Monocytes High Monocyte (Monocytosis ) & Low Monocyte Counts (Monocytopenia)

In other words, they do not need to recognize specific types of invaders but generally recognize an

invader as something that must be destroyed.

Monocytes perform their functions by surrounding and engulfing bacteria (a process known as

phagocytosis). Monocytes can engage in phagocytosis by coating the foreign material with complement or

antibodies. Antibodies are types of proteins that are formed by the body to destroy foreign proteins known

as antigens (a process known as antibody-mediated cellular cytotoxicity). Complement is a type of protein

in the blood, which play a role in inflammation. Sometimes, monocytes attach to foreign materials by

recognizing them with specialized receptors. After phagocytosis, fragments of the foreign substance that

remains can serve as an antigen when the monocytes capture them and expose them to other white blood

cells known as T-cells, which leads to a specific response against it from the immune system. They

expose the fragments of the foreign substance with help from a special molecule known as an MHC (major

histocompatibility complex) molecule. Macrophages are also believed to play a role in forming important

organs such as the heart and the brain.

Monocytes can also divide into dendritic cells in the tissues. Dendritic cells are cells that process antigen

material and present it to the body’s immune (defense system). This is why they are considered a type of

antigen presenting cell. Unlike macrophages, dendritic cells do not destroy invaders directly but present

them to T cells (usually before they are fully developed) and B cells so they can learn more about them

and destroy them the next time they are encountered. T cells and B cells are types of small white blood

cells that help provide a specific response to attack the invading organisms and tumor cells. In dendritic

cell form, monocytes act as part of the acquired immune system (aka acquired immunity) in which highly

specialized cells protect the body against disease.

Monocytes respond to signals of inflammation in the body and can arrive quickly (about 8 to 12 hours) to

areas of infection or tissue damage and divide into macrophages and dendritic cells, which provides a

further immune system response. By responding to areas of tissue damage, they contribute to wound

healing. Macrophages also instruct other cells in the immune system and produce molecules that affect

the immune system.

Monocytes can also produce cytokines. Cytokines are proteins that help other white blood cells (and other

cells) communicate with each other. Names of cytokines usually produced by monocytes are interleukin-1,

interleukin-2,and tumor necrosis factor. When monocytes are activated, cytokines that promote

inflammation are produced and those which suppress inflammation are reduced. In the laboratory,

monocytes can be used to create dendritic cells by adding cytokines such as interleukin-4 and

Granulocyte Monocyte Colony Stimulating Factor (GMCSF).

Monocytes contain delicate chromatin material with a lacy or stringy pattern that appears more condensed

where the strands are in contact with each other. Chromatin is the material inside a nucleus from which

the chromosomes are formed. Chromosomes are structures in a person's cells that contain proteins and a

substance known as DNA (an abbreviation for deoxyribonucleic acid). DNA is a chain of many connected

genes. Genes are units of material contained in a person's cells that contain coded instructions as for

how certain bodily characteristics (such as eye color) will develop.

HOW BIG ARE MONOCYTES?

Monocytes are the largest type of blood cell. The size of monocyetes has been defined as between 13

and 25 micrometers in diameter, but some references state they are between 16 and 22 micrometers in

diameter. A micrometer is a very small unit of length that measures one millionth of a meter. A meter is

approximately 39 inches (slightly more than 3 feet).

WHERE ARE MONOCYTES MADE?

Monocytes are created by a type of cell in the bone marrow known as hematopoietic stem cells (HSCs),

which are cells that give rise to other cells. They create monoblasts which are premature forms of

monocytes. Monoblasts develop into monocytes.

WHAT PERCENT OF WHITE BLOOD CELLS ARE MONOCYTES?

Approximately 2-8% of white blood cells are monocytes. Monocytes move around in the blood for about

one to three days and the usually move into tissues throughout the body.

WHERE ARE MONOCYTES NORMALLY FOUND?

Monocytes are normally found in loose connective tissue, the spleen, lymph nodes, and bone marrow (a

tissue that fills the opening of bones). The spleen is an organ next to the stomach that helps fight infection

and removes and destroys worn-out red blood cells. Red blood cells are cells that help carry oxygen in the

blood. Incidentally, some monocytes phagocytize red blood cells. Lymph nodes are small egg shaped

structures in the body that help fight against infection. About half of the monocytes are found in the spleen,

in an area of connective tissue known as the cords of Billroth.

Macrophages are found in various forms in all tissues of the human body. These forms include microglia,

osteoclasts, histiocytes, and Kupffer cells. Microglia are macrophages in the brain and spinal cord.

Osteoclasts are types of bone cells that remove bone tissue. A histiocyte is a type of macrophage of the

immune system. Kuppfer cells are types of macrophages in the liver. The liver is the largest organ in the

body and is responsible for filtering (removing) harmful chemical substances, producing important

chemicals for the body, and other important functions.

HOW DO MONOCYTES RESPOND TO LABORATORY STAINING?

When stained with dyes, monocytes display a significant amount of pale blue or blue-gray cytoplasm.

