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Page 1: faal hematopoiesis

hematopoiesihematopoiesiss

Dr. Damajanty Pangemanan, Dr. Damajanty Pangemanan, MKesMKes

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Sistem hematopoietikSistem hematopoietik

1.1. Sel stem (progenitor awal), Sel stem (progenitor awal), menyokong hematopoiesismenyokong hematopoiesis

2.2. Colony forming unit (CFU), pelopor Colony forming unit (CFU), pelopor yang selanjutnya berkembang dan yang selanjutnya berkembang dan berdeferensiasi dalam berdeferensiasi dalam memproduksi selmemproduksi sel

3.3. Faktor regulator yang mengatur Faktor regulator yang mengatur agar sistem berlangsung teraturagar sistem berlangsung teratur

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Stem selStem sel

Sel induk yang mempunyai Sel induk yang mempunyai kemampuan berdeferensiasi menjadi kemampuan berdeferensiasi menjadi beberapa turunan, membelah diri beberapa turunan, membelah diri dan memperbaharui populasi sel dan memperbaharui populasi sel stem sendiri dibawah pengaruh stem sendiri dibawah pengaruh faktor pertumbuhan hematopoietikfaktor pertumbuhan hematopoietik

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HematopoiesisHematopoiesis

Pembentukan dan perkembangan Pembentukan dan perkembangan dari sel-sel darahdari sel-sel darah

Dimulai pada awal kehidupan embrio Dimulai pada awal kehidupan embrio dan berlangsung sampai dewasadan berlangsung sampai dewasa

Secara garis besar perkembangan ini Secara garis besar perkembangan ini dibagi dalam 3 periode :dibagi dalam 3 periode :– Hematopoiesis yolk sac Hematopoiesis yolk sac – Hematopoiesis hatiHematopoiesis hati– Hematopoiesis medularHematopoiesis medular

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Hematopoiesis yolk sacHematopoiesis yolk sac

Sel darah dibuat dari jaringan Sel darah dibuat dari jaringan mesenkim 2-3 minggu setelah mesenkim 2-3 minggu setelah fertilisasifertilisasi

Sel eritrosit dapat diidentifikasi dalam Sel eritrosit dapat diidentifikasi dalam yolk sac pada masa gestasi 16 hariyolk sac pada masa gestasi 16 hari

Sel induk hematopoiesis mulai Sel induk hematopoiesis mulai berkelompok dalam hati janin pada berkelompok dalam hati janin pada masa gestasi 5-6 minggumasa gestasi 5-6 minggu

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Hematopoiesis hatiHematopoiesis hati

Berasal dari sel stem pluripoten yang Berasal dari sel stem pluripoten yang berpindah dari yolk sacberpindah dari yolk sac

Perubahan tempat hematopoiesis ini Perubahan tempat hematopoiesis ini mempunyai hubungan dengan mempunyai hubungan dengan regulasi perkembangan oleh regulasi perkembangan oleh lingkungan mikro, produksi sitokin lingkungan mikro, produksi sitokin dan ekspresi pada reseptordan ekspresi pada reseptor

Masa gestasi 9 minggu, Masa gestasi 9 minggu, hematopoiesis sudah terbentuk dalam hematopoiesis sudah terbentuk dalam hatihati

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Hematopoiesis hatiHematopoiesis hati

Yang terutama adalah eritropoiesisYang terutama adalah eritropoiesis Mencapai puncak pada masa gestasi Mencapai puncak pada masa gestasi

4-5 bulan kemudian mengalami 4-5 bulan kemudian mengalami regresi perlahanregresi perlahan

Pada pertengahan kehamilan, Pada pertengahan kehamilan, tampak pelopor hematopoietik tampak pelopor hematopoietik terdapat di limpa, thimus, kelenjar terdapat di limpa, thimus, kelenjar limfe dan ginjallimfe dan ginjal

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Hematopoiesis medularHematopoiesis medular

Periode terakhir pembentukan sistem Periode terakhir pembentukan sistem hematopoiesishematopoiesis

Dimulai sejak masa gestasi 4 bulanDimulai sejak masa gestasi 4 bulan Ruang meduler terbentuk dalam Ruang meduler terbentuk dalam

tulang rawan dan tulang panjang tulang rawan dan tulang panjang dengan proses reabsorbsidengan proses reabsorbsi

