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Kindle Notes & Highlights
by
Matt Richtel
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September 17 - September 20, 2021
Only recently have we begun to understand the pervasive role of our immune system in the brain, where damaged or outdated synapses get pruned by the organ’s own immune cells, allowing ongoing neurological health.
The job of the immune system is to circulate through this wild party, keeping an eye out for troublemakers and then—this is key—tossing out bad guys while doing as little damage to other cells as possible.
Together, autoimmunity is the third most common disease category in the United States (after cardiovascular disorders and cancer). Diabetes, the leading killer in the country, is caused by the immune system’s going to war against the pancreas.
Smoking tests the immune system like few human habits; the tiny nicks and cuts to the soft lung tissue don’t just create persistent injury but force cells to divide to replace the hurt tissue. Cell division heightens the possibility for malignancy, cancer. This is just simple math, and it can be deadly.
Fourteen years later, in 1996, it seemed from the outside that much of Linda’s life had continued in storybook fashion. She had a Stanford MBA to go with everything else, two kids, including a newborn, a husband employed at one of Silicon Valley’s most elite law firms. She was on the cusp of becoming only the sixth female partner at the Boston Consulting Group.
It’s a tale that begins with a bird, a dog, and a starfish.
At the moment of invasion, the body has an initial reaction that involves the swarming of eater cells, and the experience is not always pleasant. This is what we call inflammation.
The immune system is one of the world’s most complex organic systems, equaled perhaps only by the human brain, with its origins long preceding the evolution of our species.
In the most fundamental sense, we share an immune system with sharks and other jawed vertebrates.
Much of what I’ll explicate in this book is that magic, the way we can survive without being just one big pimple.
A major role of the immune system is to keep infection out of our circulatory system.
Survival depends on knowing what is self and what is alien. The immune system must cope with three major challenges: the variability of bad actors, the central circulatory system that sends rivers of blood throughout our body in seconds, and the need to heal.
Her father, the manager of a Franco-Chinese bank, had secured a placement in Shanghai, helping the family escape from Europe after Nazi Germany’s invasion of France.
The B cells came from bone marrow and generated antibodies. The T cells matured in the thymus and could either fight or direct action. They are generals and soldiers.
The B cells come from the bursa or bone marrow, and the T cells from the thymus,
An antigen is the mate to an antibody. The antibody and the antigen bind to each other, like a lock and a key.
An individual’s elegant defense didn’t care simply about the infection; it cared about the infection when it attacked its own personal habitat.
Studies have shown the MHC gene gives off a scent. The scent is used as a factor in how people choose their mates. If one person’s MHC is too similar to another’s, the MHC will act as a repellent. The scent of MHC that is sufficiently different will act as a magnet.
“Inflammation is—very generally speaking—the body’s immune system’s response to stimulus.”
In fact, there can be more tissue damage twenty-four hours after the insult takes place than there was at the moment it happened. During that period, the elegant defenses are examining, cleaning, and rebuilding enough of a physical space to make sure that no danger is left behind and that they can rebuild healthy new tissue seamlessly in the region around it.
The dendritic cells roam the Festival of Life, brushing up against guests at the packed affair, and presenting their identities to the T cells.
The neutrophil begins to dissolve, creating of itself digestible chunks that can be cleaned up by cells with a more janitorial function.
In the Festival of Life, when a foreign agent bursts into the party, immune cells might send lots of cytokines to one another—pulses of communication.
The thymus makes T cells. The bone marrow is the origin of B Cells. They flow in the tunnels and vessels that make up the lymphatic system and congregate in lymph nodes and lymphatic tissue. These are like command centers, surveillance hubs where the firefighters are awaiting a call. The T cells, when alerted by dendritic cells, behave as soldiers and generals, spitting out cytokines; the B cells use antibodies to connect to antigens as if they are keys in search of a lock. Macrophages, neutrophils, and natural killer cells roam the body, tasting and exploring, killing. These networks get
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“Every fall we had to go to the cotton fields for a couple of months. This was compulsory. You’d get kicked out of college if you didn’t do that. It was primitive conditions. One time I was ‘caught’ by our department chair for reading a textbook in the field.” It was a biochemistry text.
