“We are huge walking pieces of meat”: an interview with biologist Maria Kondratova

The book The Invisible Guardian. How immunity protects us from external and internal threats ”Maria Kondratova we called one of the best in 2022. It is dedicated to the work of our immunity and is written lightly and with humor.

We decided to personally meet with the author and ask some pressing questions. The main one is how to improve your own immunity? Spoiler: none. And that's why.

About the book

How did you get the idea to write a book about immunity? Why do you think this is a hot topic?

— When I dive deep enough into a topic, I want to share my knowledge with people. For example, my previous book was about cancer, because I worked for 6 years at the Curie Institute, where this disease is being researched.

Then I wrote for the Biomolecule portal. I think this is one of the best media in molecular biology. Pavel Podkosov, general director of the Alpina Non-Fiction Publishing House, came there and asked if any of the authors would like to publish. I liked this idea, and I offered to write a book about cancer.

After she left, we decided to continue cooperation. And the next job was book on immunity. One of my inspirations was COVID‑19.

When the epidemic began, the wildest ignorance of people in everything related to vaccines and the immune response was revealed. This prompted me to structure the material on immunity and collect more information about aspects that were less known to me.

In fact, a terrible year and a half or two very powerfully pushed immunological science forward.

Since people got scared, a lot of money was allocated for research, many scientists got involved in scientific projects related to COVID‑19. A lot of things have been discovered with which we still have to work and work. Misfortune is the engine of progress.

— Where do you work now? What are your responsibilities?

“Now I work for a commercial firm. We fulfill orders from pharmaceutical and biotechnology companies: we search for and analyze scientific information with an eye to how it will help create or improve a product.

— During your work, did you have an insight related to human health that struck you?

- Let's be clear: I'm not an experimenter and never have been. Always, from the very beginning of my scientific career, I have worked in theoretical biology. Therefore, I deal with other people's insights.

This is the tragic side of theoretical biology. Experimenters should check guesses. And they often have their own hypotheses that they would like to confirm or disprove.

But still we had some interesting guesses. One of them is associated with the peculiarities of the activation of immunity during the period when a person has cancer. This has not been observed before. I hope that someone will test our theory.

About Immunity

Could you describe in simple terms what immunity is?

- What will happen to food if it is left not in the refrigerator, but in a warm, unprotected place? Microbes and fungi will instantly start up on it.

It's the same with us. From the point of view of practical biology, we are huge walking pieces of meat. But we have immunity - the defense system of our body, thanks to which we "do not deteriorate."

Is it true that individual organs and systems of the body have their own immune mini-systems? That is, the immune system of the whole organism is not homogeneous?

— Yes, definitely. Macrophages - the main cells of innate immunity - are divided into two groups. The first includes monocytes that circulate with the bloodstream and come to the infected inflamed organs as needed.

In the second - resident macrophages, or police officers on the ground. They are always located in the same organ - lungs, liver, skin - and do not leave their place of deployment, exercising constant control over the state of local immunity. When needed, they send signals to other macrophages in the blood to call for help.

Therefore, it is better to catch the infection in the early stages - before it spreads and gives a signal that mobilizes the entire immune system of the body.

Is it true that the human brain has practically no immunity of its own?

- Fine brain sterile, as it is maximally isolated from everything else. The blood-brain barrier does not let in not only viruses and bacteria, but also some substances. Only glucose and a few other simple molecules can enter the brain.

Therefore, normally there are few immune cells. Of course, sometimes this system is disturbed and inflammatory processes still occur. For example, when immune cells invade the brain, they develop a standard pattern of immune response that, unfortunately, leads to damage to brain tissue and cancer.

That is, the idea of ​​protecting the brain is to prevent the infection by stopping it at the distant approaches.

— The full title of your book is How Immunity Protects Us from External and Internal Threats. What kind of threats are you talking about? Could you briefly describe how he protects us?

- Our main internal enemy is the malignant formation of cells. The immune system can detect them and destroy them before they have accumulated a large number of mutations and become cancerous.

