 Okay, so again, good morning to everyone. So for today, we will just be finishing our discussion with Hemato Pueces. So I will be ending with Erythro Pueces. So your final score, okay, your final score is already the score you've seen. So I have no corrections or manual checking that I need to do. So nandun na lahat ng answers. So you can actually check it later by the end of our period, okay? By the end of our period, you can check the correct answers already. So for this morning, we will be continuing on our discussion which is your Hemato Pueces. So it's very important for us to realize, okay, that there are two theories when it comes to how Hemato Pueces happen within the body. I say theory because up until now, okay, I say theory because up until now, there is still no absolute evidence that will point out that one theory is the one that is correct versus the other, okay? So let me just clear that. So up until now, both are just theory. But the scientific community are leaning on one of this theory of Hemato Pueces. So there are actually two theories of Hemato Pueces, okay? Two theories of Hemato Pueces which is your monophylletic theory of Hemato Pueces. So according to the monophylletic theory of Hemato Pueces, all blood cells are derived from a single progenitor stem cell which is a pluripotent hematopoetic stem cell. So monophylletic states that this pluripotent stem cell multiply to produce more pluripotent stem cell which will be discussed later on on the type of division for your stem cells, okay? For your stem cell. I hope everyone's mind is already aligned with Hemato Pueces. So Hemato Pueces, let's go back again, is the process of blood cell production, okay? Blood cell production. So according to monophylletic theory, sabi sa monophylletic theory, your white blood cell, your red blood cells, your mega-cardiocytes that eventually gives rise to your platelets came from one cell, okay? And that is a pluripotent hematopoetic stem cell meaning to say this pluripotent hematopoetic stem cell can differentiate into those different precursor, okay? They can differentiate from being a pluripotent hematopoetic stem cell, magiging eritroblasila, magiging myeloid precursor, or magiging lymphoid precursor. Yun yung ibig sabihin noon. From one cell, it will give rise to different cells depending on its differentiation. Another theory that is being proposed is also your polyphiletic theory. What do you mean by poly? By its word poly, meaning to say many, okay? So they believe that each blood cell lineges is derived from its own unique stem cell. So according to this theory, the platelets has its own hematopoetic stem cell, your red blood cells has its own precursor cell, your WBC, your basophil, your eucenophil, your lymphocytes, your monocytes, your neutrophils, all of them are having their own stem cell, okay? But between these two, okay? Between these two, makikitandaan po, please write it down on your notes because this might be coming out of the exam. So between these two, which is favored by the scientific community, anyone? Alindi ito yung pinapaboran nila. They agree that this theory is actually how hematopoesis happened. Anybody in the chat box, is it the mono or the poly? Correct, okay. Walang sumasagot sakin. It's the monofiletic, okay? If you have read your rodac already, okay? If you have read rodac already, it's found on page 52 of the 2020 edition. They are actually favoring the monofiletic theory, okay? The monofiletic theory, okay? So let us go now to your hematopoetic stem cells, okay? Hematopoetic stem cells. So a while back, last time we discussed already what apoptosis is. Now we will be discussing what self-renewal is, differentiation, and the types of division. So your hematopoetic stem cell has three fate, okay? Meron siyang katlung destination. It can either go self-renewal, differentiation, or apoptosis, okay? We already know that apoptosis is the program cell death, which is also part of your quiz, okay? It is a physiological cell death that are induced by either different cytokines or chemicals within your cell, within your body, or simply the deprivation of those growth factors will cause their death, okay? So will cause their death. What I want to focus on is the fate of your stem cell, be it self-renewal and differentiation, okay? Be it self-renewal and differentiation. Before I explain it further, let me go ahead and talk about the types of division, okay? The types of division can be symmetric or asymmetric, okay? So when we say symmetric, the daughter cell are both, both of them will be, when we say symmetric, both of the cell will undergo differentiation. But if one cell, but only one cell lang ang magdedeferensyate, and the other one will return into the pool to do self-renewal, we call that asymmetric. I know it's parang, if you haven't read the book, it doesn't make sense, okay? If you came here in class today and you haven't read the book, parang medyo nakakalito pa siya, okay? But let me try to explain it to you. I'll present my screen, okay? Wait lang ha, I'll connect and then gagawatay ng diagram, okay? Hopefully this diagram will help you understand how it happened, okay? So here, I'm already in the meeting. So can somebody confirm, ha, if you can already see my screen there? Can you see my screen now? Yes, sir. Okay, screen ng iPad, ha? Okay, thank you so much. So sabi natin kanina, your hematopoietic stem cell has three fate, okay? Meron siyang katlong fate, which is to differentiate to self-renewal and apoptosis, okay? So alam natin lahat yan, okay? So take for example, I have here, okay? I think I will best explain