The innate system informs the adaptive system: I need help. Bring the heavies.
I think of DNA as the architectural blueprint, and the RNA is the general contractor. RNA puts the plan into action, and it instructs lots of “subcontractors,” like cells and proteins.
When women complained—whether about physical or emotional duress—they were often deemed “hysterical.” Society could be quick to dismiss the work of women solely as caretakers of children and the home, employment deemed second class and not particularly taxing. In reality, this work could be brutal on the joints and compound the pain.
Women generally have more body fat than men, so perhaps they have more immune system cells, Dr. Hahn postulated to me.
When the system contributes to longer life, it comes with a powerful potential cost. More defense, more risk.
By the spring of 1997, Linda was on fifteen medications—some to help with the autoimmunity, some to stem the activity of the other medications.
Enbrel is now one of the bestselling drugs in the entire world. It generated $5.5 billion in sales in the 2017 fiscal year for Amgen, the company marketing it.
Merredith asked, “Are we Jewish?” “We were Jewish enough.”
A syndrome is a medical condition characterized by a collection of symptoms,”
A competitor of Enbrel was called Remicade, made by Janssen Biotech and approved by the FDA in 1999. It also worked by blocking TNF. But it wasn’t cheap; a story published in the New York Times when the drug was approved reported that a single treatment of Remicade cost $9,500, less than the $11,400 single-cost treatment of Enbrel.
Dr. Lemon thinks one great way to keep your immune system in balance is to . . . eat the food you drop on the floor. Her philosophy, as she puts it, is that people need to stop oversanitizing their world so that their immune systems are introduced to lots of bacteria, parasites, and other pathogens and can react to them as millions of years of evolution have refined them to do.
What does an immune system do when it’s not properly trained? It overreacts. It becomes aggrieved by things like dust mites or pollen. It develops what we called allergies, chronic immune system attacks—inflammation—in a way that is counterproductive, irritating, even dangerous.
The prevalence of diabetes is higher in Pakistanis who move to the United Kingdom than in those who remain in Pakistan.
The dust and pet filth, the cockroach miasma, and the barnyard residue, far from being an enemy, impacted the immune system through both pathways, innate and adaptive, and the Amish kids were far less likely to get an allergy.
the United States in 2015 sold 34 million pounds of antibiotics for use in “food-producing animals,” according to the FDA. That was around 80 percent of the antibiotics used in the United States altogether.
The microbiota in the gut of an infant who is delivered vaginally differs from the microbiota of an infant delivered by cesarean section.
It is in the microbiome’s self-interest to keep the body from attacking itself, so the bacteria contribute to helping keep the immune system in check.
The relationship is changing because we as a species are fighting to survive and bacteria are fighting to survive. That relationship has always been in flux, but the pressures on the relationship have intensified because of human technology, like antimicrobial soaps, antibiotics, and nonorganic foodstuffs.
We can choose to eat foods not raised with antibiotics. We can decide to pick up a piece of food dropped from the floor, rinse it, and eat it.
There are myriad other health benefits of sleep. Improved memory, cognition, and mood; less inflammation, and you know now how huge that is.
people who are deprived of sleep experience a decrease in activity of natural killer cells “to the same level of people who are depressed or stressed.”
studies show that response to vaccines is diminished in people with sleep deprivation, suggesting our immune systems don’t learn as well when we are tired.
The evil malignancies co-opt the system, and in an odd way, they get treated to the privilege of dividing quickly. There are other cells in the body that also divide quickly, including hair follicles and cells in the gut and mouth.
In short, there is nothing good about chemotherapy other than the fact that it can save your life. A trade-off, often, worth making.
“What happens today is that many people are living with imaginary bears at every step of their lives—something in the news or around the bend is going to get them.” What followed was what he called a “norepinephrine high.”
