Immunologist Max Krummel Maps Non-Linear T-Cell Networks for Cancer Therapies

How Your Immune System Works & How to Improve It | Dr. Max Krummel — Andrew Huberman

Andrew Huberman

Complex diseases require sequential biological interventions rather than single target drugs because tissue archetypes operate through redundant spatial networks.

AI-assisted summary of How Your Immune System Works & How to Improve It | Dr. Max Krummel — original source. Check the original for full context.

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Detailed notes

## Background Published on YouTube on August 3, 2026, by Andrew Huberman, this episode features Dr. Matthew (Max) Krummel, a leading immunologist and professor at UCSF. The episode description outlines an in-depth conversation covering how the immune system operates, how sleep, emotions, and memory impact immunity, and the roles of the thymus, autoimmunity, cancer immunotherapies, and vaccination dynamics.

## TL;DR Dr. Max Krummel breaks down the fundamental mechanics of the human immune system, emphasizing how circadian rhythms, sleep deprivation, and neural states actively modulate immune responses and lymphatic drainage. The discussion explores scientific breakthroughs from early T-cell checkpoint discoveries to spatial biology, organoid engineering, and AI-driven disease modeling. Krummel offers nuanced perspectives on personalized cancer vaccines, the trade-offs of historical public health communications, and the non-linear, high-failure nature of foundational research. Ultimately, the conversation highlights how genetic diversity, evolutionary trade-offs, and neural-immune crosstalk shape both individual susceptibility and biological resilience.

## Atmosphere & style The conversation carries a deeply cerebral, curious, and grounded tone, balancing high-level scientific rigor with authentic humility. Dr. Krummel and Andrew Huberman share a dynamic, peer-to-peer chemistry filled with candid insights into the messiness of scientific discovery and the realities of translational research. It feels intellectually invigorating yet approachable, moving smoothly from complex cellular mechanisms to practical reflections on human biology, medical trust, and the unpredictable nature of scientific progress.

## Key takeaways - [42:40](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=2560s) Evolutionary pressure prioritizes organism survival primarily through reproductive age (~30 years), leaving human biological maintenance and immune defenses less optimized for late-life genetic mutations and somatic mosaicism. - [49:09](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=2949s) During sleep, circulating immune cells retreat to the bone marrow while neutrophils repair tissue, making sleep a crucial reset phase where stagnant lymph fluid accumulation is cleared. - [55:05](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=3305s) Umbilical cord banking preserves hematopoietic stem cells capable of fully reconstituting the blood and immune system to cure childhood blood cancers following intensive treatment. - [01:02:14](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=3734s) Engineered CAR T-cell therapies face major challenges in solid tumors due to the strongly immunosuppressive tumor microenvironment that turns off engineered immune cells. - [01:06:55](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=4015s) Basic, curiosity-driven research is non-linear and operates with a high failure rate (~90%), yet it yields major unexpected medical breakthroughs such as CRISPR and T-cell checkpoint inhibitor cancer immunotherapies. - [01:14:14](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=4454s) Spatial biology demonstrates that immune cells function based on their precise physical localization within tissue microenvironments, including tissue-resident T cells that act as local organ guardians. - [01:19:13](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=4753s) The insular cortex and immune system form joint neuro-immune memories, allowing the brain to reactivate specific localized inflammatory states in organs without an active pathogen or chemical trigger. - [01:34:25](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=5665s) Personalized cancer vaccines utilize tumor biopsies to target unique neoantigen mutant peptides, enabling T cells to eliminate cancer cells without harming healthy tissue. - [01:36:19](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=5779s) Standard combination childhood vaccine schedules prioritize public health logistics and statistical safety over individualized timing, whereas adult vaccines often contain strong adjuvants causing significant reactogenicity. - [01:39:37](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=5977s) Opaque public health messaging and a lack of financial incentives for pharmaceutical companies to develop precision diagnostics erode public trust in scientific institutions. - [01:54:35](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=6875s) Injecting systemic inflammatory cytokines directly triggers neural sickness behaviors and social isolation, illustrating the direct sensitivity of brain receptors to immune signals. - [02:09:01](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=7741s) Single-cell single-tissue analysis reveals that complex conditions like asthma and autoimmune diseases are not monolithic, but consist of distinct immunological archetypes requiring sequential, multi-step interventions. - [02:14:30](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=8070s) Genetic diversity within populations provides evolutionary trade-offs, where hyper-reactive immune traits or disease carrier statuses protect the broader species against novel environmental pressures and lethal pathogens. - [02:17:11](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=8231s) Science communication must account for historical contexts and institutional failures to effectively bridge the gap between complex research and public trust.

## Detailed walkthrough ### [00:00](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=0s) Max Krummel

The conversation kicks off with Dr. Max Krummel sharing an intriguing historical metaphor originally drawn by a famous immunologist back in the 1970s. During World War II, American submarines operated with two critical reference books to solve a fundamental "self versus non-self" discrimination problem. The first book contained the precise engine sound profiles of all US submarines—such as the distinct cycle of a General Motors engine—so if sonar picked up that familiar whir, the crew knew not to fire. The second book cataloged the specific engine sounds of known German diesel submarines, giving the crew immediate clear authorization to attack.

Dr. Krummel bridges this naval analogy directly to the human immune system, which relies on a similar recognition system to differentiate bodily tissues from invading pathogens. However, as human bodies age and grow more complex, those reference books become infinitely crowded with every conceivable permutation of biomolecules that the body itself can synthesize. In advanced age, this biochemical noise makes it significantly harder for the immune system to distinguish a novel virus from an altered version of "self."

[00:56](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=56s) Immune System, Immunotherapy

Following Andrew Huberman's intro introducing Dr. Max Krummel—a leading expert in immunology and cancer biology at UCSF—Huberman sets the stage for a comprehensive discussion on immune health, covering everything from sleep mechanics to memory-driven immune responses and vaccines. Huberman asks Dr. Krummel to trace how our scientific understanding of the immune system has evolved over time, noting that it remains a relatively young and rapidly unfolding field of study.

Dr. Krummel reflects back to 1989 when he first entered the field during his rotations at UC Berkeley. At that time, a senior mentor in transcription factor biology candidly questioned his choice, asking, "Why do you want to work in immunology? It's not really a field." Back then, the prevailing dogma was overly simple: the immune system was viewed merely as an off-and-on switch that activated strictly in the presence of an obvious foreign virus and otherwise stayed completely quiet. That rigid view was fundamentally revolutionized by the rise of cancer immunotherapy. Researchers discovered that the immune system is actually a highly tunable system. By raising or lowering the activation threshold of T cells, therapies could unleash T cells to hunt down and destroy tumor cells—cells that originated from the host body and were once ignored as "self."

The understanding of the immune system expanded far beyond pathogen defense as scientists discovered its active involvement in virtually every organ system: * **Nervous System & Brain:** Specialized microglia perform continuous cleanup and structural maintenance. * **Gastrointestinal System:** Immune cells carefully titrate the gut microbiome, keeping essential microbes alive in optimal quantities while preventing overgrowth. * **Liver:** Dedicated immune cell populations reside in liver tissue to regulate metabolic processes. * **Heart:** Immune cells clean up metabolic byproducts and cellular debris around cardiomyocytes (heart muscle cells) to preserve cardiovascular function.

Dr. Krummel explains that in the late 1980s, the peak of the HIV/AIDS epidemic served as a tragic yet profound catalyst for immunological discovery. HIV targets CD4+ T cells—a critical subset among the roughly $10^{11}$ T cells circulating in the human body. The loss of these cells produced wide-ranging opportunistic infections (such as soil bacteria that healthy systems effortlessly neutralize), Kaposi's sarcoma, and HIV-related dementias. This underscored just how pervasive immune oversight is across human physiology. Today, scientists view every individual T cell as a "free agent" sensor within a massive distributed network. Each cell continuously samples local peptide and protein concentrations, deciding whether a biological parameter is in or out of range to keep the host healthy.

[08:36](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=516s) Illness, Childhood & Immune System

Huberman shifts the focus to a developmental perspective, asking why young children seem to fall ill so frequently, recover rapidly, and how this dynamic compares to the declining immunity seen in the later stages of life.

Before diving into developmental biology, Dr. Krummel poses a foundational question: "Where does your body end and where does the world outside start?" Humans are not self-contained genetic islands; they are heavily populated ecosystems covered inside and out by microbes. Human DNA contains only about 20,000 genes, which places a strict hard limit on our inherent metabolic capabilities. To survive, humans absorb foreign species and their genomes into a shared ecosystem. For example, gut bacteria generate crucial bile acid components required to digest animal fats, and specific gut microbes enable the breakdown of nutrients from seaweed when eating sushi.

When a child is born, their immune system faces a unique dual challenge during two distinct stages of development: * **The First 6 Months of Life:** A newborn's immune system is intentionally suppressed and poorly trained. Because infants develop and turn on new genes at a rapid pace, an overly vigilant immune system would run a high risk of misidentifying its own newly expressed proteins as foreign, causing catastrophic autoimmune attacks. This intentional delay is why many essential childhood vaccines are scheduled only after 6 months of age. * **Childhood (Up to ~10 Years):** As children grow, they get sick frequently simply because their immune system lacks immunological memory; every encounter with a common flu or cold virus is a brand-new threat. Fortunately, their young immune systems are robust and mount vigorous recoveries. However, dangerous pathogens like measles, mumps, and rubella carry high mortality risks, making early immunization vital to establish protection without risking natural infection. * **Late-in-Life Decline:** At the opposite end of the lifespan, immune function gradually declines. Overall cellular function drops, and the body produces fewer naive immune cells—largely because evolutionary pressures never selected human biology to maintain high-functioning immunity past historical lifespans.

Here is a detailed, faithful walkthrough of the transcript segment.

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[14:20](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=860s) Reproductive Fitness, Evolutionary Selection, and the Grandfather Effect

The conversation begins with a discussion on human longevity and evolutionary biology. Max Krummel notes that from a strict genetic evolution perspective, humans are capable of passing on their genes successfully by age 16. Because of this, anything that occurs biologically past reproductive age can be viewed as "cream on the crop," as there may be no real natural selection operating on genes that act later in life.

Andrew Huberman brings up a counterpoint often made by psychologists: that the wisdom of older individuals (in their 60s, 70s, and 80s) provided significant survival value to hunter-gatherer groups of around 100 people. Older generations could pass down vital information regarding long-term environmental patterns occurring on 5-to-30-year periodicities. Krummel lightly chuckles, calling that a "nice 'just so' story," though Huberman points out that population geneticists refer to a similar concept known as the **grandfather effect**. Under this framework, genes fostering prosocial and cooperative behaviors in the elderly could be selected for because they enhance the evolutionary fitness of their grandchildren—who carry their genetic lineage. Krummel agrees it is a compelling concept, though proving it empirically would require setting up controlled studies comparing villages with and without grandparents, which is both non-ethical and logistically impossible.

- **Key Concepts & Quotes:** - Selective pressure to pass on genes peaks early; past reproductive age, evolutionary selection drops off sharply. - "The grandfather effect": Genetic traits supporting elder survival may be selected for indirectly through the enhanced fitness of grandchildren.

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[15:55](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=955s) Genetic Mosaicism and the Aging Cellular Landscape

Shifting back to the core topic of the aging immune system, Krummel tackles the fundamental question of "who you are" at a cellular level. While basic biology teaches that a fertilized egg creates a clone where every cell inherits identical copies of maternal and paternal chromosomes (23 pairs from each parent), this uniformity does not last. DNA replication and maintenance are imperfect. For example, skin cells experience continuous environmental damage, undergoing roughly 10,000 to 30,000 mutations per cell per day primarily due to UV radiation exposure.

``` [Fertilized Egg] (Identical 46 Chromosomes) │ ▼ (Decades of Sun Exposure, DNA Errors & Somatic Mutations) [Mosaic Tissue] (Pastiche of Clones with Varying DNA & Efficacy) ```

Over decades, these accumulated mutations transform the body into a genetic **mosaic**—resembling the intricate, non-uniform tiled patterns found in Moroccan architecture. Certain cell clones acquire mutations that make them more "fit" to divide and fill gaps when tissue is damaged (such as repairing a skin scratch). Consequently, an adult body becomes a complex pastiche of genetically divergent cells rather than a uniform genetic entity. This presents a massive challenge for immune surveillance: if every cell in the body is slowly mutating and becoming distinct from its neighbors, defining what is "self" versus "non-self" becomes extraordinarily difficult for immune cells.

Huberman raises an exception, noting that central nervous system neurons in the brain and spinal cord, as well as inner ear hair cells, are retained throughout life rather than constantly turning over. Krummel clarifies that even in non-dividing, long-lived cells, the nuclear DNA encoding their identity remains subject to ongoing mutation. He further notes that hematopoietic stem cells are housed deep within the hollow cavities of long bones to protect this vital source of immune system replenishment from solar radiation and mutating environmental chemical cues.

- **Key Data Points:** - **Skin Cell Mutations:** ~10,000 to 30,000 mutations per cell per day due to sunlight/UV exposure. - **Mosaicism:** Somatic mutations create distinct cellular lineages across tissues over a lifespan. - **Stem Cell Niche:** Bone marrow sequestering protects long-term immune stem cells from mutational hazards.

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[18:36](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=1116s) Sponsors: Joovv & Eight Sleep

Huberman pauses the conversation for sponsor messages. He highlights **Joovv**, which produces medical-grade red light and near-infrared light therapy devices using clinically proven wavelengths to enhance cellular health, muscle recovery, skin health, and mitochondrial function. He notes using their full-body panel 3–4 times per week for 10–20 minutes, alongside their handheld device during travel. He then introduces **Eight Sleep**, showcasing the Pod 5 mattress cover, which uses automated cooling and heating ("Autopilot" AI technology) to drop body temperature by 1–3°F during sleep onset and elevate it prior to waking to optimize sleep quality and recovery.

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[21:14](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=1274s) Self vs. Non-Self Recognition: The Submarine Analogy & Cancer Risk

Resuming the discussion, Krummel introduces a vivid historical analogy from a 1970s marine biologist comparing immune surveillance to World War II submarine warfare. Submarines operating underwater in dark oceans had to identify surrounding vessels before firing torpedoes. To avoid friendly fire while engaging enemies, sonar technicians relied on two reference books: 1. **The "Self" Book:** Sound profiles of friendly engines (e.g., the distinct whir of a US General Motors diesel engine). If a detected sound matched this book, they held fire. 2. **The "Non-Self" Book:** Engine acoustic profiles of known enemy submarines (e.g., German U-boats). If a match was found, they fired immediately.

``` +-----------------------------------------------------------------------+ | SUBMARINE SONAR ANALOGY | +-----------------------------------------------------------------------+ | Sound Profile Match: US General Motors Engine ---> DO NOT FIRE (Self)| | Sound Profile Match: German U-Boat Engine ---> FIRE TORPEDO (Non-Self)| +-----------------------------------------------------------------------+ | Aging Effect: Engine sounds mutate and blur, filling the reference | | books with noise. Distinguishing enemy from friendly becomes erratic. | +-----------------------------------------------------------------------+ ```

As the body ages and cellular mosaicism increases, the immune system's internal "reference books" fill with endless variations of mutated biomolecules. The line between normal tissue and an invading pathogen or mutant cell blurs. When a virus enters, it forces cells to produce foreign viral proteins that the immune system easily flags to trigger a T-cell response. However, age-related genetic background "noise" makes immune discrimination far harder.

This loss of clarity directly links to why cancer rates rise dramatically in older age. Cancer cells arise from accumulated mutations, but because aging non-cancerous cells have also accumulated numerous benign mutations, a nascent cancer cell does not look starkly different from the surrounding mutated tissue.

- **Key Concepts & Quotes:** - "The weird doesn't look that weird anymore": Mutated cancer cells blend into an aging tissue landscape that is already genetically heterogeneous. - Aging increases background noise in immune recognition, reducing the sharpness of self vs. non-self discrimination.

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[25:07](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=1507s) Immune Pruning, Wound Healing, and the Double-Edged Sword of Selection

Huberman asks whether rapid cellular turnover eliminates mutated cells before they become problematic. Krummel agrees that active immune surveillance is constantly "pruning" aberrant cells. A visible example seen in people in their 40s or 50s is the emergence of small white spots on the skin. These spots represent areas where the immune system successfully recognized and cleared a cluster of precancerous melanocytes (melanin-producing cells), leaving behind a small depigmented void.

However, tissue repair presents a fundamental evolutionary trade-off: * **Childhood Wound Healing:** Children heal at remarkable speeds—a cut that takes an adult four weeks to clear with a lingering scab will vanish from a child's skin in three days. Rapid repair minimizes the dangerous period an open wound is exposed to wild pathogens. * **Selection for Growth:** The cells best equipped to rapidly fill a tissue void following damage are those carrying mutations that allow them to divide faster. * **The Cancer Paradox:** Selecting for cells with aggressive growth dynamics solves the immediate problem of tissue repair, but cell division speed is the defining feature of cancer.

Over a lifetime, repeated cycles of tissue damage and repair select for increasingly fast-growing cell clones. Eventually, one of these clones may escape localized control and acquire the capacity to invade distant organs—a process known as **metastasis**, which accounts for the vast majority of cancer fatalities. Krummel concludes that immunology's historical view of immunity—treating it like a simple "fuel gauge" that is either off for self or running hot against pathogens—is far too simplistic. Real immune regulation operates in a nuanced spectrum between total tolerance and destructive rage.

- **Key Data Points & Examples:** - **White Skin Spots:** Visual evidence of historical immune clearance of precancerous melanocytes. - **Wound Repair vs. Cancer Risk:** Rapid cellular proliferation heals wounds quickly but selects for clones with elevated growth rates. - **Metastasis:** The spread of fast-dividing mutant cells to distant sites, serving as the primary cause of cancer mortality.

---

<ElicitationsGroup message="Explore related aspects of immune aging and cancer surveillance:"> <Elicitation label="Examine how the thymus involution impacts T-cell diversity during aging" query="Explain how age-related thymus involution reduces T-cell diversity and affects overall immune function."/> <Elicitation label="Explore modern cancer immunotherapies targeting immune checkpoints" query="How do modern cancer immunotherapies like checkpoint inhibitors work to overcome immune tolerance?"/> </ElicitationsGroup>

[28:36](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=1716s) Pathogen Détente and Immune-Mediated Pathology

Dr. Max Krummel explains that the immune system does not operate purely to eradicate every non-self entity at all costs. In many settings—such as in the gut or even within organs like the heart—the immune system acts as a monitor that can quarantine or contain bacteria and viruses without destroying them. It maintains an equilibrium, keeping microbial populations within a specific "zone." We carry a vast collection of latent viruses, challenging the naive biological or religious belief that recovering from an illness restores the body to a state of absolute "purity." Every past infection leaves molecular signatures behind, and forcing total eradication would require the immune system to destroy huge amounts of host tissue.

A prime example of this trade-off is herpes simplex virus, which resides within nerve cells. During viral reactivation, much of the agonizing nerve pain and neurological damage is not caused directly by the virus itself, but rather by the immune system attacking host neurons to contain the outbreak—a phenomenon known as immunopathology. When the immune system's state of *détente* fails, its aggressive efforts to purge a pathogen can inflict far more harm than the infection itself.

``` +-------------------------------------------------------------------------+ | IMMUNE BALANCE: DEFENSE VS. DAMAGE | +-------------------------------------------------------------------------+ | | | [Low / Controlled Activity] [Uncontrolled Attack] | | • Latent Virus / Commensal Flora • Immunopathology | | • Immune system quarantines • Immune cells kill host | | • Tissue integrity preserved tissue trying to purge | | • Host survives and reproduces pathogen (e.g., nerve pain) | | | +-------------------------------------------------------------------------+ ```

From an evolutionary standpoint, the body prioritizes surviving long enough to reproduce (roughly to age 30) over achieving a sterile state. If an individual contracts an early liver infection such as Hepatitis B (HBV) or Hepatitis C (HCV), a tolerant immune system that leaves the virus alone allows the host to survive and pass on their genes. Conversely, if the immune system swings its fuel gauge all the way to the right and launches an all-out attack, it risks catastrophic liver destruction and death.

* "The immune system is consistently present and it's consistently measuring you... It's not just what came from the egg, it's the you that's you right now." * "Every virus leaves a little evidence of a little bit of itself. And then there's the goal for the immune system to kind of quarantine that." * "The immune system is causing as much of the damage and problem as the virus is. And it's the failure of that détente." * "If you mounted a massive immune response... went all the way in the fuel gauge to the right, your immune system can kill you."

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[31:08](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=1868s) Signal Detection, Neural Accommodation, and How Cancer Escalates

Dr. Andrew Huberman poses a hypothesis based on neurobiology: rather than responding binary-style to an isolated mutation, does the immune system integrate signals over time or average local mutation density before launching an attack? Dr. Krummel confirms this concept, drawing a direct parallel to sensory accommodation in the nervous system. He shares an anecdote about visiting the small French village of Époisses, famous for its intensely pungent cheese. Upon driving into town, the foot-odor-like stench is overwhelming, yet after sitting there for an hour, sensory accommodation tunes the smell out entirely so the olfactory system remains sensitive to novel hazards.

In a similar fashion, immune cells—specifically T cells—evaluate signals based on rate of change and duration:

* **Acute Spikes (Pathogens):** A rapid surge in viral replication accompanied by cell damage creates an unequivocal "danger signal." The immune system mounts a vigorous response, clears the threat, and retains immunological memory. * **Baseline Baseline Levels (Self-Proteins):** Normal self-proteins like insulin fluctuate within a predictable range across a lifetime. T cells recognizing these baseline levels remain minimally reactive to avoid autoimmunity. * **The "Slow Burn" (Cancer & Commensals):** A mutated cell that doubles very slowly over months gently nudges protein levels just slightly above baseline. Because this subtle increase mimics normal developmental changes or harmless commensal shifts without triggering acute cell damage, the immune system accommodates it and accepts it as part of "self."

Dr. Krummel highlights that immune cells operate like a mobile "mini-brain." Rather than being stationary like the nervous system, billions of immune cells crawl continuously through tissues like the skin. When they encounter suspicious signals, they aggregate, form immunological synapses with each other, exchange chemical information, and collectively decide whether to launch an inflammatory cascade. Because cancer develops via a slow, stealthy burn, it bypasses these trigger thresholds.

* "It's like somebody has the worst foot odor striking... but after being in the town for like an hour, you don't notice it. That's neuronal accommodation." * "Whatever you are is what the immune system is going to help you be if it's a slow direction... What it doesn't like is big spikes." * "The problem with cancer is that it is slow and nefarious... we're made to absorb slow change." * "They get together like neurons and they can form synapses and one can say to another one, 'This is what I saw'... like a neural little mini brain in our tissue."

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[36:54](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=2214s) The Thymus: T Cell Education, Aging, and Therapeutic Revitalization

Dr. Huberman directs the conversation toward the **thymus**, an organ located near the heart that has drawn growing public interest regarding peptides, banking, and anti-aging interventions. Dr. Krummel provides the history and essential biology of the organ, noting that the letter "T" in **T cell** originally stood for *thymus*.

Historically, when pediatric surgeons opened the chests of children undergoing heart surgery, they repeatedly discovered a massive, pale organ sitting over the heart. Because most prior autopsies had been performed on adults—in whom the organ has shriveled away—surgeons assumed the tissue was a pathological growth and routinely removed it. Tragically, these children later died from overwhelming opportunistic infections. In the 1960s, Dr. Jacques Miller (a researcher now in his late 90s in Australia) conducted landmark experiments in England by surgically removing the thymus from newborn mice. These mice grew normally at first, but ultimately died of severe bacterial infections and developed tumors, proving the thymus was the essential cradle of cellular immunity.

``` +-------------------------------------------------------------------------+ | T CELL LIFE CYCLE & TRAININGS | +-------------------------------------------------------------------------+ | | | Bone Marrow Stem Cells ──► Migrate via Blood ──► Thymic Education | | │ | | • Generates ~10¹¹ unique ▼ | | receptor combinations Screens against host | | genome to eliminate | | self-reactive T cells | | │ | | Mature, Tolerant T Cells ◄───────────────────────────┘ | | Released into Bloodstream | | | +-------------------------------------------------------------------------+ ```

The thymus serves as a specialized "educational academy" for T cells through a rigorous screening process:

* Precursor stem cells originate in the bone marrow and travel via the bloodstream into the thymus. * Developing T cells generate roughly $10^{11}$ (100 billion) possible unique receptor configurations to smell distinct molecular structures. * Inside the thymus, specialized cells express virtually every protein coded by the host genome. T cells that bind too strongly to self-proteins are destroyed to prevent them from attacking host tissues like the pancreas or joints. * Only properly calibrated T cells that display self-tolerance are permitted to exit into circulation.

Thymic output peaks in early childhood (from 3–6 months up to 4–5 years of age) to equip the developing child with a diverse repertoire of immune defenses against novel pathogens. As humans age past reproductive maturity, the thymus undergoes **involution**—it shrinks dramatically and its functional output drops close to zero. Consequently, older adults lack a fresh supply of naïve T cells. This organ decay explains why researchers are exploring thymic revitalization, thymic peptides, and tissue engineering: restoring thymic function could flood the aging body with pristine T cells capable of recognizing novel tumor antigens that existing, exhausted T cells have learned to tolerate.

* "T-cell originally was thymus cell... bone marrow stem cells travel through your blood to the thymus and become T cells." * "Developing T cells... each have a possible $10^{11}$ different kinds of receptors to smell different things." * "The thymus has the role of producing T cells, but also of educating them... only letting the ones that come out that have sensors that are correctly tuned to let you be you." * "In aged people, it's tiny... and so it's not putting out new T cells. The natural route might be to let the thymus make more T cells to react against this tumor."

- **Key White Blood Cell Distinctions:** White blood cells primarily comprise **B cells** (matures in bone marrow/bursa derivatives, produces antibodies) and **T cells** (matures in the thymus, drives cell-mediated immunity). - **Jacques Miller's Discovery:** Dr. Jacques Miller (born 1931) proved in 1961 that the thymus is not a redundant evolutionary remnant, but the critical organ for T cell development and immune tolerance. - **Thymic Involution Timeline:** The thymus reaches its maximum relative size in infancy and peak absolute mass at puberty, after which functional epithelial space is progressively replaced by fatty tissue (adipose involution).

<ElicitationsGroup message="Where should we go next with Dr. Max Krummel's insights?"> <Elicitation label="Explore T cell engineering and CAR-T cancer therapies" query="How do engineered CAR-T cells compare to natural T cell development in the thymus for treating cancer?"/> <Elicitation label="Examine immune system interventions for longevity" query="What evidence exists for thymic regeneration protocols or peptides in slowing immune aging?"/> </ElicitationsGroup>

Here is a detailed, faithful walkthrough of the transcript segment.

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[42:40](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=2560s) Reproduction, Evolutionary Pressure, and the "Already Reproduced" Mindset

Dr. Max Krummel and Dr. Andrew Huberman reflect on how the immune system—specifically the thymus and T-cell generation—experiences a steep decline with age, rendering older adults far more vulnerable to disease. They debate whether this drop-off represents an intentional evolutionary design or simply a total lack of selective pressure. Krummel points out that from an evolutionary standpoint, if an organism survived to age 30, successfully passed on its genes, and then succumbed to an arrow wound, it was already a "winner." Selection pressure historically cared primarily about getting individuals to reproductive age rather than preserving health into late adulthood.

Huberman illustrates this concept with a humorous anecdote about their mutual friend, Dr. David Felheim, a developmental biologist at UC Santa Cruz (who trained in Randy Schekman's Nobel Prize–winning laboratory). Years ago, Huberman watched Felheim doing microinjections using carbocyanide dyes—which contain toxic cyanide—into fixed tissue without wearing gloves. When Huberman asked him if he wanted gloves, Felheim looked up from his microscope and deadpanned, "I've already successfully reproduced," before going right back to work. Huberman and Krummel laugh over this "cell biologist mindset," though Huberman notes that because human children are born completely helpless—unlike giraffes that can run within an hour of birth—there actually *is* evolutionary pressure on humans to stay healthy long enough to rear their offspring to independence.

* "I walked over and I saw Dave doing this and he wasn't wearing any gloves... I said, 'Dave, don't you want to put on gloves?' And he literally looked up from the microscope at me... and he said, 'I've already successfully reproduced.'" * "Most humans are born pretty incapable for a period. It's not like giraffes where they drop off and... within an hour they're running."

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[45:36](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=2736s) Mosaicism, Basic Research, and "Killer Experiments"

Building on the evolution debate, Krummel emphasizes that adaptations that benefit us early in life can create complex trade-offs later on. A prime example is somatic mosaicism—the accumulation of genetic mutations in different cell lineages over time—which creates a moving, highly complex internal target that the aging immune system was never optimized to defend against. Krummel uses this to make a passionate plea for fundamental basic research. Understanding complex biological systems requires asking basic questions, even though roughly 90% of scientific hypotheses turn out to be dead ends.

He explains that non-scientists often do not realize how many hundreds of silent disappointments lie behind every major published discovery. Researchers routinely go home after flawless execution only to find the data completely disproved their favorite idea. In scientific culture, the best tests are called "killer experiments"—rigorous, well-controlled setups designed to decisively kill a hypothesis if it is wrong. Krummel cautions against trusting pure intuition or assuming the biological world works the way we think it "should," noting that immune architecture is often baroque, strange, and unintuitive. Huberman agrees, recalling how when he entered neurobiology, the central nervous system was firmly believed to be an "immune-privileged" organ devoid of immune cells—a doctrine shattered by pioneers like Carla Shatz, Ben Barres, Beth Stevens, and Schafer (Cagla Eroglu), who proved that immune mechanisms are active in the brain throughout life.

* "For all the discoveries that I made or other people have made, there is hundreds and hundreds of disappointments." * "The better experiments, the kind of—we call them killer experiments, right? The ones that kill the idea if it's wrong." * "When I started in neurobiology, the brain... was considered an immune-privileged organ. There weren't supposed to be immune cells there."

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[49:09](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=2949s) Sleep, Immune Cell Traffic, and Lymphatic Plumbing

Huberman transitions to a practical question: why does missing just a night or two of sleep make a person so dramatically more susceptible to catching infections? Krummel explains that while the exact mechanisms are still being debated across different academic factions, several striking biological events occur specifically during sleep. At night, a huge portion of circulating immune cells retreat out of the blood and dive back into the bone marrow, while neutrophils emerge to deposit collagen and carry out systemic tissue repair. Because high metabolic activity and ATP consumption generate cellular "granularity" and waste during waking hours, sleep acts as a critical reset phase where the body pauses waste production to clean house. Krummel compares it to pulling into a gas station to clean a bug-splattered windshield, which you cannot do while driving at high speed down the highway.

Huberman adds a clear physical example of fluid dynamics: the visible "bags" under a person's eyes when sleep-deprived. This appearance is caused by a physical buildup of stagnant lymph fluid that fails to drain properly without adequate sleep rest cycles. Once a person sleeps deeply for a night or two, the facial lymphatic plumbing drains, and the puffy bags vanish. Both agree that while lymphatic drainage explains the mechanical side, the protective feeling of being "robust" against a coughing person in a room after a good night's sleep highlights how profoundly sleep restores immune surveillance.

* "At night, a few wacky things happen... one of them is that a lot of your immune cells clear back to the bone marrow." * "Everybody has bags under their eyes... when they are sleep deprived. They sleep for a night or two and it goes away. That's clearly accumulation of lymph." * "When you wash your car windshield, you do it completely at that point... but you can't be driving while flying, you'll never clean it."

