A Conversation on Immunity

Over the last few decades, our knowledge surrounding human health and disease has advanced significantly, changing the landscape of modern medicine and our understanding of what it means to be “well”.

当全球范围内实施了许多锁定时，共同199的大流行迫使日常工作突然停止。当人类面临空旷的日记和常见的孤独时，有机会反思通常占据日常生活的习惯和活动。再加上外部叙述，关于保持健康以保护自己免受SARS-COV-2病毒的重要性，对于许多人来说，这种经历促使“自我护理”的新优先级 - 找到新的方法来照顾我们的身体和我们的身体头脑。

The pandemic occurred at an interesting time for the healthcare system and medical establishment more generally. Global life expectancy hasincreased根据该报告的最新报告，从2000年的67。2年到2019年的73.5岁Global Burden of Diseases。尽管我们可能寿命更长，但人类面临着不断增长的挑战，例如慢性疾病的负担和心理健康危机。因此，现代医学已开始将重点从治疗疾病当作疾病，预防疾病或维持“健康”转变。

加上越来越多的健康行业的牵引力 -now estimated to be worth $4.5 trillion- 进入方程式，可以说，现在，人类从未对我们的健康投入如此投入。或更具体地说，健康的有形方面 - 我们可以控制预防疾病的因素。

保持健康的一个关键组成部分是免疫系统的正确功能，即保护我们身体免受异物物质的复杂网络和相互作用的复杂网络。近几十年来，由科学家在免疫学领域发表的研究表明，免疫系统的失调与疾病发展之间的直接联系。过度的免疫反应会导致克罗恩病或哮喘等疾病。免疫系统无法区分外国和“自我”细胞（例如类风湿关节炎）的自身免疫性疾病可主要影响生活质量。现在，免疫系统甚至被认为是主要贡献者在阿尔茨海默氏病的病理学中，一些研究探讨了病毒感染对发展的影响精神病症状。

每天都有关于我们可以做什么来维持健康的免疫系统的不断增长的信息。此类信息的来源各不相同，从学术期刊，播客，博客到社交媒体。随着声称“增强”或“黑客”免疫系统的产品的营销，很难削减噪音并破译科学证据支持的内容以及错误的信息。

Dr. Jenna Macciochi是苏塞克斯大学免疫学讲师，她的研究中心了解营养和生活方式在人类免疫中的作用。除了她的学术生涯外，Macciochi博士还是一位知名作家。她的第一本书，Immunity: The Science of Staying Well于2020年出版，第二本书Your Blueprint for Strong Immunity于今年早些时候出版。Macciochi博士的写作和学术研究总的来说，旨在“将记录保持直截了当”，这是对人类健康和免疫力的基础的科学，使此信息可访问和可行。

在本月的专题文章中捷克葡萄牙直播与Macciochi博士坐下来问：我们该怎么能真的stay well? What has immunological research taught us about the effects of modern lifestyle on our bodies and what are some of the latest breakthroughs in this field?

莫莉·坎贝尔（MC）：您为什么对免疫学如此感兴趣，这是如何发展为您当前的研究重点的？

Jenna Macciochi (JM):I was very interested in in health and disease as a child. I grew up on a farm, and my mum worked in food in catering, so there was always a big emphasis on how illness can be prevented at the dinner table. We cooked from scratch and grew a lot of our food ourselves. Living on a farm allows you see the circle of life, and I think I became very preoccupied as a child in understanding what made people stay well, and why some people got sick.

我去了格拉斯哥大学，那里有很棒的讲师，我发现他们非常鼓舞人心，该研究所在医学院内有一个很小的免疫学计划，这意味着您必须非常了解您的同伙。我们有一群很棒的学者教我们，我终于得到了我对健康和疾病的问题的一些答案。从那里，我迷上了。

I love how the immune system weaves into every aspect of our body in health and disease; it’s not just about protection against infection, or how to develop vaccines, but there are other components such as allergies, autoimmune diseases or cancer, the gut microbiome, etc.