it using a diagram. Take for example, this is your hematopoietic stem cell. Your hematopoietic stem cell will give rise to two daughter cells, okay? To two daughter cells. So this is its daughter cell, okay? I will call them D1 and D2, okay? This are the daughter cells, okay? Take for example, I cannot zoom it out kasi, sorry. So let me just try to go to ano na lang. Here, take for example, this is your hematopoietic stem cell, okay? So this is your hematopoietic stem cell, this is your HSC, okay? Your hematopoietic stem cell. It will now give rise to two daughter cell, okay? Two daughter cell and we will call them D1 and D2, okay? So sabi, as what we were mentioning a while back, your hematopoietic stem cell has three fate, either to go up of doses, but that's not the topic for now. Oh, it can go differentiation or self-renewal. Take for example, both of this, take for example, both of this daughter cell, okay? Both of this daughter cell underwent, okay? Underwent differentiation. We call this process now as your symmetric, okay? The division is symmetric. Are we clear? The division is symmetric. So kung parayat sila ng pinuntahan, both of them differentiated, we call it symmetric. Are we clear? Hello? Yes, Puster. We call it, we call that symmetric. Sir, what about the other one, okay? Take for example, take for example D1 and D2, okay? D1 and D2. One cell will undergo differentiation and the other cell will return to the pool that is called now your self-renewal, okay? This process now is asymmetric division. Are we clear? Kung yung isa nag-proceed to differentiate, yung isa naman bumalik sa pool, okay? To take for example, this is the pool of your hematopoietic stem cell, bumalik siya dun to replenish the number of hematopoietic stem cell, that is now your self-renewal. Kung yung isa nag-self-renew, yung isa nag-differentiate, we call that asymmetric. Are we clear? Clear po tayo? Hello? Sir. Okay. So this is also the way of your, maybe some of you are wondering, sir, paano po na, how can we make sure, how can the bone marrow make sure that it will never run out of hematopoietic stem cell? The answer is asymmetric cell division, okay? Asymmetric type of division. One will own, when there is two, okay, when there is two types, when there is two daughter cell, one will go into further differentiation. So when I say differentiation, mamaya pag-uusapan natin, it can either become an erythroid precursor, amyloid precursor, or a lymphoid precursor. Are we clear? So yun lang muna yung gusto kung isetel kasi kailanganin yung mag-grasp itong idea nato, that your hematopoietic stem cell can go into three phases, apoptosis, self-differentiation, and self-renewal. Apoptosis, we explain it a while back as the program cell death, okay? Differensation, what do we mean by differentiation, sir? Differensation means it will undergo further differentiation to become now your blood cells. Are we clear? Another thing is self-renewal. Self-renewal, the daughter cell will return to the pool of hematopoietic stem cell. Sir, why? This is the process, this is the way of your bone marrow to make sure that there will be enough hematopoietic stem cell in the course of your life. Are we clear? Clear po tayo doon? Yes, po. Okay, so I hope that's clear ha na kapag both of them differentiated symmetric, ibig sabihin parayasila na ang destination. But if one differentiated, the other one under one's self-renewal, that is called your asymmetric cell division. Okay, so moving forward, maybe some of you, sir, I just wonder when will be the time that the bone marrow will realize that it's time to do self-renewal or when to do symmetric and when to do asymmetric. Haven't you wondered how? So the process is now, can you see the PowerPoint now? Can you see my PowerPoint now? Yes, po. Okay, so maybe some of you are wondering how did it happen that is actually through your models now of hematopoietic. We have your stochastic, we have your instructive, okay, and we have your multilinage priming model. So in your book, it is actually very much defined, the two models, your stochastic and your instructive. Sir, when will my bone marrow, when will my hematopoietic stem cell know kung kailan siya magaasimetric at magsisimetric? The answer is here. It's either stochastic or instructive. When we say stochastic, okay, your stochastic model of hematopoiesis is actually a random selection. So your cells randomly commit to self-renewal or differentiation, okay? It either random lang yung selection non, okay, random lang yung selection non. So self-renewal or it will differentiate, okay? It's self-renewal or differentiate. So that part, okay, in that particular part of your hematopoiesis, that is random, stochastic po sya, okay? Stochastic yung tawag. But what about your instructive, okay? When we say instructive, remember we have your bone marrow microenvironment, okay? Remember the bone marrow microenvironment yung tinawag natin na stromal cells, the endothelial cells, the macrophages, osteoblast, osteoblast, and then also yung mga soluble substances. Ayyan, itong mga tawag. I hope you still remember that, okay? This particular part is playing a big part on the instructive hematopoiesis. And the instructive hematopoiesis, your bone marrow microenvironment determine now if your stem cell will self-renew or differentiate, okay? If they will undergo self-renewal or if they are going to differentiate into a particular type of cell, okay? Into a particular type of cell. So between these two, okay? Between these two, scientists believe that the initial decision to self-renew or differentiate is probably stochastic, okay? It