IMAT Biology Lesson 6.12 | Anatomy and Physiology | Immune System Part I

Med School EU
18 Jan 202221:12

Summary

TLDRIn this educational video, Andre from Med School EU introduces the complex immune system, the body's final major organ system, highlighting its critical role in defending against infections. The video outlines the immune system's two main components: the innate and adaptive responses, with a focus on the functions of various immune cells like phagocytes, neutrophils, macrophages, and lymphocytes. It also touches on the importance of recognizing self from non-self to prevent autoimmune diseases, setting the stage for a deeper dive into the innate and adaptive immune responses in the next video.

Takeaways

  • πŸ›‘οΈ The immune system is the body's defense mechanism against diseases and infections, constantly functioning to protect us.
  • πŸ”¬ The immune system is complex and not fully understood, with many aspects still being studied and explored.
  • πŸ”‘ Glycoproteins on cell surfaces help the immune system differentiate between self and non-self, preventing autoimmune diseases.
  • πŸ₯ The immune system is divided into two parts: the innate immune system, which responds immediately to infections, and the adaptive immune system, which provides a stronger and more specific response later on.
  • πŸš‘ Innate immunity acts as the first responders in the immune response, similar to CPR or first aid, while adaptive immunity is like the hospital care that follows.
  • 🌱 Hematopoietic stem cells are the starting point for the development of all immune system cells, splitting into lymphoid and myeloid cells.
  • πŸ‘¨β€πŸ”¬ Myeloid cells produce various types of cells including neutrophils, eosinophils, monocytes, mast cells, basophils, dendritic cells, and macrophages.
  • 🦠 Phagocytes, such as neutrophils and macrophages, engulf and destroy pathogens through a process called phagocytosis.
  • 🚨 Histamine released by infected cells signals the immune system of trouble, attracting neutrophils to the site of infection through chemotaxis.
  • πŸ”„ Lymphocytes, including B cells and T cells, are part of the adaptive immune response and are produced in the bone marrow, with T cells maturing in the thymus.
  • 🧬 The diversity of B and T cells allows them to bind to specific antigens, even those from pathogens never encountered before, showcasing the adaptability of the immune system.

Q & A

  • What is the primary function of the immune system?

    -The primary function of the immune system is to protect the body from diseases and infections, keeping us alive by constantly functioning and being alert.

  • What are the two main components of the immune system?

    -The two main components of the immune system are the innate immune system and the adaptive immune system.

  • How does the immune system distinguish between self and non-self?

    -The immune system distinguishes between self and non-self using glycoproteins on the surface of cells. Healthy cells have specific glycoproteins that signal to the immune cells that they are part of the body and not to be attacked.

  • What is the role of the innate immune system in the body's response to infection?

    -The innate immune system responds immediately to an infection, acting as the first line of defense by initiating the fighting process against pathogens.

  • What is the adaptive immune system's response compared to the innate immune system?

    -The adaptive immune system provides a stronger response that occurs later on if needed. It is activated by the innate immune system and creates memory cells to recognize and respond to attacks more effectively if they occur again.

  • What are the two main types of cells in the immune system?

    -The two main types of cells in the immune system are lymphoid cells and myeloid cells.

  • What is the main function of phagocytes in the immune system?

    -Phagocytes are cells that perform phagocytosis, which means they engulf and dissolve pathogens and dead cells, playing a crucial role in the body's defense against infections.

  • What is the difference between neutrophils and macrophages in terms of their role in the immune response?

    -Neutrophils are short-lived cells that rapidly attack pathogens, while macrophages have a longer lifespan and play a role in initiating the adaptive immune response by displaying antigens from pathogens on their surface.

  • How do B cells and T cells differ in their development and maturation process?

    -B cells mature in the bone marrow, while T cells migrate from the bone marrow to the thymus where they mature. The thymus also educates T cells to recognize self and non-self, eliminating most T cells that do not pass this test.

