Two key medical concepts, autoimmunity and the self, cloud reasoning and spread confusion.
An autoimmune disease, e.
g., Grave's disease, Myasthenia gravis, or aplastic anemia, arises when the immune response of the body is directed against its own tissues. Here
this view is unacceptable since WOB is optimal
and does not commit suicide. If a phenomenon appears to be self destructive,
we simply do not understand its real
meaning. Indeed, autoimmune
diseases are the most obscure in medicine.
Self and non-self
In order to become autoimmune
and turn immunity against itself the immune system has to distinguish
between its self (auto) and non-self (hetero). These fundamental concepts of immunology are as obscure as the philosopher's
stone of the alchemists. The knowledge of the self is innate, yet
the organism grows and produces new substances (antigens), like milk
casein during lactation, which is regarded as self, otherwise it would
What about our gut flora, which deserves to be recognized as a non-self? Gut bacteria continually cross the mucous membrane into our body by a process called translocation. By this means the immune system samples gut flora antigens, and creates against them antibodies. However, it does not attack them, otherwise we would be sick like when typhoid crosses the mucosa. Think of the herpes virus which slumbers peacefully in the nervous system like other self-cells. Once in a while it is awakened by a slight fever, turns into a non-self and creates blisters. Or, the myriad of provirus sequences in the genome. Are they self or non-self?
These and other examples indicate that the self concept is useless. The immune system may apply other criteria to decide when to attack. Like danger, favored by Polly Matzinger and Ephraim Fuchs (1): "If we forget about self for the moment and step sideways to look at the other side of the equations above, we find it possible to ask a different question, namely "how does the immune system decide whether to respond or not?" I have conjectured that it might respond to danger, not to non-self."
Whenever a cell dies, a dendritic cell becomes activated,
captures normal and viral
antigens from its neighborhood up-regulates MHC molecules, loses Fc
receptors, and travels to the local lymph node, where it presents the
captured antigens to passing T cells.
A T-cell needs two signals to be activated: a normal cell antigen and the antigen
of the invader. If it faces only the first, it dies. In other words,
T-cells recognize antigens
of all cells in the body, and attack only dying cells. This attractive theory is generally ignored, and immunologists
continue preoccupying themselves with the self.
WOB is unaware of danger and cannot sense an incoming death. The sense of danger is an attribute of the mind, which it transmits to WOB. Matzinger's hypothesis ought to be modified slightly. WOB senses only necrosis. The immune system is activated only when a dendritic cell samples two antigens, that of a necrotic cell and of an invade , whereupon WOB activates the process of inflammation.
We ought to distinguish
between immune activation and inflammation. The
immune system continually surveys antigens in the body. When
detecting cell death (necrosis) it removes the debris by local means
(apoptosis). In an extensive necrosis it initiates
inflammation whose task is to clean up dead cells and repair the
damage. Since no foreign antigens are involved,
it will be called sterile
necrosis. Like following a myocardial
infarction, when inflammation removes dead muscle and replaces it with
a scar. Or following ovulation when the empty follicle gradually dies
In a non sterile necrosis, activated T-cells kill the cell and its invader, whereupon inflammation is initiated. By themselves T-cells or the immune system, do not initiate inflammation. Necrosis initiates it. Translocated bacteria activate T-cells only when causing necrosis, like in typhoid. By themselves T-cells or the immune system do not initiate destructive autoimmunity.
According to medicine, a tumor arises during a random error (mutation) of the genome. From its very beginning the tumor belongs to the realm of the non-self, and yet the immune system does not attack it. According to the theory of Immunological Surveillance by F.M.Burnet, immune system continually eliminates mutated cells, yet some succeed to sneak through its surveillance and cause cancer. Two errors cause cancer, an error in the genome and one in immunological surveillance, which we cannot accept. WOB does not err only theories do.
Matzinger has yet a different view: "A newly arising tumor cell may express antigens not expressed by its normal tissue mates, but this is not enough to alert the immune system. There is no intrinsic difference between a rapidly dividing tumor cell and a rapidly dividing hematopoietic cell". . . "Consequently, as it grows, any tumor unable to deliver signal-Two should induce deletion of tumor specific T cells". (1) Instead of concluding that immune system does not regard tumor as a threat, Matzinger proposes means to convince dendritic cells to deliver signal -Two and "convince" T-cells that the tumor is dangerous.
Hitherto all attempts to immunize the host against his tumor have failed. Nevertheless, immunologists conduct clinical trials in which this flawed reasoning is applied to patients which endure painful treatments. Tumor immunization fails even in laboratory animals with genuine tumors. Nevertheless scientists rush to immunize patients. Since host cannot be immunized against his tumor they conjured up the tumor associated antigen, against which patients are immunized. Since this antigen is tissue specific and not tumor specific antibodies actually harm the tissue itself.
Medicine ought to realize that the tumor is part of the self. It proceeds through two phases: Compensation and decompensation.. During the first it causes no harm. During decompensation it impinges upon other processes. The expanding tumor compresses capillaries and deprives the tissue from its blood supply. This is when cancer requires treatment.