---

[53:52](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=3232s) Sponsor: AG1 Pro

Huberman presents a brief sponsor breakdown for AG1's newest formulation, AG1 Pro. He explains that the updated product builds upon their original blend of vitamins, minerals, probiotics, and adaptogens by adding three specific compounds: - **Creatine monohydrate (5 g):** Supports muscle strength, physical performance, and cognitive/brain health. - **Calcium HMB:** Aids muscle recovery and reduces muscle tissue breakdown. - **Zinc carnosine:** Supports and repairs the mucosal lining of the gut.

Huberman notes that he has been taking AG1 daily for nearly 14 years, long before starting his podcast, and highlights a promotional offer at `[drinkag1.com/huberman](https://drinkag1.com/huberman)` for a free bottle of Vitamin D3+K2 / Omega-3 CoQ10 with a first subscription.

---

[55:05](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=3305s) Umbilical Cord Banking vs. Thymic Cell Banking

Returning to the topic of the thymus and immune preservation, Huberman asks about umbilical cord banking—where parents pay to freeze stem cells from a newborn's umbilical cord—and speculates whether we should be doing something similar with thymic tissue. Huberman admits he wishes he had a chunk of his own young thymus stored in a $-80^\circ\text{C}$ freezer so he could use its naive T-cell generating capacity when he reaches 85 years old.

Krummel clarifies the distinction between the two tissues. Umbilical cord banking is relatively non-invasive because the cord is normally discarded at birth. It yields hematopoietic bone marrow stem cells, which serve as a critical backup if a person ever develops a bone marrow cancer (like leukemia) later in life; radiation can wipe out the cancerous marrow, and the banked cord stem cells can be re-infused to rebuild the blood system. However, when Huberman asks if there are documented walking, breathing adults alive today specifically because their parents paid to bank their umbilical cord blood, Krummel admits it is a complex question and he does not know the exact numbers offhand, though commercial banks continue to market the service heavily.

- **Umbilical cord banking:** Stores hematopoietic stem cells harvested from discarded cord tissue at birth. - **Primary therapeutic use:** Reconstitution of the blood/immune system following ablative radiation or chemotherapy for bone marrow malignancies. - **Storage conditions:** Cryopreserved in small vials within ultra-low temperature liquid nitrogen/freezer systems requiring continuous generator backups.

<ElicitationsGroup message="Where would you like to go next?"> <Elicitation label="Continue to Part 5 of the transcript" query="Please provide the walkthrough for Part 5 of the Dr. Max Krummel episode."/> <Elicitation label="Deepen understanding of naive vs. memory T cells" query="Explain the biological differences between naive T cells from the thymus and memory T cells, and how thymic involution affects aging."/> </ElicitationsGroup>

[56:57](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=3417s) Umbilical Cord Banking and the Certainty of Cures

The conversation turns to the practical value of commercial umbilical cord blood banking. Max references the deep foundational research of scientists like David Felheim, noting that in mice, bone marrow stem cells can undeniably reconstitute an entire system and cure blood cancers. He expresses absolute certainty that this biological reality holds true for humans as well, even if he remains unsure of the specific clinical outcomes achieved by individual commercial banking companies. When Andrew points out that cord blood storage is now heavily marketed to new parents as a standard option, Max admits that if a family has the financial flexibility where the cost is "within the noise," he would personally choose to do it. The powerful instinct to protect a newborn child makes it an appealing insurance policy, particularly because if that child were to develop leukemia, these banked stem cells could provide a definitive cure.

Andrew highlights the profound weight of this assertion, noting that Max did not merely state the technology might one day "lead to a cure," but rather flatly stated it "would cure it." This absolute framing signals a rare degree of scientific confidence in the therapeutic potential of these stored cells. However, both speakers acknowledge the psychological friction inherent in these choices, where the pressure to prepare for worst-case scenarios can easily become an overwhelming focal point for parents navigating modern healthcare options.

- Bone marrow stem cell transplants can fully reconstitute a mouse and cure blood cancers. - Umbilical cord blood banking is widely offered to the public as a preventative health measure. - Max notes that banked cord blood would act as a definitive cure for childhood leukemia.

---

[58:07](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=3487s) Induced Pluripotent Stem Cells, Mutations, and Organoid Research

Andrew shifts the scope to advanced regenerative technologies popular in the biotech ecosystem, specifically the creation of induced pluripotent stem cells (iPSCs) from adult skin fibroblasts using the classical Yamanaka factors to revert cells back to a state of biological "stemness." He raises a serious concern based on their prior discussion about aging and genomic drift: if an individual's adult fibroblasts have already accumulated random DNA mutations over a lifetime, using them to grow organoids to test drugs or model heart and liver diseases could yield fundamentally flawed, unrepresentative data. Andrew emphasizes that running experiments on mutant cells under the assumption that they perfectly mirror a person's healthy baseline genetics seems like a structurally "lousy experiment."

Max offers a nuanced correction, clarifying that random baseline somatic mutations are not the primary bottleneck or the reason these experiments might fail. Instead, the far greater scientific challenge lies in the sheer difficulty of the induction process itself—specifically, whether researchers can successfully coax those stem cells to accurately replicate the complex architecture and functional physiology of a true, mature human organ. Max expresses deep faith in the iterative nature of science, specifically citing the structural framework of the California Institute for Regenerative Medicine (CIRM), but notes that a wide temporal gulf exists between basic laboratory discovery and true clinical utility.

- Yamanaka factors are utilized to revert adult fibroblasts back to a pluripotent stem cell state. - A primary hurdle in organoid research is successfully replicating the true physiological behavior of human organs. - The California Institute for Regenerative Medicine (CIRM) serves as a primary driver for testing and learning within stem cell biology.

---

[01:00:21](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=3621s) The Realities of Longevity Culture and the Limitations of Thymic Engineering

The discussion transitions into a candid critique of modern longevity culture. Max warns against overemphasizing futuristic biological insurance policies, pointing out the dark humor in spending large sums of money to bank fibroblasts or tissue only to die in a completely unrelated everyday accident, such as getting hit by a car. He notes that spending one's life perpetually anxious about the exact mechanism of one's eventual death is an exhausting and unproductive way to live. Andrew agrees completely, stating that his interest does not lie in the absolute extremes of life extension—such as reaching the theoretical human genetic limit of 120 years—but rather in maximizing healthspan, ensuring that the years one does have are defined by vitality, mobility, clear sensory perception, sharp cognition, and robust memory.

Addressing Andrew's earlier question about surgically removing and banking a portion of the thymus during youth, Max outlines the immense technical and anatomical hurdles. The thymus is a complex organ comprising both bone marrow-derived cells and a structural matrix of specialized thymic epithelial cells that act to "educate" developing T cells. While solid laboratory work demonstrates that researchers can engineer a synthetic thymic epithelium to mimic this education process, Max remains highly skeptical that a regular consumer banking these cells today would see any practical longevity benefit within their lifetime.

- The current estimated biological upper limit for human longevity sits around 120 years. - The thymus relies on a delicate matrix of thymic epithelial cells to properly train arriving bone marrow cells. - Both speakers advocate for prioritizing healthspan and functional vitality over radical, anxiety-driven lifespans.

---

[01:02:14](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=3734s) The Erratic Pace of Scientific Discovery and the Frustration of CAR T Cells

Reflecting on the unpredictable timeline of his career, Max describes how science often oscillates between long stretches of stagnation and dizzying bursts of sudden progress. He recalls instances where monumental breakthroughs appeared so rapidly that researchers barely had time to process their success before moving to the next problem. Conversely, he points to CIRM’s initial bond initiatives, which optimistic stakeholders assumed would yield robust, mainstream stem cell therapies within a seven-to-eight-year window; instead, the timeline yielded fewer direct clinical therapies than promised, though it generated an immense volume of foundational knowledge. Max describes this as the inherent, unavoidable risk of biological research, where hundreds of hours of failure in a dark lab are suddenly validated by a single hour of crystalline clarity where everything makes sense.

This pattern of frustrating delay is highly evident in the development of CAR T-cell therapies for solid tumors. Max references work done by colleagues like Alex Marson, noting that immunologists have spent the last 10 to 15 years on the absolute cusp of using engineered T cells equipped with specific synthetic receptors to systematically eliminate tumors. Yet, in patient after patient, the therapies repeatedly hit a wall: the immunosuppressive tumor microenvironment turns the engineered cells off, causing them to fail. Max explains that this lag creates immense external frustration from the public, who wonder why brilliant minds cannot simply solve the problem, highlighting that true discovery means confronting a universe that is rarely configured the way humans intuitively expect it to be.

- Public initiatives like CIRM illustrated that stem cell translations frequently take much longer than standard legislative or investment cycles predict. - CAR T-cell therapies face significant hurdles in solid tumors due to the immune system being systematically turned off by the tumor environment. - Max defines true scientific discovery as navigating the mismatch between human hypotheses and the actual configuration of the universe.

---

[01:03:55](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=3835s) How Breakthrough Technologies Leap Out of Unexpected Places

Andrew reflects deeply on his two decades in science and podcasting, observing a universal pattern across diverse scientific disciplines: fields often experience decades of steady, grinding pressure—like water wearing away rock—without achieving a major translation, until a single tool abruptly shatters the dam. He points to Ellie Tanaka's extraordinary, long-term work on salamander limb regeneration as a prime example of a field holding massive promise for human amputees and brain injury patients that is still waiting for its ultimate translational catalyst. Andrew illustrates this phenomenon by tracing the tedious history of genetic modification tools—from basic liposome electroporation and calcium phosphate transfection to zinc-finger nucleases—all of which laid essential groundwork until CRISPR suddenly broke through the noise, rapidly advancing to direct human clinical applications for sickle cell anemia and controversial germline modifications in China.

Andrew applies this same structural template to the modern metabolic health crisis. For years, public health officials lamented rising obesity rates, endlessly debating the laws of thermodynamics and behavioral compliance. Then, seemingly out of nowhere, basic research into the unique physiology of the Gila monster by an observant biologist illuminated the power of glucagon-like peptides, leading directly to the development of GLP-1 receptor agonists. Despite their known side effects like muscle wasting or apathy, these drugs have fundamentally revolutionized the treatment of obesity. Andrew argues that these sudden leaps are inherently dependent on the preceding years of quiet failure and massive financial expenditure, suggesting a natural, necessary order to scientific progress.

- Early gene transfer methodologies included calcium phosphate transfection, electroporation, and zinc-finger nucleases before the advent of CRISPR. - CRISPR technology bypassed previous technical limitations, leading directly to human therapies for sickle cell anemia. - The discovery of modern GLP-1 obesity medications traces back to basic research conducted on the metabolic dormancy of the Gila monster.

---

[01:06:57](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=4017s) Curiosity-Driven Science and the Accidental Origin of Cancer Immunotherapy

Max strongly echoes Andrew's sentiment, asserting that it is absolutely mandatory for society to fund and study things that initially appear to be mere intellectual curiosities. Using Andrew's examples, he emphasizes that the Gila monster researchers were simply trying to understand how a lizard could remain entirely dormant for 10 months without eating, and the early pioneers of CRISPR were merely trying to decipher the obscure mechanism by which bacteria use specialized enzymes to remember and chop up invading viral DNA. Neither group set out to cure human obesity or engineer the human genome; they were simply driven by the foundational question of "how does the world work?" Max warns that if society only funds narrow, direct paths toward specific cures, researchers will continuously slam into brick walls because they lack the critical workarounds provided by completely unrelated, orthogonal discoveries.

To illustrate this, Max shares the historic origin story of his own career, which perfectly spans the entire modern lifespan of cancer immunotherapy. As a graduate student, he performed the very first modern immunotherapy experiment by generating an antibody against a specific regulatory molecule on the surface of T cells. After demonstrating in vitro that blocking this molecule caused the T cells to become highly activated, Max and his legendary mentor, Jim Allison, decided to test it in vivo. Max recalls the casual, historic moment when Allison noted they had some tumor-bearing mice in the lab fridge; Max injected the antibody, and the tumors completely melted away. Andrew ensures the audience understands the full gravity of this anecdote, directly pointing out that this exact experiment was the foundational breakthrough for which Jim Allison was ultimately awarded the Nobel Prize. Max recalls with a smile that while science careens forward regardless of who physically handles the syringe or what lab the work takes place in, "the afterparties were good."

- The foundation of cancer immunotherapy began with Max Krummel physically injecting a custom-made T-cell antibody into a mouse. - The historic experiment directly led to Max's mentor, Jim Allison, winning the Nobel Prize in Physiology or Medicine. - Max emphasizes that major scientific breakthroughs historically emerge from orthogonal, basic curiosity-driven research rather than direct engineering goals.

---

[01:08:47](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=4127s) The Orthogonal Nature of Scientific Progress

Max reflects on the initial motivations behind his graduate work, noting that he and Jim Allison were absolutely not trying to cure cancer when they initiated their research. At the time, the scientific community was gripped by the AIDS crisis, which had clearly demonstrated the vital, absolute importance of T cells to human survival. Driven simply by the broad allure of understanding these critical immune players, Max chose to investigate a mysterious surface molecule despite peers questioning why he would go into immunology at all. Once they discovered that this specific molecular pathway functioned as a dial capable of turning the immune system down or up, an entire universe of therapeutic possibilities instantly materialized.

Max explains that once you possess a molecular dial to scale immune activation, the applications expand in every direction: dialing it up dramatically improves the efficacy of vaccinations, while accidentally over-activating it can severely worsen autoimmune diseases like multiple sclerosis. This realization ultimately allowed them to successfully leverage the system to attack malignant tumors. Max compares this conceptual leap to the accidental discovery of X-rays in physics, where researchers studying abstract radiation suddenly realized they could visualize living human bone. He concludes that true, revolutionary progress requires this exact kind of oblique exploration, as human engineering alone is blind to the unexpected tools hidden in unrelated disciplines.

"Once you saw you could turn things off, then everything became possible. Right? Now, you set an immune system you could dial up."

- Early T-cell research in the late 20th century was heavily catalyzed by the broader scientific urgency surrounding the AIDS epidemic. - The discovery of immune checkpoints revealed a biological "dial" that could either suppress autoimmunity or accelerate tumor clearance. - Max compares the birth of immunotherapy to the discovery of X-rays, demonstrating that transformative clinical tools routinely emerge from unrelated scientific queries.

[01:09:51](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=4191s) Basic Research, CRISPR, and the "Off-Piste" Nature of Science

Dr. Max Krummel and Dr. Andrew Huberman reflect on how major scientific breakthroughs rarely stem from direct commercial intention, but rather from pure, curiosity-driven basic research. Krummel highlights CRISPR as a primary example: it originated as an obscure bacterial defense mechanism against viruses rather than an engineered human tool. Had scientists not been pursuing fundamental questions about how bacteria defend themselves, the entire multi-billion-dollar gene-editing industry would never have existed. Trying to monetize or commercialize science from day one often limits discovery to what is already known. To create genuinely new human knowledge, researchers must venture "off-piste"—skiing off the groomed trails and into the trees, accepting that they will bump their heads along the way.

Krummel compares the scientific process to solving a complex, thousand-piece jigsaw puzzle. The initial stages are frustrating and slow—like trying to piece together a sky full of identical clouds—but fitting a key piece into place brings an irreplaceable intellectual reward. Science is fundamentally not a cost-effective or linear endeavor; putting in five hours of lab work does not guarantee five units of progress. More often than not, an experiment yields zero, but occasionally a five-hour effort unlocks a 500-fold jackpot moment.

``` High-Risk / Non-Linear Returns ┌─────────────────────────────────────────┐ │ 10% Chance of Success Per Experiment │ │ ──> Requires ≥10+ Attempts Statistically│ └─────────────────────────────────────────┘ │ ┌─────────────┴─────────────┐ ▼ ▼ [ 90% Outcomes ] [ 10% Jackpots ] Zero Return / Failure 500x Breakthrough ```

Huberman shares how he recently advised an undergraduate caller wondering whether to pursue a research PhD and a postdoc. Huberman strongly encouraged it, noting that training your brain's reward system to put steady pressure on a long-term problem for five years builds invaluable mental resilience—a rare trait in an era dominated by instant gratification. Krummel agrees, comparing a long-term research project to running a triathlon or raising a child. Huberman mentions his podcast producer, Rob, who has completed multiple Ironman triathlons and applies that exact mindset to work: expending zero energy on factors outside his control ("left column" variables) and focusing entirely on steady, controlled effort.

- **Statistical Reality of Lab Work:** If an experiment has only a 10% chance of yielding something interesting, a researcher must run far more than 10 trials just to satisfy basic statistical probability. - **Mindset & Energetic Control:** True scientific work teaches "energetic control"—learning what *not* to worry about and forcing oneself not to waste focus on uncontrollable variables.

---

[01:14:14](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=4454s) Spatial Biology, Organ Grafting, and Tissue Microenvironments

Huberman transitions the conversation to **spatial biology**—the study of how immune cells and tissues function based on their specific physical location within the body. He brings up historical and medical examples of tissue survival, such as Galen’s era of medicine (as described in *The Prince of Medicine*), where severed limbs or fingers were temporarily sewn into an incision in the abdominal cavity or gut wall to keep the tissue warm, viable, and capable of reattachment. Huberman also notes how transplanting a tiny subpopulation (around 5%) of calbindin-expressing neurons from the suprachiasmatic nucleus (SCN) into another area of the brain can fully restore circadian rhythms in an arrhythmic animal. Similarly, small pieces of pancreatic tissue can be grafted under the skin or into alternative sites and still retain basic function.

Krummel explains that while the immune system is famously migratory—circulating through blood, tissues, and the lymphatic system—it also relies heavily on **tissue-resident T cells**. These resident immune cells permanently lodge themselves within specific organs, serving as localized guardians that never re-enter circulation. Whether an organ or tissue graft survives in a new location depends on two distinct factors:

1. **Local Support System:** Does the new site offer adequate blood flow, growth factors, lymphatic drainage, and neural innervation? (e.g., pancreatic islet cells thrive under the kidney capsule because of its rich vascular bed). 2. **Immune Acceptance / Autoimmunity:** Will the immune system tolerate the tissue? In Type 1 diabetes, placing new pancreatic cells anywhere in the body fails unless the underlying autoimmune attack—where the immune system misidentifies self-tissue as foreign and destroys it—is suppressed.

- **Lymphatics as Drainage:** The lymphatic system acts as the body's drainage network, carrying excess fluid and immune signals from peripheral tissues back through lymph nodes and into the bloodstream. - **Kidney Capsule Grafting:** The skin-like capsule surrounding the kidney is a classic experimental site for pancreatic islet transplantation due to its optimal blood supply.

---

[01:19:13](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=4753s) The Mind-Immune Axis: The Insular Cortex and Neural Memory of Inflammation

Krummel highlights emerging research showing that the nervous system can encode, store, and re-trigger specific immune states in peripheral organs. The brain communicates with peripheral tissues via neural pathways like the **vagus nerve**, translating mental states of calm, stress, or specific memories into physical immune responses.

Krummel details a landmark study conducted by Dr. Asya Rolls' laboratory in Israel regarding the **insular cortex**—a brain region involved in interoception, moral decision-making, and empathy (such as feeling visceral discomfort when seeing someone else cut their hand). In this experiment, researchers induced inflammatory bowel disease (IBD) in mice using a chemical agent that damaged the intestinal lining, causing severe gut inflammation. Using chemogenetic tools (DREADDs), the team tagged the specific ensemble of insular cortex neurons that fired while the mice were actively experiencing gut pain and inflammation.

``` [ Chemically Induced IBD ] ──> Insular Cortex Neurons Fire │ (DREADD Tagging) ▼ [ Mouse Fully Recovers ] ──> Re-activate Tagged Neurons │ ▼ [ Intestinal Inflammation Re-emerges Without Any Chemical Trigger ] ```

After the mice completely recovered and their gut inflammation subsided, the researchers artificially reactivated those exact insular cortex neurons. Remarkably, reactivating these brain cells caused the immune system in the gut to immediately re-establish the precise inflammatory state, acting as if the intestine had been punctured all over again.

Huberman notes that this demonstrates a form of **contextual immune learning**. Just as the brain forms contextual memories about places or experiences—such as disliking a city after having a car broken into there—the brain and immune system form joint contextual memories. Krummel suggests this opens up profound possibilities for science: if negative neural memories can trigger peripheral disease, humans might eventually be trained to consciously evoke neural states that bring about protective or restorative immune responses in specific tissues.

- **Key Researcher & Group:** Dr. Asya Rolls' lab in Israel pioneered the work demonstrating insular cortex encoding of peripheral immune states. - **Sensory Triggers:** Just as the smell of cut grass instantly retrieves vivid childhood memories, sensory and cognitive cues can subconsciously recall physiological and immune states.

[01:22:58](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=4978s) Insular Cortex, Mindset, and the Neuro-Immune Axis

The conversation explores emerging research on how brain states actively program physical immune responses. While chronic stress clearly suppresses immune function, acute stress can actually boost immunity—an overlooked benefit of short-term cortisol release. The connection between mental states and physical health is gaining rigorous scientific backing through studies on the insular cortex. Research demonstrates that when specific neurons fire during an original inflammatory event, reactivating those same neural pathways later can induce a similar pattern of immune cell accumulation, preparing the tissue for inflammation. This bidirectionality suggests that practices like breathwork and meditation alter autonomic nervous system activity to physically reset tissue states and regulate systemic inflammation.

While these neuro-immune connections can feel intuitive—such as experiencing physical comfort from a meal prepared by a loved one—scientists caution against relying purely on intuitive logic. The mind's story must be validated by hard data, but current findings increasingly confirm a direct highway connecting specific brain regions to peripheral immune health.

- Acute stress elevates cortisol in short bursts, which actively enhances immune surveillance. - The insular cortex acts as a neural hub mapping bodily states, storing a "memory" of peripheral immune and inflammatory events. - Breathwork and meditation provide conscious entry points to regulate the autonomic nervous system, directly impacting inflammatory cell recruitment.

---

[01:26:37](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=5197s) Mindset Effects, Biohacking, and Tissue Engineering

Individuals exhibit stark differences in immune resilience, ranging from those who claim they "never get sick" to those who suffer constant illnesses. While immune cells do not listen to spoken words or written affirmations, they respond directly to overarching brain states and physiological triggers. Mindset shapes underlying neurochemical states, which in turn dictate immune readiness.

``` [Brain State / Mindsets] ---> [Autonomic & Endocrine Triggers] ---> [Immune Cell Behavior] ```

When considering future medical interventions, spatial biology highlights both opportunities and challenges. While transplanting cells (like placing pancreatic tissue in the kidney) can work under specific conditions, biohacking concepts—such as implanting encapsulated thymic tissue under the skin to preserve youthful T cell production—face complex biological barriers:

* **Immune Tolerance:** Engineering cells or introducing vectors (like viruses or plasmids) alters cellular identity, causing the host immune system to attack the implant as foreign. * **Spatial Gradients:** Tissues require precise spatial context; during wound healing, cells operate in delicate, layer-by-layer signaling gradients. Administering peptides or cells without correct timing and spatial cues disrupts natural tissue regeneration. * **Self-Experimentation Risks:** Uncontrolled self-experimentation generates unverified anecdotes rather than scientific data, making it difficult to distinguish real biological effects from coincidence or placebo.

---

[01:34:25](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=5665s) Vaccine Hesitancy, Context, and Personalized Cancer Vaccines

Public perception of medical interventions often shifts dramatically based on personal context and health status. While vaccine hesitancy regarding routine childhood immunizations remains a prominent global debate, individuals facing life-threatening conditions like advanced cancer evaluate risk and benefit quite differently.

Personalized cancer vaccines utilize the same fundamental principles as traditional immunizations, but target tumor-specific proteins:

``` [Tumor Punch Biopsy] ---> [Identify Unique Peptides] ---> [Formulate Vaccine] ---> [Train T Cells to Target Tumor] ```

By identifying unique mutant peptides (neoantigens) present exclusively within a patient's tumor and delivering them alongside immune-stimulating adjuvants, cancer vaccines train the immune system to recognize and destroy malignant cells without harming healthy tissue. This demonstrates that public trust and clinical acceptance depend heavily on context—when standard treatments offer few options, advanced immunotherapies become vital tools for survival.

<FollowUp label="Want to know how personalized cancer vaccines train T cells to target specific tumor mutations?" query="How do personalized cancer vaccines identify unique tumor peptides and train T cells to target cancer cells without attacking healthy tissue?"/>

[01:36:19](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=5779s) Vaccine Nuance, Schedules, and Nuanced Decision-Making

Andrew Huberman and Dr. Max Krummel frame the discussion on vaccines away from polarized, black-and-white rhetoric, focusing instead on the practical nuances that concern everyday people. Krummel highlights that while standard chemotherapy remains a brutal and limited option for many advanced cancers, novel treatments—such as therapeutic cancer vaccines—offer compelling life-saving potential. For patients facing severe terminal outcomes, the choice to try an experimental vaccine becomes highly context-dependent. Shifting to childhood immunizations, Huberman notes that a vast majority of parents are neither strictly anti-vaccine nor unconditionally pro-vaccine; rather, they have reasonable questions regarding the timing, spacing, and cumulative burden of administering multiple shots simultaneously to developing immune systems.

Addressing these concerns as an immunologist, Krummel acknowledges that many clinical vaccination protocols were historically evaluated on individual schedules rather than in complex, overlapping combinations. While empirical evidence showing widespread harm from standard combination schedules remains weak and largely anecdotal, he stresses that individual parental worry is completely valid. Clinical protocols in medicine—much like early cancer immunotherapy schedules derived from mouse models—are designed primarily around standardized statistical safety, efficacy, and clinical convenience. However, Krummel shares that as a parent and immunologist, he occasionally chose to slightly delay a vaccine by a month when his own daughter was feeling unwell. Based on extensive laboratory experience, shifting a vaccination window slightly does not inherently destroy protective immunity, even if standard schedules exist to keep public health administration simple and manageable.

- **Cancer Treatment Context:** Traditional chemotherapy often has limited efficacy for certain advanced cancers, making therapeutic vaccines an attractive alternative despite general public hesitancy. - **Protocol Flexibility:** Medical protocols are typically derived from controlled trials (and often early animal models), but alternative timing or spacing can still yield effective protective immunity. - **Personal Anecdote:** Dr. Krummel recalls intentionally delaying one of his daughter's scheduled vaccines by a month because she was unwell, noting that slight adjustments do not negate overall immune protection. - **Reactogenicity Example:** Krummel mentions that adult vaccines, such as the heavily adjuvanted shingles vaccine, can cause potent systemic responses ("knocked me completely out"), illustrating the raw power of immune stimulants.

---

[01:39:37](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=5977s) Scientific Authority, Corporate Incentives, and Institutional Trust

The conversation delves into the deeper cultural and structural reasons driving public skepticism toward pharmaceutical guidance and scientific institutions. Krummel points out a major flaw in how science is communicated: authority figures often treat science as an unassailable "papacy," delivering rigid commands using complex jargon without explaining the underlying rationale or acknowledging existing knowledge gaps. Huberman agrees, explaining that the core mission of his podcast is to dismantle this exact dynamic by giving top researchers a direct platform to speak candidly about real-world nuances, personal health choices, and scientific uncertainties.

A significant driver of public distrust stems from the misaligned incentives inherent to commercial pharmaceutical development. Krummel highlights how corporate interests can inadvertently suppress useful medical innovation. For instance, in melanoma treatment, immune checkpoint inhibitors carry roughly a 50% response rate. However, pharmaceutical companies lack a financial incentive to develop diagnostic tests that predict non-responders, as doing so would instantly cut their addressable market in half. When individuals sense these perverse financial motives or feel alienated by top-down public health mandates, they naturally adopt a self-reliant, pioneering spirit—seeking alternative health strategies, off-label peptides, or independent self-experimentation.

- **The "Papacy of Science":** Treating scientific institutions as infallible authorities creates public alienation when nuances, limitations, and underlying mechanisms are omitted from public discourse. - **Market Dynamics in Oncology:** Checkpoint inhibitor drugs for melanoma help about 50% of patients; because non-responders cannot currently be pre-identified, 100% of the market purchases the drug. - **Financial Disincentives:** Diagnostic tests that identify non-responders would cut a drug maker's market size by 50%, creating a structural disincentive for corporations to fund those specific biomarker studies. - **Psychological Drivers:** Parents who suspect a adverse health reaction in their child after a medical intervention experience intense emotional distress and guilt, driving them to question established institutional protocols. - **Misaligned Incentives:** While 99.9% of academic scientists actively work to improve human health, broader public trust is repeatedly damaged when corporate profit motives conflict with optimized individual care.

<ElicitationsGroup message="Where would you like to go next in this conversation?"> {/* Reason: The user requested a section of the transcript; offering relevant follow-ups deepens the exploration of the transcript topics. */} <Elicitation label="Explore the next segment on disease risk and immunity" query="Please continue the detailed transcript walkthrough for the next segment starting around 01:49:22."/> <Elicitation label="Summarize the core takeaways on vaccine schedules" query="Summarize the key takeaways regarding vaccine timing, schedules, and immune response from Dr. Max Krummel's discussion."/> </ElicitationsGroup>

[01:49:15](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=6555s) Open Scientific Inquiry and Public Communication Around Vaccines

Dr. Max Krummel and Andrew Huberman dive into the necessity of open, nuanced public discourse regarding vaccine schedules and safety. Krummel emphasizes that science should not lock its doors or demand compliance through force; instead, researchers need to design transparent experiments that directly address valid public questions. Huberman reflects on the public health communications during the COVID-19 pandemic, arguing that relying on a single figurehead to deliver top-down mandates with an "or else" tone severely damaged trust. He notes that parents seeking clearer information about immunization schedules are not political extremists or "antivaxxers," but rather caring parents trying to make informed decisions in a realm filled with mixed incentives.

Both speakers advocate for rigorous, publicly accessible studies to test potential modifications to standard regimens rather than dismissing public concern. Krummel points to the historical reality of terrifying infectious diseases like smallpox and measles to underline why vaccines were developed in the first place. For instance, measles is not just a mild childhood rite of passage—it carries a real risk of severe brain inflammation and long-term harm. Comparing the decision to forgo vaccination to failing to teach a child how to cross the street safely, Krummel stresses that while we must respect historical data showing how deadly these pathogens are, science should remain humble, curious, and open to refining its methods through continuous testing.

- Top-down public health messaging that uses coercion or insults fails to build trust and alienates concerned parents. - Transparent, head-to-head clinical trials comparing old, new, or alternative vaccination schedules would help resolve public skepticism with empirical data. - Historically, infectious diseases such as smallpox, measles, and mumps caused severe morbidity, including life-threatening neurological damage.

[01:54:35](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=6875s) Immune Challenges, Maternal Infection, and Neural Development

Shifting to the biological mechanisms linking immune activation and brain function, Krummel shares a well-established laboratory model used in neurobiology: inducing autism-like behaviors in rodent offspring. Researchers accomplish this not through vaccines, but by injecting pregnant mice with a mock bacterial or viral infection, triggering a maternal immune response. This maternal immune activation proves that inflammatory signals during gestation directly influence the neural architecture of the developing fetus. Krummel notes that while inflammatory molecules (cytokines) clearly affect brain development, applying this concept directly to childhood vaccines requires careful scientific distinction, especially given that autism diagnoses typically coincide with the age (around two years) when many routine pediatric vaccines are administered.

To illustrate how profoundly immune signaling alters behavior even in mature animals, Huberman and Krummel discuss landmark studies on sickness behavior. When researchers inject gamma interferon ($\text{IFN-}\gamma$)—a signaling molecule produced by immune cells during infection—into the bloodstream of healthy mice, the animals instantly display profound social isolation. They retreat and seek solitude simply from receiving the immune molecule itself, despite having no active pathogen or illness. This demonstrates that the brain possesses specific receptors for peripheral immune signals, allowing systemic inflammation to directly drive behavioral shifts.

