The story of immunotherapy is one of the most interesting and provocative in medical history. William B. Coley, MD, first harnessed the immune system against cancer in the late 19th century by injecting mixtures of live and inactivated bacteria into patients’ tumors. For various reasons, immunotherapy fell out of favor with the scientific oncology community, save for the true believers who stayed the course.
Since then, painstaking study has revealed the world of immunity not as a circuit involving a few types of immune cells, but as a dynamic interlocking system. A new book called The Beautiful Cure: The Revolution in Immunology and What It Means for Your Health explores the discoveries that are sparking a revolution in medicine in the 21st century.
Title: The Beautiful Cure: The Revolution in Immunology and What It Means for Your Health
Author: Daniel M. Davis, PhD
Publisher: University of Chicago Press
Publication date: September 2018
Price: $25.00, hardcover; 256 pages
A World-Class Scientist
IMMUNOLOGY IS vastly complicated, but the author, Daniel M. Davis, PhD, does a wonderful job breaking the science down into readable bites, lacing the narrative with thought-provoking stories. A scientist himself, with a heady pedigree in this field, Dr. Davis is Visiting Professor at the Imperial College London as well as Director of Research at the Manchester Collaborative Centre for Inflammation Research. He also pioneered novel imaging techniques to help visualize key molecular components of the immune response. His work helped establish new concepts about how immune cells communicate with each other and how they recognize disease.
The Beautiful Cure is divided into two succinct sections, The Scientific Revolution in Immunity and The Galaxy Within. It is also a mercifully short book, unlike other works in this genre, which tend to be flabby and jargon-laden. As readers will discover, short is better. Dr. Davis not only knows his subject matter, he’s an accomplished writer who embraces the golden rule of science writing: omit all unnecessary words.
Stories Behind the White Coat
PART ONE takes the reader on a tour of immunology’s history up to the present, and readers of The ASCO Post will be familiar with much of it. However, there are jewels within this section that highlight the behind-the-scenes drama of scientific discovery, oftentimes serendipitous. In 1989, immunologist Charles Janeway, MD, was puzzling over what he called the “dirty little secret,” which is that vaccines only work well when the so-called adjuvants are added, but no one could really explain why this happened. Later that year, Dr. Janeway was driving in a car with his wife, fellow immunologist Kim Bottomly, PhD, arguing about how an immune response actually starts.
During the heated discussion, Dr. Janeway had a revelatory idea, which he later fleshed out in a now famous paper, “Approaching the Asymptote? Evolution and Revolution in Immunology.” Nobody at the time paid much attention to it. In fact, it was all but forgotten for the next 7 years, until it inspired a student some 4,500 miles away at Moscow University, and it changed his life. That student, Ruslan Medzhitov, went on to work in Dr. Janeway’s lab and became an innovative investigator himself, helping to spark the revolution in immunology. It is an enthralling story, one that in different guises has permeated the annals of science since Aristotle.
Colorful Road to Discovery
PART TWO delves heavily into the science of immunology, using pioneers in the field to lead off each chapter. At certain points, where the author struggles to simplify some intricate biology, it becomes unclear who the audience is. The history, told in sharp anecdotes, will help lay readers, but not so much the seasoned science reader. A long discussion of tumor necrosis factor and hyperthermia will test the lay reader, who will need Google on hand.
“[W]e must not expect everything the immune system does to fit any one overarching principle."— Daniel M. Davis, PhD
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Dr. Davis’ peregrinations include a story about a female prisoner who exchanged the death penalty for life behind bars by agreeing to have smallpox pus extracts applied up her nose. Stories abound of bitter internecine battles between potential Nobel Laureates, in sharp contrast with those who pushed egos aside and put science and patients first, like recent Noble Prize winner James Allison, PhD. The author also tackles much of the popular discourse about diet and lifestyle, including unproven ways of boosting the immune system to defeat cancer.
PERHAPS THE book’s best chapter concerns what we do and don’t know about how outside stressors affect our immune system’s ability to fight cancer. Here, Dr. Davis notes that our body’s own remedy to sickness, our immune system, is far more powerful than any medicine we have devised.
Near the end of the book, the author offers the following gem, leaving readers satisfied but wanting more: “[W]e must not expect everything the immune system does to fit any one overarching principle. The system discriminates between self and non-self, and it detects germs, and it responds to danger, and it does all these things concurrently—and messily.” This book is highly recommended for The ASCO Post readers. ■