What does a low neutrophil count mean? Segmentonuclear are lowered for a reason. Video: neutrophil fights bacteria

Granulocytes or polymorphonuclear blood cells are called a special kind of leukocytes (white blood cells) that provide protective functions of the body. A blood test for granulocytes is the simplest and fastest way to diagnose pathological conditions. Granulocytes can be increased, decreased in.

Granulocytes come from the specifics of their structure: granular cells with two nuclei inside. Polymorphonuclear cells are divided into three groups: basophils, neutrophils and eosinophils, each of which performs its own functions. So, they are responsible for the regulation of immune processes, preventing the spread of infection throughout the organ or the body as a whole. Before doing a blood test for granulocytes, we will analyze their composition.

They contribute to the removal of various poisons from the body, participate in the development of allergic reactions, are responsible for the appearance of new capillaries and provide an acceleration of the suppression of allergens. produce enzymes that are responsible for bactericidal functions.

Granulocytes in the blood are produced by the bone marrow. Granular leukocytes have a short life cycle: after leaving the blood, in which they live for about a week, they stay in the tissue for about two days.

Thus, it has a high diagnostic potential for detecting pathological disorders in the functioning of the body or for clarifying various inflammatory processes occurring in it.

Norm

As with any indicator, normative values ​​are set, deviations from which allow one to judge the ongoing changes. The level and norm of granulocytes is estimated by quantitative and qualitative parameters and is expressed as a percentage of the total number of leukocytes.

In a blood test for granulocytes, the norm of the content of the absolute amount varies within the range from 1.1 to 6.7 × 10⁹/l. For newborns, acceptable values ​​​​are in the range from 5.5 to 12.5x10⁹ / l. The norm of granulocytes in the blood for children under the age of twelve is 4.5 - 10.0x10⁹ / l .; for adolescents of the pubertal period - 4.3 - 9.5x10⁹ / l.

The relative content of granular leukocytes ranges from 44% to 71%. This applies to mature cells, but the level of young cells is also studied. A variant of the norm of granulocytes in the blood is considered if from 1 to 5% of young neutrophils, eosinophils and basophils are found in the blood.

A change in the level of mature, both up and down in relation to the normative value, is evidence of the presence of deviations in the state of the body.

In some cases, a deeper study of the level of content of polymorphonuclear cells is carried out, in this case, the content of cells by groups becomes the subject of analysis.

Neutrophils in the blood exist in two forms: rod-shaped and segmented. The norm of rod-shaped neutrophils is considered to be 1-5.9% of the total number of leukocytes and in the range of 45-72%.

For eosinophils, the content in the blood in the range of 0.5-5% corresponds to the norm, for basophils - within 1%.

Promotion and demotion

According to studies, deviations in the content of cells in the blood from the norm can be presented in two varieties: when, according to a blood test, granulocytes are lowered or when, according to a blood test, granulocytes are increased.

Exceeding the norm of the content of immature granulocytes in the blood is also evidence of trouble in the body. Most often, an increase in young granulocyte cells in the blood is due to the presence of acute and chronic diseases (tuberculosis, pyelonephritis, influenza, psoriasis, cholera, rubella). With burns, acute bleeding, and poisoning with chemicals, there is also an increase in granulocytes in the blood.

The reasons for the increase in the level of granulocytes in the blood can be associated with the peculiarities of the physiological state of the body, these include childbirth, pregnancy, lactating mothers also have an increased level of these cells, they also provoke excessive physical activity or abundant nutrition. In women, an increase in the level of granulocytes in the blood is observed regularly before critical days.

These changes can be recognized as a physiological norm, provided that the level of cells remains constant.

Autoimmune diseases such as rheumatism, scarlet fever, tumor, sarcoidosis can cause a low level and decrease in granulocytes in the blood.

In some cases, the level of deviations of granulocytes from the norm for groups of granular leukocytes is examined:

Neutrophils are a type of white blood cell that carry out the body's defense against infections. Their formation occurs in the bone marrow, and with further penetration into the tissues, they destroy pathogenic microorganisms. The state when neutrophils are lowered is called neutropenia and indicates the presence of pathologies in the body.

