Early understanding of immunology ‘takes your breath away’
Click Here to Manage Email Alerts
DESTIN, Fla. — The history of immunology includes snake bites and cowpox, and is built on the work of scientists dating back more than 2,000 years, according to a presenter at the 2023 Congress of Clinical Rheumatology-East.
“The history of immunology is a family history,” Leonard Calabrese, DO, RJ Fasenmyer chair of Clinical Immunology at the Cleveland Clinic, and chief medical editor of Healio Rheumatology, told attendees. “It is something that I think is close to all of our hearts.”
Although the title of the CCR-East program implies “rheumatology,” Calabrese stated that immunology lies at the heart of the specialty.
“We are all clinical immunologists,” he said. “Any practitioner that applies the principles of immunologic science to the care of patients is an immunologist.”
The word immunology derives from the Latin “immunitas,” which translates as “exception,” Calabrese noted.
“Initially, it meant you were exempted from taxation during the Roman empire,” he said.
However, Calabrese suggested that the first quasi-clinical use applied to snake handlers.
“They recognized that if you were bitten by a snake and survived, you might survive the next bite,” he said.
That said, applying the term to actual medicine came “far later,” according to Calabrese. As with the snake bites, it eventually became clear that if a person survived one plague, they were more likely to survive another.
“This was several thousand years ago, and it was a very loose framework” of the definition of immunology today, Calabrese said.
He then traced a long line from one scientist to the next, from the 16th century anatomist Andreas Vesalius to Giovanni Battista Morgagni, who was among the earliest pathologists.
“Morgagni said that sick people have different tissue than well people,” Calabrese said.
Moving forward to the 18th century, Edward Jenner arrived at a conclusion similar to that of the aforementioned snake handlers.
“He applied the blister fluid of a milk maiden with cowpox to his boy’s arm, and the boy survived,” Calabrese said. “This built upon observations made centuries before in Asia and the sub-Asian continent.”
That said, getting into the 19th century, there was “still no talk of immunology,” according to Calabrese.
However, as the 1800s drew to a close, Calabrese suggested that two theories of immunology developed.
“One was that cells were important,” he said. “The other was that there was something in the serum that was important.”
The cellular side was represented by Ilya Ilyich Mechnikov and Paul Ehrlich, who conducted their research in France.
“They believed there are cells in the body that can eat dangerous things,” Calabrese said.
Meanwhile, Emil von Behring, working at the Robert Koch Institute in Berlin, represented the serum argument.
“He said that we can take serum and administer it to people and it will protect them,” Calabrese said.
However, these arguments were just “theoretic” at that time, he added.
“There was no understanding of what was happening at the cellular level,” Calabrese said.
It takes your breath away to think about how close they were.”
At the dawn of the 20th century, the prevailing school of thought favored the serum side, rather than the cellular side of the argument.
“The field of immunology became a chemist’s field for 50 years,” Calabrese said. “There was no understanding of T cells or B cells.”
However, in 1957, Sir Thomas Burnet engaged with the idea that there were cells in the body that made antibodies.
“These antibodies had to be curated so you did not make antibodies against the self,” Calabrese said.
By 1970, T cells and B cells had been discovered, and the field of cellular immunology “had started to burgeon,” according to Calabrese.
“But they still did not know how these cells worked,” he said.
Moving into the modern era, several scientists have pushed the field forward, describing the nuances of both the innate and adaptive immune systems. Ruslan Medzhitov, PhD, is a key player in understanding innate control of adaptive immunity, while Bruce Beutler, MD, and Jules Hoffmann, PhD, shared the 2011 Nobel Prize for understanding of the activation of innate immunity. In addition, Ralph Steinman, MD, received the 2011 Nobel Prize for his discovery of the dendritic cell and its role in adaptive immunity. Their work is still being processed and expanded upon today.
No history would be complete without a look to the future, according to Calabrese.
“The next forefront in immunology is the role of the immune system as the seventh sense,” he said. “The brain and the immune system are a single organ.”
Calabrese described “bidirectional communication” between the immune system and the central nervous system that is just beginning to be understood. He predicted that the next generation of scientists will describe and define the nature of this communication.
“We are at the beginning of something truly remarkable,” he said.
Collapse
Calabrese L. The history of immunology. Presented at: Congress of Clinical Rheumatology-East annual symposium; May 4-7, 2023.
Read more about
Click Here to Manage Email Alerts