When I was a medical student 40 years ago, immunology – the study of how our bodies fight infection – was a rather marginal area of clinical medicine. Frank MacFarlane Burnet and Peter Medawar had shared the Nobel prize in 1960 for their work on immunological tolerance, which laid the foundations of our understanding of why transplanted organs were rejected. The discovery of immunosuppressive drugs (in particular cyclosporin in the 1970s) made transplant surgery possible, and autoimmune diseases (such as rheumatoid arthritis and Crohn’s) – illnesses where our immune systems attack our own bodies rather than just alien infections or transplants – had first been described in the 1960s. Nevertheless, relatively little was understood about the immune system and clinical immunology was not considered to be an important or prestigious area of medical practice. Nor was it thought that the immune system could “see” cancer cells, and the idea that it might be enhanced and harnessed to treat the condition was seen as little short of quackery.
How things change! Daniel M Davis’s wonderful book The Beautiful Cure recounts how research into the immune system in recent decades has resulted in what amounts to a health revolution. Immunotherapy drugs are now worth billions of dollars, and cancers and autoimmune diseases that were once considered untreatable can now be fought and, in a few cases, even cured. There is little doubt that there will be further progress in the years to come.
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