Bicol University

Graduate School
Master of Arts in Nursing

Capillary Blood Glucose

Test, HBA1C, ABO Blood
Typing, Cross Matching,
DNA, T3T4T5
Influence of Disease in
Blood Cell Count:
Neutrophils, Eosinophils,
Basophils, Lymphocytes,
Monocytes

Jim D. Baclili RM RN
MAN Student
Dr. Julia Tessa A.
Lastrella
Professor

Capillary Blood Glucose Test

Blood glucose monitoring is a way of
testing the concentration of glucose in the
blood (glycemia). Particularly important in the
care of diabetes mellitus, a capillary blood
glucose test is performed by piercing
the skin (typically, on the finger) to draw
blood, then applying the blood to a
chemically active disposable 'test-strip'.
Different
manufacturers
use
different
technology, but most systems measure an
electrical characteristic, and use this to
determine the glucose level in the blood. The
test is usually referred to as capillary blood
glucose.

Capillary Blood Glucose Test

Healthcare professionals advise patients with
diabetes on the appropriate monitoring
regimen for their condition. Most people with
Type 2 diabetes test at least once per day.
Diabetics who use insulin (all Type 1
diabetes and many Type 2s) usually test their
blood sugar more often (3 to 10 times per
day), both to assess the effectiveness of their
prior insulin dose and to help determine their
next insulin dose.

Capillary Blood Glucose Test

Purpose
Blood glucose monitoring reveals
individual patterns of blood glucose
changes, and helps in the planning of
meals, activities, and at what time of day
to take medications.
Also, testing allows for quick response to
high blood sugar (hyperglycemia) or low
blood sugar (hypoglycemia). This might
include diet adjustments, exercise, and
insulin (as instructed by the health care
provider)

Blood Glucose Meter

A blood glucose meter is an electronic
device for measuring the blood glucose
level. A relatively small drop of blood is
placed on a disposable test strip which
interfaces with a digital meter. Within several
seconds, the level of blood glucose will be
shown on the digital display.
Needing only a small drop of blood for the
meter means that the time and effort
required for testing is reduced and the
compliance of diabetic people to their testing
regimens is improved. Although the cost of
using blood glucose meters seems high, it is
believed to be a cost benefit relative to the
avoided medical costs of the complications
of diabetes.

Recent Advances:
'alternate site testing', the use of blood
drops from places other than the finger,
usually the palm or forearm. This
alternate site testing uses the same test
strips and meter, is practically pain free,
and gives the real estate on the finger
tips a needed break if they become sore.
The disadvantage of this technique is
that there is usually less blood flow to
alternate sites, which prevents the
reading from being accurate when the
blood sugar level is changing.

Recent Advances:
'no coding' systems. Older systems
required 'coding' of the strips to the
meter. This carried a risk of 'miscoding',
which can lead to inaccurate results. Two
approaches have resulted in systems
that no longer require coding. Some
systems are 'autocoded', where
technology is used to code each strip to
the meter. And some are manufactured
to a 'single code', thereby avoiding the
risk of miscoding.

Recent Advances:
'multi-test' systems. Some systems use a
cartridge or a disc containing multiple test
strips. This has the advantage that the user
doesn't have to load individual strips each
time, which is convenient and can enable
quicker testing.
'downloadable' meters. Most newer
systems come with software that allows
the user to download meter results to a
computer. This information can then be
used, together with health care
professional guidance, to enhance and
improve diabetes management. The
meters usually require a connection cable,
unless they are designed to work
wirelessly with an insulin pump, or are
designed to plug directly into the computer.

Target Levels
by Type

Upon waking

Before meals
(pre prandial)

Non-diabetic*
Type 2 diabetes

At least 90 minutes after

meals
(post prandial)

