The Song of the Cell - by Siddhartha Mukherjee


The Song of the Cell - by Siddhartha Mukherjee

Read: 2024-02-11

Recommend: 8/10

The book delves into a wide range of topics including blood, cancer, in vitro fertilization (IVF), organ transplants, HIV, LDL treatments, and the origins of the smallpox vaccine in AD 900 China. “The Song of the Cell” brilliantly weaves these themes into a cohesive narrative, reminding us of the vast knowledge we’ve amassed about cellular biology and the remarkable strides made in medical science.


Here are some text that I highlighted in the book:

  1. It occurs to me, as I write this, how much this framework—germs, cells, risk—still scaffolds the diagnostic art in medicine. Each time I see a patient, I realize, I am probing the cause of his or her disease through three elemental questions. Is it an exogenous agent, such as a bacterium or virus? Is there an endogenous disturbance of cellular physiology? Is it the consequence of a particular risk, be it exposure to some pathogen, a family history, or an environmental toxin?

  2. New evidence suggests that this “modern” eukaryotic cell arose within archaea. In other words, life has only two principal domains—bacteria and archaea—and eukaryotes (“our” cells) represent a relatively recent sub-branch of archaea. We are, perhaps, life-come-lately, the sawdust left over from the carvings of the two main domains of life.

  3. Scientists at Verve have devised ways to insert catheters into the arteries leading to the liver. (The dexterity that Sek learned from decades of practice in cardiology helped.) These catheters will deliver gene-editing enzymes, loaded inside tiny nanoparticles, to the organ. Once these particles off-load their cargos inside the liver cells, the gene-editing enzymes will change the scripts of genes that aid and abet cholesterol metabolism, thereby drastically decreasing the amount of circulating cholesterol in the blood—in essence, activating the LDL metabolizing pathways. It’s a one-and-done infusion. Once the genes have been altered, they are altered for life. If successful, Verve’s gene therapy would transform you into a human with permanently lowered cholesterol level, permanently protected from coronary artery disease, permanently safe from myocardial infarction. It would be the ultimate feat of cellular reengineering for heart disease. The river of life (to use my preceptor’s favored phrase) would be cleansed forever.

  4. The Indian tika practitioners had likely learned it from Arabic physicians who, in turn, had learned it from the Chinese. As early as AD 900, medical healers in China had realized that people who survived smallpox did not catch the illness again, thus making them ideal caregivers for those suffering from the disease. A prior bout with an illness somehow protected the body from future instances of that illness, as if it retained a “memory” of the initial exposure. To harness this idea, Chinese doctors harvested a smallpox scab from a patient, ground it into a dry, fine powder, and used a long silver pipe to insufflate it through a child’s nose. Vaccination was a tightrope walk: if the powder contained too much inoculum of live virus, the child would acquire not immunity but the disease—a devastating outcome that occurred about one in a hundred times. But if the child survived the inoculum and its “fester,” he or she would develop merely an attenuated, local disease, with either no symptoms or mild ones, and be immunized for life.

  5. Cancers, we now know, can use both these mechanisms to cloak themselves against immune attack. Some express PD-L1, in essence, stitching their own orange jackets of invisibility: “Don’t shoot. I’m harmless!” When PD-1 inhibitors were injected into mice, Honjo found, T cells were incited to attack even orange-jacketed, immune-resistant tumors; the cancer’s bluff was called. Both Honjo and Allison had independently converged on the same paradigm: turn off the safety locks on a T cell, or strip away the orange jackets of the cancer cells, and the immune response could actually turn against cancer. They had checkmated the checkpoints.

  6. Virchow argued that cells were the basic units of all organisms and the key to understanding human illness was to understand the dysfunctions of cells. His book Cellular Pathology would transform our understanding of human disease.

  7. Dr. Robert Koch (1843–1910), a German microbiologist who, along with Pasteur, would introduce “germ theory.” Koch’s major contribution was to formalize the idea of the “cause” of a disease. By defining criteria that qualified as “cause,” Koch brought scientific rigor to medicine.

  8. an experimental transplant of bone marrow with “donor” cells that contained an unusual natural variant of the CCR5 delta 32 cell-surface receptor that had been proven to render cells resistant to HIV infection.