Blood fractionation is the process of fractionating whole blood or separating it into its component parts. This is usually done through the process of centrifugation in a centrifuge (Machlus et al., 2014).
The resulting components are:
• A clear solution of blood plasma in the upper phase (which can be separated into its fractions),
• The buffy coat, which is the thin layer of leucocytes mixed with platelets in the middle, and
• Erythrocytes at the bottom of the centrifuge tube (Yip et al., 2005).
2.9.1 Plasma Protein Fractionation
Plasma proteins are separated by using the inherent differences of each protein. Fractionation involves changing the conditions of the blood plasma (the temperature or the acidity) so that proteins that are normally dissolved in the plasma fluid become insoluble, forming large clumps, called precipitate. The insoluble protein can be collected by centrifugation (Yip et al., 2005).
2.10.0 WHAT IS ALCOHOL?
In chemistry, an alcohol is any organic compound in which the hydroxyl functional group (O-H) is bond to a saturated carbon atom. The term alcohol originally referred to the primary alcohol, ethyl alcohol (ethanol), which is the predominant constituent in alcoholic beverages (Berrington et al., 2005).
Ethyl alcohol or commonly ethanol is an intoxicating ingredient found in beer, wine and liquor. Alcohol is produced by the fermentation by yeast or other microorganisms of sugars or starchy materials. Alcohol is a central nervous system depressant that reduces the function or activity of some specific parts of the body, such as the brain. In small doses, alcohol can reduce anxiety and lessen inhibitions making you feel more sociable. When alcohol is taken in, it is rapidly absorbed from the stomach and small intestine in the bloodstream (Berrington et al., 2005).
It gets into the blood circulation to some parts of the body and also into the brain, it slows down the way the brain carries information. The alcohol in the brain also affects the ability of the brain to interpret nerve impulses. At taking the alcohol, one may feel released and happy. The liver functions in the alcohol detoxification to some extent. A healthy liver can breakdown about one standard alcoholic drink in one hour (Berrington et al., 2005).
When the body takes alcohol faster than the liver can detoxify, and the level of alcohol content in the blood increases drastically, one becomes profusely intoxicated and the alcohol begins to cause some damage after a while or after a long time accumulation. This is why it is really important to drink slowly and not more than the recommended amounts (Berrington et al., 2005).
There are three types of alcohols classified according to the percentage of ethanol in them; these include:
• Beer
• Wine
• Spirits
Beer:
Beer is produced by brewing and fermentation of grains, followed by flavouring by the addition of hops which give the beer its bitterness. The beer type of alcohol does not go through the process of distillation during production, and so it is called non-distilled alcohol. The alcohol content of beer usually ranges from 4% to 6% alcohol by volume. Examples of beer are porter and stout (Owoyele et al., 2013).
Wine:
Wine is the second type of alcohol in either the order of increasing or decreasing alcohol content by volume. It is made using fermented fruits mostly grapes, which give wine its characteristic red colour. Wine is completely fermented and has along aging process, which leads it to having an alcohol content off around 9% to 16% alcohol by volume. An example is red wind produced from grapes (Hull and Stone, 2004).
Spirits:
Spirits are produced from the processes of fermentation and distillation hence they are called distilled alcohols. They have higher alcohol content more than the beer and the wine because of the process of distillation they undergo. The process of distillation removes all traces of water thereby concentrating the alcohol content. Their higher alcohol content also is brought about by a long section of aging and longer length of distillation. The spirits have alcohol content range of 20% to 70%. Examples of spirits include vodka, whisky, rum, gin, and so on (Fowkes, 1996).
2.10.1 ALCOHOL AND BLOOD COMPONENTS
The percentage of alcohol in the blood which is called blood alcohol concentration (BAC) can be used to study the extent to which a person is addicted to alcohol. Those who abuse alcohol, that is those whose blood alcohol concentrations (BACs) are high have a greater risk of alcohol related medical complications (Maxwel et al., 2010). The medical complications of alcohol intake are those affecting the blood cells as well as proteins present in the blood plasma and the bone marrow is also affected (Hull and Stone, 2004).
Excessive drinking of alcohol has both direct and indirect effects on the blood-building or hematopoietic systems. The direct effects of alcohol ingestion include toxic consequences on the bone marrow, the blood cell precursors, and the mature red blood cells (RBCs) and platelets. The indirect effects of alcohol consumption include nutritional deficiencies that impair the production and function of various blood cells (Warrel et al., 2005).
These direct and indirect effects of alcohol intake can result in serious medical complications for the drinker. For example, anaemia resulting from diminished RBC production and impaired red blood cell metabolism and function can cause fatigue, shortness of breath, light-headedness, and even reduced mental capacities and abnormal heartbeats. A decrease in the number and function of white blood cells (WBCs) increases the drinker’s risk of serious infections and impaired platelet production and function interfere with blood clotting, leading to symptoms ranging from a simple nose-bleeding to bleeding in the brain (that is, hemorrhagic stroke). Finally, alcohol-induced abnormalities in the plasma proteins that are requires for blood clotting can lead to the formation of blood clots (thrombosis) (Raupp et al., 2001).
