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An elegant defense : the extraordinary new science of the immune system : a tale in four lives
2019
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Summary

"One of those rare nonfiction books that transcends the genre. ... Extraordinary." --Douglas Preston

Magnificently reported and soulfully crafted, An Elegant Defense is an epic, first-of-its-kind exploration of the human immune system and the secrets of health, by the Pulitzer Prize-winning New York Times journalist

A terminal cancer patient rises from the grave. A medical marvel defies HIV. Two women with autoimmunity discover their own bodies have turned against them. Matt Richtel's An Elegant Defense uniquely entwines these intimate stories with science's centuries-long quest to unlock the mysteries of sickness and health, and illuminates the immune system as never before.

The immune system is our body's essential defense network, a guardian vigilantly fighting illness, healing wounds, maintaining order and balance, and keeping us alive. Its legion of microscopic foot soldiers--from T cells to "natural killers"--patrols our body, linked by a nearly instantaneous communications grid. It has been honed by evolution over millennia to face an almost infinite array of threats.

For all its astonishing complexity, however, the immune system can be easily compromised by fatigue, stress, toxins, advanced age, and poor nutrition--hallmarks of modern life--and even by excessive hygiene. Paradoxically, it is a fragile wonder weapon that can turn on our own bodies with startling results, leading today to epidemic levels of autoimmune disorders.

Richtel effortlessly guides readers on a scientific detective tale winding from the Black Plague to twentieth-century breakthroughs in vaccination and antibiotics, to the cutting-edge laboratories that are revolutionizing immunology--perhaps the most extraordinary and consequential medical story of our time. The foundation that Richtel builds makes accessible revelations about cancer immunotherapy, the microbiome, and autoimmune treatments that are changing millions of lives. An Elegant Defense also captures in vivid detail how these powerful therapies, along with our behavior and environment, interact with the immune system, often for the good but always on a razor's edge that can throw this remarkable system out of balance.

Drawing on his groundbreaking reporting for the New York Times and based on extensive new interviews with dozens of world-renowned scientists, Matt Richtel has produced a landmark book, equally an investigation into the deepest riddles of survival and a profoundly human tale that is movingly brought to life through the eyes of his four main characters, each of whom illuminates an essential facet of our "elegant defense."

Trade Reviews
Booklist Review
Pulitzer Prize-winning reporter, nonfiction writer, and crime novelist Richtel adroitly mingles cellular biology, scientific history, medical research, and patients' experiences as he explains how the immune system primarily protects our health but is also implicated in cancer, AIDS, and autoimmune disorders (e.g., rheumatoid arthritis, lupus). He explores how the immune system recognizes self and other and how it distinguishes biological partner from biological foe. Richtel's discussion of immunology encompasses T cells and B cells, monoclonal antibodies, inflammation and fever, the human microbiome, and allies of the immune system (vaccines and antibiotics). Four individuals are cast as the faces of either hyperfunctioning or less than optimal immune systems. Jason, the author's friend from childhood, has late stage Hodgkin's lymphoma. Linda and Merredith have autoimmune diseases. Bob is HIV-infected but asymptomatic. The hygiene hypothesis gets hyped with one MD seriously suggesting, You should not only pick your nose, you should eat it (a yucky way perhaps to give your immune system a frequent workout). Ancient and intricate, highly effective and ever vigilant, your immune system is engaged in a perpetual biological balancing act, making trade-offs to keep the peace, to maintain homeostasis, to let the individual live as long as is practical."" Richtel approaches this essential subject with awe, his writing meticulous and empathic.--Tony Miksanek Copyright 2010 Booklist
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