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Neutrophil - Its Functions, Normal Count, and Related Disorders

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Neutrophils are white blood cells that help heal tissues and resolve infections. Read this article to know about it.

Medically reviewed by

Dr. Goswami Parth Rajendragiri

Published At October 17, 2022
Reviewed AtJune 23, 2023

Introduction

The three main types of white blood cells are granulocytes, lymphocytes, and monocytes. In addition, neutrophils, eosinophils, and basophils are a subset of granulocytes. Neutrophils help prevent infections by constantly searching for signs of infection and quickly responding to trap, block, disable, digest, or ward off and kill pathogens invading particles and microorganisms.

Neutrophils play an essential role in regulating the immune system and inflammation in your body by communicating with other cells to help them repair damaged cells and mount an immune response. The neutrophils are produced in the bone marrow and make up 50 to 70 % of all white blood cells in the blood vessels. The amount of neutrophils in the blood usually rises when a person gets sick or injured and helps the body heal. Conversely, neutrophil levels may decrease if a person has a long-term infection, cancer, or an autoimmune condition or takes certain medications.

What Are Neutrophils?

Neutrophils are the most abundant white blood cells in the body that functions as a front-line defense of the immune system and helps to heal injuries and fight infections. It is a type of white blood cell essential to the immune system and helps the body fight infections.

When microorganisms such as bacteria and viruses invade the body, neutrophils become one of the first immune cells to react. They travel to the site of infection, where they ingest the microbes and destroy them by releasing enzymes that kill them. Neutrophils also enhance the response of other immune cells. Neutrophils are a type of granulocyte and a type of phagocyte.

What Do Neutrophils Do?

White blood cells (neutrophils, basophils, and eosinophils) circulate in the bloodstream and reach tissues to prepare for foreign objects that may cause illness, infection, or disease. The body reacts with redness and swelling (inflammation), while the neutrophils start the tissue repair process, healing injury or damage.

Where Are Neutrophils Located?

Neutrophils are produced by bone marrow cells and travel the circulating blood system in the body to tissues, lymph nodes, and other parts of the body.

What Are Common Conditions That Affect Neutrophils?

Neutrophils in the body should remain in range for that particular age group. If the range shifts to high or low, conditions develop, such as -

  • Neutropenia - Neutropenia is a condition seen when the neutrophil count is too low, causing swelling and multiple infections. Neutropenia results from either a cancer treatment, an autoimmune disorder, or an infection.

  • Neutrophilia - Neutrophilia, also known as neutrophilic leukocytosis, occurs because the neutrophil count is too high, which is often associated with a bacterial infection (the body releases immature neutrophils from the bone marrow too soon to fight the infection).

What Are the Symptoms Seen With Neutrophil Conditions?

Symptoms of a neutrophil condition include -

  • Fever.

  • Repeated infections.

  • Sores.

  • Swelling.

What Causes a High Neutrophil Count?

It is prevalent for the body to produce more neutrophils to help repair, for example, a bone fracture or severe burn. But when the number of neutrophils does not decrease to normal levels after repairing an injury, it can turn into a condition and affect the overall health of a person. The number of neutrophils in your body may increase due to -

  • Infections (especially bacterial).

  • Inflammation (non-infectious).

  • Injury or trauma.

  • Certain types of leukemia (cancer).

  • Allergic reactions to certain drugs.

  • Smoking cigarettes or sniffing tobacco.

  • Excessive exercise.

  • Steroids.

What Causes a Low Neutrophil Count?

Neutropenia (low neutrophil count) results from your body losing neutrophils before the bone marrow can generate new ones. Neutropenia arises due to the following conditions such as -

  • Infection (such as hepatitis, tuberculosis, and sepsis).

  • Chemotherapy (cancer treatment).

  • Bone marrow disorder or failure (leukemia).

  • Vitamin deficiency (for example - vitamin B12, folate, copper, and calcium).

  • Autoimmune disease (such as rheumatoid arthritis).

  • Suppressed immune system.

  • Aplastic anemia.

  • Hepatitis A, B, or C.

  • HIV or AIDS (acquired immune deficiency virus).

  • Myelodysplastic syndrome.

What Is the Normal Range of Neutrophil Counts?

Absolute neutrophil count indicates the number of neutrophils contained in a blood sample. It ranges from 4000 to 11,000 neutrophils per microliter of blood for healthy adults. Numbers above 11,000 or less than 4000 are at risk for neutrophil disease.

What Are the General Tests to Check the Health of Neutrophils?

The tests to check the health of neutrophils include:

  • Complete Blood Count (CBC) - A complete blood count test determines the cells in a blood sample that counts the number of exact cells.

  • Absolute Neutrophil Count (ANC) - An ANC determines how many neutrophil cells are in a sample of your blood.

  • Bone Marrow Biopsy - A bone marrow biopsy verifies how many cells your body has and identifies where they grow.

What Are the Treatments Used for Neutrophil Disease?

Some treatments for both low and high neutrophil counts are mentioned below -

  • Take antibiotics prescribed by your doctor.

  • Get a bone marrow transplant if needed.

  • Immediate discontinuation or change of medication that causes neutropenia.

  • Treatment of underlying conditions that affect the neutrophil count.

  • White blood cell transfusion.

  • Treatment for the underlying condition.

How to Increase the Neutrophil Count?

The neutrophil is the first line of defense of the immune system of the body, and they should be adequate to fight off infections. A healthcare provider can guide you to make an action plan. They might suggest:

  • Changing dosage or incorporating an immunity booster for chemotherapy.

  • Getting a white blood cell transfusion.

