Dying to Live: How our Bodies Fight Disease

208 Pages·1998·4.74 MB·English

by  Marion D. Kendall

How do our bodies fight disease? Written in a clear accessible style, this book gives an up-to-
date account of the inner workings of our immune system. Aimed at the general reader, it
looks at fascinating areas of science including fever, AIDS and cancer.
Central to the book, from which the title derives, is the idea that in the war against disease
our bodies sacrifice millions of cells - some are lost in choosing which cells fight diseases
most effectively, others die in these efforts, and yet others die in the recovery and repair
processes. The result is a finely tuned and well directed attack against invaders of the body
which is aimed at the restoration of good health. Only by pitting all manner of complex
immune cells against such infectious agents can we continue to survive in the world.
This book is of interest to anyone who has wondered what is really happening when we
become ill and recover.
Marion D. Kendall, Emeritus Professor of London University, is now at the Babraham
Institute in Cambridge where her work focuses on the thymus.
Also of interest in popular science
The Thread of Life: the story of genes and genetic
engineering
SUSAN ALDRIDGE
Evolving the Mind: on the nature of matter and the
origin of consciousness
A. G. CAIRNS-SMITH
Extraterrestrial Intelligence
JEAN HEIDMANN
Hard to Swallow: a brief history of food
RICHARD LACEY
The Clock of Ages: why we age — how we age —
winding back the clock
JOHN J.MEDINA
Improving Nature? The science and ethics of
engineering
MICHAEL J. REISS AND ROGER STRAUGHAN
Beyond Science: the wider human context
JOHN POLKINGHORNE
Figments of Reality: the evolution of the curious mind
IAN STEWART AND JACK COHEN
Perils of a Restless Planet
ERNEST ZEBROWSKI
Does the Weather Really Matter?
WILLIAM BURROUGHS
MARION KENDALL
Dying to live
how our bodies
fight disease
CAMBRIDGE
UNIVERSITY PRESS
CAMBRIDGE UNIVERSITY PRESS
Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, Sao Paulo
Cambridge University Press
The Edinburgh Building, Cambridge CB2 8RU, UK
Published in the United States of America by Cambridge University Press, New York
www.cambridge.org
Information on this title: www.cambridge.org/9780521584791
© Marion Kendall 1998
This publication is in copyright. Subject to statutory exception
and to the provisions of relevant collective licensing agreements,
no reproduction of any part may take place without the written
permission of Cambridge University Press.
First published 1998
This digitally printed version 2007
A catalogue record for this publication is available from the British Library
Library of Congress Cataloguing in Publication data
Kendall, Marion D.
Dying to live : how our bodies fight disease / Marion Kendall.
p. cm.
Includes bibliographical references and index.
ISBN 0 521 58479 5 hb
1. Immune system — Popular works. I. Title.
QR181.7.K46 1998
616.07'9-dc21 98-3646 CIP
ISBN 978-0-521-58479-1 hardback
ISBN 978-0-521-03655-9 paperback
Contents
Introduction page ix
Acknowledgements xi
PART I - RECOGNITION 1
1 Molecules of Distinction 1
Similarity and Disimilarity 2
Distinctive Markers 5
Distinguishing People 9
Identifying the Enemy 12
2 Distinctive Families 17
The Family Tre 17
Family Estates 20
The T Cel Family 23
The B Cel Family 27
Other Families of Imune Cels 29
The Family Retinue 31
Population Explosions 32
3 Paterns of Life 35
Life Begins 36
The New World 38
First Chalenges 40
Adjusting to Life 42
The Later Stages of Life 49
Traveling the World 50
PART I - REACTION 5
4 Repeling Invaders 5
Major Defences 5
Ports of Entry 60
vi Contents
Breaching the Defences 64
Subversive Agents 68
5 The Fight Begins 73
General Defence Policy and the Enemy 74
Sentry Duty 78
The Alarm Cal 81
The Weapons of War 83
The Batle Field 8
6 The Main Campaigns 93
Mobilising the Trops 93
Primitive Prions 95
Virile Viruses 95
Batling Bacteria 97
Particular Parasites 10
The Critical Batle 101
PART I - RECOVERY 109
7 Life After Death 109
Dying to Live 10
Fiery Fevers 13
Sothing Slep 15
Repairing the Damage 17
Lasting Relationships 121
8 Survival of the Fitest 126
A Sound Constitution 127
A Fit Body 134
The Stimulation of Stres 137
Inherited Health 142
9 Struggle for Survival 146
Cancers and their Incidence 147
Normal and Abnormal Cel Cycles 150
Carcinogens and Chemicals 156
The Immune System and Cancer 160
Autoimmunity, Antibodies and Altered Self 162
10 The New Milennium 165
The Apearance of New Diseases 16
The Disappearance of Old Diseases 168
Perenial Problems 170
Contents vi
Vacines in the Future 172
Manipulating the Immune System 175
Asisting the Fight against AIDS 178
Atacking Autoimmunities 180
Caring for Cancer Suferers 182
Final Thoughts 187
Glosary 189
Index 193
Introduction
Acquired Immunodeficiency Syndrome (AIDS) AIDS patients are
severely immunocompromised, since the human immunodeficiency virus (HIV)
attacks many of the immune system cells and destroys them. As a result, the patient
