The Song of the Cell: An Exploration of Medicine and the New Human

by Siddhartha Mukherjee

Or, as Virchow reminds me daily: “Every pathological disturbance, every therapeutic effect, finds its ultimate explanation only when it’s possible to designate the specific living cellular elements involved.”

Like hermits, microbes need only be concerned with feeding themselves; neither coordination nor cooperation with others is necessary, though some microbes occasionally join forces. In contrast, cells in a multicellular organism, from the four cells in some algae to the thirty-seven trillion in a human, give up their independence to stick together tenaciously; they take on specialized functions, and they curtail their own reproduction for the greater good, growing only as much as they need to fulfill their functions. When they rebel, cancer can break out. —Elizabeth Pennisi, Science, 2018

“Omne vivum ex vivo,” Redi wrote. “All life comes from life.”

There is much that is irresolute and restless about me. —Rudolf Virchow, in a letter to his father, 1842

These catheters will deliver gene-editing enzymes, loaded inside tiny nanoparticles, to the organ. Once these particles off-load their cargos inside the liver cells, the gene-editing enzymes will change the scripts of genes that aid and abet cholesterol metabolism, thereby drastically decreasing the amount of circulating cholesterol in the blood—in essence, activating the LDL metabolizing pathways. It’s a one-and-done infusion.

Milstein, working with the German cell biologist Georges Köhler, came up with a solution that was as brilliant as it was unorthodox: using a virus that could glue cells together, they fused the B cell with a cancer cell. I am still awestruck by the idea. How did they even think of using the undead to resuscitate the dying? The result was one of the strangest cells in biology. The plasma cell retained its antibody-secreting property, while the cancer cell conferred its immortality. They called their peculiar cell a hybridoma—a, well, hybrid of hybrid and oma, the suffix of carcinoma. The immortal plasma cell was now capable of perpetually secreting only one kind of antibody. We call this antibody of a single type (in other words, a clone), a monoclonal antibody.

“And then,” Levy continued, “in 1975, suddenly, Milstein and Köhler came up with this method of fusing a plasma cell with a cancer cell. The fusion enabled the antibody-making cell to live forever.” Levy’s face grew animated; his hands began to drum his desk. “It was a revelation. A bon-aaaaaa-nza. Ironically, we could use the immortality of a cancer cell [fused with a plasma cell] to make an immortal cell to produce an antibody against cancer. We could fight fire with fire.”