White blood cells

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White blood cells

• Dr Q Sedick

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Haemopoeisis

• Haemopoeisis starts with a pluripotential stem
  cell that gives rise to separate cell lineages.

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(No Transcript)
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Leucocytes

• May be divided into 2 groups
• 1.Phagocytesgranulocytes monocytes
• 2.Immunocyteslymphocytes plasma cells
• Phagocytes immunocytes serve to protect the
  body against infection using immunoglobin and
  complement systems.

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Granulocytes

• Comprised of neutrophils, eosinophils basophils

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Neutrophil development
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Granulopoeisis

• Many growth factors are involved in the
  maturation process
• Includes IL-1/IL-3/IL-5/IL-6/IL-11/GM-CSF/G-CSF/M-
  CSF
• GF stimulate proliferation and differentiation
  and also affect the function of mature cells on
  which they act

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Neutrophils

• Characterized by a dense nucleus consisting of
  2-5 lobes, pale cytoplasm with an irregular
  outline containing many fine pink granules

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Neutrophil granules

• Consists if primary secondary granules
• Primary myeloperoxidase/acid phosphatase/acid
  hydrolases
• Secondary collagenase/lactoferrin lysozyme

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Monocytes

• Large oval/indented nucleus, clumped chromatin
  abundant blue cytoplasm

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Neutrophil/monocyte functions

• Chemotaxis-phagocytes are attracted to bacteria
  by chemotactic substances released from the
  damaged tissues/by complement or by leucocyte
  adhesion molecules
• Phagocytosis-neutrophils monocytes have FC and
  C3B receptors which aid in opsonization of
  bacteria

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Neutrophil/monocyte function

• Secretion of growth factors chemokines-aid in
  pro-inflammatory processes
• Killing and digestion via oxygen-dependant and
  oxygen- independent pathways

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Eosinophils

• Consists of 2-3 nuclear lobes/ red-staining
  coarser cytoplasmic granules
• Enter inflammatory exudates
• Special role in allergic responses/defense
  against parasites and removal of fibrin formed
  during inflammation

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Basophils

• Dark cytoplasmic granules which overly the
  nucleus
• Contain heparin and histamine-released on
  degranulation
• Have IGE attachment sites
• In tissues-mast cells

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Defects of leucocytes

• NEUTROPHIL LEUCOCYTOSIS
• gt7,5 X 109/L
• Bacterial infections, e.g. periodontitis
• Inflammation and tissue necrosis,
• Metabolic disorders
• Neoplasm's
• Acute haemorrhage/ haemolysis
• Drugs e.g. lithium

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Leucocytosis

1. Haematological malignancies CML/myeloproliferativ
   e disorders/polycythaemia vera/myelofibrosis/AML
2. Treatment with myeloid growth factors
3. Asplenia
4. Rare inherited disorders, e.g. Down syndrome

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The leukemoid reaction

• Reactive and excessive leucocytosis characterised
  by the presence of immature cells in the
  peripheral blood
• Seen in severe chronic infections/severe
  haemolysis metastatic cancer

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Severe chronic infections
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Malignancy
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Eosinophilia

• gt0,4 x 109/l
• Causes are as follows
• Allergy / atopy
• Parasitic disease
• Skin diseases- urticuria
• Drug-induced
• Asthma pulmonary syndromes-association with
  nasal polyps

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Urticuria
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Eosinophilia

• Vasculitidis-polyarteritis nodosa
• Malignancies-metastatic and haematological
• Chronic eosinophilic leukaemia
• Hypereosinophilic syndrome

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Allergy/atopy
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Basophilia

• gt0,1 x 109/l
• Causes include reactive and malignant
• Reactive infections like small pox chicken pox
  
• Myeloproliferative disorders-Chronic myeloid
  leukaemia

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Monocytosis

• gt0,8 x 109/l
• Chronic bacterial infections
• Protozoan infections
• Collagen vascular disease-SLE
• Lymphoma
• Myelodysplasia

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Neutropaenia

• lt2,5 x 109/l
• Infections of the mouth throat(bacterial/viral)
• Immune-SLE,hypersensitivity,anaphylaxis
• Drug-induced
• Congenital - Kostmanns syndrome
• Bone marrow failure

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Lymphocytes

• Lymphocytes are the immunologically competent
  cells that assist the phagocytes in defense of
  the body against infection
• They are involved in processes such as antigen
  specificity and immunological memory

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Lymphocyte development

• Consists of T and B cells
• B cells
• Derives from the stem cell,matures in the bone
  marrow and circulates in the peripheral blood
  until antigen recognition
• On activation B cells secrete immunoglobulin and
  is known as plasma cells

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B cells/plasma cells
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T cells

• T CELLS
• Derive from the thymus and differentiates into
  mature T cells during its passage to the bone
  marrow
• Involved in immunological processes such as cell
  mediated cytotoxicity

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Lymphocytosis

• Acute infections-infectious mononucleosis/rubella/
  pertussis/mumps/herpes/CMV/HIV
• Chronic infections-TB/brucellosis/syphillus
• Chronic lymphocytic leukaemias
• Acute lymphoblastic leukaemia/NHL

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Infectious mononucleosis
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