The Nobel Prize in medicine was announced on Oct. 3, 2011. Following the tradition of the prestigious award, medicine was the first prize announced by the Nobel committee. Ralph Steinmann, Jules Hoffmann and Bruce Beutler have been awarded the Nobel Prize for medicine this year for their roles in defining the pathway of the immune system.

The three scientists’ work regarding the immune system is crucial to developing the study of immunology and may become the basic foundation of vaccine technology to fight infections and cancer. Beutler and Hoffmann found a protein receptor that is the first line for human immunity in recognizing bacteria and other microorganisms. Meanwhile, Steinman’s work showed how important dendritic cells are to adaptive immunity.

Although the award came after Steinman died three days before the Nobel Prize announcement, his invention has brought a clearer pathway for identifying the immune system. Steinmann, one of the founders of the immunotherapy method of fighting cancer, died due to pancreatic cancer. Steinman was diagnosed with pancreatic cancer four years ago, and his life was prolonged by immunotherapy based on his own design using dendritic cells.

Immunology has been a favorite subject for Nobel Prize laureates since 1901, when Von Behring won the Nobel Prize for his achievements in discovering serum therapy, especially for its application against diphtheria. Immunology breakthroughs have garnered 20 Nobel Prizes.

From the time Edward Jenner found the smallpox vaccination in 1798, to when Steinmann found how dendritic cells work on adaptive immunity, there have been huge leaps in understanding the immune system. Each invention, from the 18th century until now, has filled in the puzzle of the immune system, though some pieces are still missing. There are questions as to why the immune system can be so helpful and sometimes can be so destructive to the human body.

The immune system is one of the body’s systems that is very hard to understand. On one side, it can be your friend and on the other side, it can ruin your health. We need our immune systems when there are viral or bacterial infections. When there is an infection, antigen cells will attach to the bacteria and start to invite the lymphocytes or the macrophages to destroy the invading organism.

Yet, right now many diseases are related to the immune system. This condition is called autoimmune disease. Many of these diseases are hard to cure and need lifelong treatment. This long term therapy is not without risks of complications. The therapy can also cause some severe manifestations.

Autoimmune diseases such as systemic lupus erythematosus (SLE) can become a nightmare those who suffer from it. SLE affects almost all the body’s organs including the heart (endocarditis), joints (joint pains), skin (butterfly rash), lungs (pleural effusions), blood vessels, liver, kidneys (lupus nephritis) and nervous system (neuropsychiatric syndrome).

The course of SLE is unpredictable with periods of illness called flares alternating with remissions. Another autoimmune disease is Guillan Barre syndrome. GBS is due to an autoimmune response to foreign antigens that targets the host nerve tissue. The end result is nerve damage leading to muscle paralysis.

Autoimmune diseases decrease patients’ quality of life, and therapy for it is very expensive. Two months ago, there was a story about two children being treated for GBS, Azka and Shafa. Their parents cannot afford treatment for GBS. Autoimmune diseases are complex and thus the treatment is expensive. Sadly, insurance companies cannot cover such autoimmune diseases.

Autoimmunity is the failure of an organism to recognize its own constituent parts, which allows an immune response against its own cells and tissues. Prominent examples include SLE, rheumatoid arthritis, idiopathic thrombocytopenic purpura and allergies. The concept that a body cannot recognize its own cells as part of itself has been known since the beginning of 20th century, when Paul Erlich proposed a hypothesis called horror autotoxicus.

One of the autoimmune hypotheses related to Steinmann’s work is dendritic cell apoptosis. Dendritic cells, as one of the immune system cells, present antigens to other active lymphocytes. Dendritic cells with faulty apoptosis can lead to inappropriate systemic lymphocyte activation and a consequent decline in self tolerance.

Many factors are recognized as being predispositions for autoimmune disease such as environmental factors, genes, sex and infection. There are some diseases more likely in females such as Graves’s disease, SLE and rheumatoid arthritis. Another factor is the environment.

There is a relationship between autoimmune diseases and pollution. According to Ritz the Journal of Medical Hypothesis, in 2009, said that pollution was one of the key factors for the rising occurrence of autoimmune disease. Another factor inducing autoimmune disease is cigarette smoking, which has been a major risk factor for rheumatoid arthritis as well.

There is also a relationship between viral or bacterial infections and autoimmune diseases. In GBS patients, there is a relationship between infection of Campylobacter jejuni and the influenza virus to elicitation of GBS. The supposed mechanism is that the parasite or bacterial infection stimulates the host’s immune response to protect itself.

Immunity is not only about self destruction. By knowing the application of immunology, scientists can discover vaccines that are very important to human life. In 2005, Ian Frazer, a well known scientist from Australia, discovered a vaccine to fight human papillomavirus (HPV) that has been related to cervical cancer.

Immunology is an interesting science, but we still don’t know much about it. If we know more we can understand how to overcome autoimmune diseases.