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Hematopoiesis medularHematopoiesis medular Masa gestasi 32 minggu – lahir semua Masa gestasi 32 minggu – lahir semua

rongga sum-sum tulang terisi dengan rongga sum-sum tulang terisi dengan jaringan hematopoietik yang aktif dan sum-jaringan hematopoietik yang aktif dan sum-sum tulang berisi sel-sel darahsum tulang berisi sel-sel darah

Pada perkembangan selanjutnya fungsi Pada perkembangan selanjutnya fungsi pembuatan sel darah diambil oleh sum-sum pembuatan sel darah diambil oleh sum-sum tulangtulang

Sel mesenkim yang mempunyai Sel mesenkim yang mempunyai kemampuan membentuk sel darah menjadi kemampuan membentuk sel darah menjadi kurang, tapi tetap ada dalam sumsum kurang, tapi tetap ada dalam sumsum tulang, hati limpa,kelenjar getah bening tulang, hati limpa,kelenjar getah bening dan dinding usus dikenal sebagai RESdan dinding usus dikenal sebagai RES

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Hematopoiesis medularHematopoiesis medular

Pada bayi dan anak hematopoiesis Pada bayi dan anak hematopoiesis yang aktif terjadi pada sumsum tulang, yang aktif terjadi pada sumsum tulang, termasuk bagian distal tulang panjangtermasuk bagian distal tulang panjang

Orang dewasa normal, hematopoiesis Orang dewasa normal, hematopoiesis terbatas pada vertebra (tulang terbatas pada vertebra (tulang belakang),costa, sternum, pelvis, belakang),costa, sternum, pelvis, skapula, skull ( dan jarang berlokasi skapula, skull ( dan jarang berlokasi pada humerus dan femur)pada humerus dan femur)

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Hematopoiesis in a fetusHematopoiesis in a fetus

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Hemopoiesis in the embryo takes Hemopoiesis in the embryo takes place in the yolk sac, liver and place in the yolk sac, liver and spleen, and bone marrowspleen, and bone marrow

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Hematopoiesis in a fetusHematopoiesis in a fetus

Sel darah pertama yang dibentuk Sel darah pertama yang dibentuk adalah eritrosit adalah eritrosit

Pada 2-8 minggu pertama sel Pada 2-8 minggu pertama sel eritrosit primitif ditemukan di yolk eritrosit primitif ditemukan di yolk sacsac

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Hematopoiesis in a fetusHematopoiesis in a fetus

Selama 2 bulan pertama Selama 2 bulan pertama hematopiesis extrameduler hematopiesis extrameduler berkembang, dan yolk sac berpindah berkembang, dan yolk sac berpindah ke liver ke liver

Granulocytes also appear in the liver Granulocytes also appear in the liver during the 2nd month during the 2nd month

The spleen also contributes to The spleen also contributes to hematopoiesis at this point.hematopoiesis at this point.

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Hematopoiesis in a fetusHematopoiesis in a fetus

During the 4th month medullary During the 4th month medullary hematopoiesis develops when the hematopoiesis develops when the bone marrow begins to contribute to bone marrow begins to contribute to hematopoiesis.hematopoiesis.

During the 5th month bone marrow During the 5th month bone marrow takes over as chief production site takes over as chief production site and continues throughout life.and continues throughout life.

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Hematopoiesis after Hematopoiesis after birthbirth

At birth the liver and spleen have At birth the liver and spleen have ceased production of blood cells and ceased production of blood cells and hematopoiesis is occurring in the red hematopoiesis is occurring in the red bone marrow of almost every bone bone marrow of almost every bone (axial and appendicular skeletons).(axial and appendicular skeletons).

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Hematopoiesis after Hematopoiesis after birthbirth

As a child develops and matures As a child develops and matures (beginning at 4 years) the (beginning at 4 years) the hematopoietic activity begins to hematopoietic activity begins to move to the axial skeleton (flat move to the axial skeleton (flat bones, skull, ribs, sternum, clavicle, bones, skull, ribs, sternum, clavicle, vertebrae, pelvic bones) and vertebrae, pelvic bones) and proximal ends of long bones proximal ends of long bones (humerus and femur).(humerus and femur).

