Clinical Immunology: Principles and Practice, 5th Edition

By Robert R. Rich, MD; Thomas A. Fleisher, MD; William T. Shearer, MD, PhD; Harry W. Schroeder Jr. MD PhD; Anthony J. Frew MD DRCP; Cornelia M Weyand, MD, PhD

ISBN: 9780702068966

Pub Date: 13 Mar 18

Reviewed by: Christopher M Snyder, PhD (Thomas Jefferson University)

Description

This book broadly covers basic immunology and the many clinical scenarios in which immune cells and immune responses contribute to disease pathogenesis. It attempts to be comprehensive and largely succeeds. It is designed for practicing physicians, but is also useful for teaching the clinical context of immune responses and immune dysfunction. There are many clinical pearls and tables of diagnostic information, as well as multiple figures of clinical disease states and pathological findings. The previous edition was published in 2013, but given the rapid growth in our understanding of immunology in disease and our ability to target specific immune pathways, this update was much needed.

Purpose

The purpose is to provide a comprehensive picture of how the immune system contributes to disease or protection from disease. The stated goal is to provide a reference for practicing clinicians. In this context, it begins with an overview of basic immunology and covers most of what can be found in basic immunology textbooks in somewhat less detail than is found in purely fundamental immunology book. Approximately one third of the book is devoted to this overview. The remaining two thirds are devoted to the enormous number of recognized immune-related diseases, or clinical situations in which the immune system plays a critical role (e.g. cancer or transplantation). The production of a single reference for understanding immunology in disease that does not ignore the basic science is absolutely a worthy objective and this book largely succeeds. Because of the depth of the material, this book also serves as an excellent reference for educators teaching immunology to medical students and biomedical graduate students. Given the breadth of the subject, the chapters are all written by different people who are experts in their respective areas.

In general, this works. However, the quality of writing and the breadth of information seems somewhat variable from chapter to chapter. In addition, figures are quite variable from chapter to chapter.

Audience

This book is written for practicing physicians as a reference for how the immune system functions and impacts clinical practice. The target audience is physicians in nearly any specialty and, thus, it provides a general picture of immune processes in health and disease and covers an enormous range of specific diseases in significant detail. It is also an excellent resource for designing immunology education for medical students and biomedical graduate students because it provides the clinical context for basic immunology. It is probably too big and broad to be a required textbook for a class, but it is an excellent resource for educators.

Features

The book covers the field of immunology from basic science to clinical context.

The first several sections are devoted to basic immunology with an emphasis on human immunology and the clinical context. The majority of this information is readily available in many well-respected immunology books and this book covers the basic science in less depth than is found in fundamental immunology books.

Nevertheless, all of the major concepts of immunology are addressed in a clear manner. As a reference for someone who is already familiar with basic immunology, the level of coverage is good. The remaining sections of the book focus specifically on the role of the immune system in health and disease. The book is broken into sections based on the major immunological contributions to human health and disease. These chapters focus on both the fundamental role of the immune system in each disease process as well as the clinical context, diagnosis, and treatment of each disease. Sections are organized by the role of the immune system (e.g. systemic or organ-specific autoimmune disease, immune deficiencies, allergies) as well as by disease process (e.g. immunology of cancers or transplantation). In total, this book provides a very comprehensive discussion of the immune system in health and disease, including both basic scientific underpinnings of disease as well as detailed clinical information.

One shortcoming is the variability from chapter to chapter. This is clearly unavoidable as the book covers so many topics that it requires many authors.

However, while the writing is generally very good and clear, some of the chapters appear to be more thorough than others. Likewise, figures and figure quality can vary from chapter to chapter. For the most part, figures are clear and accurate. However, as an example, the figure on the Direct Coomb’s test (chapter 62) is inaccurate and misleading. With so many figures and so many authors, oversights like this are inevitable. Nevertheless, it is a shortcoming.

Assessment

This book is fairly unique in this field in that it provides a comprehensive picture of both basic immunology and the immune system in human health and disease. Most basic immunology books are very detailed in the basic immunology that they cover, but are very thin on clinical content. In contrast, most books on clinical immunology pair it with infectious disease material and provide only a very brief overview of the immune system and immune response. Otherwise, the information is generally scattered among specialty publications that only focus on one group of diseases. This book does an outstanding job of combining clinical immunology with basic science and covering the enormous number of clinical scenarios in which the immune system plays a recognized role. The rapid pace of discovery in immunology, along with the recent development of interventions that target or use the immune response in clinical medicine, makes this update necessary.

Doody’s Review Service Weighted Numerical Score: 92- 4 Stars!