Ne: what does it mean - definition

Neutrophils (designation Ne) is a group of leukocytes, which is divided into two subgroups.

These include:

• Segmented. Mature cells with a segmented nucleus that circulate in the blood and carry out the destruction of bacteria as a result of their absorption.
• Band nuclear. They have a solid and rod-shaped nucleus. "Grow" to segmented, which subsequently allows the attack of foreign microorganisms.

The pattern of decrease in neutrophils is called the neutrophilic shift to the left, which is typical for almost all inflammatory pathologies. However, the bone marrow cannot constantly produce neutrophils in large volumes, and with prolonged infectious pathologies, this indicator decreases.

Absolute number

The number of segmented cells depends on the age of the person.

The average relative norms are presented in the table:

Stab cells must be present in the blood in an amount not exceeding 5 percent. If a large number of stab cells are found in the blood, the causes of this are most often serious infections that lead to a massive consumption of "mature" cells.

The absolute number of neutrophils is a quantitative indicator that allows you to get more accurate results. It is used to make a diagnosis in conjunction with relative data. The average indicators of ACH can be seen in the table:

Absolute Counting

In order to calculate the absolute number of neutrophils, the number of leukocytes in absolute units is multiplied by relative indicators, expressed as a percentage (8500 * 15% \u003d 1275). Calculations are carried out in laboratory conditions on the basis of the obtained analyses.

Causes of a decrease in neutrophils

The reasons for the low number of segmented neutrophils and the high number of stab neutrophils most often indicate the presence of an inflammatory process.

The percentage of neutrophils is lowered with:

A decrease in the number of neutrophils is called neutropenia. The relative decrease is expressed as a percentage and most often coincides with the absolute decrease.

Relative and absolute neutropenia is determined by a biochemical blood test.

A significant decrease in neutrophils and an increase in lymphocytes most often occurs after the transfer of acute viral infections. In a short period of time, the indicators normalize on their own.

If reduced rates are observed over a long period, and lymphocytes are increased, one can suspect:

• Tuberculosis.
• Lymphocytic leukemia.

A reduced number of neutrophils does not always indicate the presence of a particular disease.

In order to make a diagnosis, additional examinations are required. Reduced blood counts are indirect and without examining the patient it is impossible to predict what is the cause of the pathology.

A low level of neutrophils can be observed after overwork and heavy physical exertion. In this case, the reduced indicators in a short period of time normalize on their own and do not affect the general condition of the person.

The development of the infectious process against the background of neutropenia

When pathogenic bacteria appear in the body, neutrophils tend to them, forming a kind of inflammation focus, which prevents the infection from spreading. A low neutrophil count and the presence of neutropenia can cause infection to spread throughout the body and blood poisoning.

Initially, significantly reduced neutrophil counts may manifest:

• Stomatitis and gingivitis.
• Purulent angina.
• cystitis.
• Osteomyelitis and abscesses.

If the neutrophil counts are below normal, a person can easily be infected in crowded places and in the presence of patients with viral pathologies among close people.

How to increase the level of neutrophils?

How to increase the level of neutrophils depends on the reasons that caused their decrease. In most cases, after an infection, the reduced rates are restored on their own. At the moment, there are no drugs that allow you to raise neutrophils, therefore, medications are used to increase the general increase in leukocytes.

If the rate of neutrophils is reduced due to a certain drug therapy aimed at eliminating any disease, the treatment regimen is corrected. With an imbalance of nutrients and reduced neutrophils, the use of B vitamins and diet are most often indicated. For allergies, antihistamines are prescribed.

After the complete elimination of the factor that provokes the fall of neutrophils, the lowered rates are normalized for 1-2 weeks.

Treatment with drugs to increase leukocytes is indicated only with persistent neutropenia. In this case, leukopoiesis stimulants, pentoxyl and methyluracil can be prescribed. Women and men are prescribed an immunogram and check the lowered rates throughout the treatment.

If treatment is ineffective, colony-stimulating factor drugs are included in the therapy. These include such potent drugs as filgrastim and lenograstim. Treatment with these drugs is possible only in a hospital due to the large number of side effects.