4.0 to 5.9
mmol/L

under 7.8 mmol/L

4 to 7 mmol/L

under 8.5 mmol/L

Type 1 diabetes

5 to 7
mmol/L

4 to 7 mmol/L

5 to 9 mmol/L

Children w/ type
1 diabetes

4 to 7
mmol/L

4 to 7 mmol/L

5 to 9 mmol/L

Plasma glucose
test

Normal

Prediabetes

Diabetes

Random

Below 11.1
mmol/l
Below 200 mg/dl

N/A

11.1 mmol/l or
more
200 mg/dl or more

Fasting

Below 6.1 mmol/l

Below 108 mg/dl

6.1 to 6.9 mmol/l

108 to 125 mg/dl

7.0 mmol/l or
more
126 mg/dl or more

2 hour postprandial

Below 7.8 mmol/l

Below 140 mg/dl

7.8 to 11.0 mmol/l

140 to 199 mg/dl

11.1 mmol/l or
more
200 mg/dl or more

HbA1c
The term HbA1c or simply A1c refers to
glycated hemoglobin. It develops when
hemoglobin, a protein within red blood
cells that carries oxygen throughout your
body, joins with glucose in the blood,
becoming 'glycated'.
By measuring glycated haemoglobin
(HbA1c), clinicians are able to get an
overall picture of what our average blood
sugar levels have been over a period of
weeks/months.

HbA1c

HbA1c
For people with diabetes this is important
as the higher the HbA1c, the greater the
risk of developing diabetes-related
complications.
Because red blood cells in the human
body survive for 8-12 weeks before
renewal, measuring glycated haemoglobin
(or HbA1c) can be used to reflect average
blood glucose levels over that duration,
providing a useful longer-term gauge of
blood glucose control.
If your blood sugar levels have been high
in recent weeks, your HbA1c will also be
greater.

HbA1c vs CBG
HbA1c provides a longer-term trend,
similar to an average, of how high your
blood sugar levels have been over a
period of time.
An HbA1c reading can be taken from
blood from a finger but is often taken from
a blood sample that is taken from your
arm.
Blood glucose level is the concentration
of glucose in your blood at a single point in
time, i.e. the very moment of the test. This
is measured using a fasting plasma
glucose test, which can be carried out
using blood taken from a finger or can be
taken from a blood sample from the arm.

HbA1c vs CBG
However, fasting glucose tests provide an
indication of your current glucose levels
only, whereas the HbA1c test serves as an
overall marker of what your average levels
are over a period of 2-3 months.
HbA1c can be expressed as a percentage
(DCCT unit) or as a value in mmol/mol
(IFCC unit). Since 2009, mmol/mol has
been the default unit to use in the UK.
Note that the HbA1c value, which is
measured in mmol/mol, should not be
confused with a blood glucose level which
is measured in mmol/l.

HbA1c Targets
The HbA1c target for people with diabetes
to aim for is:
48 mmol/mol (6.5%)
Note that this is a general target and
people with diabetes should be given an
individual target to aim towards by their
health team.
An individual HbA1c should take into
account your ability to achieve the target
based on your day to day life and whether
you are at risk of having regular or severe
hypos.

HbA1c in diagnosis
HbA1c

mmol/mol

Normal

Below 42 mmol/mol

Below 6.0%

42 to 47 mmol/mol

6.0% to 6.4%

48 mmol/mol or over

6.5% or over

Prediabetes
Diabetes

Blood glucose levels compared

with HbA1c readings
HbA1c

eAG (estimated average glucose)

(%)

(mmol/mol)

(mmol/L)

(mg/dL)

31

5.4 (4.26.7)

97 (76120)

42

7.0 (5.58.5)

126 (100152)

53

8.6 (6.810.3)

154 (123185)

64

10.2 (8.112.1)

183 (147217)

75

11.8 (9.413.9)

212 (170249)

10

86

13.4 (10.715.7)

240 (193282)

11

97

14.9 (12.017.5)

269 (217314)

12

108

16.5 (13.319.3)

298 (240347)

13

119

18.1 (1521)

326 (260380)

14

130

19.7 (1623)

355 (290410)

15

140

21.3 (1725)

384 (310440)

16

151

22.9 (1926)

413 (330480)

17

162

24.5 (2028)

441 (460510)

18

173

26.1 (2130)

470 (380540)

19

184

27.7 (2332)

499 (410570)

average blood sugar levels in mmol/L would be

translated into HbA1c readings, and vice versa.

