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After studying this chapter, you should be able to:

  • Describe how white blood cells work in concert to combat infection and to trigger an inflammatory response.

  • List the basic steps in elimination of infectious microorganisms by phagocytosis.

  • Describe the role of chemotaxis in leukocyte function.

  • List the key components found within the granules of phagocytes and basophils and describe their primary functions.

  • List the reactive oxygen species produced during the respiratory burst.

  • Explain the basis for the physiologic effects caused by defects in the NADPH oxidase system.

  • Explain the molecular basis of type 1 leukocyte adhesion deficiency.

  • Describe how neutrophils and eosinophils entrap parasites using neutrophil extracellular traps (NETs).

  • Describe the role of the helper T cells in the production of new antibodies.

  • Define the term cytokine and describe the key characteristics of interleukins, interferons, prostaglandins, and leukotrienes.


White blood cells, or leukocytes, serve as key sentries and potent defenders against invading pathogens. Neutrophils, the most abundant type of white blood cell, ingest and destroy invading bacteria and fungi by a process known as phagocytosis, while eosinophils phagocytize larger parasites. Circulating monocytes migrate from the bloodstream to diseased tissues, where they differentiate into phagocytic macrophages. Granulocytes such as basophils and mast cells release stored effectors that attract additional leukocytes to the site of infection and trigger an inflammatory response. B lymphocytes generate and release protective antibodies with the assistance of T lymphocytes. Other lymphocytes, such as cytotoxic T cells and natural killer cells, target virally infected and malignantly transformed host cells.

Malignant neoplasms of blood-forming tissues, called leukemias, can lead to the uncontrolled production of one or more of the major classes of white blood cells. The hyperactivation of granulocytes during an allergic response can, in extreme cases, lead to anaphylaxis and death. Leukopenia, a depression in the production of white blood cells, can result from physical injury or infection of the bone marrow, chemotherapy, ionizing radiation, infection by the Epstein-Barr virus (mononucleosis), an autoimmune response (lupus), or the displacement of bone marrow cells by fibrous tissues (myelofibrosis). The resulting deficit in the levels of circulating leukocytes can leave the affected individual vulnerable to infection (immunocompromised).


The white blood cells, or leukocytes, are key participants in the acute inflammatory response, a multicomponent process that defends the body against infectious organisms and ameliorates the impact of tissue infection or morbidity. The principal steps in an inflammatory response include (1) an increase in vascular permeability, (2) entry of activated leukocytes into the tissues, (3) activation of platelets, and (4) spontaneous subsidence (resolution) if the invading microorganisms have been dealt with successfully. Basophils secrete hematologic effectors such as histamines (Figure 54–1) that facilitate the accumulation of fluid ...

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