Granulocytes are a group of white cells whose cytoplasm contains granules. They are also called granular leukocytes. Granulocytes include neutrophils, basophils and eosinophils. They make up about 60% of all white blood cells. The most numerous group is neutrophilic granulocytes, the least of all in the blood are basophils.

These cells are produced in the bone marrow from progenitor cells that divide within four days, then morphological maturation occurs, which takes five days. As soon as granulocytes enter the bloodstream, they are immediately divided into parietal (temporarily adhering to the walls of blood vessels) and actively circulating. They stay in the blood for about one week, after entering the tissues they live for about two days.

Granulocytes contain a large number of granules in the cytoplasm, which is why the cells got their name.

Types of granulocytes

Granulocytes are divided into neutrophilic, basophilic and eosinophilic, depending on how they perceive standard dyes. The size of these cells is 9-12 microns.

Neutrophils are the most numerous group of granular leukocytes. Their name is due to the fact that, according to the Romanovsky method, they are stained with both a basic dye and an acid one (eosin). Mature neutrophilic granulocytes are polymorphonuclear cells, since their nucleus consists of four to five segments. In the blood of a healthy person, mainly mature segmented forms and a small amount of stab granulocytes circulate.

Eosinophils got their name due to the fact that they stain only with an acid dye (eosin) and do not absorb the basic one. Their core consists of two lobes.

Basophilic granulocytes are intensely stained only with the main dye and do not perceive acid, for which they got their name. These granular white blood cells are high in histamine, prostaglandins, heparin, serotonin, and others. Their core is vague, structureless, usually consists of two segments. It is difficult to see it because of the large number of histamine granules in the cytoplasm.

Functions of neutrophils

Neutrophils are able to actively move, can move outside the blood vessels. Mostly they move to the site of inflammation. Neutrophils can carry out phagocytosis, but are able to absorb only small particles, so they are referred to as microphages. After the absorption of foreign cells, they die, while a large number of active substances are released, which lead to damage to harmful microorganisms, increase inflammation and the movement of immune cells to the source of infection.

From neutrophils, tissues destroyed as a result of inflammation, and the microorganisms that caused this process, a mass is formed that is known to everyone as pus. The main function of these granulocytes is protection against fungal and bacterial infection. Much less they protect against viruses and do not take part in the protection against helminths and tumors. In acute bacterial infections, the very first immune response is neutrophilic. It is always ahead of the specific lymphocytic. At the same time, in chronic processes, the role of neutrophils is small; in this case, the lymphocytic response predominates.

Functions of basophils

The main function of basophils is to participate in the formation of an immediate allergic reaction, an example is anaphylactic shock. They instantly react when bitten by insects and snakes, blocking their poison and preventing it from spreading throughout the body. There are other functions of basophilic granulocytes. They are involved in the regulation of blood coagulation due to the heparin in their cytoplasm. On their surface, basophils carry immunoglobulin E, they can release the contents of the granules into the external environment and dissolve the cells upon contact with the allergen. During degranulation and dissolution of cells, a large amount of histamine, prostaglandins, serotonin, leukotrienes and other bioactive substances are released. As a result, an allergic reaction to the allergen that has entered the body is observed. Basophils can enter and live outside of blood vessels. They are capable of phagocytosis, although this function is not natural for them. Their main purpose is instant degranulation, which enhances blood flow, increases vascular permeability, provides fluid flow and attracts other granulocytes to the site of inflammation.

Functions of eosinophils

Basophils rise in the blood with allergies

Norm of granulocytes

The norm of granulocytes for adult men and women is from 1.2 to 6.8X10⁹ per liter of blood. Relative content (percentage of the total number of leukocytes) - from 47 to 72%.

Elevated granulocytes during pregnancy are considered a physiological norm, but if their level is high and continues to grow, there is a high probability of developing pathology. .

The norm for children may differ under the age of 12 years. This is especially true of the percentage of certain types of granulocytes. After 12 years, the norm in a child is the same as in adults.

Why are granulocytes increased?

