IMMUNOLOGY AND SEROLOGY
MIDTERMS: WEEK 3 – BASIC IMMUNOLOGIC PRINCIPLES
IMMUNITY
- Sum total of the defense mechanisms of the
human body to resist infectious disease.
- Natural/Innate/Non-Specific
- Acquired/Adaptive/Specific
additional notes:
- Non-specific immunity there is no specificity.
It is a body’s general response when a
pathogen enters the body.
- Your injury will break the intact skin and other
underlying tissue because of the non-intact
skin or any other problem with the skin the
microbes will enter the body. The body will
detect phagocytes and other activated cells
like macrophage, dendritic cells.
- After that, the cell will send inflammatory
mediators to induce inflammation that will
increase vasodilation, increased
vasopermeability, and fluid and proteins will
go out in the blood and go to the tissue that's
the result of inflammation. And because of
that it will result in attraction in other immune
cells such as white blood cells.
- The white blood cell will go to the site of
infection and because of the permeability ,
the other complement proteins will go out
and attack microbes. Other things with
inflammatory mediators, they will activate
phagocytes as a result of migration or
chemotaxis to kill microbes.
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NATURAL/INNATE/NON-SPECIFIC IMMUNITY
- Immediate - most of the components of the
natural innate or non specific immunity is free
form. Bago pa magkaroon ng invasion ng
pathogens nasaktan muna sya unlike in acquired
immune system na kailangan mag develop like
antigen presentation. Sa ating innate response
nandon na sya hindi sya kailangan iform pa
pagkatapos pumasok ng microbes.
- Standardized
- No memory
- Rarely malfunction - kase nga free form na sya
lahat ng natural immune system nanggaling sila
endangered line?? (diko naintindihan sinabi ni sir).
- Non-specific response- kase hindi nagbabago ang
response ng immune system. Kahit ano man na
pumasok na bacteria or anong pathogens na
pumasok it is the same response. The effect is still
the same.
- Pattern recognition molecules - ito yung
hinahanap or kumakabit sa WBC, para malaman if
hindi sa kanila yung antigen. It is composed of
lipids, proteins, nucleic acids and many other
biomolecules that are constantly or usually
present at groups of bacteria (that enter your
body). Example is Lipoteichoic acid ( can be seen
sa cell wall ng gram positive bacteria). WBC has
receptors that have pattern recognition
molecules, so that if they detect it, they will
induce a response.
- Present at birth (self explanatory)
EXTERNAL DEFENSE SYSTEM
- First line of defense
● They are the barriers against infections. The
main purpose is to prevent pathogens from
entering the body.
INTERNAL DEFENSE SYSTEM
- Second line of defense
● This includes the phagocytes the response
would be in the phagocytes. The neutrophils,
macrophage.
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MIDTERMS: WEEK 3 – BASIC IMMUNOLOGIC PRINCIPLES
NATURAL/INNATE/NON-SPECIFIC IMMUNITY:
FIRST LINE OF DEFENSE
MECHANICAL BARRIERS TO INFECTION
- Intact Skin
- Viscous mucus
- Coughing and sneezing (
Body’s response to reject pathogens like
in allergic rhinitis, if it is triggered you’ll
sneeze which is body’s response to
prevent allergens from entering
- Beating of cilia of Epithelial Cell (EC)
Example is cilia in our respiratory tract, it
propels everything palabas (particularly in
mucus)
- Vomiting, diarrhea
BIOCHEMICAL FACTORS
- Secretions
- Saliva
- Sweat
- Tears
- They contain lysozyme defensins
- Very low pH of vagina and stomach
-The bacteria is very sensitive to pH. They need to
be 0.4 pH. That’s why the media needs to be pH
and needs a buffer.
- Those girls who always rinse their vagina with
water and soap are prone to UTI because the pH
increases and the soap is basic alkaline and
chemically compound. If the girl always uses it, it
neutralizes the naturally acidic pH of the vagina.
Because they normally inhibit the acidic vagina
and they proliferate because the vagina is normal
pH.
- The feminine wash doesn’t alter the natural pH
of the vagina.
-Your lactobacillus and Helicobacter pylori in the
stomach are all resistant to pH. Most of your
pathogens are sensitive to pathogens kaya nga
kahit marumi yung pagkain or nalaglag ng 3
seconds tapos kinain hindi naman nagkaka
infection kase yung stomach sya yung papatay sa
microorganism na normally sensitive sa pH.
MISCELLANEOUS DEFENSES
- pH
- Body temperature
- Oxygen saturation
Normally, the anaerobic microorganisms don’t
multiply in the lungs because there a high
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concentration of oxygen present
- Hormonal Imbalance (Corticosteroids)
Those who take corticosteroids have impaired
immune systems because their phagocytes
rest/sleep because of steroids.
- Age
as we age, we are prone to diseases and our
immune system weakens
NATURAL/INNATE/NON-SPECIFIC IMMUNITY:
SECOND LINE OF DEFENSE
CELLULAR COMPONENT
- Phagocytic cells
- Natural Killer cells
HUMORAL (FLUID)/ BIOCHEMICAL FACTORS
- Cytokines - Interferons and Interleukins
- Complement - Alternative and Lectin
The complement system has three types
which are Classical (part of the acquired
immune response), Alternative, Lectin (these
two are part of second line defense under
innate immune response)
PROCESSES
(those pathogens that did not die on the first line of
defense will either undergo these two processes)
1. Phagocytosis
2. Inflammation
NEUTROPHILS
- Principal Leukocyte
- fastest response in all phagocytes
- Neutrophils are known as the first responder
white blood cells during acute infection.
Additional notes:
In acute infection, the composition of accumulated
cells are neutrophils.
- Chemotaxins
EOSINOPHILS
- Major Basic protein
- Eosinophil Cationic protein
Additional notes.
- phagocytes din sya
- more commonly associated with helminths
- major basic proteins of eosinophils and
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catanionic protein NATURAL KILLER CELLS / NULL CELLS