Cytoplasm is all the substance of a cell except the nucleus and cell wall. Monocvtes have a large amount

of cytoplasm. The cytoplasm of monocytes is filled with many fine, dust-like, reddish-blue granules.

Vacuoles are often present, which are clear spaces in the substance of a cell. This is typically the case

when the monocyte has phagocytized a foreign substance. Monocytes also contain many vesicles (small

bubbles within a cell) for processing foreign materials. A picture of a monocyte is shown below.

WHAT ARE THE DIFFERENT TYPES OF MONOCYTES?

There are at least three different types of monocytes located in the blood of humans. The first is known as

a classical monocyte, which has a high amount of CD14 receptors on the surface. The CD14 receptor

helps detect certain types of bacteria molecules. There is a non-classical monocyte, which has a low

amount of CD14 receptors on the surface but has some CD16 receptors, which contributes to the

protective function of the immune system. There is also an intermediate monocytes which has a high level

of CD14 receptors and a low level of CD16 receptors.

The classical monocyte (which does not have CD 16 receptors) appears to develop into intermediate

monocytes and then into the non-classical monocyte. This is why the non-classical monocyte is

sometimes viewed as more mature type of monocyte. When stimulated, the intermediate monocytes

produce high amounts of cytokines that promote inflammation (e.g., interleukin-12 and tumor necrosis

factor). A protein known as PD-1 (programmed cell death 1) is found more in intermediate monocytes than

classical monocytes. PD-1 interacts with another molecule (known as PD-L1) to prevent overreaction of

the immune system.

WHAT CAUSES THE MONOCYTE LEVEL TO BE TOO HIGH?

When the monocyte level is too high, this is known as monocytosis. This can happen for several reasons

such as stress, inflammation, a fever from a virus, severe infection (because more macrophages are

needed to fight it), premature cell death in living tissue, diseases that result from abnormal activity of the

immune system, and regeneration of red blood cells.

Another cause of high monocytes is sarcoidosis. Sarcoidosis is a condition in which small, rounded

bumps form on tissues. Chronic granulomatous disease (CGD) can also cause monocytosis. CGD is an

inherited disorder in which cells that perform phagocytosis do not function correctly. Another cause of high

monocytes is Cushing’s syndrome, a condition caused by excessive exposure to high levels of cortisol.

Cortisol is a type of hormone produced by the adrenal glands that helps reduce inflammation. Hormones

are types of chemicals in the body that affect other cells. The adrenal glands are a pair of glands that play

an important role in metabolism and help the body respond to physical and emotional stress by releasing

certain hormones. Metabolism is the chemical actions in cells that release energy from nutrients or use

energy to create other substances.

WHAT CAUSES THE MONOCYTE LEVEL TO BE TOO LOW?

When the monocyte level is too low, this is known as monocytopenia. Because monocytes are produced

in the bone marrow, any illness or chemical that affects the bone marrow can cause a low monocyte

count. There are many health conditions that affect the bone marrow. One example is HIV (human

immunodeficiency virus). HIV is a virus that attacks the body’s immune system, leading to infections and

harmful tumors. Tumors are abnormal masses of tissue that form when cells in a certain area of the body

reproduce at an increased rate.

Another example of a condition that can affect bone marrow is aplastic anemia. Anaplastic anemia is a

condition in which the body stops producing enough blood cells due to bone marrow damage. Yet another

example is systemic lupus erythematosus (SLE). SLE is a long-term disease in which the connective

tissues throughout the body are inflamed because the body's defense system attacks these tissues as if

they were foreign substances.

Another example is rheumatoid arthritis. Rheumatoid arthritis is an immune disorder in which the body's

defense system attacks its own tissues, causing inflammation of bone joints. Other examples include

tuberculosis, malaria, and Epstein-Barr virus. Tuberculosis is a highly infectious diseases characterized

by the formation of small swellings called nodules (or tubercles) in tissues, especially the lungs. Malaria is

a serious disease caused by parasites that is spread by mosquitoes. The Epstein-Barr virus is one of the

most common viruses in humans.

Medications that can interfere with bone marrow and lower the monocyte count includes chemotherapy,

radiation therapy, interferons, and glucocorticoids This can be caused by therapy with glucocorticoids,

which are types of steroid hormones that suppress the immune system. Chemotherapy is a type of

medication used to treat cancer. Cancer is an abnormal growth of new tissue characterized by

uncontrolled growth of abnormally structured cells that have a more primitive form. Radiation is a type of

energy that is sometimes aimed at cancer tumors to destroy or weaken them. Interferons are proteins

released in the body in response to the presence of harmful substances (such as tumor cells) which then

trigger the immune system to fight them. Low monocyte counts can also be caused low levels of folic acid

(a type of vitamin) and vitamin B12.

WHAT IS THE ORIGIN OF THE TERM "MONOCYTE"?

Monocyte comes from the Greek word "monos" meaning "single," and the Greek word "kytos" meaning

"cell." Put the two words together and you have "single cell."