- In rodent models, maternal immune activation via simulated prenatal infection is a standard method to study neurodevelopmental changes and autism-like behaviors. - Gamma interferon ($\text{IFN-}\gamma$) administration in healthy mice triggers immediate social isolation and sickness behavior, proving the brain actively responds to circulating immune cytokines. - The temporal alignment between routine two-year childhood vaccinations and the typical window for autism diagnosis creates a correlation that requires rigorous, data-driven clarification rather than speculative assumptions.

[01:57:28](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=7048s) Navigating Data-Sparse Environments and Biological Resilience

Reflecting on how society synthesizes knowledge during crises, Krummel describes the early days of the COVID-19 pandemic as a classic "data-sparse" environment. When faced with novel pathogens or emerging medical debates, decisions are often made under pressure with limited information, leading to conflicting guidance around masking, surface transmission, or isolation. Huberman adds that in data-sparse conditions, financial incentives and anecdotal observations ("anecdata") often collide, feeding public confusion and media sensationalism.

Beyond public health policy, Krummel explains how human physiology maintains homeostasis through deep biological resilience. Humans can endure extreme temperature swings, prolonged fasting, and continuous pathogen exposures because biological systems are built as interconnected, redundant networks rather than single linear pathways. In medicine, while "one-and-done" drugs (such as immune checkpoint blockades in oncology) can yield dramatic cures for specific conditions, most complex diseases require pushing entire cellular ecosystems through developmental state shifts rather than flipping a single toggle.

- Data-sparse situations force public health officials and the public to make high-stakes decisions with incomplete facts, making transparent communication vital. - Human physiology is fundamentally non-linear and resilient, capable of absorbing significant external stress without immediate system failure. - Cancer immunotherapies like checkpoint blockade offer remarkable outcomes in roughly 50% of advanced melanoma cases, but broader treatments must account for complex network dynamics and cellular states.

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[02:02:37](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=7357s) Computational Biology, Machine Learning, and Nuanced Cures

Reflecting on the sheer complexity of biological systems, Andrew Huberman draws an analogy to theoretical physics, recalling a conversation with his father about how quantum mechanics cannot be grasped purely through logical intuition—it requires mathematical proofs to demonstrate reality. In the same way, the sociology of modern science, which demands paper publication with single take-home messages alongside tight funding constraints, might be hitting a barrier. Huberman asks whether artificial intelligence and machine learning could overcome human cognitive limitations to map biological networks, run complex perturbation experiments, and uncover new therapeutic windows.

Dr. Max Krummel carefully distinguishes between general artificial intelligence and machine learning in the context of scientific discovery. AI models excel at synthesizing information already present within the existing body of literature ("the corpus"). However, scientific discovery fundamentally requires uncovering what does not yet exist in that corpus. While machine learning can construct *in silico* biological networks—such as mapping every cellular connection inside a dissected tumor to model the downstream effects of clipping a specific molecule—human judgment remains essential. Researchers must still choose which costly, year-long experimental hypotheses are worth pursuing in the laboratory.

Dr. Krummel emphasizes that curing complex diseases will rarely come from a single "one-and-done" drug or a silver-bullet discovery like a mythical fountain of youth. Instead, biology functions as a series of interconnected, semi-stable states or "archetypes"—how immune, fibroblast, and epithelial cells organize themselves in a tissue. Moving a disease state across a boundary toward healing requires a deliberate sequence of carefully timed, nudging interventions. Much like maintaining personal health requires an interconnected collection of daily choices—sleep, nutrition, exercise, social bonds, and meaningful relationships—reversing a complex disease requires systematically disassembling its defenses before guiding the immune system to step in.

- **Quantum Physics Analogy:** Huberman notes his dad's advice that anyone claiming to intuitively understand quantum fields must be asked to demonstrate the math, as complex systems often defy raw conceptual intuition. - **AI vs. Machine Learning:** AI synthesizes existing corpus knowledge, whereas machine learning discovers novel statistical relationships between cellular features to propose testable hypotheses. - **Tissue Archetypes:** Biological tissues organize into defined spatial patterns and cellular states involving complex interactions between immune cells, fibroblasts, and epithelial cells. - **Sequential Therapies:** Achieving therapeutic breakthroughs in complex conditions (like tumors or chronic inflammation) often requires nudging tissue archetypes in a precise, chronological order rather than relying on a single compound. - **Lifestyle Foundations:** Huberman quotes a Bay Area physician friend: *"Better living through chemistry still requires better living,"* reinforcing that advanced medicine cannot replace foundational health pillars like light, sleep, and social connection.

---

[02:09:01](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=7741s) Decoding Autoimmunity, Asthma, and Tissue Archetypes

Turning to chronic conditions that cause widespread discomfort—such as chronic fatigue, myalgia, psoriasis, and asthma—Huberman asks what drives the formation of autoimmune conditions and what modern treatments are on the horizon. Dr. Krummel frames these conditions as the immune system executing a misplaced "playbook." In these scenarios, the body’s defensive machinery incorrectly senses an ongoing attack or misinterprets its biological role, driven by a combination of underlying genetic susceptibility and environmental triggers.

For instance, in conditions like systemic lupus erythematosus, familial genetic mutations in B-cell receptors impair the body's normal off-switches. This leads to the overproduction of self-targeting autoantibodies by B cells—the same immune cells targeted for stimulation during vaccination. Similarly, diseases traditionally categorized as simple allergies, such as asthma, are far more heterogeneous than historical pathology suggested. Rather than a single disease characterized by airway thickening, single-cell analysis reveals at least seven or eight distinct immunological archetypes of asthma. Some are driven predominantly by eosinophils, others by neutrophils, explaining why specific inhalers or environmental triggers (such as cold air or chlorine) affect individual patients so differently.

The clinical management of autoimmune diseases, including inflammatory bowel disease (IBD) and psoriasis, often mirrors the trial-and-error approach seen in psychiatry. A biological therapy, such as anti-TNF cytokine blockers, may work dramatically well for one patient or perform successfully for a period before suddenly losing efficacy, forcing clinicians into a game of "whack-a-mole." Dr. Krummel notes that ongoing research aims to map these shared immunological flavors across different conditions, which will allow treatments to be matched to a patient's precise cellular archetype rather than relying on broad diagnostic labels.

- **B Cells and Autoantibodies:** Unlike T cells, B cells produce antibodies; genetic defects in their inhibitory receptors can cause unchecked autoantibody production, as seen in lupus. - **Heterogeneity of Asthma:** High-resolution single-cell mapping demonstrates that asthma consists of 7–8 distinct biological variants, categorized by dominant cell types like eosinophils or neutrophils. - **Inflammatory Bowel Disease (IBD):** Targeted cytokine therapies (e.g., anti-TNF drugs) provide immense relief for specific sub-classes of IBD patients, though treatment resistance frequently develops over time. - **Immunological Flavors:** Autoimmune conditions share distinct underlying cellular configurations with tumors, meaning therapeutic success depends on identifying the active "football team" of cells present in the tissue.

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[02:14:30](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=8070s) Evolutionary Trade-Offs and Population Diversity

Huberman notes an intriguing concept in immunology: mild autoimmune conditions or localized hyper-reactivity might historically confer enhanced protection against severe bacterial or viral infections. For example, mild psoriasis driven by pathways such as interleukin-17 (IL-17) might represent an evolutionary trade-off where a heightened inflammatory stance trade-offs localized skin discomfort for superior systemic pathogen resistance.

Dr. Krummel agrees with this broader evolutionary perspective, drawing a direct parallel to well-documented genetic trade-offs like the sickle cell trait. Carrying a single copy of the sickle cell gene variant provides significant protection against death from malaria, explaining why the gene persisted across generations despite the severe illness caused by carrying two copies. Genetic variations that predispose certain individuals to hyper-sensitive immune responses or autoimmune traits maintained population diversity over evolutionary time, ensuring that human groups could survive novel, devastating pandemics.

- **Interleukin-17 (IL-17):** A key inflammatory signaling molecule implicated in psoriasis pathology and targetable by modern therapeutic options. - **Evolutionary Trade-Offs:** Hyper-reactive immune states or specific genetic variants can enhance baseline resistance to deadly infectious agents like viruses or bacteria. - **Sickle Cell & Malaria Example:** The classic evolutionary balance where a gene causing blood disorders in homozygous individuals persists because it protects heterozygous carriers against malaria infection. - **Population Diversity:** Broad genetic variation in immune responsiveness ensures human survival as a species when confronted with novel environmental pathogens.

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[02:16:13](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=8173s) Autoimmunity, Genetic Diversity, and Individualized Requirements

Dr. Max Krummel explains how genetic diversity across a population is an essential evolutionary trade-off, even when it causes specific individuals to develop conditions like psoriasis or other autoimmune diseases. To illustrate this concept, he shares an analogy of growing bacteria in a flask with glucose (simple sugar): the colony grows rapidly as "winning" fast-dividing cells multiply into billions or trillions. However, there are almost always a few "losers" dividing very slowly. If you take a sample from that culture and place it into galactose (milk sugar), the original winners stall out, and the new thriving population emerges directly from the former loser pool. This demonstrates "crowd fitness"—a collective resilience that stems from genetic diversity. A gene variant that makes someone susceptible to disease in one environment might prove lifesaving under different environmental pressures.

This inherent biological variation also explains why dietary and medical recommendations are not one-size-fits-all. Dr. Huberman and Dr. Krummel point out that individual requirements for vitamins can vary profoundly because metabolic enzymes differ significantly between people. Recommended FDA limits represent population averages; one individual might require five times the standard dose of a vitamin, while another may need only a fifth. When it comes to therapies like peptides, while some are clearly beneficial and others remain experimental, the underlying goal must always be collecting robust data in the right ways and communicating it accurately.

* **Bacterial Culture Analogy**: Fast-dividing cells thrive in glucose, but switching the medium to galactose shifts the evolutionary advantage to the slow-dividing "loser" pool. * **Nutritional Variation**: Differences in metabolic enzymes mean vitamin requirements can range from a fifth to five times the standard FDA recommended daily allowance.

---

[02:17:11](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=8231s) Science Communication, History, and the Human Side of Research

Addressing what inspired him to write his Substack and pursue public science education over the past decade, Dr. Krummel recalls a conversation with colleagues following a research conference. They were discussing the societal disconnect with science and why people often struggle to accept data or act logically on scientific findings. A key realization was that science communication often fails when it uses alienating, ultra-precise vocabulary, which acts like a foreign language—missing one unfamiliar word can cause a listener to lose track of the entire conversation. Using relatable analogies brings concepts down a level and preserves their real-world impact.

Furthermore, stating "I am a scientist" is not a neutral statement because "history is stronger than science." Institutional missteps and historical ethical breaches, such as the Tuskegee Syphilis Study from 60–80 years ago, leave lasting legacies of distrust—such as hesitancy among African Americans to take certain medications—even for generations who did not live through them. To bridge this gap, scientists must relate as complete human beings with loves, hates, and "certainly foibles," rather than detached, nerdy caricatures. Dr. Krummel notes that science operates much like a casino: the public hears the bells ringing when a major breakthrough or device is announced, but behind the scenes, a crowd of researchers is pulling the arm and losing far more often than winning. Sharing these losses and the realities of the scientific process makes the field far more relatable and trustworthy.

> "Science has a history and history is stronger than science actually."

* **Substack Goal**: Dr. Krummel's writing focuses on demystifying the immune system and detailing the human experience of research, including the frequent failures that precede discovery. * **Science as a Casino**: Breakthroughs represent rare wins amidst countlessly pulled slot arms that don't pay out.

---

[02:24:07](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=8647s) Closing Remarks and Huberman Lab Resources

Dr. Huberman praises Dr. Krummel for his unique, analogy-driven approach to teaching immunology and encourages listeners to check out his Substack. He notes that inspiring public education often leads to life-changing moments where readers choose to study immunology or collaborate with their physicians to explore novel treatments. Huberman expresses deep gratitude for Dr. Krummel's lab work and public advocacy, inviting him back for a future episode focused specifically on cancer immunology.

Wrapping up the episode, Dr. Huberman outlines the best zero-cost ways to support the podcast: * **Subscriptions & Reviews**: Subscribe on YouTube, follow on Spotify and Apple Podcasts, and leave up to a five-star review or comment. * **Sponsor Support**: Check out the sponsors featured throughout the episode as the primary way to support the show's production. * **Protocols Book**: Dr. Huberman highlights his book, *Protocols: An Operating Manual for the Human Body*, built on 30 years of experience and 5 years of writing, covering actionable, science-backed protocols for sleep, exercise, stress, and motivation (available at `protocolsbook.com`). * **Social Media & Newsletter**: Follow `@hubermanlab` across Instagram, X, Threads, Facebook, and LinkedIn for distinct scientific tools, or sign up for the free monthly Neural Network Newsletter at `hubermanlab.com` to access 1–3 page PDF protocol summaries.

## Notable quotes > [49:09](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=2949s) At night, a few wacky things happen... one of them is that a lot of your immune cells clear back to the bone marrow. — Max Krummel

> [49:09](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=2949s) Everybody has bags under their eyes... when they are sleep deprived. They sleep for a night or two and it goes away. That's clearly accumulation of lymph. — Andrew Huberman

> [49:09](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=2949s) When you wash your car windshield, you do it completely at that point... but you can't be driving while flying, you'll never clean it. — Max Krummel

> For all the discoveries that I made or other people have made, there is hundreds and hundreds of disappointments.

> The better experiments, the kind of—we call them killer experiments, right? The ones that kill the idea if it's wrong.

> When I started in neurobiology, the brain... was considered an immune-privileged organ. There weren't supposed to be immune cells there.

> [01:08:47](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=4127s) Once you saw you could turn things off, then everything became possible. Right? Now, you set an immune system you could dial up. — Max Krummel

> [02:17:11](https://www.youtube.com/watch?v=s_tkMm5U9aY&t=8231s) Science has a history and history is stronger than science actually. — Dr. Max Krummel

## Mentioned Max Krummel, Andrew Huberman, David Felheim, Randy Schekman, UC Santa Cruz, AG1 Pro, Shinya Yamanaka, California Institute for Regenerative Medicine (CIRM), Alex Marson, Ellie Tanaka, CRISPR, Jim Allison, Galen, Asya Rolls, Rob, Carla Shatz, Ben Barres, Beth Stevens, Cagla Eroglu, Huberman Lab Podcast, Substack, Tuskegee Syphilis Study, FDA, Protocols: An Operating Manual for the Human Body, YouTube, Spotify, Apple Podcasts, Instagram, X, Threads, Facebook, LinkedIn, Neural Network Newsletter

[Source](https://www.youtube.com/watch?v=s_tkMm5U9aY)

中文简报

免疫学家Max Krummel绘制用于癌症治疗的非线性T细胞网络图谱 复杂疾病需要序贯生物干预而非单一靶点药物,因为组织原型是通过冗余空间网络运作的。 Max Krummel博士深入剖析了人体免疫系统的基本机制,重点阐述了昼夜节律、睡眠剥夺和神经状态如何主动调节免疫反应与淋巴引流。讨论探讨了从早期T细胞检查点的发现到空间生物学、类器官工程以及AI驱动的疾病建模等科学突破。Krummel就个性化癌症疫苗、历史公共卫生传播的权衡取舍,以及基础研究非线性与高失败率的本质提供了细致入微的视角。最后,对话强调了遗传多样性、演化权衡和神经-免疫串扰如何共同塑造个体的易感性与生物韧性。 进化压力主要优先确保生物体生存至生育年龄(约 30 岁),导致人体的生理维护与免疫系统并未针对晚年积累的基因突变和体细胞嵌合现象进行充分优化。 (14:20) 胸腺是 T 细胞发育与耐受性训练的核心器官,其功能在婴幼儿期达到顶峰,但随着年龄增长会发生退化萎缩,导致老年人体内缺乏新鲜的初始 T 细胞以识别突变肿瘤细胞。 (36:54) 免疫细胞如同在组织中持续巡弋的“微型大脑”,它们通过突触相互传递信息并整合变化速率,而缓慢生长的癌细胞往往会借助类似神经适应的机制逃脱免疫监视。 (31:08) 在睡眠期间,循环免疫细胞会回撤至骨髓,同时中性粒细胞执行组织修复,使睡眠成为清除滞留淋巴液并重置免疫状态的关键阶段。 (47:28)

Reading summary

Immunologist Dr. Max Krummel argues that the human immune system is not a rigid binary defense switch, but a dynamic, tunable sensory network governed by evolutionary compromises, neural communication, and accumulating somatic mutations. Across a lifespan, immune surveillance continuously balances pathogen elimination against self-inflicted tissue damage, requiring nuanced ecological understanding rather than one-size-fits-all medical directives. Dynamic Self-Recognition and the Aging Mosaic (15:55) Historically conceptualized as an off-and-on switch that triggers only in the presence of foreign invaders, the immune system functions more like World War II submarine sonar, referencing acoustic profiles of friendly engines against enemy vessels to decide whether to attack. However, human cellular biology complicates this distinction over time. Human skin cells alone suffer roughly 10,000 to 30,000 somatic mutations per day from ultraviolet radiation, transforming uniform embryonic tissue into a genetic mosaic akin to Moroccan tile patterns. As the body's internal reference library becomes crowded with mutated variants of 'self,' distinguishing novel pathogens or early malignant cells from altered host tissues becomes increasingly noisy. Pathogen detection also parallels neural sensory accommodation. Dr. Krummel notes that while acute viral replication generates unmistakable danger signals that prompt rapid immune clearance, mutated cells that divide slowly over months gradually alter baseline protein levels without triggering an emergency response. Much like the olfactory system tuning out the pungent odor of Époisses cheese after prolonged exposure, T cells accommodate slow-burning mutations, allowing slowly proliferating tumors to escape immune surveillance. Evolutionary Trade-Offs in Repair and Autoimmunity (25:07) Immune mechanics reflect evolutionary compromises rather than optimal engineering. Because natural selection operates primarily up to reproductive age (around 16 to 30), post-reproductive survival lacks strong selective optimization. This creates biological trade-offs, particularly in tissue repair: childhood wound healing operates rapidly to close breaks against pathogens, which selects for fast-dividing cell clones. However, aggressive cell division velocity is the core engine of cancer, meaning decades of repeated tissue repair inadvertently select for clones capable of escaping growth controls. Furthermore, the immune system does not operate to achieve sterile purity; it often enforces a détente, containing latent viruses and gut bacteria within set boundaries. Overzealous eradication attempts cause severe immunopathology—tissue destruction driven by the immune response itself, such as nerve damage during herpes reactivation. At the population level, conditions like psoriasis (linked to interleukin-17 pathways) and the sickle cell trait highlight 'crowd fitness,' wherein genetic predispositions toward hyper-reactive immunity or blood anomalies confer survival advantages against lethal pandemics like malaria, preserving genetic diversity across groups. The Mind-Immune Axis and Sickness Behavior (79:13) The nervous and immune systems engage in direct, bidirectional crosstalk. Dr. Krummel highlights research from Dr. Asya Rolls' laboratory showing that the insular cortex stores a neural memory of peripheral inflammation. Using chemogenetic tools in mice recovered from chemically induced colitis, researchers reactivated the specific insular neurons that fired during original gut inflammation, which spontaneously re-induced intestinal inflammation without any chemical trigger. Immune signaling similarly commands brain function and behavior. Injecting healthy mice with the inflammatory cytokine gamma interferon (IFN-γ) instantly induces classic 'sickness behavior,' causing animals to socially isolate despite having no active pathogen. Physical behaviors like sleep directly govern this interface: during rest, circulating immune cells retreat into bone marrow and neutrophils orchestrate tissue repair, while facial and systemic lymphatic networks drain stagnant fluids and metabolic waste accumulated during waking hours. Basic Science Serendipity and Institutional Trust (66:57) Major medical breakthroughs consistently stem from curiosity-driven basic research rather than narrow commercial targets. Dr. Krummel's discovery with Jim Allison of T-cell checkpoint molecules—which founded modern cancer immunotherapy—began not as an effort to cure cancer, but as basic research into T cells during the AIDS crisis. Similarly, CRISPR originated from obscure bacterial viral defenses, and GLP-1 metabolic treatments arose from studying Gila monster dormancy. Dr. Krummel cautions that demanding immediate translational results restricts discovery by discouraging high-risk exploration. Public skepticism toward scientific guidance often stems from communication failures and misaligned corporate incentives. For example, commercial pharmaceutical developers lack financial incentive to produce diagnostic tests identifying checkpoint inhibitor non-responders, as doing so would cut their addressable market in half. Rebuilding public trust—particularly regarding pediatric vaccine schedules—requires transparent, publicly funded trials that address parental questions directly, rather than relying on top-down institutional mandates that dismiss public uncertainty. Dr. Krummel and Andrew Huberman conclude that enhancing immune resilience requires viewing the body as an interconnected, non-linear ecosystem rather than relying on isolated pharmaceutical toggles. While machine learning offers promise in mapping complex tissue networks, effective clinical translation remains bounded by evolutionary trade-offs, necessitating long-term investment in basic science and open communication regarding biological uncertainty.

精炼阅读摘要

免疫学专家Max Krummel指出,人体免疫系统并非非黑即白的开闭开关,而是一个动态调节、兼顾自我识别与病原体共存的复杂网络;理解衰老、癌症微环境与神经免疫调控的内在权衡,对于改进现代医疗策略至关重要。 自我识别、体细胞嵌合与衰老挑战 (21:14) Krummel用二战潜艇声呐识别敌友舰船引擎声的双重参考书比喻免疫系统的“自身与非自身”区分。受精卵虽携带相同的46条染色体,但人体细胞并非终生均一;以皮肤细胞为例,在紫外线照射等环境压力下,每个细胞每天发生约10,000至30,000次突变。数十年后,人体会演化为由不同突变克隆构成的基因嵌合体(mosaicism)。这种复杂噪声大幅增加了免疫监视识别外来病毒或畸变细胞的难度。免疫系统虽在持续清除异常细胞(例如四五十岁人群皮肤上出现的白色去色素斑点,往往是清除癌前黑素细胞后的痕迹),但组织损伤修复又倾向于选择分裂更快的克隆,这构成了伤口愈合与癌症生长之间的演化权衡。 胸腺萎缩、睡眠机制与干细胞储存考量 (36:54) 胸腺是T细胞接受“教育”的关键中枢器官,历史观察发现切除婴儿胸腺会导致致死性感染与肿瘤,但成年后该器官会严重萎缩。针对是否应冷冻保存自体年轻胸腺组织以延缓免疫衰老,Krummel指出胸腺不仅包含骨髓衍生细胞,还依赖特殊的胸腺上皮细胞基质,体外人造胸腺上皮虽在实验室有所进展,但普通消费级应用面临巨大的工程与解剖障碍。相比之下,脐带血造血干细胞储存的技术路径明确,可在白血病放疗后重建血液系统,不过商用储存机构的实际成效仍取决于家庭经济与临床现实。在基础生理层面,睡眠在免疫维持中扮演物理与细胞级维护角色:夜间大量循环免疫细胞回流至骨髓,嗜中性粒细胞参与组织胶原修复,淋巴系统引流停滞液体以清除代谢废物。 病原体妥协、神经免疫轴与脑区记忆 (28:36) 免疫系统并非一味消灭所有外来物质,而是通过“妥协(détente)”将大量潜伏病毒与共生微生物限制在特定区域,避免过度免疫病理反应损伤宿主。例如疱疹病毒潜伏在神经节内,其引发的剧烈神经疼痛和损伤往往源于免疫系统的围堵攻击而非病毒本身。同时,免疫反应受到神经系统的精细调控:急性压力通过皮质醇短暂释放增强免疫巡视,而Asya Rolls实验室的研究证实,岛叶皮层(insular cortex)能记录外周炎症状态。在小鼠化学诱导肠炎康复后,通过化学遗传学手段(DREADDs)重新激活先前标记的岛叶神经元群,可直接在外周肠道诱发免疫细胞聚集与炎症复发,证实了大脑神经回路对免疫状态的直接编码与重现能力。 科学探索范式、意外发现与监管沟通 (69:51) 重大医学突破多源于好奇心驱动的基础研究,而非预设的商业目标。CRISPR源于细菌抵御病毒的基础防御机制研究,GLP-1药物源于对美国毒蜥(Gila monster)十个月禁食冬眠机制的探索,而Krummel与Jim Allison开发癌症免疫疗法之初,也仅是试图解析T细胞表面的调节旋钮。对于疫苗与公共卫生决策,Huberman与Krummel强调科学界需摒弃居高临下的专断态度,正视公众对联合接种时间表的合理关切。例如儿童体内发育速度极快,免疫系统在出生前六个月处于特意抑制状态以避免自身免疫攻击;同时孕期母体免疫激活与干扰素释放也会显著改变神经发育与病态行为,因此在面对初期数据匮乏的危机时,透明的实验验证与包容的科普沟通至关重要。 自身免疫成因、群体多样性与适应度折衷 (129:01) 自身免疫病本质上是免疫防线执行了“错位的战术”。在系统性红斑狼疮中,B细胞受体的基因突变破坏了正常的关闭机制,导致自身抗体过量分泌;而哮喘并非单一疾病,单细胞分析表明其存在嗜酸性粒细胞或嗜中性粒细胞主导等至少七到八种免疫架构。从演化角度看,轻度自反应倾向或特定突变在群体层面上常带有生存优势。正如单拷贝镰状细胞贫血基因有助于抵御疟疾,白细胞介素-17(IL-17)途径引发的轻度银屑病可能在历史上传递了更强的抗感染屏障。类似细菌群落从葡萄糖环境转换至半乳糖环境时的优劣逆转,群体的基因多样性提供了抵御未知的生态韧性,也决定了微量营养素需求与药物干预必须因人而异。 人体免疫健康由精细的网络冗余与平衡决定,而非单一的强弱开关;未来医学需要平衡好奇心驱动的基础探索与转化研究,并在公共卫生实践中建立更透明的沟通机制。

Source quotes

[49:09] Max Krummel: At night, a few wacky things happen... one of them is that a lot of your immune cells clear back to the bone marrow. [49:09] Andrew Huberman: Everybody has bags under their eyes... when they are sleep deprived. They sleep for a night or two and it goes away. That's clearly accumulation of lymph. [49:09] Max Krummel: When you wash your car windshield, you do it completely at that point... but you can't be driving while flying, you'll never clean it. For all the discoveries that I made or other people have made, there is hundreds and hundreds of disappointments. The better experiments, the kind of—we call them killer experiments, right? The ones that kill the idea if it's wrong. When I started in neurobiology, the brain... was considered an immune-privileged organ. There weren't supposed to be immune cells there. [68:47] Max Krummel: Once you saw you could turn things off, then everything became possible. Right? Now, you set an immune system you could dial up. [137:11] Dr. Max Krummel: Science has a history and history is stronger than science actually.

