A simple way to learn about the human body’s immune system

I finished reading an interesting and informative book called An Elegant Defense by Matt Richtel, a Pulitzer prize winning journalist.  The author explains the science of the human immune system in an easy to understand way and uses analogies to facilitate that.  If one wants to know how to communicate science to a general audience the writing in this book is an exemplary model to emulate.  Check out an excerpt from the book:

“So what does this inflammatory response look like up close, on the molecular level? It resembles the aftermath of a disaster—an armed attack, a multicar crash, a hurricane. I distinguish such events from, say, a fender bender, where one cop might show up and send everyone home. When an insult, like the splinter, happens, it might seem like a fender bender from the outside, but our elegant defenses need a lot of information to make that call and to repair the area of the insult, however small it may be, and this brings multiple cells into the fray. Let’s meet them.”

The book covers how the immune system is involved in fighting cancer, in autoimmune diseases, and fighting infections.  In the process of discussing the science the author also conveys the history of immunology, the evolution of immunology therapeutics and how those therapeutics work.  What makes the book even more powerful is the incorporation of the perspective of how doctors treated patients with these diseases and the perspective of patients on how the disease affects their lives, including how they manage to endure variety of treatments.  Several doctors are key figures in this book, including Dr. Anthony Fauci.  Yes, the same Dr. Fauci who is now one of the leading figures of the coronavirus task force team and on TV a lot.

The science part of this story starts from the late 19th century, in the time of Dr. Elie Metchnikoff in Sicily and Dr. Paul Ehrlich in Germany, who is known as the godfather of immunology, through Dr. Jacques Miller’s work in England that led to the discovery of T cells and B cells through Dr. Charles Dinarello in the mid 1970’s with the discovery of interleukin-1 and includes the vital contributions of several other researchers.   It is not just a chronological telling of how science advances through history. It is also the science itself and some of the key experiments explained in simple terms so that a general audience can understand it.  

For example, the reader will learn the details of how a fever is a result of the patient’s immune system attacking a foreign presence in the body, such as parasites, viruses and bacteria.  Furthermore, there are interleukins that target different things: IL-1 induces fever; IL-2 causes T cells to grow; and IL-6 causes B cells to grow.  And how PDL-1, a programmed death ligand, found on cancers applies brakes to the immune system by preventing its response via binding to T-cells and destroying them.  Thus, the birth of drugs called checkpoint inhibitors, such as Keytruda and Opdivo that release the brakes on the immune system.  On the other hand, the readers will learn how a cytokine storm is an over-reaction by the patient’s immune system, which puts the immune system in hyperdrive mode and leads to great inflammation (what could happen in the case of severe flus such as the 1918 Spanish Flu, and including probably severe cases of the coronavirus). Beyond what one would typically consider the purview of the immune system, the author also discusses the role of the gut microbiome with respect to balancing the immune system and also how the immune system can play a role in Alzheimer’s disease. 

By the time readers finish reading the book they will have a good understanding on why the author calls it an elegant defense.  As the author would say you are on your way to a Bachelor’s Degree in Immunology.  This is a fascinating book and I would highly recommend it.  Furthermore, it is a timely read given the coronavirus pandemic occurring now, and provides parents a simple way to attempt explaining to their children how the body’s immune system reacts to Covid-19.