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Notes
1 Nietzsche, “On Truth and Falsity.”
2 See Johnson, et al. "Epidemiology and Estimated Population Burden of Selected Autoimmune Diseases in the United States.”
3 For a basic explanation of autoimmune etiologies that includes a link to a table of diseases, syndromes and conditions considered to derive from them see http://autoimmune.pathology.jhmi.edu/whatisautoimmunity.html (accessed November 20, 2015). Recently a new parsing of the field has introduced a bifurcation of ‘autoimmune’ and ‘autoinflammatory’ diseases, the former referring to those mediated through acquired immune activity and the latter referring to those mediated through innate immune response. However, this distinction is not yet well established and it is not yet clear which diseases (if any) currently classified as autoimmune will be rechristened autoinflammatory. See for example: Kanazawa et al. “Autoimmunity versus Autoinflammation – Friend or Foe?;” Touitou. “Inheritance of autoinflammatory diseases: shifting paradigms and nomenclature;” Kastner et al. “Autoinflammatory Disease Reloaded: A Clinical Perspective;” Grateau et al. “Autoinflammatory conditions: when to suspect? How to treat?;” Masters et al. “Horror Autoinflammaticus: The Molecular Pathophysiology of Autoinflammatory Disease;” Yao and Furst. “Autoinflammatory diseases: an update of clinical and genetic aspects.”
4 While this represents the prevailing interpretation of autoimmune diseases, recently a few immunologists have begun to suggest that autoimmunity derives primarily from immune deficiencies in which the regulatory aspects of the immune system fail to limit autoreactivity, rather than primarily for excessive autoreactivity. This theory derives primarily from the evidence that deleterious autoimmune manifestations occur in those diagnosed with Primary Immune Deficiency Disorders. For examples, see: Lehman, “Autoimmunity and Immune Dysregulation in Primary Immune Deficiency Disorders;” Maggadottir and Sullivan, “The intersection of immune deficiency and autoimmunity;” Atkinson, “Immune deficiency and autoimmunity;” Bussone and Mouthon. “Autoimmune manifestations in primary immune deficiencies;” Carneiro-Sampaio and Coutinho, “Tolerance and autoimmunity: lessons at the bedside of primary immunodeficiencies;” Marks et al. “Crohn’s Disease: an Immune Deficiency State;” Folwacznya et al. “Crohn’s disease: an immunodeficiency?”
5 See Tsumiyama, Miyazaki and Shiozawa, “Self-Organized Criticality Theory of Autoimmunity.” ‘Since ‘clonal selection theory of immunity’ of Burnet and subsequent molecular biological discoveries on V(D)J recombination and the diversity and individuality of immune response, how autoimmunity arises remains unclear’. For a summary of current hypotheses about autoimmune causalities see Root-Burnstein and Fairweather, “Complexities in the Relationship between Infection and Autoimmunity,” 407.
6 See Burnet, The Clonal Selection Theory of Acquired Immunity and Self and not-self; cellular immunology, book one. For a survey of the field since then see Mackay, “Autoimmunity since the 1957 clonal selection theory: a little acorn to a large oak,” 67-71.
7 Burnet, “Auto-immune Disease: 1. Modern Immunological Concepts,” 645-650 and “Auto-immune Disease: 2. Pathology of Immune Response,” 720-725.
8 Ehrlich, Studies in Immunity:
[O]ne might be justified in speaking of a "horror autotoxicus" of the organism. These contrivances are naturally of the highest importance for the existence of the individual. During the individual's life, even under physiological though especially under pathological conditions, the absorption of all material of its own body can and must occur very frequently. The formation of tissue autotoxins would therefore constitute a danger threatening the organism more frequently and much more severely than all exogenous injuries. (82-83)
For a consideration of how Ehrlich’s dogma gave way to the study of autoimmune disease, see Silverstein. “Horror Autotoxicus versus Autoimmunity: The Struggle for Recognition,” 279-281.
