Before reading this chapter please start with chapters:
First Concepts.
WOB is Optimal

Two key medical concepts, autoimmunity and the self,  cloud reasoning and spread confusion.

Autoimmune disease

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 be destroyed.

Gut flora

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?

Dendritic cell

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 (atresia).

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.

Patient suffering

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.


Polly Matzinger  THE REAL FUNCTION OF THE IMMUNE SYSTEM or  TOLERANCE AND THE FOUR D's (danger, death, destruction and distress)