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PHYSIOLOGY OF LEUKOCYTES . IMMUNITY Function of leukocytes 1. Protective 2. Transport 3. Metabolic 4. Regenerator Quantity of leukocytes and their changes Most white blood cells are the body outside the vascular: in the intercellular space in the bone marrow. In the bloodstream is about 20 % of white blood cells of the body. It is believed that the blood of a healthy person contains 4-9 G/l leukocytes. If the number of white blood cells is less than 4 , then talk about leucopenia. Leukopenia occurs only in pathology. If you exceed the number of leukocytes than 9 , it will leukocytosis. There leukocytosis : first one is, physiological, and secondly on - pathological (inflammatory , infectious processes) . Physiological leukocytosis are: 1. food , after eating , especially protein ; 2. myogenic , after hard physical work 3. stress (psycho-emotional) 4. pregnant 5. ovulation 6. in newborns. The number of leukocytes ranges during the day , there is a maximum in the evening. Physiological leukocytosis in newborn The number of leukocytes in them is 16,7-30 G / l . Explain this by saying that in the early days is a resolution of the decay products of tissues, bleeding that occurred during childbirth. At the end of the first month of life and reduced number of white blood cells is 12-15 G / l . At the end of the first year of life -7 ,5 -12 , 5. At the age of 10-14 years, the number of white blood cells is almost adult size and is 4,5-10 G/l. Development of monocytes common progenitor cell – uncommited stem cell – commited stem cell – monoblast – promonocyte – monocyte – tissue macrophage. Development of lymphocytes common progenitor cell – bone marrow lymphocytes precursor – lymphoblast – prolymphocyte – large lymphocyte – small lymphocyte. Lymphocytes in the fetus are thought to arise first in the thymus. Later they are found in lymph nodes, spleen, and other lymphoid tissues as well as in bone marrow. Development of gtanulocytes common progenitor cell – uncommited stem cell – commited stem cell – myeloblast (basophil, neutrophil, eosinophil) – promyelocyte – myelocyte – metamyelocyte – juvenile – rod-shaped neutrophil (basophil, eosinophil), segmented neutrophil, basophil, eosinophil. Functional features of neutrophils Located in the bloodstream up to 20 hours, quickly migrate into tissue, mucous membranes, where they live about 3 days. Days produced 100 • 109 granulocytes. Neutrophils phagocytosis of bacteria, fungi, and tissue breakdown products of its enzymes break down hydrogen peroxide. In addition to responses to infection, neutrophils also secrete transkobalamin. For neutrophils can determine the sex of the person: the presence of the female genotype neutrophils "Drumsticks". Functional features of eosinophilic granulocytes Stay period of eosinophils in the blood is very short. Especially many of these cells in the mucous membranes of the gastrointestinal tract, respiratory tract and urinary organs. Number eosinophils is subject to fluctuations during the day: the day of eosinophils approximately 20% less, and in the night by 30 % compared with an average number . These oscillations are associated with the level of secretion of glucocorticoids adrenal cortex . Increase of corticoids leads to a decrease in eosinophils and vice versa. This functional test Thorne . Features : 1) anti-allergic , and 2) phagocytic . Eosinophils contain histaminase , which neutralizes histamine, which abound with allergies. Functional features of basophilic granulocytes The residence time of cells in the bloodstream for about 12 hours. They are capable of phagocytosis. Granules in the cytoplasm of basophils stained intensely basophilic dyes and contain heparin and histamine, which actively affect the blood vessels. Functional features of lymphocytes Lymphocytes are formed in the lymph nodes, spleen, retrosternal gland, appendix and bone marrow. They play a major role in shaping the immune system and carry out immune surveillance. After the bone marrow of the lymphocyte differentiation in the thymus is (retrosternal gland) and converted into T-lymphocytes. Other cells undergo differentiation in the lymphoid tissue of the tonsils, appendix, intestines Peyer's plaques B-lymphocytes. Physiological role of lymphocytes Function of T-lymphocytes: 1. Immune memory. 2. Anti viruses immunity. 3. Anti tissue immunity. 4. Regulate phagocytosis. Function of В-lymphocytes: 1. Immune memory. 