Neutrophils are – White blood cells are the cells that make up blood components.
These white blood cells function to help the body fight various infectious diseases as part of the
immune system. White blood cells are colorless, nucleated, can migrate amoebae, and can
penetrate capillary or choroidal walls.
In the body, white blood cells are not closely associated with any particular organ or tissue, they
function independently as a single-celled organism. Leukocytes can move freely and interact
with and capture cellular debris, foreign particles or invading microorganisms.
Furthermore, white blood cells cannot divide or reproduce on their own but are a product of pluripotent
hematopoietic stem cells found in the bone marrow.
White blood cells have an important role in the immune system. Among the various types of
white blood cells, neutrophils are the most numerous, about 55-70%.
Neutrophils are a type of white blood cell that play an important role in your immune system.
Blood levels that are lower or higher than normal can indicate the condition of your body.
Sinaumed’s friends , maybe you are still new to the term neutrophil. In fact, it is
quite important to understand it because it is closely related to body health. In order to
understand this more deeply, come on, see the full review below!
What are Neutrophils?
Neutrophils (English: neutrophil, polymorphonuclear neutrophilic leukocyte, PMN) are white blood
cells belonging to the granulocyte group. Together with the other two granulocytes namely
eosinophils and basophils which have granules in the cytoplasm, they are also known as polymorphonuclear
leukocytes. Neutrophil granules are red-green.
This type of white blood cell is involved in the body’s defense against bacterial infections and other
inflammatory processes, and is also the first cell to appear when an infection occurs elsewhere.
. With phagocytic properties similar to macrophages, neutrophils attack pathogens by
invading the respiratory tract with a variety of toxic substances containing strong oxidants, including
hydrogen peroxide, oxygen free radicals, and hypochlorites.
The ratio of white blood cells to neutrophils is usually 50 to 60%. Normal adult bone marrow
produces at least 100 billion neutrophils per day, and this increases 10-fold in acute inflammation.
After leaving the bone marrow, this type of white blood cell will go through 6 morphological stages, namely:
neutrophils, metamorphosed, non-fragmented (banded), segmented neutrophils. Segmented
neutrophils are fully functional cells, containing cytoplasmic granules (primary or azurophil, secondary or
specific) and a hollow nucleus rich in chromatin. Damaged neutrophils appear as pus.
Neutrophils are the first leukocytes to reach areas of inflammation and initiate host defense against
pathogens. Neutrophil activation also plays a role in effective infection fighting, together
with monocytes and macrophages, through phagocytosis and microbiology or through release of pathogens,
inflammation such as oxygen radicals, proteases or peroxidases. Neutrophil migration from
circulating blood to inflamed tissues is a complex process and depends on many cellular functions.
One of the keys to this process is the adhesion receptor (Craig et al., 2009).
Histopathological observations were made by counting the number of inflammatory cells (neutrophils), the
formation of new blood vessels (neovascularization), the percentage of re-epithelialization, and the
percentage of collagen connective tissue area (Chen et al., 2005; Winarsih et al., 2010). The
rate of re-epithelialization is calculated by the following formula: the length of the wound with new
epithelium divided by the total length of the wound multiplied by 100%. Calculations were
performed on 10 visual fields with an objective magnification of 40x and then averaged.
Neutrophil Function
In general, there are 2 types of white blood cells to pay attention to, neutrophils and lymphocytes.
Both function to maintain the immune system. The difference is that white blood cells
fight bacteria or viruses by producing antibodies, whereas neutrophils fight infection directly.
This type of white blood cell is produced in the bone marrow and distributed throughout the body via the
bloodstream. Unlike other white blood cells, neutrophils can leave blood vessels and enter
infected body tissues to fight bacteria or viruses.
Neutrophils help prevent infection by blocking, inactivating, digesting, and repelling invading particles
and microorganisms. This type of white blood cell constantly monitors for signs of infection
and reacts quickly to trap and destroy pathogens.
These white blood cells communicate with other cells to help repair damaged cells and promote an immune
response. In addition, these white blood cells also play an important role in regulating the
immune system and inflammation in the body.
The body produces these white blood cells in the bone marrow, which make up about 50-70% of the total
number of white blood cells in the blood. The overall level of white blood cells in the
bloodstream for an adult is 4500-11000 per cubic millimeter (mm3).
When there is an infection or other source of inflammation in the body, special chemicals alert mature
neutrophils, which then leave the bone marrow and travel through the bloodstream to where they are needed.