在20多岁的时候，我第一次打了倦怠。我意识到我对免疫系统以及如何保持健康有所有这些知识，但是我并没有将其应用于自己的生活。那时，我真正开始遵循围绕饮食，生活方式和我们触手可及的有形事物的兴趣，以帮助我们保持健康。从那里开始，我想让我们所有人都可以访问和行动，因为我认为知道什么能使我们变得良好并应用它之间存在很大的脱节。

MC：考虑到人类生活和社会的景观，为什么免疫学会这样一个有趣的研究领域？

JM：免疫学branched off from an older line of science – microbiology. This is a research field that emerged when we first discovered microbes, tiny organisms that we can’t see but that can cause us to get sick. Prior to that, many sicknesses were attributed to miasma, or “bad air”; we didn’t have the tools to visualize microbes, so we couldn’t see them or analyze them. When those tools became available, we could finally see and study microbes. As a result, microbiology was founded.

后来，我们意识到有些人缺少其免疫系统的一部分，因此微生物可以接管并使人们更加生病，或者更频繁地生病。那时该领域开始发现白细胞（我们的免疫细胞），从那里开始，免疫学成为其自身的学科。

As a field, immunology is therefore relatively new. We’re discovering more and more, all the time – it evolves rapidly. In 2018, the Nobel Prize in Physiology and Medicine was awarded to詹姆斯·艾莉森（James Allison）和塔苏克·霍霍（Tasuku Honjo）for their discovery of cancer immunotherapy. Twenty years ago, the idea that the immune system could be involved in cancer, and the concept of weaponizing that same system to treat cancer, would not have been on anybody’s radar.

现在，我们有有关临床抑郁症患者和其他心理健康问题的免疫系统出现问题的数据。如果我们可以上游修复其免疫系统中发生的事情，我们可以解决它们所经历的一些抑郁症状。对我来说，这是令人震惊的。没有记录在某种程度上涉及免疫系统的单一疾病，我认为这在公共卫生中具有很大的潜力以及我们在当今世界受到挑战的许多疾病风险。

MC：您能确定您认为有助于免疫学研究领域蓬勃发展的关键突破吗？

JM：The cancer immunotherapy breakthrough is incredible. In addition, the discovery of how we are all immunologically unique is fascinating – the genes that differ most between us are those attributed to different aspects of the immune system.Susumu Tonegawawon the 1987 Nobel Prize for his research exploring the genes that recombine in a unique way to make each of our individual antibodies and receptors for T cells. Even though we have a specific amount of DNA in our cells, we can make a limitless number of different antibodies and T cell receptors. Before, nobody could really figure out why that was. It is a finding that is especially relevant today when we look at how different individuals respond to SARS-CoV-2 infection. There is so much clinical variability, not just in COVID-19, but in other infectious diseases too.

在我看来，免疫系统与心理健康之间的联系是另一个突破。精神健康不良是一个日益严重的问题，其身体方面越来越清楚。将免疫学和心理健康研究融合在一起对于应对治疗心理健康状况时面临的挑战非常有用。

我们也不能忽略这样一个事实，即疫苗实际上正在对病原体和该空间中发生的发展进行训练。当第一次疫苗推出时，我们从地球的表面消除了天花。我们生活在可能杀死了我们的祖父母或曾祖父母的病原体中，我们对他们有防御能力。疫苗确实改变了公共卫生的面貌。

MC: Could you talk about the research methods that are adopted in immunology – how do we study the immune system?

