A Cornell physician-scientist who helped lead the university's COVID-19 testing effort has written a book for general readers about how the immune system works, from infections and vaccines to autoimmune disease and cancer treatments.
Gary Koretzky's “Your Immune System: The Amazing Science of Who You Are” was published Tuesday by Johns Hopkins University Press. In a Cornell Chronicle interview, Koretzky said years of treating people with immune-related illness and answering community questions during the pandemic convinced him that accessible explanations were needed. Koretzky is Cornell's vice provost for research and a professor emeritus at Weill Cornell Medicine and the College of Veterinary Medicine.
Why explain immunology now?
Terms such as antibodies, T cells and antigen tests became familiar during COVID-19, but the field's complexity can leave readers without a clear account of what those terms mean together, Koretzky said. He recalled searching for material to give patients with serious illnesses when he was a young rheumatologist and finding little written for non-specialists.
Later, cancer immunotherapy moved from a promising idea to treatments reported widely in the news. Koretzky said short articles could describe the results without explaining the underlying biology. His book starts with the basics of immune defenses and moves through allergies, vaccines, autoimmune disorders and newer cancer treatments.
The book also addresses scientific uncertainty. Koretzky said people sometimes see a revised explanation as evidence that an earlier one was dishonest. More often, he said, researchers have learned more. He wants readers to see both the gradual accumulation of evidence and the discoveries or missteps that change a field's understanding.
That approach reflects his experience in Ithaca during the pandemic. Koretzky helped organize Cornell's COVID-19 town halls and testing program and said the team was deliberate about explaining what it knew and what remained uncertain. He said the public can handle uncertainty when scientists are candid about it.
Vaccines, autoimmunity and balance
Koretzky devotes three chapters to immunization. He uses the histories of smallpox and polio vaccines and the finding that vaccination against a virus can prevent cervical cancer to explain how immune science translates into prevention. He said his goal is to give readers enough information to make informed decisions, not to write from a political position.
He describes the immune system's central task as distinguishing the body's own tissues from outside threats. Autoimmune diseases occur when safeguards against attacking the body fail. The book uses lupus, rheumatoid arthritis, rheumatic fever and myasthenia gravis to trace how scientists identified those safeguards and developed treatments.
Koretzky also compares immunity to walking a tightrope: a response must be strong enough to fight infection and detect some cancers without becoming so forceful that it damages healthy tissue. Allergies, asthma and autoimmune illness illustrate different ways that balance can be lost, he said. The book is an explanation of science, not individualized medical advice or a claim that every disease has the same mechanism.
One area he finds particularly striking is the microbiome, the community of microorganisms that live in and on people. Scientists once viewed many of them as largely passive, Koretzky said; research now shows they interact with immune health in ways that are still being worked out.
Koretzky has spent his career studying T cells, caring for patients with immune disorders and teaching medical and graduate students. The book brings those threads together for a broader audience at a time when public attention to infectious disease and vaccines remains high.
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