Band cells are an immature form of neutrophils that are produced when the body is fighting an infection or
inflammation. Excess band of cells in the blood is called hemophilia. When this
occurs, it usually indicates an infection or inflammation.
Unlike some other cells or blood components, neutrophils can cross the cell junctions lining the walls of blood
vessels and enter tissues directly.
Neutrophil Types
These neutrophils when examined in more detail microscopically, based on their shape, can be divided into 2
types, namely rod neutrophils and segmental neutrophils.
1. Stem Neutrophils
Stem neutrophils are immature forms of neutrophil cells which also function to help fight germs that enter the
body, and in general the normal ratio in the body is used as an international standard. The reality is 0% to 6%
(subject to change) depending on the reference each laboratory).
2. Segmented Neutrophils
Segmental neutrophils are fully functional cells containing cytoplasmic granulomas and chromatin-rich
hollow nuclei. Segmental neutrophils are involved in the body’s defense against infection and
inflammation and are the first cells to appear in the event of an infection.
Difference Between Stem Neutrophils and
Segment Neutrophils
The difference between the two is that rod neutrophils are the juvenile form of segmental neutrophils which
are commonly known as horseshoe neutrophils as they have a horseshoe shaped nucleus. Along with
the maturation process, the shape of the nucleus will be segmented and become segmented neutrophils.
Neutrophils have large pale pink cytoplasm and fine purple granules.
Segmental neutrophils, which have thin (pale) cytoplasmic granules, are often called polymorphonuclear
leukocytes because their nuclei consist of 2 to 5 segments (lobes) that differ in shape from one another and
are connected by chromatin filaments. The number of fractionated neutrophils is 3 to 6, and if
more than 6 are called hypersegmented neutrophils (Kiswari, 2014).
How to Calculate Neutrophil Levels in the Body
Neutrophils are granulocytes that are effective in defending organisms, especially against bacterial
infections (Widman, 1995; Howard, 2008). Total neutrophil value, hereinafter referred to as
ANC, is the number of immature and mature neutrophils circulating in the peripheral blood.
The number of PNC often increases in the presence of bacterial infection (Howard, 2008; Levy, 2004).
The ANC value can be calculated from the results of a typical count by adding the fractional
percentage and bars, then multiplying by the total white blood cell count.
Doctors can see the number of certain neutrophils in the body by doing a test called a complete blood count
(CBC).
You need to know that the normal number or level of white blood cells in an adult’s body is around 4,500 to
11,000 per microliter of blood. While the normal value or neutrophil level is 1500 to 8000 per
microliter of blood.
It’s more likely that your doctor will order a complete blood test when symptoms related to infection, injury, or
chronic disease are present.
If the white blood cell count on examination does not match normal limits, then proceed to look at the
neutrophil value. Checking neutrophil levels is also important.
The level of neutrophils in your white blood cells can be detected with a differential blood test which
includes checking the levels of each type of white blood cell. Blood differential tests can
also show abnormal cells in your blood.
This test is usually done to diagnose infection, anemia, or leukemia. This test can also be
used to check whether the treatment you are undergoing is going well.
Any infection or acute stress can increase your white blood cell count and form a condition called
leukocytosis. A high white blood cell count can be caused by inflammation, an immune response,
or a blood disease such as leukemia.
It is important to know that an abnormal increase in one type of white blood cell can decrease the number of
another.
Function Disturbances
An increase in the number of neutrophils is called neutrophilia. Neutropenia can occur as a
result of a physiological response to stress, for example by exercise, extreme weather conditions, acute
bleeding or hemolysis, childbirth, and acute emotional stress.
Pathological conditions that cause neutropenia include acute infection, inflammation or inflammation,
tissue damage, metabolic disorders, appendicitis, and myeloid leukemia. While a decrease in the
number of neutrophils is known as neutropenia, neutropenia is found in viral diseases, leprosy, leukemia,
erythrocytosis, anemia, drug effects (Riswanto, 2013).
Neutrophilia
Having very high levels of neutrophils in the blood is called neutropenia or also known as neutrophilia.
Neutrophilia is a condition where the number of neutrophils in the blood exceeds normal limits.
Some conditions that can cause neutrophilia include strenuous exercise, smoking, extreme stress,
injuries or burns, infectious diseases, and blood cancers.