is probably stochastic. So kung magre-renew ba yan or mag-de-differentiate, it's random. But it is very much known that when it starts to differentiate, the process now becomes instructive. Bakit po instructive, sir? Because later on when we discuss, there are particular substances, I think you remember one, like your erythropoietin. Your erythropoietin influences now your differentiated cell. Take for example, I'm just going to take the erythropoietin. Take for example, it is your erythropoietin that influences the differentiated cell. It will now influence the cell into becoming a red blood cell. So ganun siya. Sir, is that the same thing with WBC, with megacardiocytes? Yes. So later on, we will be talking about the colony forming unit, the colony stimulating factors, G-E-M-M, and we also have other colony stimulating factors as we go along, okay? Meran pang isa, okay? So alam na natin, stochastic, instructive, and we also have your multilineage priming model. So the cell's fate is determined by internal and external factor. This is now part of your hematopoietic inductive microenvironment. But to be more specific, this is actually now because of the amplification or repression of your genes, okay? Yung mga genes punat and we're going to DNA now, okay? So sir, can you help us to differentiate this three model? Okay, let's do this. We are talking about stochastic, we are talking about what? Random, okay? They are randomly committed to self-renewal or differentiation. Ito, this is the model when it comes to being asymmetric or symmetric. Are we clear? Stochastic, random. When we say instructive by the root word of instructive, meaning to say somebody instructed your cells now to differentiate further. And where does that instruction coming from? It comes from the bone marrow microenvironment. Are we still clear? Malinao pa po ba ako? Yes, sir. Okay, so parang take for example, yung mga kasalubong mo every single day sa jeep that is stochastic. You don't know whoever will you be coming into contact with, okay? But when it comes to instructive, take for example, I instructed that all three MTO3 will pass through this, okay? There is a certain instruction, okay? There's a certain influence or instruction given to you guys. So all of you will follow that. Ganon din si cell. So they can influence the cell by giving off cytokines and colony-stimulating factors, which I will be discussing later on. Kalma lang, okay? Wag magpapanik. So basta ang poin ko lang may instructions, okay? May signals, my chemical signals that influence your bone marrow to become who will they become in the future. A multilinage priming model, okay? What I want you to remember here are your genes, your G-E-N-E-S, your genes. Either a repressed or an amplified gene, okay? So ayun siya, okay? So here, on the other hand, okay? So let me just dig deeper with the multilinage priming model. Okay. Yung mga genes natin within our body, within the DNA, influences your microenvironment as well. So sila yung magsasabi palalo na, ito yung ilabas mo palalo, ito yung wag mo ng ilabas para mag-focus tayo sa pag-produce ng ganyong bagay. So that is how the dose model is happening. Are we clear so far? Clear pa po tayo. Hello. Okay. So I hope I want you to have a strong concept when it comes to the fate, the cell division and the model, okay? So hopefully you also did draw on your part, okay? Para mas maintindihan niya siya. Sometimes I don't need you guys to narrate to me, Rodak, verbatim. What I want is to hear your actual answers, okay? To hear your actual answers. So take for example, what is symmetric and what is asymmetric, yung mga ganong drama, okay? So that is self-renewal, differentiation and apoptosis, your asymmetric and symmetric, your stochastic instructive in the multilinage priming model, okay? So let's go now to your stem cell cycle kinetics, okay? Your stem cell cycle kinetics. So every single day, okay? Every single day, your bone marrow produced 2.5 billion of erythrocytes, 2.5 billion platelets, and 1 billion granulocyte per kilogram of body weight daily. So imagine that, okay? Imagine that. And to tell you honestly, one of the key factor that controls the rate of your fish, the rate of production is your fish-o-logic need. Makikitandaan po ako, mga kapated, it is your fish-o-logic need, okay? What do we mean by fish-o-logic need? Yung pangangailangan ng sarili mo, okay? I've been seeing ano do yung kailangan unahin red tap or purple tap. Kailangan mo do unahin yung sarili mo. So that is how your body is responding, okay? They respond according to the need of your body. Take for example, you are in an environment na deprived of oxygen. Your body now will tend to, take for example, there's hypoxia. Your body now will tend to produce more red blood cells so that there will be more hemoglobin in your body. Take for example, you have infection. There is parasite bacteria or virus that is inside your body. Your body's response to that fish-o-logic need is to produce more of your white blood cells. Are you getting me? Kuha po tayo. Okay. So when it comes to stem cell kinetics, it's very important for you guys to remember that the normal mitotic index is 1-2%. Okay? 1-2%. So imagine that, no? That your mitotic index is only 1-2%. Okay? I will not be, I will not be, I will not be discussing PMAT already here. So this is your G1, your S phase and your G2, your G0, which is the rest thing. And then eventually, your, yan, yung G1, S1, yung S and yung G2 phase natin, before it undergo your mitosis. Makikerebyo lang tayo. What are the, what are the, what are the different phases of mitosis? Chat