  • What is the significance of the thymus in the development of T cells?

    -The thymus is where T cells mature and are educated to distinguish between self and non-self. It is also known as a 'deadly university' because it eliminates a large number of T cells during this process.

  • What is the process of phagocytosis and how does it relate to the immune response?

    -Phagocytosis is the process by which phagocytes engulf and digest pathogens. It begins with the attraction of neutrophils to the site of infection by histamine released by infected cells, leading to the engulfment and destruction of pathogens.

Outlines

00:00

πŸ›‘οΈ Introduction to the Immune System

Andre, the host of Med School EU, introduces the immune system as the final major organ system in the anatomy and physiology unit. He emphasizes its complexity and the limited understanding we have of it compared to other systems like the brain. The immune system's primary role is to protect the body from diseases and infections, and it operates continuously. Andre explains the immune system's distinction between self and non-self using glycoproteins, which are crucial for avoiding autoimmune diseases. The video will cover both the innate and adaptive immune systems, with the innate system responding immediately to infections and the adaptive system providing a stronger, memory-based response.

05:01

πŸ”¬ Cells of the Immune System

This paragraph delves into the various cells that make up the immune system, divided into lymphoid and myeloid cells. The myeloid cells produce different types of cells, including neutrophils, eosinophils, monocytes, mast cells, basophils, dendritic cells, and macrophages. The focus is on the roles of macrophages, neutrophils, and monocytes, which are phagocytes that engulf and destroy pathogens. Lymphoid cells, which include B cells, T cells, and their various subtypes, are part of the adaptive immune response. The video will further explore these cells' functions in the next installment, with a particular emphasis on the myeloid cells and their role in the immune response.

10:02

🚨 Phagocytosis and the Role of Neutrophils and Macrophages

The paragraph explains the process of phagocytosis, where phagocytes like neutrophils and macrophages engulf and destroy pathogens. Neutrophils are the first responders to an infection, rapidly attacking and killing pathogens but having a short lifespan. Macrophages, derived from monocytes, have a longer lifespan and reside in organs. They play a crucial role in initiating the adaptive immune response by displaying antigens from pathogens on their surface for lymphocytes to recognize. The paragraph also describes the inflammatory response triggered by histamine release, attracting neutrophils to the site of infection, where they perform chemotaxis and phagocytosis.

15:02

πŸ›‚ The Sacrifice of Neutrophils and the Function of Lymphocytes

This section discusses the self-destruction of neutrophils after they have performed their function, which results in the formation of pus at infected sites. It highlights the sacrifice of these cells to protect the body from harmful pathogens. The paragraph then transitions to lymphocytes, which are part of the adaptive immune response. Lymphocytes, including B and T cells, are smaller than phagocytes but have a large nucleus. They are produced in the bone marrow and mature before they can carry out immune responses. The paragraph sets the stage for a deeper discussion on B and T cells' roles in the next video, focusing on their development, specificity to antigens, and the importance of the adaptive immune system's diversity.

20:03

🏫 Maturation of B and T Cells and the Function of the Thymus

The final paragraph focuses on the maturation process of B and T cells. B cells mature in the bone marrow and spread throughout the body, concentrating in the lymph and spleen. In contrast, T cells mature in the thymus, which is described as a 'university' where most T cells die, and only a select few graduate to perform the adaptive immune response. The thymus's role in educating T cells to distinguish between self and non-self is critical to prevent autoimmune reactions. The paragraph concludes with a note on the thymus's size changes throughout life, impacting the strength of the immune system as we age. The next video promises a more detailed exploration of the innate and adaptive immune responses.

Mindmap

Keywords

πŸ’‘Immune System

The immune system is a complex network of cells, tissues, and organs that work together to defend the body against harmful pathogens such as bacteria, viruses, and parasites. In the video, the immune system is the central theme, with its primary function being the protection from infections and diseases, highlighting its continuous and vigilant role in maintaining health.

