Immunology

 I recently read An Elegant Defense by Matt Richtel. Richtel is a journalist who suffered some version of auto-immune syndrome and went on a quest to learn more about it. I have a few interesting takeaways.

First is that we have come so far in understanding the immune system in the past 70 years. Immunology was basically not understood at all 70 years ago and scientists barely knew what the thymus or bone marrow did for the body. Now, we know about T cells and B cells, and macrophages, interleukins, cytokins, etc. And I'm hopeful about the next 70 years - I would not be surprised if humans cured the majority of forms of cancer within my lifetime. 

Second is the role of stress and sleep on the immune system. Stress is really terrible. It causes the body to go into a fight or flight response which keeps us awake and alert, enlarges our blood vessels, and pulls resources away from digestion, and our immune systems. It also prevents us from going to sleep, which has huge restorative benefits. A study that drew blood from West Point students during finals and during another time showed much lower immune system markers during times of stress - and was particularly lower for students who had signs of loneliness. 

Third was the complexity involved in study something in the body. One example of a study required a scientist to remove the immune system from mice (which is a multi-week process), inject it with cells from a human, and watch the interaction with cancerous cells. It was also fascinating to learn about Dr. Fauci's work over the years and learn why he is the expert on immunology. It takes the work of many scientists, tinkering with one small thing after another. For example, one immunologist developed an interesting technique to measure the number of a type of immune cells (it is akin to figuring out how to measure cholesterol or blood pressure). It opened a whole new set of doors and facilitated other breakthroughs. The book also mentioned the AIDS (which is an immunodeficiency syndrome) epidemic and how immunology has helped us understand and create treatments for AIDS. Given the rate of progress, I'd hope humans can find a cure of AIDS within my lifetime as well. 

The last thing I'll mention is that antibiotics (and chemotherapy for that matter) is like a napalm that destroys multiple types of bacteria (or cells) in the body. In the future, immunologists hope to create much more targeted forms of antibodies (somewhat like vaccines, but more like targeted antibodies) that can cure infection and viruses in a better way. Antibiotics also have an element of making bacteria more powerful since they can evolve in order to be resistant to antibiotics, but I think for the most part that we're developing a better understanding faster than bacteria can evolve (but who knows). Thus, antibiotics should not be taken frequently, since there is lots of good bacteria in your body that needs to be replaced. There are also studies around allergies and other conditions like Celiac disease, which immunologists believe is developed by not having enough interaction with bacteria during childhood. Inflammation and allergies are an overreaction by the immune system - it detects a threat and expends resources to fight a foreign substance that isn't actually toxic. Thus, there is this new wave of understanding about the microbiome and how important your gut is (since most of your body's foreign bacteria lives in your gut - because you injest lots of bacteria). Chemotherapy is similar to antibiotics since it attacks all rapid-multiplying cells, which include hair but more importantly other essential cells in the body. It almost seems like a very primitive treatment since it puts your body in a semi-alive state and hopes that it kills the cancer and doesn't kill the patient.  

To summarize, the only real action steps are to sleep more, reduce stress, try not to take antibiotics so often, and root for the immunologists that are making pretty big breakthroughs in health!