What are the benefits of

lowering HbA1c?
improving HbA1c by 1% (or 11 mmol/mol) for
people with type 1 diabetes or type 2 diabetes cuts
the risk of microvascular complications by 25%.
Microvascular complications include:
Retinopathy
Neuropathy
Diabetic nephropathy (kidney disease)
Research has also shown that people with type 2
diabetes who reduce their HbA1c level by 1% are:
19% less likely to suffer cataracts
16% less likely to suffer heart failure
43% less likely to suffer amputation or death due
to peripheral vascular disease

ABO Blood Typing

Blood typing is a method to tell what specific
type of blood you have. What type you have
depends on whether or not there are certain
proteins, called antigens, on your red blood
cells.
Blood is often grouped according to the ABO
blood typing system. This method breaks
blood types down into four types:
Type A
Type B
Type AB
Type O
Your blood type (or blood group) depends
on the types that are passed down to you
from your parents.

ABO Blood Typing

A blood sample is needed and will be drawn
from a vein.
The test to determine your blood group is
called ABO typing. Your blood sample is mixed
with antibodies against type A and B blood, and
the sample is checked to see whether or not
the blood cells stick together (agglutinate). If
blood cells stick
together, it means
the blood reacted
with one of the
antibodies.

ABO Blood Typing

The second step is called back typing. The
liquid part of your blood without cells
(serum) is mixed with blood that is known to
be type A and type B. Persons with type A
blood have anti-B antibodies, and those with
type B blood have anti-A antibodies. Type O
blood contains both types of antibodies.
These two steps can accurately determine
your blood type.
Blood typing is also done to tell whether or
not you have a substance called Rh factor
on the surface of your red blood cells. If you
have this substance, you are considered
Rh+ (positive). Those without it are
considered Rh- (negative). Rh typing uses a
method similar to ABO typing.

Importance of Blood Testing

This test is done to determine a person's blood
type. Health care providers need to know your
blood type when you get a blood transfusion or
transplant, because not all blood types are
compatible with each other. For example:
If you have type A blood, you can only
receive types A and O blood.
If you have type B blood, you can only
receive types B and O blood.
If you have type AB blood, you can receive
types A, B, AB, and O blood.
If you have type O blood, you can only
receive type O blood.

Importance of Blood Testing

Type O blood can be
given to anyone with
any blood type. That
is why people with
type O blood are
called universal blood
donors.
Blood typing is especially important during
pregnancy. If the mother is found to be Rh-, the
father should also be tested. If the father has Rh+
blood, the mother needs to receive a treatment to
help prevent the development of substances that
may harm the unborn baby. If you are Rh+, you
can receive Rh+ or Rh- blood.
If you are Rh-, you can only receive Rh- blood.

Blood Testing Results

ABO Typing
If your blood cells stick together when mixed
with:
Anti-A serum, you have type A blood
Anti-B serum, you have type B blood
Both anti-A and anti-B serums, you have
type AB blood
If your blood cells do not stick together when
anti-A and anti-B are added, you have type
O blood.

Blood Testing Results

Back Typing
If the blood clumps together only when B
cells are added to your sample, you have
type A blood.
If the blood clumps together only when A
cells are added to your sample, you have
type B blood.
If the blood clumps together when either
types of cells are added to your sample, you
have type O blood.
Lack of blood cells sticking together when
your sample is mixed with both types of
blood indicates you have type AB blood.

Cross Matching
refers to the test that is performed prior to a
blood transfusion in order to determine if the
donor's blood is compatible with the blood of
an intended recipient. Cross-matching is also
used to determine compatibility between a
donor and recipient, in organ transplantation
or blood transfusion. Compatibility is
determined through matching of
different blood group systems, the most
important of which are
the ABO and Rh system, and/or by directly
testing for the presence of antibodies against
a sample of donor tissues or blood.

Cross Matching
Cross-matching is done by a certified
laboratory technologist, in a laboratory. It can
be done electronically, with a computer
database if a patient has previously been
tested, or serologically by way of testing.
Simpler tests may be used to determine
blood type (only), or to screen for antibodies
(only).

Abbreviated cross-matching
Immediate-spin cross-matching (ISCM)
Immediate-spin cross-matching is an
abbreviated form of cross-matching that is
faster, less expensive but also
less sensitive. It is an immediate test that
takes several minutes to do and it can be
done at room temperature. Indications for
ISCM are dependent on the circumstances
of the patient and it can be used in place
of a full cross-match or performed as a
preliminary test.