2. Specific immunity. B-lymphocytes syntheses the immunoglobulins such as IgM, IgN, IgA, IgG, IgB, IgE. Functional features of monocytes Formed in the bone marrow. As blood is about 72 hours. From blood monocytes entering into the surrounding tissue. Here they grow, the content of lysosomes and mitochondria increases. Upon reaching maturity, monocytes are converted to fixed cells or tissue macrophages. These cells are in connective tissue and are called histiocytes, in the liver - Kuppherovsky‘s cells, in the lungs - alveolar macrophages, in spleen, bone marrow, lymph nodes, glia, pleura - macrophages. System of mononucleares phagocytes These is the system, which common the cells with one nucleus, common origin from red bone marrow, common function of high specific phagocytosis The specific functional characteristics of macrophages is phagocytosis of microorganisms, tumor cells, collecting and directing lymphocytes to the antigenic material, the formation of tissue growth factor, pinocytosis LEUKOCYTE FORMULA The index of nuclear’s changing of neutrophyls, it interpretation NCN=(M+J+S1)/S2, where M – myelocytes, J– juvenile, S1 – stab neutrophils, S2 – segmented neutrophils Norm is 0,06-0,09 IMMUNITY The body is under constant attack by micro-organisms. They may enter the body via an orifice eg mouth nasal passage or vagina, or through broken skin. The micro –organisms feed on the body tissues and /or pass toxins into the bloodstream. This causes disease. Disease causing organisms are called pathogenic. Inside the body the micro-organism has ideal conditions of food, water and temperature, so flourish. Immunity is the body’s ability to resist infection by a disease-causing organism (pathogen) or to destroy it after invasion. Immunity can be innate or acquired. Innate immunity This is inborn and unchanging and occurs in several non-specific ways. 1. Skin. This is an effective physical barrier 2. Stomach acid. This destroys the protein membrane of any invading mico-organism. 3.Lysozyme. An enzyme found in tears, saliva and nasal secretions which digests bacterial cell walls 4. Interferon. This is released by an infected cell , binds to a non-invaded cell inducing it to produce antiviral proteins in readiness for invasion. 5. Phagocytosis. Some types of white blood cells engulf invading bacterial cells and digest them using enzymes enclosed in lysosomes ( diagram P 50) Phagocytic white blood cells, monocytes, and macrophages derived from monocytes, are produced in the bone marrow. They are found static or fixed in the lining of tubules in the liver, spleen and lymph nodes, and remove pathogens as blood or lymph passes by. Pus at an infected wound is the remains of dead pathogens and phagocytic white blood cells. Acquired immunity This type of immunity is acquired throughout a lifetime, and depends on the production of special protein molecules called antibodies. These antibodies are produced in response to specific foreign molecules called antigens. An antigen is a polysaccharide or protein which is recognised as foreign by special white blood cells, lymphocytes. These lymphocytes respond by producing specific antibodies for that antigen. An antibody is a Y shaped protein which has specific receptor or binding sites on each arm. There are thousands of different lymphocytes each capable of responding to a specific antigen and producing a specific antibody. Acquired immunity can be developed either naturally or artificially. Naturally acquired immunity This occurs when the body suffers an infection. Lymphocytes are derived from unspecialised cells in the bone marrow. On production some of these cells migrate to the thymus gland and the lymph nodes where they reproduce to form colonies. Thymus lymphocytes are called T lymphocytes or T cells. Those from the lymph nodes are called B cells. B cell action. Humoral response, the release of free antibodies When a B cell encounters an antigen it divides repeatedly to produce identical daughter cells, which make and release the specific antibody for that antigen. In the blood or lymph these antigens bind with the antigen to form an antigen/antibody complex. This acts as a signal for phagocytic white blood cells to engulf and destroy the whole complex. Some of the activated B cells remain in the body fluids as memory cells, and continue to produce the antibody. This means that on further infection by the same antigen many antibodies can be released very quickly reducing response time. (Antibodies or immunoglobulins are proteins that are able to act against what they recognise as foreign (antigens). There are 5 major classes of immunoglobulin, IgA,IgD ,IgG IgM and IgE. IgG is the only