9 Indeed, classical immune theory, whether defined in terms of self/non-self, or its analogue friend/foe, gives rise to a number of regular aporia: e.g., autoimmunity, cancer, pregnancy, host versus graft disease, along with questions about why we don’t develop autoimmune responses to cells that only appear later in the life cycle (including sperm, breast milk) while we don’t mount immunological responses to commensal bacteria and viruses. Matzinger offers the most robust alternative to self/non-self with her ‘danger theory’ which attempts to break with the immunological dogma that immunity is a form of ‘self-defence’, and instead suggests that immune response might better be understood in terms of an organism’s attempts to negotiate dangerous situations and events. Matzinger’s interventions have catalyzed a number of revisions to and defences of MacFarlane’s theory. For an overview of the debates, see both the special issues in Seminars in Immunology 12:3 (2000) and the Scandinavian Journal of Immunology 54 (2001) and the special section of Nature Immunology 8:1 (2007); 1-13. For several other recent theoretical attempts to explain autoimmunity, see Tsumiyama et al. “Self-Organized Criticality Theory of Autoimmunity;” Irie and Ridgway, “A Modular Theory of Autoimmunity.”
10 The opposition self/other, or any other logical opposition, is neither universal nor transhistorical. Rather it emerges from the coetaneous development of political and philosophical technologies for generating “truth” in Ancient Greece as both Michel Foucualt and Jean Pierre Vernant demonstrate (see Foucault. Leçons sur la volonté de savoir; and Vernant, Myth and Thought among the Greeks). To the contrary, as Jullien illustrates, in ancient Chinese thought, logical opposition appeared as ‘partial’ and regarded the complementarity of contraries as a more encompassing “logic” (see Jullien, “Did Philosophers Have to Become Fixated on the Truth?”).
11 Cohen. “My Self as an Other: On Autoimmunity and ‘Other’ Paradoxes.”
12 The fact that commensal bacteria and viruses do not usually catalyze immune responses seems to imply that they exist in the interstices of self/not-self. In other words, that this binary is not as oppositional as its negative formulation might first suggest. Some recent hypotheses about several autoimmune illnesses suggest that the microbiome could play a significant part. See for example: Moran, Sheehan and Shanahan, “The small bowel microbiota;” Raedler and Schaub, “Immune mechanisms and development of childhood asthma;” Peng et al. “Long term effect of gut microbiota transfer on diabetes development;” Meelu et al. “Impaired innate immune function associated with fecal supernatant from Crohn's disease patients: insights into potential pathogenic role of the microbiome;” Huang, “The respiratory microbiome and innate immunity in asthma;” Van Praet, “Commensal microbiota influence systemic autoimmune responses;” among many, many others.
13 For the best overview how immunology construes ‘self’, see Tauber, Immune Self: Theory or Metaphor.
14 The following account summarizes my longer argument in my A Body Worth Defending: Immunity, Biopolitics and the Apotheosis of the Modern Body.
15 Fauvel, Le Choléra, 281.
16 Metchnikoff’s focus on cellular immunity comes back into vogue in the second half of the twentieth century when visualizing technologies revealed the existence of T- and B-lymphocytes, whose role in HIV/AIDS proved so central. Today even Metchnikoff’s focus on phagocytes (macrophages) appears to have been prescient, as new studies foreground the way “innate immunity” centrally participates in inflammatory processes. The best survey of immunology remains: Silverstein, A History of Immunology.
17 Pololsky and Tauber, The Generation of Diversity: Colonal Selection Theory and the Rise of Molecular Immunology, 19-57.
18 On the history of humoral immunology and its focus on immunochemistry, see Mazumdar, Species and Specificity: An Interpretation of the History of Immunology.
19 Jerne, “The Natural-Selection Theory of Antibody Formation.”
20 The theory is currently supplemented by the notion that in neo-natal life specific T-regulatory cells are generated that inhibit autoimmune illnesses and sustain self tolerance by modulating those self-reactive T-cells that escape pre-natal deletion in the thymus.
