
I didn’t like biology when I was a kid. I remember dissecting a flatworm in high school and thinking, “How relevant is this to my life?” The answer, of course, is a lot, but at the time I didn’t see the connection between the biology of a worm and that of a person. It wasn’t until I started learning about global health that I began to fully understand and appreciate the topic.
If I could have read The song of the cell by Siddhartha Mukherjee in school, I might have fallen in love with biology much earlier. He does an excellent job of explaining in clear and accessible language not only as The cells work but because They are the basis of all life.
Although he is a Pulitzer Prize-winning author, Mukherjee is primarily an oncologist whose passion for the subject of cell biology shines through on every page. At the beginning of the book, he writes: “I love looking at cells the way a gardener loves looking at plants: not just the whole, but also the parts within the parts.” The result is as good as his two previous books: The emperor of all evilwhich is about cancer, and The Genwhich you can probably guess the theme of.
The song of the cell It starts by helping you understand the evolution of life. When life first emerged on our planet, it was in the form of single-celled organisms. (The vital question (by Nick Lane is another fantastic book that addresses this topic). Billions of years later, the human body houses hundreds of highly specialized cells, which work in harmony with each other to help it grow and continue functioning into adulthood. Mukherjee does a great job of explaining how every dysfunction (every disease or consequence of aging) eventually boils down to something being wrong with one of these cells.
Although it has been almost two centuries since two German scientists first proposed cell theory (the idea that all organisms are made of cells), our understanding of how to manipulate the building blocks of life to treat diseases is still in its infancy. relative childhood. Mukherjee spends a lot of time exploring the history and current state of cell therapy, which involves extracting cells, growing new ones, and then putting them back.
The most successful and well-known type of cell therapy today involves stem cells. Unlike most cells in the human body, stem cells are a blank canvas. Think of them as potential, with the ability to become almost any cell in the body. When an embryo first forms in the womb, it is made up almost entirely of these blank canvases. When you’re an adult, you have many fewer, but the stem cells you do have play a key role in replacing damaged cells. As you get older, they get older with you. Their DNA becomes damaged over time and they become less effective, meaning it takes longer for the tissue to replenish itself. (If you’ve reached an age where it takes much longer to recover from an injury than before, your aging stem cells deserve some of the blame.)
Scientists have long been excited about the therapeutic potential of stem cells. The hope is that, one day, we can use stem cells to revert your cells to a younger, healthier state. I’m still optimistic that that will be the case eventually, but I think the initial enthusiasm was a little too optimistic. For example, researchers had grand visions of repairing a broken spine with neural stem cells that would regrow the spinal cord. That has yet to work, and to date, there is only one form of successful stem cell therapy: hematopoietic stem cell transplantation, which involves blood cells.
The story of stem cell transplantation is at once surprising, inspiring and heartbreaking. Mukherjee devotes an entire chapter to the topic. In 1963, a team at the Fred Hutchinson Cancer Research Center (affectionately known here in Seattle as Fred Hutch) knew that the most effective way to treat leukemia was to destroy cancer cells with chemotherapy. But there was a problem: the process destroyed the immune system.
If left untreated, leukemia is often fatal. So, they came up with a bold solution. Doctors would give a patient chemotherapy and then give them stem cells from a donor to rebuild the entire immune system from scratch. When the procedure was first performed, it was very risky and initial patients died. Mukherjee interviewed some of the nurses who worked in Fred Hutch’s leukemia ward. It is difficult to read his stories of how his patients (many of whom were children) struggled to recover after the procedure.
Slowly but surely, over time, both the operation itself and the ongoing survival rate improved. Today, hematopoietic stem cell transplantation is a common treatment for leukemia and other cancers such as multiple myeloma. And research is underway into whether it could be used to treat deadly diseases such as HIV and sickle cell anemia.
The road to effective cell therapies has been long and bumpy, but I am optimistic that our new understanding of cells will soon lead to massive advances. As Mukherjee explains in the book, we are just beginning to understand how cells interact with each other. “We can name cells, and even cell systems, but we still have to learn the songs of cell biology,” he writes. We still don’t know how cells work together to create the cohesive melody that drives the human body. Once we learn those songs, as he so elegantly puts it, I believe we will unlock transformative new treatments that will change the way we think about medicine.
If I could go back in time and tell my teenage self how relevant biology is in her life, I would say this: We will all get sick at some point. We will all have loved ones who will get sick. To understand what is happening in those moments and feel optimistic that things will get better, you need a fundamental understanding of the building blocks of life. Mukherjee understands that “to locate the heart of normal physiology or disease, you must first look at the cells.” The world of medicine is advancing very quickly and The song of the cell It will help you appreciate how far we’ve come to achieve each advancement.