This move is completed by age 18This move is completed by age 18

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Hematopoiesis after Hematopoiesis after birthbirth

Remaining marrow cavities are Remaining marrow cavities are replaced with fat (yellow bone replaced with fat (yellow bone marrow).marrow).

By age 40 the marrow in sternum, By age 40 the marrow in sternum, ribs, pelvis and vertebrae is ribs, pelvis and vertebrae is composed of equal amounts of composed of equal amounts of hematopoietic tissue and fat.hematopoietic tissue and fat.

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Hematopoiesis after Hematopoiesis after birthbirth

Extramedullary hematopoiesis may Extramedullary hematopoiesis may occur under two conditions:occur under two conditions:– If the bone marrow is no longer If the bone marrow is no longer

functional functional – When the bone marrow is not able to When the bone marrow is not able to

keep up with the demand for blood cells keep up with the demand for blood cells When extramedullary hematopoiesis When extramedullary hematopoiesis

occurs, the liver and spleen will occurs, the liver and spleen will become enlarged.become enlarged.

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The Blood CellsThe Blood Cells

red blood cells (RBCs) or red blood cells (RBCs) or erythrocytes erythrocytes

white blood cells (WBCs) or white blood cells (WBCs) or leukocytes leukocytes

platelets or thrombocytes (actually platelets or thrombocytes (actually cytoplasm fragments) cytoplasm fragments)

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Blood cell development in Blood cell development in adultsadults

All blood cells develop from All blood cells develop from pluripotent stem cells that are found pluripotent stem cells that are found in the red bone marrow. in the red bone marrow.

Stem cells are able to proliferate as Stem cells are able to proliferate as well as differentiate into the different well as differentiate into the different types of blood cells. They are also types of blood cells. They are also able to renew themselves.able to renew themselves.

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Blood cell development in Blood cell development in adultsadults

The pluripotent stem cell is the The pluripotent stem cell is the progenitor of two multipotential stem progenitor of two multipotential stem cell lines: the myeloid and the cell lines: the myeloid and the lymphoid lines. lymphoid lines.

Myeloid stem cells are precursors of Myeloid stem cells are precursors of granulocytes, monocyte, RBCs and granulocytes, monocyte, RBCs and platelets; lymphoid stem cells are platelets; lymphoid stem cells are precursor of lymphocytes precursor of lymphocytes

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ControlControl

Many Many ‘Growth Factors’ ‘Growth Factors’ (also known (also known as cytokines and interleukins and as cytokines and interleukins and hormones) precisely regulate all hormones) precisely regulate all stages of the process. For examplestages of the process. For example..

1.CSF 1.CSF - colony stimulating factors - colony stimulating factors function at various stages of function at various stages of development of blood cells. There development of blood cells. There are several CSFs, each stimulating are several CSFs, each stimulating the development of different types of the development of different types of cellscells

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2. Interleukins2. Interleukins - protein molecules that - protein molecules that work with the CSFs to stimulate work with the CSFs to stimulate particular cell lines to proliferate and particular cell lines to proliferate and differentiate. differentiate.

3. Erythropoietin3. Erythropoietin – (EPO) the hormone – (EPO) the hormone produced by kidney to stimulate RBC produced by kidney to stimulate RBC production (production (regulates erythropoiesis)regulates erythropoiesis)

4. filgrastim:4. filgrastim: is produced by stromal cells is produced by stromal cells and regulates granulopoiesisand regulates granulopoiesis

5. thrombopoietin: 5. thrombopoietin: is produced by the liver, is produced by the liver, and regulates platelet productionand regulates platelet production

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They have many different They have many different effects:effects:

   proliferationproliferation differentiationdifferentiation maturationmaturation functional activationfunctional activation prevention of apoptosis prevention of apoptosis

(programmed cell death)(programmed cell death)

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Pools of hematopoietic Pools of hematopoietic activityactivity

1. Bone marrow 1. Bone marrow Stem cell pool - comprised of Stem cell pool - comprised of

multipotential stem cells and unipotential multipotential stem cells and unipotential committed colony-forming units (CFUs), all committed colony-forming units (CFUs), all of which are morphologically of which are morphologically unidentifiable.unidentifiable.

Proliferating pool - cells are capable of Proliferating pool - cells are capable of DNA synthesis and are undergoing mitosis.DNA synthesis and are undergoing mitosis.