External enemies are viruses, bacteria, fungi, parasitic worms.

- If a person is often sick, does he have a weak immune system?

- No. If a person is often sick, this rather indicates the peculiarities of his life - that he constantly communicates with people and encounters new varieties of viruses and bacteria.

If we are talking about infectious diseases, then basically people get infected from people. The likelihood of coming down with the flu depends on the number of contacts.

If a person travels, he encounters viruses and bacteria from other regions to which he has no immunity. In this case, getting sick is completely normal.

It is impossible to compare the incidence of a traveler and a person who lives all his life in the same city, in the same microbial environment.

More important is not how often a person gets sick, but how his illness proceeds.

If we talk about respiratory infections, then when a person coughs and snotty for a week or two - this is good immunity. If a viral or bacterial infection quickly goes deep into the body and leads to inflammation of the lungs, it probably has problems with the immune system. If any wound begins to fester and does not heal for months, this may also indicate problems with it.

- Can problems with immunity not manifest themselves clearly?

- Any serious deficiency in the immune system immediately catches the eye. For example, immunoglobulins M and J are critical. If they are not produced, it is very bad.

And there are rare immunoglobulins that one in a few hundred people produce in very small quantities. However, this is not noticeable. Yes, such people are a little more likely to get colds, but this does not make any big contribution to their health.

- How do people determine the quality of their immune system? Is it possible to take an analysis to determine the immune status?

- Question: why? What will you do if you find out that something is wrong with the immune system? Here it is worth moving smoothly to another point - is it possible to do something with your immune system? Answer: practically not.

Serious chronic problems with immunity are visible, they are hard to miss. For example, in people who undergo chemotherapy, the immune system suffers greatly. At some point, they become completely defenseless. All we can do is isolate them completely. Settle in the most disinfected wards for several months until their immune system is restored.

If you're thinking, "I've had five colds this year instead of the usual three. Probably, my immunity has fallen, ”then, most likely, this is just your suspiciousness.

Find any collection of healthy lifestyle tips and try to stick to them: eat well, eat well, engage in physical activity, be strong sleep. Beyond that, you can't do anything.

The only thing I can advise is sometimes to take a general blood test. In a sense, this is an immunity test. It gives an idea of ​​whether you have enough leukocytes in your blood and in what quantity they are present.

Yes, there are more subtle methods, but they should be resorted to if there are any serious symptoms, the causes of which cannot be established.

- One gets the impression that damage to the immune system is very dangerous, since medicine is practically powerless.

- Damage to the immune system is really dangerous, but it is very rare. Throughout evolution, people with weak immunity died in early childhood, leaving no offspring. Therefore, getting a severe immune disease by inheritance is unlikely.

Yes, in one case in several hundred thousand children are born with congenital problems with immunity. But most often it is seen in infancy.

If you have lived to adulthood and have been feeling fine most of the time, then most likely you do not have serious problems with the immune system.

In this case, it is not necessary to isolate yourself from civilization, except in special situations. Quite the contrary: there is speculation that the modern outbreak of autoimmune diseases and the rise of allergies are due to the fact that our lifestyle has become too sterile.

Immunity, which is trained to fight without encountering real threats, begins to invent them from scratch.

By the way, the first description of allergies refers to the English aristocracy - a hygienically concerned class, whose people constantly bathed and kept their children clean. It was they who began to develop allergies in large numbers. The same hay fever - a runny nose caused by pollen - has long been considered a sign of blue blood.

And then everyone who had access to bathrooms, showers, laundry and ironing. And suddenly it turned out that there was nothing aristocratic in this disease. The children of commoners, who grew up in a sterile environment, also became more likely to get sick with allergies and autoimmune diseases.

Do not overdo it with hygiene, unless there are very good reasons for it, such as severe damage to the immune system caused by chemotherapy, bone marrow transplantation, and so on.

