When we think of the immune system, we picture a blood test: WBCs, lymphocyte percentages. Mechanistic immunology reminds us that ๐˜ช๐˜ฎ๐˜ฎ๐˜ถ๐˜ฏ๐˜ช๐˜ต๐˜บ ๐˜ช๐˜ด ๐˜ฏ๐˜ฐ๐˜ต ๐˜ซ๐˜ถ๐˜ด๐˜ต ๐˜ฃ๐˜ญ๐˜ฐ๐˜ฐ๐˜ฅ; it is a body-wide cellular network embedded in specialized organs and tissues. 

๐—ฃ๐—ฟ๐—ถ๐—บ๐—ฎ๐—ฟ๐˜†ย ๐—น๐˜†๐—บ๐—ฝ๐—ต๐—ผ๐—ถ๐—ฑย ๐—ผ๐—ฟ๐—ด๐—ฎ๐—ป๐˜€ย (๐—ฏ๐—ผ๐—ป๐—ฒย ๐—บ๐—ฎ๐—ฟ๐—ฟ๐—ผ๐˜„,ย ๐˜๐—ต๐˜†๐—บ๐˜‚๐˜€) are where immune cells are generated. Bone marrow produces HSC. In the thymus, immature T cells undergo positive and negativeย selectionย – recognition of self-MHC butย eliminatingย dangerous autoreactive clones [1]. Without it, adaptive immunity would collapse into autoimmunity.

๐—ฆ๐—ฒ๐—ฐ๐—ผ๐—ป๐—ฑ๐—ฎ๐—ฟ๐˜† ๐—น๐˜†๐—บ๐—ฝ๐—ต๐—ผ๐—ถ๐—ฑ ๐—ผ๐—ฟ๐—ด๐—ฎ๐—ป๐˜€ (๐—น๐˜†๐—บ๐—ฝ๐—ต ๐—ป๐—ผ๐—ฑ๐—ฒ๐˜€, ๐˜€๐—ฝ๐—น๐—ฒ๐—ฒ๐—ป, ๐—ฃ๐—ฒ๐˜†๐—ฒ๐—ฟโ€™๐˜€ ๐—ฝ๐—ฎ๐˜๐—ฐ๐—ต๐—ฒ๐˜€) are command centers where adaptive responses are orchestrated. Antigen-presenting cells bring signals from peripheral tissues, where naรฏve lymphocytes are activated, clonally expanded, and differentiated into effectors. The spleen, is indispensable for filtering blood-borne antigens and generating systemic antibody responses [2]. 

Immune system is different when compared to any other body organ-system. Cardiovascular system – the heart and blood vessels. The immune system, in contrast, is ๐˜ฅ๐˜ฆ๐˜ง๐˜ช๐˜ฏ๐˜ฆ๐˜ฅ ๐˜ฃ๐˜บ ๐˜ค๐˜ฆ๐˜ญ๐˜ญ๐˜ด ๐˜ช๐˜ฏ ๐˜ฎ๐˜ฐ๐˜ต๐˜ช๐˜ฐ๐˜ฏ – T and B lymphocytes, macrophages, dendritic cells – circulating through blood, lymph, and tissues. 

This is why basic research goes beyond blood draws. In ๐˜ฎ๐˜ฐ๐˜ถ๐˜ด๐˜ฆ ๐˜ช๐˜ฎ๐˜ฎ๐˜ถ๐˜ฏ๐˜ฐ๐˜ญ๐˜ฐ๐˜จ๐˜บ, ๐˜ธ๐˜ฆ ๐˜ณ๐˜ฐ๐˜ถ๐˜ต๐˜ช๐˜ฏ๐˜ฆ๐˜ญ๐˜บ ๐˜ช๐˜ด๐˜ฐ๐˜ญ๐˜ข๐˜ต๐˜ฆ ๐˜ด๐˜ฑ๐˜ญ๐˜ฆ๐˜ฏ๐˜ฐ๐˜ค๐˜บ๐˜ต๐˜ฆ๐˜ด ๐˜ข๐˜ฏ๐˜ฅ ๐˜ต๐˜ฉ๐˜บ๐˜ฎ๐˜ฐ๐˜ค๐˜บ๐˜ต๐˜ฆ๐˜ด ๐˜ต๐˜ฐ ๐˜ค๐˜ข๐˜ฑ๐˜ต๐˜ถ๐˜ณ๐˜ฆ ๐˜ต๐˜ฉ๐˜ฆ ๐˜ช๐˜ฎ๐˜ฎ๐˜ถ๐˜ฏ๐˜ฆ ๐˜ณ๐˜ฆ๐˜ด๐˜ฑ๐˜ฐ๐˜ฏ๐˜ด๐˜ฆ๐˜ด. Blood is the visible tip of a deeper network. 