Storage pool - mature cells that are stored Storage pool - mature cells that are stored for later release into the peripheral blood for later release into the peripheral blood and cells that are maturing. They are no and cells that are maturing. They are no longer capable of mitosis.longer capable of mitosis.

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2. Peripheral blood2. Peripheral blood

a. Circulating pool a. Circulating pool – functioning cells in circulation, in transit functioning cells in circulation, in transit

to tissues. to tissues. – The blood we draw for evaluation comes The blood we draw for evaluation comes

from this pool. from this pool. – The circulating pool is found more The circulating pool is found more

towards the center of the tubular blood towards the center of the tubular blood vessel.vessel.

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b. Marginating pool b. Marginating pool Primarily a term used for white blood Primarily a term used for white blood

cells. cells. The cells are adhered to walls of blood The cells are adhered to walls of blood

vessels and are ready to move through vessels and are ready to move through into the tissues (diapedesis). into the tissues (diapedesis).

There is constant movement between There is constant movement between the circulating and marginating pools. the circulating and marginating pools. At a given time the ratio of cells in the At a given time the ratio of cells in the circulating pool to the cells in the circulating pool to the cells in the marginating pool is 50:50. Neutrophils marginating pool is 50:50. Neutrophils move freely between the two pools.move freely between the two pools.

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The two pools of circulation in The two pools of circulation in peripheral blood peripheral blood

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HemopoiesisHemopoiesis

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34

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HematopoiesisHematopoiesisfrom pluripotent stem cells tofrom pluripotent stem cells to

mature, differentiated,mature, differentiated, cellular effectors of immunity cellular effectors of immunity

and moreand more

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TThh- Helper Cell- Helper Cell B CellB Cell MacrophageMacrophage NeutrophilNeutrophil (alternative (alternative

path)path)

Mast CellMast Cell PlateletsPlatelets

TTcc CytotoxicCytotoxic Cell Cell DendriticDendritic Cell Cell NeutrophilNeutrophil EosinophilEosinophil BasophilBasophil ErythrocyteErythrocyte

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Dendritic cell pathwayDendritic cell pathway

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Sel dendritikSel dendritik

Sel dengan bentuk tidak teraturSel dengan bentuk tidak teratur Ditemukan pada jaringan , pada kulit Ditemukan pada jaringan , pada kulit

disebut sel Langerhans epidermaldisebut sel Langerhans epidermal Berperan sebagai presentasi antigen Berperan sebagai presentasi antigen

ke sel T dan aktivasi limfositke sel T dan aktivasi limfosit

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Pluripotent Stem CellPluripotent Stem CellThis is the undifferentiated precursor to This is the undifferentiated precursor to all of the blood cells, red and white, and all of the blood cells, red and white, and

other immune effector cells, and platelets.other immune effector cells, and platelets.

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Myeloid Stem Cells… Myeloid Stem Cells… daughters daughters of the Pluripotent Stem Cells, these are the of the Pluripotent Stem Cells, these are the

progenitors of a host of specialized white blood progenitors of a host of specialized white blood cells (WBCs), red blood cells (RBCs) and the blood cells (WBCs), red blood cells (RBCs) and the blood

platelets which are crucial to blood clotting.platelets which are crucial to blood clotting.

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Granulocyte -Monocyte Progenitor Granulocyte -Monocyte Progenitor cells cells can differentiate into monocytes or can differentiate into monocytes or

neutrophilsneutrophils

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Monocytes… Monocytes… act as antigen act as antigen presenting cells (APCs), as Antibody-presenting cells (APCs), as Antibody-

Dependent Cytotoxic Cells (ADCC) , and Dependent Cytotoxic Cells (ADCC) , and promote inflammation.promote inflammation.

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Dendritic Cell…Dendritic Cell… like the like the macrophage, this cell is phagocytic it macrophage, this cell is phagocytic it inhabits the tissues looking for foreign inhabits the tissues looking for foreign

intruders to devour.intruders to devour.