cannot fight off any pathogens that enter the body through the skin or other major
ports of entry, such as the mouth, anus, eyes and sweat glands. Nor can the patient
combat uncontrolled growth of cancerous cells within the body. In the initial stages
of an HIV infection, before any serious problems are suspected, the skin may have a
transient rash. As the disease progresses, patients may develop a number of skin
conditions, such as dermatitis around the sebaceous glands of hairs, persistent
genital ulcers, and eczema. Fungi such as Candida albicans, which can affect many
healthy people without harming them, become a problem and cannot be controlled.
Later on in the HIV infection, many patients have shingles, and the serious skin and
connective tissue cancer, Kaposi's syndrome, takes hold. This is seen as
pink/purple blotches on the skin which may ulcerate, and swellings caused by
enlarged lymph nodes. As many as 40% of homosexual patients with AIDS develop
Kaposi's syndrome, yet in healthy men that are not infected with HIV it is rare and
only occurs in older men of certain Mediterranean origins. In Africa, both men and
women may develop Kaposi's syndrome in AIDS. Over 70% of patients get infec-
tions in the eyes, and these problems are often the first reason for patients seeking
help from the medical profession.
Thus, observing the problems that arise in AIDS, and other more commonly
encountered diseases that are totally unrelated to AIDS, demonstrates how the
normal, healthy body tries to combat disease. The immune system often wins, but
if it cannot cope then many conditions can get out of control and become life-
threatening.
It was the publicity surrounding the shocking news that millions of people
could die from a disease caused by HIV that doctors were unable to cure that
made so many people, from a very wide spectrum of backgrounds and
lifestyles, stop and think about immunity. The science of immunology is rel-
atively new to medicine compared to other disciplines such as surgery. It is
evolving so rapidly that even those involved in immunology every day have
to read widely to keep abreast of developments. The more that is known
Introduction
about the processes governing the immune reactions, the more the pathways
are found to be astoundingly intricate. Immunologists use a very large
vocabulary of specialist words, and often shorten the terms to a series of
capital letters; thus, the jargon is impossible for the uninitiated to under-
stand.
This book was conceived to appeal to the very many people who, during
their lifetime, have relatives or friends who suffer(ed) from diseases involv-
ing the immune system. It is about the modern science of immunology that
has grown up around disease and how the body copes with it. Most people
will have only a rudimentary idea of how the body functions, so I have
started quite simply. As the story unfolds, the descriptions of the various
interactions get more complicated, so each chapter can be read on its own
and, if the details are not understood, a few paragraphs here and there can
be skipped over, and a new aspect of immunology explored with the next
chapter (seef igureo n p. 15).
Immunology is about combating disease. Most people have a knowledge
of certain aspects, perhaps of childhood measles, or the concept of vaccina-
tion and immunisation in childhood, or before travel. Very few, other than
interested specialists, try to grapple with the breadth of the subject. Yet we
would all benefit from understanding more about the body's defences to
viruses, bacteria and other pathogens in order to cope with life-threatening
situations such as cancers, AIDS and autoimmunity. Firstly one needs an
understanding of the principles of the processes involved, then to be alerted
to the possible interactions with daily life, pollution, diet, etc., before appre-
ciating how immune status affects the quality of life and its outcome. Much
of immunology relies upon three tenets: recognition, reaction and recovery.
Each of these topics forms a section of this book, and one leads on naturally
to the next. Reading the whole book will not allow the diagnosis or treatment
of immune diseases, but it may enable a better understanding. I hope that in
so doing, the reader will be fascinated to discover the ingenuity of the
human body and of pathogens.
The human body is made up of millions of cells. A stereotyped cell was
explained to most of us in school, but there is a major step between knowing
what a basic building block is, and understanding how cells interact to allow
the whole body to function. We all know that an egg can be fertilised, after
which it divides and new cells are created that can develop into bone, nerve
or muscle, or systems that can allow sights to be memorised and thoughts
processed. Furthermore specialised cells can roam the body, recognise
invaders in the form of viruses, bacteria or foreign proteins and initiate a