Original transcript

[0:00] a famous um marinologist in the 1970s [0:03] drew this parallel in wartime and said [0:05] in World War II submarines had two sets [0:07] of books. One of them was a book that [0:10] gave them the sound profile of all the [0:12] US submarines and so they could listen [0:14] to the were of the engines and if they [0:15] heard a were of the engine that had the [0:17] certain cycle of a general mo you know [0:19] motors engine they wouldn't fire. So [0:21] that's the sort of like self I know what [0:23] self is. And then they had another book [0:25] that was the engine sounds of the known [0:28] diesel engines of whatever engines of [0:29] the German submarines. And if they heard [0:31] that then they absolutely would fire. [0:33] And that's a self versus [0:34] non-self-discrimination problem just [0:36] like the immune system has to do. But [0:38] what I bring you with it aging is this [0:40] concept that as you get weirder and [0:41] different your body is getting like more [0:43] complex then that those books you know [0:46] start to have every possible possibly [0:48] every possible permutation of every [0:49] biomolelecule could could could be made [0:51] by your body at that point and then a [0:53] virus doesn't necessarily have anything [0:55] unique about it. [0:56] >> Welcome to the Huberman Lab podcast [0:58] where we discuss science [music] [1:00] and science-based tools for everyday [1:02] life. [1:04] >> [music] [1:05] >> I'm Andrew Huberman and I'm a professor [1:07] of neurobiology and opthalmology at [1:10] Stanford School of Medicine. My guest [1:12] today is Dr. Max Kuml, a professor and [1:15] leading expert in immunology and cancer [1:17] biology at the University of California, [1:19] San Francisco. Today we discuss your [1:22] immune system, how it works, what it [1:24] needs to function at its best, and how [1:26] things like aging, vaccines, sleep, and [1:28] even your thoughts and emotions shape [1:30] immune function. For instance, most [1:32] everybody knows that being sleepd [1:33] deprived makes you more prone to getting [1:35] sick. But why? Meaning mechanistically [1:37] why? Well, it turns out there's a [1:39] specific set of cells that need to [1:40] migrate in a particular way during [1:42] sleep. And we talk about how you can [1:44] reinforce that process in ways other [1:46] than sleep. We also discuss incredible [1:48] findings that certain brain states and [1:50] memories can be associated with an [1:52] immune system status you had when those [1:54] memories formed and evidence that just [1:57] recalling those memories, thinking about [1:59] where you were, what you were feeling at [2:01] those times when the memories formed can [2:03] activate your immune system in the same [2:05] way, which is remarkable. We also have a [2:08] very candid discussion about vaccines [2:10] and medications more broadly. You'll [2:12] notice that Dr. Dr. Croml is incredibly [2:13] balanced throughout today's conversation [2:16] and yet he's also willing to state his [2:17] views very clearly. So it provides a [2:20] very rich discussion about vaccines and [2:22] all the rest. Indeed, thanks to Max's [2:24] incredible breadth of understanding of [2:25] immunology and much more and his ability [2:28] to break down complex topics and make [2:30] them accessible, plus his genuine care [2:32] for public education and science. [2:34] Today's is a truly special and important [2:36] episode to educate and inform you in [2:39] actionable ways. I should also mention [2:40] that Dr. Dr. Crumbl has an incredible [2:42] zerocost substack. It's called the [2:44] immune beyond. You can access it by [2:46] going to the immune beyond all [2:47] oneword.substack.com. [2:50] And there he teaches about science and [2:51] more. Again, it's awesome. It's free. So [2:54] definitely check it out. Before we [2:56] begin, I'd like to emphasize that this [2:57] podcast is separate from my teaching and [2:59] research roles at Stanford. It is, [3:01] however, part of my desire and effort to [3:03] bring zerocost to consumer information [3:04] about science and science related tools [3:06] to the general public. In keeping with [3:08] that theme, today's episode does include [3:10] sponsors. And now for my discussion with [3:13] Dr. Maxruml. Dr. Max Kuml, welcome. [3:17] >> Thanks. [3:17] >> Most everybody, including me, has heard [3:19] of this thing we call the immune system. [3:21] And most people just think, okay, this [3:23] is the thing that when I'm rested, keeps [3:25] me from getting sick. And when I'm not [3:27] as well rested, I tend to get more sick. [3:30] And there are these airborne things and [3:31] we can get sick. And there's like [3:34] funguses and viruses and and I think [3:36] that's probably what most people [3:38] understand and they probably also [3:39] understand that there are like cells and [3:41] T- cells and B cells. But if we want to [3:44] think about a little bit of the history [3:46] of our understanding of the immune [3:48] system and what we understand now, maybe [3:50] you could orient us because in reading [3:53] your work prior to this discussion, I'm [3:55] realizing that this is a very recent [3:58] field and also there's still a lot that [4:01] we do not understand. When I started [4:03] immunology sort of 30 years ago, I was [4:05] rotating in labs at Berkeley. I think [4:08] you were at Berkeley as well. And uh one [4:10] of the transcription factor biologists, [4:12] you know, mentor said, uh, you know, why [4:14] do you want to work in imunology? It's [4:15] not really a field. And so at the time [4:17] it was kind of true, you know, [4:18] everything was about um DNA cloning. We [4:21] still, you know, it's obviously still a [4:22] lot about molecular biology, what we do, [4:24] but uh, you know, at the time it was [4:26] pretty simple. We thought of the immune [4:28] system as something that on the one hand [4:29] it had to come into play when you saw a [4:31] virus or something foreign. [4:34] Um and otherwise it generally had to be [4:36] quiet and kind of leave you alone. I [4:38] think cancer imunotherapy changed that a [4:39] lot. that that gave us the idea that you [4:41] could tune its reactivity so that you [4:43] could get to the point where if you gave [4:45] an amnotherapy, what it was actually [4:47] doing was raising the threshold of when [4:49] a T- cell would activate and allowing [4:51] tea cells that might be just letting the [4:53] tumor get by get they'd be able to go [4:56] and go after that tumor and and and kill [4:58] it. I think that changed the spectrum a [5:00] certain degree where we suddenly saw [5:02] okay this isn't just a just a you know [5:04] foreign versus self thing because it's a [5:06] tumor is kind of not exactly self but [5:08] it's exactly it's also not foreign it's [5:10] was once you it's a cell that's kind of [5:12] evolved so I think tumor immunology [5:14] really changed our perspective on that [5:16] you know to the point where we now think [5:18] of it as a as a tunable system [5:21] but then I think you know a lot has [5:22] happened in the last 20 years there's [5:24] been a lot of excitement about cancer [5:25] imunotherapy because we're curing people [5:27] with cancer [5:28] which really wasn't done before. And [5:30] you're now in this space where um the [5:32] immune system is showing all these other [5:34] roles. I mean, you know it in the in the [5:35] nervous system, the brain, there's [5:37] microglea that do various functions, [5:39] cleaning up, etc. But it's in your gut. [5:42] It's allowing microbes to live in you, [5:44] but it's titrating them. It's keeping [5:46] them there in kind of like the right [5:47] quantity. So, it's kind of guarding [5:49] yourself. It's uh, you know, it sits in [5:52] your liver regulating how how much you [5:55] metabolize. there's a collection of [5:57] cells there. Um, it's in your heart. [5:59] It's, you know, regulating cardiomyio [6:02] function. Those are the the muscle cells [6:04] of your heart. Uh, they have to be [6:06] cleaned up from time to time. So, [6:07] there's a set of immune cells that will [6:09] help get rid of their byproducts in in [6:11] the in the heart. So, it has all these [6:13] additional functions that kind of before [6:15] were were lost in the in the just, you [6:18] know, the foreign battle against the [6:20] foreign and now we have this kind of [6:22] perspective of this system that measures [6:24] us all the time. It measures everything [6:26] about us and it exists in some ways. I [6:28] think it's to to help us be who we are, [6:31] you know, and that's hopefully that's [6:33] you as a healthy person, you know, and [6:35] chronic disease unfortunately can be [6:37] part of the problem where it becomes [6:38] part of the things that's letting the [6:40] chronic thing whether that's a tumor or [6:42] kidney disease or what have you. It can [6:44] it can actually help perpetuate it [6:45] because um well it's you know some ways [6:47] it's trying its best [6:49] >> but it's applying the wrong program to [6:51] the wrong situation. Um so yeah it's [6:54] it's changed a ton and I'll give you [6:56] another little funny story which is that [6:58] that um you know when I first came into [7:00] immunology again we had the story like [7:02] you know the mentor who says you know [7:04] this isn't really a field the year was [7:07] like came to the field in 1989 and [7:09] that's right at the peak of AIDS and um [7:13] AIDS was like as as a biologist was [7:15] really interesting because you know the [7:17] HIV virus infects tea cells so your body [7:20] is filled with 10 the 11th or so T- [7:22] cells like a ton of different kinds of [7:24] T- cells and um you had a you have a [7:26] subset of TE- cells that are called CD4 [7:28] T cells they're kind of a flavor of TE- [7:30] cells and the virus gets rid of those so [7:34] HIV virus will infect the CD4 T cells [7:36] and then then you end up with not having [7:38] them and the the manifestations of AIDS [7:41] for those that weren't around dur was it [7:43] was just a ton of different [7:45] opportunistic infections so like soil [7:47] bacteria that you and I you know fight [7:49] off without even thinking about it would [7:51] would would kill people but so too would [7:54] you see you saw people with carbosio [7:56] saroma you saw like a opportunistic vi [7:58] like where you know a cancer is emerging [8:01] um and you just saw all these kind of [8:03] manifestations of where the immune [8:04] system was important dementias in in [8:07] people with HIV as well you know it was [8:09] early accent at the time on how many [8:11] different things the immune system might [8:12] be important for so regardless of [8:14] whether you know it was a field or not [8:16] it was clearly important and it was all [8:18] these things we didn't know about it [8:19] that like fueled the discoveries ies [8:21] that have led to where we are right now. [8:23] And some of those I, you know, I think [8:24] it's worth pointing out were just these [8:26] curiosity questions like what are these [8:28] cells? Like they were hard to study at [8:30] in the beginning. You know, they're they [8:31] don't live, you know, it's sometimes [8:33] hard to keep cells out of out of a out [8:34] of a human body alive. So, you know, [8:37] there's there's issues about how do you [8:39] keep these things alive in the very [8:40] first place and then and then what kinds [8:42] of things, you know, trigger them to do [8:43] stuff and you got to make reagents to [8:46] test those, you know, ideas you might [8:47] have about what they might do. It was a [8:49] long haul, I think, to get ourselves [8:50] together where we now have a pretty good [8:52] understanding of all the molecules and [8:54] the cell types and the and the behaviors [8:56] that they can engage in. And it just [8:58] gets more comp, you know, more more [9:00] complex and more like rich as we [9:02] understand that they're basically every [9:03] single T- cell in your body is like a [9:05] free agent and they're part of a sensory [9:07] system. Each one can measure the [9:09] concentration of a of a of a set of [9:11] biomolelecules, proteins, and they form [9:14] a peptides. they can measure that and [9:16] each one then can say that's out of [9:18] range or that's in range. So it's like [9:20] you have like 10 to the 11th little [9:21] sensors going around you curating you [9:24] know making sure you're the right thing [9:26] and if they see something that's out of [9:28] range they can do something about it you [9:30] know like the whole thing is [9:31] magnificent. It is magnificent. Do you [9:34] mind if we take a developmental um [9:37] perspective on this for a second and [9:38] then I have a basic health question. [9:40] Yeah. The developmental perspective is I [9:43] think most of us either remember or have [9:45] observed that when humans are young they [9:49] get sick a lot more. Presumably that's [9:52] because their immune system isn't as [9:54] well developed. But kids tend to get [9:57] sick and then get over being sick pretty [9:59] quickly. [9:59] >> Yeah. [9:59] >> Maybe you could describe what's going on [10:01] there. [10:02] >> Yeah. And it also is the case that you [10:05] know as we get older much older in fact [10:09] uh last quarter of life let's say people [10:12] tend to get sick more uh what's going on [10:15] um in terms of immune system function um [10:18] or is there something more broadly [10:20] happening at level of just kind of [10:22] energetics mitochondrial function very [10:24] curious about this [10:25] >> if I can take a step even further back [10:28] I'll ask you a question of like who are [10:30] you and I don't mean that like in the [10:32] personal sense, but I can talk about [10:33] that too if you want. Uh, but the more [10:34] the question is like at at some point [10:36] where does your body end and where does [10:38] the world outside start [10:41] and one of the things that, you know, [10:42] you start to realize if you look in a [10:43] microscope is that we're covered with [10:45] microbes all over our surface. We're [10:47] covered with microbes all the way in our [10:48] gut. In fact, we can't, you know, you [10:50] can't digest, you've probably heard this [10:52] before, but you can't digest animal fats [10:54] if it weren't for the bugs, the bacteria [10:55] in your gut. They make some of the key [10:57] components of of bile acids that allow [11:00] you to digest animal fats. So, you need [11:02] this system that's around you. So, you [11:04] aren't just the cell like if you learn [11:06] biology, you've got the again, we're [11:08] going to go way back. There's the egg [11:09] and the sperm and they fertilize and now [11:11] you got this this this cell that starts [11:13] to divide and gives rise to every other [11:15] cell in our body. So you might say that [11:16] your body is just that collection of [11:18] cells, [snorts] [11:20] but in fact it's it's it's it's absorbed [11:22] a lot of viruses and and bacteria from [11:25] our environment. And you know, to go [11:27] into that really briefly, that's really [11:28] important because we only have 20,000 [11:30] genes in our genome. So there's only so [11:32] much in a given life that we can do with [11:34] those genes. And so by absorbing all [11:36] kinds of other species onto us, we get [11:38] their genomes. So like you said, like I [11:40] was saying, the the bacteria in your gut [11:42] can now help you absorb nutrients that [11:44] you wouldn't otherwise. If you eat [11:45] sushi, you know, you've heard this [11:46] probably, right? You get you get [11:47] bacteria in your gut that can help you [11:48] absorb the the the seaweed, you know, [11:52] nutrients from seaweed. So, so taking [11:55] this into your question, you know, when [11:56] you're first born, you've never really [11:58] seen anything. And so, two things are [12:00] are I think worth pointing out at the [12:03] early phase of life. One of them is for [12:05] the first six months or so, your immune [12:06] system is pretty poor at being trained [12:09] on things. And it's presumably we [12:11] presume that for those six six months [12:13] that's because your body is developing [12:14] so fast that if you were to have a super [12:16] active immune system you might actually [12:18] find yourself attacking yourself. You [12:19] might think that you're foreign because [12:21] some genes turn on during development [12:22] and then all of a sudden you're you know [12:24] your immune system's like oh I see [12:25] something different and now I need to [12:27] react. So that's well known and that's [12:29] that's one of the reasons why some [12:30] childhood vaccinations they're really [12:32] important to protect kids in long over [12:34] life. Why they aren't given until you're [12:36] 6 months or or older. But I think to [12:39] your point, one of the things that's [12:41] happening with kids is that they then [12:42] then as they go into their like until [12:44] they're 10 and you're talking about they [12:45] get sick a lot, they just haven't seen a [12:47] lot of these bugs before. So they don't [12:49] have an immune system that knows what [12:50] flu is cuz they've never seen the body's [12:53] never that body and kids body has never [12:55] seen flu before. So every single virus [12:57] and pathogen that hits it is going to [12:59] elicit some, you know, some amount of [13:01] illness. But then they have a very [13:03] strong immune system. it reacts and you [13:05] know gets rid of that with the exception [13:07] of the ones that you know are those [13:08] those certain viruses and bacteras [13:10] mumps, measles, rebella that are they're [13:12] lethal and that's why we immunize as we [13:13] say and that's those are things that [13:14] your immune system if they get too much [13:16] of those kids will die and so it's [13:18] better to protect them with a vaccine. [13:21] All right. So that's the front end, [13:22] right? The front end has this initial, [13:24] you know, imunosuppression, then just [13:26] exposure to all these things that are in [13:28] our environment and you and I take on as [13:30] part of our genomes. But we have to get [13:32] a we have to reach a day tant with some [13:34] of them. You know, we have to get to the [13:35] point where the immune system can kind [13:36] of like fire back when they show up if [13:38] they're bad and and and allow them to [13:40] live in us if they're good with us. And [13:42] so I think that's what's happening a lot [13:44] in those first years of life. And you [13:45] know, you can see that both in the form [13:47] of, you know, kids getting sick a lot, [13:48] but you'll also see that their guts [13:50] develop way diverse microbiome. You [13:53] know, they allow a whole bunch of things [13:54] that come in from the outside and are [13:56] acceptable and are quite good for you. [13:59] That's the front end. In the back end of [14:00] life, it's a little bit more [14:01] complicated, but I'll tell you I'll tell [14:03] you two things that I think are [14:04] important. On the one hand is the idea [14:05] that is is the fact that a lot of your [14:08] cells in general become less functional, [14:09] including immune cells, and you get less [14:12] cells produced. And and that might just [14:14] be because, you know, we were never [14:16] selected as organisms to live as long as [14:18] we do right now. That's one idea of [14:19] aging, right? [14:20] >> We know that that we just were supposed [14:22] to be dead by 70. [14:23] >> Well, no, but we do know that that we [14:26] can reproduce and and you pass on our [14:28] genes successfully already when we're [14:29] 16. So, you know, the selective pressure [14:32] to pass on your genes, if you imagine [14:34] that's how genetic evolution happens is [14:36] that you pass on your genes as being [14:37] successful, you can already do that at [14:40] 16 and anything after that is just cream [14:42] on the crop. [14:43] um you know at some point maybe there's [14:45] no selection. So we don't know that but [14:47] it's it's a reasonable hypothesis to say [14:49] there wasn't any real selective pressure [14:50] for passing on genes that do anything [14:53] past when you're actually having kids. [14:55] The psychologists would tell us that uh [14:57] the wisdom of people, you know, 60, 70, [15:00] 80 and beyond is useful for um groups of [15:04] humans that live in, you know, you know, [15:07] villages of 100 or so people because [15:08] they can give information to younger [15:10] people that is on the periodicity of [15:13] like every 5 to 10 years, maybe every 30 [15:15] years. [15:16] >> But that's a just so story, right? I [15:18] mean, it's a nice just so story. [15:20] >> I like it too. And the I think the [15:22] genome geneticists will refer to that as [15:24] like the grandfather effect where genes [15:26] may be selected for and maybe they're [15:28] mostly about you know genes that make us [15:30] social in the in for for for the elderly [15:33] that do you know they're going to have [15:35] effects on the fitness of their [15:37] grandchildren which is their genes. [15:39] >> And so this yeah I think there's [15:41] something to be said for that in in [15:43] conceptual space. I don't know if I can [15:45] prove it to you that that's [15:46] >> it's a tough experiment to do. It's a [15:47] really tough experience to have two [15:48] villages where the you know the [15:50] grandparents are eliminated or like kept [15:52] you know both non-ethical and also non [15:55] >> but we were talking about the aging [15:56] immune system and I think I think [15:57] there's two things that again come to [15:59] this question that I was asking you like [16:00] who are you um and I was saying okay [16:03] well in aging you have this issue that [16:04] the immune system is is tapering in its [16:06] efficacy it's many of the cells that you [16:08] you know you've been holding your whole [16:09] life start to to literally they die off [16:12] but there's another thing which is I [16:13] think a lot of people don't realize when [16:15] you say when basic biology ology say [16:17] that sperm, you know, like uh fertilizes [16:19] the egg. So, you've got your mom's genes [16:20] and your dad's genes. You got 23 [16:22] chromosomes for your mom, 23 chromosomes [16:24] for your dad. And and and at least in [16:26] when you're first born, every cell is a [16:28] clone. It has exactly the same [16:29] information. [16:31] But DNA replication and and DNA sort of [16:34] like fidelity isn't perfect. Like they [16:36] say that on your skin, the cells of your [16:38] skin may have somewhere between 10 and [16:39] 30,000 mutations per cell per day just [16:43] from like by basic sun exposure. And [16:45] it's that that's higher than some of the [16:47] other organs. But the basic idea is that [16:48] your DNA, you know, it's susceptible to [16:50] UV radiation. That's one of the reasons [16:52] we put on sunscreen. [gasps] [16:54] But what it what it practically means, [16:55] no matter what number you put in there, [16:57] whether it's 10,000 mutations per day or [16:59] remember the the genomes are huge, [17:01] right? So 10,000 mutations out of [17:03] terabytes of of of information, still is [17:06] only a certain number. But do that over [17:07] every over years. And the main thing is [17:10] that that means is that every cell in [17:12] your body is no longer identical to the [17:13] one next to it because this one got [17:15] different mutations on day one. This one [17:17] got some mutations on day two. And [17:19] slowly but surely, you are becoming like [17:21] a mosaic. And I say mosaic, you know, [17:23] because like the tile that you see in [17:25] Morocco, you know, very intricate [17:27] designs because if you actually, you [17:29] know, start to look into tissue, you [17:30] know, you'll find that certain clones, [17:32] certain mutations do make certain cells [17:34] more fit. And they're the ones that if [17:36] you scratch yourself and a cell has to [17:38] like some some new has to has to form, [17:40] they might be the fittest to fill that [17:41] void. [laughter] [17:42] >> And one of the other clones over here [17:44] that got a different mutation may not be [17:45] fit to fill that clone. And so you you [17:47] end up with this pastiche of who you [17:48] are. So now again I ask you like who are [17:51] you now? So if I want to defend against [17:54] something that looks different, what if [17:57] everything looks different? What if [17:59] every cell is different from every other [18:00] cell? It's it's it okay. You want you [18:03] want another analogy? I would like [18:05] another analogy. The only um exception [18:08] that I can think of to this and I could [18:10] be wrong is that our neurons, our [18:13] central nervous system neurons, our [18:14] brain and spinal cord, most all of them [18:17] are the same ones that we were born [18:18] with. [18:19] >> Same cells, but [18:20] >> same cells, but so you're saying [18:21] mutations are constantly occurring in [18:22] the neurons in the DNA. So there it is [18:25] fascinating by the way that neurons live [18:26] that long. and you know hair cells that [18:28] they say that the the proteins in in our [18:30] hair hair cells of our ear are the same [18:32] exact molecules atoms as we had when we [18:36] were born. So there's there's some cells [18:37] that are along the but in their nuclei [18:39] the DNA that's encoding who they are who [18:42] those cells are is subject to mutation [18:44] ongoing and it depends on how deep they [18:45] are like the we tend to think that one [18:47] of the reasons that immune stem cells [18:49] live in our bone marrows you know our [18:51] long bones are hollow and in there is [18:53] the source of the immune systems you [18:56] know revitalization it's the stem cells [18:57] that make more white blood cells we like [19:00] to think that they live in there because [19:01] it protects them from a reagent they [19:03] they they they hang out stem cells are [19:06] You know that the bone actually serves [19:07] not only a structural purpose in our [19:08] body, but they it's a cavity in which [19:10] things can live and [19:11] >> keep it away from from solar radiation. [19:14] >> Keep it away from chemical cues in the [19:16] environment that can mutate. [19:17] >> Sequester your stem cells [19:19] >> and um [19:19] >> don't burn them. [19:20] >> Yeah. [19:21] >> That kind of thing. [19:22] >> Yeah. Likewise, the neurons in the in [19:24] the uh inside of the skull. [19:26] >> Yeah. [19:27] >> And the spinal cord [19:28] >> are protected. [19:29] >> They're protected. [19:29] >> Yeah. [19:30] >> And that's interesting. [19:32] >> Yeah. [19:32] >> Yeah. I would like to take a quick break [19:34] and acknowledge one of our sponsors, [19:36] JWVE. JWV makes medical grade red light [19:39] therapy devices. Now, if there's one [19:41] thing that I have consistently [19:42] emphasized on this podcast, is the [19:44] incredible impact that light can have on [19:46] our biology and our health. 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And in order to wake up [21:16] feeling refreshed and energized, your [21:17] body temperature actually has to [21:19] increase by about 1 to 3°. Eight [21:22] automatically regulates the temperature [21:23] of your bed throughout the night [21:25] according to your unique needs. I've [21:27] been sleeping on an eightle mattress [21:28] cover for nearly 5 years now and it has [21:31] completely transformed and improved the [21:33] quality of my sleep. The latest EightLe [21:35] model is the Pod 5. This is what I'm now [21:37] sleeping on and I absolutely love it. It [21:39] has so many incredible features. For [21:41] instance, the Pod 5 has a feature called [21:43] autopilot, which is an AI engine that [21:45] learns your sleep patterns and then [21:47] adjusts the temperature of your sleeping [21:48] environment across different sleep [21:50] stages. It'll even elevate your head if [21:52] you're snoring, and it makes other [21:53] shifts to optimize your sleep. If you'd [21:55] like to try eight, go to [21:57] eightsleep.com/huberman [21:59] to get up to $350 off the new Pod 5. [22:02] Eight ships to many countries worldwide, [22:04] including Mexico and the UAE. Again, [22:06] that's eight.com/huberman [22:09] to save up to $350. [22:11] >> Sometimes I tend to think the immune [22:12] system, you want to defend it like you [22:14] want to defend a nation and you want to [22:16] defend it from outsiders. And I've just [22:18] told you a story that's if you want to [22:19] take a political statement from it's [22:21] pro- immigration because all these [22:22] bacteria that live on us are actually [22:24] bringing us goods and they they do a [22:26] lot. [22:26] >> We just lost half the audience. No, I'm [22:28] just kidding. I'm I'm totally joking. We [22:29] we're a bipartisan audience. I'm joking. [22:32] Take it how you want. But by analogy, [22:35] it's the argument for, you know, why why [22:37] certain um you know, influx of of of u [22:40] in this case organisms onto us, you [22:42] know, create a more robust, you know, [22:44] person than we were before. But I want [22:46] to give you this story that one of a [22:48] famous um marinologist in the 1970s drew [22:51] this parallel in wartime and said in you [22:54] know World War II submarines would be [22:56] underneath the ocean and they'd be [22:58] traveling around and they would if they [23:00] could if they heard another submarine [23:02] they would scuttle the missiles the [23:05] torpedoes because that could be the [23:07] enemy and the enemy could fire at them. [23:09] [snorts] And so they had two sets of [23:10] books that they used. Uh, one of them [23:14] was a book that gave them the sound [23:16] profile of all, let's say it's a US, of [23:19] all the US submarines. And so they could [23:21] listen to the were of the engines and if [23:22] they heard a were of the engine that had [23:24] the certain cycle of a general mo, you [23:26] know, motors engine, they wouldn't fire. [23:29] So that's the sort of like self I know [23:31] what self is. And then they had another [23:34] book that was the engine sounds of the [23:36] known diesel engines of whatever engines [23:38] of the German uh, you know, submarines. [23:40] And if they heard that then they [23:41] absolutely would fire. And that's a self [23:44] versus non-self-discrimination problem [23:45] just like the immune system has to do. [23:47] But what I bring you with the aging is [23:49] this concept that as you get weirder and [23:51] different your body is getting like more [23:53] complex then that those books you know [23:56] start to have every possible possibly [23:58] every possible permutation of every [23:59] biomolelecule could could could be made [24:01] by your body at that point. And then a [24:03] virus doesn't necessarily have anything [24:05] unique about it. A virus is also going [24:06] to make proteins and that's your immune [24:08] system can see the viral proteins and [24:09] say oh a new thing has come in and [24:12] that's you know that's out of range and [24:14] now I need to mount that a T- cell [24:16] response against this I need to make the [24:17] you know bring in the troops but with [24:19] aging we have this this kind of you know [24:22] us diverging problem so that this you [24:25] know this system that's supposed to [24:26] sense us [24:27] >> is just you know has a lot of cosmic [24:29] background has a lot of noise in it and [24:31] so I think it I think that's one of the [24:33] reasons why we also have issue when [24:34] we're aging and it's I I think it's also [24:36] one of the issu reasons why cancer is [24:37] more prevalent in later life for I mean [24:40] there's two parts of that one is of [24:41] course you've accumulated mutations in [24:43] your cells that could be cancerous but [24:45] also the immune system has been seeing [24:47] those and all the various different [24:48] accumulations of them and ones like them [24:51] you know over these years to the point [24:52] where the weird doesn't look that weird [24:54] anymore you know something like a cancer [24:56] that is different than you it's not that [24:58] much different than like another cell [25:00] over here that's gone you know like and [25:02] it's just happily making skin and isn't [25:04] cancerous but you you know, is it's got [25:06] some differences. [25:07] >> What about the argument that there's so [25:09] much cellular turnover that um the cells [25:13] that accumulate these mutations are [25:15] being eliminated? You're saying because [25:17] they're clonal, they're producing [25:20] different they become different, they [25:21] produce cells that are also different, [25:23] then they die. Is this is that the way [25:25] it works? [25:26] >> Yeah. And I think I think you you are [25:28] bringing something up that's also true, [25:29] which is that all the time I think the [25:31] immune system is defending us against, [25:33] you know, mutations. So, one example [25:35] that everybody sees when they get to be [25:37] about 40 or 50 is is little these white [25:39] spots on your skin. And we we think that [25:42] those are places where the immune system [25:44] has sensed a collection of cells that [25:46] were precancerous, maybe they were even [25:48] beginning of cancer, and has wiped them [25:50] out. And and so the you know, a lot of [25:52] the origin of cancers in skin is is [25:54] melanin producing cells like melan, you [25:56] know, melanoma is what we call skin [25:59] cancer. um those melanocytes that that [26:02] white area they've been wiped of a whole [26:04] collection of melanocytes and that's why [26:06] it's you know it's white instead [26:08] [snorts] of as dark as your as the rest [26:09] of your skin. So you know to that extent [26:12] the idea that the immune system is is [26:13] pruning you all the time is you know [26:15] there it looks like there's pretty good [26:16] evidence for that. [26:17] >> Um and the question is when does [26:19] something become dangerous [26:22] that's that's that's you know that's [26:23] fundamentally question with cancer and [26:25] these sorts of things. If you said, "I [26:26] want to actually have the fittest cells [26:28] in my skin to uh fill in a gap if I [26:31] scratch myself. I would like to have [26:32] cells that quickly replicate just like [26:34] maybe in kids. Kids heal so ridiculously [26:36] quickly, right? Because they have an [26:38] abundance of these cells that [26:39] >> I think I think they're they're their [26:40] wound healing. I mean, there's a group [26:42] out of Stanford that studies this, but [26:43] essentially, you know, wound healing in [26:44] in in young is quite quite a bit faster [26:47] and more efficient and and there's many [26:49] that there's many levels of that. Yeah. [26:52] >> But um yeah, remarkably faster. If [26:54] you're a parent, you've seen this. You [26:55] know, you cut yourself on the same day [26:56] as a kid, your kid cut yourself and [26:58] they're they're 3 days later, they can't [27:00] even find it on them and you know, like [27:02] four weeks later, you're still like got, [27:03] you know, scap or something. But I was [27:05] just coming to the point that if you do [27:07] that and you you want this, do you want [27:08] you maybe want that to fill back in [27:10] because you certainly out in the wild [27:12] having an open wound is a bad thing. So, [27:14] you like to heal quickly. Well, if a [27:17] mutation has happened that fills that [27:18] cell in quick, more quickly, that is [27:20] almost by definition a mutation that's [27:22] let that cell divide faster. [27:25] Well, what is cancer? It's cells that [27:27] divide faster. So, in some sense, all [27:29] these events in your life where winners [27:31] win by filling in the space left by [27:33] cells that die is selecting for cells [27:36] that get a little out of range with [27:38] growth. They may be a little bit better [27:39] at growing. And then again, the question [27:42] is like, well, how much better do you [27:43] want that? You want it to like help you, [27:45] but at some point you don't want it to [27:46] basically form a lesion and grow grow [27:48] grow and go other places and grow, which [27:51] is called metastasis in cancer, which is [27:53] how most people die. To me, that the [27:55] issue of self and non-self is one of the [27:57] ones that's been with immunology for a [27:59] very long time. And again, it's way [28:02] richer than we thought about, I think, [28:03] in the 1990s or 2000s, you know. And [28:06] then at the same time, the idea of what [28:08] you can do with that information is also [28:10] I call this kind of a new immunity. [28:12] Immunity used to be like a fuel gauge. [28:14] You'd say it was low for itself and it [28:16] was really high against viruses and it [28:18] was like a fuel gauge. You don't know. [28:19] Now it's really hot. And what we [28:21] originally thought we were doing with [28:22] cancer imotherapy was making it just [28:23] hotter generally. But now you realize [28:26] that in between like the immune system [28:28] not caring about something at all and [28:30] and going and you know like releasing [28:32] all its fury on something are all these [28:35] other things it can do with the [28:36] information it gathers in there. And [28:37] that's where I was saying you know it [28:38] can it can like quarantine bacteria. [28:40] It's not going to kill them. It's it's [28:41] in that zone. The bacteria as long as [28:43] they're in the right zone, there's not [28:44] too many of them, there's not too few of [28:45] them, immune system can actually help [28:47] them be there. It can produce things [28:48] that like either tighters them out of [28:50] circulation or keeps them there. You [28:52] know, in all these other settings, like [28:53] I say, in the heart and the can go to [28:56] almost any organ and uh and the immune [28:58] system is consistently present and it's [29:01] consistently measuring you. And the U [29:04] again is this complex you. It's not just [29:05] what came from the egg, it's the you [29:07] that's you right now, including all the [29:09] mutations that you might have acred and [29:11] all the bacteria and and and the [29:13] viruses. You know, we have a lot of [29:14] viruses in our bodies that we tend to [29:16] think that at the end of a of a illness [29:18] that we've gone back to our pure state. [29:20] This may came from religion. You know, [29:21] that we were born pure and if God made [29:23] us correctly, then we would be pure at [29:25] the end of things and you know that [29:27] would be pure immunity would would [29:29] purify us of things. But the more we [29:31] look, the more we find that every virus [29:33] leaves a little evidence of a little bit [29:35] of itself. And then there's a then [29:37] there's the goal for the immune system [29:38] to kind of quarantine that to say this, [29:40] you know, maybe we don't want to kill [29:41] every one of our cells to get rid of [29:43] every virus that's infected one of our [29:44] cells. We need to leave some of those [29:47] alive. We don't like for example herpes [29:49] virus infection infects the nerves and [29:51] when people have uh you know emergence [29:53] they they get nerve pain and worse. A [29:56] lot of that is caused by the immune [29:58] system reacting to the virus trying to [30:00] get out and then killing off neurons. So [30:02] the the the it's imopathology. The [30:05] immune system is c causing as much of [30:07] the damage and problem as the virus is. [30:09] And it's the failure of that day tant. [30:11] And when certain viruses are just [30:13] sitting in us, we're perfectly fine. You [30:15] know, we have new viruses sitting [30:16] around. As long as they're laying [30:18] dormant, our immune system can say, [30:19] "Okay, I'm going to hang out here and if [30:21] anything bad happens, I'm going to [30:23] squatchch that." But it's not like we've [30:25] been purified. [30:26] >> You know, that's a reality that's a [30:27] little bit too bad. But, you know, it's [30:29] also one where you say, again, if if the [30:31] goal of us is to make it to 30, let's [30:33] say you get a a an early liver infection [30:36] of a HCV or HPV. If the immune system [30:39] can just let that be, you're not going [30:42] to destroy your own liver and you'll [30:43] live to produce and your genes will get [30:45] passed on. On the other hand, if you [30:47] mounted a massive immune response, you [30:49] know, you went all the way in the fuel [30:50] gauge to the right, your immune system [30:53] can kill you. It absolutely can. You [30:55] know, it's can can kill any cell it [30:57] wants. So, so that that that again that [30:59] idea that the space in between is the [31:00] one that we actually are starting to [31:02] understand that it has all these [31:03] specialized roles that are not always [31:05] about getting rid of things at all cost. [31:08] This raises a question for me and [31:09] obviously I'm not an immunologist but it [31:11] seems like one [31:12] >> you're going to be one by the end of I [31:14] like the sound of that. Um as will the [31:16] audience. One potentially useful [31:20] strategy the immune system could have [31:23] perhaps would be rather than to decide [31:26] to launch an attack on a particular cell [31:28] because it's mutated and different [31:31] >> um enough to assess how many cells [31:35] throughout the body or even just get a [31:38] local average of how many cells have [31:39] similar mutations or just are different. [31:42] Right? So that if we are indeed born [31:44] pure um in the biological sense um [31:47] [laughter] [31:48] let's just keep it there for sake of [31:49] today's discussion and you know by the [31:52] time we are um you know 32 years old we [31:56] are a mosaic of mutations [31:58] >> as it it appears we are if the immune [32:00] system could surveil multiple regions in [32:03] the body [32:04] >> maybe compare organs or maybe keep it [32:07] within organ system and say you know the [32:10] number of of mutated cells or not pure [32:13] me cells would be one way to do it more [32:16] simply perhaps has exceeded a certain [32:18] threshold measured I don't know like [32:20] enough receptors have something in them [32:22] that the cell goes okay you know what [32:24] I'm going to fight y [32:25] >> right in the same way that you know [32:27] soldiers you know they might hear a shot [32:29] whis by but then do they necessarily [32:32] reveal their location and launch an [32:33] attack no but but if it's enough of an [32:36] of an attack they'll uh fight back [32:39] >> it seems like there should be some way [32:42] to that the immune system could quantify [32:44] either bodywide or or local organ or or [32:47] over some period of time they could [32:48] integrate over time. I have to imagine [32:50] that such a mechanism exists. you're [32:53] coming from neurobiology as I know and [32:55] so there is that in neurobiology of [32:56] accommodation right if I always tell the [32:58] story of I went to this little village [33:00] in in France called aas if you know the [33:03] names is a kind of a famous cheese that [33:05] they make in this town and it's super [33:06] stinky and they make it only in that [33:08] town and they make a lot of it in that [33:10] town and so when you drive into that [33:11] town it's like somebody has the worst [33:13] foot odor striking it really hits you [33:16] but after being in the town for like an [33:18] hour [33:18] >> Mhm. you don't notice it. Yeah. [33:20] >> And that's neuronal accommodation where [33:22] your nervous the same kind of thing [33:23] you're talking about where the you know [33:24] the sensors in your nose can become [33:28] they're like okay I've seen it. I'm [33:29] seeing it now it's not anymore and and [33:30] so I'm going to tune that out because [33:32] then your nose has the potential to [33:33] smell other dangers or other stuff. [33:35] Right. So that's the nervous system. I I [33:38] think you're exactly right where you're [33:39] going with this is and we think this is [33:40] true that the immune system is it you [33:43] know for danger it's looking for [33:45] something you would call like a it's how [33:47] it's seeing the signal over time. So, a [33:49] virus may, you know, let's let's say [33:51] you're a T- cell that recognize a virus. [33:53] Well, you're looking for something that [33:55] you've had nothing of before and then [33:57] all of a sudden the virus comes in, it [33:58] starts replicating and you have a lot of [34:00] it. And then at some point, if you get [34:02] rid of it, it'll come back down to next [34:04] to nothing. And in that period, you [34:05] mount an immune [clears throat] response [34:07] and you learn it and so the next time [34:08] around you'll be faster to respond to it [34:10] and keep you from getting sick. That's [34:12] one kind of signal. But self can have [34:16] either one of two signals, I think. One [34:17] of them is that you've had it your [34:18] entire life. So that amount of protein, [34:21] maybe it's a maybe it's insulin, you [34:23] know, which we think in general, you [34:25] know, it has a little bit of signal up [34:26] and down as you have a sugar, but [34:27] there's a range for that. And so your [34:29] body gets used to that range. And the [34:30] tea cells that see insulin, they are [34:32] very low. They're going to only be very [34:34] very low reactive to that. And there's [34:36] there's a whole story behind that, but [34:38] basically they're going to see that [34:39] level. But you can also have things that [34:42] the immune system is going to want to [34:43] treat like self that maybe do a slow [34:45] rise. they don't have this peak that you [34:47] have with virus and so like a a mutant [34:49] cell and maybe it's just a tiny tiny bit [34:52] above normal for months and then it [34:54] makes two copies of your cells and now [34:56] it's a little bit higher than normal and [34:57] the immune system is you know has I [34:59] think one of the deficits with cancer is [35:01] exactly that that things that you do and [35:04] this is sort of like I try to live my [35:05] life a little bit this way but it's not [35:07] validated by any you know any [35:08] experimental stuff is the idea that [35:10] whatever you are is what the immune [35:13] system is going to help you be if it if [35:15] it's if If it's a slow direction this [35:17] way, it's going to it's going to be okay [35:18] with that. What it doesn't like is like [35:20] big spikes and and and and that's maybe [35:22] the signal that you're asking about, [35:24] like could you actually get to the point [35:26] where you be reactive? The problem with [35:28] cancer is that it is, you know, slow and [35:30] nefarious. It grows over time and it and [35:32] and I think we're made to absorb slow [35:35] change [35:37] >> because if it's not causing us to be [35:38] sick yesterday and a little bit more of [35:40] it isn't causing us to be sick today, [35:42] then it's probably just a developmental [35:44] change. Maybe it's a new bacteria, maybe [35:46] it's a new, you know, this commensal is [35:48] so long as it doesn't accompany. Again, [35:50] viruses have two features in common. One [35:52] one is this spike of of, you know, [35:54] appearance. But they also cause damage [35:55] in that window. And so you have like [35:57] these cues that I think the immune [35:58] system, and I say the immune system [36:00] because it's some cells are going to see [36:01] the damage and some cells are going to [36:03] see the the additional proteins that [36:04] come in and then they exchange [36:06] information just like your brain, you [36:07] know, uh you can talk about the fact [36:09] that the brain has this wired, you know, [36:11] set of cells that are wired in space. [36:13] They're, you know, across your body from [36:15] your brain all the way to a muscle. [36:16] Let's say immune system has this [36:19] collection of cells that are they're [36:20] literally crawling around us right now. [36:22] And we used to do we still do a lot of [36:24] imaging. If you look in a piece of skin, [36:25] you can see the cells the immune system [36:27] are really really surveying us. They're [36:28] crawling around. But they get together [36:31] like neurons and they can form synapses [36:33] and one can say to another one, "This is [36:34] what I saw." And oh, you saw that? Oh, I [36:38] you know, I'm just being this. and they [36:39] can, you know, form a cluster of cells [36:41] that basically get together like a [36:43] neural little mini brain in our tissue [36:44] and they can say this is bad. We got to [36:46] do something about that. But I think the [36:48] slow burn doesn't do that. The slow burn [36:50] is one of the ones where the cells are [36:52] like, "Yeah, it's not that bad." I [36:54] realize this perhaps is not your [36:56] immediate area of uh research, but [36:58] recently I've been seeing a lot more [36:59] interest um in the thymus, [37:02] >> this organ that we have when we're young [37:04] and it disappears as we get older. And [37:06] there's a lot of interest in the thymus. [37:09] um because [snorts] we've never covered [37:10] the thymus on this podcast in any amount [37:12] of detail. If you could just uh educate [37:14] us a bit uh what it is, what it does, [37:15] and why it might be interesting as a as [37:18] a um therapeutic. I mean, maybe we in a [37:21] few years we'll all be banking our [37:22] thymic cells. Um maybe we will be [37:25] >> I know some people are already injecting [37:27] non-FDA approved peptides that uh come [37:30] from the thymus. I'm not recommending [37:31] anyone do that, but people are already [37:32] doing it um because that's the the [37:34] internet in 2026. But what's the thymus? [37:37] What does it do? Wh why this interest? [37:40] >> Yeah. Well, I can back up one step and [37:42] I've I've used the word T- cell before [37:43] >> and T- cell originally was thymus cell. [37:46] So, for those that maybe don't, you [37:49] know, have gone to had blood taken, you [37:50] know, if you have blood taken in [37:52] hospital, whatever, you you'll get red [37:54] blood cells and those are the cells that [37:55] carry oxygen around your body. And then [37:58] you have white blood cells that come in [37:59] two flavors, two me well, they come in [38:01] multiple flavors, but we for the moment [38:03] we'll talk about two. One are called B [38:04] cells and one are called T- cells. And [38:06] TE- cells were named because of the [38:07] thymus. So the thymus is this funny [38:09] organ. And it has a funny history. In [38:11] fact, I'm writing these substacks these [38:13] days and and I'm writing one that's [38:14] supposed to be released tomorrow about [38:15] the thymus because it uh it really [38:18] should have gotten the Nobel Prize. [38:19] There's a guy who's alive. He's like 97 [38:21] years old in in Australia who did this [38:23] saw did this remarkable kind of [38:24] experiment. There was this time when [38:27] kids that had heart issues would come in [38:30] for surgeries and they would discover [38:33] this enormous white whitish organ as [38:36] growth near the heart as they were [38:39] taking the body, you know, this cutting [38:41] open. And all the autopsies up to that [38:44] point had been done mostly with adults. [38:46] And in adults, there's only this small [38:48] little thing there. And so they were [38:49] like, "Oh my god, part of the heart [38:51] thing is this overgrown thing." they [38:54] they didn't really know what it did [38:55] [snorts] and so they would remove it and [38:58] uh the kids then would go home and it [39:00] was usually exploratory heart surgery [39:01] but then kids would go home and uh far [39:04] from you know dying of heart disease [39:05] many of them would die from like [39:06] opportunistic infections they get all [39:08] these infections they get flu and etc [39:11] and so there was this hint that maybe [39:13] this removal had taken out a critical [39:15] part of your immune system had made it [39:17] so you were super susceptible to [39:18] bacteria and so this guy named Jo Miller [39:21] who's this this 97-year-old codger in in [39:24] Australia at the time he was in in [39:26] England and he basically took a bunch of [39:28] mice and then when they were newborn he [39:30] removed their thymus the same same [39:31] little whitish organ. And sure enough, [39:34] those mice were they basically grew up, [39:36] okay? But then they all would succumb to [39:39] bacterial infections. And in fact, a few [39:41] of them even got tumors, which was kind [39:42] of noted at the time, but forgot. And [39:44] the reason why that is is because the [39:46] thymus is the place that makes all your [39:47] tea cells. And it and it comes from a [39:49] kind of a convoluted path, but you [39:50] remember how we talking about how the [39:52] stem cells of your immune system lives [39:54] in your bone? Well, there's stem cells [39:55] that live in your bone and they travel [39:56] through your bone through your blood to [39:58] the thymus and become te- cells. And [40:01] [snorts] the the reason they need to do [40:03] that is that the thymus is this kind of [40:05] super special place that is able to [40:07] present to them to show them all of the [40:09] genes in your genome in various [40:11] different ways. And so the tea cells [40:13] that come in there, the tea cells are [40:15] developing and they each have a possible [40:16] 10 to the 11th different kinds of [40:18] receptors to smell different things. And [40:20] you don't want any to come out that are [40:21] too reactive to you. So you don't want [40:23] you don't want to produce tea cells that [40:25] are going to go off and kill your [40:26] pancreas or, you know, kill your big toe [40:28] or anything, right? you want to you want [40:30] to maintain like tolerance. So you want [40:32] to make sure that you don't make the [40:33] immune system that's too harsh. So the [40:34] the thymus has the the role of producing [40:37] tea cells but also of educating them in [40:39] some ways of only letting the ones that [40:41] come out that have sensors that are [40:43] correctly tuned to to let you be you in [40:47] that way. Now to [snorts] the point [40:49] about the the story and you were asking [40:51] about aging is that is that in kids [40:53] those are really big because at that [40:54] point we were talking about the [40:55] developing immune system. It has to go [40:57] from like, you know, living under the [40:59] veil of your mother's immunity and then [41:02] it needs to let some development happen [41:03] and then it needs to burst out and start [41:05] to be able to react against whatever [41:07] bacteria and viruses you're going to see [41:09] over life. So your thymus has this huge [41:11] output. So as like between [snorts] [41:13] really from you know three to six months [41:15] old and you know into your into your [41:17] four or five years age but tapering your [41:20] body makes tons of tea cells and it's [41:21] because probably what you're talking [41:22] about you're getting exposed to all [41:23] kinds of different back bacteria and [41:25] viruses and so you need to make that [41:26] make that collection of immune cells [41:28] that both some of them you know see self [41:30] at low levels but then they also can [41:32] maybe react against different things in [41:34] the environment including the ones you [41:35] need to defend against. Then what [41:37] happens is because again I think we're [41:39] not needing that later and maybe we [41:41] don't even want that the thymus [41:42] involutes it gets super super small so [41:45] that in aged people it's like tiny [41:47] [snorts] and um and so it's not putting [41:49] out new tea cells and so the reason why [41:51] there's interest in like these peptides [41:53] but all these other approaches to like [41:55] revitalize the thymus is that like in [41:57] cancer for example wouldn't you like to [42:00] have a whole bunch of new tea cells that [42:02] could come into into you flood in there [42:04] with exactly the specificity for the for [42:07] the tumor the tumor has managed to teach [42:09] all your normal cell your other diesel [42:11] cell in your body that it's normal maybe [42:13] you need a source of new material to [42:14] come in and do that and there's really [42:16] two ways I think you you mentioned you [42:18] talked to Alex Marson not too long ago [42:19] and I'm sure he would have talked about [42:21] engineering cells that you can engineer [42:23] on the outside and give them specificity [42:25] but [snorts] the sort of like if you [42:26] will the more natural route to that [42:28] might be to to let the thymus make use [42:30] more tea cells and and make sure that as [42:32] they come out you make sure that they [42:34] can react against this tumor or whatever [42:37] it is you need to defend against. It's [42:38] always been a fascinating organ from the [42:40] sense that it's the origin of all the [42:42] cell types that we care about, the T- [42:44] cells in that case. But it does have [42:46] this like aging hit, you know, sort of [42:48] aging effect that seems to make us a [42:51] little bit more susceptible to things [42:52] later in life. [42:53] You know, again, we could argue about [42:54] what whether there was a big [42:56] evolutionary design behind doing that or [42:58] whether there just wasn't needed because [43:00] if you got you got to 30 and you died of [43:02] an arrow wound, you know, you know, and [43:05] but you given your genes, you're you're [43:06] a winner in the evolutionary sense. You [43:09] know, I love this uh uh this stance on [43:12] well, if you've already reproduced, I'll [43:14] just give a brief uh vignette. Uh we [43:17] were introduced by our uh mutual friend [43:20] uh David Felheim who's a a phenomenal [43:22] developmental biologist from UC Santa [43:25] Cruz and his wife Sophie Salama's also [43:27] phenomenal biologist a mutual friend and [43:29] years ago I was in Dave's lab because we [43:31] are longtime collaborators and published [43:34] a bunch of papers together and uh he was [43:36] doing some injections. I'm going to get [43:37] you in trouble Dave. He doesn't do this [43:39] any longer. [43:40] >> Yeah. I'm going to I'm going to join him [43:41] to get you in trouble cuz we [43:42] >> he was doing some injections and he [43:43] might have been using might have been [43:45] using carocyanide dyes. [43:47] >> This was kind of conventional tool back. [43:49] You put a little crystal in a piece of [43:50] tissue that's fixed tissue so it's not a [43:52] live animal or anything. And then you [43:54] put it in the fridge and then the [43:55] fluorescent dye would label a set of [43:56] neurons in a pathway. And um and I [43:59] walked over and I I saw Dave doing this [44:01] and he wasn't wearing any gloves. [44:03] >> And I thought, these are carboyanide [44:05] dyes [44:07] >> with cyanide. [44:07] >> Cyanide being the And I said, um [44:11] >> Dave, uh don't you want to put on [44:14] gloves? And he literally looked up from [44:16] the microscope at me. I'll never forget. [44:17] And he said, I've already successfully [44:19] reproduced. And he went back to doing [44:22] it. And it's his lab. So, and everyone [44:24] else was following a safety protocol. [44:25] Don't go after him. doesn't do this any [44:27] longer, folks. But, um, there's an [44:29] interesting mindset among you because he [44:31] comes from cell biology, Randy [44:33] Sheckchman's lab. You both trained in [44:34] Nobel Prize winning laboratories as [44:36] graduate students. So, I I find it [44:38] remarkable that this this stance of uh, [44:40] well, if you've already successfully [44:41] reproduced, we really aren't needed. [44:43] But, um, his kids are now graduated or [44:46] in college. So, there is this thing [44:47] about raising the young, too, and not [44:49] just creating them and then dying. [44:51] >> Agreed. I think there's a fitness [44:52] associated with being older than that. [44:54] And again when I say that this it is [44:56] maybe just taking this from a purely [44:57] like what would have been the source of [45:01] what we are today. You know what would [45:03] have been the selective pressures on [45:05] them and it would have been a little bit [45:06] like David saying you got to you know [45:07] the selective pressure is to get your uh [45:10] you know for for my genes to be passed [45:12] on my offspring have to be born [45:15] >> and then have to get to some age because [45:17] most humans are born pretty incapable [45:20] for a period. It's not like giraffes [45:21] where they drop off and they you know [45:22] drop out and within an hour they're [45:24] running. Um [clears throat] so that that [45:26] that period of of raising children I [45:28] think creates more pressure in in humans [45:30] to to to you know to successfully be [45:33] healthy longer. But I guess just you [45:36] know that there may be a negative [45:37] viewpoint there may but that concept [45:40] that maybe there isn't as much pressure [45:42] for you to be healthy and and going with [45:44] this is the idea that some of the things [45:46] that we want to be super efficient early [45:48] on might actually be bad for us as we [45:51] get like I'm like like I think this [45:52] issue that I that I brought up of our [45:54] mosaics is is a is a real confounder to [45:56] everything because that creates [45:58] something that is [46:00] >> quite hard to defend against. I think [46:02] that that that that aging backdrop um [46:05] and uh you know some of the immune [46:07] system that is really going to be [46:08] important to just be super reactive [46:09] early on may have some you know [46:12] compensatory problems when in faced with [46:14] that new reality of a 50-year-old or [46:17] 70-year-old or whatever it looks quite [46:19] you know looks quite more complex but [46:21] you would have you would have definitely [46:22] wanted in gene space you know gene space [46:25] what genes you have to select for you [46:27] know an immune system let's say or even [46:29] just your body system that makes sure [46:31] that you get to 30 that say who are you? [46:34] And and it's again there's that isn't to [46:36] say that we can't overcome some of those [46:38] deficiencies if we understand them. But [46:40] here's my plug for basic research is [46:42] that to understand them we have to ask [46:44] some some questions that are almost 90% [46:47] of them are going to be dead ends. You [46:48] know you can hypothesize it's one thing. [46:50] Well, you got to do the experiment to [46:51] like eliminate that. Mhm. [46:53] >> And this is one of the things that [46:54] people I don't think always understand [46:55] about science is that for all the [46:57] discoveries that you know I made or [46:58] other people have made, there is [47:00] hundreds [snorts] and hundreds of like [47:02] disappointments. You know, and you'll [47:04] recognize this where you you just go [47:06] home from the lab at the end of the day [47:07] and you've you know you've you've done [47:08] everything right, but the answer isn't [47:11] the one isn't the right one. [47:12] >> Yeah. One control experiment can [47:15] >> nuke your whole project. [47:16] >> Well, there's that. [47:17] There's obviously that you have to do [47:19] the experiment well and have it [47:20] controlled, but but the answer just [47:21] could be not the one you thought. And [47:23] and you know, we can only imagine stuff [47:26] >> and then try and see if it's true and or [47:27] or more importantly try to prove that [47:29] it's not true. So the better [47:31] experiments, the kind of we call them [47:32] killer experiments, right? The ones that [47:34] kill them kill the idea if they're [47:35] wrong. if the idea is wrong, but it's [47:37] killer because it if it's turns out the [47:39] way you hope it will, you know, again, [47:41] when we get to some of these aging [47:42] things, there's a lot of in there's a [47:44] lot of intuition that we all can put [47:46] into this, whether we're like [47:48] professional scientists or at home [47:49] scientists, but it's really hard to say [47:52] that intuition like your idea about how [47:54] the way the world should work is in fact [47:56] the way the world does work. You know, [47:58] that that I I wish that because of age [48:01] certain things would happen. That's [48:02] that's a that's lovely. But it could be [48:06] super the word was baroque, you know, [48:07] like [clears throat] it should the whole [48:09] system could be, you know, configured in [48:11] a completely weird way that doesn't [48:13] really initially make intuitive sense to [48:15] us. And that's also why some of those [48:17] discoveries are so big to us. We're [48:19] like, "Oh my god, I didn't realize that [48:20] this system that seems like it might be [48:22] quite as simple is so complicated. The [48:24] world is so strange." [48:25] >> Well, when I started in neurobiology, [48:27] the brain, the actually the entire [48:29] central nervous system was considered an [48:31] immuneprivileged organ. Yes. There [48:33] weren't supposed to be immune cells [48:34] there. And thanks to the beautiful work [48:36] of Carla Shatz with the major histo [48:39] compatibility complex work and um Ben [48:42] Baris and I'm failing to mention all [48:45] their scientific offspring but Beth [48:46] Steven, Shala Ergloo like and on and on. [48:49] Um it would take the rest of the episode [48:50] to name all all of Ben's scientific [48:52] offspring and Carlos too being you one [48:55] of [48:55] >> right I didn't work on those issues but [48:57] um but I was in those labs when it was [48:59] happening. We now know that the immune [49:00] system is active and alive in the [49:02] central nervous system throughout the [49:04] whole lifespan serving critical roles. [49:06] >> There are two things that well three [49:09] really that that are somewhat practical [49:10] questions. I'll start with the most [49:12] basic one. Why is it at a mechanistic [49:15] level that if you miss a night or two of [49:17] sleep that your immune system seems so [49:19] less effective in fighting off off [49:22] infections? Do we know what's happening? [49:23] Is it like you've got so much adenosine [49:25] which is the sleeping molecule and and [49:27] [clears throat] uh like that that [49:28] adenosine inhibits T- cell function or [49:30] something? Do we actually know? Because [49:32] I think all of us are familiar with the [49:33] fact that if we we don't sleep well or [49:35] enough for a couple of nights, we're [49:37] much more susceptible to getting sick. [49:39] Yeah. [49:39] >> Is there a mechanistic understanding of [49:41] why that's so? [49:42] >> I think there are bits and pieces of it. [49:43] I think um some some really nice work [49:46] shows that at night a few wacky thing [49:49] when you're sleep a few what you might [49:51] have thought would be wacky things [49:52] happen and and one of them is that a lot [49:54] of your immune cells clear back to the [49:56] bone marrow [49:58] um and and your tissues become populated [50:00] with a bunch of neutrfils that come out [50:02] of the bone marrow and and seem to be [50:05] you know depositing collagen around your [50:07] body and and so there's a lot of things [50:09] that I think are reparative about sleep. [50:11] But I've thought about this a lot in my [50:12] own life as probably you have with sleep [50:14] is to one of the questions of course is [50:16] why do we bother to have sleep and and I [50:18] guess I can only imagine this because [50:20] our you know we've created these these [50:22] bodies of ours are so capable and [50:24] they're so energetically and you know [50:26] you know um consumptive and they make [50:28] all these byproducts during the day that [50:30] that at some point you just need a [50:32] cleanup phase and that's that's one [50:33] interpretation of sleep. You just need [50:35] to reset. So the immune system is [50:37] definitely resetting and and you know [50:38] there's as I said there's evidence that [50:40] a lot of the cells go kind of quesuscent [50:41] into the tissues and they they may leave [50:43] you alone for those reparative processes [50:45] and actually allow those [50:47] >> you know in terms of the data on there [50:49] there's there's a lot of studies that [50:51] are being done and and I can't say that [50:53] I've come to a a conclusion about that. [50:55] This is this comes in the question of [50:57] like is it known or do I do I not know [50:59] it or is it does nobody know it and I'd [51:02] say this is might be one of these areas [51:03] where about 10 factions of people know [51:06] it but they don't agree [51:07] >> you know so there's variations on things [51:09] but I I think the data for example that [51:11] immune cells dive into the bone marrow [51:12] at night is is pretty solid [51:14] >> that makes sense [51:15] >> what they're doing and why that's [51:16] important in the long sense of like what [51:18] you're talking about everything from [51:19] well but I think it's you know things [51:21] that happen overnight you you're [51:23] definitely your cognition improves is [51:25] that immune immune or is that neuronal [51:26] or both? I think it's both. [51:28] >> Something in the lymph plumbing immune [51:30] system. One thing that's just striking [51:32] like that is undeniable is probably the [51:35] best way to put it is um everybody has [51:37] bags under their eyes and looks like [51:38] when they are sleepd deprived. They [51:40] sleep for a night or two [51:42] >> and it goes away. [51:44] >> That's clearly accumulation of lymph. We [51:46] we actually know that. That's just lymph [51:48] fluid that's not being cleared. And it [51:50] might not even be the brain's uh [51:51] glimpmphatic clearance system. It's just [51:53] there's a bunch of lymph pooling under [51:55] your eyes. That's why you look like [51:57] >> Yeah. [51:57] >> And then you sleep for two nights. [51:59] >> Well, and you look better again. And the [52:02] eyes get glassy. We know that the eyes [52:04] get glassy when we're sleepd deprived. [52:06] >> That's also a a lymphatic clearance [52:08] issue. This is well established. Like, [52:10] so there's some things that are just [52:11] like plumbing works better when we sleep [52:13] and get up again. There's something [52:14] literally about lying down and getting [52:15] up. But but that to me can't explain the [52:18] the immune thing entirely because like [52:23] the lymphatic system is like among other [52:25] things, you know, immune surveillance. [52:28] But [52:28] >> I mean, one night lousy sleep and the [52:32] person coughing across the room gets you [52:34] sick [52:35] >> often. [52:36] >> But when you're well rested, you [52:37] actually feel this robustness like n [52:40] like okay, I might wash my hands or just [52:41] kind of avoid them and you're good. [52:43] >> Yeah. So it's it's I mean it's an [52:45] incredible effect one way or the other. [52:47] >> Again, I don't know the degree to which [52:49] we can nail down, you know, which which [52:52] part of things that are happening is [52:53] which. I always like the story that that [52:55] the um there's macrofasages, immune [52:57] cells in your eye that are basically [52:59] clearing the clearing the lens, [53:01] >> you know. So there's there's all these [53:02] like places where it's doing little [53:05] cleanup that you can imagine that if the [53:07] the thing it's trying to get rid of is [53:09] granularity that that you need to have [53:11] sleep where you just aren't making more [53:13] granularity so they can you know sort of [53:15] like when you wash your car windshield [53:16] you do it completely at that point and [53:19] but you can't be driving with flying and [53:21] right [laughter] [53:22] you'll never clean. [53:23] >> That's a great analogy [53:24] >> you So, I think there's certain elements [53:25] of some of these cleanup processes that [53:27] happen best when you're not getting [53:29] things, you know, you know, dirty or [53:31] again, I think a lot of what we're [53:33] talking about is byproducts of our [53:34] energetics that leave, you know, some [53:36] damage behind it. I I think we just use [53:38] a lot of ATP and we do a lot of stuff as [53:40] our bodies in in the sleep time where [53:43] you can not be, you know, producing more [53:45] of that and get ahead of the curve on [53:47] cleaning things up a bit. [53:48] >> Um, like pulling into a gas station, [53:49] cleaning off your windshield. I'd like [53:52] to take a quick break and acknowledge [53:53] our sponsor, AG1. I'm excited to share [53:56] that AG1 has just launched their newest [53:58] formulation, AG1 Pro. 