Oleh:

dr. Herdiantri Sufriyana

HerdiantriSufriyana.com
@herdiants
 G-CSF  granulosit
 GM-CSF granulosit, makrofag, eosinofil
 Fitur biokimia leukosit
 Active glycolysis
 Active pentose phosphate pathway
 Moderate oxidative phosphorylation
 Rich in lysosomes and their degradative enzymes
 Certain unique enzymes (eg, myeloperoxidase
and NADPH-oxidase) and proteins
 CD 11/CD18 integrins in plasma membrane
 Atoms or groups of atoms that have an unpaired electron:
Reactive oxygen species (ROS)  superoxide (O2), hydrogen
peroxide (H2O2), peroxyl radicals (ROO), and hydroxyl radicals (OH)
(1) Production of superoxide O2 + e– O2
(2) NADPH-oxidase 2 O2 + NADPH 2 O2 + NADP + H+
(3) Superoxide dismutase O2 + O2 + 2 H+ H2O2 + O2
(4) Catalase H2O2 2 H2O + O2
(5) Myeloperoxidase H2O2 + X– + H+ HOX + H2O (X– = Cl–,
Br–, SCN–)
(6) Glutathione peroxidase (Se) 2 GSH + R-O-OH GSSG + H2O + ROH
(7) Fenton reaction Fe2+ + H2O2 Fe3+ + OH + OH–
(8) Iron-catalyzed Haber-Weiss re. O2 + H2O2 O2 + OH + OH–
(9) G6PD G6P + NADP 6 P.gl. + NADPH + H+
(10) Glutathione reductase G-S-S-G + NADPH + H+ 2 GSH + NADP
 Enzyme or Reaction Catalyzed or Comment
Protein Function
Myeloperoxidase H2O2 + X– (halide) + H+ Responsible for the green color of pus
(MPO) HOX + H2O (where X– = Cl–
Genetic deficiency can cause recurrent
, HOX = hypochlorous
infections
acid)
NADPH-oxidase 2O2 + NADPH 2O2 + NADP Key component of the respiratory burst
+ H+
Deficient in chronic granulomatous disease

Lysozyme Hydrolyzes link between Abundant in macrophages

N-acetylmuramic acid
and N-acetyl-D-
glucosamine found in
certain bact. cell walls
Defensins Basic antibiotic peptidesApparently kill bacteria by causing
of 20–33 amino acids membrane damage
Lactoferrin Iron-binding protein May inhibit growth of certain bacteria by
binding iron and may be involved in
regulation of proliferation of myeloid cells
CD11a/CD18, Adhesion molecules Deficient in leukocyte adhesion deficiency
CD11b/CD18, (members of the integrin type I (MIM 116920)
CD11c/CD182 family)
Receptors for Fc Bind Fc fragments of IgG Target antigen-antibody complexes to
fragments of IgGs molecules myeloid and lymphoid cells, eliciting
phagocytosis and other responses
 Bakterimemasuki jaringan
 Respon inflamasi akut:
 Peningkatan permeabilitas vaskular
 Sel mast & basofil  histamin
 Platelet  serotonin
 Neutrofil  PAF, eicosanoid (PG & leukotrien)
 Protein plasma  C3a, C4a, C5a, bradikinin, fibrin
 Masuknya neutrofil aktif ke jaringan
 Faktor kemotaktik: C5a, peptida bakteri (N-formyl-
methionyl-leucyl-phenylalanine), leukotrien
 Adhesi: Integrin (neutrofil) ~ prot. reseptor (endotel)
 Respon inflamasi akut:
 Masuknya neutrofil aktif ke jaringan
 Movement:
 Integrin (extracell. segment) ~ extracell. ligand
 Integrin (intracell. segment) ~ cytoskeleton
 Fagositosis:
 Faktor kemotaktik bakteri ~ reseptor  Ca2+ intrasel
meningkat  perub. mikrotubul  melingkupi
bakteri  sekresi oleh granul  respiratory burst
 Respiratory burst  NADPH oksidase  ROS
 Aktivasi platelet
 Resolusi spontanjika bakteri kalah
 Vasokontriksi menurunkan aliran darah
 Platelet terikat pada kolagen  ADP +
tromboksan A2  aggregasi
 Thrombin  koagulasi  menjaring lebih
banyak trombosit
 7.0–7.5 g/dL
 Albumin (3.4–4.7 g/dL)
 60% total protein plasma
 Tubuh:
 40% albumin in plasma
 60% albumin in
extracellular space
 Liver  12 g /day
 25% total hepatic protein
synthesis and half its
secreted protein
 In arterioles,
 the hydrostatic pressure is about 37 mm Hg,
 with an interstitial (tissue) pressure of 1 mm Hg
opposing it.
 The osmotic pressure (oncotic pressure) exerted by the
plasma proteins is approximately 25 mm Hg.
 Thus, a net outward force of about 11 mm Hg drives
fluid out into the interstitial spaces.
 In venules,
 the hydrostatic pressure is about 17 mm Hg,
 with the oncotic and interstitial pressures as described
above;
 thus, a net force of about 9 mm Hg attracts water back
into the circulation.
 The above pressures are often referred to as the
Starling forces.