Abbreviated cross-matching
Immediate-spin cross-matching (ISCM)
An immediate spin phase is performed with
donor RBCs prepared as a 2%-5% suspension
in normal saline or ethylenediaminetetraacetic
acid (EDTA) saline and the patient's serum.
The 2 samples are mixed together and
centrifuged at room temperature to visualize
hemolysis or agglutination, which would signify a
positive test result and the presence of an
additional antibody. Crossmatch-incompatible
blood is rarely encountered, since donor blood
units are selected after an effective antibody
screen. When only type and screen are
combined with the immediate spin phase, this is
known as an abbreviated crossmatch and is
99.9% effective in preventing an incompatible
transfusion.

Abbreviated cross-matching
Electronic cross-matching
Electronic cross-matching is a computerassisted analysis using data, from
the donor unit (where a donor's blood is tested
prior to donation) and testing done on blood
samples from the intended recipient. This
includes ABO/Rh typing of the unit and of the
recipient, and an antibody screen of the
recipient. Electronic cross-matching can only
be used if a patient has a negative antibody
screen, which means that they do not have
any active red blood cell atypical antibodies, or
they are below the detectable level of current
testing methods. If all of the data entered is
compatible, the computer will print a
compatibility label stating that the unit is safe
to transfuse.

Importance
Hemolytic transfusion reactions occur when the
recipient's
immune
system
encounters
antigens from donor blood. Antibodies may
form in response to these antigens, resulting in
destruction of donor red blood cells (RBCs),
with sequelae leading to clinical manifestations
of fever, hypotension, rigors, acute respiratory
failure, and acute renal failure. The crossmatch
is the final step of pretransfusion testing as a
routine procedure. A portion of donor blood is
combined with patient plasma or serum and is
checked for agglutination, which would signify
incompatible blood. This important step, also
known as major crossmatch, serves as the last
guard to ensure a safe transfusion.

Importance

DNA Testing
DNA testing also known as Genetic Testing is
a powerful tool for identification and has
many practical applications. Common uses
include:
Parental testing - to establish if someone
is the biological parent of a child
Forensic testing - to help identify suspects
or victims in a criminal investigation
Gene therapy - to test parents or fetuses
for genetic conditions or birth defects
Genetic genealogy - to find out more about
someone's ancestry

DNA Testing
Medical/Diagnostic Use:
Newborn screening
Diagnostic testing
Carrier testing
Preimplantation genetic diagnosis
Prenatal diagnosis
Predictive and presymptomatic testing
Pharmacogenomics
Non-Diagnostic Use:
Forensic
Paternity
Genalogical
Research Test

What is DNA?
Deoxyribonucleic Acid is a molecule that carries
the genetic instructions used in the growth,
development, functioning and reproduction of all
known living organisms and many viruses. DNA
and RNA are nucleic acids;
alongside proteins and complex carbohydrates
(polysaccharides), they are one of the three major
types of macromolecule that are essential for all
known forms of life. Most DNA molecules consist
of two biopolymer strands coiled around each
other to form a double helix.
Every cell in our bodies - from heart to skin, blood
to bone - contains a complete set of our DNA.

Importance
99.9% of the DNA from two people will be
identical. The 0.1% of DNA code sequences
that vary from person to person are what
make us unique.
These sequences are called genetic markers,
and are the part of the code that forensic
scientists use when doing a DNA test.
Identical twins are the only people who have
identical genetic markers.

Importance
However, the more closely related two people
are, the more likely it is that some of their
genetic markers will be similar.
The key to DNA testing is knowing where to
look in the billions of letters of genetic code to
find the genetic markers that will identify the
important similarities or differences between
people.

DNA Testing
Parental, forensic and genetic testing look for
similarities in the genetic markers between
two biological samples.
Because all cells in the body contain exactly
the same DNA, samples can be taken from
almost anywhere in the body, including skin,
hair follicles, blood and other bodily fluids.
A forensic scientist might be asked to
compare DNA from skin cells found
underneath the fingernails of an attack victim,
with the DNA from a blood sample taken from
a potential suspect.