- implicated in hypersensitivity reaction or are known as large granular lymphocyte (LGL) or third
allergy population lymphocyte
- Non-T, Non-B (other name in textbooks)
MONOCYTES - Markers: CD16, CD56
- Percentage: at least 10 -15%
- Mononuclear Cells
- Becomes macrophages Process of killing of NK Cells
- Interleukin 1 and other cytokines

Additional notes:
- In chronic infection, the composition of cells
has monocyte (it takes a lot of time for
monocyte to go to the site of inflammation)
- Monocytes (blood) macrophage (tissue)
- Which of the ff cells is immature?The answer
would be monocytes because some of the -looks like CD8 or cytotoxic T cell
reference books say that monocytes must go -Once it encounters your microorganism, it will kill the
to the tissue in order to mature. one that presents the antigen like CD8. It should have
- Kapag naman may nakita na band form tapos a receptor, usually the receptor of NK cell is MHC class
si neutrophils may PMS (Polymorphonuclear I. Kapag ang inyong cell nakakuha ng pathogen
cells) it means mature na yon pero kapag recognition receptor (PRR) that recognize
naman stab neutrophils yun naman yung mga pathogen-associated molecular patterns (PAMPs) pero
immature. nagppresent ang normal cell nyo ng MHC I, di sya
papatayin. Kapag walang MHC class I, doon siya
MONONUCLEAR CELLS papatayin. This is a natural response of the body since
most of the cells that are infected, they will have a
- Consist of monocytes (in blood) and macrophages decreased production/presence of MHC I. That is
(in tissues) what NK cells detect.
1. Alveolar macrophages (lungs) Kabaliktaran ng sa T-cell, sa tcell need muna ng
2. Histiocytes (connective tissues) receptor bago magrespnd, sa NK cell, kapag wala tsaka
3. Kupffer cells (liver) magrerespond.
4. Mesangial cells (kidney)
5. Microglial cells (brain)
6. Osteoclasts (bone)
7. Splenic macrophages (spleen)
8. Peritoneal macrophages (peritoneal fluid)
9. Dendritic cells (lymph nodes)
10. Langerhans cells (dendritic cells in the skin)

Additional notes:
- They are also known as transform monocytes.
- They are once activated or once you
Other function of Nk cell:
encounter a microorganism they secrete
- Injured cell and Virus infected cell will also be
cytokines.
killed by NK cell. If the cell was infected or
- They are also known as antigen presenting
damaged during the process, there would be a
cells since they process antigen and project to
decreased presentation or expression of MHC
the adaptive immune system.
molecules and that would trigger the CD8 cell
LYMPHOCYTES THAT CONTRIBUTE TO NON-SPECIFIC to kill the cell.
IMMUNITY

