Basophils

Introduction

Basophils are a type of granulocyte, which are white blood cells characterized by their large, dark blue granules in their cytoplasm. They are the least common of the granulocytes, making up less than 1% of circulating white blood cells.

Overview of the Immune System

The immune system is a complex network of cells, tissues, and organs that work together to protect the body from harmful pathogens, such as bacteria, viruses, fungi, and parasites. It is made up of two main components: the innate immune system and the adaptive immune system.  

Innate immune system: This is the body’s first line of defense against pathogens. It is non-specific, meaning it does not target a particular pathogen. The innate immune system includes physical barriers like the skin and mucous membranes, as well as cells such as neutrophils, macrophages, and natural killer cells.  

Adaptive immune system: This is a more specific and slower-acting immune response. It is able to recognize and target specific pathogens. The adaptive immune system involves lymphocytes, including B cells and T cells. B cells produce antibodies that bind to specific antigens on pathogens, while T cells directly attack infected cells.

Both the innate and adaptive immune systems work together to protect the body from infections. When a pathogen enters the body, the innate immune system responds first. If the pathogen is not eliminated by the innate immune system, the adaptive immune system is activated. The adaptive immune system is able to develop memory cells, which allow the body to quickly respond to future infections with the same pathogen.

Role of Granulocytes in Immune Responses 

Granulocytes play a crucial role in immune responses by providing a rapid and effective first line of defense against pathogens. These white blood cells are characterized by their granules in their cytoplasm, which contain various enzymes and toxic substances that help to destroy invading microorganisms.

Key functions of granulocytes

  • Phagocytosis: Granulocytes, particularly neutrophils, are capable of engulfing and destroying bacteria, fungi, and other foreign particles through a process known as phagocytosis. They use their granules to release enzymes that break down the engulfed material.
  • Release of inflammatory mediators: Granulocytes, especially basophils and eosinophils, play a vital role in allergic reactions and inflammation. They release various inflammatory mediators, such as histamine, prostaglandins, and leukotrienes, which help to recruit other immune cells to the site of infection or injury and promote tissue repair.
  • Killing of parasites: Eosinophils are particularly effective at killing parasites. They release toxic substances that damage the parasite’s cell membrane.
  • Regulation of immune responses: Granulocytes can also help to regulate immune responses by releasing factors that can either promote or suppress inflammation.

Morphology of Basophils

A basophil found in the peripheral blood smear. Basophils have large deep bluish-purplish cytoplasmic granules which obscure the nucleus.
Basophils contain large cytoplasmic granules which obscure the cell nucleus under the microscope when stained. The cytoplasmic granules are stained deep blue-purplish. “File:A type of white cell (Basophil).jpg” by Dr Erhabor Osaro is licensed under CC BY-SA 3.0

Basophils are a type of granulocyte characterized by their distinctive morphology.

Nucleus

  • Bilobed: The nucleus of a basophil is typically divided into two lobes, although it can sometimes appear as a single, horseshoe-shaped nucleus.
  • Chromatin: The chromatin within the nucleus is condensed and stains dark blue or purple with Romanowsky-type stains.

Cytoplasmic Granules

  • Large: The granules in basophil cytoplasm are significantly larger than those found in neutrophils or eosinophils.
  • Dark blue: The granules stain a dark blue or purple color due to their high content of histamine and other vasoactive substances.
  • Abundant: Basophils are packed with numerous granules, often obscuring the nucleus.

Comparison with Other Granulocytes

FeatureNeutrophilsEosinophilsBasophils
NucleusMultilobed (3-5 lobes)BilobedBilobed
GranulesSmall, pale pinkLarge, orange-pinkLarge, dark blue
FunctionPhagocytosis of bacteria and fungiKilling of parasites and involvement in allergic reactionsRelease of histamine and other mediators involved in allergic reactions

Lifespan in Blood and Reference Range

Lifespan in Bloodstream

  • Short-lived: Basophils have a relatively short lifespan in the bloodstream, typically ranging from 8 to 12 hours. This is in contrast to neutrophils, which have a lifespan of a few days, and eosinophils, which can survive for several weeks.
  • Rapid turnover: The short lifespan of basophils reflects their role in immediate immune responses, particularly allergic reactions. They are rapidly mobilized to sites of inflammation and are consumed or degraded after fulfilling their function.