box. What are the different phases of mitosis? The P is, what is the P? Okay, wala. Profase, metafase, ayan o di ba? Naging keyboard warrior na po si Miss Martin. Profase, metafase, anafase and telophase. Okay, PMAT. And please remember that our, that our, your interface is not part of the cell division proper. Okay. The interface kasi is actually part of yung, yung G2. Okay, sa G2 siya. Okay. So ayun yung sa interface. Interface is the preparation of your cell before undergoing mitosis. So again ha, guys, please remember that your mitotic index is only 1-2%. Sir, what if it becomes 5%? Meaning there is an abnormal, there is an increased cell proliferation. What do we mean by that? Matas, matas daw yung pag-dedevine ng cell mo. Okay. And an increase mitotic index now would imply that there is increased proliferation within your body. So understanding now, your stem cell, your stem cell cycle kinetics. Okay. Your stem cell cycle kinetics. Dito ngayon mag-fo-foil. Kung bakit nagtataka kayo? Bakit kaya alam nung mga doctors? For example, yung mga may leukemia went to give a particular part or went to give this type of chemotherapy or chemo-therapeutic drug to a patient. Okay. They know that based on their mitotic index. Okay. Based on the mitotic index. So kanina nyo pa ako siguro na rinig that there are specific cytokines. Okay. There are specific cytokines that are influencing the rate of mitosis. There are cytokines that influence the differentiation of a particular cell. So what are cytokines? Okay. So cytokines are soluble proteins that are hematopoetic growth factors. Okay. So when we say hematopoetic growth factors and cytokines, they are synonymous, mga kapatid. Okay. Cytokines and hematopoetic growth factors, they are one and the same. So what do they do? They regulate, okay. They regulate the proliferation, the differentiation and the maturation of your hematopoetic precursor cell. Once again, they regulate the proliferation, the differentiation and the maturation of your hematopoetic stem cell. Okay. Or your hematopoetic precursor cells. Okay. So there are a few here. Okay. When I say IL, these are your interleukins. Okay. These are your interleukins. So obviously we have your lymphokines, we have your monokines, we have your interferons, your chemokines and your colony stimulating factors. Okay. Your colony stimulating factors. So please do remember. Okay. Please do remember that when it comes to cytokines, when it comes to influence the cytokines that influences your differentiation, there can be two major differentiation that can either be a positive, a positive influence or a negative influence cytokine. So what do we mean by that? When we say positive influence on the hematopoetic stem cell, they promote the differentiation, they promote the maturation, they promote the proliferation. Okay. So I'll just gonna give you the, the, the ano ha. So on the chat box, okay. I posted there that hematopoetic growth factor or cytokines are the one that regulate the proliferation, differentiation and maturation. When we say positive, okay. When we say positive, it actually favors the proliferation, the differentiation and the maturation of your hematopoetic stem cell. When we say negative naman, okay. It's the opposite obviously. When we say negative, it hampers or it limits the proliferation, the differentiation and the maturation of your stem cell. Are we clear? Yes, sir. Okay. So ay ano siya ha. So moving forward now, okay. Moving forward now, in your book, there are actually several, there are actually several cytokines that will influence and will, that will influence your hematopoesis positively or negatively, okay. Positively or negatively. So that is actually found on page 54, okay. Page 54 to 56, okay. Page 54 to 56. Just for the sake of discussion, okay. Just for the sake of discussion, the cytokines and growth factors are very important, okay. They have a diverse group and I am not expecting you to memorize each of the growth factors that influence them, okay. But they're actually main, okay. We have main cytokines and colony-stimulating factors that you guys need to remember, okay. So take for example, okay, I'm just gonna paste it on the chat box, okay. So we have a positive, those that positively influence, your hematopoietic stem cell are as follows. Your kit ligand, your FL3 ligand, your GM, CFU, so that is your granulocyte, your granulocyte, mega-carliocyte, colony-stimulating factors, your interleukin 1, 3, 6, and 11. And you also have your negative negative cytokines, okay. That includes your growth factor beta, your tumor necrosis factor alpha in your interferons. Sir, that is, sir, where can we read that? You can read that on page 54 to 56, okay. Page 54 to 56. So when I, when we told you guys that you need to go to your book, it's still very important, okay. So explain lang, explain ko lang ng mabilis, ha. Your cytokines, okay. Your cytokines and growth factors sabingan natin kanina, they regulate your proliferation, differentiation, and maturation of your different precursor cell. So these cytokines are really diverse, okay. They are diverse when it comes to their classification, but most of them are actually positively influencing your, they positively influence your hematopoiesis. And the examples are on the chat box already. So you have your kit ligand, your FL3 ligand, your GM and CSF, your interleukin 1, 3, 6, and 11. So this cytokines, okay. So this cytokines naman, okay. On the other hand, yung mga nasa-negative, they prevent, okay. They prevent yung differentiation, yung proliferation, and maturation of your cells, okay. Maturation