The reasons for the increase in granulocytes can be different. Most often, they are elevated due to inflammatory processes occurring in the body. The most frequent include:

Neutrophilia is caused by the following factors:

• acute bacterial infections;
• endogenous and exogenous intoxications;
• acute hemorrhages;
• myeloproliferative diseases;
• taking medications.

This is what neutrophilia looks like on a blood smear

Causes of basophilia:

• ulcerative colitis and other inflammation of the gastrointestinal tract;
• Hodgkin's syndrome;
• allergy;
• blood diseases;
• hemolytic anemia;
• taking medication.

Modern medicine implies high-quality and quick diagnosis based on various studies. It is IMPORTANT for an ordinary person to have an idea about the results of the tests and the possible consequences in the absence of adequate treatment. Neutrophils - blood cells that are part of the group of granulocytic leukocytes, are involved in maintaining the body's defenses. They are in the bloodstream for only a few hours and are distributed to organs in which there is inflammation. Be sure the doctor draws attention to the reduced level of neutrophils.

What are neutrophils and types

What are the types of neutrophils

All types of leukocytes in the blood test make up the leukocyte formula. Types of neutrophils differ from each other in the degree of maturity and functions in a living organism.

• myeloblast - a stem cell, the progenitor of blood granulocytes;
• promyelocyte - the next stage of cell differentiation;
• myelocyte - a young cell of granulocytes, located only in the bone marrow;
• metamyelocyte - a young cell from which the following types of neutrophils develop;
• - a type of immature cell with a rod-shaped nucleus;
• segmented - mature cells.

NOTE! By the ratio of these elements in the blood test, the doctor determines the degree of inflammation and a possible disease.

Immediately requires diagnosis and treatment if there is a decrease in neutrophils.

What are the functions of neutrophilic leukocytes in the body?

Neutrophils, along with other cells, are involved in the protection of internal organs from pathogenic organisms. The fight against infection includes phagocytosis - the process of capturing and digesting foreign particles by cells. Several lysosomal enzymes are produced that break down the protein of the bacterial cell. Then chemotaxis is observed - a transition through the basement membranes of cells and a purposeful movement to microorganisms in the focus of inflammation. After an intense attack, the neutrophil dies, while destroying about 7 pathogenic cells. Also, when directed to the inflamed organ, they deliver additional proteolytic enzymes that break down dead tissues.

Neutrophil development

Neutrophils have antibacterial and antitoxic properties, cause an increase in body temperature and support the inflammatory process.

Norm indicators in research results

Neutrophils are designated by the letters NEU. In the leukocyte formula, mature (segmented) cells and young immature () are considered.

For an adult, when he is healthy, an indicator of 45 to 70% is considered from the total volume of leukocytes in the blood or 1.80–6.5 × 109 / l. These data are suitable for both men and women, but depend on age.

For healthy children up to a year, the ratio is from 30 to 50% or 1.8-8.5x109 / l.

Up to 6 years - from 40 to 60% or 2.2-6.2x109 / l.

The number of immature cells is less than segmented and constitute 0.5-6% of the total volume of "white" blood.

Causes of a decrease in neutrophils

For a specialist, the results of the tests are of great importance for the correct diagnosis and selection of the appropriate treatment. There are several sources of decreased neutrophil counts in the bloodstream:

The reason for the decrease in neutrophilic leukocytes determines the diagnosis of the disease and the treatment regimen.

How neutrophils work

Types of conditions with a low number of neutrophils in the blood

A condition in which the levels of neutrophils in the blood are reduced is called neutropenia. Agranulocytosis - with a low level of all granulocytes, a more severe form of leukopenia. Neutropenia is divided into congenital, acquired and unclear etiology. There are degrees of severity:

1. light (1 - 1.5x109 / l);
2. moderate (0.5 - 1x109 / l);
3. heavy (0)

IMPORTANT! The decrease in neutrophils can be absolute and relative. Only the absolute number of mature cells is considered reliable.

Pathologies in which there is a decrease in neutrophilic leukocytes

The level of granulocytes is affected by various diseases that pose a danger to the health of the body and require immediate treatment:

• oncological damage to the bone marrow;
• peptic ulcers of the digestive system;
• leukemia;
• low platelets;
• decrease in hemoglobin in the blood;
• body poisoning;
• complications after treatment;
• thyrotoxicosis.

