Immunology - Haematology Flashcards

1
Q

Define haematopoeisis? Erythropoiesis?

A
  • The production of cells that circulate in the bloodstream.
  • Specifically, erythropoiesis is the process by which red blood cells (erythrocytes) are produced.
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2
Q

Where does erythropoiesis occur:

  1. in the very early foetus?
  2. from 2-5 months gestation
  3. from 5 months gestation
A
  1. in the yolk sac
  2. in the liver and spleen
  3. in the bone marrow
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3
Q

When erythropoiesis is inadequate in the bone marrow, what can this trigger? Where is this commonly seen?

A
  • This can trigger extramedullary haematopoiesis – i.e. haematopoiesis occurring outside the marrow
  • This is commonly seen in haemoglobulinopathies, in particular thalassaemias and myelofibrosis.
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4
Q

What does the production of all blood cells begin with?

A
  • A multipotent haematopoietic stem cell –> a haemocytoblast
  • Haemocytoblasts differentiate into common myeloid progenitor cells OR common lymphoid progenitor cells The
    • The common myeloid progenitor cells –> these then differentiate into erythrocytes and other cells
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5
Q

What cell line are erythrocytes from?

A

Common myeloid progenitor

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6
Q

What cell line are T and B lymphocytes from?

A

Common lymphoid progenitors

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7
Q

What cell line are natural killer cells from?

A

Common lymphoid progenitors

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8
Q

What cell line are macrophages, mast cells, basophils, neutrophils and eosinophils from?

A

Common myeloid progenitors

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9
Q

Which hormone drives erythropoiesis? What secretes this hormone?

A
  • Erythropoietin (EPO), which is a glycoprotein cytokine
  • Secreted by the kidney
    • It is constantly secreted at a low level, sufficient for the normal regulation of erythropoiesis.
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10
Q

If the erythrocyte level becomes inadequate, what happens to the O2 levels in the blood? How does this then affect EPO levels?

A
  • The blood becomes relatively hypoxic
  • When there is a reduced partial pressure of oxygen (pO2) in the kidney, this is detected by the renal interstitial peritubular cells.
  • In response, there is a surge in EPO production, which acts in the bone marrow to stimulate increased red blood cell production.
  • This causes haemoglobin levels to increase, subsequently causing the pO2 to rise and therefore EPO levels to fall.
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11
Q

What is the mononuclear phagocyte system (MPS)?

A
  • An important part of the innate immune system.
  • It serves as a network of phagocytic cells in the blood and lymphatic system as well as the lymph nodes, liver and spleen.
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12
Q

What is the main role of the MPS?

A
  • Identify foreign antigens and mount an appropriate immune response.
    • These antigens are phagocytosed before they have a chance to cause further harm to the body.
  • Additionally, the MPS plays a key role in the destruction of old and dysfunctional cells
    • Allows the body to recycle key materials such as iron.
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13
Q

What is the primary cell of the MPS?

A

The phagocyte

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14
Q

What are common phagocytes?

A
  • Macrophages
  • Dendritic cells (derived from monocytes)
  • Granulocytes
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15
Q

Monocytes are formed in the bone marrow and circulated in the blood, from where they migrate into surrounding tissues. Here, what do they mature into?

A

Either tissue histiocytes or macrophages.

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16
Q

How are macrophages further classified?

A

According to the organ they reside in

17
Q

What are macrophages called in the:

  • CNS
  • Liver
  • Lungs
  • Skin and mucosa
A
  • Microglial cells
  • Kupffer cells
  • Alveolar macrophages
  • Langerhans cells
18
Q

What is the function of the spleen?

A
  • The spleen is formed from both red pulp and white pulp.
    • Red pulp: endothelial macrophages
      • Play a key role in ensuring that defective or ageing red blood cells are phagocytosed
    • White pulp: contains B and T lymphocytes
      • Any antigen presenting cell passing through the spleen can stimulate activation of the lymphocytes to mount an appropriate immunological response.
  • Spleen serves as pool for platelets and red blood cells
    • Can be rapidly mobilised when needed
19
Q

What does the lymphatic system consist of?

A
  • Lymphatic vessels and lymph nodes which act to filter tissue fluid from the blood
    • Lymph nodes house B and T lymphocytes
20
Q

What are the macrophages in the liver called? Where do they reside?

A
  • Kupffer cells
    • Reside in the vessels forming the capillary beds of the liver, known as sinusoids.
21
Q

As blood enters the liver via the portal vein and drains into the sinusoids, what is role of Kupffer cells?

A
  • Remove foreign materials through phagocytosis
  • They stimulate a local inflammatory responses using cytokines and oxygen radicals.
22
Q

How are Kupffer cells also involved in the metabolism of red blood cells and haemoglobin?

A
  • The haem portion is further broken down into iron for immediate reuse or for storage, whilst the globin chains are reused
  • Bilirubin is conjugated here and secreted in the bile.