of your cells. So clear pa ba tayo? Are you still there? Yes, sir. Okay. So moving forward now, okay, moving forward, let's go on. So your human stem cell now, okay, your human stem cell, sabi natin kanina, di ba, in case that I do not finish this discussion, wag kay magalala, I will record na lang, I will record the the part that I did not finish. Roughly siguro mga ilang ilang slides lang naman ito, if ever, like, 1, 2, 3, 4, 5, 6. Like, ano lang? Less than 10 pa lang siya. Although para hindi tayo mag-extend, okay, so we won't be extending. I will just be sending you guys a recorded slide, okay, a recorded slide of this discussion. And by the way, it's already been set the final coverage of your hematology is from the beginning until erythropoiesis. Okay, erythropoiesis. So, ayun, let's move on. So your human stem cell has three types, sabi ko nga di ba, meron tayong toti potential stem cell which is present in the first few hours after an ovum is fertilized. So this is the most versatile. This is the most versatile type of stem cell because it can develop into any human cell type. We have your pluripotential stem cell on the other hand. This is now present several days after fertilization. And this can develop into any cell type as well. We also have here your multi-potential stem cell. This is derived now from your pluripotent stem cell. It came from your pluripotent stem cell. And this is found in adults but are limited in specific types of cell to form your tissue. Example natin yan is your bone marrow. Your bone marrow stem cell can give rise to blood cells, bone cartilage and your adipose cell. Adipose cell. So these are the three types of human stem cell. But what we're going to talk about here, okay, alone is your what? What we're going to talk about here is your hematopoietic stem cell. Your hematopoietic stem cell is a multi-potent stem cell. Are we clear? A multi-potent stem cell. So type 3 sa, okay, pang so your hematopoietic stem cell are multi-potent stem cell that give rise now to all blood types. Cell types including your myeloid and your lymphoid. Okay, wait lang, explain ko lang ko nang mabilis. Your hematopoietic stem cell can differentiate into two. Ito na po yung sinasabi natin kanina na differentiation. It can differentiate into two. It can differentiate into becoming myeloid precursor or a lymphoid precursor. Sir, dalawa lang? Yes, dalawa lang. Your myeloid precursor can give rise to your gem or your granulocyte, eritrocyte, your monocyte and your megacaryocyte. Okay, sumakikisulat ako ha? Okay, your myeloid okay, your myeloid can give rise to your gem. Your gem stands for your granulocyte. Okay, what are the different granulocyte that is your neutrophil, eucinophil and your basophil? We also have your eritrocyte. Okay, it can also give rise to your eritrocyte to your monocyte and your megacaryocyte. Megacaryocyte. Maybe some of you are wondering sir, bakit po hi nahiwalay si monocyte? Because remember your monocyte is agranulositic cell. Okay, wala siyang granules. Are we clear? Can you still remember that ay ang granulositic and agranulosite and granulosites? So, on the other hand we have your lymphoid naman. Okay? Your lymphoid precursor. Your lymphoid precursor now will give rise to your lymphocytes obviously your natural killer cells or your NK cells and also your natural killer cells and lymphocytes and natural killer cells. Are we clear? Clear pa po tayo? Yes, po sir. Okay, so ganun yung konto niya. So later on siguro before I end mamaya, I'll try to wrap it up okay? So pakikitandaan lang that your hematopoietic stem cell can differentiate into two okay? Into two main your myeloid and your lymphoid. Okay? Your myeloid and your lymphoid. Okay? So moving forward now okay? Moving forward these cells can be obtained directly by removal from the hip okay? So sabi natin kanina, di ba? Yung mga stem cell sabi natin can either be aspirated for testing. Tanina in your quiz, there was a choice there. Meron kang proximal long bone tapos meron kang iliac crest. Your iliac crest is part of your pelvis okay? Or your pelvic bone. Between the two, you need to choose which is the best which is the best site for bone marrow collection. And the answer there will be your iliac crest bone okay? So this now are being aspirated by a needle. Yes sir being aspirated po siya using your needle so gina grind gina grind yung bone mo para makapasok sa bone marrow. So at the same time okay? So using needle and syringe or from the blood following pretreatment with cytokines okay? Pretreatment with cytokines. This cytokines okay? This cytokines like your granulocyte colony stimulating factor okay? They induce the release of your they induce the release of your granulocyte from the bone marrow okay? From the bone marrow. So other sources panang ano, so other sources panang stem cell natin can also be your umbilical cord ayan your umbilical cord. Kaya di ba remember whenever meron tayong ano um whenever may pinapanganak they are collecting stem cell through the umbilical cord okay? Through the umbilical cord and aside from that for experimental purposes naman you can actually have um you can actually gather the hematopoietic stem cell from fetal liver, fetal spleen ayortagonad mesonephros the AGM, what face of hematopoiesis is this? Anyone? Sige nga, I hope may makasagot. Okay? Anong face ng hematopoiesis pag nasa ayortagonad mesonephros? What face of hematopoiesis? Misumasagot ba sa ano? Okay, correct. Misumasagot na pala dito. It is your mesoblastic face, correct? Sa mesoblastic face po siya. Okay? So this is for animals for experimental purposes only. Okay? So, you