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It's a great product and it's now [54:41] made even better with the new AG1 Pro [54:43] formula. If you would like to try AG1 [54:46] Pro, you can go to [54:47] drinkaga1.com/huberman [54:49] to get a special offer. AG1 is giving [54:52] away a free bottle of omega-3 co-enzyme [54:54] Q10 with your first subscription. Again, [54:56] go to drinka1.com/huberman [54:59] to get a free bottle of omega-3 [55:01] co-enzyme Q10 with your first AG1 [55:03] subscription. This thymus thing is [55:06] really intriguing. And uh I know a lot [55:08] of people who um opted to bank their [55:11] child's umbilical cord in the hopes that [55:14] the stem cells from the umbilical cord [55:15] will someday be useful. [55:16] >> Yeah. [55:17] >> How invasive is it? Andor should we be [55:19] uh banking thyic cells? [55:22] >> Uh because these seem like incredibly [55:24] valuable cells for their ability to [55:27] immune surveil and create kind of the [55:30] perfect situation using our own [55:31] indogenous tea cells to battle [55:33] infections. I mean, I kind of wish I had [55:35] a little little chunk of my thymus. [55:37] Yeah. [55:37] >> Um, in a minus 80 freezer someplace so [55:40] that when I'm 85 years old, [55:42] >> you might [55:43] >> I might be able to exploit that. [55:44] >> Yeah. [55:46] >> Well, I'll I'll say that the umbilical [55:48] cord one is is pretty straightforward. [55:50] It's, you know, the umbilical cord is [55:51] being essentially discarded anyway and [55:54] it contains a lot of, as you know, bone [55:56] marrow stem cells that um the utility of [55:59] those is a little different than the [56:00] thymus. the utility of of banking that [56:02] material and banking just means you put [56:04] it into a vial small little you know [56:06] small little vial with right of media [56:08] and you set it in a very very cold [56:10] environment for whenever you might need [56:11] it is that if you need to have a bone [56:14] marrow transplant so for example if you [56:15] have a tumor of the bone marrow system [56:18] you can subject yourself to radiation [56:21] and wipe out all that tumor cells but [56:23] you'll wipe out all the stem cells but [56:24] if you get this vial here you've got a [56:26] little replacement [56:27] >> has that ever been done successfully [56:29] >> yeah you can do Are there kids even kids [56:32] or adults that are alive today because [56:34] they banked their umbilical courses? [56:36] >> But certainly companies sell access to [56:37] that [56:38] >> somebody has to pay to keep the freezers [56:39] on backup generators and things like [56:41] that. So people invest time and money [56:43] into this idea. Is is there a [56:45] >> walking talking breathing human who [56:48] would be otherwise dead would otherwise [56:50] be dead excuse me because they they paid [56:52] money to bank their their umbilical [56:54] cord? [56:54] >> It's a really good question. I don't [56:55] know the answer to that question. I [56:56] guess the parents pay the [56:57] >> I can tell you and this will be just [56:59] like this is this is the depth of to [57:01] which you're you're describing uh Dave [57:03] Felheim injecting a you know mouse is [57:05] that in mice this is true that if you [57:08] take you know bone marrow stem cells you [57:10] can reconstitute a mouse with a blood [57:13] blood cancer and you can do that. I'm [57:15] sure you can do it in humans too. I have [57:17] zero doubt that it also works. I don't [57:19] know whether those companies have done [57:20] that. That's that's just actually [57:21] something where I [57:23] >> this is offered in mass now. [57:24] >> Yeah. Yeah. [57:26] Do you want to do you want to keep the [57:27] umbilical cord? [57:27] >> Honestly, honestly, I would do it [57:29] because it's one of those situations [57:30] where if it's not too Well, I don't know [57:32] if it you know, it depends on your your [57:33] how much money you have to spend because [57:35] the [57:35] >> it's within within the noise. Yeah. [57:37] Yeah. It's one of those so it's one of [57:39] those ones where you particularly when [57:41] you have kids there's this whole aspect [57:42] of like I would like to protect them [57:44] from anything that could come their way [57:45] and then I think this would if if they [57:48] happen to have a a childhood leukemia [57:51] this would this would cure it [57:53] >> which is an incredible statement if you [57:54] think about it even if it hasn't been [57:56] done successfully yet you didn't say it [57:58] might be able to lead to a cure by [58:00] virtue of a new technology you said it [58:03] >> would cure it [58:05] >> I mean that's a big statement [58:07] >> you can tell I'm ratcheting up from like [58:08] sleep to banking thymus and umbilical [58:10] cord. Now I'm going to go to the sort of [58:12] next level which is um not just in the [58:14] Bay Area. A lot of people uh however are [58:16] starting to think about oh maybe I make [58:19] some induced pur potent stem cells from [58:21] a fiberblast from one of my skin cells [58:23] put the so-called Yamanaka factors on [58:25] revert to stemness and then I might be [58:27] able to grow a new pancreas or study my [58:30] uh you know whatever organs in these [58:32] so-called organoids or what however [58:34] they're referred to. Yep. [58:35] >> But I learned today from you that if I [58:38] take that fibroblast now, that [58:40] fibroblast might not be completely [58:44] Andrew Huberman as I know him to be [58:45] [clears throat] genetically. It's [58:47] actually could have some uh mutations. [58:50] That seems important to compare against [58:52] a sort of um a standard cell. [58:56] >> I don't want to grow organ organoids [58:58] from a from an IPS environment that um [59:02] carries mutations. that that seems like [59:04] a bad idea. [59:05] >> Yeah, [59:05] >> because then anything I would I'm not [59:07] talking about transplanting in those [59:08] organoids. I'm talking about studying [59:09] them, thinking I'm getting information [59:10] about them. People are doing this and [59:12] thinking, oh, I'm seeing what drugs are [59:14] effective in treating uh, you know, a [59:16] liver [snorts] disease or a heart [59:17] disease. But if those are mutant cells, [59:20] that's a lousy experiment. [59:21] >> Yeah, I wouldn't I wouldn't say they're [59:22] likely mutant cells for that reason. I [59:24] think the biggest question would be [59:25] whether your induction of them to become [59:27] the organ that you, you know, want was [59:30] successful, was replicating the actual [59:32] organ itself. So you're you're [59:33] referencing these things called [59:34] organoids which are collections of cells [59:37] from a body of a human for example that [59:41] are are induced with various different [59:42] factors to grow to resemble maybe an [59:45] organ a particular organ. [59:47] You know I think all of us have little [59:49] doubt and this this is the source of the [59:50] California Institute for Regenerative [59:52] Medicine that making stem cells that can [59:54] become particular organs will at some [59:56] happen. We will figure all these things [59:58] out. And I I believe in science. I [60:01] believe in our ability to sort of like [60:02] test learn test learn test learn how [60:06] soon you know that becomes useful is a [60:08] bigger question. If you take out your [60:09] fiberblast today, that might only cure [60:12] you someday in the future. And [60:14] meanwhile, you may die of that thing [60:15] that you wish you had the stem cells [60:17] because it's not yet ready. The [60:18] technology and the understanding isn't [60:20] yet ready. But the other problem about [60:21] those is you probably will die of [60:22] something else. You get hit by a car, [60:24] you know, [laughter] [60:25] it won't help you that you've got those [60:26] things bang. I think in some of these [60:28] cases like overemphasizing this might be [60:30] your point about the storage of of [60:33] umbilical cords is like at what point is [60:35] that a high odds situation where you [60:38] your kid needs it and you have it stored [60:40] away versus all the other things fates [60:42] that can be flawless as humans that have [60:45] nothing to do with you know stem cells [60:47] from the bone marrow and and to me [60:49] that's that's a point where you could [60:51] spend your life worrying about how [60:52] you're going to die and and maybe that's [60:54] not a good way to live. Well, that's [60:55] certainly not how I live right now. [60:57] There's a lot of [60:58] >> kind of excitement, attention around [60:59] so-called longevity. And um at at the [61:02] extremes of never dying or living to be [61:04] 120, which seems to be the [61:06] >> perhaps the genetic limit uh currently. [61:09] Um it's not my fascination. I'm more [61:11] interested in living in the years I've [61:12] got as it seems you are too. Exactly. [61:15] Vital, healthy, you know, being able to [61:17] move, [61:18] >> sense, and and think [clears throat] [61:19] seems like and remember, you know, those [61:21] seem like the critical ones. You know, [61:22] you know, a moment ago you mentioned the [61:24] concept of like removing a bit of thymus [61:25] and I I think that the issues with for [61:27] me with that are or you know, it's an [61:28] invasive surgery and like if you were to [61:30] take out thymus it would it's not clear [61:32] to me that it's the thymus that you [61:35] need. You might be able I mean in fact [61:36] you can make thyic that so the thymus is [61:40] both the cells that come into it from [61:42] the bone marrow. So it as an organ it [61:44] has contents but its structure are some [61:47] thymic epithelial cells a kind of cell [61:49] that make a matrix that all those cells [61:51] live in and they get educated in and um [61:54] there's definitely you know pretty [61:56] strong work that says that you can [61:57] create sort of a thymic epithelium that [61:59] will do some of this work but whether [62:02] you know a guy at home [laughter] could [62:05] hold on to the thymic cells and we would [62:07] be in a position to do something [62:08] important for longevity in our lifetime [62:12] I don't No, I I I I honestly don't know. [62:14] Some things in my career, I've seen [62:16] things happen really fast. So fast that [62:18] almost like you didn't realize that you [62:20] were doing it. You're like, "Oh my god, [62:21] we've got a cure for cancer. That's [62:22] great. Okay, let's go and do the next [62:23] thing." Two things that So you're like, [62:25] you know, the California Institute for [62:27] Regenerative Medicine, they we thought [62:28] that we would have some stem cell [62:30] therapies, you know, within the seven or [62:32] eight year window of that bond, first [62:33] bond, and then there's a second bond. We [62:35] didn't really get very many out of that. [62:37] We learn a lot and that is the risk [62:39] >> about stem cell biology [62:40] >> about stem cell about biology and that [62:41] is the risk we take when we do research. [62:43] You know we're talking a moment ago [62:44] about how many times you might be in a [62:46] lab spending hundreds of hours and not [62:48] getting anything that you understand and [62:49] then and then one hour and you [62:50] understand everything because you know [62:52] so all of a sudden all those failures [62:53] make us make make sense. I think when we [62:55] get into some of this stem cell biology [62:57] it's it's intuitive and it's almost [62:59] certainly true that we will have some of [63:00] these things. Whether we'll have them in [63:02] time for like you or me I I don't know. [63:06] I just don't [clears throat] know. And I [63:07] I think that's true of a lot of these [63:08] things that say, "Oh, you know, we seem [63:09] to be right on the cusp right now." For [63:11] example, in in cancer therapy, we've [63:12] been on the cusp for 10 or 15 years of [63:14] these things called cartis. Alex will [63:17] have told you about these where you [63:18] engineer your tea cells and you give [63:19] them special receptors that can get them [63:21] to go into to eliminate tumors. But for [63:24] whatever reason, they haven't worked in [63:25] patients. They haven't worked. They [63:26] haven't worked. They haven't worked. And [63:28] T- cell the immune system gets turned [63:29] off. These cells don't make it. They [63:31] don't fail they fail to eliminate the [63:32] tumor. We will figure that out. But [63:35] we've been thinking, we've figured out, [63:36] you know, sort of for five or 10 years. [63:38] And it's it's, you know, that gets [63:39] frustrating. And I think it gets [63:40] frustrating for people that are like [63:42] waiting for it to um on the outside like [63:44] why can't you solve this? And you're [63:45] well because the universe isn't always [63:47] configured how we think it is. And [63:49] that's discovery. That's the problem of [63:50] discovery. If we knew what we needed to [63:52] do, we would engineer it and it would [63:53] work. [63:55] >> This is an important discussion that we [63:56] haven't spent enough time on in this [63:59] podcast that I think is very important [64:01] for people to hear. And I have some [64:02] thoughts about it, but I I'd love for [64:04] any disagreements. I'm not looking for [64:06] um just agreements, but [64:08] >> yeah. [64:08] >> So my observation from a couple decades [64:11] or more doing science and then mainly [64:13] shifting to podcasting, but this is what [64:15] I do. I talk with great scientists. [64:17] >> So that's the podcast. [clears throat] [64:18] So I'm very immersed in like what's [64:19] happening right at the cutting edge. And [64:21] um because of great guests like you, you [64:24] know, my my sense is that in every field [64:26] there's been like this kind of steady [64:28] pressure like water on rock pressure [64:30] like okay we're going to understand like [64:32] salamanders regenerate. Wouldn't it be [64:34] great if we could do that too? Cut off a [64:35] limb it could grow back. Okay, amazing. [64:37] I think it's like Ellie Tanaka's work [64:39] has just shown that you're like wow this [64:40] would be incredible for amputees and [64:42] brain regeneration and right [64:44] >> but then it never really transfers or [64:46] like oh we're going to figure out ways [64:47] to get genes into cells. We're going to [64:49] electroporate liposomes. Uh we're going [64:51] to use calcium phosphate. Like great [64:54] research tools. Tons of things happen. [64:56] It's like we're going to modify genes. [64:57] Zinc finger nucleus. All this. Okay. [64:59] Crisper. Boom. And one thing just breaks [65:02] through and goes so much further. And [65:04] even though you know the ethics are [65:06] questionable, there are babies that have [65:09] deliberately induced uh gene alterations [65:12] with crisper cickle cell anemia [65:14] treatments as well. More benevolent [65:15] example. [65:16] than the person who went rogue and just [65:18] kind of did this in humans in China. But [65:20] Crisper just kind of broke through it [65:22] all. [65:23] >> This the excitement about stem cells led [65:24] to like Yeah. I mean even initiatives at [65:26] the legislative level and like all these [65:29] labs working on things and then as you [65:30] said it's kind of like [65:32] >> run up against the dam. [65:33] >> Yeah. [65:34] >> But I feel like in 10 years some or all [65:37] of that information will be extremely [65:39] relevant when boom one thing will just [65:41] like leap out of bacteria or like [65:42] grasshoppers, no pun intended with the [65:44] grasshoppers. But the the last example [65:46] would be, you know, for years it was [65:48] like the country is getting fatter. The [65:49] c the country is getting obese. What are [65:51] we going to do? Do calories matter? Of [65:53] course calories matter. This kind of [65:55] thing, you know, laws of thermodynamics [65:57] still apply. And then all of a sudden, [66:00] this freaking helila monster biologist. [66:03] >> Yeah. Yeah. [66:03] >> Tells people what they already knew [66:05] because the GLPs were already being used [66:08] as a drug, just not at significantly [66:10] high levels. Yeah. [66:11] >> And all of a sudden we have a imperfect [66:14] but very important more or less dare I [66:18] say cure [66:19] >> for obesity. It's got problems. There's [66:21] muscle wasting. You know there could be [66:22] other issues, apathy, etc. I'm not I'm [66:24] not trying to discount any of that. But [66:26] I feel like that's the way science [66:28] works. It's like steady pressure, steady [66:29] pressure, steady pressure, frustration, [66:31] and something comes out of nowhere [66:33] >> and it almost seems prerequisite to have [66:35] all those years of frustration and [66:37] failure. [66:37] >> Yeah. And then and you say, "Well, [66:39] couldn't we have just gotten Crisper [66:40] first or the GLP's first? Like, why did [66:42] we go through all these, you know, [66:43] billions of dollars of expenditures, [66:45] time, energy?" [66:46] >> Yeah. [66:47] >> I don't know. I feel like there's some [66:48] natural order to this. And and I ju just [66:51] would like your thoughts on I feel like [66:52] it's necessary, but not sufficient to [66:55] have lots and lots and lots of failures. [66:57] >> Yeah. And I think it's necessary and [66:59] necessary, absolutely necessary to study [67:01] things that are just at some point [67:03] curiosities. And that sounds like [67:05] science is about trivia, but you know, [67:08] you you gave the example clip one. [67:09] Somebody was just curious as to why Hila [67:12] monsters. It was the feature was that [67:14] Hila monsters can go into, you know, [67:16] dormcancy for like 10 months, not eat, [67:19] and then uh and then come out and like [67:20] how do they manage that? And so that's [67:22] that was just like what is that? What is [67:24] it? What causes that? Crisper, you know, [67:26] that was people were studying like how [67:28] do bacteria defend against other [67:29] bacteria? Well, they use this. It turns [67:31] out there's this enzyme and it it [67:33] remembers the sequence of this one [67:34] bacteria that has come and invaded you [67:36] before and then can like modify the [67:38] genome and get rid of that and like kill [67:39] it. Well, that same you know that same [67:41] enzyme then which we now use for all [67:42] this human engineering came out of a [67:44] basic like how do bacteria defend [67:46] themselves. It's not anything about like [67:48] you know modifying single cell anemia. [67:50] It was about how does the world work? My [67:52] career is exactly as long as as the as [67:54] the lifespan of of this this field we [67:56] call cancer imotherapy. I did the first [67:58] imotherapy experiment. I injected a [68:00] mouse with an antibbody that I had made. [68:02] It was against molecules on te- cells [68:04] and I'd shown already in the lab that [68:06] that molecule caused the tea cells to [68:07] get more activated when you blocked it [68:09] and uh and we did a series of like other [68:11] mouse experiments of like all kinds of [68:13] diseases and it you know kept jamming up [68:14] the tea cells and then then you know Jim [68:17] I said we got some tumors in the fridge [68:19] and so we set up that experiment and uh [68:21] you know he injected this antibbody and [68:22] the tumors melted. Well that was the [68:24] start of cancer imunotherapy. We're like [68:26] that's that's this that's the origin. [68:27] This is the experiment for which let's [68:28] just be direct here that your your [68:30] adviser won the Nobel Prize. [68:32] >> Correct. Correct. [68:32] >> Did you at least get to attend the [68:33] ceremony? [68:34] >> Yeah. Yeah. [68:35] >> It was a little thing. [68:36] >> This is how science works folks. Doesn't [68:37] matter who did the experiment. Doesn't [68:39] matter what lab you're in. [68:40] >> Yeah. You got, you know, got to go to [68:42] the the afterparties were good. Uh but I [68:44] guess I take you back like we weren't [68:47] trying to cure cancer when we started [68:48] this. I the thesis project when I went [68:50] into Jim my my mentor at that point. The [68:54] discussion was like, well, there's some [68:55] molecules on TE- cells and and I said, [68:57] you know, we knew from AIDS and a few [68:58] other things that T- cells were [68:59] important. So, that was the attraction, [69:01] even though you had people say, why [69:02] would you do immunology? Well, we they [69:04] seem to be interested. And there was a [69:05] molecule. I was like, well, yeah, let's [69:06] just see what it does. And once you saw [69:09] you could turn things off, then [69:10] everything became possible. Right? Now, [69:12] you set an immune system you could dial [69:13] up. You can say, well, if I could dial [69:15] up, what will happen to vaccination? [69:16] Well, it got better. What will happen [69:18] to, you know, multiple scerosis? The [69:20] disease got worse. You know, what will [69:21] happen to cancer? Oh, we can start to [69:23] have an effect on and and and you know [69:25] the X-ray you know the people were [69:27] studying physics and then it turns out [69:28] to be that that they were like oh I can [69:30] measure I can I can measure bone and [69:32] that's how we use X-rays now like to to [69:34] you know so there's all these examples [69:35] that everything you know like the big [69:37] things often come from these orthogonal [69:40] directions and then we realize what it [69:42] might mean and I think you have to start [69:44] there otherwise you'll just plow this [69:46] direction and you'll hit those walls [69:47] because you don't have the workaround [69:49] that comes with some orthogonal piece of [69:51] The orthogonal meaning at right angles, [69:53] right? So, you know, again, the crisper [69:56] came from bacteria, but it's really [69:57] useful in us as an engineering tool. But [70:00] we wouldn't have known that if somebody [70:01] hadn't been out there sort of saying, [70:03] okay, well, how do how do bacteria do [70:05] it? You know, how do they defend [70:06] themselves? Oh, they use this enzyme. [70:08] And I think that's a really important [70:09] message that that dispels this idea that [70:12] everything is sort of like basically [70:14] just easy for us to engineer. Yes, once [70:16] you have the crisper tool, it becomes [70:17] actually kind of easy to do some really [70:19] cool things with it and still creative. [70:20] But the fundamental leap that you're [70:22] describing, I don't think in many of [70:24] those cases that people were kind of [70:25] conceiving when they were in in the [70:27] first drags of doing it, [70:30] this would become an industry. [70:32] >> You know, this would become a whole [70:33] thing. And and maybe that's important [70:34] because you need to foster that. If if [70:36] everybody always thought they were doing [70:37] it to build a company and, you know, [70:40] sell a product or something, then then I [70:42] don't think we would do the things that [70:43] get us new. You know, that's that's all [70:45] that's all kind of what we already know. [70:47] That's human knowledge. We want to build [70:48] human knowledge. And to build human [70:49] knowledge, we got to go off the piece. [70:51] You can't ski on the slope. You got to [70:53] be like in the trees. And maybe you'll [70:55] bunk your head a bunch of times. I I [70:57] think that's the reality. And it's like [70:58] you got a lot of people out there that [70:59] are that have decided to do that for a [71:01] life because it's a it's a it's a chance [71:03] to like solve a puzzle. It's like [71:05] there's there's puzzles about how the [71:07] world works. And if you've ever done a [71:08] jigsaw puzzle where you there's always [71:10] like the oh you get in and especially in [71:11] the end you're like how you what pieces [71:13] come together to do it. I think that's [71:15] what makes this whole science thing [71:16] really fun. It's that's the that's the [71:18] reward is that you get the puzzle piece [71:20] in and you're like oh you know it makes [71:23] sense that now I know what I've been [71:24] building. and I've been building this [71:25] puzzle and and then you go back and you [71:27] do it again because that's really [71:29] satisfying at the end of it even though [71:31] you know you again with a family puzzle [71:32] the first parts are so hard thousand [71:35] pieces and you you maybe find the edge [71:37] but the intervening where there's like [71:39] all clouds super hard and and I think [71:42] that's that's that is what science is a [71:44] lot about is uh is doing that and then [71:46] realizing what the picture is you know [71:48] what is that picture of and then then [71:51] all the you know the brakes are are off [71:54] I often tell people that if if an if an [71:55] experiment if experiment you'll do in [71:57] lab has a 10% chance of yielding [71:59] anything interesting you got to do at [72:00] least 10 you know to even meet the [72:03] fundamental stats you actually have to [72:04] do quite a few more. So that's where [72:08] it's not a um it's not a cost-effective [72:10] thing if you it's it's really difficult [72:12] to be a scientist because there's no [72:14] quid proquo. There's nothing there's [72:15] nothing to say if you put in five hours [72:17] that you'll get five units of goodness [72:19] of of knowledge out of it. A lot of [72:21] times you get zero and and but then [72:24] sometimes you put five and you get 500, [72:25] >> right? [72:26] >> And and those are the jackpot moments [72:27] where you're like [72:28] >> it's like life. [72:28] >> It's like life. It really is. I have to [72:31] say anyone who's considering a PhD. We [72:33] had a call in from audience recently and [72:35] someone said they're finishing [72:36] undergraduate, they want to go the or [72:38] finishing graduate school, should they [72:39] go the research route? They want to do a [72:41] posttock. And I'm like yes, yes, and [72:43] yes. I rather than answer publicly, I [72:45] decided to just have a call with this [72:46] individual because it's a rather niche [72:48] qu question. But I mean also just in [72:51] training your reward system to work for [72:55] 5 years on something [72:56] >> is so valuable especially in this day [72:58] and age because everything else feels [73:00] like it comes at like warp speed. [73:02] >> Yeah, you know it clicks. [73:03] >> Yeah. Like and um to just put steady [73:06] pressure on something with all the [73:07] failures and all the things and then to [73:09] finally complete something it's a lot of [73:11] people think it'll be underwhelming. I [73:12] think I think quite the opposite. [73:14] >> Yeah. It's like anyone that's like done [73:16] a triathlon or, you know, raised raised [73:19] a kid or done anything, you're like, "Oh [73:20] my goodness." Like, and that never ends, [73:22] right? There's nothing better than these [73:25] long-term investments. [73:26] >> Yeah. [73:27] >> Nothing. [73:27] >> Yeah. When they break through that [73:29] you're like your analogy, when you break [73:31] through that dam or when you realize [73:32] sometimes that you broken through the [73:33] dam. That's that's one of the funny [73:34] things about I think science and maybe [73:37] it's true in triathlons and stuff too [73:38] where you've realized that you've all of [73:40] a sudden got somewhere. [73:41] >> I haven't done a triathlon so I have to [73:43] be fair. Rob, our producer sitting to [73:45] our left is he has done many Iron Mans. [73:48] Um, and he has that mindset of just [73:50] steady pressure. I mean, his [73:51] relationship to work and effort is [73:53] remarkable because he burns so little [73:55] energy worrying about things that we [73:56] refer to as in the left column, like the [73:58] stuff you can't impact and just focusing [74:00] on what you can impact. [74:01] >> And so, a lot of it is about learning [74:03] energetic control, like doing science [74:05] that is, or anything is about what not [74:06] to think about, what not what to force [74:08] yourself not to do or think about. [74:10] >> Yeah. If I may, I'd like to shift us to [74:12] this very interesting area of immunology [74:16] and biology, which you refer to as [74:17] spatial biology. [74:18] >> Okay? [74:19] >> And I'm going to pose a question that [74:20] may or may not fit with um this [74:22] framework, but either way, I'd like like [74:24] you to educate us on it. [74:26] >> I'm fascinated by these old kind of [74:28] barbaric experiments in medicine. Um [74:31] wonderful book, by the way, folks, is uh [74:33] The Prince of Medicine about Galen. If [74:34] you ever want to learn about how we [74:36] learned about medicine back when, it was [74:37] truly barbaric. It was like surgeries [74:40] done on warriors and without anesthesia. [74:44] And we've known for a long time that if [74:46] uh somebody, god forbid, has a finger [74:48] lpped off or a hand lpped off, that [74:51] might actually be a worthwhile [74:52] investment to make an incision in the [74:54] gut and stuff that thing in the gut to [74:55] keep it warm and keep the tissue viable [74:58] for regeneration once you try and put it [75:00] back on. Turns out that's true. [75:01] >> Is that true? [75:02] >> Yeah. There's a bunch of juicy stuff in [75:03] the in the gut that maybe it's the [75:05] warmth. Maybe it's the immune system. [75:08] Okay. [75:08] >> Maybe it's the lack of infection from [75:10] being inside as opposed to outside the [75:11] body. Who knows? [75:13] >> Gut. You mean the intestine or you mean [75:15] the sto within the stomach? The stomach [75:17] itself. [75:17] >> Yeah. I'm not suggesting anyone do this [75:18] experiment. As I started reading into [75:20] this, I discovered that there are a lot [75:22] of really cool experiments not just in [75:25] limb or tissue preservation and and [75:27] restoration. Like for instance, I've [75:30] talked many times on this podcast about [75:31] the fact that above our the roof of our [75:33] mouth, we have this small cluster of [75:34] neurons, the super kaismatic nucleus [75:36] organizes the circadian rhythms of every [75:39] cell in our body from the genetic to the [75:41] transmitter level, peptides, etc. Keeps [75:43] us [75:43] >> sleepwake cycles, does all the [75:45] organization that we need for circadian [75:47] rhythms. So much so that you can take [75:50] just one subpopul of these neurons, the [75:53] calbindon expressing super chaismatic [75:55] nucleus neurons. It's like 5% of the [75:57] total neurons in this already tiny [75:59] cluster of neurons and you can [76:01] transplant them pretty much anywhere [76:06] and certainly in the brain and you'll [76:08] restore the circadian rhythm of an [76:09] arythmic animal. [76:11] >> Okay, [76:12] >> so that tells you a lot of cool things. [76:14] it says, "Okay, there's probably [76:15] something that's secreted or but like [76:17] these cells are that important and it [76:19] doesn't really matter where they are, [76:21] >> at least in the brain. They can do what [76:23] they need to do, which is super cool." [76:25] >> Yeah. [76:26] >> And then I started reading about, oh, [76:27] like you could actually take perhaps [76:29] like a little bit of pancreatic tissue [76:31] and like stuff it in the, you know, [76:33] under the skin. Not ideal, but you get [76:36] some function back. [76:38] >> So, I'm fascinated by this because we [76:39] like to think that the organization of [76:41] our organs is so critical. [76:42] >> Yeah. But maybe they just need to be [76:44] there. Now, no one should test this [76:46] hypothesis unless they have to. But when [76:49] we think about the immune system, [76:50] >> you described the function of the thymus [76:52] beautifully. You talked about the bone [76:53] marrow, but you also talked about the [76:55] massive migration of these cells that [76:57] are working in this network. [77:00] >> How important is spatial [77:02] compartmentalization of these cells or [77:04] is the rule eliminate spatial [77:07] compartmentalization in order to make [77:09] the immune system function at its best? [77:10] And there's a very specific practical [77:12] question for which I'm asking this, but [77:14] I'm just going to tuck that away uh to [77:15] peique people's interest and I'll get to [77:17] it. But this is relevant to how we to [77:20] decision important decisions that we [77:21] make I believe. [77:22] >> Well, the the answer is yes and yes, you [77:25] know, it's it's both. So although I [77:27] described the immune system in the [77:29] earlier part of this discussion as super [77:31] migratory, it you know hitches a ride in [77:33] the blood gets into tissues. It travels [77:36] through your lymphatics. There are these [77:37] things called lymph nodes down the [77:38] lymphatic tubing which for those that [77:40] don't know lymphatics are like drainage. [77:42] It's how you drain the the fluid back [77:43] out of your tissue. [snorts] [77:45] So [clears throat] although there's you [77:46] know these mass migration of cells [77:48] there's also in like even in just in T- [77:50] cells there's tea cells that lodge in [77:52] particular settings and they you know [77:54] act to protect that tissue and they um [77:57] and they're resident cells of those [77:59] tissues. they never leave. And um so [78:01] both are true that you have, you know, [78:03] parts of your immune system that are, [78:04] you know, protective or or like [78:06] nurturing of particular areas and then [78:08] there's ones that are circulating and [78:10] can hit any any spot. You know, going [78:12] back to your idea of organs and and such [78:14] being moved. I think there's two [78:16] components of that that you might be [78:18] thinking about. One of them is the [78:19] question of whether the organ can [78:21] survive in the new space like does it [78:23] have the growth factors and the blood [78:25] flow and the and lymphatic outflow and [78:28] maybe even some neuronal activity that [78:30] you know makes that tissue work. So so [78:33] that's where like if you take the [78:34] pancreas you can famously put it [78:36] underneath a kidney capsule. Kidney has [78:37] kind of like a skin around it. You can [78:39] tuck some some some pancreatic cells in [78:41] there and they're super happy. They love [78:43] that. They get all the blood flow they [78:45] need and it seems to be just right for [78:46] them. But if you've got somebody with [78:49] diabetes, for example, and you try to [78:51] put new pancreatic cells in anywhere in [78:53] their body, the immune system will [78:54] attack it just as it did the first [78:57] diabetes for those, you know, type 1 [78:58] diabetes or is caused by the immune [79:00] system. It gets too active against the [79:02] pancreas. It's autoimmunity. It's where [79:04] it's now saying the pancreas is is not [79:06] self. It's something foreign and it [79:08] wipes it out. And that's the source of [79:10] what I said earlier, like your immune [79:11] system can be quite dangerous. [79:13] So like when you talk about this concept [79:15] of like spatial um there's a few things [79:17] to bring in. One is does the organ can [79:19] the organ get what it needs and then [79:21] does the immune system accept it in some [79:23] ways in that environment. And that's [79:25] where like some some of your immune [79:26] system that lives spatially in certain [79:28] areas is going to be very like defensive [79:30] against whatever it's you know specific [79:32] against in that area but may not care [79:34] what's happening elsewhere because those [79:35] cells just aren't it's not like the [79:37] brain where like if I I do something [79:38] here it's sensed in my brain immune [79:40] system that if it does if the cells [79:42] don't migrate they don't have really a [79:44] lot of ways to communicate that they can [79:46] they can hitch some signals on neurons [79:48] and that's a really interesting we could [79:50] talk about the the capacity for your [79:51] brain and you know the insular cortex [79:53] there's great set of stories emerging [79:55] about how your insular cortex can [79:57] program your immune state into organs [79:59] and can via via the Vegas can can [80:02] essentially program [80:03] >> by levels of of calm or stress or by [80:05] thoughts themselves. [80:06] >> Well, the the one the latter one is the [80:08] one that gets me super excited about the [80:10] possibility that you could have triggers [80:12] for thoughts that so the insular cortex [80:14] as I understand it it's a source of some [80:16] of our moral decision- making. And it's [80:18] also the the thought to be the part of [80:20] our brain where if you cut your hand and [80:22] and I see a bleeding, I can feel it in [80:23] my hand, I oh ow. You know, I can sense [80:26] and you can sense each other's pain. [80:28] It's a set set that this very nice uh [80:30] Israeli group did this Royce lab did [80:32] this very nice study where they induced [80:34] into the guts of of mice inflammatory [80:37] bowel disease. They fed them a really [80:39] kind of weird sugar that causes the the [80:41] bowel to puncture and then they get they [80:43] get a really bad, you know, stomach [80:45] ache. um uh stomach ache, inflammatory [80:49] bowel disease, diarrhea and um and in [80:52] that period they used you know you know [80:53] what dreads are. So they they marked um [80:56] for the for the crowd it's they used [80:57] they they used they used a way to to [80:59] mark all the neurons that were firing [81:01] during that period in the instrumental [81:02] cortex and then later they could fire [81:04] them like after the mouse had recovered [81:05] and the they saw evidence that the [81:07] immune system was resetting up itself in [81:09] the gut as if it had just been punctured [81:12] you know like with and the cues for that [81:14] in that case were a drug but we know [81:16] that we can you know cue the insular [81:18] cortex like me watching you do things [81:20] >> so it's always it's maybe wonder whether [81:22] you know like some of the things we we [81:23] smell all cut grass and we can it'll [81:26] instantly take us back to a whole bunch [81:27] of thoughts about how we were when we [81:29] were kids and maybe even make you feel a [81:30] little like that. Whether there's [81:32] aspects to this to which our you know [81:34] our ability of our thoughts to control [81:36] that region are are going to be revealed [81:38] to you know to have potential that you [81:40] could train [81:41] >> uh you know train yourself to to you [81:44] know to bring up an immune state in a [81:46] particular tissue. [81:47] >> And just so I'm we make sure everyone's [81:50] on board what you just described because [81:52] there's a lot there. If I understand [81:54] correctly, we know that the nervous [81:56] system can do contextual learning. Like [81:58] if like if an animal or or human, let's [82:01] just keep it at humans, gets um shocked, [82:03] scared, or traumatized in a given [82:05] region. Yeah. [82:05] >> Or even I've had friends visit San [82:07] Francisco and get their cars broken into [82:08] and their computers stolen. [82:10] >> You can develop a context context [82:12] dependent or and or place dependent [82:14] memory where you kind of don't like San [82:16] Francisco as much even though the rest [82:18] of the trip was awesome. That's a pretty [82:19] broad interpretation. or um you have a [82:23] great experience someplace and you [82:24] actually really love [82:26] >> San Francisco because you met your [82:29] future spouse there or you just had a [82:30] particularly awesome experience there [82:32] even if it was just in one part you [82:34] might feel better about your computer [82:35] getting stolen anyway okay insula seems [82:38] like a you know let's take the positive [82:40] example let's keep it positive for a [82:41] moment I think what you're describing is [82:43] that if we remember the positive thing [82:46] if there was a positive immune status [82:50] >> associated [82:51] The immune system is also part of that [82:53] contextual memory. And [snorts] so [82:56] merely by recalling the positive or [82:58] negative, but in this case positive [83:00] memory, we can also rec we recall not [83:02] just the memory but also the body state. [83:04] And the body state includes the immune [83:06] status that accompanied the positive or [83:09] negative event. [83:10] >> That's what these studies are starting [83:12] to emerge. And [83:13] >> that's cool. That's really cool because [83:15] um we've heard for so long that like we [83:17] know that chronic stress impedes [83:20] >> immunity. We also know that acute stress [83:23] >> boosts it. And that's something that you [83:24] know with all due respect to my [83:26] colleagues who've focused on the ill [83:27] effects of chronically elevated cortisol [83:30] like that the the immune enhancing [83:33] effects of acute cortisol and stress are [83:35] are really important and and I think [83:37] they've been overlooked. But I love this [83:39] because one of the problems slash um [83:41] luxuries that I I have is I sit sort of [83:43] at the interface between like real [83:45] science and biology and like what most [83:47] people perceive as complete nonsense [83:49] wackiness. [83:50] >> But more and more we're finding that [83:51] within the complete nonsense wackiness [83:53] there are kernels of truth like that you [83:55] can actually meditate your way into a [83:57] better state which helps serve your [83:59] immune system and so on and so and [84:01] that's seeming less and less wacky even [84:03] outside California. Yeah. [84:05] >> Because of studies like the one you [84:06] described. One of my friends who's a [84:08] faculty, Dan Lim at NYU, we were talking [84:10] about the same study and he was like [84:11] that may be what meditation is doing [84:13] because it may be allowing your brain to [84:16] you know communicate and reset um you [84:19] know less inflammatory states [84:21] >> across your body because of this axis [84:23] and the study was really I think it was [84:26] you know there's still work to be done [84:27] it but the you know the the fundamentals [84:29] of it was in the actual event there were [84:32] certain cells that would accumulate in [84:33] there and then in the induced event when [84:35] you made the the brain fire again of [84:37] this mouse you would see you not as [84:39] profound but you saw this this evidence [84:41] of these same sorts of cells [84:43] accumulating there as if they you know [84:45] they're ready for that inflammation and [84:46] I think what we're talking about is the [84:47] idea that you could have that go both [84:49] directions and that again you know that [84:51] the concept of I mean I'm sure you've [84:52] talked about this before of of [84:54] meditation where the idea is that you um [84:57] you know you it's one of the ways that [84:59] you can control your autonomous nervous [85:01] system is through is through your breath [85:03] >> um that happens with meditation I think [85:05] that [85:05] >> to me there's something intuitive about [85:07] that. But you know, I just an hour ago [85:09] warned you about the problem of science [85:11] being intuitive that some things that [85:12] make that they sort of make a great [85:14] story in our minds and don't turn out to [85:16] be true. But the the data on this insert [85:18] cortex thing is starting to look like [85:19] it's a real thing. Like there's a real [85:22] connection between some of the [85:23] peripheral states and and like a regions [85:26] of the brain and however those are [85:28] triggered. Now, maybe, you know, again, [85:30] I've I've lost that. Well, maybe when [85:31] you're healthy, you should smell like [85:32] mint, and then when you want to be [85:34] healthy again, like, you know, there's [85:36] there kind of crazy thoughts, but but [85:37] again, there's an element of that that's [85:38] intuitive, too, where we say, "Oh, that [85:40] seems to be the case. My mom makes me a [85:42] comfort meal." Is it really the meal [85:44] settling in, or is it just the that the [85:46] sensations that make me feel like, you [85:48] know, less, you know, stressed in one [85:51] sense, [85:52] >> but maybe also to this point and [85:54] literally resetting your tissue. I'd [85:56] like to take a quick break and [85:58] acknowledge our sponsor, Function. [86:00] Function provides over 160 advanced lab [86:03] tests to give you a clear snapshot of [86:05] your bodily health. This snapshot gives [86:07] you insights into your heart health, [86:09] your hormone health, autoimmune [86:10] function, nutrient levels, and much [86:12] more. They've also recently added access [86:15] to advanced MRI and CT scans. function [86:18] not only provides testing of over 160 [86:20] biomarkers key to your physical and [86:22] mental health, it also analyzes these [86:24] results and provides recommendations for [86:26] improving your health from top doctors. 