A lucid, up-to-date account of the body's immune system from a pro
who has taught the subject at UCLA for 25 years. Infectious disease
is news Big Time these days - it has been ever since AIDS appeared.
What is fascinating is the game of catch-up that science has been
playing - unraveling the intricacies of the body's immune system
and, more recently, its intimate relation to the nervous system.
Clark reminds us that just a generation ago the body's defenses
were thought to consist only of antibodies: the molecules that
destroy foreign invaders. Not only does Clark explain how the body
can be stimulated, say, by vaccines, to make millions of
antibodies, but he goes into detail about T cells - the other ann
of the immune system. T cells (the T is for the thymus, where they
are made) come in several varieties, of which the most noted today
are the "killer" T cells that search and destroy aberrant cells and
the CD4 "helper" T cells that are killed by the AIDS virus.
Sometimes the immune system is overzealous, however, mounting an
attack that adds insult and injury: There is a misreading of
molecular markers, resulting in attacks on healthy cells, as
happens in autoimmune diseases such as multiple sclerosis (the war
within), and sometimes there is a need to suppress the system - in
the case of organ transplants. Clark's upbeat outlook suggests that
we can curb excesses as well as stimulate a weakened immune system
with new drugs or gene therapy approaches. He is convinced that
ongoing discoveries of the brain-immune system dialogue will lead
to new approaches to therapy. He is also aware of the pressing need
for organ transplants, raising provocative ethical issues but at
the same time providing a valid Uniform Anatomical Gift Act donor
card for readers to fill out. A good idea that, given his overall
enthusiasm and mastery in explaining complex science, might
persuade more than a few readers. (Kirkus Reviews)
In the seventeenth century, smallpox reigned as the world's worst
killer. Luck, more than anything else, decided who would live and
who would die. That is, until Lady Mary Wortley Montagu, an English
aristocrat, moved to Constantinople and noticed the Turkish
practice of "ingrafting" or inoculation, which, she wrote, made
"the small- pox...entirely harmless." Convinced by what she
witnessed, she allowed her six-year-old son to be ingrafted, and
the treatment was a complete success--the young Montagu enjoyed
lifelong immunity from smallpox. Lady Montagu's discovery would,
however, remain a quiet one; it would be almost 150 years before
inoculation (in the more modern form of vaccination) would become
widely accepted while the medical community struggled to understand
the way our bodies defend themselves against disease.
William Clark's At War Within takes us on a fascinating tour
through the immune system, examining the history of its discovery,
the ways in which it protects us, and how it may bring its full
force to bear at the wrong time or in the wrong place. Scientists
have only gradually come to realize that this elegant defense
system not only has the potential to help, as in the case of
smallpox, but also the potential to do profound harm in health
problems ranging from allergies to AIDS, and from organ transplants
to cancer. Dr. Clark discusses the myriad of medical problems
involving the immune system, and he systematically explains each
one. For example, in both tuberculosis and AIDS, the underlying
pathogens take up residence within the immune system itself,
something Clark compares to having a prowler take up residence in
your house, crawling around through the walls and ceilings while
waiting to do you in. He discusses organ transplants, showing how
the immune system can work far too well, and touching on the heated
ethical debate over the use of both primate and human organs. He
explores the mind's powerful ability to influence the performance
of the immune system; and the speculation that women, because they
have developed more powerful immune systems in connection with
childbearing, are more prone than men to contract certain diseases
such as lupus. In a fascinating chapter on AIDS, arguably the most
deadly epidemic seen on Earth since the smallpox, Clark explains
how the disease originated and the ways in which it operates. And,
in each section, we learn about the most recent medical
breakthroughs.
At first glance, it may appear that our immune system faces
daunting odds; it must learn to successfully fend off, not
thousands, but millions of different types of microbes.
Fortunately, according to Clark, it would be almost impossible to
imagine a more elegant strategy for our protection than the one
chosen by our immune system, and his At War Within provides a
thorough and engaging explanation of this most complex and
delicately balanced mechanism.
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