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In this work, the various theories of ageing are explained and assessed. The author presents case accounts about disorders that open windows on to the ageing process. The impacts of ageing on the brain and nervous system are given special attention, as are the effects of caloric restriction on maximum lifespan.

In the seventeenth century, smallpox reigned as the world’s worst killer. Luck, more than anything else, decided who would live and who would die. That is, until Lady Mary Wortley Montagu, an English aristocrat, moved to Constantinople and noticed the Turkish practice of “ingrafting” or inoculation, which, she wrote, made “the small-pox … entirely harmless.” Convinced by what she witnessed, she allowed her six-year-old son to be ingrafted, and the treatment was a complete success--the young Montagu enjoyed lifelong immunity from smallpox. Lady Montagu’s discovery would, however, remain a quiet one; it would be almost 150 years before inoculation (in the more modern form of vaccination) would become widely accepted while the medical community struggled to understand the way our bodies defend themselves against disease. William Clark’s At War Within takes us on a fascinating tour through the immune system, examining the history of its discovery, the ways in which it protects us, and how it may bring its full force to bear at the wrong time or in the wrong place. Scientists have only gradually come to realize that this elegant defence system not only has the potential to help, as in the case of smallpox, but also the potential to do profound harm in health problems ranging from allergies to AIDS, and from organ transplants to cancer. Dr. Clark discusses the myriad of medical problems involving the immune system, and he systematically explains each one. For example, in both tuberculosis and AIDS, the underlying pathogens take up residence within the immune system itself, something Clark compares to having a prowler take up residence in your house, crawling around through the walls and ceilings while waiting to do you in. He discusses organ transplants, showing how the immune system can work far too well, and touching on the heated ethical debate over the use of both primate and human organs. He explores the mind’s powerful ability to influence the performance of the immune system; and the speculation that women, because they have developed more powerful immune systems in connection with childbearing, are more prone than men to contract certain diseases such as lupus. In a fascinating chapter on AIDS, arguably the most deadly epidemic seen on Earth since the smallpox, Clark explains how the disease originated and the ways in which it operates. And, in each section, we learn about the most recent medical breakthroughs. At first glance, it may appear that our immune system faces daunting odds; it must learn to successfully fend off, not thousands, but millions of different types of microbes. Fortunately, according to Clark, it would be almost impossible to imagine a more elegant strategy for our protection than the one chosen by our immune system, and his At War Within provides a thorough and engaging explanation of this most complex and delicately balanced mechanism.

This popular exploration of gene therapy presents the underlying molecular biology in readily accessible form, and lays out the early efforts and future prospects for gene therapy to revolutionize the treatment of human genetic diseases.

The immune system is the only thing standing between us and a world of microbial predators that could send us to an early and ugly death. It would be our only defense during the first hours of a bioterrorist attack using some of these very microbes. Evolved over millions of years of to keep us alive long enough to reproduce, the immune system has developed an impressive armamentarium of powerful chemical and cellular weapons that make short work of hostile viruses and bacteria. It has also evolved amazing genetic strategies to keep pace with invading microbes that can reproduce — and thus alter their genetic blueprint — in under an hour. But this same system prevents us from accepting life-saving organ transplants. It is also capable of over-reacting, leading to immunopathologies and causing serious, even lethal, damage to our tissues and organs. Worse yet, our immune systems may decide we ourselves are foreign and attack otherwise healthy tissues, resulting in autoimmune disease. And finally, it is itself the target of one of the most deadly viruses humans have ever known: HIV, the agent of AIDS. Part I of this book describes the structure and function of the immune system at a biological and biochemical level. Part II examines the role of the immune system in a range of human diseases — many caused by the immune system itself.

Death, for bacteria, is not inevitable. Protect a bacterium from predators, and provide it with adequate food and space to grow, and it would continue living--and reproducing asexually--forever. But a paramecium (a slightly more advanced single-cell organism), under the same ideal conditions, would stop dividing after about 200 generations--and die. Death, for paramecia and their offspring, is inevitable. Unless they have sex. If at any point during that 200 or so generations, two of the progeny of our paramecium have sex, their clock will be reset to zero. They and their progeny are granted another 200 generations. Those who fail to have sex eventually die. Immortality for bacteria is automatic; for all other living beings--including humans--immortality depends on having sex. But why is this so? Why must death be inevitable? And what is the connection between death and sexual reproduction? In Sex and the Origins of Death, William R. Clark looks at life and death at the level of the cell, as he addresses such profound questions as why we age, why death exists, and why death and sex go hand in hand. Clark reveals that there are in fact two kinds of cell death--accidental death, caused by extreme cold or heat, starvation, or physical destruction, and “programmed cell death,” initiated by codes embedded in our DNA. (Bacteria have no such codes.) We learn that every cell in our body has a self-destruct program embedded into it and that cell suicide is in fact a fairly commonplace event. We also discover that virtually every aspect of a cell’s life is regulated by its DNA, including its own death, that the span of life is genetically determined (identical twins on average die 36 months apart, randomly selected siblings 106 months apart), that human tissue in culture will divide some 50 times and then die (an important exception being tumor cells, which divide indefinitely). But why do our cells have such programs? Why must we die? To shed light on this question, Clark reaches far back in evolutionary history, to the moment when “inevitable death” (death from ageing) first appeared. For cells during the first billion years, death, when it occurred, was accidental; there was nothing programmed into them that said they must die. But fierce competition gradually led to multicellular animals--size being an advantage against predators--and with this change came cell specialization and, most important, germ cells in which reproductive DNA was segregated. When sexual reproduction evolved, it became the dominant form of reproduction on the planet, in part because mixing DNA from two individuals corrects errors that have crept into the code. But this improved DNA made DNA in the other (somatic) cells not only superfluous, but dangerous, because somatic DNA might harbour mutations. Nature’s solution to this danger, Clark concludes, was programmed death--the somatic cells must die. Unfortunately, we are the somatic cells. Death is necessary to exploit to the fullest the advantages of sexual reproduction. In Sex and the Origins of Death, William Clark ranges far and wide over fascinating terrain. Whether describing a 62-year-old man having a major heart attack (and how his myocardial cells rupture and die), or discussing curious life-forms that defy any definition of life (including bacterial spores, which can regenerate after decades of inactivity, and viruses, which are nothing more than DNA or RNA wrapped in protein), this brilliant, profound volume illuminates the miraculous workings of life at its most elemental level and finds in these tiny spaces the answers to some of our largest questions.