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Macrophage pathwayMacrophage pathway

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Monosit/macrofagMonosit/macrofag

Merupakan sel darah terbesarMerupakan sel darah terbesar Mengandung granul dan nucleus Mengandung granul dan nucleus

bentuk lobularbentuk lobular Mempunyai aktivitas baktericidalMempunyai aktivitas baktericidal Monosit bermigrasi dari sirkulasi Monosit bermigrasi dari sirkulasi

kejaringan seperti sel Kupfer di heparkejaringan seperti sel Kupfer di hepar Berperan penting pada imunitas Berperan penting pada imunitas

spesifik dan non spesifikspesifik dan non spesifik

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Pluripotent Stem CellPluripotent Stem CellThis is the undifferentiated precursor to This is the undifferentiated precursor to all of the blood cells, red and white, and all of the blood cells, red and white, and

other immune effector cells, and platelets.other immune effector cells, and platelets.

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Myeloid Stem Cells… Myeloid Stem Cells… daughters daughters of the Pluripotent Stem Cells, these are the of the Pluripotent Stem Cells, these are the

progenitors of a host of specialized white blood progenitors of a host of specialized white blood cells (WBCs), red blood cells (RBCs) and the blood cells (WBCs), red blood cells (RBCs) and the blood

platelets which are crucial to blood clotting.platelets which are crucial to blood clotting.

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Granulocyte -Monocyte Progenitor Granulocyte -Monocyte Progenitor cells cells can differentiate into monocytes or can differentiate into monocytes or

neutrophilsneutrophils

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Monocytes… Monocytes… act as antigen act as antigen presenting cells (APCs), as Antibody-presenting cells (APCs), as Antibody-

Dependent Cytotoxic Cells (ADCC) , and Dependent Cytotoxic Cells (ADCC) , and promote inflammation.promote inflammation.

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Macrophage…Macrophage…functions as antigen functions as antigen presenting cell (APC), in inflammation, and presenting cell (APC), in inflammation, and in ADCC (antibody-dependent cell-mediated in ADCC (antibody-dependent cell-mediated

cytotoxicitycytotoxicity

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leukositleukosit

Sel darah putihSel darah putih Konsentrasi : 4800 – 10.800/mm kubik Konsentrasi : 4800 – 10.800/mm kubik

darahdarah Berfungsi sebagai alat pertahanan Berfungsi sebagai alat pertahanan

tubuh terhadap bakteri, virus, parasit, tubuh terhadap bakteri, virus, parasit, racun dan sel tumorracun dan sel tumor

Tdd :Tdd :– Granulosit (neutrofil, basofil dan eusinofil)Granulosit (neutrofil, basofil dan eusinofil)– Agranulosit (limfosit dan monosit)Agranulosit (limfosit dan monosit)

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GranulopoiesisGranulopoiesis

Granulocytes include 3 types of cells:Granulocytes include 3 types of cells:

– neutrophils or polymorphsneutrophils or polymorphs– eosinophilseosinophils– basophilsbasophils

  

  

  

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GranulopoiesisGranulopoiesis

Granulocytes and a fourth cell type - the Granulocytes and a fourth cell type - the monocyte are made in the bone marrow from a monocyte are made in the bone marrow from a common precursor cell, the common precursor cell, the mixed myeloidmixed myeloid progenitor cellprogenitor cell or CFUGEMM. or CFUGEMM.

This process takes between 6-10 days in the This process takes between 6-10 days in the marrow. marrow.

Once released from the marrow, into the marrow Once released from the marrow, into the marrow sinusoids, and from there into the peripheral sinusoids, and from there into the peripheral blood, these cells circulate for only 6-10 hours. blood, these cells circulate for only 6-10 hours.

They then take up residence in tissue where they They then take up residence in tissue where they live for 4-5 days before they die.live for 4-5 days before they die.

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NeutrofilNeutrofil

Jumlahnya paling banyak dari jenis Jumlahnya paling banyak dari jenis leukosit (50-70%)leukosit (50-70%)

Fungsi : fagositik, terutama terhadap Fungsi : fagositik, terutama terhadap bakteribakteri

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Neutrophil PathwayNeutrophil Pathway

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Pluripotent Stem CellPluripotent Stem CellThis is the undifferentiated precursor to This is the undifferentiated precursor to all of the blood cells, red and white, and all of the blood cells, red and white, and

other immune effector cells, and platelets.other immune effector cells, and platelets.