21 Burnet. “A Modification of Jerne’s Theory of Antibody Production using the Concept of Clonal Selection.”
22 Burnet, “A Modification of Jerne’s Theory,” 119.
23 Burnet, “A Modification of Jerne’s Theory,” 121.
24 Lewis and Short, A Latin Dictionary.
25 This aspect of the theory developed in order to account for what is now considered acquired immune response rather than innate immune response. Today it is clear that certain aspects of the immune system (macrophages in particular) do respond to self insofar as the clear effete or damaged cells and molecules. Matzinger’s danger theory evolved in part to account for this fact.
26 In this sense, Burnet’s adoption of tolerance to describe self as that which does not elicit immunological response recapitulates a classic precept of liberal political philosophy, first articulated by John Locke in the second edition of An Essay Concerning Human Understanding (1690). In the chapter “Of Identity and Diversity,” Locke argued that the personal identity (from the Latin identidem: repeatedly, several times, often, now and then, at intervals, ever and anon; continually, constantly, habitually) persists through and despite diversity (which he refers to as ‘constantly fleeting particles of matter’). The famous crux of Locke’s thesis rests on the continuity of memory: so long as we remember ourselves as our ‘selves’ we remain the same person. Locke’s argument primarily concerned legal and moral responsibility (he states ‘person is a forensic term’), nevertheless his argument has underwritten numerous theories of the self –including Sigmund Freud’s–over the past three hundred years. Not surprisingly then following the triumph of Burnet’s Clonal Selection Theory, immunology foregrounded the question of ‘immunological memory’ as one of its key concerns.
27 Burnet, “Auto-immune Disease: I. Modern Immunological Concepts,” 645.
28 Burnet, “Auto-immune Disease: I. Modern Immunological Concepts,” 645.
29 De Beauvoir, The Second Sex, xxiii.
30 Burnet, “Auto-immune Disease: I. Modern Immunological Concepts,” 645.
31 Root-Bernstein, “Antigenic Complementarity in the Induction of Autoimmunity: A General Theory and Review,” 274.
32 Gilbert, Sapp and Tauber, “We Have Never Been Individuals.”
33 Given the increasing number of aporia that characterize the reigning immunological dogma, the paucity of immunological alternatives to the interlocking oppositions of self: not-self and friend: enemy seems surprising, not to mention the extreme hostility that these few alternatives generate among the immunologically indoctrinated. Matzinger’s ‘danger theory’ remains the most robust of the alternative.
34 On the philosophical significance of folding, see Deleuze. The Fold: Leibniz and the Baroque.
35 Varela, “Organism: a meshwork of selfless selves,” 85.
36 “Immunity does not merely guard the body against other hostile organisms in the environment; it also mediates the body’s participation in a community of ‘others’ that contribute to its welfare” see Gilbert, Sapp and Tauber, “We Have Never Been Individuals,” 333.
37 Simondon, L’Individuation à la Lumière des Notions de Forme et d’Information. This text (re)presents Simondon’s 1958 dissertation, which was subsequently published in two parts. The citations used here appear in the second published volume: L’Individuation Psychique et Collective.
38 Simondon, L’Individuation à la Lumière des Notions de Forme et d’Information, 13.
39 Simondon, L’Individuation à la Lumière des Notions de Forme et d’Information, 17.
40 Metchnikoff, “A Yeast Disease of Daphnia: A Contribution to the Theory of the Struggle of Phagocytes against Pathogens,” 193.
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Notes on contributors
Ed Cohen
Ed Cohen teaches Modern Thought in the Department of Women’s and Gender Studies at Rutgers University. His most recent book is A Body Worth Defending: Immunity, Biopolitics and the Apotheosis of the Modern Body (Duke University Press, 2009). He is currently finishing a new book Shit Happens: Ruminations on Illness and Healing. For more information check his websites: www.healingcounsel.com and http://womens-studies.rutgers.edu/faculty/core-faculty/122-ed-cohen.
Email: [email protected].