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book reviews Steroid Hormones and the T-Cell Cytokine Profile
ISBN 3 540 76057 1
edited by G.A.W. Rook and S. Lightman, Springer-Verlag, 1997. £69.50/ $119.00/DM184.00 (xi + 227 pages)
T-cell responses are major players in host defence or protagonists of various diseases including autoimmunity/atopy. Since many of those diseases are not only treated with steroid hormones, but may also be related to defects in endogenous steroid biology, it is evident that the knowledge of how steroid hormones and T cells interact would be of primary interest. In this respect, this book is long overdue. In contrast to the dogma that endogenous cortisol acts to suppress immunity or to restrain the immune system from overreacting, the current concept that has evolved suggests that the physiological cortisol response serves to pre-set and orchestrate immune reactions; this involves suppression, and, possibly even more important, enhancing and directing immune functions. Furthermore, it has become increasingly clear that the actions of endogenous glucocorticoids, in contrast with most synthetic glucocorticoids, are subject to complex and specific mechanisms that regulate their action. These latter aspects have been highly disregarded by most immunologists.
Immunology (8th edn) by D.M. Weir and J. Stewart, Churchill Livingstone, 1995. £17.00 (362 pages) ISBN 0 443 05452 5
When Donald Weir’s little textbook of Immunology first appeared, nearly 30 years
In their book, Rook and Lightman put cortisol, its metabolism and its natural antagonists in the centre of the discussion, providing an example for steroid hormones in general. This is certainly justified inasmuch as cortisol is one, if not the only, essential hormone (director) of a highly complex symphony called host defence. The book starts with some very comprehensive introductory chapters that elegantly review the complex interactions between mediators of inflammation and the hypothalamo– pituitary adrenal axis, which will ultimately lead to the synthesis and release of cortisol from the adrenal cortex, provided an appropriate stimulus is given. A most intriguing section discusses a new concept, comprising tissue specific steroid metabolism and its effect on the dichotomy between T helper 1 (Th1)- and Th2-like responses; the impact of cortisol biology on the development of diseases, including autoimmunity and tuberculosis; and the interaction of cortisol with other steroids or their natural antagonist. The importance of cortisol biology is impressively documented in various disease models as being highly relevant for immunity. However, in taking everything into consideration, the authors are confronted with a problem that scientists often face: how to fit the new data with those obtained by the majority of earlier experimental approaches that often did not reflect physiological conditions or disregarded the growing knowledge on glucocorticoid physiology. Thus, since it is not only a futile but possibly a politically dangerous task to re-evaluate the
existing work, the authors are often left to conform to the unjustified dogma that glucocorticoids are in general immunosuppressive. The struggle to comply with this dogma provides a fascinating battle that will intrigue many readers, not only those familiar with this field. The data presented are sometimes open to interpretations that may appear quite rebellious, despite being closer to the actual physiology. In summary, keeping that last caveat in mind, this book certainly provides enlightenment for all scientists. In general, it raises important questions and shows interesting new perspectives, although these sometimes could have been made clearer and more specific. On one hand it tells a story of how a dogma starts to crumble if one reads between the lines, on the other, it adds not just one, but many pieces to the puzzle of how host defence might be organized – it is up to the reader to play with these pieces. The book should provide very valuable information not only for those in the field but also, and even more importantly, it should attract those from fields ranging from physiology and molecular biology, to immunology and endocrinology, since it might help them to appreciate new challenges, which will open new avenues to target disease.
ago, it had the field largely to itself and was the ‘bible’ for a generation of medical and biology students. Since then, immunology has been transformed by advances in cellular and molecular biology – and there is a much wider range of textbooks in the marketplace. Consequently, the book, now in its 8th edition, seeks to cater for a new generation of students. Has Weir’s book, now co-authored by John Stewart, moved with the times sufficiently for it to remain competitive? The answer is a qualified yes. The book is split into two sections. The first, entitled ‘Basic immunology’, occupies slightly
less than half the book, and is divided into four chapters – an ‘Introduction’, ‘Innate immunity’, ‘Antigens and antigen recognition’, and ‘Acquired immunity’, the last two being much longer than the first two. The second section is entitled ’Immunology in action’, and contains five chapters dealing with infection, immunohaematology, transplantation, cancer, immunopathology and antibody–antigen interactions in laboratory investigations. This last chapter is perhaps symptomatic of the book’s venerable origins; much of it is devoted to detailed descriptions of largely forgotten assays, such
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as optimal proportions and immunoelectrophoresis, yet flow cytometry, a technique that has revolutionized clinical immunology, gets a mere six lines. Other recent developments are also given short shrift elsewhere in the book; there is much on reactive oxygen compounds but very little on reactive nitrogen compounds, and apoptosis is only mentioned in passing – its importance in thymic selection, for example, is not mentioned. It is to be hoped that a ninth edition will appear in which a thorough revamping has taken place, rather then a ‘bolting-on’ of new developments to a classic text. How-
ever, this criticism should not overshadow the fact that other areas, such as mechanisms of antigen processing, have been brought up to date much more comprehensively, with TAP transporters and the CPL vesicle properly described. The treatment of complement is detailed but maintains clarity, as also is the genetics of immunoglobulins and the T-cell receptor. The two-section layout provides a novel way of distinguishing between the nature of immunological mechanisms, and what they can actually do, while at the same time it manages to avoid splitting basic infor-
mation between the two sections. The book is clearly written, well indexed and contains a good number of useful diagrams and tables. Medical and biology students, particularly those with no previous knowledge of immunology, will find it a useful purchase, so long as they are aware that some recent developments get rather cursory treatment. Jeremy H. Brock Dept of Immunology, Western Infirmary, Glasgow, UK G11 6NT.
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