πŸ’‘Lymph Nodes

Lymph nodes are small, bean-shaped structures that are part of the lymphatic system, playing a crucial role in the immune response. They act as filters for harmful substances and are the sites where immune cells are activated. The script mentions lymph nodes as part of the 'highway' the immune system uses, emphasizing their importance in the immune response.

πŸ’‘Glycoproteins

Glycoproteins are molecules composed of carbohydrates and proteins that are found on the surface of cells. They serve as identifiers for the immune system to distinguish between self and non-self. In the video, glycoproteins are described as being instrumental in the immune system's ability to recognize and avoid attacking the body's own cells, thus preventing autoimmune diseases.

πŸ’‘Innate Immune System

The innate immune system represents the body's first line of defense against pathogens and is characterized by its rapid, non-specific response. The script explains that this system is activated immediately upon infection and is the 'first responder' in the body's fight against invaders.

πŸ’‘Adaptive Immune System

The adaptive immune system is a more specialized and targeted response to pathogens, capable of learning and remembering specific threats for a more effective response upon future encounters. The video script describes it as being activated later in the immune response and creating memory cells for long-term protection.

πŸ’‘Phagocytosis

Phagocytosis is the process by which certain immune cells, known as phagocytes, engulf and destroy pathogens. The script describes this as 'cell eating' and explains that it is a crucial mechanism by which the immune system eliminates harmful microorganisms from the body.

πŸ’‘Neutrophils

Neutrophils are a type of white blood cell and a primary component of the innate immune system. They are the most abundant and are rapidly deployed to the site of infection to perform phagocytosis. The video script highlights their role as aggressive and short-lived cells that sacrifice themselves to protect the body.

πŸ’‘Macrophages

Macrophages are large immune cells that originate from monocytes and play a significant role in both the innate and adaptive immune responses. They engulf pathogens but also have the unique function of presenting antigens to lymphocytes, thus initiating the adaptive immune response. The script describes macrophages as long-lived cells that reside in organs and are crucial in the immune system's response.

πŸ’‘Lymphocytes

Lymphocytes are a type of white blood cell that includes B cells and T cells, which are central to the adaptive immune response. They are smaller than phagocytes but have a large nucleus, which is a distinctive feature when viewed under a microscope. The script explains that lymphocytes circulate in the blood and lymph, playing a vital role in the body's defense against specific pathogens.

πŸ’‘Thymus

The thymus is a gland located in the chest where T cells mature. It is described in the script as a 'university' for T cells, where they are educated to recognize self from non-self, with a high rate of T cell death during this process, ensuring that only those capable of correctly identifying threats survive to contribute to the adaptive immune response.

πŸ’‘Autoimmune Diseases

Autoimmune diseases occur when the immune system mistakenly attacks the body's own healthy cells. The script explains that this happens when immune cells fail to recognize self cells as non-threatening, leading to conditions where the body's defenses turn against itself, causing various health issues.

Highlights

Introduction to the immune system as the last major organ system covered in the anatomy and physiology unit.

The immune system's primary function is to protect from disease and infections, highlighting its continuous and crucial role in maintaining life.

Explanation of the immune system's complexity and the vast amount of unknowns compared to other systems, particularly the brain.

The immune system's distinction between self and non-self using glycoproteins for recognition to prevent autoimmune diseases.

Division of the immune system into innate and adaptive components, with the innate system providing immediate responses and the adaptive system offering a stronger, later response.

Description of the immune system's cells and their development from hematopoietic stem cells into lymphoid and myeloid cells.

Role of phagocytes, including neutrophils, macrophages, and monocytes, in engulfing and eliminating pathogens through phagocytosis.

Differentiation between neutrophils, which are the most abundant white blood cells, and macrophages, which have a longer lifespan and a role in initiating the adaptive immune response.

The process of phagocytosis, starting with the release of histamine and the attraction of neutrophils to the site of infection via chemotaxis.