can see medyo malabu lang pero these are the hematopoietic stem cell. Sir pa, how can I differentiate it? Actually you cannot differentiate it. Visually you cannot differentiate your visually we cannot differentiate them from the other. Okay? So, you can differentiate which one is the myeloid and which one is the lymphoid. Okay? So, let's go now to the difference ang stem cell. Okay? So functional characteristic of your stem cell, they are multi-potency and they can do self-renewal. Okay? It has their own ability to form multiple cell types. Okay? Multi-potency and their ability to renew is attributed because it's attributed to this characteristic of your stem cell. So, your hematopoietic stem cell can also expand to generate very large amount of progeny cell. Okay? So when we say progeny cell progeny cell in the hematopoietic stem cell. So these are now your what do you call this? Your colony, yung myeloid progeny colony of myeloid progeny and then your CLP which is now for your lymphoid on the other hand. Okay? Which is for the lymphoid. So let's just finish this one. I think, I'm not sure kung matatapos ko yung eritropoiesis mamaya but I'll just try to explain something pa kasi later. Okay? So hematopoietic stem cell. Okay? So their mobility naman, let's talk about their mobility. So hematopoietic stem cell than other immature blood cell. So immature blood cells to pass the bone marrow barrier. So your hematopoietic stem cell may travel in the blood from the bone marrow. Okay? Pwede yon. So aside from that, your hematopoietic stem cell can travel from one bone to another bone. So if they settle on the thymus, okay, take example, if your hematopoietic stem cell settled on the thymus, they will now develop into your T lymph, your T-cells. Okay? And this is the answer in your quiz. It's just your thymus. Some of you answered thymus, nilagay nyo na lahat para sure, but that is incorrect. Okay? It's only your thymus. Okay? Your thymus your your thymus give rise to your T-cell. Okay? So let me just share to you. Let me just share to you my screen once more. Let me just share to you my screen once more para makita ninyo yung ano. Okay? Can you guys see my screen right now? Hello? Yes, sir. Yes, sir. Okay? I'm using your actually using your raw duck here Okay? So this is actually seen in page 55. Okay? Page 55. So take for example, this is your this is your stem cell. Okay? This is your hematopoietic stem cell. I'll draw na lang another one. Okay? This is take for example your hematopoietic stem cell. Okay? This is your hematopoietic stem cell. Okay? This is your hematopoietic stem cell. Sabi natin kanina, it can give rise to two doctor cell. One that will undergo what undergo self-renewal or the other one. Okay? The other one can differentiate into becoming your pluripotent hematopoietic stem cell. And as you can see here, guys. Okay? As you can see here, there are particular cytokines that influence it. Okay? That influence it. So take for example, this is the HSC sabi natin kanina. Okay? Yung process ng pagpunta niya if whether it is going to renew or differentiate it is stochastic. Okay? Are we clear? It is stochastic. But the process now because of this, okay? I hope nakikita niyo ha yung mga kitlaigan natin. This one, can you see the thing that I am highlighting right now? Those FL3 kitlaigan, those are your cytokines that influences the differentiation that is now called your instructive. Clear tayo? We call that instructive hematopoiesis. Are we clear? Instructive na po. Okay? Ito stochastic. Ibig sabihin random lang siyang nangyayari. Ito naman instructive na po. Okay? Sabi natin kanina. Okay? Sabi natin kanina. Okay? There are two. Yung CLP at yung CL, yung progeny natin. Okay? Yung progeny natin can become your common lymphoid progenitor or your common myeloid your common myeloid progenitor and your common lymphoid progenitor. Ibangin natin yung color. Sabi ni sir kanina yung common myeloid precursor natin. Yung common myeloid precursor natin will give rise to your gem. And what is that? What are those gem that we are talking about those are actually your what? Your granulocytes Okay? Tanggalin ko yung isa. Just for the sake of accuracy your granulocytes which is your aosinofil basofil and your neutrophil Okay? We also have here your letter E. Sabi doon. Ano yung E that is your eritrocyte. The other M here is your monocyte your monocyte or even your masell to interchangeably monocyte or your masell and the other M is your megacharyocyte that will give rise to your platelets. Nakikita po ninyo So from your common myeloid precursor it can give rise now to three or to four rather. It can become your granulocyte your granulocyte your aobeso which it will be discussed in the new copoises eventually and we also have here your megacharyocyte eritrocyte precursor. Okay? So nag-a-gets nyo po ako. Yung common myeloid po natin but it can become your granulocytes your eritrocytes your megacharyocytes and your monocyte and your masell. On the other hand what about your common lymphoid precursor? Very simple. It can only become two types of cells if I am going to be more specific. Those two types of cells is actually just your lymphocytes and your natural killer cell. But if we're going to be more specific okay? Your common lymphoid precursor can become your dendritic cell your pre-beta your pre-b cell and your pre-T cell natural killer cells. Natural killer cells your your common lymphoid precursor if it mature okay? Your common lymphoid precursor if it went to your if it went to your thymus okay? it will be following this path but if it is in the bone marrow it