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Myeloid Stem Cells… Myeloid Stem Cells… daughters daughters of the Pluripotent Stem Cells, these are the of the Pluripotent Stem Cells, these are the

progenitors of a host of specialized white blood progenitors of a host of specialized white blood cells (WBCs), red blood cells (RBCs) and the blood cells (WBCs), red blood cells (RBCs) and the blood

platelets which are crucial to blood clotting.platelets which are crucial to blood clotting.

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Granulocyte -Monocyte Progenitor Granulocyte -Monocyte Progenitor cells cells can differentiate into monocytes or can differentiate into monocytes or

neutrophilsneutrophils

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Monocytes… Monocytes… act as antigen act as antigen presenting cells (APCs), as Antibody-presenting cells (APCs), as Antibody-

Dependent Cytotoxic Cells (ADCC) , and Dependent Cytotoxic Cells (ADCC) , and promote inflammation.promote inflammation.

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Neutrophils…Neutrophils…function in function in antimicrobial activity, inflammation antimicrobial activity, inflammation

response, and antibody-dependent, cell-response, and antibody-dependent, cell-mediated cytotoxicity (ADCC)mediated cytotoxicity (ADCC)

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Alternative Neutrophil Alternative Neutrophil pathwaypathway

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Pluripotent Stem CellPluripotent Stem CellThis is the undifferentiated precursor to This is the undifferentiated precursor to all of the blood cells, red and white, and all of the blood cells, red and white, and

other immune effector cells, and platelets.other immune effector cells, and platelets.

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Myeloid Stem Cells… Myeloid Stem Cells… daughters daughters of the Pluripotent Stem Cells, these are the of the Pluripotent Stem Cells, these are the

progenitors of a host of specialized white blood progenitors of a host of specialized white blood cells (WBCs), red blood cells (RBCs) and the blood cells (WBCs), red blood cells (RBCs) and the blood

platelets which are crucial to blood clotting.platelets which are crucial to blood clotting.

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Granulocyte -Monocyte Progenitor Granulocyte -Monocyte Progenitor cells cells can differentiate into monocytes or can differentiate into monocytes or

neutrophilsneutrophils

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Neutrophils…Neutrophils…function in function in antimicrobial activity, inflammation antimicrobial activity, inflammation

response, and antibody-dependent, cell-response, and antibody-dependent, cell-mediated cytotoxicity (ADCC)mediated cytotoxicity (ADCC)

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Eosinophil PathwayEosinophil Pathway

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EosinofilEosinofil

Merupakan 2-5% dari leukositMerupakan 2-5% dari leukosit Fungsi sebagai fagosit yang lemahFungsi sebagai fagosit yang lemah Berperan juga pada imunitas parasit Berperan juga pada imunitas parasit

dan reaksi alergidan reaksi alergi

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Pluripotent Stem CellPluripotent Stem CellThis is the undifferentiated precursor to This is the undifferentiated precursor to all of the blood cells, red and white, and all of the blood cells, red and white, and

other immune effector cells, and platelets.other immune effector cells, and platelets.

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Myeloid Stem Cells… Myeloid Stem Cells… daughters daughters of the Pluripotent Stem Cells, these are the of the Pluripotent Stem Cells, these are the

progenitors of a host of specialized white blood progenitors of a host of specialized white blood cells (WBCs), red blood cells (RBCs) and the blood cells (WBCs), red blood cells (RBCs) and the blood

platelets which are crucial to blood clotting.platelets which are crucial to blood clotting.

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Eosinophil Progenitor…Eosinophil Progenitor…will will produce eosinophilsproduce eosinophils

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Eosinophil…Eosinophil…these cells are active in these cells are active in the immune response to asthma, allergies, the immune response to asthma, allergies,

and parasites.and parasites.

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Mast Cell PathwayMast Cell Pathway

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Pluripotent Stem CellPluripotent Stem CellThis is the undifferentiated precursor to This is the undifferentiated precursor to all of the blood cells, red and white, and all of the blood cells, red and white, and

other immune effector cells, and platelets.other immune effector cells, and platelets.

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Myeloid Stem Cells… Myeloid Stem Cells… daughters daughters of the Pluripotent Stem Cells, these are the of the Pluripotent Stem Cells, these are the

progenitors of a host of specialized white blood progenitors of a host of specialized white blood cells (WBCs), red blood cells (RBCs) and the blood cells (WBCs), red blood cells (RBCs) and the blood

platelets which are crucial to blood clotting.platelets which are crucial to blood clotting.

