Some insights into immunology.

Text adapted from the British Society for Immunology.

What is Immunology?
Immunology is the scientific study of the immune system, representing a pivotal branch
of both medical and biological sciences. The immune system plays a critical role in
safeguarding our bodies against infections by deploying various layers of defense
mechanisms. When the immune system malfunctions, it can lead to diseases such as
autoimmunity, allergies, and even cancer. Increasingly, research reveals that immune
responses contribute to the development of various common conditions not
traditionally seen as immunological, including metabolic, cardiovascular, and
neurodegenerative disorders such as Alzheimer's.

Why is Immunology Important?

From Edward Jenner's groundbreaking work in the 18th century, which paved the way
for modern vaccination (arguably one of the most life-saving medical advancements), to
the numerous scientific breakthroughs in the 19th and 20th centuries that resulted in
safe organ transplantation, the discovery of blood groups, and the widespread use of
monoclonal antibodies across science and healthcare, immunology has profoundly
transformed modern medicine. Ongoing immunological research continues to expand
our understanding of addressing significant health challenges, including
immunotherapy, autoimmune diseases, and vaccines for emerging threats like Ebola.
Progress in basic immunology is vital for both clinical and commercial applications and
has led to the development of new diagnostics and treatments for a wide range of
diseases. Additionally, immunological research, coupled with advancing technology, has
provided indispensable research techniques and tools like flow cytometry and antibody
technology.

What is an Immunologist?
An immunologist is a specialist in the field of immunology, either as a scientist or
clinician. Many immunologists conduct research in laboratories, whether in academia or
the private sector (e.g., pharmaceutical industry). Clinical immunologists, on the other
hand, focus on diagnosing and managing diseases related to the immune system,
including autoimmune diseases and allergies.

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The Immune System
The immune system is a complex network of structures and processes that has evolved
to protect our bodies from diseases. It comprises molecular and cellular components,
which serve two main functions: nonspecific mechanisms (innate to organisms) and
specific responses (adaptive to particular pathogens). Classical immunology investigates
the components that make up both the innate and adaptive immune systems.
Innate immunity serves as the initial defense and is non-specific, meaning it provides the
same responses to all potential pathogens, regardless of their differences. Innate
immunity includes physical barriers (e.g., skin, saliva) and various cell types (e.g.,
macrophages, neutrophils, basophils, mast cells), which are always ready to counter
infections during the initial days of exposure. In some cases, innate immunity
successfully eliminates the pathogen, but in others, it may become overwhelmed,
leading to the activation of a secondary defense.
Adaptive immunity, the secondary line of defense, involves building a memory of past
infections to mount a targeted response against specific pathogens or foreign
substances. Adaptive immunity engages antibodies, which typically target circulating
foreign pathogens, and T cells, specialized in addressing pathogens within host cells or
aiding in the antibody response.

Immune Dysfunction and Clinical Immunology

The immune system operates under precise regulation and balance, and when this
equilibrium is disrupted, diseases can ensue. Research in this field focuses on the study
of diseases caused by dysfunctions within the immune system. Much of this work holds
significant implications for the development of novel therapies and treatments aimed at
managing or even curing these conditions. These approaches may involve altering the
way the immune system functions or, in the case of vaccines, priming the immune system
and enhancing its response to specific pathogens.
Immunodeficiency disorders refer to conditions in which the immune system encounters
challenges that impair its ability to mount an appropriate defense. Consequently, these
disorders are nearly always associated with severe, persistent, recurring, and/or
complication-prone infections, rendering them profoundly debilitating and sometimes
even fatal. Two main categories of immunodeficiency disorders exist:
-Primary Immunodeficiencies: Typically present from birth, these disorders are generally
hereditary and relatively rare. An example is common variable immunodeficiency (CVID).
-Secondary Immunodeficiencies: These conditions usually develop later in life and can
result from factors such as infections, as seen in the case of AIDS following HIV infection.

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Autoimmune diseases manifest when the immune system mistakenly attacks the body
it's meant to protect. Individuals suffering from autoimmune diseases have a defect that
renders them incapable of distinguishing between "self" and "non-self" or "foreign"
molecules. Principles of immunology have led to the development of a wide array of
laboratory tests for the detection of autoimmune diseases. These diseases can be
categorized as follows:
-Primary Autoimmune Diseases: Such as type-1 diabetes, these may manifest from birth
or during early life.
-Secondary Autoimmune Diseases: These conditions emerge later in life due to various
factors. Examples include rheumatoid arthritis and multiple sclerosis.
Autoimmune diseases can also be classified as localized, affecting specific areas like
Crohn’s Disease impacting the gastrointestinal tract, or systemic, as in the case of
systemic lupus erythematosus (SLE).

Allergies represent hypersensitivity disorders arising when the body's immune system
reacts against harmless foreign substances, resulting in harm to the body's own tissues.
Nearly any substance can serve as an allergen, but the most common allergies occur
after the consumption of specific foods (e.g., peanuts) or exposure to airborne
substances (e.g., pollen or dust). During allergic reactions, the body perceives allergens
as threats and promptly releases substances to combat them. This prompts immune
system cells to release potent chemicals like histamine, causing inflammation and the
associated symptoms of allergies. Immunology endeavours to elucidate the processes
occurring within the body during an allergic response and the factors responsible for
triggering them. Such understanding can lead to improved methods for diagnosing,
preventing, and managing allergic diseases.

Asthma, a debilitating, and occasionally life-threatening condition affecting the airways,

typically arises when the immune system reacts to inhaled particles from the
environment. Over time, this reaction can lead to the thickening of airway walls in
affected individuals. Asthma is a significant source of illness, particularly among children.
While it may have an allergic component in some cases, its origins in many instances are
multifaceted and not yet fully understood.

Cancer is characterized by abnormal, uncontrolled cell growth and proliferation, marked

by specific hallmarks. One of these hallmarks is the capacity of cancer cells to evade
immune destruction. Recognizing the role of immune system evasion in cancer,
researchers have harnessed the power of immunotherapy to combat the disease. Cancer
immunotherapy seeks to activate the innate abilities of the immune system to target and

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eliminate cancerous tissue, offering promising results as a formidable weapon against
cancer. Additionally, the application of immunological knowledge in the fight against
cancer includes the use of monoclonal antibodies, which are proteins designed to seek
out and directly bind to specific target proteins called antigens. An example is Herceptin,
a monoclonal antibody used to treat breast and stomach cancer. Furthermore, several
successful cancer vaccines have been developed, with the HPV vaccine being a notable
example.