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also in humans.
- They have a toll-like 1-10 in humans.
Additional notes:
- Pathogen-associated molecular patterns
(PAMPs) are molecules that are recognized by
Pathogen recognition receptor (PRR)
molecules.
- PAMP is located in the bacteria also in our
cells.
- These are molecules that induce response.
These cytokines activate macrophages. Sometimes
- PRR are located in our immune cells (WBC)
macrophages engulf the microorganism but they don’t
and recognize PAMP.
kill it, unless they get a signal from a cytotoxic t cell.
- PAMP are being produced if there’s an
For example, yung macrophage kumain ng bacteria,
infection. Naturally our bacteria has PAMPs.
mananatili lang yun sa macrophage and it will release
They are naturally occurring substances in
IL-12 until it encounters NK cells, NK cells will notice
bacteria. PAMPS are normally needed by
IL-12 and will produce Interferon gamma. Interferon
bacteria in order to survive and that is
gamma will project to digest or phagocytose the
detected by PRR.
microorganism.
- Kaya kapag pumasok na yung bacteria sa
katawan mag bind na sya sa PRR. They are
LYMPHOKINE-ACTIVATED KILLER CELLS
also expressed in our cells in our body in
- Interleukin: 2
somatic cells. Sa loob ng cells may mga
They are the first responder against tumor
PAMPs. Lalabas lang yung mga PAMPS kapag
cells.
injured yung cell or undergoing ng infection
yung cell. And because of that we call them
ANTIBODY-DEPENDENT CYTOTOXIC CELLS (ADCC)
DAMPs (Damage Associated Molecular
- Can lyse antibody-coated cells
Proteins).
Sila yung kumakabit sa Fc potion ng
immunoglobulins that is because of PATHOGEN ASSOCIATED MOLECULAR PROTEINS
opsonizing (coating) function of
immunoglobulins. Sila yung nakaka infect non NUCLEIC ACIDS ssRNA; virus
yung mga ADCC cells, kapag nadetect na nila - single stranded
yung sa Fc portion na nakakabit sa - usually seen in
microorganism they will automatically kill the viral DNA and dsRNA; viruses
cell so that they can lyse antibody-coated RNA because they - double stranded
cells. are the main
mode of
PATHOGEN-ASSOCIATED MOLECULAR PATTERNS AND transmission of
PATTERN RECOGNITION RECEPTORS (PAMPS) virus.
1. Secreted PRR - Blood and Lymph PROTEINS Pili; bacteria
2. Phagocytosis Receptors - Release of effector
molecules Flagellin; bacteria
3. Toll-Like Receptors - Recognize different
PAMPs CELL WALL LIPIDS LPS; gram negative
- They are the ones that recognize bacteria
different PAMPs on the bacterial cell
wall. Lipoteichoic Acid; gram
- They are originally discovered in flies positive bacteria
(langaw) that are responsible for
recognizing PAMPs and they see it CARBOHYDRATES Mannan; fungal bacteria
- a sugar molecule
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that is found in
fungi and other
bacteria.
- This is very
important
because it is a
trigger of one of
your compliment
protein which is
lectin pathway.

Glucans; fungi
- abundant
present in fungi

DAMAGE ASSOCIATED MOLECULAR PROTEINS

- bacteria sa katawan ng tao sa somatic cell

- They are produced when the cell is damaged
or infected.

Stress induced proteins HSPs

Crystals Monosodium urate

Proteolytically cleaved Proteoglycan peptides

extracellular matrix

Mitochondrial Extracellular formylated

components found peptides and ATP
outside mitochondria
RIG-like receptors (RLRs) & NOD-like receptors
Nuclear proteins or Extracellular HMGB1, (NLRs) - are located in cytoplasm and are responsible
Nucleic acids found Histones, Cytoplasmic for the formation of inflammasomes.
outside nucleus dsDNA

PATTERN RECOGNITION RECEPTORS

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TOLL LIKE RECEPTORS

NOD1 and NOD2 are the most common

-The toll-like receptors inside are important because
they are the one that detects viruses.
-Viruses are considered non-living organism , their
main purpose is to hijack nucleus to be able for them
to reproduce. so the defense mechanisms for viruses
should be inside to detect if there are viruses that
have already entered.
NOD1 - DAP is the activating stimuli
NOD2- MDP is the activating stimuli
DAP and MDP can be seen in bacteria
NOD1 & NOD2 - Both of them, once activated by DAP
and MDP it signals transduction to NF-κB that would
result to formation of Interleukin-1β (IL-1β)
SIGNAL TRANSDUCTION

NOD LIKE RECEPTORS

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-Once Peptidoglycan is recognized, there will be a other cells

signal transduction (enzymatic reaction that happens
inside) ● Pro-inflammatory or anti-inflammatory
-It will activate the NF-κB and will produce cytokines,
chemokines, adhesion molecules that will result in
acute inflammation and stimulation of adaptive
immunity.