ATTENTION! To determine the number of neutrophils allows the usual general blood test from a finger.

Finger blood test

When neutrophils are low, a person urgently needs to consult a healthcare professional.

Mechanism of neutropenia

There are 2 main types of mechanism for reducing neutrophilic leukocytes in circulating blood: the production of new cells has worsened and the destruction of mature cells has increased. There is a distinction in the course of pathological processes into 4 varieties:

• the production of young neutrophils in the bone marrow decreases;
• the release of cells from the bone marrow into the general bloodstream slows down;
• the time of circulation in the blood is reduced;
• there is a redistribution of leukocytes in the vascular bed.

With a long-term inflammatory process, a large number of defender cells die, their rate decreases, and qualified medical assistance is required.

Neutropenia - low neutrophils

How to treat a decrease in neutrophils

Understanding the mechanism of the fall in the rate of neutrophilic leukocytes in a blood test gives an answer to the question of treatment. Since these cells are involved in immune processes, it means that a decrease in neutrophils necessarily indicates the presence of an inflamed organ. First of all, the doctor must find the cause.

IMPORTANT! Do not self-medicate. You will conduct high-quality research and provide the necessary assistance in a medical institution. No herbal teas will help in this case.

Neutrophils are on the defense of our body. Their number must be monitored regularly, because this will prevent generalized infections and maintain human health. Contact the nearest medical institution with a request for a general blood test and do not forget to consult a specialist about the results of the study.

White blood cells (leukocytes) are divided into two classes or, as it is commonly called, two series: granulocytic and agranulocytic. The presence in the cytoplasm of individual populations of leukocytes (neutrophils, eosinophils, basophils) of specific granules refers these cells to granular leukocytes - granulocytes. The rest, which do not have such inclusions, make up the agranulocytic series (lymphocytes, monocytes).

Granulocytes (GRA) belong to the first line of defense of the body against microbes, these cells notice the disorder earlier than others and are sent to the focus of inflammation, they also take part in the implementation of the effector phase of the body's immune response.

Granulocytes or polymorphonuclear cells

Granulocytes contain irregularly shaped nuclei, which, in turn, are divided into lobules (segments, which are from 2 to 5), therefore, representatives of the granulocytic series are also called polymorphonuclear cells. In a word, granulocytes are all those cells (eosinophils, basophils, neutrophils) that make up to 75% of all leukocytes that “live” in peripheral blood and human tissues. Different forms of the inflammatory process attract different types of granulocytes, where (at the level of cellular immunity) they always get the leading role. However, they do not work in isolation, both within the group and in the entire community of representatives of the leukocyte link, for example, neutrophils actively cooperate with macrophages, and eosinophils, having some similarity with basophils, are also often seen in some reactions.

The ancestors of granulocytes are myeloblasts, which have the ability to differentiate and proliferative division. Normally, when maturing, they (myeloblasts) differentiate into promyelocytes, and then into myelocytes belonging to two generations: larger maternal (immature) forms and smaller daughter (mature) cells (do not confuse - mature myelocytes and mature granulocytes). At the myelocyte stage, the ability of granulocytes to proliferative division ends. These cells are not seen in the peripheral blood, in a normal state, they do not leave the place of their birth - the bone marrow. True, in extreme situations, when all available neutrophils are involved in reactions (both circulating and the reserve fund), and they, having completed their task, die in 1-2 days, a shortage of cells capable of fighting is created in the blood. That's when immature granulocytes (young) come to their aid, which are found in the general blood test (shift to the left).

Granulocytes are unpretentious, edematous, inflamed tissues that are not sufficiently supplied with blood, and, therefore, with oxygen, are a normal environment for them, where granulocytes take energy from anaerobic glycolysis.

Granulocytes live for a short time from 2-3 to 10 days (depending on the type and condition), unlike some other representatives of the leukocyte link, for example, lymphocytes responsible for immunological memory, which, once "acquainted" with a foreign protein, can live for a long time. years to protect the body at the next meeting. Granulocytes "do not remember evil", because, having fulfilled their function, they die and are replaced by new cells that "do not know" anything about previous events.