Normal Reference Range

  • Low percentage: Basophils are the least abundant granulocyte in peripheral blood, typically comprising less than 1% of the total white blood cell count.
  • Reference range: The normal reference range for basophils can vary slightly between laboratories but generally falls within the following range:
    • 0.01-0.1% of total white blood cells
    • 20-50 cells/µL

It’s important to note that these values may be influenced by various factors, including age, gender, and specific laboratory methods.

Functions of Basophils

Role in Allergic Reactions (Type I Hypersensitivity)

  • Central mediators: Basophils are key players in type I hypersensitivity reactions, which are immediate allergic responses triggered by exposure to allergens.
  • Histamine release: Upon activation by allergens, basophils release preformed granules containing histamine, a potent inflammatory mediator. Histamine causes vasodilation, increased capillary permeability, and contraction of smooth muscle, leading to the symptoms of allergic reactions such as sneezing, runny nose, watery eyes, and skin rashes.
  • Other mediators: Basophils also release other inflammatory mediators, including leukotrienes and prostaglandins, which contribute to the development and progression of allergic reactions.

Histamine and Other Mediators’ Mechanism of Release 

  • Preformed granules: Basophilic granules are filled with a variety of preformed mediators, including histamine, heparin, and proteases.
  • Degranulation: When activated by allergens or other stimuli, basophils undergo degranulation, releasing these mediators into the surrounding tissues.
  • Inflammatory effects: Histamine, in particular, has a profound effect on blood vessels and smooth muscle, leading to the symptoms of allergic reactions and inflammation.

Involvement in Parasitic Infections

  • Eosinophil-basophil axis: Basophils and eosinophils often work together in response to parasitic infections.
  • Mediators: Both cell types release mediators that can damage parasites and promote inflammation.
  • Modulation of immune response: Basophils may also play a role in regulating the immune response to parasites, helping to balance the body’s response to the infection.

Basopoiesis

Basophils, like other blood cells, originate from hematopoietic stem cells (HSCs) in the bone marrow. The process of basophil development, known as basopoiesis, involves a series of differentiation steps.

Stages of Basopoiesis

  1. Hematopoietic stem cell (HSC): The process begins with a pluripotent HSC, which can give rise to all types of blood cells.
  2. Common myeloid progenitor (CMP): The HSC differentiates into a CMP, a cell that can produce granulocytes, monocytes, and erythrocytes.
  3. Granulocyte-monocyte progenitor (GMP): The CMP further differentiates into a GMP, which can give rise to neutrophils, eosinophils, basophils, and monocytes.
  4. Common basophil-mast cell progenitor (CBMP): The GMP commits to the basophil lineage and becomes a CBMP, a precursor cell that can also differentiate into mast cells.
  5. Basophil progenitor: The CBMP develops into a basophil progenitor.
  6. Mature basophil: The basophil progenitor undergoes maturation and differentiation to become a mature basophil, which is released into the bloodstream.

Factors Influencing Basophil Production

Several factors can influence basophil production, including:

  • Cytokines: Various cytokines, such as interleukin-3 (IL-3), granulocyte-macrophage colony-stimulating factor (GM-CSF), and stem cell factor (SCF), play a crucial role in promoting basophil development and survival.
  • Hormones: Hormones, such as glucocorticoids and thyroid hormones, can also influence basophil production. For example, high levels of glucocorticoids can suppress basophil production, while low levels of thyroid hormones can lead to basophilia.
  • Infections and allergies: Infections and allergic reactions can stimulate basophil production in response to the need for increased inflammatory cells.
  • Hematological disorders: Certain hematological disorders, such as chronic myelogenous leukemia, can lead to overproduction of basophils.

Causes of High Basophils (Basophilia)

Basophilia (high basophils), an increase in the number of basophils in the blood, can be caused by various factors.

Allergic Conditions

  • Asthma: Chronic inflammation of the airways often associated with high basophil numbers.
  • Rhinitis: Inflammation of the nasal mucosa, often caused by allergic reactions, can lead to basophilia (high basophils).
  • Urticaria: A skin condition characterized by hives, often due to allergic reactions, can be associated with increased basophil counts.

Hematological Disorders

Hypothyroidism

  • Reduced metabolism: Hypothyroidism, a condition characterized by decreased thyroid hormone production, can lead to various metabolic changes, including increased basophil counts.

Infections

  • Parasitic infections: Certain parasitic infections, such as helminthiasis (worm infections), can trigger an increase in basophil numbers as part of the immune response.

Medications

  • Heparin: This anticoagulant medication can sometimes cause basophilia (high basophils) as a side effect.
  • Corticosteroids: While typically used to suppress inflammation, corticosteroids can paradoxically cause basophilia (high basophils) in some individuals.

