Reticulocyte Index - Physiology

Physiology

Reticulocytes are newly-produced red blood cells. They are slightly larger than totally mature red blood cells, and have some residual ribosomal RNA. The presence of RNA allows a visible blue stain to bind or, in the case of fluorescent dye, result in a different brightness. This allows them to be detected and counted as a distinct population.

The idea of the RPI is to assess whether the bone marrow is producing an appropriate response to an anemic state. Reticulocyte production should increase in response to any loss of red blood cells. It should increase within 2-3 days of a major acute hemorrhage, for instance, and reach its peak in 6-10 days. If reticulocyte production is not raised in response to anemia, then the anemia may be due to an acute cause with insufficient time to compensate, or there is a defect with red blood cell production in the bone marrow. Marrow defects include nutritional deficiencies (i.e. iron, folate, or B12) or insufficient erythropoietin, the stimulus for red blood cell production. Reticulocytopenia, or "aplastic crisis", is the medical term for an abnormal decrease of reticulocytes in the body

The reticulocyte percentage index may find new use as a more reliable detector of erythropoietin-doping in athletes. The use of this method is referred to as "biological passport."

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