Mechanism of self-destruction in neutrophils after depleting their energy, contributing to the formation of pus in infected areas.

Introduction to lymphocytes, which are part of the adaptive immune response and include B and T cells.

The maturation process of B and T cells, starting in the bone marrow for B cells and in the thymus for T cells.

The thymus's role as the 'university' for T cells, where most T cells die during the education process to ensure they can recognize self from non-self.

The decline of the thymus's function after puberty, which contributes to a weaker immune response as we age.

Upcoming detailed discussion on the innate versus adaptive immune response in the next video.

Transcripts

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[Music]

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hi everyone my name is andre and welcome

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back to med school eu

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and the topic of today's video is going

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to be the immune system so this is the

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last major organ system that we'll be

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covering in this

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unit of anatomy and physiology there is

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one more to go after this but it will be

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covered fully in this stage it will also

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involve the homeostasis unit therefore

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this is officially the last uh organ

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system that we will cover

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and this is the last topic that we're

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going to talk about in terms of anatomy

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and physiology however it will pertain

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uh

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several

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videos because the immune system is so

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complex and there's so many things we

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don't know about it there's so many

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things we do know about it

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we're going to have to keep this very

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brief very short and just include the

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things

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in the

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surface level just the tip of the

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iceberg so to speak because this is one

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of the most

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uh

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less understood systems that we have

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after our brain

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and uh

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therefore there won't be too much

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that we're going to have to cover

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because it goes extremely extensively

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and very complicated

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but in terms of high school knowledge

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there's going to be limited things we'll

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have to know so just to overview what

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the immune system is is of course it

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protects from disease it protects from

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infections

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and that is its primary functions it's

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the things that keep you alive the

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immune system

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is continuously functioning it is always

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alert it is always

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working

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and it is something that keeps us alive

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and it's extremely important there's a

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lot of organs that are involved

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in response with the immune system

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but the major kind of highway that it

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uses is the lymph

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nodes and and the lymph system now the

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cells of the immune system that are used

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to attack pathogens they must recognize

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what is self

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and

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what is non-self because if

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the

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immune cells are going to recognize the

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self

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cells

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as uh as non-self they're going to

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recognize them as enemies and then

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they're going to attack them and when

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this occurs when the immune cells attack

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the self so they attack healthy cells

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this causes autoimmune diseases now the

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question is how does the immune system

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recognize self from the non-self and

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typically that is done with

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glycoproteins so healthy cells are

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are going to have the surface receptors

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so they're going to have little

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receptors on their cell membranes

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they will be sticking out that will be

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signaling it's the cells and these are

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formed by glycoproteins so it's

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a combination of

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sugars carbohydrates and proteins and

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these molecules will be there to

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indicate to

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the large phagocytes

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that they cannot just come in and eat

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them

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because they are self they are

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allies they are part of the same system

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whereas

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a bacteria would come in it would have

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different glycoproteins

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on its surface and therefore the cells

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of the immune system would recognize

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that and they would perform phagocytosis

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to remove them

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from the body now another important

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thing to mention about the immune system

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is that it's composed of two parts the

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innate immune system and the adaptive

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immune system now the innate immune

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system is something that responds

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immediately as soon as an infection

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occurs let's say you cut your finger and

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you have bacteria that are on the knife

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that you cut your finger with they're

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going to enter inside and even the

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bacteria just from the surfaces are

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going to enter inside

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of of your skin

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and inside the body and the immune the

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innate immune system is the one that is

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going to respond immediately and begin

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the fighting process now the adaptive

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immune system is something that occurs

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later on if the help is needed the

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adaptive immune system

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will be able to be activated by the

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innate immune system

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and the adaptive immune system is much

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stronger response and it creates

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things like memory cells in order to

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recognize

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these sorts of attacks

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later on if they occur

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again and again so

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typically the innate immune system what

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happens is it

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is the first responders kind of doing