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Basophil Progenitor…Basophil Progenitor… a product a product of the specialization of Myeloid stem cells, of the specialization of Myeloid stem cells, this cell will produce either Mast Cells or this cell will produce either Mast Cells or

BasophilsBasophils

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Mast Cell…Mast Cell…like the related basophils like the related basophils these cells function in inflammation and these cells function in inflammation and allergic response. When mature, they allergic response. When mature, they

become granulated and are found in tissues, become granulated and are found in tissues, not in peripheral blood.not in peripheral blood.

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Basophil pathwayBasophil pathway

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basofilbasofil

Jumlah yang ditemukan dalam darah Jumlah yang ditemukan dalam darah sangat sedikit, sekitar <0,5% dari sangat sedikit, sekitar <0,5% dari seluruh leukositseluruh leukosit

Mempunyai fungsi fagosit mirip sel Mempunyai fungsi fagosit mirip sel mastmast

Melepaskan bahan-bahan yang Melepaskan bahan-bahan yang mempunyai aktivitas biologik, antara mempunyai aktivitas biologik, antara lain meningkatkan permeabilitas lain meningkatkan permeabilitas vaskular dan respons inflamasivaskular dan respons inflamasi

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Pluripotent Stem CellPluripotent Stem CellThis is the undifferentiated precursor to This is the undifferentiated precursor to all of the blood cells, red and white, and all of the blood cells, red and white, and

other immune effector cells, and platelets.other immune effector cells, and platelets.

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Myeloid Stem Cells… Myeloid Stem Cells… daughters daughters of the Pluripotent Stem Cells, these are the of the Pluripotent Stem Cells, these are the

progenitors of a host of specialized white blood progenitors of a host of specialized white blood cells (WBCs), red blood cells (RBCs) and the blood cells (WBCs), red blood cells (RBCs) and the blood

platelets which are crucial to blood clotting.platelets which are crucial to blood clotting.

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Basophil Progenitor…Basophil Progenitor… a product a product of the specialization of Myeloid stem cells, of the specialization of Myeloid stem cells, this cell will produce either Mast Cells or this cell will produce either Mast Cells or

BasophilsBasophils

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Basophil…Basophil…this IgE responsive cell is this IgE responsive cell is characterized by cytoplasmic granules characterized by cytoplasmic granules

which, when released, function in which, when released, function in destruction of parasites and also in allergic destruction of parasites and also in allergic reactions. The cell releases histamine and reactions. The cell releases histamine and

platelet activator and other chemical platelet activator and other chemical signals.signals.

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Page 92: faal hematopoiesis

Platelet pathwayPlatelet pathway

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MegakaryopoiesisMegakaryopoiesis

Platelets are produced from very large cells called Platelets are produced from very large cells called megakaryocytes which develop in the bone megakaryocytes which develop in the bone marrow from megakaryoblasts which, like other marrow from megakaryoblasts which, like other cells in the marrow, are derived from a cells in the marrow, are derived from a haemopoietic stem cell.haemopoietic stem cell.

   The nucleus in a megakaryocyte reduplicates, but The nucleus in a megakaryocyte reduplicates, but

the cell does not divide so eventually a very large the cell does not divide so eventually a very large cell with multiple nuclear lobes is formed. This is cell with multiple nuclear lobes is formed. This is referred to as "endomitosis".referred to as "endomitosis".

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Each megakaryocyte makes Each megakaryocyte makes approximately 4000 platelets and this approximately 4000 platelets and this

process takes about 10 days. The process takes about 10 days. The megakaryocyte straddles the marrow megakaryocyte straddles the marrow

sinusoids and little bits of cytoplasm - the sinusoids and little bits of cytoplasm - the platelet - are extruded through the sinus platelet - are extruded through the sinus

wall and into the blood stream.wall and into the blood stream.

The normal lifespan of a platelet is 7-11 The normal lifespan of a platelet is 7-11 daysdays

Page 95: faal hematopoiesis

Pluripotent Stem CellPluripotent Stem CellThis is the undifferentiated precursor to This is the undifferentiated precursor to all of the blood cells, red and white, and all of the blood cells, red and white, and

other immune effector cells, and platelets.other immune effector cells, and platelets.