The only exception is travel to distant countries. It’s better to rest a thousand times there, wash your hands several times, drink only bottled water, and so on.

Evolutionarily, our immunity is sharpened to fight microbes. But our resilience is largely determined by the experience of the first days of life in a certain environment.

When we find ourselves in a space different from ours, we encounter completely different microbes, bacteria and viruses. A visitor can become seriously ill due to something that the local population does not react to in any way.

For example, about India: I know several cases when people, even observing hygiene rules, fell very seriously ill and miraculously escaped.

Is it true that the quality of immunity changes with age?

- This is true. thymuswhich is responsible for maturation T cells reaches its maximum size teenagers, and then begins to shrink in size. In older people, it almost does not function. Therefore, immunity with age really weakens.

However, there is good news: moderate regular exercise can slow down this process. Older people who play sports have a “younger” immune system than their peers who lead a sedentary lifestyle. We cannot stop this process, but we can significantly slow it down.

- Let's summarize what the quality of immunity depends on.

- Yes, they play an important role here:

• genetics,
• experience of the first days of life,
• Lifestyle.

On the future of immunity and immunology

— Could you tell us about the history of immunology? How have the views of scientists changed over time?

Immunology is a very young science. Because of this, it is difficult to talk about how it has changed. It all started with Mechnikov, who watched phagocytosis and believed that the main ability of immune cells is that they simply devour bacteria. Then it turned out that in addition to this property, there are others that are more interesting.

In the second half of the 20th century, the mechanisms of molecular analysis and molecular genetics appeared, as well as the ability to isolate individual molecules and analyze their properties. Before that, it was only a system of observations at the level of the organism.

Later discoveries described the nature of those phenomena that were observed earlier. But it cannot be said that our views in this area have somehow changed dramatically.

— What inventions and discoveries in the field of immunology should be expected?

Predicting is a thankless task, but I'll try. First, I hope we can make some progress in maintaining immunity in old age. There is progress in this direction.

Secondly, like all people working in oncoimmunology, I hope that new therapies will help to fight cancer more actively. I think there is potential in this area.

- Do you think that in the future the immunity of people will be more likely to be stronger or weaker?

“Unfortunately, I think that it will only get weaker if we don’t learn how to intervene in this process directly, for example, by genetic editing methods.

In modern civilization, the action of natural selection is greatly weakened.

People with low immunity, thanks to medical care, leave offspring. Accordingly, the chances of inheriting weak immunity increase.

When I lectured, I said: “If you are thinking about a career in medicine, choose immunology. In the coming decades, this will be a very popular specialty.”

- If we do not take into account fantastic stories like genetic editing, how to increase the immunity of ordinary people?

— We can do almost nothing for ourselves, but we can improve the immunity of our children during pregnancy and in their first years of life.

During pregnancy, a healthy diet is important, from which the mother will receive enough vitamins. She must take care of herself so that the fetus is formed in the most successful conditions.

Another simple method is breastfeeding. This is the natural way in which the child "gets immunity".

Moderate hygiene in the early years is also important so that the child has a minimal risk of autoimmune diseases and allergies.

Finally, self-medication should be avoided. antibioticsespecially in the first days of life. Such interference leads to a disruption of the natural microbiome, which plays an important role in setting up primary immunity. Antibiotics should be taken only when necessary and under the supervision of a doctor, and not "just in case", as is customary in our country.

Should we change our attitude towards vaccines?

Vaccines are what help fight viral and bacterial infections. Here, in terms of immunity, there are two options: when you encounter an infection in the first place and when you meet with it in subsequent times.

In the second case, your immune system is already trained to quickly recognize the enemy, and the disease either does not develop at all or passes in a mild form. The problem is how to survive the first encounter with the infection. It can be very severe, with many side effects, even death.

Therefore, in order to train the immune system in advance to recognize the enemy, we vaccinate. It makes sense to do this against potentially dangerous diseases with severe side effects or death. For example, it was thanks to vaccination that we defeated smallpox and diphtheria.