This is an important function of neutrophilia in the immune system. Remember that neutrophil
levels can also describe your health. However, this is not the only visible benchmark.
If you feel any complaints, try to consult a doctor. If your doctor recommends a complete
blood count to look at your white blood cell or neutrophil levels, ask your doctor about the purpose of the
test and what you need to prepare before the test.
1. Stress
The number of neutrophils can increase due to stress, such as exercise, epilepsy, and stress.
2. Bacterial infection
Sudden onset of bacterial infection can cause tissue inflammation leading to a sharp increase in neutrophil
count.
3. Ketosis
Ketosis occurs when the body makes acids and toxins. When the disease moves to a chronic
stage, it can cause an increase in the number of neutrophils.
4. Eclampsia
Occurs in second trimester pregnant women due to increased blood pressure, increased protein in the urine and
edema.
5. Cancer
The number of neutrophils can increase as cancer spreads throughout the body.
6. Hemolytic anemia
Occurs when red blood cells are damaged and cause disruption of oxygen transport in the blood.
7. Treatment effect
Some drugs can cause a large increase in the absolute number of neutrophils. Like,
corticosteroids. The effects of these drugs are similar to corticosteroid hormones.
This hormone can control the nutrients, salt and water in the body.
In general, the main cause of neutrophilia is a bacterial infection. In addition, lifestyle
factors, such as excessive exercise, stress, and smoking, can also increase the risk of neutrophilia.
In old age, a high white blood cell count can occur due to infection, corticosteroid treatment, Down’s syndrome,
or delayed separation of the umbilical cord.
Treatment of neutrophilia usually depends on the disease or condition causing it. Consult a
doctor to find out more definite causes and treatment.
Neutropenia
A low level of neutrophils is called neutropenia. The cause of a low neutrophil count usually
occurs when the body uses immune cells more quickly than normal.
Neutropenia is a condition when the level of neutrophils in the blood is below normal limits.
Several conditions can cause leukopenia, including vitamin B12 deficiency, aplastic anemia,
tuberculosis, autoimmune diseases, and side effects of certain drugs or chemotherapy.
Another possible cause of decreased neutrophil value and function is if the bone marrow is abnormally producing
neutrophils.
Furthermore, an enlarged spleen can also lead to decreased levels of neutrophils because the spleen can destroy
neutrophils and other blood cells.
The following conditions and procedures are risk factors for a low neutrophil level, such as:
1. Deficiency of folic acid (B12)
Reduced levels of B12 in the body can cause a decrease in ANC, which makes the body unable to function optimally.
2. Severe bacterial infection
Severe infection can cause destruction of neutrophils, leading to the formation of pus in the blood.
3. Aplastic anemia
Aplastic anemia can occur when the bone marrow cannot produce enough blood cells in the body.
4. Preleukemia and Leukemia
Leukemia is an increase in the number of white blood cells in the body that are large and not
normal, while preleukemia is a decrease in the number of white blood cells in the body.
5. Autoimmune disease
When the body produces proteins such as antineutrophils which destroy neutrophils. For example
in people with lupus.
6. Impotence
Erectile dysfunction is an abnormal enlargement of the spleen that occurs in the spleen and can cause an increase
in the white blood cell count.
7. Cardiopulmonary pathway
Conduction of blood flow from the heart to the lungs to the aorta can reduce blood neutrophils.
8. Dialysis
Dialysis to improve kidney function. Dialysis can reduce the neutrophil count.
9. Drug effect
Some drugs can reduce the number of neutrophils in the blood, such as allergy medications, psychosis, and nausea.
Difference between Neutrophils, Eosinophils and
Basophils
Neutrophils, eosinophils and basophils are myeloid cells formed during hematopoiesis. These
are all granulocytes circulating in the blood and migrating to inflamed tissues. The main
difference between neutrophil and basophil eosinophil is their structure and role in the vertebrate body.
Granulocytes and lymphocytes collectively form a group of cells called white blood cells.
Neutrophils are professional phagocytes involved in ingesting pathogens such as bacteria and
destroying them by intercellular digestion.
The recruitment of neutrophils to sites of inflammation is called chemotaxis, which is regulated by
cytokines. Eosinophils fight most parasites. They provide protection against
hypersensitivity reactions via cytotoxicity, which is mediated by the granular components.
Basophils, along with eosinophils and mast cells, provide defense against allergic reactions.
They also contain histamine and heparin, which help reduce blood clots.