Expert Lecture (Granulocytes Disorders)
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hendra2darmawanExpert Lecture (Granulocytes Disorders)
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hendra2darmawanMODULE HEMATOLOGY
EXPERT LECTURE
SUB MODULE 5: GRANULOCYTE DISORDERS
FACULTY OF MEDICINE UNIVERSITY OF BRAWIJAYA MALANG
No. 1 Describe in brief three types of granulocytes (neutrophils, eosinophils, basophils) and monocytes !
A. Neutrophils : - has dense nucleus consisting 2-5 lobes & a pale cytoplasm with an irregular outline containing many fine pink-blue (azurophilic) or grey-blue granules - the granule : primary (promyelocytes stage) and secondary (myelocyte & mature neutrophils) - the lifespan : 10 hours
B. Eosinophils : - similar to neutrophils, except : the cytoplasmic granules are coarser & > deeply red staining, and rarely > 3 nuclear lobes - the blood transit time is longer than neutrophils - have a special role in allergic responses, defence against parasites & removal of fibrin formed during inflammation
C. Basophils : - have many dark cytoplasmic granules - in the tissues they become mast cells - have immunoglobulin E (IgE) attachment sites and their degranulation is associated with histamine release D. Monocytes : - usually larger than other peripheral blood leucocytes - have a large central oval or idented nucleus with clumped chromatin - the abundant cytoplasm stains blue and contains many fine vacuoles, giving a ground-glass appearance; cytoplasmic granules are often present
No. 2 Describe in brief the normal functions of neutrophil and monocytes into three phases !
The normal function of neutrophils & monocytes : A. Chemotaxis (cell mobilization and migration) The phagocyte is attracted to bacteria or the site of inflammation by chemotactic substances released from : - damaged tissues or by complement components, and - by the interaction of leucocyte adhesion molecules with ligands on the damaged tissues B. Phagocytosis - The foreign material (bacteria, fungi, etc.) or dead or damaged cells of the host are phagocytosed - Recognition of a foreign particle is aided by opsonization with immunoglobulin or complement, because both neutrophils and monocytes have Fc and C3b receptors
C. Killing and digestion - Occurs by oxygen-dependent and oxygen-independent pathways - In neutrophils: H2O2 reacts with myeloperoxidase and intracellular halide to kill bacteria activated oxygen may be involves a fall in pH within phagocytic vacuoles into which lysosomal anzymes are released - Lactoferrin an iron-binding protein present in neutrophil granules is bacteriostatic by depriving bacteria of iron
No. 3 Describe in brief defects of phagocytic cell function !
Defects of phagocytic cell function : A. Defects of chemotaxis - Occurs in rare congenital abnormalities (e.g. lazy leucocyte syndrome) and in more common acquired abnormalities either of the environment, (e.g. corticosteroid therapy) or of the leucocytes themselves (e.g. in acute or chronic myeloid leukemia, myelodysplasia and the myeloproliferative syndromes) B. Defects of phagocytosis - Usually arise because of a lack of opsonization may - be caused by congenital or acquired causes of - hypogammaglobulinemia or lack of complement components
C. Defects of killing and digestion - Is clearly illustrated by the rare X-linked or autosomal recessive chronic granulomatous disease - There is an abnormality affecting different elements of the respiratory burst oxidase or its activating mechanism reccuring infections (bacterial or fungal) which present in infancy or early childhood - Other rare congenital abnormalities may result in defects of bacterial killing e.g. myeloperoxidase deficiency and the Chediak-Higashi syndrome - AML, CML and myelodysplastic syndromes may also be associated with defective killing of ingested microorganisms
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