After publishing over 600 scientific articles and editing several editions of the Fundamental Immunology textbook, distinguished scientist William E. Paul wrote a book titled simply, Immunity. Paul’s goal is to empower general readers to make informed decisions about personal and public health. Immunity is neither textbook nor memoir, yet it captures the best aspects of both genres. By depicting how the people underneath the lab coats have struggled to unravel the complexities of the immune system, Paul introduces readers to the principles of scientific inquiry and challenges them to see the impacts of immunity in their own lives.
The text sets up a fundamental tension between the immune system’s protective functions and its destructive capabilities. The eradication of smallpox via vaccination exemplifies the ability of the immune system to protect from devastating disease. In contrast, Paul also explains how type 1 diabetes is caused by immune cells attacking insulin-producing cells in the pancreas. How do we reconcile the productive and destructive effects of immunity? The text invokes three laws that guide immune function: universality, tolerance, and appropriateness. Paul explains that these laws are not immutable like the laws of physics but rather like the laws guiding human behavior: “these laws can be broken, but there is a price to pay, often a very steep one” (pg XII). Therefore, type 1 diabetes becomes an example of the terrible price that is paid when the law of tolerance is broken.
Instead of simply stating how each law works, Paul traces the thoughts of scientists that made the discoveries, guiding readers down the wrong turns, confusing results, and moments of understanding. When relevant, Paul injects personal stories that show the human side of investigators. With the law of universality, readers can debate the merits of the instruction theory versus the clonal selection theory and ultimately come to a deeper understanding of how lymphocytes form surface receptors that can bind to antigens. In the chapter on tolerance, readers learn about a scientist who grew up on a farm and then went on to study blood groups in cattle, making a fundamental discovery about central tolerance along the way. As an example of the law of appropriateness, Paul describes his own laboratory’s discovery of interleukin-4 and how this helped scientists understand that different types of infections are combated by specialized cells that carry out distinct functions.
The text concludes with a discussion of how immunity impacts a wide range of human diseases, including rheumatoid arthritis, allergy, and cancer. Paul argues that future immunological research must tackle the development of novel vaccines for diseases such as tuberculosis and malaria. He also predicts that a better understanding of the microbiome will allow breakthroughs to be made in the treatment of inflammatory diseases. By stressing the work that is yet to be done, Paul highlights the importance of continued support for research in immunology. Perhaps more importantly, he calls on every reader to become an informed citizen, capable of using knowledge about immunology to make critical decisions about human health.