Now let's move to studying the white cells in your blood.
And we'll start with the lymphocytes, the major cells of the adaptive immune system.
So these cells comprise the adaptive immune system.
And as we've discussed in the first lecture, there are two main subtypes.
B cells, they make antibodies which are very useful to binding to viruses, bacteria
and either neutralizing those pathogens or signaling them for destruction by neutrophils or monocytes.
Whereas T cells play a role in regulating immunity.
They can help B cells to make high-quality antibodies.
And they can directly kill virally infected cells.
In fact there's also an awful lot of interest now and importance of T cells in controlling cancer
and fighting off low levels of transformed cells perhaps in our body.
On the left you'll see a cartoon of a lymphocyte again showing a very large nuclei to cytoplasmic ratio.
And some granules within the lymphocyte
that's shown again on the slide on the right where you'll see the granules within the lymphocytes.
Now, although this course is about blood and hematology,
we must remember that 95% of lymphocytes within your body
are not actually within the blood at any one time, they're within the lymphoid tissue.
So lymphocytes are constantly entering lymph nodes through lymph or through high endothelial venules.
And there they're searching for any evidence of infection
brought to them by dendritic cells within the lymph node.
And then finally they leave the lymph nodes via lymphatic vessels and come back into the blood.
So on the right we've got a representation of this.
You've got the blood lymphocyte pull at the top.
And as we moved down that, those three arrows that the lymphocytes may go out to the spleen.
Some of them may go directly to tissues.
And the majority can enter lymph nodes through these high endothelial venules
before being returned through the lymph via the important thoracic duct into the blood system.
Most lymphocytes are actually found in what we call mucosal associated lymphoid tissue.
Your mucosa needs protection against external pathogens.
And so here we've got a representation in the cartoon of lymphoid tissue around the oropharyngeal tract,
the lung and indeed the gastrointestinal system.
And that lymphoid tissue, you know – you'll know it is tonsils, adenoids so forth.
And this is where the majority of lymphocytes within your body reside at any one time.
It's really very sophisticated system and the types of lymphocytes and each of those different areas are very different.
And if they're activated in one area, perhaps the lung, then they will return to the lung
and they home back to the region of activation.
Neutrophils of the classic cell of what we call the innate immune system,
the immediate immune response to a pathogen.
And as I explained in the first lecture, they have this very characteristic multi-lobe nucleus
represented on the left cartoon and on the right in the blood film.
They contain a lot of granules which have a range of functions in killing bacteria.
As you can see on the left, tertiary granules, azurophile granules and specific granules.
Also on that neutrophil we've got complement receptors, receptors for Fc portion of IgG.
And really what those are doing is searching for any pathogens or in the cells
which have been coated by complement or antibody
and are deemed necessary to be destroyed by the neutrophil system.
Let's have a look at this process of phagocytosis.
Bacteria taken up by the – by recognition of molecules directly by the neutrophil on the pathogen called –
so-called pathogen associated molecules or by attachment of antibody or complement coated organisms.
As you can see there, the pathogen is taken in.
In this case, we have attachment like complement, and it enters what we call a phagosome within the neutrophil.
The neutrophil has now captured the pathogen within the cell.
And then you see there's lysosome.
They go and merge with this phagosome and all of the toxic molecules
within the lysosome are unleashed onto the bacteria and we form a phagolysosome
and that's usually enough to kill the bacteria or fungus.
Now neutrophil production is of course highly regulated as well by the body.
It's particularly increased during infection.
If you take a blood count from a patient with inflammation or infection,
almost the first thing you'll see is an increase in the neutrophil count
and that's rather beautifully represented on this blood film.
With this line of five neutrophils together. Monocytes.
We talked about this cell a little in our introductory lecture.
These cells also help to ingest pathogens and kill bacteria.
And when they migrate to tissues, we call them macrophages.
Now they also play an important role in linking this innate immune response,
this ingestion of pathogens to the adaptive immune response
where the T cells and B cells are selected to generate a specific memory immune response.
And you'll see on the left where we have the cartoon representation of the monocyte.
At the bottom, the MHC class II there which is a very important molecule for triggering T cell and B cell activation.
On the right there's the classic blood film picture of a monocyte.
You can see that folded nucleus and the slightly pale blue cytoplasm.
Now, as well as neutrophils, there are two other types of closely related cells eosinophils, basophils.
When scientists were staining blood many decades ago, they used stains with different pH's, basic or acidic.
And the neutrophil stains were the neutral stain.
Whereas eosinophils and basophils stay more with acid and base stains.
That's where these old names come from.
On the right there's a very beautiful blood film.
I think the person who generated that was very lucky
because we see these three cells all next to each other.
In the middle you've got the neutrophil.
Above it, a basophil. Very darkly staining – very dark granules, large granules so much that you can hardly see through it.
And at the bottom, the eosinophil.
Characteristic: two lobe nucleus and you can just see slightly pink.
Now what's the function of these type of cells?
Polymorphonuclear granular cells as we call them.
Well, eosinophils has a very important role in immune response to helminths which is a posh word for saying worms.
So, when an eosinophil recognizes a worm, it combined to it – and as you'll see on the left,
it has these things called specific granules which contain quite toxic substances such as major basic protein.
And these will be released onto the parasitic worm in an attempt to destroy it.
Now actually in many societies of course, we've eradicated helminth's infections.
We still see patients who have increased eosinophils. Why is that?
The common reason now is allergy; patients with hayfever, asthma, perhaps a drug reaction.
And for some reason that is also quite a strong stimulus of the eosinophil production.
Now the basophil that's quite a rare cell.
We don't tend to see many in normal blood.
And to be honest, we're not entirely sure what it does and it may have relation to cells like histamine from mast cells.
So it might be similar too in a mast cell in some way.
This representation is just focusing on one area of hemopoiesis
and it just shows that myeloid cells and monocytes can derive from a common precursor cell.
Scientists have spent a long time in the last 20 or 30 years working out the different lineages of hemopoiesis.
And the top there, you'll see a cell which is called the CFU-GM. What does that mean?
Well we've written it down for you there.
The colony forming unit granulocyte monocyte and that's a common precursor cell.
A colony forming unit comes from the fact that when people take these cells out of the blood
or the bone marrow and put them in an –
culture in the laboratory they see colonies growing up.
And that's where the name comes from. All of these cells are myeloid cells.
And remember that that will be very important when we talk about the classification of leukemia.
All of these are myeloid cells and can be involved myeloid leukemia.
So in summary in this lecture, we've looked in more detail at the function of red cells and the major white cells.
We've learned how red cells have become perfectly evolved to carry maximal amounts of oxygen into tissues.
We've seen how lymphocytes of the cells of the immune system
and they're primarily located within lymphoid tissue, constantly providing surveillance against infection.
Whereas granulocytes such as neutrophils, eosinophils and basophils are relatively short-lived
and they are critical in fighting infection
and really constitute very important cells within the innate immune response.
I hope you've enjoyed this lecture.