It’s important to note that these are just some of the possible causes of basophilia (high basophils). Other factors, such as specific genetic predispositions or unknown mechanisms, may also contribute to increased basophil counts.

Causes of Low Basophils (Basopenia)

Basopenia, a decrease in the number of basophils in the blood, can be caused by various factors. Here are some common causes:

Acute Infections

  • Neutrophilia: During acute infections, there is often a surge in neutrophils, which are another type of granulocyte. This can lead to a relative decrease in basophils.
  • Inflammation: The inflammatory response associated with acute infections can also affect basophil numbers.

Corticosteroid Therapy

  • Anti-inflammatory effects: Corticosteroids are potent anti-inflammatory drugs that can suppress the production and release of basophils.
  • Dosage and duration: The extent of basopenia induced by corticosteroids can depend on the dosage and duration of treatment.

Stress

  • Hormonal changes: Stress can lead to the release of stress hormones, such as cortisol, which can influence basophil production and function.
  • Immune system suppression: Chronic stress can also suppress the immune system, including basophil activity.

Pregnancy

  • Hormonal changes: Hormonal fluctuations during pregnancy can affect basophil numbers.
  • Immune system adjustments: The body’s immune system undergoes various adjustments during pregnancy, which can influence basophil counts.

Laboratory Investigations

Several laboratory tests can be used to evaluate basophil function and count. These laboratory tests can be used in various clinical settings for:

Diagnose allergic conditions: Elevated basophil counts and positive BAT results can be indicative of allergic diseases such as asthma, rhinitis, and urticaria.

Evaluate hematological disorders: Basophil counts can be helpful in diagnosing certain hematological disorders, such as chronic myeloid leukemia.

Monitor treatment response: These tests can be used to monitor the response to treatment for allergic conditions or other disorders associated with abnormal basophil function.

Research: Laboratory investigations of basophils are also used in research to study the role of these cells in various immune responses and diseases.

Complete Blood Count (CBC) with Differential

  • Basophil percentage: A CBC with differential includes a count of all white blood cells, including basophils. The percentage of basophils in the total white blood cell count can be used to assess whether there is basophilia or basopenia.

Basophil Count

  • Absolute number: A basophil count provides the absolute number of basophils per microliter of blood. This can be helpful in quantifying the degree of basophilia or basopenia.

Basophil Activation Test (BAT)

  • In vitro activation: The BAT measures the ability of basophils to degranulate and release mediators in response to stimuli.
  • Allergen-specific testing: The BAT can be used to assess sensitivity to specific allergens by exposing basophils to these allergens in vitro.

Measurement of Basophil-Derived Mediators

  • Histamine: Histamine is a key mediator released by basophils. Measuring histamine levels in the blood or other body fluids can provide insights into basophil activation.
  • Tryptase: Tryptase is another mediator released by basophils. Measuring tryptase levels can also be helpful in assessing basophil activation, particularly in conditions such as mastocytosis.

Disclaimer: This article is intended for informational purposes only and is specifically targeted towards medical students. It is not intended to be a substitute for informed professional medical advice, diagnosis, or treatment. While the information presented here is derived from credible medical sources and is believed to be accurate and up-to-date, it is not guaranteed to be complete or error-free. See additional information.

References

  1. Goldberg S, Hoffman J. Clinical Hematology Made Ridiculously Simple, 1st Edition: An Incredibly Easy Way to Learn for Medical, Nursing, PA Students, and General Practitioners (MedMaster Medical Books). 2021.
  2. Keohane EM, Otto CN, Walenga JM. Rodak’s Hematology 6th Edition (Saunders). 2019.
  3. Blumenreich MS. The White Blood Cell and Differential Count. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 153.
  4. Poto R, Loffredo S, Marone G, Di Salvatore A, de Paulis A, Schroeder JT, Varricchi G. Basophils beyond allergic and parasitic diseases. Front Immunol. 2023 May 2;14:1190034. doi: 10.3389/fimmu.2023.1190034. PMID: 37205111; PMCID: PMC10185837.
  5. Karasuyama, Hajime et al. Multifaceted roles of basophils in health and disease. Journal of Allergy and Clinical Immunology, Volume 142, Issue 2, 370 – 380
  6. Miyake K, Ito J, Karasuyama H. Role of Basophils in a Broad Spectrum of Disorders. Front Immunol. 2022 May 27;13:902494. doi: 10.3389/fimmu.2022.902494. PMID: 35693800; PMCID: PMC9186123.

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