PROTECTIVE EFFECTS OF INTERFERONS

- Inhibit viral replication in the neighboring

-Toll-like receptor (TLR), once activated it will signal
NF-κB, it will produce Pro- Interleukin-1β (Pro-IL-1β)
- Pro-IL-1β needs to be cleaved (split) by caspase-1
which is an enzyme
- Caspase-1 are from NOD-like receptors and RLR that
form inflammasomes. The inflammasomes would in
turn produce caspase-1 that would cleave the
Pro-IL-1β, making it IL1β which would be released and
result in acute inflammation.
-Interleukin 1 is a pyrogenic and an inducer of
inflammation.
- one of the most notorious inflammatory cytokine is
IL1β
uninfected cell
- Activate macrophages
- Enhance T-cell activity
- Increase cytotoxic action of NK cells
note:
Interferons are produced by damaged cells, these
interferons will go to other cells in order to stop the
attachment of virus to neighboring cells, It also
enhances the activation of macrophages and T cell
activity.

CYTOKINES

- Lymphokine - produced by lymphocyte

- Monokine - produced by monocyte
- Chemokine - chemotactic attractants;
nagpapagalaw sa WBC (ability to stimulate the
migration of cells)
Chemokine needs to be produced to know
where the infection is, otherwise random lang
yung movement ng WBCs - PAMP (bacteria)
- Interleukin - are produce by T cells to activate - DAMP (somatic cell)