How to find granulocytes in the leukocyte formula?

In the leukocyte formula, leukocytes belonging to the granulocytic series are represented by:

• (1-5%).
• (0-1%).
• (stab + segmented = 40-70%).

The norm of all cells of the granulocytic series together in the general blood test is not indicated separately, it is approximately 50-70% of the total number of all leukocytes(2500 - 7000 in 1 ml of blood). However, their number is easy to calculate by the formula:

granulocytes \u003d (total number of leukocytes) - ( + ).

More detailed data on the norms of each type of leukocytes for children and adults can be found in the table below.

Table: norms of granulocytes (eosinophils, neutrophils) and other leukocytes

Increased numbers most often indicate inflammatory diseases of an infectious nature. An increase in the level of individual forms may indicate other reactions of the body: basophils grow with allergies, eosinophils - with helminthic invasions and allergies too. Physiologically, granulocytes increase:

1. During pregnancy (second half);
2. During childbirth;
3. Before menstruation;
4. During intense physical activity;
5. After a good lunch.

Lower values ​​in most cases make one suspect:

• Hematological pathology;
• viral infection;
• collagenoses.

Although the list of diseases in which the indicators are increased or decreased is certainly much wider. It is obvious that in women the number of granulocytes should be somewhat higher, although, perhaps, men cover women's indicators with the need (or necessity) for physical labor and abundant food?

Any reason leading to a decrease in the production of granulocytes in the bone marrow will manifest itself in a change in their content in the peripheral blood - the number of representatives of the granulocyte series will be reduced. In addition to hematological pathology, such situations, when granulocytes are reduced, can be induced by certain pharmaceutical agents (antibiotics, sulfonamides, anticancer drugs, etc.) or be the result of genetically determined diseases. However, the following pattern is clearly observed: the production of mature forms is low - susceptibility to infections of the respiratory tract and skin is high.

In older children, the norms, in general, correspond to the norms of adults, in addition, the child's leukocyte formula is studied by the number of individual cells, and not all granular forms in a crowd. The ratio of individual populations of leukocytes in a child is somewhat different from that in an adult (second cross: the number of neutrophils after 6 years increases in accordance with the decrease in lymphocytes).

In the body, some granulocytes float freely along the blood vessels, others stick to the endothelial walls and wait to be “called” for help, so the granular leukocytes counted in the blood formula make up only a certain part of the entire community. When taking the analysis, only those granulocytes that circulate get into the test tube, and the laboratory assistant will count them, and the sticky ones will remain “behind the scenes”. The norm of all granulocytes in an adult in the bloodstream is about 5.0 X 10 11 or 2000-9000 per 1 cu. mm of blood. In children under 3-6 years old, the number of granulocytes is somewhat lower due to the increased content of lymphocytes, which is the norm for a child of this age.

Representatives of granular leukocytes, their main purpose

Thus, granulocyte-dependent type reactions are carried out by granular leukocytes, but further events - the binding of immunoglobulins of other classes (IgG, IgM) are mostly within the competence of lymphocytes (first T-populations, and then B-cells).

But these are already delayed-type reactions that develop after a day or three or weeks and months after the penetration of a foreign substance. Granulocytes do not stand aside there either, however, they are already losing the main role to other participants in the immunological process, since humoral immunity is triggered.

In the activity of granulocytes, too, everything is not always simple and smooth. The literature describes and in life there are cases when the information received at birth regarding the functional abilities of granulocytic cells turns out to be distorted, that is, certain groups of granular leukocytes, due to genetic disorders, become functionally defective:

In addition, when in contact with adverse factors, granulocytes face various dangers, which turn into acquired defects and anomalies. Of course, each of these violations has a bad effect on human health, making it unprotected against a variety of infectious agents that live in the environment.

More detailed information about each of the representatives of the leukocyte link can be gleaned from the corresponding more detailed materials posted on SosudInfo.ru. This work is for informational purposes, it contains only general concepts about one, but very important part, called the granulocytic series, or simply - granulocytes.

Video: what are granulocytes - medical animation