100th Anniversary of Jules Bordet's Nobel Prize: Tribute to a Founding Father of Immunology.

The 100th Anniversary of the Nobel Prize in Physiology or Medicine 1919 awarded to Jules Bordet offers the opportunity to underline the contributions of this Belgian doctor to the blooming of immunology at the end of the nineteenth century at the Institut Pasteur de Paris. It is also the occasion to emphasize his achievements as director of the Institut Pasteur du Brabant and professor at the Université libre de Bruxelles. Both in France and Belgium, he developed a holistic vision of immunology as a science at the crossroads of chemistry, physiology, and microbiology.

Development of the clinic of pulmonology and allergy.

University Pulmology and Allergy Clinic was founded in 1975 when the Depertment of Internal Medicine, directed by Prof. Dr. Dimitar Arsov, later member of the Macedonian Academy of Sciencies and Arts, was divided into eight separate and independent clinics. The first head of the Pulmonology and Allergy Clinic was Prof. Dr. Ljubomir Kotevski. He had a very difficult goal: to establish and further develop the newly formed clinic. The Clinic flourished and became one of the leading Clinics in the Clinical Centre during the directorship of Prof. dr. Dejan Dokic.. He completely rebuilt and refurbished the Clinic, which became a modern Clinic providing excellent working conditions for the employees and, most importantly, provided a first class service to the patients. During his mandate he obtained a grant from the Japanese Government worth $1,000,000 which was used to obtain a new, modern and sophisticated medical equipment. Since the establishment of the clinic, many national and international scientific projects were carried out and many scientific papers were published as well as many monographs, and chapters in scientific books. As a result of continuous education, of the total number of 24 doctors there are 16 subspecialists in respiratory medicine and 4 specialists in internal medicine. There are 9 professors in internal medicine at the University of Pulmonology and Allergy Clinic lecturing at the Medical Faculty in Skopje. The University Pulmonology and Allergy Clinic has an international reputation due to many contacts with famous European Institutions. All these international interrelations have resulted in honouring 3 professors: Prof. Dr. Gert Kunkel from Berlin, Germany, Prof. Dr. Robert Loddenkemper from Berlin, Germany and Prof. Dr. Peter Howard from Southampton, UK.

Haematology in the Republic of Macedonia: present situation and brief history.

The development of clinical haematology in Macedonia has taken place over the past nine decades. The greatest expansion of its development took place in the second half of the 20th century. The oficial start of clinical haematology dates from 1956, when the Department of Haematology was founded within the framework of the Internal Medicine Clinic in Skopje. In the beginning, haematology represented a form of virtual sub-specialty, but its expansion was so progressive and rapid that it reached the highest peaks of Yugoslav haematology in those times. The period from 1968 to 1979 was a period of integral development of haematology and blood-transfusion science in Macedonia. Nowadays, the autonomous Public Health Institution, the University Hematology Clinic, is a unique healthcare, educational and scientific establishment in the Republic of Macedonia in its field of work. The diagnostics algorithm comprises cyto-morphologic and cyto-chemical analysis, through immunologic characterization with the assistance of a flow cytometer, to sophisticated molecular analysis for detecting genetic abnormalities. The therapeutic approach is based upon modern poly-haemotherapeutic protocols, application of monoclonal antibodies, immuno-modulatory agents, molecular target therapy and the use of alogeneic and autologous transplantation of fresh bone-marrow and frozen haemopoietic stem-cells. The current motto of the Haematology Clinic is: always help those who seek help, provide precise and early diagnostics, and apply all up-to-date therapeutic strategies, scientific research, continual education and day-to-day implementation of the latest achievements in the field of haematology in daily practice.

From Neuroendocrinology to Neuroimmunomodulation - a tribute to Prof. Dr. Samuel McCann.

One of the leading experts in the field of Neuroendocrinology and Neuroimmunmodulation, Samuel Mac Donald McCann, known by all his friends as 'Don', passed away in 2007. This article pays tribute to his outstanding scientific contribution and a glimpse on his fascinating personality. A member of the National Academy of Sciences of the United States and pioneer in the field of neuroendocrine regulation, he identified numerous hormones and peptides and set the stage for basic concepts in physiology and clinical medicine.

Instructive selection and immunological theory.

