Immunology for Medical Students
Nairn, R., and Helbert, M.; Mosby International, Edinburgh, Scotland, United Kingdom, 2002, 326 pp., ISBN 0-7234-3190-6, £19.99.
Immunology is a topic that is attractive to both science and medical students perhaps because it is so easy to see its relevance to everyday life and health, from one's first polio vaccination to the tragedy of AIDS. To some degree this makes immunology easy to teach (because students that see a subject's relevance are attentive and active students), but we should not forget that immunology is also an immensely complicated topic (as students gradually begin to realize). There is an abundance of immunology books at present aimed at a variety of audiences. This one, with one author (Nairn, a Ph.D.) from Creighton University School of Medicine, Omaha, Nebraska and the other (Helbert, an M.D.) from St. Bartholomew's Hospital in London, United Kingdom, is aimed at medical students. It has many “Boxes” that describe diseases where the immune system plays a part or is malfunctioning that bring the subject to life in a clinical context, but these are not arcane medical descriptions, and they would, I am sure, also be of great interest to science students. There is another attraction too. As the authors say in their Preface, the book is simple, straightforward, and short (well fairly short). As they admit, this of course means that some “details dear to the hearts of some immunologists” are not covered. In addition, the book is colorful and easy to read. Nevertheless, to paraphrase the authors, about 50 years ago the subject was in its infancy: who knows what the next 50 years will bring.
The plan of the book is to divide the subject up into parts covered by four multichapter sections. There are two overview/introductory chapters, and then the four sections are: Antigen-recognition molecules (antibodies, the T cell receptor, and the major histocompatibility complex (MHC)); Physiology (hematopoiesis, lymphocyte development, immunological memory); Innate immunity (complement, phagocytes, and inflammation); and finally, The immune system in health and disease (autoimmunity, hypersensitivity, transplantation, and tumor immunology). The distinction between a medical student's book and a biochemist's is that there are few molecular structures derived from x-ray crystallography but quite a lot of histology and also pictures of patients. So the book would not be suitable for an advanced molecular immunology course, but it would suit almost any other course in immunology. To get an idea of the writing style and flavor, one might start at the end by reading the Transplantation chapter. Most of the chapters, the authors say, contain the information needed for a typical 50-min class or a small group learning session.
The authors have devised a system of icons with related colors to tell you whether this is a “clinical box” (icon of a stethoscope) or a “technical box” (icon of a centrifuge?), and there are also standard symbols for MHC molecules, T cell receptor, and the various cells as well as symbols for “key tissues” (bone marrow, thymus). I thought that this was an interesting idea but was a bit overdone and perhaps not all that useful because you had to remember so many icons. Each short chapter starts with a sort of flow diagram of what it deals with and ends with Learning Points. There are no references of citations to Further Reading (do students ever look these up?) and no questions or problems. However, students can go on to a website www.fleshandbones.com that offers multiple- choice questions, on-line support and revision, and other things (including prizes) and, for instructors, free images and access to other “products.”
I found this to be a good read and learned a lot quickly. The diagrams are very well done, and the Boxes con-stantly make riveting reading (examples: “Molecular genetic engineering: immunotherapy for B cell lymphoma” on the one hand and “Occupational rhinitis,” “Multiple sclerosis,” “Leprosy,” and “Tuberculosis” on the other hand), which relieves the hard slog of trying to understand the complex processes that go on in the immune system. The book is certainly worth considering for any lower level immunology course, not just the medical one. The book is highly recommended.