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Medical Milestones

Immunology: making magic bullets

BMJ 2007; 334 doi: (Published 04 January 2007) Cite this as: BMJ 2007;334:s13
  1. D Michael Kemeny, head of department,
  2. Paul A MacAry, assistant professor
  1. 1Immunology Programme and Department of Microbiology, Centre for Life Sciences, The Yong Loo Lin School of Medicine, National University of Singapore, Singapore

    Continuing developments in our understanding of antibodies are taking us into a future of limitless and highly specific treatments

    The discovery of vaccination at the end of the 18th century undoubtedly had a great impact on human survival. Since then, our understanding of the immune system has advanced in leaps and bounds, and we now know how vaccination endows us with the capacity to fight invading pathogens. We appreciate too that our immune system has been shaped by the challenges of dealing with diverse infectious organisms and that similar immune mechanisms underlie conditions such as autoimmunity, allergy, transplant rejection, and tumour immunity, even though these may not involve invading pathogens.

    Understanding of how the immune system distinguishes host cells from “foreign” cells leapt in 1958, when the French medical researcher Jean Dausset described the first of many human histocompatibility antigens (HLA antigens). Our immune system uses the pattern of HLA antigens on the surface of cells as a biological signature—one that is almost unique to each of us. Whenever the immune system does not recognise the pattern of HLA antigens on a cell it creates antibodies and other substances to attack and destroy it. This is the main mechanism for immune recognition of infectious organisms. It …

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