Page 96: faal hematopoiesis

Myeloid Stem Cells… Myeloid Stem Cells… daughters daughters of the Pluripotent Stem Cells, these are the of the Pluripotent Stem Cells, these are the

progenitors of a host of specialized white blood progenitors of a host of specialized white blood cells (WBCs), red blood cells (RBCs) and the blood cells (WBCs), red blood cells (RBCs) and the blood

platelets which are crucial to blood clotting.platelets which are crucial to blood clotting.

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Megakaryocyte…Megakaryocyte…fragments into fragments into subcellular pieces called plateletssubcellular pieces called platelets

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Platelets…Platelets…are blood elements without are blood elements without nuclei that circulate and are involved in nuclei that circulate and are involved in

blood clotting and inflammation.blood clotting and inflammation.

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Erythrocyte PathwayErythrocyte Pathway

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ErythropoiesisErythropoiesis Erythropoiesis, or the production of red Erythropoiesis, or the production of red

cells, is regulated by a hormone called cells, is regulated by a hormone called erythropoietin. erythropoietin.

Approximately 1012 new red cells are Approximately 1012 new red cells are made each day through successive made each day through successive doubling of a progenitor cell called a doubling of a progenitor cell called a proerythroblastproerythroblast until 16 cells are formed. until 16 cells are formed.

The cells become progressively smaller and The cells become progressively smaller and contain increasing amounts of haemoglobincontain increasing amounts of haemoglobin

It circulates for 1-2 days and finally It circulates for 1-2 days and finally becomes a mature red cell becomes a mature red cell

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eritrositeritrosit

Sel darah merahSel darah merah Discus/lempeng biconkcafDiscus/lempeng biconkcaf Diameter 7,5 umDiameter 7,5 um Faktor penentu utama kekentalan darahFaktor penentu utama kekentalan darah Konsentrasi normal :Konsentrasi normal :

– Wanita : 4,3-5,2 juta/mm kubik darahWanita : 4,3-5,2 juta/mm kubik darah– Pria : 5,1-5,8 juta/mm kubik darahPria : 5,1-5,8 juta/mm kubik darah

Masa hidup : 120 hariMasa hidup : 120 hari Fungsi : transportasi gas respirasiFungsi : transportasi gas respirasi

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hemoglobinhemoglobin

Bagian eritrosit yang berkaitan dengan Bagian eritrosit yang berkaitan dengan gas respirasigas respirasi

Tdd : protein globin dengan empat rantai Tdd : protein globin dengan empat rantai polipeptida dan empat pigmen merah polipeptida dan empat pigmen merah “heme” yang mengandung besi tempat “heme” yang mengandung besi tempat oksigen diangkutoksigen diangkut

Mengandung 250 juta molekul oksigenMengandung 250 juta molekul oksigen Kadar normal :Kadar normal :

– Pria : 13,9-16 gr/dlPria : 13,9-16 gr/dl– Wanita : 12-15 gr/dlWanita : 12-15 gr/dl

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Pluripotent Stem CellPluripotent Stem CellThis is the undifferentiated precursor to This is the undifferentiated precursor to all of the blood cells, red and white, and all of the blood cells, red and white, and

other immune effector cells, and platelets.other immune effector cells, and platelets.

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Myeloid Stem Cells… Myeloid Stem Cells… daughters daughters of the Pluripotent Stem Cells, these are the of the Pluripotent Stem Cells, these are the

progenitors of a host of specialized white blood progenitors of a host of specialized white blood cells (WBCs), red blood cells (RBCs) and the blood cells (WBCs), red blood cells (RBCs) and the blood

platelets which are crucial to blood clotting.platelets which are crucial to blood clotting.

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Erythroid Progenitor…Erythroid Progenitor…derived derived from a myeloid stem cell, this is destined to from a myeloid stem cell, this is destined to produce the most common blood cell, the produce the most common blood cell, the

erythrocyte.erythrocyte.

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Erythrocytes…Erythrocytes…or red blood cells or red blood cells (RBCs)are enucleated cells that travel (RBCs)are enucleated cells that travel throughout the Circulatory System and throughout the Circulatory System and

carry Oxygen to all parts of the body via carry Oxygen to all parts of the body via the abundant hemoglobin found within the abundant hemoglobin found within

them. them.