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like cpr first aid and the adaptive

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immune system is the hospitals

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and the clinics that are able to assess

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the patient further do

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operations and other things like that so

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that's the two ways of thinking about

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the immune system as it pertains

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as it has two different parts and two

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different types of responses

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these responses will be covered in the

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next video there will be too much to

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cover in one video if we talk about

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everything that is involved with the

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immune system so i decided to split it

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up into two videos the first video we'll

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talk about an overview of the immune

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system we'll mention the cells that are

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involved and what they do and then the

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next video we're going to talk about the

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innate versus the adaptive immune

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response so let's take a look at the

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cells of the immune system so this is

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the complete division of the cells of

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the immune system there's quite a lot

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however we're just going to cover the

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names of these and briefly what they do

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and

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of course we're not even going to

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include

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a lot of the cells that are

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part of this diagram i just wanted to

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show how complex the immune system is

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and how many different types of cells

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that actually

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involve so

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we begin with the

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hematopoietic

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stem cell so that's the stem cell right

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here

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this stem cell is the one that develops

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the rest of the cells of the immune

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system now the stem cell would split

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into two types

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of cells and there's generally two types

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of

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cells

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in the immune system they all fall under

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these two categories as you can see

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based on

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the diagram

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on the top here we're going to have the

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lymphoid cells and at the bottom here

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we're gonna have the myeloid

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now the myeloid cells are going to

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produce five different cells and i want

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you to note that the way they actually

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look they've got this

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weird uh nucleus so the one on the top

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is called the neutrophil the one in the

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middle is called a cinephil and the one

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here at the bottom is a monocyte now the

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other two cells that are made directly

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from the myeloid

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is going to be a mast cell and a

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basophil and finally from the monocyte

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we would produce

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the dendritic cell so the one that has

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all these sticky pointy pointy sides

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that's the dendritic cell and a

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macrophage so the two cells that we're

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definitely going to talk about are going

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to be the macrophage

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and the neutrophil and a little bit

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about monocytes as well

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now if we're looking at the lymphoid

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cell and what uh what type of cells are

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made out of that

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we're going to have b cell precursor to

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b cells

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so b cell

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pre we're going to have a killer cell in

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the middle here and

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the one on the side there is a t cell

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precursor

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now from the t cell it's going to

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produce

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three different

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t cells it's going to produce memory t

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cell we'll have a cytotoxic t cell and

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the helper t cell and from the b cell a

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precursor we're going to generate memory

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b cells and a plasma cell

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so we're going to discuss all of these

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but primarily they will be discussed in

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the second video we're just going to

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quickly mention about b cells and t

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cells in general and for the most part

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we're going to talk about the myeloids

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monocytes

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neutrophils and macrophages so the

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immune system is split into two types of

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cells as mentioned we've got the

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phagocytes

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and the lymphocytes lymphocytes would

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include b cells and t cells phagocytes

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would include neutrophils macrophages

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and the monocytes so let's discuss

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monocytes or and or the

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phagocytes first

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phagocytes

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are cells that do phagocytosis

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in phagocytosis meaning that it's going

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to engulf cells it's called cell eating

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so basically when a bacteria or a

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pathogen or microorganism comes along

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that where it shouldn't be

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in the body

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the

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phagocytes that the cells are going to

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attack it and they're going to engulf it

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dissolve it and get rid of it now these

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phagocytes are produced and stored

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in the bone marrow phagocytes are

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typically scavengers

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so they're going to go all around you

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know throughout the body

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and what the their major function is to

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remove dead cells

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and

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to remove invasive

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microorganisms so they would be called

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scavengers

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kind of searching around the body

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looking for

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microorganisms that shouldn't be there

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and looking for dead cells to clean them

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up now let's talk about neutrophils and

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macrophages the the two major types

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of phagocytes the neutrophils

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make up 60

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of white blood cells in in the blood so

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primarily the blood is composed