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INTERFERONS (IFN)
- TYPE 1
known as non-immune interferons which
means it is being produced by innate
immunity
● Interferon Alpha (IFN⍺) - Leukocytes
● Interferon Beta (IFN𝛽) - Fibroblast
- TYPE 2
● Interferon Gamma (IFN𝛾) - Stimulation with a
specific antigen
-an immune type of interferon and produced
by a stimulation of a specific antigen
TUMOR NECROSIS FACTOR (TNF)
are produce during inflammation
- TNF ALPHA
- “Cachetin/Cachexin”
- produced by cytotoxic t cell against tumor
cells and virally infected cells
- TNF BETA
- “Lymphotoxin”
- primarily produced by macrophage, also in B
cell and T cell
INTERLEUKINS
- IL1 - Proinflammatory cytokine
- pyrogen
- IL2 - T-cell growth factor
- will bind with CD25 to induce proliferation
- IL3 - Hematopoiesis; multicolony stimulating
factor
- interleukin that will be produced during
infection that will induce hematopoiesis
- IL6 - Induces the acute phase response of
inflammation
- kumakabit sa immune cells to release TNF
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beta and Interleukin 1
OTHER HUMORAL COMPONENTS
- Acute Phase Reactants - Infection
- normal substances in blood that rises during
infection
- Betalysin - Bactericidal
- are produced by platelets during coagulation
- inhibit gram positive microorganisms
- Complement - Cell lysis
- protein found in blood that mitigates lysis
- Lysozyme - Hydrolyzes mucopeptide layer
- are present in secretions like sweat, tears and
saliva that hydrolyzes mucopeptide layer of
bacteria
- Properdin - C3 and magnesium
- a part of complement system in lectin pathway
that has bactericidal effect when combined with
C3 and magnesium
PHAGOCYTOSIS
- Process of ingesting and engulfing other cells or
particles
- PHAGOCYTES: Cells that are capable of ingesting
in the phagocytic process
- RESPIRATORY BURST (production of reactive
oxygen species or ROS which are produced by
immune cells/phagocytes to digest
microorganisms)
- Example of ROS are superoxide anion =
superoxide dismutase (SOD), Hydrogen
peroxide (H2O2) = Catalase
- Superoxide anion and Hydrogen peroxide are
essential for killing bacteria
- some microorganisms produce enzymes that
combat the above-mentioned ROS which are
superoxide dismutase (SOD) and catalase in
order to neutralize the ROS.
1. Physical contact between the phagocytic cell
and the microorganism occurs.
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MIDTERMS: WEEK 3 – BASIC IMMUNOLOGIC PRINCIPLES
2. Outflow of the cytoplasm to surround the
microorganism.
3. Formation of PHAGOSOME.
4. Formation of the PHAGOLYSOSOME.
5. Digestion of the microorganism by hydrolytic
enzymes.
6. Excretion of contents of phagolysosome to the
outside by exocytosis.
STAGES OF PHAGOCYTOSIS:
1. Initiation
2. Chemotaxis
3. Engulfment
4. Digestion
INITIATION
RECEPTORS
1. Complement receptor
2. Laminin receptor
3. Leucyl-Formyl-Methionyl-Phenylalanine-recep
tor
Additional notes:
- can be further initiated by tissue damage or as
a result of the contact of microorganism on
microbial proteins to the cell. If there has
been contact, it will bind with these receptors.
CHEMOTAXIS
- Chemotaxin - produced because of
chemotaxis as a result of movement. The
movement of bacteria can be divided into two
types: positive chemotaxis and negative
chemotaxis. Chemotaxis doesn't only happen
in phagocytes, it can also happen in bacteria.
- Diapedesis - is the movement from the
tissue, registration of neutrophils. Half of your
neutrophils are circulating , half is within the
vessel.
- The WBC is circulating, half is in the
blood vessel wall ready for diapedesis.
Kapag nagkaroon yung half ng
chemotaxin mag diapedesis agad yon,
commonly nagpapalit palit ng work
throughout the time.
- Bakit kailangan sa CBC nakaupo yung
patient? Kase yung half nung WBC sa
blood vessel wall ay nag circulating sa
Rapid movement ng katawan that
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would be result to false increase in
WBC. Kaya dapat yung patient yung
patient kapag WBC counting, need
muna pagpahingahin bago kuhanan.
Kase rapid movement will induced the
resting WBC to go in circulation.
- Chemokines
- Positive chemotaxis - (phagocytic
cells), if there’s chemotaxins
produced, they will go towards the
source of chemotaxins.
- Negative chemotaxis - this is the one
employed by bacteria; if there’s
chemotaxins produced, they will go
away from the source of chemotaxins.
- additional info: The movement of cells
toward a higher concentration of a
stimulating substance is defined as
positive chemotaxis (attractant), while
the movement away is defined as
negative chemotaxis (repellent).
DISORDERS AFFECTING CHEMOTAXIS
- Job’s Syndrome - normal yung random activity
ng white blood cell pero abnormal yung
chemotactic activity. Hindi niya kayang ma
recognize yung chemotaxis.
- Lazy Leukocyte Syndrome - abnormal
parehas. Abnormal yung random movement
and abnormal din yung chemotactic
movement.
ENGULFMENT
- Opsonization
- Opsonins - Complement (C3b, C4a, C5b),
antibodies, fibronectin, leukotrienes, and
tuftsin
Additional notes:
- Opsonization can be further enhanced by the
use of your opsonins. The examples of
opsonins are the C3D, C4A, and C5D.
antibodies, fibronectin, and toxins are the
normal components of the humoral immune
system. They bind the bacteria rendering
them with enhanced phagocytosis. Kase etong
mga to yung complements kakabit sa
receptors ng WBC.
- For example: May mga antibody kase tayo na
kakabit sa surface. Yung bacteria, tapos yung
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antigen kakabit yung antibody tapos ma
recognize ng cells tapos kakabit sila sa Fc
portion. Kapag na trigger nila yung cell
automatic na kahit walang adherens yung
bacteria kakainin or mag initiate sya ng
engulfment. Kahit hindi mag rush or walang
adherens yung bacteria yung mismong
immune cell mag engulf sya because of
opsonizing protein of your opsonins.
DIGESTION
- Cells become degranulated as foreign
materials are digested
- also known as cytopepsis
- where respiratory burst and formation of
phagolysosome happens
PROCESS OF PHAGOCYTOSIS
FACTORS THAT ENHANCES PHAGOCYTOSIS
- Integrins - Enhances cell-to-cell interaction
- They activate macrophages
- They enhances cell to cell contact
- Transmembrane proteins
- Kapag infected yung cell nagkakaroon sya ng
mas mataas na concentration ng integrins.
- Sticky substance kaya kapag nagkaroon ng
rush contact sa immune cell nagkakaroon ng
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cell to cell interaction.
- Opsonins - coat particles
1. complement proteins
2. Fc of immunoglobulins
3. Fibronectin
4. Leukotrienes - Arachidonic acid
5. Tuftsin- found on the spleen
ANTIGEN DESTRUCTION
- Phagolysosome - defensins, lactoferrin, and
lysozyme
- phagosome with merge with defensins,
lactoferrin, and lysozyme
- Nitric oxide- this is produced by activated
macrophages in order to destroy the antigens.
- NADPH oxidase - reactive oxygen intermediates
(superoxide anion, hydrogen peroxide, hydroxyl
radicals)
-this are the ROS (Reactive oxygen species)
INFLAMMATION
- It is the overall reaction of the body to injury or
invasion by an infectious agent.
- 5 Cardinal Signs:
1. Rubor - redness
2. Tumor - swelling
3. Calor - heat
4. Dolor- pain
5. Functio laesa- loss of function
Additional notes:
- Bakit nagkakaroon may rubor? Kase kapag
nagkaroon ng inflammation at nagkaroon pa
ng damage, ang unang response ng katawan
mo ay vasoconstriction. Because in order for
your blood or platelets to clot kailangan nya
mag constrict para magkaroon ng clot.
Because of that magkakaroon ng attraction ng
mga phagocytes magrerelease sila ng
kailangan cytokines, because of that
magkakaroon ng vasodilation, response
against constriction para mainhibit yung blood
loss. Kase kapag ang unang ginawa ng
katawan mo magdilate mas lalong mag
dudugo. Constrict muna bago mag dilate.
Yung dilation that will increase the flow of
blood that would lead to rubor or to the
redness kase maraming circulation dito.
- Followed by tumor or swelling, following
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vasodilation because kapag nagdilate yung na patay na.