JM：很难研究免疫系统，这阻碍了该领域的很多进展。我们的白细胞不仅在血液中发现。它们存在于整个身体上，因此，如果您从一个人那里拿出血液样本，您将不承诺整体上的整个免疫系统正在做什么。白细胞将聚集在人体的障碍物上 - 我们最有可能接触病原体或毒素 - 例如口腔，空气方法，消化道，皮肤下方。当然，您不一定要从身体的所有这些不同部位获得活检，以找出免疫系统在该特定位置所做的事情。

许多免疫学研究实验室将使用动物模型系统。这提供了研究完整的哺乳动物并查看整个免疫系统的机会。但是，当您考虑物种差异时，当然也有限制，并且在研究免疫系统的同时，您仍然无法从身体的特定位置获得样品in vivo.

MC：我们该怎么做才能帮助我们的免疫系统并更普遍地改善健康？

JM：这是我们所有人都意识到全球大流行状况的事情。我喜欢“固定屋顶的时间是阳光照耀的时候”。当他们生病时，许多人会来找我，并问：“我如何变得更好？”您的免疫系统所需的两件事是时间和精力。您的身体可能需要五天的时间才能产生与病原体作斗争所需的高度特异性抗体。休息使您的能源资源可以针对此过程。许多人不想听到这一点。他们想知道他们可以采用哪些维生素和矿物质来重新恢复康复之路。

我认为这可以反映现代世界。时间确实是任何康复过程中的重要因素。免疫反应在精力上是昂贵的。发烧时，基础代谢率可能会上升10-15％。

我们想将饮食和生活方式视为预防措施。您如何进入感染过程将有望确定您的身体应对和反应如何摆脱这种感染。

当我们看饮食，我们的睡眠程度以及每天移动多少身体时，这些都是有形的，我们可以控制。重要的是要探索我们如何“撞到一个或两个档次”，而不是做出巨大的改变并重新设计我们的生活 - 这只是保持一致的障碍。最终，一致性是我们的目标。

MC:有太多的“健康神话”和错误的信息流传。您是否想“保持唱片直截了当”的健康神话例子？

JM：The first one is around “boosting” your immune system. There is no scientific way in which we can do that. When your immune system is “switched on”, it makes you feel quite lousy. When you have a fever or a flu and you feel unwell, that’s because of inflammation in your body that occurs as part of your immune response to make your body hostile for pathogens. It can result in collateral damage on your own tissue, so we only want it to happen in a short-term, controlled way. Half of your immune system is therefore designed to turn this mechanism off when we don’t need it. It’s therefore not that you want to “boost” your immune system, but rather, you want it to be balanced.

禁食及其对免疫系统的影响（例如“重置”）也存在很多错误信息。实际上，那些可能会从“免疫系统重置”中受益的人无法在长时间内安全地安全。

We hear a lot about how we need to be eating “superfoods” to be well. In fact, we need to look at our dietary patterns holistically, not through a reductionist lens whereby one or two nutrients or fruits will satisfy our bodies and provide the nutrition that we need.

MC：您认为社会知道什么构成健康的生活方式，以及我们如何照顾自己？这是否受到全球大流行的影响或影响？

JM：I think, unfortunately, we’ve lost touch with that.

We have concepts such as green prescribing happening in the United Kingdom, where an increasing number of GPs prescribe going outside for a walk, in nature. It really makes me think – when did we get to a point where we had to be told to do something as simple as that as part of our holistic health care?

有时，我们从食物中去除天然存在的纤维，这对我们的肠道微生物非常重要 - 然后添加合成纤维。或者，我们用饮料或奶昔代替宣传为“健康”的奶昔，但比煮饭更昂贵，营养浓度更低。

The aggressive marketing of food that is advertised as “healthy” because it contains one or two ingredients that are loosely linked to our well-being is problematic. It has gotten people really confused, and almost pathologized the feeling of being full after a meal, so many people now snack throughout the day rather than eating balanced meals.

Many of us also sit at a computer all day and then believe that we can undo this by spending a short amount of time at the gym. In fact, research tells us that we must break up sedentary time in addition to doing physical activity that increases our heart rate. We narrow down human movement requirements to these contrived pockets of time that we spend at the gym, but we need to think more about how we can move throughout the day and in lots of different ways.

