An Elegant Defense
"A groundbreaking narrative exploration of the human immune system--the key to human health and longevity--from the Pulitzer Prize-winning New York Times journalist and acclaimed author of A Deadly Wandering"-- The immune system is a guardian vigilantly fighting illness, healing wounds, maintaining order and balance, and keeping us alive. Richtel interweaves the stories of four people: a terminal cancer patient who rises from the grave; a medical marvel who defies HIV; two women with autoimmunity who discover their own bodies have turned against them. As he leads us from the Black Plague to twentieth-century breakthroughs in vaccination and antibiotics, to the cutting-edge laboratories that are revolutionizing immunology, his four patients each illuminates an essential facet of our "elegant defense." -- adapted from jacket
Stats for nerds
4recommend
4mentions
4people
2020–2023years
100% recommend
Mentions per year
What Hacker News says
- I've not read it myself, but An Elegant Defense [1] by Matt Richtel has come highly recommended to me. My understanding is that it takes a more human-interest angle, but also does a good job explaining how the immune system works and how it can go wrong at a high level. May be worth checking out as well.
[1] https://www.goodreads.com/book/show/41806641-an-elegant-defe...
- I’m very sorry to hear this and I’m going through something similar. My mother has been diagnosed with late stage cancer a couple of months ago. Here’s what I’m doing:
- I’m taking time of work. To look after her, but also my role as primary caregiver is impossible to combine with work
- I’m personally seeing a psychologist specialized in oncology. She taught me a useful self-care framework that consists of four pillars: autonomy, physical well-being, social support, and doing meaningful things.
- My mum is also seeing a similar person to talk about the disease, its implications and possible death
- My role as primary caregiver and only child is complex. We involved a mediator to set mutual expectations
- I’m using the time to learn how to take care of myself both physically and mentally. For instance, I’m experimenting with light therapy and nutritional supplements
- I am learning about cancer. This is sometimes emotionally tough, but I like that I can now better help my mother navigate the medical complexities. Cancer is also an interesting gateway into immunology. I recommend “Elegant Defense” by Matt Richtel
- I spent a lot of energy organizing professional care (e.g., nurses, food l). This means that my support for her now feels of a higher quality.
- I am helping my mum keep track of her medical condition over time. This relates for instance to pain, side-effects, complications etc.
- I am trying to figure out what she finds difficult from an emotional and energy perspective. I outsource this. She needs to focus on getting through the therapy.
- I didn’t read all the comments, but it’s very true that outsiders often don’t know what to do but want to help. Make a list of things that need to happen and share it with them.
I wish you and your mother lots of strength.
- Your body has two types of immune response, one called an innate immunity, which basically is programmed to attack certain types of pathogens at birth, and another an adaptive or acquired immunity. Vaccines target the adaptive immunity.
If we only had an innate immunity, viruses and other pathogens would learn to bypass it by hiding or disguising themselves in various ways. In order to counter this, our bodies constantly learn to recognize new pathogens. This is done by breaking down viruses into protein parts called antigens and creating antibodies that bind to those parts. Think of it like a lock and key.
Viruses typically have many proteins that can serve as these antigens on the surface of their cells. Many of these protein structures are actually used by the virus to bind to cells in our body and enter them.
Once antibodies to those antigens are being produced, they’re able to lock onto those surface structures and interfere with a viruses ability to function.
So a vaccine is simply a way to introduce those antigens and surface binding proteins in order to cause your body to generate an antibody immune response.
Another key component is that once your immune system creates antibodies, it “remembers” them through certain memory cells that are able to quickly produce the same antibody when needed at a later date.
Now all that sounds pretty simple, but the details get complicated, which is why vaccine effectiveness varies. Oftentimes certain types of viruses change their outer proteins so often, that a vaccine targeting one strain produces an immune memory that doesn’t work well with the next mutation.
Or other times the antibodies only bind to certain proteins that only partially interfere with virus infection. Or in some cases the way the vaccine is produced means that the antigens change subtly during the process making them less potent for good antibodies.
These new COVID vaccines are actually a method if introducing specific and accurate antigens to our immune system in a novel way. In this case it’s a bit of RNA that causes our cells to generate the antigen proteins themselves. It has the promise of being able to produce antigens of greater number and specificity than other methods. It’s basically using the same process as many viruses themselves (rna getting our cells to produce proteins) meaning our immune system is primed to take advantage and produce stronger immunity.
So the short answer is these vaccines are likely to produce strong and lasting immunity to the coronavirus they are targeting. What is unclear however is how fast this new strain of coronavirus will mutate into strains requiring more yearly shots to deal with changing antigen profiles (like the annual flu).
So the unknown is simply how this virus will evolve... if we’re lucky mutations that significantly change the surface antigens targeted by these vaccines will also mean the virus either becomes less contagious or less deadly.
If you’re truly interested I highly recommend this book on how the immune system works, full of excellent sources.
https://www.amazon.com/Elegant-Defense-Extraordinary-Science...
More technical information on Wikipedia’s immunity sections:
https://en.m.wikipedia.org/wiki/Adaptive_immune_system
https://en.m.wikipedia.org/wiki/Antigen
- For anyone curious to learn more about our immune system I highly recommend the book "An Elegant Defense: The Extraordinary New Science of the Immune System".
It will really open your eyes into how complex, and in most cases unknown, our immune system is. It's fascinating what sort of internal defenses arise out of the chemical soup of billions of years of evolution.