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and the white blood cells are composed

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primarily of neutrophils

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and they circulate the patrol throughout

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the body so their main function is to

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patrol and when an infection occurs

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we are going to have a response and this

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is going to be an an anatomy response

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and during this infection

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plenty of neutrophils are going to be

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released in great numbers

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and they're going to vigorously attack

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the pathogens that have entered the body

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so they're very vicious they they kill

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rapidly

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however they have a very short

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life span so these cells actually do

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the phagocytosis

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now if we talk about macrophages they

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are originally made in the bone marrow

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as monocytes

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so we discussed monocytes lead to

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macrophages

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and so originally it is made in the bone

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marrow as monocytes

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then

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the monocytes are going to circulate

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around the blood and as they leave the

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blood they're going to develop into

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macrophages

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as they settle in organs so they

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typically reside in organs they have a

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long lifespan so they are long lived

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much longer

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than the neutrophils but also going to

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be viciously dissolving

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different microorganisms that enter the

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body

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as part of the immune response

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but the difference is they do not

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directly destroy

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the

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pathogens

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fully and what i mean by that is

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they play a role in initiating the

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adaptive immune response

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by

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cutting pathogens and displaying their

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antigens or displaying little pieces of

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the pathogens on their surfaces

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that can be recognized by the

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lymphocytes and lymphocytes are part of

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the cells the b and the t cells that are

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part of the adaptive immune response and

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we're going to talk this in more detail

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in the next video but i wanted to just

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give you a quick introduction because it

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is part of the duties of the macrophages

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it's their function to initiate and to

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they play a crucial role in initiating

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the adaptive immune response

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by

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not simply dissolving the pathogens

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completely but what they're going to do

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is they're going to cut them into pieces

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and they're going to display

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their antigens on their surface

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therefore

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the b cells and the t cells are able to

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find them and bind to them and

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begin dividing and initiating the

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adaptive immune response so what is

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phagocytosis and how does it actually

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occur so

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we have to begin with an infection

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of the body so when infection of the

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body occurs

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we're going to have cells that will be

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under attack

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and they're going to release

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histamine now once the cells are being

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destroyed by the infection of

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microorganisms like bacteria or viruses

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they're attacking our healthy cells some

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of them are going to release histamine

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histamine is an inflammatory chemical

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and it's going to spread all around the

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body as it

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kind of signals

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and it

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is going to go to the bloodstream it's

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going to go to the lymph nodes and it's

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going to signal that there is an

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infection going on there is cells dying

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there is trouble

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the

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immune system must come and help the

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first responders of course

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the neutrophils are going to be

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attracted to the histamine call so

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neutrophils are going to be those first

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responders that will get to the site

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also the site is going to be flooded

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with with blood and water and different

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substances

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and that is part of the inflammatory

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response that we will talk about

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in the in the next video however what i

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wanted to point out here is how this

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phagocytosis begins and how it happens

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so

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once this neutrophils are arrive at the

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site of infection because of the call of

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histamine

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and this

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whole process is called chemotaxis

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because it is a attraction of this

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chemical

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neutrophils attraction to the chemical

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that promotes the neutrophils flooding

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into the area then the neutrophils are

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going to engulf

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the pathogen

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via phagocytosis so that's going to be

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endocytosis they are as you can see in

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this diagram they're going to wrap

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around the bacteria and they're going to

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fully surround them and fully engulf it

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in its own

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cell and once inside the cell the

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the lysosomes that are inside the cell

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are going to release

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enzymes they're going to release

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digestive enzymes an example of

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digestive enzymes that they release are

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going to be proteases and after several

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kills

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from the neutrophil they are going to

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deplete their batteries they're going to

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deplete their energy and the neutrophil

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is going to do self-destruction it's

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going to kill itself

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and all of those neutrophils that are

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going to die and they're going to kill

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themselves they form this pus that we

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get from an infected area that is the

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action of neutrophils sacrificing

