Hematology: Control of Red Cell Production

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Abstract
It is generally accepted that the rate of red cell production is geared towards maintaining in the circulating blood a hemoglobin concentration optimal for the transfer of O2 from the lungs to the tissue cells. In order to maintain or approximate such a hemoglobin concentration a sensitive feedback mechanism must exist between the erythro-poietic tissue and one or many O2 -consuming tissues. This review has attempted to show that almost all clinical and experimental observations point towards a feedback circuit leading from the erythropoietic tissue through the red cell mass, the hemoglobin concentration, the tissue tension of O2, the erythropoietic factor, and back to the erythropoietic tissue again. The weakness of this theory lies in the fact that we do not know the organ or cellular system which releases the erythropoietic factor and feeds information about the tissue tension of O2 to the bone marrow. Nevertheless, the proposed feedback control of red cell production appears to be our most challenging and most promising working hypothesis.
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