Other plasma components

Some plasma constituents occur in plasma in low concentration but have a high turnover rateand great physiological importance. Among these is glucose, the blood sugar. Glucose is absorbed from the gastrointestinal tract or may be released into the circulation from the liver. It provides a source of energy for tissue cells and is the only source for some, including the red cells. Glucose is conserved and used and not excreted. Amino acids also are so rapidly transported that the plasma level remains low, although they are required for all protein synthesis throughout the body. Urea, an end product of protein metabolism, is rapidly excreted by the kidneys. Other nitrogenous waste products—uric acid and creatinine—are similarly removed.

Several inorganic materials are essential constituents of plasma, and each has special functional attributes. The predominant cation (positively charged ion) of the plasma is sodium, an ion that occurs within cells at a much lower concentration. Because of the effect ofsodium on osmotic pressure and fluid movements, the amount of sodium in the body is an influential determinant of the total volume of extracellular fluid. The amount of sodium in plasma is controlled by the kidneys under the influence of a hormone (aldosterone) of the adrenal gland. If dietary sodium exceeds requirements, the excess is excreted by the kidneys. Potassium, the principal intracellular cation, occurs in plasma at a much lower concentration than sodium. The renal excretion of potassium is influenced by aldosterone, which causes retention of sodium and loss of potassium. Calcium in plasma is in part bound toprotein and in part ionized. Its concentration is under the control of two hormones: parathyroid hormone, which causes the level to rise, and calcitonin, which causes it to fall. Magnesium, like potassium, is a predominantly intracellular cation and occurs in plasma in low concentration. Variations in the concentrations of these cations may have profound effects on the nervous system, the muscles, and the heart, effects normally prevented by precise regulatory mechanisms. Iron, copper, and zinc are required in trace amounts for synthesis of essential enzymes; much more iron is needed in addition for production of hemoglobin and myoglobin, the oxygen-binding pigment of muscles. These metals occur in plasma in low concentrations. The principal anion (negatively charged ion) of plasma is chloride; sodium chloride is its major salt. Bicarbonate participates in the transport of carbon dioxide and in the regulation of pH. Phosphate also has a buffering effect on the pH of the blood and is vital for chemical reactions of cells and for the metabolism of calcium. Iodide is transported through plasma in trace amounts; it is avidly taken up by the thyroid gland, which incorporates it into thyroid hormone.

The hormones of all the endocrine glands are secreted into the plasma and transported to their target organs, the organs in which they exert their effect. The plasma levels of these agents often reflect the functional activity of the glands that secrete them; in some instancesmeasurements are possible though concentrations are extremely low. Among the many otherconstituents of plasma are numerous enzymes. Some of these appear simply to have escaped from tissue cells and have no functional significance in the blood.