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?


6 Responses to “and here i thought we knew it all”

  1. Erin Zoller November 2, 2010 at 7:53 am #

    That is what makes immunology so amazing! I have such job security as an immunologist.I totally met Abbas this past February at the FOCIS advanced course in Immunology. He is an amazing lecturer.

    I hate to break it to you, but while it is mostly true SOME of the “we don’t understand this” is a little bit of a lie because it is med school and you don’t have time to learn all the info.
    They tell some of the answers to the immunology PhD students. Shhh don’t tell.
    You have to realize a lot of immunology was discovered in the first 10 years of the 20th century and basically forgotten about and ignored until 50 years later. This field is frighteningly young. Everyone who made all of those discoveries in the text book were not trained as immunologists. Those degrees didn’t exist. They stumbled upon it and fell in love!
    Also keep in mind that the reason that autoimmunity is so poorly understood is because it breaks every rule that we have discovered about the immune system: “tell the difference between self and non/self (or danger)”

    I remember you staying at my house that one night a couple of years ago and you hadn’t had any cell biology yet and didn’t know what a mitochondria was. You said “woah… like you are a real scientist!” It was awesome.

    • annaojesus November 2, 2010 at 8:14 am #

      Hi Erin!

      Wow, thanks so much for the note! I’m studying immuno as we speak, so your comment was perfectly timed motivation! Awesome that you med Abbas. His textbook is _really_ good; just incredible easy for us non-scientists to understand.

      That’s hilarious!–definitely not the first time med students have been left in the dark. My favorite is when a classmate asks a question, and the professor just shrugs and says something like “Magic,” or “Math happens.” I’m glad you’re in the know!

      And thanks for the bit of history–I really love knowing more about the background to the different fields. We get some if it, but certainly not enough, the year just moves too quickly (in a good way). I’m loving this block of classes way more than the last!

      Yeah, autoimmunity = totally crazy! I’m so glad (cough cough) that, as a woman, I’m much more likely to have autoimmune disease…fantastic.

      Ha! I totally remember that night! I was scared out of my mind about science…I still kind of am, but don’t tell anyone. I mostly feel like I sort of fake my way through, but it’s working out. Definitely not a real scientist like you, but still totally fascinated by it!

      How are you and James?? I wish I could make it to the concert, but I need to be holed up in a library, lest I fail anatomy. Have a blast, and safe travels!

      • Erin Zoller November 3, 2010 at 10:09 pm #

        Well, if you get enough time to really THINK about the immunology, I think you will realize the “holes” they aren’t telling you about in med school. If you have questions, just ask. I like to think of immunology as almost this secret field that affects everything. It is a whole set of cytokines and cells that know one seems to know about yet it is so important to how life adapts and works on this planet. It is the best example of the balance of the universe in my mind. ( I think general physiology is like that too) but it amazes me that for every action in the immune system there is an opposite reaction. So brilliant and so usually subtle. It literally takes my breath away. And every day we find the immune system is involved in pathologies we thought were completely separate. I’ll chat about it with you anytime:)

      • annaojesus November 6, 2010 at 1:03 am #

        I just want to talk with you more about this! So exciting! Unfortunately, right now I feel like I’m literally drinking from a fire hose, so I should probably worry about passing my tests next week first :/ Immuno is just starting to come together, at a very basic level. I would love to hear more about your research. Hope you’re having a blast this weekend! Miss you and James so much!

  2. Josh St. Louis November 2, 2010 at 9:11 am #

    I’m so glad that somebody else feels the same way! We’re just about finished with Immunology right now and I LOVED that aspect of it! It’s so exciting to continually be reminded about the developing nature of science and the true need for good researchers. Especially with regard to autoimmunity, it’s really quite absurd how little is really known and how much remains to be seen.

    Hope you’re enjoying this wild ride as much as I am 🙂

    • annaojesus November 6, 2010 at 1:07 am #

      I completely agree, Josh! Well said 🙂

      How are you doing?? Finishing up with biochem? It is, indeed, a wild ride. I’m loving it, but finding it hard to live in the present and not get caught up with what’s coming up…one of the reasons I’m trying to keep up with this blog :/

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