总的来说，我们在一个奇怪的地方。当我与父母一代人交谈时，这对我来说变得非常清楚。他们常常没有与基本面失去联系。他们在家里做饭，他们知道他们必须在饮食中得到水果和蔬菜，但是可以吃点零食。他们与食物和运动有着良好的关系 - 从长远来看，我们的免疫系统需要保持良好状态的所有投入。不幸的是，许多年轻一代已经不再存在了，对我们的免疫系统产生负面影响的行为已成为“规范”。这意味着您必须非常努力地与之抗衡，并养成可能被认为是“不寻常”的习惯才能保持健康。

MC: Could you talk about some of the key challenges that you encounter in your work? How do you envision overcoming them?

JM：There are quite a lot of challenges when measuring your immune system comprehensively. A lot of immunology research involves piecing together different tests modalities to create what I call an “immunobiography”. Your immune system is a product of your life in many ways, and how your life shifts and evolves over time, so we rely a lot on patient narratives and work to fit these different pieces together, which can be challenging.

I also think that we need to look at improving microbiome testing so that it can become more useful. The microbiome is a huge aspect of immunology research. Right now, we can look at stool samples and gauge an idea of what’s going on in the body, almost like a snapshot. But we are limited in how much that actually tells us and informs us about an individual’s health in a preventative way, rather than just reaching the stage of testing when intervention is required. I think tools that are evolving, such as machine learning and the ability to analyze large data sets, will collectively allow us to dive deeper and unpick more.

MC：您认为，健康行业对我们对健康和疾病的理解有何影响？

JM：我认为，在某些方面，健康行业可能会有益，因为它鼓励健康的行为成为许多人的生活方式。它可以鼓励新的活动和爱好，并培养友谊团体和社区。赌欧洲杯赔率

但是，它还可以鼓励人们在这种情况下感到自己无法享受生活的某些方面，因为这与健康行业的处方相吻合。一个例子可能是和朋友一起吃披萨。有些人可能会选择避免这种经历，因为他们认为披萨对他们来说是可怕的。但是，与您的朋友在一起，社交和活动本身可能对您来说非常有利。

我认为该行业的营销方面存在一个巨大的问题，该方面鼓励人们购买产品并驱动消费主义，并可能对环境产生不利影响。它还可以将个人排除在某些社会经济背景之外。

As a researcher, it's interesting to see more and more academics using social media channels and sharing information, which I think is fantastic. I get to learn about other fields that I'm interested in and collaborate with people to communicate science. However, sometimes messages can get overblown or taken out of context. Many people apply the information they learn from these sources to their lives to a tee, without understanding that science is constantly evolving, and new publications are released which can challenge information we previously thought to be correct. Without an understanding of the publication process and scientific training, the nuances of these processes may not be appreciated.

MC: What do you envision the next 10 years will look like in terms of how people look at their health and the focus of immunology research?

JM：我认为将对个性化的健康有真正的转变，我们开始越来越多地看到。一个例子是我们的遗传学和环境可以对我们的消化和处理食物的能力产生的影响 - 该领域被称为Nutrigenomics。相同的双胞胎在相同的餐食中可以产生非常不同的血糖反应。这是为什么？考虑到这些个人因素，很明显，我们不能拥有一揽子准则 - 需要量身定制。

我认为健康心理学将在未来几年的健康状况中发挥重要作用。我们有公共卫生的指导，信息和技巧，以了解人们应该吃什么，应该为照顾自己做什么，但是人们并不总是这样做。为什么？因为我们的生活的建设方式。我们经常忙碌，压力或疲倦。我们被越来越抗拒的肥大食品轰炸。健康心理学，探索帮助人们采取行动和生活更健康的生活的方法，肯定会发挥越来越重要的作用。

Jenna MacCiochi博士正在与技术网络高级科学作家Molly Campbell进行交谈。捷克葡萄牙直播