one that can cross the placenta, and food or environmental allergies involve IgA, IgM and IgE.) T cell action. Cell mediated response On invasion of a body cell by a micro-organism, microbial proteins are released. These move to the body cell membrane and act as antigens. The antigens are recognised as foreign by Killer –T cells. The killer T cells attach to the infected body cell releasing chemicals, which perforate the body cell membrane. This destroys the body cell and the microorganisms inside. Another type of T cell , Helper T cells do not kill the cells but act as ’lookouts’ by patrolling the body, recognising antigens and activating B cells and Killer T cells. Primary and Secondary responses After invasion by a micro-organism the individual will suffer the disease until there are sufficient antibodies produced. This is the primary response. If the individual is infected by the same microorganism, memory B cells in the body will quickly produce many antibodies, and memory killer T cells will attack the infected cells, so the response is much faster preventing the disease. This is the secondary response. Artificially acquired immunity Inoculation. This is the deliberate introduction of an antigen into the body to stimulate an immune response. Vaccination is a form of inoculation, where the antigen is introduced either by injection or orally. The antigen is first rendered harmless by heat or chemical treatment but will still induce an immune response by production of B and T cells. Treated micro-organism toxins can also be used in this way. Active and Passive immunity Active. When the body produces its own antibodies either by infection or inoculation.( as already described) Passive. When the body receives readymade antibodies. Naturally acquired passive immunity. Where antibodies are passed across the placenta or in breast milk. This gives ready made immunity until the babies immune system can produce its own antibodies. Allergy The word allergy means ‘altered working’, and is used to describe an over reaction to harmless foreign matter .eg. feathers, pollen animal fur or antibiotics. These antigenic triggers of allergies are called allergens. B cells stimulated by the allergen release antibodies (IgE) which are picked up, by and attach to ,the surface of mast cells in connective tissue. If these cells encounter the allergen again they release a substance, histamine. Histamine causes dilation of surrounding blood vessels, loss of fluid from the vessels and damage to the tissues. This causes localised heat and swelling. Antihistamine is needed to counteract the reaction. Anaphylaxis is a life threatening rapid allergic response. Self and non-self. The human body recognises its own cells due to the antigens found on their surface. These ‘self’ cells will be accepted and not attacked by the immune system. Cells lacking these antigen markers are identified as foreign ( non-self) ,an immune response occurs and the cells are destroyed. Antigen signature Body cells have antigens on their membranes (other than those on red blood cells- see later.) which make up the human leukocyte antigen H.L.A. The H.L.A. is controlled by 4 genes each with many alleles which can code for many antigens. This allows for a wide range of different combination of antigens. As a result onepersons antigen signature has an almost unique combination of these antigens, and the possibility of this combination being repeated in another person is very low. The exception to this is in monozygotic twins. Rejection of transplanted tissue Living tissue transplanted from one body to another is identified as foreign by T cells and is destroyed. This is tissue rejection. Prevention of rejection is by tissue typing and matching to ensure the donor tissue or organ has an antigen signature as close to the recipient antigen signature as possible. Identical twins would be the ideal donor and recipient. Immunosuppressor drugs are used to prevent rejection but this leaves the recipient open to infection by diseases such as pneumonia . New drugs are being developed to inhibit the activity of killer T cells without affecting the B cell activity. In addition new agents are being developed to induce immunological tolerance before the transplant. Autoimmunity This is when the body fails to recognise the antigen self markers on its own cells and attacks them. Examples of autoimmunity are, rheumatoid arthritis where the immune system attacks and destroys the cartilage at joints, and multiple schlerosis where the immune system attacks the myelin coating of nerves.