The turning point of modern immunological theory was the advent of the clonal selection theory (Burnet, Talmage - 1957). A useful heuristic in the classification of theoretical models was the contrast of 'instructive' with 'selective' models of the acquisition of information by biological systems. The neo-Darwinian synthesis of the 1940s had consolidated biologists' model of evolution based on prior random variation and natural selection, viz. differential fecundity. While evolution in the large was by then pretty well settled, controversy remained about examples of cellular adaptation to chemical challenges, like induced drug-resistance, enzyme formation and the antibody response. While instructive theories have been on the decline, some clear cut examples can be found of molecular imprinting in the abiotic world, leading, e.g. to the production of specific sorbents. Template-driven assembly, as in DNA synthesis, has remained a paradigm of instructive specification. Nevertheless, the classification may break down with more microscopic scrutiny of the processes of molecular fit of substrates with enzymes, of monomers to an elongating polymer chain, as the reactants often traverse a state space from with activated components are appropriately selected. The same process may be 'instructive' from a holistic, 'selective' from an atomic perspective.

Complementary medicine for the allergist.

The objective of this article is to provide a historical overview of the present state of complementary and alternative medicine (CAM) in the treatment of atopic disorders. The evolution of medicine in the United States has been in flux with the advent of newer technologies, new designs in managed care, and integrating the cultural differences into a complex multidisciplinary health care delivery process. There have been several herbal modalities that contain various anti-allergy and asthma components with effects on bronchodilation, congestion, pulmonary function tests, and antagonism of asthma mediators such as histamine and PAF, corticosteroid levels, and clearance of mucus. In the field of allergy, asthma, and immunology, the popularity of CAM is more widespread than other common chronic medical problems. Overall, CAM use has created a $15-billion-a-year industry in dietary supplements alone. This has been especially fueled by the deregulation of the "herbal" industry by the congressional passage of the Dietary Supplement Health and Education Act of 1994. It would appear that our specialty would clearly benefit from expanding its knowledge base about these entities because "allergies" are high on the list of patients seeking CAM. This will prepare us to better coordinate the future possibilities and to "doctor" (i.e., teach) our patients about the risks and benefits of these modalities.

Specificity and degeneracy in antigen recognition: yin and yang in the immune system.

One of the hallmarks of the immune system is specificity, a concept based on innumerable observations that antibodies react with the substance that elicited their production and only a few other structurally similar substances. The study of T cells has begun to suggest, however, that in responses mediated by their antibody-like receptors (T cell receptor or TCR) an individual T cell, expressing a singular TCR, can discriminate as exquisitely among antigens as the most specific antibodies but also exhibit "degeneracy": i.e., it can react with many disparate antigens (peptide-MHC complexes). An explanation for this duality (specificity and degeneracy) can be found in (i) the powerful amplifying signal transduction cascades that allow a T cell to respond to the stable engagement of very few TCR molecules, initially perhaps only one or two out of around 100,000 per cell, by their natural ligands (peptide-MHC complexes or epitopes on antigen-presenting cells--or APC) and (ii) the inverse relationship between TCR affinity for epitopes and epitope density (the number of copies of an epitope per APC). Older observations on the excess of total globulin production over specific antibody production in response to conventional immunization procedures suggest that B cells also exhibit degeneracy, as well as specificity. These views are developed against a backdrop describing how the author became interested in the immune system and has pursued that interest. "...a concept of science drawn from ...is [textbooks]...is no more likely to fit the enterprise that produced them than an image of a national culture drawn from a tourist brochure." Thomas Kuhn, Structure Of Scientific Revolutions

Burnet oration. Politics, personalities and the development of science.

This lecture recounts a story that attempts to trace the history of ideas relating to tissue transplantation from the earliest times through to the present. This story was shaped by the strong Darwinian approach to biology championed by Burnet and Medawar. It also describes the political influence developed from the strong Lamarckian leanings of the communist supporters in the USSR, and the fact that the biological argument between those supporting Lamarck and those supporting Darwin was seen by the Praesidium of the USSR Academy of Sciences to be equated with the ideological class struggle between socialism and capitalism. This story points out that while science is valued for its objectivity, its dependence on personalities adds a subjective element. This subjective element is always present and it colours our science by reflecting both the political and cultural movements of the time.