Ever wanted to find out more about a subject before committing to five years at university? Newcastle University’s Mini Medical School is a series of lectures aimed at 15-year-olds considering a degree in medicine. Members of Immunology North East, a regional group of the British Society for Immunology, designed a session putting immunology centre stage, exploring how modern medicine can modify the immune system to protect us against disease. Immunology North East wanted to get involved in this project to highlight the exciting field of immunology to the doctors of tomorrow. Ask a doctor what the word immunology means to them and you will likely conjure up thoughts of a diagnostic laboratory whereas in real terms, often overlooked, the immune system and medicines that modify the immune system underlie many medical conditions and their treatment. We hoped to make immunology more visible.
The Mini-Medical School team: Dr Nicola Maney, Dr Kevin Marchbank, Helen Lawrence, Dr Rachel Harry, Dr Amy Anderson and Dr Rachel Dickinson
A shocking start
Firstly, the power and strength of the immune system was dramatised in a ‘24 Hours in A&E’ style sketch. SimMan, a patient robot, suffered an anaphylaxis reaction to nuts which was swiftly brought under control by the medical team. Following this shock opener, Nicola Maney introduced students to the immune system and the cells underlying the response we had just observed. Nicola elaborated on the speedy and no holds barred innate immune response versus the more conserved time dependent adaptive immune response. This led to a discussion of the adaptive immune system with a particular focus on T cell development. Amy Anderson explained how T cells of the immune system are educated to recognise self versus non-self and also introduced the concept of immunological memory. Amy went on to describe the fundamental role of dendritic cells in T cell activation and their importance in maintaining the fine balance between immunity and tolerance.
The value of herd immunity
Having introduced a normal immune system, Rachel Dickinson guided students through the most common medical intervention of the immune system, namely vaccination. The students took a brief tour of the history of vaccine development from Jenner’s somewhat unorthodox methods to today’s high standards. To demonstrate the importance of vaccination, Helen Lawrence tasked the entire audience to join in a demonstration of the value of herd immunity in protecting the population. Helen aka ‘patient zero’ was infected with measles and – having touched door handles, sneezed, handed out goodie bags and spoken to students – was sure she had spread the disease. Using two sets of coloured paper, two scenarios were demonstrated – firstly where only 50% of the population were vaccinated resulting in 95% of the unvaccinated population falling ill, versus the striking effect of protection when 95% of people were vaccinated with only three cases of measles detected.
Friend or foe?
The next session looked at how a normal immune response is problematic in the context of a lifesaving transplant. Kevin Marchbank presented a history of immunology in transplantation, using pictures of ‘Will Self’ and ‘Bill Self’ to raise a laugh and help reinforce the difficulties our immune systems face in discriminating what is friend and foe. Using an old clip from a Professor Robert Winston broadcast on the ‘sweaty T-shirt’ experiment, filmed at Newcastle University, instilled a sense of the power of HLA and got the odd giggle as well. This led to a discussion on the chronic organ shortage we face, touching on the particular issues of HLA matching in ethnic minorities.
Autoimmunity – immune response to self
The final session of the event examined the immune response to self-tissue, the process we call autoimmunity. After highlighting the many different types and the organs affected, Rachel Harry discussed some of the genetic and environmental factors known to influence susceptibility to autoimmune disease and even touched on molecular mimicry as a theory underlying autoimmune disease. Using rheumatoid arthritis as an example, Rachel went on to describe how autoimmune diseases are currently managed and the urgent need for new treatments. She introduced the concept of immune reprogramming and how a novel tolerogenic dendritic cell therapy developed at Newcastle University may lead the way.
The students were given a final challenge to identify the most important cell of the immune system, a question that divided the presenting team. The most popular by far was that of the dendritic cell; however the Immunology North East team conceded that all cells were fundamental to a fully functioning immune system. We could tell the students thoroughly enjoyed the session and were completely enthused by immunology as a whole, with many questions spanning the entire session. Indeed, 76% of the students who attended rated the session as ‘excellent’ or ‘good’ and some even went as far as to say, “I really enjoyed the immunisation and transplant lecture and thought the speakers were really good and the content interesting. Particularly in the immunology lecture as they really involved the audience” and, “Everything about the mini medical has been absolutely superb, each lecture was well delivered and highly interesting and engaging and ultimately very inspiring also. I enjoyed it all extremely much!”
Dr Rachel Harry, Research Associate, and Dr Kevin Marchbank, Lecturer, Institute of Cellular Medicine, Newcastle University.
Image credits: Rachel Harry