DNA Testing
First of all, the DNA is isolated from the cells
and millions of copies are made, using a
method called 'polymerase chain reaction', or
PCR.
PCR uses a naturally occurring enzyme to
copy a specific stretch of DNA over and over
again. Having lots of DNA makes the genetic
code easier to analyze.
The DNA molecules are then split at
particular locations to separate them into
known 'chunks' and the code at those specific
points is analyzed to create a DNA fingerprint.
The fingerprints from the two different
samples are then compared to see if they
match.

DNA Test Accuracy

The accuracy of DNA tests has big
implications. DNA tests are sometimes the
only evidence to prove that a suspect was
involved in a crime, or free someone who has
been wrongly convicted.
It is easy to tell if DNA from two biological
samples does not match. But a match doesn't
make you totally certain that the two samples
come from the same person.
There is always a small chance that two
different people's genetic markers could be
the same, especially if they are related.

DNA Test Accuracy

To reduce the chance of error, scientists test
more than one genetic marker. The more
identical markers there are in two samples,
the more accurate the test.
However, testing more markers takes more
time and is more expensive. Forensic DNA
tests usually examine six to ten markers. The
chances that two unrelated people have
identical profiles is less than one in one
billion.

Thyroid Function Tests

is a collective term for blood tests used to
check the function of the thyroid
TFTs may be requested if a patient is
thought to suffer
from hyperthyroidism (overactive thyroid)
or hypothyroidism (underactive thyroid), or
to monitor the effectiveness of either
thyroid-suppression or hormone
replacement therapy. It is also requested
routinely in conditions linked to thyroid
disease, such as atrial
fibrillation and anxiety disorder.

Thyroid Function Tests

In some situations, such as during
pregnancy or while taking birth control
pills, high levels of total T4 and T3 can
exist. This is because the estrogens
increase the level of the binding proteins.
In these situations, it is better to ask both
for TSH and free T4 for thyroid evaluation.

TSH (Thyroid Stimulating

Hormone) Test
The best way to initially test thyroid function
is to measure the TSH level in a blood
sample. A high TSH level indicates that the
thyroid gland is failing because of a problem
that is directly affecting the thyroid (primary
hypothyroidism). The opposite situation, in
which the TSH level is low, usually indicates
that the person has an overactive thyroid
that is producing too much thyroid hormone
(hyperthyroidism). Occasionally, a low TSH
may result from an abnormality in the
pituitary gland, which prevents it from
making enough TSH to stimulate the thyroid
(secondary hypothyroidism). In most healthy
individuals, a normal TSH value means that
the thyroid is functioning normally

T3 (Triiodothyronine) Test
T3 tests are often useful to diagnose
hyperthyroidism or to determine the
severity of the hyperthyroidism. Patients
who are hyperthyroid will have an elevated
T3 level. In some individuals with a low
TSH, only the T3 is elevated and the FT4
or FTI is normal. T3 testing rarely is helpful
in the hypothyroid patient, since it is the
last test to become abnormal. Patients can
be severely hypothyroid with a high TSH
and low FT4 or FTI, but have a normal T3.

T4(Thyroxine) Test
T4 circulates in the blood in two forms:
1) T4 bound to proteins that prevent the T4
from entering the various tissues that need
thyroid hormone.
2) Free T4, which does enter the various
target tissues to exert its effects. The free
T4 fraction is the most important to
determine how the thyroid is functioning,
and tests to measure this are called the
Free T4 (FT4) and the Free T4 Index (FT4I
or FTI). Individuals who have
hyperthyroidism will have an elevated FT4
or FTI, whereas patients with
hypothyroidism will have a low level of FT4
or FTI.

T4 Test
Combining the TSH test with the FT4 or
FTI accurately determines how the thyroid
gland is functioning.
The finding of an elevated TSH and low
FT4 or FTI indicates primary
hypothyroidism due to disease in the
thyroid gland. A low TSH and low FT4 or
FTI indicates hypothyroidism due to a
problem involving the pituitary gland. A low
TSH with an elevated FT4 or FTI is found
in individuals who have hyperthyroidism.

