An Elegant Defense: The Extraordinary New Science of the Immune System: A Tale in Four Lives

by Matt Richtel

In fact, many interleukins are designed to be anti-inflammatory. They are immune system brakes, not accelerants. In fact, some of the sets of monocyte cells that help fuel inflammation also have subsets that dampen inflammation. For example, we now know that the IL-1 family has dozens of members, of which many are anti-inflammatory. At least a third of the variations of this key principal immune system protein are designed to stop the immune system from inflaming. “Before antibiotics, these inflammatory cytokines helped kill off infection,” Dr. Dinarello says, and the cytokines still play that role. How do the cytokines know to turn off? What happens if they don’t turn off? “If you fail to make anti-inflammatory cytokines, you die of mild inflammation.” That’s how powerful this system is. Mild inflammation, wholly unchecked, can kill. Dinarello likes the analogy that the immune system has turned the body into a police state. “You need inflammation to protect against invaders. You need policemen. But if police get too rambunctious, they cause damage and kill innocent people.” The discovery of all these proteins provides evidence of what Dr. Fauci told me so eloquently about the immune system. It’s a supercomputer. Dr. Fauci was poised to redefine its purpose.