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themselves to keep you

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alive from the dangers of rapidly

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dividing bacteria or rapidly dividing

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viruses

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or or other parasites and pathogens that

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may enter the body

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now let's talk a little bit about

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lymphocytes and that's typically

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lymphocytes are part of the adaptive

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immune response

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they are the classic b and the t cells

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and

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lymphocytes are going to be smaller

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than the phagocytes

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however they're going to have a much

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larger nucleus so the nucleus is going

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to fill up almost the entire cell

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as their distinctive feature when you're

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looking through a light microscope

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and there are two types that we are

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going to discuss

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the two types are b and t cells

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so we will talk about the general

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b and t cell where they come from and

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how do they mature and then in the next

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video we'll discuss more about their

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action

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in the adaptive immune response but in

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general both

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are produced in

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bone marrow

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so that they are born in the bone marrow

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and they develop in the bone marrow

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before the child's birth so while um

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the

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fetus is being developed the b and the t

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cells are going to be forming in the

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bone marrow and only mature lymphocytes

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can perform immune responses so the

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immune cells that are born

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in the bone marrow are not mature yet

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they're going to have to go through a

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process before they're able to act so

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only material lymphocytes will be able

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to carry out

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responses

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of the adaptive immune system now during

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the maturation process after they're

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born in the bone marrow

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the

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b and the t cells could be made in a

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variety of different ways with millions

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of different combinations

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and the reason for that is because there

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are going to be millions of different

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pathogens that can infect the body and

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therefore the b and t cells

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must be specific to one

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antigen so from the millions of

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different combinations that are possible

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this is why our b and t cells are able

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to

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bind to a specific pathogen even if it's

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never seen it before it's fascinating

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how our immune system works in this way

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and that's why our adaptive immune

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system is just

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so incredible and so diverse and so

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compact

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with with information that we still have

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not discovered everything about it and

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it's the least understood

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after the brain

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but once the b and the t cells are

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mature they circulate

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in the blood and the lymph now let's

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take a look at the similarities and the

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differences between the b

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and the t cells so beginning with the b

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cells

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they will be born in the bone marrow and

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they're going to mature

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in the bone marrow then once they're

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mature in the bone marrow they're going

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to spread all around the body and

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concentrate

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in the lymph and the spleen now if we're

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talking about t cells they are going to

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mature in the thymus so they're they're

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going to leave the bone marrow

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and they're going to collect in the

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thymus and they're going to mature in

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the thymus which is

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and the thymus is a gland that is

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considered the university of t cells

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and it is a deadly university because it

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kills 98 of t cells that enter it and

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basically in in terms of education what

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type of education it does is the thymus

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is going to educate the t cells

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to

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be able to recognize self and the

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non-self because it's going to be

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extremely detrimental if t and b cells

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these very very powerful cells

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are going to recognize self

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and

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and they will attack the self then that

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could be

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deadly for the body therefore the thymus

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is a brutal deadly university where most

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t cells are going to

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die they're not going to make it and

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only about two percent of t cells that

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enter the thymus are going to mature and

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properly do their adaptive immune

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response so in the thymus this is where

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they are educated now as soon as they

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graduate from the death university of

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thymus

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they are going to spread all around the

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body

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and

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just to

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mention a couple of other things

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about thymus

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is that the thymus is

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is basically a gland

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in the chest beneath the sternum

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and it grows two times its size from

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birth to puberty and then afterwards

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after puberty it's going to shrink so

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this is why our immune system is not

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going to be as responsive it's not going

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to be as strong

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as we age past puberty so this concludes

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our first video on the immune system in

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the next one we are going to talk about

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the anatomy response versus the adaptive

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immune response in greater detail

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[Music]

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you

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Related Tags
Immune SystemAnatomyPhysiologyInnate ResponseAdaptive ResponseLymphocytesPhagocytesNeutrophilsMacrophagesEducationalHealth Science