Thyroid Test Values

Test

Abbreviation

Typical Ranges

Serum thyroxine

T4

4.6-12 ug/dl

Free thyroxine fraction

FT4F

0.03-0.005%

Free Thyroxine

FT4

0.7-1.9 ng/dl

Free Thyroxine index

FT4I

4-11

Serum
Triiodothyronine

T3

80-180 ng/dl

Free Triiodothyronine l

FT3

230-619 pg/d

Free T3 Index

FT3I

80-180

Radioactive iodine
uptake

RAIU

10-30%

Serum thyrotropin

TSH

0.5-6 uU/ml

Blood Cell Count

White blood cells (WBCs), also
called leukocytes or leucocytes, are
the cells of the immune system that are
involved in protecting the body against
both infectious disease and foreign
invaders. All white blood cells are
produced and derived from
multipotent cells in the bone
marrow known as hematopoietic stem
cells. Leukocytes are found throughout the
body, including the blood and lymphatic
system.

Blood Cell Count

All white blood cells have nuclei, which
distinguishes them from the other blood
cells, the anucleated red blood
cells (RBCs) and platelets. Types of white
blood cells can be classified in standard
ways. Two pairs of broadest categories
classify them either by structure
(granulocytes or agranulocytes) or by cell
division lineage (myeloid cells or lymphoid
cells). These broadest categories can be
further divided into the five main
types: neutrophils, eosinophils, basophils, l
ymphocytes, and monocytes. These types
are distinguished by their physical and
functional characteristics.

Blood Cell Count

Blood Cell Count

Blood Cell Count

The number of leukocytes in the blood is
often an indicator of disease, and thus
the WBC count is an important subset of
the complete blood count. The normal
white cell count is usually between 4 and
11 109/L. In the US this is usually
expressed as 4,00011,000 white blood
cells per microliter of blood. They make up
approximately 1% of the total blood
volume in a healthy adult, making them
substantially less numerous than the
RBCs at 40% to 45%.

Blood Cell Count

However, this 1% of the blood makes a
large difference to health,
because immunity depends on it. An
increase in the number of leukocytes over
the upper limits is called leukocytosis. It is
normal when it is part of healthy immune
responses, which happen frequently. It is
occasionally abnormal, when it
is neoplastic or autoimmune in origin. A
decrease below the lower limit is
called leukopenia. It weakens the immune
system.

Neutrophils
Neutrophil (also known as neutrophils or
occasionally neutrocytes) are the most
abundant type of granulocytes and the most
abundant (40% to 75%) type of white blood
cells in most mammals. They form an
essential part of the innate immune system.
Its functionality varies in different animals.
They are short-lived and highly motile, or
mobile, as they can enter parts of tissue
where other cells/molecules wouldn't be
able to enter otherwise. Neutrophils may be
subdivided into segmented neutrophils and
banded neutrophils (or bands). They form
part of the polymorphonuclear cell family
(PMNs) together with basophils and
eosinophils.

Neutrophils
Neutrophils are a type of phagocyte and
are normally found in the bloodstream.
During the beginning (acute) phase
of inflammation, particularly as a result
of bacterial infection, environmental
exposure, and some cancers, neutrophils
are one of the first-responders of
inflammatory cells to migrate towards the
site of inflammation. They migrate through
the blood vessels, then through
interstitial tissue, following chemical
signals in a process called chemotaxis.
They are the predominant cells in pus,
accounting for its whitish/yellowish
appearance.

Eosinophils
Eosinophils, sometimes
called eosinophiles or, less
commonly, acidophils, are a variety
of white blood cell and one of the immune
system components responsible for
combating multicellular parasites and
certain infections in vertebrates. Along
with mast cells, they also control
mechanisms associated
with allergy and asthma. They
are granulocytes that develop
during hematopoiesis in the bone
marrow before migrating into blood.

Eosinophils
In normal individuals, eosinophils make up
about 16% of white blood cells, and are
about 1217 micrometres in size. They are
found in the medulla and the junction
between the cortex and medulla of
the thymus, and, in the
lower gastrointestinal tract, ovary,
uterus, spleen, and lymph nodes, but not
in the lung, skin, esophagus, or some
other internal organs under normal
conditions. The presence of eosinophils in
these latter organs is associated with
disease. Eosinophils persist in the
circulation for 812 hours, and can survive
in tissue for an additional 812 days in the
absence of stimulation.

