Archive | 1:54 am

and here i thought we knew it all

2 Nov

I’ve been reading the recommended textbook for Immunology (Basic Immunology: Functions and Disorders of the Immune System by Abbas and Lightman–if you ever feel as hopelessly lost in a stream of acronyms as I do, with all them HLAs, MHCs, APCs, IL-2s, etc., I definitely recommend this text).  It seems like at the end of most every paragraph (at least in the chapter of autoimmunity), there is something to the effect of: “the basis of this effect of infections is unknown”; “how T cells choose…is not understood”; “it is not known which types of self antigens induce anergy.”

First of all, I find it absolutely refreshing that we’re being so open about what we do and do not know in this medical field (not exactly sure why I’m including myself in the general “we” here…I guess I’m using the term loosely).  And it’s also quite exciting that they’re still so much left to discover.  On the other hand, it’s unsettling, really.  Going into medical school, I knew that there were plenty of things left to unravel in the sciences, and I knew that I would be taught plenty of skills and concepts that would, frankly, be proven wrong at some point over the course of my career.  I just didn’t expect this level of uncertainty at what seems to be the most fundamental level.  This class is, essentially, Immunology 101, the very basics.  At the center of field, the building blocks of how our immune cells work, there is a huge level of uncertainly.  We observe a chain of events in the immune system (the role of CTLA-4 in both T cell inactivation and activation through completely different mechanisms), over and over again until we accept it as a rule, and yet we seem to rarely have any idea why that progression or mechanism is in place, what makes it function.

Exciting or absolutely terrifying?