will be following this path. Are we clear? What do you want to see? That is what I want you guys to see. That your common myeloid precursor your common lymphoid precursor will give rise to your gem and this one will give rise to your lympho and your NK cells. When I say lympho we have here your B and your T cells. Are we clear? Clear po tayo. Yes po sir. What about the others? Clear po tayo? Guys, ganito ha? Yes sir. If things are not clear with you hindi naman ako ano, hindi naman ako nakangain ng buhay okay? Lalo na ako hindi ko naman kayo abot kamay di ba? So kung may hindi clear magsabi na agad para hindi na lumalaki ang maliit na problema okay? Are we clear? Hindi ako na puputol magsabi Naga, are we clear? Masiglat? Yes sir. Yes sir. Aben niya ita, are we clear? Hello? Okay, clear. So actually yun yung hematopoetic stem cell okay? So kung ako sa inyo ganito ko siya irereview kung ako sa inyo. I will just draw I will just draw So meron ako stem cell tapos naging dalawa siya I am just trying to wrap it up para ma reinforce natin okay? So ulitin natin guys okay? I will just be sending you the erythropoiesis para mas ano Actually ano lang naman na yun mabilis na lang naman yung sa erythropoiesis okay? So take for example na dito na tayo sa ano na dito na tayo sa part na to So I have two okay? Aben natin kanina okay? So let me just try to be artistic as possible okay? If this two cell okay? They differentiate differentiate okay? If this two cell differentiate we call it symmetric sorry kaya talaga sulat ko but okay kaya talaga sulat sorry no o silang ako kayaan, pag nag-differentiate siya but if one differentiate okay? Nag-differentiate the other one went back to the pool okay? Renewal we call that your what? kasi metric kakalaruhin ko guys I want you to remember this is the reason why hindi na uubos yung inyong stem cell hala kung yung mga accounts natin kanina 1 billion, 2.5 billion of eritrosite and platelet hindi ba na uubos sir yun siguro yung tanong nyo hindi because it can go self-renewal okay? in this particular process in this particular process sabihin na natin in this particular process na tinatawag natin kanina in this particular part here okay? itong particular part na to ng ating mga cell I undergoing stochastic so na nang ibig sabihin ng stochastic ibig sabihin random po yan it can randomly go symmetric or randomly go asymmetric, are we clear? okay? so take for example ngayon nag differentiate na siya it differentiated now into becoming your common myeloid precursor and your common lymphoid precursor I will just be explaining the simple part ha? guys please please review the cytokines the colony stimulating factors sabihin sir kanina meron daw cytokines may cytokines that influences the proliferation the differentiation and the maturation of cell either positively or negatively on this particular part now of the process in this particular part of the process ano na itong nangyari dito this particular part here okay later on hanggang matapos to we call that now what? we call that your ano to? kung yung kanina stochastic anong tawag ko dapat dito? instructive sir correct this is your instructive hematopoises whereby there will be some colony stimulating factors your yeah, colony stimulating factors cytokines that will influence now your colony your common myelite precursor and your common lymphoid precursor to further differentiate so this one can become your granulocyte okay it can become your granulocyte your erythrocytes your mack or your muscle and your megakaryocyte on the other hand this one will give rise to your B cell if it mature on your bone marrow your T cell if it is in your thymus and your NK cells okay your NK cells so yung diniskasko po mula kanina actually majority of those are already here in this diagram so napag nagreview maging madali na po for you okay I still have 15 minutes do you have any questions with regards to everything that I discuss today please raise them now ok yung magtanong that silence ba means you understood everything hello sir, question po yung D1 in dito po is it ka pares po lang nung HSC po parang ano to jm it nagmustu so when you take daughter cell parang has lang ni mother question sir niba po may certain cytokines po to be influenced ang differentiation ilangan po ba lahat nung cytokines na yung present for it to be a common myeloid progenitor yung kanyang na po pinakita niyo may IL-1, IL-6 ito po na yung mga nakahailight okay buburain ko lang ha ito okay ito ba hindi na sabi ko so habi natin kanina na after differentiation doon na actually nagstart yung instructive hematopoasis when we say instructive there are cytokines coming from the bone marrow microenvironment that will influence when will they become one or the other sir, kailangan ba ito lahat na doon kumapapansin niyo this one is the kit ligand the interleukin-136 are very para siyang common okay common siya so it instructs now the differentiation so kumakikita mo dito dito it is your FL-3 ligand and your kit ligand and your interleukin-7 will influence your pluripotent stem cell into becoming your common lymphoid progenitor dito naman itong mga to palitan natin ng kulay para hindi kayo malito this one naman the FL-3 ligand kit ligand your GM colonistimulating factor your interleukin-136-11 they will give rise to your myeloid progenitor maybe some of you are wondering sir, anong ibig sa binang FL-3 ng KIT sa kit ligand these are actually gene na doon na siya sa gene which will now lead me sa multi-lineage na priming model okay doon naman siya galing sa gene gets po sir thank you kuna re ang na release po mga kapatid ang na release within your bone