Clinical Review Recent advances

Immunology

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7131.600 (Published 14 February 1998) Cite this as: BMJ 1998;316:600
  1. Mike Kemeny, professor of immunology (m.kemeny@kcl.ac.uk),
  2. Mark Peakman, reader in immunology
  1. Department of Immunology, King's College School of Medicine and Dentistry, London SE5 9PJ
  1. Correspondence to: Professor Kemeny

    Immunology is one of the most recent subjects to have emerged as a separate discipline in biomedical science. Therefore, many clinicians currently practising will have received little or no basic or clinical training in this subject, while those who have will find that much has changed in the past five to 10 years. Access to this important aspect of medicine is hampered by the profligate use of acronyms and jargon, but some attempt has been made to bring order where chaos threatened. The CD (cluster of differentiation) system defines cell surface molecules and now stretches to CD161. The interleukin system of cytokine nomenclature (now up to interleukin 18) has rid the literature of BCGF (B cell growth factor) and other acronyms. The genetic age has brought with it a new nomenclature for the HLA system, which may be difficult for clinicians who are required to adapt from the old one but will be beneficial to new generations of clinicians. The reality is that immunology can no longer be avoided. Its relevance spans from pregnancy to senescence and from vaccination to cancer, a fact recognised by the 10 Nobel prizes for medicine or physiology awarded for key immunological advances, most recently to Zinkernagel and Doherty for their work on the specificity of cell mediated immune defence.

    Methods

    We have chosen what we consider to be some of the most exciting recent discoveries in immunology, focusing on subjects in which the frontiers of basic immunological research are shaping up to give rise to clinical applications in the next decade.

    Mechanisms of resistance to HIV infection

    HIV attacks CD4 T lymphocytes and macrophages and dendritic cells (fig 1). Until recently, the CD4 molecule was believed to be the only receptor that HIV uses to enter lymphocytes, but not all of the experimental data supported this. For example, although 1010 …

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