone marrow as the seedbed of our blood: from antiquity tothe time of Osler" (http://baylorhealth.edu/proceedings/24_2/24_2_Cooper.pdf). Baylor University Medical Center

15. National Marrow Donor Program Donor Guide(http://www.marrow.org/DONOR/When_You_re_Asked_to_Donate_fo/index.html). Marrow.org.Retrieved 5 November 2012.

16. Bone marrow donation: What to expect when you donate (http://www.mayoclinic.com/health/bone-marrow/CA00047). Mayo Clinic. Retrieved 16 February 2013.

17. McGuckin, C. P. Forraz, N. Baradez, M. -O. Navran, S. Zhao, J. Urban, R. Tilton, R. Denner, L.(2005). "Production of stem cells with embryonic characteristics from human umbilical cord blood".Cell Proliferation 38 (4): 245255. doi:10.1111/j.1365-2184.2005.00346.x(https://dx.doi.org/10.1111%2Fj.1365-2184.2005.00346.x). PMID16098183(https://www.ncbi.nlm.nih.gov/pubmed/16098183).

18. Sanchez S., Tafforeau P. and Ahlberg P. E. (2014) "The humerus of Eusthenopteron: a puzzlingorganization presaging the establishment of tetrapod limb bone marrow"(http://rspb.royalsocietypublishing.org/content/281/1782/20140299). Proceedings of the RoyalSociety B: Biological Sciences 281 (1782): 20140299. doi:10.1098/rspb.2014.0299(https://dx.doi.org/10.1098%2Frspb.2014.0299)

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Proceedings 24 (2): 1158. PMC3069519 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3069519). PMID21566758(https://www.ncbi.nlm.nih.gov/pubmed/21566758).

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Categories: Bone marrow Skeletal system Hematopoiesis Endocrine system Lymphatic system Stem cellsLymphoid organ

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