Professor Arne Akbar
President, British Society For Immunology
Immunology is trailblazing a path of medical discovery. What are the emerging areas that experts think will have a significant impact on our ability to treat disease?
Immunology is at the cutting-edge of medical discovery, with many new biological agents now translating from bench to bedside. As our understanding of how the immune system functions has grown, so too has our knowledge of the many different areas of health that the immune system affects.
Alongside this, the therapeutic possibilities for diseases that may be amenable to treatment through harnessing the immune system have also increased hugely. This has led to a number of emerging areas where we can bring new knowledge on the intricacies of immune functioning to increase understanding of disease mechanisms and therapeutics and drive significant steps forward for the benefit of patients.
There has never been a more exciting time to be an immunologist.
Promising research areas in white blood cell research
One exciting development is the discovery that white cells, the enforcers of the immune system, have intrinsic brakes that stop them from functioning. This is a safety mechanism that prevents over-activation of the immune system.
However, by disengaging these brakes therapeutically in patients with certain types of cancer, immunity against the tumour is enhanced significantly, to the benefit of the patients. Indeed, the 2018 Nobel Prize in Physiology or Medicine was awarded for this discovery and, in the coming years, it will be exciting to see how the therapeutic potential of this approach develops.
Research looks at exercise and diet affecting the body’s nutrient resources
Another area of major interest is in understanding the way that white cells utilise energy to elicit different functions. This new research area, termed ‘immunometabolism’, is providing us with exciting insights into the complex relationship between immunity and metabolic reprogramming. This is linked to available nutrient resources in the body and this area of research may provide the basis of how diet and exercise could regulate immune responses.
A third area of intense interest is how microbes that co-exist with us on our skin, in our gut and in our airways – our microbiome – shape the function and type of immune cells that are found at these sites. Antibiotics don’t only kill pathogenic bacteria but destroy these ‘friendly’ microbial communities as well. Therefore, while the use of antibiotics is essential in certain situations, overuse of these agents may be detrimental in some circumstances, and may also lead to the development of antibiotic resistance in certain organisms. This requires further investigation.
Finally, the immune system operates on a tightrope; insufficient immunity may lead to the increased incidence of infections and cancer, while excessive immunity, akin to ‘friendly fire’ may lead to the development of autoimmunity. Understanding how this balance of sufficient but not excessive immunity is regulated will ultimately enable immunologists to manipulate the immune system safely in many disease areas.
Big data and genome editing pose exciting opportunities for research
There has never been a more exciting time to be an immunologist, with new technologies in ‘big data’ and genome editing now complimenting detailed animal and human studies.
However, we still have much to learn and many questions are, as yet, unanswered. The opportunities for immunologists to innovate are ripe and the next few years should prove an exciting time for immunology research.