Immunity: How Elie Metchnikoff Changed the Course of Modern Medicine by Luba Vikhanski (review)

Élie Metchnikoff (also Ilya Ilyich Mechnikov) was not one of those unrecognized geniuses acknowledged only post mortem. He, by all accounts, had an exceptionally successful career. His discovery of phagocytosis – the process by which specialized white blood cells ingest bacteria and other particles, facilitating their disposal – brought him to the front line of what, at that time, was microbiology. He had a dream job at the Pasteur Institute in Paris, having been invited by the great Louis Pasteur himself. Metchnikoff won countless prestigious awards from the best universities in Europe and both Americas, and as a jewel on his crown, he was awarded (jointly with Paul Ehrlich) the Nobel Prize in Physiology or Medicine in 1908. Metchnikoff enjoyed the enormous respect of his colleagues, even among his opponents and adversaries. This reflected not only the scientific merit of his work, but also his personality, and his status as a fair and honest man. And yet … after his death, for some decades, his ideas were considered mainly as history, although a glorious history.

In the past decade, however, there has come a remarkable eruption of interest in his work, his ideas, and even his personal life. Luba Vikhanski, a science journalist and writer, has done an outstanding job, presenting in more than 250 pages not only milestones of Metchnikoff’s scientific achievements, but also insights into his personal life and his ups and downs, all in the context of the events that shook Western Europe and Russia as the nineteenth century unfolded into the twentieth. Born in the Russian Empire (modern Ukraine) and educated in Russia and Germany, he made his first major discovery – the discovery of phagocytosis – in Italy in 1882 while experimenting on the larvae of starfish. Metchnikoff, a biologist studying marine fauna, brought his general biological interests into the field of medicine. Vikhanski guides us through the course followed by the man considered a maverick by some. Metchnikoff’s theoretical ideas were met with suspicion by many practitioners, some of whom called his theories “metaphysical speculations” or even “an oriental fairy tale”. (Even today, this is an attitude of many practitioners regarding new, theoretical ideas and concepts.) The book follows the rivalry played out between the phagocytosis and humoral camps, as well as Metchnikoff’s uneasy relationship with the great scientist Paul Ehrlich. All this has generally been known; Vikhanski adds much that was considerably less known. The book reads almost as a detective story, particularly the telling of her unexpected discovery regarding his possible descendants. She presents this with taste and respect, avoiding any suggestion of a tabloid story.

Towards the end of the book, Vikhanski outlines some of Metchnikoff’s ideas about life extension and the postponing of aging. His view that “Aging is a disease that should be treated like any other” (p. 149) sounds familiar in our time, but then, as now, could stir controversy. Still, consider: Generally, scientific discovery accelerates so quickly that, other things being equal, we likely will not have to wait another 100 years to see whether new advances in line with Metchnikoff’s dreams might emerge. For example, his ideas about the gut’s microflora have been linked to advances in current biology. His suggestion to use yogurt based on lactobacillus bulgaricus (also known as kefir) has been so widely adopted that this yogurt is now part of the common diet. A final testament to Metchnikoff’s ideas as they relate to our contemporary understanding is that the Nobel Prize in Physiology or Medicine 2016, 100 years after Metchnikoff’s death, was awarded to Yoshinori Ohsumi. Ohsumi has laid the foundation for understanding mechanisms that underlie autophagy, another highly conserved cellular process in which damaged organelles are consumed (phagocytosed) as part of their disposal. Luba Vikhanski’s biography is an excellent and highly readable account of the life of a man whose ideas changed the course of science and medicine, with consequences for how we understand aging.