  • Stopping and changing any medication or therapy causes a low white blood cell count.

  • Adding antibiotics or drugs that promote healthy white blood cell production.

  • GCSF (granulocyte colony-stimulating factor) is also used to increase the neutrophil count in severe neutropenia to prevent infection.

How to Decrease the Neutrophil Count?

Neutrophils increase in number in response to the immune system to fight infection. However, the doctor will identify and treat possible infections with prescribed antibiotics if the number is above normal levels.

Conclusion:

Neutrophils protect the body against infections and help heal injuries. In addition, neutrophils help heal and repair damaged tissue and eliminate infections. Neutrophil levels can rise or fall depending on the infection, injury, medication, hereditary disease, and stress. Maintain the neutrophil count within a healthy range by reducing the chances of infection. This includes- practicing good hygiene and eating a healthy diet. In healthy individuals, neutrophils account for 55 to 70 % of circulating white blood cells.

Frequently Asked Questions

1.

What Are Neutrophils?

White blood cells or neutrophils help fight infections in the body. When any microorganisms or foreign bodies enter human body, the first immune cells that fight them are the neutrophils. These phagocytic cells destroy germs and are vital components in the body's defense mechanism.

2.

What Are Neutrophil Disorders?

The disorders that affect the body's ability to fight infection are neutrophil disorders. These include:
- Neutropenia - Decrease in neutrophil count.
- Shwachman-Diamond Syndrome - An inherent condition in which the neutrophils are affected.
- Cyclic neutropenia - A rare blood disorder leading to a recurrent abnormal decrease in neutrophil count.

3.

What Happens if the Neutrophil Count Is High?

The neutrophil count increases in infections and stress-inducing conditions. A high total white blood cell count or leukocytosis may result in an increase in the neutrophil count. The individual might have symptoms such as fever and tissue damage. Some cancers of the white blood cells can also increase neutrophil count.

4.

What Is the Role of Neutrophil Count in Infections?

Neutrophils are the body’s defense cells that help fight infections. When germs or other foreign agents enter the body, the neutrophils destroy them by phagocytosis and mediating other immune responses. Thus, in the case of acute infections, the neutrophil count is often found to be high. A blood test with a high neutrophil count is a common indicator of infections in the body.

5.

What Are Neutropenia Types?

When neutrophils are lower than normal levels in the white blood cells in a is known as neutropenia. It is classified as mild (1000 to 1500 cells per microliter), moderate (500 to 1000 cells per microliter), and severe neutropenia (less than 500 cells per microliter). In addition, it is classified as:
- Acute or short-lasting or temporary neutropenia.
- Chronic or long-term neutropenia.
- Congenital (from birth).
- Acquired (neutropenia due to different conditions that happen over time).

6.

What Is Neutrophilia?

A higher neutrophil count (compared to the normal reference range) in a person's blood is known as neutrophilia or neutrophilic leukocytosis. An increase in neutrophils can occur in cases of inflammation, stress, infections, and certain cancers. Thus, a blood test with a high neutrophil count requires further evaluation for acute infections in the body.

7.

What Infections Cause Neutrophilia?

Neutrophilia or an increase in neutrophils in the blood can result from acute infections in the body. These can be caused by:
- Bacterial infections, including staphylococci, pneumococci, and streptococci infections.
- Fungal infections, including candidal infections.
- Certain viral infections.
Stress and certain cancers can also increase the neutrophil count.

8.

Why Is a Neutrophil Function Test Performed?

Neutrophil function tests are uncommon tests performed only in specialized laboratories. These tests are performed to :
- Investigate recurrent pyogenic bacterial or fungal infections (chest infections, skin, and gingival infections).
- Screen for chronic granulomatous disease(CGD).
- Screen for primary defects in neutrophil function.
- To detect the chronic granulomatous disease(CGD) carriers.

9.

What Happens if the Neutrophil Count Is Low?

A person with a low neutrophil count or neutropenia has too few neutrophils to fight infections. As a result, it is difficult for the body to protect itself from disease-causing pathogens. Thus, the person has a greater chance of falling sick from a wide range of infections.

10.

Do Viruses Cause Low Neutrophil Count?

Viruses can cause a decrease in the neutrophil count or neutropenia. This is due to peripheral destruction of the neutrophils by the viruses or the bone marrow suppression caused by viruses. The viral agents commonly associated with neutropenia include:
- Epstein-Barr virus.
- Cytomegalovirus.
- Hepatitis A and B viruses.
- Parvovirus.
- Influenza virus species.

11.

Can Cancers Cause Neutrophilia?

Cancers can cause the neutrophil count to rise. In advanced cancer patients, peripheral neutrophil counts are often found elevated. The exact mechanism is unknown; however, the production of GM-CSF (granulocyte-macrophage colony-stimulating factor) in certain cancers could affect the mechanism controlling the neutrophil release or retention in the bone marrow, resulting in neutrophilia.

12.

Can Stress Cause Low Neutrophils?

Yes, stress can lower neutrophil count. Several studies prove that psychological stress and stressful life events significantly decrease the neutrophil count and function in individuals, especially in the elderly. As a result, such individuals are more prone to infectious diseases.

13.

Which Fruits Are Good for Increasing Neutrophils?

Eating food rich in vitamins such as vitamin C, B9, and B12, including fruits, eggs, milk, vegetables, and vitamin supplements, helps improve neutrophil levels in the blood. Fruits that are high sources of vitamin C, such as oranges, apples, bananas, and pears, improve neutrophil count and help prevent infections.
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Dr. Goswami Parth Rajendragiri
Dr. Goswami Parth Rajendragiri

Pathology

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