Basophils
A basophil is a type of white blood cell.
Basophils are the least common of
the granulocytes, representing about 0.5 to
1% of circulating white blood
cells. However, they are the largest type of
granulocyte. They are responsible for
inflammatory reactions during immune
response, as well as in the formation of
acute and chronic allergic diseases,
including anaphylaxis, asthma, atopic
dermatitis and hay fever. They can perform
phagocytosis (cell eating), produce
histamine and serotonin that induce
inflammation, and heparin that prevents
blood clotting.

Basophils
Basophils appear in many specific kinds
of inflammatory reactions, particularly
those that cause allergic symptoms.
Basophils contain anticoagulant heparin,
which prevents blood from clotting too
quickly. They also contain the
vasodilator histamine, which promotes
blood flow to tissues. They can be found in
unusually high numbers at sites
of ectoparasite infection, e.g., ticks.
Like eosinophils, basophils play a role in
both parasitic infections and
allergies. They are found in tissues where
allergic reactions are occurring and
probably contribute to the severity of these
reactions.

Lymphocytes
A lymphocyte is one of the subtypes
of white blood cell in
a vertebrate's immune system.
Lymphocytes include natural killer cells
(NK cells) (which function in cellmediated, cytotoxic innate immunity), T
cells (for cell-mediated, cytotoxic adaptive
immunity), and B
cells (for humoral, antibodydriven adaptive immunity). They are the
main type of cell found in lymph, which
prompted the name lymphocyte.

Lymphocytes
T cells (thymus cells) and B cells (bone
marrow- or bursa-derived cells) are the
major cellular components of the adaptive
immune response. T cells are involved
in cell-mediated immunity, whereas B cells
are primarily responsible for humoral
immunity (relating to antibodies). The
function of T cells and B cells is to
recognize specific non-self antigens,
during a process known as antigen
presentation. Once they have identified an
invader, the cells generate specific
responses that are tailored to maximally
eliminate specific pathogens or pathogeninfected cells.

Lymphocytes
B cells respond to pathogens by
producing large quantities
of antibodies which then neutralize
foreign objects like bacteria and
viruses. In response to pathogens
some T cells, called T helper cells,
produce cytokines that direct the
immune response, while other T cells,
called cytotoxic T cells, produce
toxic granules that contain powerful
enzymes which induce the death of
pathogen-infected cells.

Lymphocytes
Following activation, B cells and T cells
leave a lasting legacy of the antigens they
have encountered, in the form of memory
cells. Throughout the lifetime of an animal,
these memory cells will remember each
specific pathogen encountered, and are
able to mount a strong and rapid response
if the pathogen is detected again.

Lymphocytes
NK cells are a part of the innate immune
system and play a major role in defending
the host from both tumors and virally
infected cells. NK cells distinguish infected
cells and tumors from normal and
uninfected cells by recognizing changes of
a surface molecule called MHC (major
histocompatibility complex) class I. NK
cells are activated in response to a family
of cytokines called interferons. Activated
NK cells release cytotoxic (cell-killing)
granules which then destroy the altered
cells. They were named "natural killer
cells" because of the notion that they do
not require prior activation in order to kill
cells which are missing MHC class I.

Monocytes
Monocytes are a type of white blood cell,
or leukocyte. They are the largest type of
leukocyte and can differentiate into
macrophages or dendritic cells. As a part
of the vertebrate innate immune
system monocytes also influence the
process of adaptive immunity. Monocytes
and their macrophage and dendritic-cell
progeny serve three main functions in the
immune system. These are phagocytosis,
antigen presentation, and cytokine
production.

Monocytes
Phagocytosis is the process of uptake of
microbes and particles followed by
digestion and destruction of this material.
Monocytes can perform phagocytosis
using intermediary (opsonising) proteins
such as antibodies or complement that
coat the pathogen, as well as by binding to
the microbe directly via pattern-recognition
receptors that recognize pathogens.
Monocytes are also capable of killing
infected host cells via antibody-dependent
cell-mediated cytotoxicity. Vacuolization
may be present in a cell that has recently
phagocytized foreign matter.

Complete Blood Count Values

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"You mustn't let mistakes weigh you

down. Acknowledge them and take
what you've learned to move on.
That is the privilege of being a
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