marrow are this factor kung mapapansin nyo medyo redundant but it will now different yung mga minor na differences nila doon yung nagpapaiba okay so makikita nyo dito yung granulocyte monocyte progenitor your aocinophil, basophil progenitor this is your kit ligand that's your intraducent 3 that's your intraducent 3 and 5 iba yung ipu-produce eto yung gusto kung makikita rin yung isapa okay are you guys seeing this the mega-carouside eritracide progenitor yes po sir ayan so from a common progenitor by the influence of your your FL-3 yung FL-T FL-T-3 ligand natin yung CM colonistimulating factor it will now become your mega-carouside eritracide progenitor a big question sa inyo siguro sir paano pumalalaman ni sel kung kailangan niya maging eritracide paano niya pumalalaman kung kailangan niya maging trombosides or platelets doon ngayon papasok na tatandaan ninyo yung tinatawag natin mga hormones si eritropoetin at siya kasi trombopoetin okay si trombopoetin later on ko pa dapat i-discuss pero trombopoetin tandaan yun na lang baka lumabas pa sa exam trombopoetin okay this is your eritropoetin okay so balik ako so kapag meron po tayong eritropoetin sa sabihin niya okay mega-carouside eritracide progenitor ayam EPO ay need more red blood cells so doon siya ngayon magiging pronormo blast ito kulang toha pero short cut to magiging eritracide na siya ngayon nagigets pag naman si TPO ang nag-interact kay mega-carouside eritracide progenitor natin it will influence the cell into becoming your mega-carouside your mega-carouside and eventually your platelets are we clear? So nakikita niyo ngayon yun yung point ko sa instructive na may mga cytokines that influences a particular cell into becoming that specific cell na kailangan are we clear? yes po sir go yung trombopoetin po ba? hormone din po siya? hormone created by the liver okay po pasulat na lang ha yung trombopoetin natin a hormone secreted by the liver si eritropoetin a hormone secreted by what by what organ? chat box okay correct it is by your kidneys okay tatandaan yun ha bakit ko paulit-ulit tinatan ko kasi if you're going through I don't know if you realize but one important thing okay parang lahat connected naman si spleen, si liver pero bakit may naliligao ko y kidney so I don't know kung magagrass nyo makukuhan nyo pa yung idea pero doon kasi sa kidneys ninyo yun yung pinakasensitif na nakakadetek kung may hypoxha what is hypoxha? kulang sa oxygen okay si kidney na didetek na ay kulang sa oxygen lalabas ngayon si eritropoetin okay napupunta sa bone marrow danon siya inhima actually makakatulong sa inyo yung pag-dodrawing ninyo kung paano nangyari yung bagay-bagay okay kasi doon nyo parang doon nyo mas masos solidify yung topics na alam ninyo okay so clear na ba tayo ha sa common lymphoid precursor okay so dahil sinabi ko na rin kanina di ba mamaya kasi didesk mamaya asesent hopefully okay medyo jump back ng friday ko ngayon pero i'll try na matapos mamayang madaling araw yung part na yung part na yung part na tao dito yung part nang eritropoetin para mabigay ko sa inyo over ng friday okay so ano ba ba? sir question go with all the diagrams po ano po yung kailangan namin i-memorize or i-review po with all the diagrams that are here for me nga sa eritropoetin kasi mamaya meron kasi yung meron kasi yung patlong eto kasing nakita nyo dito short cut to merong pro normal blast tapos merong normal blast merong iba iba pa siyang stage which is actually here sa chapter eto eto yung susunod na i-discuss ko eto siguro eto yung isa nakailangan yung i-memorize yung pro normal blast yan eto eto yung isang kailangan yung i-memorize actually din naman diagram actually kahit ito lang i-memorize nyo yung mga names yan na siya siguro yung point ko lang jm na sinasabi kong diagram mas mas i-intindihan ninyo yung parang ito mas mas i-intindihan ninyo yung point ko ng stochastic ng asymmetric kapag may diagram na anan ninyo siya parang pagbinasang mo lang ok ito yung stochastic random ok parang sometimes kasi we need to visualize ako kasi visual ako I don't know yung iba sa inyo naman na siya pero yan nga ito yung sinasabi ko sa inyo kanina na itong part na yan so may tanong pa sir yun pa paulit yung posan ko nag-offer yung multilingage priming model yung dun ko sa ay napo yung diagrams ito yung multilingage kasi yung multilingage natin is governed by your genes ok sabi natin kanina yung mga genes yung mga genes na yan they will either repress or amplify amplify mapapansin kanina di ba sabi ko si FL-3 at si Kit Ligan or actually yung production nila are influenced by your genes so Kit yung instructive at yung multilingage model natin they overlap nagigets ko ako so parang gali ito siya di ba sabi ko kanina yung instructive natin is because of the bone marrow micro environment ok nakakuha so siyang instructive but if we are going to dig deeper dito sa dito sa topic nato there are internal and external factors that will now influence micro environment so parang si multilingage mo dito ok eto si internal and external factors ok internal factors i mean the gene external factor what i mean by there is your physiologic factors na so parang si multilingage they also influence your bone marrow micro environment hello thank you sir clear ba thank you so parang yung instructive mo at yung multilingage they overlap thank you sir so any question may tanong pa po gula kanong na guys hello po i think sir wala naman po at since wala naman na po at so if you don't have any questions now ayan siguro may night i'll send the power point with voice over na lang ok and i'll stop the recording na just like what i told you guys yesterday give me feedback