blood vessels mo lalabas yung mga normal
plasma constituents magkakaroon ng
increased migration or increased fluid osmosis
in neighboring tissue that will lead to
inflammation or swelling.
- Bakit naman nagiinit yung part ng
inflammation? Because this is the increased
blood flow dahil maraming dugo. Kaya yung
site ng inflammation mas tataas ang
temperature part na yon or body
temperature.
- Bakit naman may dolor/pain? because yung
tissue kapag may swelling, naiipit yung mga
nerves kaya nagkakaroon ng pain.
- Hindi lahat ng inflammation may functio laesa
pero yung chronic inflammation is present.
Yung acute naman walang functio laesa.
2 types of inflammation
● acute - mediated by neutrophils
● chronic - macrophage
3. Resolution and Repair - your tissue can be
repaired by three methods: totally repaired,
formation of abscess, and formation of
granuloma.
- totally repaired - fibroblast, they will
replace platelets and will yield to total
repair. However in chronic
inflammation, you can form abscess
formation and granuloma.
- Abscess - formation of pus
nagkakaroon ng nana.
- Granuloma - another method of
response for example yung bacteria.
Ang gagawin ng macrophage is mag
recruit sya ng other phagocytes para
palibutan sya. Hindi namamatay yung
bacteria pero naeencase sya ng
maraming maraming cells. Hindi siya
kayang patayin ng macrophage so ang
gagawin sa kanya is papalibutan sya
para hindi makatakas. Yun yung
makikita sa lungs kapag may
tuberculosis.

VASCULAR RESPONSE

- Mast cells: Histamine (smooth muscle contraction)

- Dilation
- Redness and heat: because of additional blood
flow
- Endothelial cells contract - act as a fissures,
increased formation of osmosis in fluid in
endothelial lining.
- Swelling and pain:
STAGES OF INFLAMMATION

1. Vascular Response
2. Cellular Response- Neutrophils - 30-60 mins
makakarating sya sa site of inflammation.
- Then proceed to acute inflammation
24-48 days kayang mag persist.
- Followed by monocytes 15-48 hours.
Kapag predominant ang monocytes
that would mean na yung
inflammation is no longer acute this is
chronic inflammation.
- Pag naman may macrophage
aatakihin yung neutrophils, nagiging
pus cells. The pus cells refer to WBC
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1. Pumasok ang bacteria

2. May tissue damage kaya nakapasok.
3. Kinain sya then nagsecrete ng cytokines
4. Then vasodilation and inflammatory response.
5. Then phagocytosis
Additional:

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