Most of us give our immune system remarkably little thought. We simply expect it to protect us from cancer cells, countless viruses, bacteria, and other potentially harmful organisms we encounter every day; to help us recover when we become ill; and to quietly do its job in the background.
Yet behind the scenes, one of the most remarkable systems in the human body is at work every second of every day. Without us ever noticing, it identifies potential threats, remembers previous infections, repairs damage, and constantly decides what to attack and what to leave alone.
Specialist physician Dr Lukas Moolman, who practises at Netcare Unitas Hospital in Centurion and has a special interest in clinical immunology, points out that most of us notice our immune system only when something goes wrong. “When your immune system is working as it should, you'll probably never think about it. It's only when it loses its balance that we begin to appreciate how dependent our health is on it.”
Dr Moolman offers another way of thinking about it.
“Your immune system has a better memory than you do. It never forgets a germ: every virus, bacterium or other foreign invader your body has ever encountered is filed away in its permanent records. If that troublemaker reappears years later, your immune system instantly recognises its molecular fingerprint and mounts a targeted response, often before you even realise you've been exposed.”
This extraordinary ability to recognise, remember, and respond explains why most of us contract illnesses such as chickenpox only once. But fighting infection is only one part of the immune system's role. Every moment it makes finely balanced decisions about what to attack, what to tolerate and when to stand down.
“People often ask how they can strengthen their immune system. But the immune system isn't trying to become stronger. It's trying to become smarter. Its job is to recognise genuine threats, ignore what is harmless, and know exactly when to stop. That's what keeps us healthy,” explains Dr Moolman.
When balance is lost
Like any highly sophisticated system, the immune system depends on balance. It must be powerful enough to protect us from harmful invaders, yet restrained enough not to attack the body it is designed to defend.
“When people think about immune disorders, they often assume the immune system is simply weak. In reality, problems arise in several ways,” says Dr Moolman.
Sometimes the immune system is weakened. Known as immunodeficiency, this can leave people vulnerable to frequent or unusually severe infections, such as repeated sinus and ear infections, pneumonia, or infections that recur despite appropriate treatment.
For some individuals, the immune system may be too reactive, responding aggressively to substances that are normally harmless. This can result in hay fever, asthma, eczema, food allergies or even life-threatening anaphylaxis.
In other cases, the immune system mistakenly identifies the body's own tissues as a threat. Instead of protecting us, it attacks healthy organs and tissues, leading to autoimmune diseases such as rheumatoid arthritis, lupus, multiple sclerosis, psoriasis or autoimmune thyroid disease.
And sometimes the immune system fails to switch off. Even after the original trigger has disappeared, inflammation persists, damaging healthy tissues and contributing to chronic inflammatory conditions.
“Although these conditions may seem unrelated, they are all different expressions of the same underlying system. Understanding why the immune system is behaving this way is the first step towards the correct diagnosis and treatment,” explains Dr Moolman.
Because the immune system influences almost every organ in the body, clinical immunologists often work closely with your general practitioner and a wide range of other specialists. They provide highly specialised input when recurrent infections, allergies, autoimmune disease, chronic inflammation, or other immune-related conditions suggest an underlying disorder of the immune system. Together with your GP and other healthcare professionals, clinical immunologists determine the cause of a specific problem and develop the most appropriate treatment plan.
Looking beyond individual symptoms
One of the greatest challenges in clinical immunology is that immune disorders often don't announce themselves clearly. Instead, they can present as a collection of seemingly unrelated symptoms affecting multiple parts of the body.
“Many people spend years treating individual symptoms without anyone recognising that there may be a common immune cause. Recurring infections, persistent allergies, unexplained inflammation, autoimmune disease, recurrent unexplained fevers, or several immune-related conditions affecting one person or a family may all suggest that the immune system warrants closer attention,” he says.
“Clinical immunologists look beyond the individual disease to understand why the immune system is behaving as it is. Our role isn't simply to treat infections or autoimmune diseases. It's to understand the underlying problem driving them, because once we understand the cause, we can make better treatment decisions,” notes Dr Moolman.
Looking after your immune system
“Although some immune disorders are inherited and others develop as a result of medical conditions or treatments, the way the immune system functions throughout life is also influenced by factors within our control. Every night while you sleep, every healthy meal you eat, every walk you take and every vaccine you receive contributes to the way your immune system learns, adapts and functions,” notes Dr Moolman.
“There is no magic supplement that can replace the fundamentals of good health. Your immune system constantly adapts and learns throughout your life. The goal isn't to boost it indiscriminately but to provide the conditions it needs to function as it was designed to,” he adds.
A remarkable system worth understanding
The immune system is one of the most complex and sophisticated systems in the human body. When it is working well, it protects us without seeking recognition. When it loses its balance, however, it can affect almost every organ and almost every stage of life.
“Most people will go through today without giving their immune system a second thought, which is just as it should be. Understanding how it works is about much more than understanding disease; it's about understanding your body,” concludes Dr Moolman.
Could these symptoms have something in common?
Most people experience the occasional infection or allergy. However, if you notice a pattern, it may be worth discussing it with your GP. In some cases, these seemingly unrelated symptoms can point to an underlying immune disorder.
- Frequent ear or sinus infections
- Repeated pneumonia or chest infections
- Needing antibiotics more often than expected
- Persistent or severe allergies
- Autoimmune disease
- Several immune-related conditions affecting one person or family
Next in the series: Are we born with immune disorders, or do they develop over time? In this second story in our series, Dr Moolman explores how genetics, the environment and everyday life combine to shape our immune system from birth onwards.
Ends.
Notes to editor
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