2.10.1.1 Alcohol effect on the bone marrow and on red blood cell production
Chronic excessive alcohol injection reduces the number of blood cell precursors in the bone marrow and causes characteristic structural abnormalities in these cells resulting in fewer-than-normal or non-functional mature cells. As a matter of fact, alcoholics may suffer from moderate anaemia; characterized by enlarged, structurally abnormal red blood cells; mildly reduced numbers of white blood cells, especially of neutrophils; and moderately to severely reduced numbers of platelets. Although this generalized reduction in blood cell number (which is referred to as pancytopenia) usually is not progressive or fatal, and is reversible with abstinence. Complex aberrations of hematopoiesis can develop over time that may cause death. These abnormalities on blood cells include precursors containing fluid-filled cavities (that is, vacuoles) or characterized iron deposits (Ang et al., 2002).
The most striking indication of alcohol’s toxic effects on bone marrow cells is the appearance of numerous large vacuoles in early red blood cell precursor cells. The vacuoles usually appear in the pronormoblasts 5 to 7days following the initiation of heavy alcohol consumption. Moreover, the vacuoles on average disappear after 3 to 7days of abstinence, although in some patients, they persist for up to 2weeks. To a lesser extent, vacuoles also decrease in the granulocyte precursors of alcoholics. This finding is not specifically alcohol-related, however because other events that interfere with white blood cell production (example infections) may induce similar structural changes in the granulocyte precursors (Frank, 2005).
Another complication of red blood cell as a result of alcoholism is sideroblastic anaemia. Here the bone marrow produces ringed sideroblasts rather than healthy red blood cells. In sideroblastic anaemia, the body has iron available but cannot incorporate it into haemoglobin, which red blood cells need to transport oxygen efficiently (Raupp et al., 2001).
2.10.1.1 Alcohol-related Red Blood Cell Disorders
Alcohol-related abnormalities in red blood cell production manifest themselves not only in the bone marrow but also through the presence of defective red blood cells in the blood. For example, grossly enlarged red blood cells can occur in the blood (a condition which is known as macrocytosis); as well as oddly shaped red blood cells that are subjected to premature or accelerated destruction (that is, hemolysis) because of their structural abnormalities. As a result, alcoholics frequently are diagnosed with anaemia (Fowkes, 1996).
In macrocytosis, the mean corpuscular volume (MCV), which measures the sizes of red blood cells in the blood is significantly larger than normal. The presence of enlarged red blood cells in the blood is an indication of variety of complications in addition to alcoholism, including different kinds of anaemia and a dysfunction of the thyroid gland. The enlarged red blood cells in patients with macrocytosis generally are uniformly round, in contrast to the oval cells characteristic of megaloblastic anaemia. People who drink excessive amounts of alcohol can develop macrocytosis even in the absence of other factors associated with red blood cell enlargement, such as alcoholic liver disease and folic acid deficiency (Ramachandra, 2004).
Furthermore, several types of haemolytic anaemia may be caused by chronic heavy alcohol ingestion. Two of these disorders are known by the presence of deformed red blood cells (stomatocytes and spur cells); whereas one alcohol related haemolytic anaemia is caused by reduced phosphate levels in the blood (hypophosphataemia). Diagnosing hemolysis in alcoholic patients is a difficult one because these pastients frequently exhibit confounding conditions, such as alcohol withdrawal, abnormal folic acid levels, bleeding or an enlarged spleen (Weatherall et al., 2001).
2.10.1.2 Alcohols Effect on Iron Metabolism
In addition to interfering with the proper absorption of iron into the haemoglobin molecules of red blood cells, alcohol use can lead to either iron deficiency or exclusively high levels of iron in the body. Because iron is essential to red blood cell functioning, iron deficiency which is commonly caused by excessive blood loss, can result in anaemia (Maxwel et al., 2010). In many alcoholic patients, blood loss and subsequent iron deficiency are caused by gastrointestinal bleeding. Iron deficiency in alcoholics often is difficult to diagnose; however, because it may be masked by symptoms of other deficiencies (example, folic acid deficiency) or by co-existing liver disease and other alcohol-related inflammatory disorders. For an accurate diagnosis, the physician must therefore exclude folic acid deficiency and evaluate the patients iron stores in the bone marrow (Raupp et al., 2001).
Conversely, alcohol abuse can increase iron levels in the body. For example, iron absorption from the food in the gastrointestinal tract may be evaluated in alcoholics. Iron levels also can rise from excessive ingestions of iron-containing alcoholic beverages such as red wine. The increased iron levels can cause hemochromatosis, a condition characterized by the formation of iron- deposits throughout the body (example in the liver, pancreas, heart, joints and gonads). Moreover, patients whose chronic consumption and hemochromatosis have led to liver cirrhosis are at risk for liver cancer
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