Hereโ€™s ๐˜๐—ต๐—ฒ ๐˜„๐—ผ๐—ป๐—ฑ๐—ฒ๐—ฟ: 

Some individualsย ๐—น๐—ถ๐˜ƒ๐—ฒย ๐˜„๐—ถ๐˜๐—ตย ๐—ฐ๐—ต๐—ฟ๐—ผ๐—ป๐—ถ๐—ฐ๐—ฎ๐—น๐—น๐˜†ย ๐—น๐—ผ๐˜„ย ๐—น๐˜†๐—บ๐—ฝ๐—ต๐—ผ๐—ฐ๐˜†๐˜๐—ฒย ๐—ฐ๐—ผ๐˜‚๐—ป๐˜๐˜€,ย ๐˜†๐—ฒ๐˜ย ๐—ฑ๐—ผย ๐—ป๐—ผ๐˜ย ๐—ฒ๐˜…๐—ฝ๐—ฒ๐—ฟ๐—ถ๐—ฒ๐—ป๐—ฐ๐—ฒย ๐—ต๐—ถ๐—ด๐—ตย ๐—ถ๐—ป๐—ณ๐—ฒ๐—ฐ๐˜๐—ถ๐—ผ๐—ปย ๐—ฟ๐—ฎ๐˜๐—ฒ๐˜€,ย ๐—ฐ๐—ต๐—ฟ๐—ผ๐—ป๐—ถ๐—ฐย ๐—ถ๐—ป๐—ณ๐—น๐—ฎ๐—บ๐—บ๐—ฎ๐˜๐—ถ๐—ผ๐—ป,ย ๐—ผ๐—ฟย ๐—ฎ๐˜‚๐˜๐—ผ๐—ถ๐—บ๐—บ๐˜‚๐—ป๐—ถ๐˜๐˜†.ย Howย canย thatย be?ย 

This paradox highlights that blood counts are not the ideal representative of human health state for immune competence. This is why hardly any blood test is the wonder diagnostic product (e.g. infamous Theranos blood kit). 

I๐˜ฎ๐˜ฎ๐˜ถ๐˜ฏ๐˜ช๐˜ต๐˜บย ๐˜ช๐˜ดย ๐˜ฏ๐˜ฐ๐˜ตย ๐˜ขย ๐˜ฏ๐˜ถ๐˜ฎ๐˜ฃ๐˜ฆ๐˜ณย ๐˜ช๐˜ฏย ๐˜ขย ๐˜ฃ๐˜ญ๐˜ฐ๐˜ฐ๐˜ฅย ๐˜ต๐˜ฆ๐˜ด๐˜ต,ย ๐˜ฃ๐˜ถ๐˜ตย ๐˜ขย ๐˜ธ๐˜ฉ๐˜ฐ๐˜ญ๐˜ฆ ๐˜ฃ๐˜ฐ๐˜ฅ๐˜บย ๐˜ค๐˜ฆ๐˜ญ๐˜ญ๐˜ถ๐˜ญ๐˜ข๐˜ณย ๐˜ด๐˜บ๐˜ด๐˜ต๐˜ฆ๐˜ฎย ๐˜ด๐˜ถ๐˜ด๐˜ต๐˜ข๐˜ช๐˜ฏ๐˜ฆ๐˜ฅย ๐˜ฃ๐˜บย ๐˜ด๐˜ฑ๐˜ฆ๐˜ค๐˜ช๐˜ข๐˜ญ๐˜ช๐˜ป๐˜ฆ๐˜ฅย ๐˜ฐ๐˜ณ๐˜จ๐˜ข๐˜ฏ๐˜ดย ๐˜ข๐˜ฏ๐˜ฅย ๐˜ฅ๐˜บ๐˜ฏ๐˜ข๐˜ฎ๐˜ช๐˜คย ๐˜ค๐˜ช๐˜ณ๐˜ค๐˜ถ๐˜ญ๐˜ข๐˜ต๐˜ช๐˜ฐ๐˜ฏ. [3,4]ย 

Stay tuned for ๐——๐—ฎ๐˜† ๐Ÿฏ: ๐—œ๐—ป๐—ป๐—ฎ๐˜๐—ฒ ๐˜ƒ๐˜€. ๐—ฎ๐—ฑ๐—ฎ๐—ฝ๐˜๐—ถ๐˜ƒ๐—ฒ ๐—ถ๐—บ๐—บ๐˜‚๐—ป๐—ถ๐˜๐˜† 

ย Referencesย 

1. https://pubmed.ncbi.nlm.nih.gov/12414722/ 

2. https://www.cell.com/action/showPdf?pii=S1074-7613%2813%2900470-6 

3. Janewayโ€™s Immunobiology, 9th Ed. 

4. Abbas & Lichtman, Cellular and Molecular Immunology, 10th Ed. 

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