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A [87:09] function membership is only a dollar a [87:11] day, $365 a year. And if you think about [87:14] the information it provides and the [87:16] health challenges it helps you avoid and [87:17] the proactive things that it can do for [87:19] you to enhance your health, I truly look [87:21] at it as a savings. To learn more, visit [87:24] functionhealth.com/huberman [87:26] and use the code hubman for a $50 credit [87:29] towards your membership. Again, that's [87:31] functionhealth.com/huberman. [87:34] I'm always struck by um extreme of [87:37] personality but in both directions. So [87:40] there are these [clears throat] people [87:41] who just say like I don't get sick [87:44] >> and they don't get sick and it's super [87:45] frustrating because I'm not one of these [87:47] people that's very sickly but I [87:49] occasionally get like a sniffle or a [87:51] cold or something you less and less with [87:52] each year because I do feel I pay more [87:55] attention to the sleep piece [87:57] >> um than I certainly than I did when I [87:58] was a graduate student postto or junior [88:01] professor but there does seem to be this [88:04] quote unquote [88:05] >> positive or let's just call it a [88:06] reinforced mindset as opposed like [88:08] [clears throat] an immune rein [88:09] reinforcement associated with mindset [88:11] because um some people will say like I I [88:14] just always get sick and I believe them. [88:15] They always seem sick. But it could be [88:18] that um you get sick in in a given [88:21] environment once and then you you just [88:23] decide that you're sickly. So then you [88:25] you know it could be that the immune [88:27] system is listening to these thoughts [88:29] but not in the form of words. I think [88:30] this is where like it gets hokey for [88:32] people like real biologists and and [88:34] physicians are like yeah you got to be [88:36] kidding me like but because immune cells [88:39] don't listen to thoughts they listen to [88:41] brain states [88:42] >> triggers of some sort [88:43] >> triggers of some sort right um and then [88:45] there's like as humans we have this [88:46] obsession with language that makes it [88:48] seem like you can you know write [88:50] affirmations and then it's the word [88:52] content but it's the feeling state [88:54] associated with that that [88:56] >> a biological level makes total sense. So [88:59] we were talking about spatial biology [89:00] and the fact that you can tuck some [89:01] pancreas in the kidney and unless they [89:03] someone has type 1 diabetes [89:05] >> a lot of the functions of the pancreas [89:07] can um can persist or transplantation of [89:11] these clock neurons and clearly there [89:13] are limits to this but in the context of [89:15] the immune system [89:17] >> I'm wondering [89:19] can we take a little bit of thyic tissue [89:22] bank it just later like put it in a [89:25] slowrelease capsule under our skin of [89:28] our hand, you know, like. And that might [89:31] sound crazy, but I have friends, one of [89:33] whom might be at Neurolink [89:34] [clears throat] [89:34] now, who actually embedded a little [89:36] radio receiver under his hand to be able [89:38] to open his [89:39] >> um locks at his home and his car. And [89:41] his wife might have one also. And like [89:43] that might sound really like Bay Area [89:45] like future tech kind of wacky [89:46] biohacking, but [89:48] >> if I knew that I could be much healthier [89:51] >> by taking a few thyic cells and in a you [89:55] know a sterile capsule and sliding it [89:56] under the skin, you know, people get [89:58] their ears pierced with, you know, right [90:00] >> less less invasive uh procedures. Why [90:03] not? [90:04] >> Well, I mean the question is why would [90:06] that you know is that likely to work? [90:08] You're basically remember how we were [90:09] just talking about if I do 10 [90:10] experiments, one might work. yours isn't [90:13] a bad idea, but you know, is there it's [90:15] it's more than likely at one of the nine [90:17] out of 10, I would guess. [90:18] >> Sure. But is there a correlate from any [90:19] studies on animals? Um I mean, we know [90:22] that in a lot of studies of cancer and [90:24] tumors, I used to see these mice down in [90:26] the vivarium, [90:27] >> they would slide tumors under the skin [90:29] and study them [90:30] >> and give animals drugs or give animals [90:32] stuff. [90:32] >> Very common. Yeah. [90:33] >> Yeah. Uh tumors are happy to thrive in [90:36] novel environments. So why wouldn't [90:38] healthy cells [90:38] >> No, I think you can. I think one of the [90:40] things that comes into play a little bit [90:41] about that that's more about you know um [90:44] replacing an organ with one that might [90:46] be better is that at some point if you [90:48] come in so one of the the challenges of [90:51] tissue engineering is if you want to [90:53] bring in new genes the vector the [90:56] material the the the surrounding whether [90:58] you bring in using a virus to and you [91:00] know to bring it into those cells that [91:02] you're going to now put into the person [91:03] whether it's a virus or a small piece of [91:05] DNA called a plasmid you you effectively [91:08] are giving that a new bit of identity [91:11] and when that when you go to transplant [91:13] that organ back in it's seen as foreign [91:16] >> and it's it's just like you just put an [91:18] infected cell in you you know as far as [91:19] the immune system knows all of a sudden [91:20] there's a cell with huge number of new [91:23] things being expressed and some of them [91:25] viral literally so you know that's a [91:27] that represents an issue I think when we [91:29] talk about any kind of you know sort of [91:31] engineering at the you know the moment [91:33] is is if you engineer a system to be [91:36] maybe better the immune system isn't [91:38] necessarily going want better and and so [91:40] you have to overcome this issue of [91:41] tolerance maybe at the same time and and [91:44] and again that's why that particular [91:45] experiment depending on what you're [91:47] putting under the kidney capsule or [91:48] whatever it matters what the immune [91:50] state is and what that thing is as to [91:52] whether your immune system is going to [91:53] let it fly. [91:55] >> I'm not considering doing this. I just I [91:57] think we are I don't know how old you [91:59] are, but I can guess based on some [92:00] mutual friends we have, but I'm guessing [92:03] >> that a lot of people [92:06] who are able to understand speech, [92:08] they're old enough to understand speech, [92:10] are thinking that in our lifetime, we [92:13] are going to be able to use our own [92:14] cells or peptides or synthetic versions [92:17] of peptides from our own cells and and [92:20] so forth to to overcome a lot of the [92:22] issues that our parents and grandparents [92:23] were not able to overcome. you know, [92:25] with regards to like the peptide side of [92:27] things and even the cells and this is [92:29] maybe where you're going with space is [92:31] that context does matter for the immune [92:34] system. So, [92:36] and and it matters for all biological [92:38] systems. I'll just give you an example. [92:39] We did a study of of wound healing uh [92:42] some years ago and if you have a wound [92:44] in a mouse that's maybe just a like you [92:46] know if you ever have a melanoma removed [92:48] they do a punch biopsy. It's a little [92:50] circle. So you can do that in the back [92:52] of a mouse and then you can watch the [92:53] wound healing happen. The there's zones [92:57] within there where certain biology is [92:59] really important to be happening and [93:00] then so so imagine the the wound is like [93:03] this and it's open. The cells like one [93:05] layer back are doing certain things but [93:07] the other ones behind that are also [93:09] induced to do so. The wound isn't just [93:11] this area. It's it's actually sensed all [93:14] like a gradient almost like in the [93:15] neurons. And so these cells need to do [93:17] different things than these cells. So if [93:18] you wanted to administer some you know [93:20] like like a peptide or even just a cell [93:22] type you have to be a little bit [93:23] conscious of like where it's going to do [93:25] the work you want it to do and the [93:27] natural system does that naturally like [93:29] the cells on the inside actually [93:30] instruct the cells one layer back [93:32] >> but you don't necessarily want everybody [93:34] getting the same signal [93:35] >> so like development happens that way you [93:37] know about gradients and we were talking [93:38] about this earlier that there's [93:39] gradients so so I think one of the [93:40] tricks that we don't really understand [93:42] about this is when is something good uh [93:45] for a process and when is it only good [93:47] when it's given in the right dose at the [93:48] right time. [93:50] >> And I think that's one of the tricks [93:51] about some of these things. And again, [93:53] that's where, you know, both in the lab [93:55] and, you know, like I I would say that [93:56] more so than ever in in in our lives, [93:59] you know, we're seeing, you know, people [94:00] kind of like experimenting with things [94:03] on themselves. And one of the sad parts [94:05] about this, we don't capture a lot of [94:06] data. Therefore, you know, because it's [94:08] not seen as a study and we can't say [94:10] everybody that took this gets this [94:11] result. And and then you have this rise [94:13] of things on the internet of of [94:14] anecdotes that become seen as data like [94:17] I took this thing and this happened. And [94:19] that's you know I I I could drink this [94:21] drink and have something great happen to [94:23] me or something bad happen to me but [94:24] might have nothing to do with the drink, [94:25] right? [94:26] >> You know that that issue is one that I [94:28] think is really um is really critical in [94:31] in this in this window of time right [94:32] now. And honestly I don't know what to [94:33] think about the idea that people you [94:35] know do experiments on themselves. I I [94:36] think we all want to improve ourselves. [94:37] We all do all all do some kind of [94:39] experiments on ourselves. you read a [94:40] book, you're trying to improve yourself, [94:42] right? Um the physical one gets a bit [94:44] tricky when uh you know, you're not sure [94:46] whether something's going to be [94:47] dangerous or not, but [94:48] >> Oh, yeah. And I'm not promoting that [94:49] people do this. I think that of course [94:51] you would want to see pre-clinical, [94:54] clinical, and and other um trials for [94:57] this. I [94:57] >> think I would personally. I mean, just [94:59] >> Yeah. I mean, I'm I there are a few [95:00] areas well where I am um a bit more [95:03] adventurous, but for the most part, I'm [95:06] like, you know, based on my training and [95:08] [clears throat] background, I have to [95:09] orient toward, you know, I'd like a [95:11] bunch of Let me put this way. I'd like [95:13] to a bunch of other people to do it [95:14] first. [95:15] >> Yeah. [95:15] >> Like, who wouldn't? It's fun to be first [95:17] unless you're doing something really [95:18] stupid and that can get you killed in [95:20] which case like let other people go [95:21] first. [95:22] >> Yeah. Well, I think a good example of [95:23] that right now is and this is, you know, [95:25] sort of nationwide or even international [95:27] is vaccine hesitancy. And I know this is [95:29] a touchy topic, so we can open. Well, [95:32] I'll just point out that that the one [95:35] group that's completely no matter [95:36] whether they're hesitant against [95:37] childhood vaccines and the number of [95:38] them we get and the the fact that the [95:40] government makes you take them and these [95:42] sort of things, if those people have [95:44] cancer, they're very interested in [95:46] vaccines because it's a there there's [95:48] really good data that you can promote [95:50] more immune cells against the um tumor [95:52] by making a vaccine that consists of [95:56] some of the proteins and peptides that [95:58] are unique to the tumor and not [95:59] different from you. and you introduce [96:01] those as if you would introduce a virus [96:03] or anything in in a childhood vaccine on [96:06] similar concept um just different [96:09] peptides. their peptides from the tumor [96:11] and and in those situations it's [96:13] context, right? So if if you and I had [96:15] cancer and we don't have the the [96:16] conventional cures are not going to work [96:18] on us. We know there we know statistics [96:19] really well. Chemo is not very good for [96:21] a lot of you know cancers and that's the [96:24] only thing we got. But if you have [96:25] access to something that's relatively [96:27] new and particularly vaccines despite [96:28] what you know some people worry about [96:30] they're pretty safe. Um, and so the the [96:33] certain die versus try out a vaccine [96:35] drives a lot of people to be interested [96:36] in vaccines. And I would say yeah in [96:38] that case it's a really you know you can [96:41] see where people's their their question [96:43] about whether they're going to try [96:44] something or not is very context [96:45] dependent [96:46] >> very I think uh I don't want to go too [96:48] deep into the vaccine debate and I don't [96:49] want to be a spokesperson for either [96:51] side because that's not my role today [96:53] but [96:54] >> I think that the um the what you refer [96:57] to as vaccine hesitancy actually comes [96:59] back to an earlier issue that maybe [97:01] you'd be willing to comment on. [97:02] >> Sure. um which is I think there are a [97:05] very large number of people for whom [97:07] they are neither antivaccine [97:09] nor super pro but they are um they're [97:12] asking about timing and combinations. [97:15] >> Agreed. [97:15] >> They're saying okay listen and we had [97:17] Jay Bachari on here and I've had several [97:20] others who said maybe there should be an [97:22] investigation of the spacing of these [97:25] things how many um how critical it is to [97:27] do at a given age you know um and on and [97:30] on. We could pick any vaccine for that [97:31] reason. And as an immunologist, [97:35] do any of those questions make sense to [97:36] ask? I mean, I could see how, you know, [97:39] bombarding the immune the young immune [97:41] system with a lot of vaccines is a very [97:44] different thing than spacing out the uh [97:46] delivery of those vaccines. I'm not [97:48] saying don't give them all. I'm saying [97:50] >> over what time window does one give [97:52] them? Yeah. [97:53] >> I think a lot of people, many more [97:54] people are asking that question. Yeah. [97:56] It's just a quieter murmur [97:58] >> than our um saying, "Listen, we don't [98:01] want to take any of these things." [98:02] >> Yeah. [98:03] >> We don't want our kids to take any of [98:04] these. [98:04] >> Well, I've heard that, too. And I I [98:05] think there's some fair aspect to which [98:08] most of these vaccines were not studied [98:10] in the context when they were studied of [98:12] of what it does, you know, in in in [98:15] combination and and these sorts of [98:17] timings. The fact is that, you know, the [98:19] the evidence that there's that there's [98:22] bad things happening doesn't look to me, [98:24] you know, tremendously strong. It's [98:25] almost like anecdotal sort of [98:27] information. So, [98:28] >> unless it's your kid. [98:30] >> Unless it's your kid, in which case [98:31] you're going to look for an explanation. [98:32] So, I I don't know. [98:33] >> Just being fair, as long as we're [98:35] admitting psychology as a factor. [98:36] >> Yeah. [98:37] >> Yeah. [98:37] >> Yeah. So, there there's fairness on both [98:40] sides of that discussion. And I think I [98:42] think that almost certainly where we are [98:44] now, there's probably ways to put [98:46] together vaccines and certainly more [98:49] convenient ways. It's I I I as a parent [98:51] I I actually had something very similar [98:53] where we delayed you know my first [98:54] daughter's one of her vaccines partly [98:57] because I know that that as a you know [98:59] like there's a certain element to which [99:01] when we designed a protocol like the the [99:03] protocol for imotherapy of cancer for [99:04] patients was was actually based a little [99:06] bit on the mouse work a lot on the mouse [99:08] work that I did you can imagine that [99:09] mice and humans are quite different but [99:11] that is the protocol the protocol is [99:13] protocol and that's how it's done in [99:14] medicine and that's because you have a [99:16] fairly good sense of the safety of it [99:18] because of statistics [99:19] But that isn't to say that it's the only [99:21] protocol that would work. And I think [99:22] you're getting at this concept like [99:24] could there be at least a more [99:25] convenient one [99:26] >> and also or safest or even one that is [99:29] less disruptive to the lives of the [99:30] children and the parents. We we delayed [99:32] one of our kids vaccines, you know, by [99:34] just a month or something because uh she [99:36] had not been feeling well just straight [99:38] up. And it is true, you know, and I'd [99:40] say that a couple of the vaccines that [99:41] have come out that I've had recently, [99:42] the shingles one is a good example. I [99:43] had the other has knocked me completely [99:45] out and it, you know, it's very very [99:47] heavily advented. So, it's clear that [99:48] it's, you know, it's having to um does [99:51] it does it need to be, you know, I [99:53] actually don't know. I don't know what [99:54] studies were done. And and there's kind [99:56] of an aspect to which you I don't know [99:58] that we're all um being shielded from [100:00] the information, but I don't know that [100:01] we all know how to read the information [100:03] about how these regimens were chosen. [100:06] >> Um some of them are chosen by competing [100:08] far pharma companies that each make [100:09] their own, you know, materials. And [100:12] you know, again, I think there's a [100:14] there's a lot in this question. And I [100:15] don't know how much of it also [100:18] represents the one problem of science [100:20] that I could talk about is this um this [100:23] issue that's a lot of science treat [100:25] science as a kind of a papacy like we [100:26] know the language we know the facts and [100:28] and we probably don't have time to tell [100:30] you why we think this and where where [100:32] the holes are. [100:33] >> Excuse me for interrupting but you know [100:35] a huge basis of this podcast is to [100:39] counter exactly that. I know. [100:41] >> I mean, I know all these incredibly [100:42] smart, incredibly well-meaning [100:45] >> people who have lives of their own, [100:47] health lives of their own, health [100:48] challenges of their own, kids of their [100:50] own, and on and on, and no one was [100:53] hearing from them. [100:54] >> Yeah, [100:54] >> it it was and as things get more [100:56] politicized, there's less incentive to [100:59] give nuance. I actually really [101:00] appreciate you providing some nuance on [101:02] the I mean it's clear where you stand on [101:04] vaccines generally based on what you've [101:05] said but you're you're offering perhaps [101:08] the opportunity for for better [101:10] understanding and certainly delivery of [101:12] the information. [101:12] >> Yeah. [101:13] >> Yeah. I mean it's it's a huge problem. [101:15] >> Yeah. Well, I guess it's it's one of [101:17] those ones that I can only speak about [101:18] what I did, right, as a as a as a human [101:21] when I had kids and I looked at the data [101:23] and I have probably better capacity than [101:25] some anyways to read it and look at risk [101:28] versus harm, you know, the percentages [101:30] of these things. I absolutely, you know, [101:33] vaccinated kids and that was it seemed [101:34] like it seems even now like a a [101:36] reasonable no-brainer. But I just told [101:38] you too that I I asked to go off [101:40] protocol because at some point I know [101:43] that these protocols have a little bit [101:44] of like again they were designed on a [101:45] one study but it doesn't mean that it [101:47] doesn't work if you wait another month. [101:48] In fact if you do if you've done enough [101:50] mouse experiments as I have you know [101:51] that when you vaccinate on a slightly [101:53] different schedule you can still end up [101:54] with the same outcome you know that is [101:56] protection you know with slightly [101:58] different schedules. It's not that [102:00] convenient for doctors and hospitals and [102:02] and even sometimes for patients to get [102:04] off on, you know, like weird schedule [102:06] and then you forget a dose and then it [102:08] isn't as effective, right? So there's [102:09] there's efficacy that comes with, you [102:11] know, trying to follow the protocol and [102:12] because the protocol has some [102:15] convenience built into it that means [102:16] you're going to do it. It's um it's like [102:18] it's like brushing your teeth in the [102:19] morning, you do it in the morning, the [102:20] evening, it's when you do it and so [102:22] you'll do it twice a day. So there's a [102:25] lot in this. I mean, you know, there's a [102:27] lot of politics, I think, involved in in [102:28] vaccine 2 that relates to the question [102:30] of like at what point can the government [102:32] do tell you what to do, which is, you [102:35] know, it's a it's a surrogate question [102:36] to the vaccine one where vaccine is, you [102:39] know, if there's a harm, who gets to [102:41] choose with the harm benefit and then [102:43] how resources are given out for like [102:45] schools and you know, we know all these [102:46] we know all these sort of nuances. From [102:48] the science standpoint, I don't think [102:49] you want to wipe out the baby with the [102:51] bath water. I don't think you personally [102:53] like I wouldn't not immunize my kids. [102:55] Could there be additional studies about [102:56] the combination of these into like fewer [102:58] shots? I think so. I don't see why not. [103:01] Here's where you get the financial re. [103:03] What's the benefit to any pharma company [103:05] of doing that? [103:06] >> Well, I think this is again I I [103:07] [clears throat] have to be careful that [103:08] I don't place myself into an advocacy [103:11] group that I'm not. I I'm I look at [103:13] everything on a case- by case basis. I [103:16] try to do that. [103:16] >> I really try to do that. But the you [103:19] know and I've tried to be in recent [103:22] years more open to the to at least [103:24] understanding what the anti- big pharma [103:27] stance is really about. [103:29] >> You know it comes up a lot around SSRIs. [103:31] But you talk to somebody with clinical [103:33] grade OCD and they will tell you that [103:35] SSRI saved their life. [103:37] >> So then you go okay well you know so we [103:39] can say all we want about pharma. Are [103:40] you talking about people getting in [103:41] taking insulin or you know and till [103:44] recently the GLPs were mostly available [103:46] through pharma. Now they're sort of it's [103:48] kind of the wild west. People are micro [103:50] doing them from all sorts of [103:51] compoundingies as their own issues and [103:53] so on. But my sense is that the [103:56] frustration around the kind of [103:58] dictatorial like you're going to do this [104:00] at this point because this or else like [104:03] your persona non grata that kind of like [104:05] people not people being shunned [104:08] >> in both directions in either direction [104:10] rather. That's you know that that's [104:12] really the source of the problem there. [104:14] There really hasn't ever been a [104:15] conversation quite like this. [104:17] >> Yeah, I agree. [104:18] >> At least not one I've seen publicly. [104:20] Yeah, there not a lot of labs that are [104:21] going to devote themselves to this. [104:23] People will wage the argument that and I [104:26] don't know if this is actually true, but [104:27] that the pharma companies are protected [104:29] against lawsuits about vaccine injuries. [104:31] >> Yeah. Yeah. I mean, I think that [104:32] probably is frustrating to very [104:34] frustrating, excuse me, to a parent [104:36] whose kid seemed essentially fine, got a [104:39] vaccine, and 3 days later started [104:41] exhibiting symptoms that then set them [104:43] off on a course that was um really, [104:45] really tragic. [104:46] >> Yeah. [104:46] >> Um and those groups are the ones that [104:49] have accumulated the most oomph out [104:52] there. [104:53] >> And if you think about the those [104:54] parents, it's totally understandable. [104:56] >> Yeah. why they would feel that way. [104:58] Whether or not the basis of their [105:00] feelings is exactly right, I can't speak [105:02] to. But you can understand if your kid [105:04] is one way, walked out of the doctor's [105:06] office is is another way. And you can't [105:08] do anything about it. That's got to be [105:11] >> I mean beyond maddening [105:12] >> and and and the question is what could [105:14] you have done differently? I think is in [105:16] those situations having been in them not [105:18] that exact situation where you said oh [105:19] now it's done and now it can't go [105:21] backward. [105:22] >> And you did that to them. This is the [105:24] thing that well this is the thing I [105:25] think that is not often discussed is [105:27] that the the parents made that choice on [105:29] the basis of what they thought was the [105:31] best. So that there's a certain um [105:34] >> guilt/ anger. I mean there's a whole [105:36] psychology to it that's completely [105:38] understandable. [105:39] >> Yeah. [105:40] >> Didn't wander into the clinic. [105:41] >> Yeah. Well, I mean, you know, on the way [105:43] over here, I was thinking about some of [105:44] the things that, you know, are happening [105:46] in in uh medical space and, you know, [105:49] you guys obviously from time to time [105:51] talk about peptides and these sorts of [105:52] things that people are using, you know, [105:54] off lab, well, not even off label, [105:55] they're just getting them from from uh [105:57] who wherever the internet. And you know [105:59] that I was thinking, well, you know, [106:00] there's a funny thing there because the [106:02] legitimacy of pharma companies has sort [106:04] of fallen into even worse straits than [106:07] before because I think it I was thinking [106:08] about this a lot of it does relate to [106:09] the fact that we are advertised to take [106:11] a lot of things that often aren't you [106:13] know the side effects are worse than the [106:15] than the symptoms that we're leaving and [106:18] and that sort of uh you know again I I [106:20] may find myself like having a bunch of [106:22] colleagues hate me for talking about [106:23] this with you but I do think it's kind [106:24] of important at some point to surface [106:26] where all this comes from you know and [106:28] and the idea that we can do experiments [106:30] on ourselves on our own bodies. Again, [106:32] it's quite different to say read a book [106:34] although you can be infected by we [106:36] believe like by you know strict [106:38] scripture and things and than your [106:40] behavior but somehow [snorts] in here [106:42] this idea that that um you know we can [106:44] be told to do things by people that [106:46] aren't quite in our best interests. I [106:49] think it opens up the idea well why why [106:51] can't I choose my best interest? You [106:52] know who who are these experts that I [106:54] can't always trust? [106:56] >> What's more American than that after [106:57] all? Well, it is it is it is part of the [106:59] pioneering spirit. Like if the if the [107:01] government's not going to protect my 40 [107:03] acres, I got to have a gun and protect [107:04] it myself. And that's that's been a part [107:06] of our culture for a very long time. And [107:08] I think this idea of individuality plays [107:09] into this. But it could be exacerbated [107:12] at the moment by the by the fact that [107:13] there, you know, haven't always been [107:15] good communication with something you're [107:17] trying to work out and and and maybe [107:18] even surface any of these ideas that are [107:20] hard to talk about like should we trust [107:22] farm companies? I know a lot of people [107:23] that work for pharma and they really [107:25] they are doing good. They they you know [107:27] they're like you and me. They they [107:28] really think and they are treating [107:31] disease. They're making really good [107:32] drugs and they do really good things. [107:34] But that's not always true. Not just [107:35] just because you know a bunch of people [107:37] and it's not always true that the subtle [107:39] best interest of a corporation is the [107:40] same as the best interest of an [107:42] individual. So you know we have to [107:43] surface those things exist. It's not [107:44] like we have to say that it's right or [107:46] wrong or whatever but at some point [107:47] those these kind of perverse incentives [107:49] exist. I I wonder why, you know, like [107:51] pharma companies haven't um gotten [107:53] better tests for who's going to respond [107:54] to these checkpoint drugs that we made. [107:56] We've had we've had a few papers that [107:58] show who are the responders and who are [107:59] not. But it's still the case that if you [108:01] get come in with melanoma, even though [108:02] there's only a 50% chance you're going [108:04] to be cured, which is great. You used to [108:05] be zero with these drugs, you still take [108:08] 100% of the market takes that drug. [108:11] Well, because the 50% that aren't going [108:13] to respond, they don't know who they [108:14] are. And so everybody takes it. So the [108:17] companies that sell those have no [108:18] incentive to develop a test although get [108:21] if they develop a test that shows who is [108:22] and who isn't going to respond they'll [108:24] cut their market into 50 in half. So I [108:28] don't think any pharma executives out [108:29] out there going but there's no there's [108:32] no positive incentive to do that study [108:35] to study those things and I think it's [108:37] kind of true in some of these other [108:38] drugs that we've been you know brought [108:40] brought forward some of which are better [108:41] and worse than others we could told that [108:43] this is going to be good for us and and [108:45] we should take it and and there's a [108:47] again you're you're getting to the [108:48] American kind of like mentality which is [108:49] to say well some point if you fool me [108:52] twice or you know I'm not going to [108:53] believe it and and I might not believe [108:54] it against the entire spectrum of things [108:57] called science. And the problem is that [108:59] there's people like you and me that are [109:00] trying to actually do and and most of [109:02] us, I'd say 99.9% of us are working our [109:05] asses off to like you figure things out [109:07] and discover stuff that's important for [109:08] mankind. And then you have these sort of [109:11] issues that arise and you're like, well [109:12] then should you distrust as a as a as a [109:15] species, should you distrust the entire [109:17] class of science? Probably not. You just [109:20] need to maybe make it so that knowledge [109:22] is is freer and knowledge is better [109:24] communicated and that [109:25] >> and that um and you do watch out for [109:27] those situations where there should be [109:29] you know uh you know and maybe vaccines [109:31] are one we you know we just need to do [109:34] something sensible like what you're [109:35] describing and just to do a study and [109:36] say let's do that study and and make [109:38] that very public that we do it and say [109:40] we're going to do that and and and [109:42] obviously people can sign up for you [109:44] know be you can have this regimen or you [109:46] the old regimen or the new regimen and [109:48] you know again I I may speaking. I don't [109:51] do vaccines. It's not what my lab [109:53] studies, but there could be some sense [109:54] to saying, well, maybe science as a [109:56] whole could take this on and say what [109:58] would be maybe the answer isn't just say [110:00] no vaccines and we we think they do. [110:03] There's good evidence that they're [110:04] protective. But to the extent that [110:05] you're coming out, could we make it less [110:09] let's do it and let's just do it. Let's [110:10] do that experiment. But I don't see that [110:12] that's one of the things that's not [110:13] happening right now is that nobody's [110:14] actually describing an experiment. [110:17] >> What would be the experiment? [110:19] >> Yeah. Well, the discussions haven't [110:20] happened and I should say a couple of [110:22] things. Um, first of all, thank you for [110:23] being willing to venture into this area. [110:26] I seriously doubt that any of your [110:28] colleagues are going to be upset that [110:29] you're having this conversation. I will [110:30] make sure that anything we put out is in [110:32] context. If anyone cuts a clip, I will [110:35] be the first to dive in there and say [110:36] this is taken out of context. It um but [110:40] to any people, colleagues or otherwise [110:43] that would say, hey, actually this is [110:45] the wrong stance. You don't want to be [110:46] talking about nuance in a time when [110:47] there's so much threat to uh traditional [110:50] medicine and vaccines etc. I will say [110:52] this [110:54] the idea that you need to push back with [110:56] a with just a fire hose of do this or [110:58] else [110:59] >> did not work. [111:01] >> The pandemic proved that the in fact I [111:04] think one of the biggest mistakes was to [111:06] have one individual as opposed to a [111:08] panel of people [111:09] >> with more nuance communicating public [111:11] health information at that time. any [111:13] person, scientist, doctor, or otherwise, [111:15] who thinks that the way to convince [111:17] people to change their behavior around [111:19] vaccines or anything else is to just ram [111:22] it down the public's throat and say, "Or [111:25] else, you're whatever. You're political [111:27] this or you're a fascist or whatever." [111:29] Okay, that is proven to be wrong. [111:33] >> And the path forward is really this kind [111:35] of conversation. It's highly educated [111:38] people like yourself in the educated in [111:40] the immune system who understand this [111:42] who have children who've made certain [111:44] choices saying yes and I can understand [111:47] why you would be considering the [111:49] following um questions and we should do [111:51] a study and and in the meantime you're [111:54] not preventing anyone from getting [111:55] vaccines. There's now a hunger for more [111:58] nuanced conversation around these [111:59] things. I think it's the right time to [112:00] have it when we're not in the throws of [112:02] a pandemic. [112:03] >> Yeah. [112:04] >> Yet yet. I mean, there's some things [112:05] that are on the rise. It is scary. I'll [112:07] I'll be quite blunt. Um, you know, the [112:10] the rise in measles is scary. People [112:12] say, "Well, measles, they used to have [112:13] measles parties." Talk to somebody who [112:15] had massive inflammation [112:17] >> and brain inflammation from measles. Not [112:19] a pretty picture. [112:21] >> Not a pretty picture. Yeah. [112:22] >> So, I think it's great that these [112:24] conversations are starting [112:26] >> and it won't be taken out of context. [112:28] >> Yeah. Well, I mean on the vaccination [112:29] front, I mean, I just wrote a little a [112:31] little subsequ um you know, the origins [112:33] of small vaccination and I think what's [112:36] lost in those stories is if you look on [112:38] the internet that the the absolute that [112:40] that's a terrible disease. I mean that [112:42] you know the reality of what we're [112:44] protecting against we haven't it's [112:46] really hard to to like also have the [112:48] conversation without doing a little bit [112:50] of reading into your history [112:52] >> you know and I I don't think the history [112:53] books are pulling the wool over our eyes [112:55] by saying some of these things were [112:57] really horrendous [112:58] >> small box was dreadful [112:59] >> so so there's an element of that though [113:01] that I think you know that we have to [113:03] make sure that the conversation focuses [113:05] on on what are we what are we trying to [113:07] achieve here and and and sometimes that [113:10] that question is can get lost. But I [113:12] think man, if my kid got smallox or got [113:15] measles or got mouse and and and and you [113:17] know, as we know like measles is not a a [113:19] theoretical again, you know, that that [113:22] concept uh is enough to say, well, there [113:25] is a risk of that. And that's one where [113:26] you [113:27] >> it's like you you know, not teaching [113:28] your kid how to cross the street [113:29] properly. If you didn't do that and then [113:31] the kid got hit by a car, you'd just be [113:33] decimated. So, you know, just because we [113:35] haven't seen these things for a while [113:37] doesn't mean that they're not still [113:39] real. And I [clears throat] think that's [113:40] also an important again that's what [113:42] that's me as a parent saying and I did [113:44] look at the history of these things and [113:45] they really are bad and so we are you [113:48] know we are defending against something [113:50] but you know is there a better way to do [113:52] it uh you propose experiment that's [113:55] let's you know I think there's a you [113:58] know like cutting off you know the [114:00] concept of human curiosity and science [114:02] at the legs is probably not the way to [114:05] figure something out from my experience [114:07] you you you dive in you think of the [114:09] experiment they would answer the [114:10] question and you say well that is that [114:12] the killer experiment for this thing [114:14] again I think you look at the numbers [114:15] and the numbers from my this is me as a [114:17] parent looking at the numbers of of u [114:19] you know like the the danger of of of of [114:22] bad stuff happening versus the the odds [114:25] of an adverse effect they were all that [114:28] high but you know again if you're one of [114:29] the people that even if it is that even [114:31] if it is caused by a vaccine which I [114:33] don't by the way can I tell you a little [114:35] story please maybe you know this already [114:37] but if you want to induce autism in [114:39] mice. People do it by injecting a [114:41] bacterial infection into the mom when [114:43] she's pregnant. [114:44] >> Mhm. [114:45] >> Which tells you that an immune challenge [114:48] can affect the neurons of the of a [114:50] developing pup. So, it's not outside the [114:54] realm to say that in some situations and [114:56] in an aduant situation. Again, I I may [114:58] regret saying this because it's, you [115:00] know, it's going to open up a [115:01] conversation to have this, but to say [115:02] it's not outside the bounds to say that [115:04] a immune insult will have influence on [115:07] neural development, period. Is it the [115:11] source of autistic children? Or was it [115:14] in fact that the mom had infection [115:16] during pregnancy? That's not absolutely [115:18] wacko to think, and you should think [115:20] this is a neurobiologist. I think you'll [115:21] probably agree, to think that [115:22] inflammation, some of the molecules of [115:23] inflammation will affect the the the [115:27] cells of the brain. [115:28] >> In fact, one of the one of the best [115:29] experiments that I love along these [115:30] lines, it's not about about autism at [115:32] all, but it's about um when you get a [115:34] flu, [115:35] >> you tend to go you you tend to feel like [115:37] you want to socially isolate yourself. [115:39] At least I do and most people do. I [115:40] think they kind of want to crawl in a [115:41] hole in a hole. There's an experiment [115:43] that was done that involved injecting [115:45] gamurfon which is one of the things your [115:47] immune system makes when it's fighting [115:48] off an infection into the bloodstream of [115:51] a mouse and then just watching it and [115:53] [snorts] they become uh you know [115:55] socially isolating from just the [115:57] molecule that's made by the immune [115:59] response during infection [116:00] >> not even from being sick [116:01] >> not even being sick they're not sick [116:03] they just are given this this cue that's [116:04] part of the systemic immune response and [116:06] then they they show the signs of social [116:09] isolation and [116:10] >> the lab that did this um also showed [116:13] that the brain has receptors for these [116:15] immune molecules. And you know the [116:17] simple conclusion of that paper and you [116:19] know there's still always work to be [116:21] done but simple conclusion was that the [116:22] brain could sense infection and and it [116:24] would affect behavior [snorts] um even [116:27] in mature in us as mature. So, you know, [116:31] again, there's these these ideas that [116:32] there is there's something that I mean, [116:35] scientists use that infection of a mom, [116:38] you know, to lead to neuronal changes [116:39] that lead us to be able to under study [116:41] autism in later mice. So, there there's [116:43] definitely potential there. I don't know [116:45] that the vaccines and all of them and or [116:48] whether there's a circumstance or [116:49] whether it's, you know, again, the mom [116:50] actually had a fever before and that [116:52] vaccine now disgued or didn't or just [116:54] circumstance because you give vaccines [116:56] at 2 years of age, which is when autism [116:57] appears. there's all kinds of options, [117:00] you know, and that and and the sort of [117:01] anecdotes of of that. And and um I just [117:05] think that that that fact that, you [117:07] know, the way that we study autism is by [117:09] giving a pregnant female mouse an [117:13] infection is sort of like, okay, that's [117:15] that's important to know. [117:17] >> That work is still ongoing by [117:18] laboratories to understand autism. They [117:20] want to understand the origins of it and [117:23] maybe it will not turn out to be [117:24] vaccines at all. Again, we we need data [117:27] and and we're in we definitely need [117:28] data. [117:28] >> We're almost in a co situation. I [117:30] describe the co situation now in [117:31] retrospect as one that is data sparse [117:33] >> and this is why I've been trying to work [117:34] on I was telling you about this project [117:36] of trying to work on the publishing [117:38] problem. But it's not it's not just the [117:40] publishing problem. It's how we how we [117:42] synthesize knowledge that under data [117:45] sparse circumstances to make decisions. [117:47] I think we're not very good at that [117:49] society. Um you when we have tons of [117:52] data and it says absolutely if you have [117:54] cancer and you take imotherapy then [117:56] there's a 50% chance you're going to [117:58] revive great those stats are solid [118:00] they're very good and I would I would [118:02] take that drug every time but if it's [118:04] sort of a case where you're like no [118:05] there's some things that are happening [118:06] and there's some other things that [118:07] happen we don't know you remember at the [118:09] beginning of co we talked about it [118:10] amongst ourselves in labels and we were [118:11] coming in to analyze blood and it was [118:14] kind of unsafe because we didn't know [118:16] what was safe we didn't know how it was [118:17] transmitted we didn't know anything [118:18] about it was it could we get it from [118:20] blood um and and that kind of went on [118:23] for a while, right? And this was the [118:24] source of like a lot of confusion that [118:26] came from the medical it was seem seen [118:28] as confusion that matter of fact it's [118:29] like do you mask you not mask do you [118:31] touch do you not touch I think that's a [118:33] that's a data sparse situation you know [118:35] the data that we had was sparse it [118:37] wasn't a lot of information and so you [118:39] know how do you make a decision when you [118:41] don't have a lot of data well I think [118:42] that's the major argument when there you [118:44] know there are people that will critique [118:48] people saying okay your experience is [118:50] anecdata it's correlative but then the [118:53] the the w with regard to vaccines and [118:56] autism and other issues, but then the [118:58] push back is well this vaccine, etc. was [119:02] directionally guided by sparse [119:04] information to begin with under times [119:05] [clears throat] of pressure. There's [119:06] financial incentives. So, it's just this [119:08] pingpong that goes back and forth, but [119:10] many thousands of parents write to me [119:13] and say, [119:14] >> "Should I wait on certain vaccines?" And [119:16] I'm like, "Listen, I am not the person [119:17] to answer that question." [119:18] >> Um, but you have every right to ask your [119:20] doctor, [119:21] >> right? But they're not asking because [119:22] they're extremists. They're not [119:24] antivaxers. They're asking because they [119:25] love their kids and they've seen enough [119:27] things to call into question the [119:29] incentives and they just know that the [119:30] conversation cannot be as polarized as [119:33] it's presented to them in re in reality. [119:35] The data cannot be as polarized as it's [119:37] been presented. [119:37] >> Yeah. Certainly certainly in media some [119:39] of these things get presented quite [119:41] quite um you know inflammatory and again [119:43] if if newspapers want to sell a [119:45] newspaper they show a plane crash you [119:47] know so it's not happening every day [119:49] >> but they'll show you an airline ad in [119:50] the same issue. Well, there's that, too. [119:52] Yeah. So, [119:53] >> I think one of the interesting things [119:54] that we could get into is that in you in [119:57] a lot of these studies, scientists are [119:59] there's a motivation to to make the most [120:01] of your result. And we've talked about [120:02] why that's important is that if you find [120:04] something orthogonal, crisper, [120:06] checkpoint blockade, uh, you know, [120:08] x-rays, you look for that orthogonal use [120:10] for it, right? And you or that that [120:12] orthogonal meaning that would sometimes [120:14] be called extensibility. Like I see that [120:16] if I if I drop coffee cup on the thing [120:18] that gravity pulls it down. Well, then I [120:20] can learn that I can drop all kinds of [120:21] things. I can make gravity work for me. [120:23] You know, it becomes a tool. And and [120:25] [snorts] I think one of the things [120:26] that's that that is lost sometimes is [120:29] that some things are not extensible. So, [120:31] you know, you can imagine that like if I [120:33] if I had something that move makes a [120:34] cell move that that might screw up the [120:36] whole system forever. But humans and our [120:39] bodies turn out to be remarkably [120:41] resilient. I mean, we can go from [120:42] minus20 degrees to, you know, 110 [120:45] degrees. We can not eat for a long time. [120:47] you know, all you know, all these things [120:49] don't cause us to fall apart. So, if we [120:52] didn't have resilience, I think our [120:53] species wouldn't exist because there's [120:55] all these pressures and all these [120:56] varieties of life under which we lead. [120:58] And I think a lot of science sometimes [121:00] doesn't, you know, and and from the [121:02] outsider, even as an insider, you can [121:04] read a paper and they they they point to [121:06] why it might be important, but they're [121:08] really doing that to to to get garner [121:10] interest for their story, you know, and [121:11] then say, "This might be important for [121:13] this, but I haven't shown it's important [121:14] for they don't say it's important as it [121:16] might be important." And they're trying [121:17] to look for that orthor that orthogonal [121:19] or that extensibility of it. And I think [121:22] that's kind of important also just to go [121:23] a little bit off this topic for a moment [121:26] in how we think about drugging diseases [121:28] as we go forward. And that is to say [121:30] we've looked for these oneanddone drugs [121:32] that you you take a pill and it cures [121:34] everything you know forever. That's sort [121:36] of found of youthish. And um you know we [121:39] found a few of those. I'd say check one [121:40] blockade is one of those that you can [121:41] take it and you know in 50% of melanomas [121:44] everything the tumor goes away and [121:45] everything's great. [121:47] But most biological systems, if you have [121:49] one button to push, they're super [121:51] non-resilient. A virus can exploit that [121:53] button. Uh, you know, that that can [121:56] cause, you know, collapse. And so, most [121:58] things are wired like in these really [121:59] complicated ways. And I think what a few [122:01] of us are thinking, this is for cancer [122:03] in particular, where you want to get the [122:04] immune state from like, you remember I [122:06] had a little concept of a fuel gauge. [122:08] You want to get it from one position to [122:09] another position. It may not just be [122:11] about a push here. You may have to push [122:13] some cells that way, create some new [122:16] environment that looks like development. [122:18] You know, your cells develop through [122:19] states and and you push the the [122:21] biological systems to reach this new [122:22] state in a way that doesn't look like [122:24] the linear between like low immune [122:26] reactivity and high reactivity. You [122:28] might have to push it in a serious way [122:30] because resiliency the res the systems [122:33] like even in chronic disease but even in [122:35] health we're pretty resilient and like [122:37] we you can stand up to a lot of stuff. [122:40] Can humans do that even in the context [122:43] of abundant funding for basic research? [122:46] Can what you just described actually be [122:48] tested to the point where we can develop [122:52] things? And the analogy here is I had my [122:55] dad on the podcast. He's a theoretical [122:56] physicist and he explained to me that [122:59] one of the most important things you [123:00] learn in physics is that you can't [123:01] really understand quantum mechanics [123:03] using your logical brain. You need the [123:06] math to prove it. M [123:07] >> and this is when whenever somebody he [123:09] also warned whenever somebody says they [123:10] understand quantum stuff you have to ask [123:13] them to demonstrate it for you because [123:14] because people talk quantum because [123:17] >> and and we make all these assumptions [123:18] about quantum they talk about quantum [123:20] fields so we think they're smart but but [123:22] that [123:22] >> theoretical physicists [123:24] >> and therefore engineers you know develop [123:27] all sorts of incredible theorems and [123:29] real experiments and then technologies [123:31] based on all of that [123:33] >> because the math works not because we [123:36] can conceptualize it. And I wonder given [123:38] the complexity of biological systems, [123:40] >> perhaps in 2026, we're running up [123:43] against this barrier where by virtue of [123:46] the sociology of science that papers [123:48] need to have one maybe two take-home [123:50] messages by virtue of the fact that [123:52] >> there's limited amount of funding, [123:55] people need to sleep at night and on and [123:56] on. that doing the kinds of experiments [123:58] like you described like pushing the [124:00] cells this way, nudging them that way [124:01] and then drugging the the outcome in a [124:04] way that is beneficial but not [124:07] detrimental. [124:08] Is this a place where machines are going [124:10] to be better or at least helpful in [124:14] doing these experiments? [124:15] >> I take the standpoint that AI is and I [124:18] think you know this is back to talking [124:19] to experts. It's really quite good at at [124:21] at producing stuff that is in the [124:23] corpus. The corpus is the knowledge that [124:25] we already have. [124:28] almost by definition when you're coming [124:29] at that with orthopedic discovery you're [124:32] discovering something it doesn't exist [124:34] in the corpus you might have hints of it [124:36] there but you still have to do [124:38] experiments at some point so if I mean [124:41] going answer you know the question [124:42] you're trying to raise if I get a tumor [124:44] from a patient and I take apart all the [124:46] cell and I look at all the genes that [124:47] are expressed in all the different cell [124:48] types I can build in silicico a network [124:51] where I can look at how all those cells [124:52] are wired together now and I can ask you [124:55] know what would be the possible [124:56] consequence of clipping this molecule's [124:58] ability to touch that cell. [snorts] [125:00] That that's that's now doable, but it [125:03] relies on an area of math is not really [125:05] AI. It's called machine learning. And [125:07] sometimes these things are conflated, [125:09] but machine learning is basically [125:10] looking to say what are some of the [125:12] relationships that I can discover about, [125:15] you know, um the relationship between [125:16] this feature of the cell and this other [125:18] feature of the cell. So it's it's [125:19] learning about it and then it's it [125:21] allows you to propose a bunch of [125:22] experiments but you still kind of have [125:24] to choose and select which ones you're [125:25] going to do. Some experiments are just [125:27] really expensive and that's where you [125:29] have to have I think still human [125:30] judgment that comes into that and say am [125:32] I going to spend a year studying this [125:35] question or am I going to study a little [125:37] bit more and try to understand some some [125:38] things in a greater detail than maybe [125:40] the machine learning gave me but it's [125:42] not clear to me that any anywhere right [125:44] now we can say the the corpus of [125:46] knowledge doesn't have a bunch of [125:48] examples of cures you know across from [125:51] treatments and say oh all I need to do [125:53] is match those up which is kind of what [125:54] AI does when it comes to large language [125:56] Well, you query it. It looks in [125:58] statistically and says what are the what [125:59] are the relationships between what you [126:01] query and what I give you back as an [126:02] answer. In a discovery space, we don't [126:05] have examples of the you know the other [126:07] end. we have you know sure I can tell [126:09] you all the things you could do but you [126:11] know knowing which one is going to be [126:12] orthogonal big big hit isn't there but [126:15] what I'm talking about a little bit is [126:16] is to is to take a problem apart and say [126:19] if I have something like I want to [126:21] change something and anything this could [126:24] be how if I want to change the world [126:26] it's unlikely that any one act will do [126:29] it also the world is pretty sure [126:30] political systems despite what we think [126:32] are somehow semi-stable but a series of [126:35] of of these nudges can create the [126:38] condition where the last one takes you [126:39] across the border. And I think that's [126:40] what we're going to have to do in [126:41] disease where we say, look, nature [126:44] doesn't necessarily want us banging on [126:46] it, it'll bang back. What in in fact we [126:49] need to do is if we want this tumor to [126:50] get cured, we need to first let it not [126:53] look like it's a wound that's healing. [126:54] So don't give it the power of the immune [126:56] system, the positive power, and then get [126:58] to the point where we can say, well, now [126:59] we want it to teach the immune system to [127:01] kill it. But we might not be able to do [127:02] that until we kind of dissemble some of [127:04] its defenses. And that's that's a way of [127:07] you know again in this in this kind of [127:08] deep computational space we end up with [127:10] a lot of feature the tissue of the of [127:12] tissue cells and how they're organized [127:13] and what genes are expressing that start [127:15] to look like Mellin's map of the of the [127:17] of the world that you know in its early [127:19] phase it only had parts and then you [127:21] know starts as you explore and you add [127:23] things to it it I think when we start to [127:25] think about how tissues are configured [127:26] we're starting to be able to see these [127:28] really complicated states where the [127:29] immune system is doing this and [127:31] fibroblast certain cells are doing this [127:33] and epithelial cells are doing this and [127:34] that's That's a we call them archetypes. [127:37] They're [snorts] they're like they're [127:38] like a way that biology organizes [127:41] itself. And to get from one to the next, [127:43] we need to understand how it does it [127:44] developmentally. That would be a really [127:45] nice thing to follow. And then we need [127:47] to give those cues in order. And that's [127:49] where I was coming back. You know, when [127:50] you were talking about peptides earlier [127:52] and saying, well, they may some some of [127:53] these drugs may well work, but I might [127:56] imagine that they might work best if [127:57] given in the right sequence and the time [127:59] and the place. And that that's when you [128:01] really want to like hammer it to get the [128:03] system to go to that but then it might [128:04] be connected to another one and we all [128:06] want to find the one thing that like you [128:08] know the fountain of youth the thing [128:10] that cures a disease and and and it's [128:12] been forever that we've looked for a [128:14] single you know single hits one and done [128:17] but it may be a collection of and you [128:19] know this is probably this is how I live [128:20] my life for health too collection of [128:23] behaviors and foods you eat and sleep [128:24] you get and all these things create and [128:27] partners you know your [128:29] >> loves of your life, the the friends you [128:32] have, they're all part of I think this [128:34] this and that's getting a little away [128:36] from imology obviously, but [128:37] >> no, but an thing about the insula, you [128:40] know, not so much a good friend of mine [128:41] who's a physician in the Bay Area says [128:43] uh you know, better living through [128:44] chemistry still requires better living, [128:47] >> which I love because it says you should [128:48] never abandon as much as one can the [128:51] foundational stuff of sleep, exercise, [128:53] nutrition, circadian rhythm, light, [128:55] social connection, you know, stress [128:57] mitigation and on and on. Could I ask [128:59] you a couple of additional questions [129:00] about the immune system? [129:01] >> Yeah, please. [129:02] >> Before we wrap because I know um [129:05] >> many people are curious about autoimmune [129:08] >> issues. More and more I hear about, you [129:12] know, I don't know is chronic fatigue [129:13] considered an autoimmune issue by most. [129:16] A lot of people seem to have chronic [129:17] fatigue. There was a debate, does it [129:19] really exist? For someone who believes [129:20] they have it, uh they it absolutely [129:22] exists. Um they're tired. I believe [129:24] them. I know someone who had a myalgia [129:28] >> uh recently. Um psoriasis is something [129:32] that I maybe have known to be now [129:36] >> autoimmune. Um asthma [129:38] >> these are interesting conditions not all [129:40] of them life-threatening. Yeah. [129:42] >> But some of them cause a lot of [129:43] discomfort. um what is known about the [129:45] formation of autoimmune conditions [129:48] either inheritance lifestyle factors and [129:50] then what excites you about some of the [129:52] newer treatments that might be available [129:54] or currently available for those and [129:56] other things. It's a big question but [129:58] >> yeah it's a big question. Well, [130:00] fundamentally, again, this is I think [130:02] where um the immune system and you know, [130:05] our bodies have I think they have [130:07] playbooks like a football team or [130:08] something that they can run and they can [130:10] put players in particular [130:11] configurations. Again, we call those [130:13] archetypes. The immune system is trying [130:15] to do a certain kind of thing. It's [130:17] genetically and through history, it's [130:18] wired to work with with cells in certain [130:21] ways. And I think if you look at [130:22] autoimmunities, there's a there's a view [130:24] of them that they represent a misplaced [130:26] immune system that's either thinks that [130:28] it's under attack or it thinks that it's [130:30] meant to be doing something that it [130:32] really isn't. And so the origins of some [130:34] of those are genetic for sure. There's [130:36] um you know lupus there's a familial [130:38] mutation in a a receptor that's on a B [130:41] cell that normally helps turn off the [130:42] immune system and it's defective. And so [130:46] those those people are susceptible to [130:47] getting what are called auto antibodies. [130:50] That's where the B cells, we talked a [130:51] lot about T- cells, but B cells are the [130:52] ones that make antibodies and they're [130:54] the ones that you try to pro, you know, [130:56] to jazz up for COVID vaccines, you know, [130:59] those can be overactive and they can be [131:01] genetically overactive and you know, one [131:03] wonders why we'd ever have such genes [131:05] and why they would be propagated except [131:06] that maybe in some s circumstances you [131:08] need it when there's a big pandemic or [131:10] something people might have a [131:11] particularly good response. So there's [131:13] definitely genetic origins of some of [131:15] these things. I think what's uh you know [131:17] what's interesting to some extent is is [131:18] something that you'd alluded to with [131:19] asthma where asthma was one of these [131:21] things that historically would be called [131:23] an allergy and it still is an allergy [131:25] you know where you have you know [131:26] inciting things that are grass pollen [131:29] you know these sorts of things but in a [131:31] lot of these settings the concept that [131:33] that is is coming in part and parcel [131:35] with you know the immune system [131:37] recognizing self you know is is a is a [131:40] thing and to the degree that we don't [131:43] understand some of the diseases as well [131:45] as we should given the tools we have [131:47] today. There's a lot there's actually [131:48] work to be done in a lot of these areas [131:49] where you say what is the immune system [131:52] up to like like 10 years ago we might [131:54] have just said you know what is if I I [131:57] might have taken a a lung of a asthmatic [131:59] patient who died and like cut it and [132:01] look it in a microscope and say oh yeah [132:02] I can really see that there's thickening [132:04] of the airways and that why that's why [132:06] they couldn't breathe but like I'm [132:07] saying now we can go into those and we [132:09] can look at every single cell and ask [132:11] how those are wired together. Is there [132:12] only one form of asthma? That's no. [132:14] There's actually definitely like seven [132:16] or eight and they have and that's why [132:17] some people are, you know, like can take [132:19] the inhalers and it works and other [132:20] people can't. Some people they're very [132:22] like chlorine sensitive. They go to a [132:24] pool and it and initiates are cold [132:25] sensitive. So there's there's variations [132:27] on what sets up that inflammatory focus [132:29] and I would call it like an archetype. [132:31] Some of them have lots of cells called [132:32] eosinaphils. Other ones have lots of [132:34] cells called neutrfils. So it's asthma [132:36] isn't just one disease. It's one symptom [132:39] fail, you know, difficulty breathing, [132:41] but it has many different sort of [132:43] configurations and and I guess I'm I [132:46] would just say that in a lot of this [132:48] domain, I mean, we have a study right [132:49] now that's looking at across a bunch of [132:51] autoimmunities to figure out whether [132:53] they have things in common with each [132:54] other and psoriasis is one where you [132:56] start to see, you know, variations and [132:58] lupus for sure and inflammatory bowel [133:00] disease and and and you know this in the [133:02] clinic because inflammatory bowel [133:04] disease, you ask about drugs, is a good [133:05] case where there's a couple different [133:07] drugs is that for some patients work [133:09] really well. TNF therapy for example it [133:13] blocks a cytoine and some people with [133:15] IBDs is like really bad diarrhea and [133:18] manifests and very very painful um you [133:21] know some people they so there starts to [133:23] be classes of patients that have [133:25] responses to these things. Those drugs [133:27] are exciting because they say you can [133:28] modulate this but a little bit like the [133:30] checkpoint drugs we don't really [133:32] understand why one works in one patient [133:34] and one doesn't. Inflammatory bowel [133:36] disease and autoimmunity is pretty [133:38] tricky too because people will respond [133:39] to a drug for a while and then they'll [133:40] stop [133:41] >> and then the doctors just have to do [133:43] this like whack-a-mole thing where they [133:45] try one and it doesn't work. They try [133:47] the next thing then where it doesn't [133:48] work. [133:48] >> Sounds like psychiatry. [133:49] >> It does. Yeah, there's [laughter] a lot. [133:51] It sounds like a [133:52] >> no disrespect to the psychiatrist. [133:55] >> But they have a hard job, right? I mean [133:56] drugs will work for a while then they [133:57] don't work. Side effects crop up that [133:59] never existed before. It's it's a tough [134:01] one. [134:02] >> Yeah. Agreed. Agreed. So yeah, [134:04] autoimmunity is a real thing. It's it [134:06] has, you know, I think it's similar to [134:09] cancer where we're just with cancer [134:11] starting to understand the fact that it [134:12] comes in these different immune flavors. [134:15] And so the drugs that you try to use, [134:17] it's clearly immune system can do a lot [134:18] of good work for us, but what you need [134:21] to do to it in these different sort of [134:23] archetypal immune systems is going to be [134:26] different. You know, you you just got a [134:27] different football team out there [134:28] playing or they running a different [134:30] play. If somebody has a kind of mild [134:33] autoimmune condition like let's say mild [134:35] psoriasis [134:37] >> does that I've read but that doesn't [134:39] necessarily mean anything. Um I've read [134:42] that that might confer because it's [134:44] autoimmune that might confer them with a [134:46] bit better uh viral and bacterial [134:50] infection resistance. So, you know, [134:52] there's a trade-off there like, okay, so [134:53] scalp cells are like sloing off and like [134:56] I think it's like interlucan 17 or [134:58] something now like the treatment they [134:59] have some good shampoos for this or but [135:02] >> anti-influc [135:06] but but you that individual is um maybe [135:10] better at fighting out other infections. [135:12] So, you know, given there's a [135:14] anti-influcch [135:19] um and uh and yet you're more resistant [135:22] to infection. So, you could see how it's [135:24] adaptive in the modern context. And now, [135:27] severe psoriasis can be very disruptive [135:28] for people. And people might wonder [135:30] like, are we really talking about [135:31] psoriasis? But I think it's sort of a [135:32] individ [135:35] point for why autoimmunity could [135:38] actually be useful. Yeah. [135:40] >> Um it's not always the case. It's like [135:41] there to give us asthma or flaky scalp. [135:44] >> You know, we could talk about there's a [135:45] lot of disease states, you know, the [135:46] argument for why we would ever have a [135:47] cickle cell gene. This is the one that [135:49] causes people to have hemoph you know [135:51] hemophilia and it's a lot of subsaharan [135:54] African gene people from that origin [135:56] have this is that it's actually [135:58] defensive against malaria is you know it [136:00] seems to be the case that so so having [136:01] that I think this is true a lot of these [136:04] situations where the diversity of the [136:05] human population over time you by having [136:09] some of these things that make some [136:10] people hyper sensitive to you know uh to [136:13] maybe bacter viral infection at the cost [136:16] of having things like psoriasis pop up [136:19] or you know various various other [136:20] autoimmunities is the only way that you [136:23] know like a a billion strong population [136:25] has to to to to move forward and I I [136:28] always give this example that because I [136:30] think it's a really straightforward one [136:31] if you take a a flask of bacteria [136:34] and um and you put them in glucose which [136:37] is like sugar like you put in your [136:38] coffee um maybe sucrossse either one you [136:41] put them in a in a in a simple sugar uh [136:43] and you watch the colony grow you'll get [136:45] these cells that grow really really fast [136:46] the bacteria you know becomes billions, [136:48] trillions of of individual cells, but [136:50] there's almost always some just losers [136:52] that are dividing slowly. And it's for [136:55] whatever reason, the system always [136:56] springs us off. You're like, why would [136:57] you do that? Why would the system why [136:58] why wouldn't just the winners win? But [137:00] if you take a little bit of that culture [137:01] and you put it into galactose, which is [137:03] a milk sugar, often the ones that were [137:06] winners don't win anymore. And it's from [137:07] the loser pool that the new ones emerge. [137:10] And this is a case of like, you know, [137:12] like uh crowd uh fitness that comes from [137:16] diversity of of genes. And so some of [137:19] these things that make some of us [137:20] susceptible to disease are also, as [137:22] you're pointing out, in other situations [137:24] going to be quite good for you. And and [137:26] and that seems unfair at the time that [137:28] you have these kind of bad genes, but [137:30] like a different day you would have been [137:31] happy, right? you know, so I think [137:33] there's a lot to be said and and that's [137:35] also why a lot of the things that we [137:36] look at, you know, anecdotally somebody [137:38] takes a supplement and it works for [137:40] them. [137:41] >> I mean, I don't know how much you know [137:42] about this literature, but the the [137:44] differences in urine mine vitamin [137:46] requirements is going to be quite [137:47] profound because the metabolic enzymes [137:49] we have for the vitamins that we might [137:50] take in are going to be different [137:52] between us. And so these FDA limits, [137:54] these these numbers are averages. Some [137:56] people may need five times that amount [137:58] of, you know, vitamin X and other people [138:00] may need a fifth. And I think this is [138:02] super critical. The supplement world is [138:04] kind of like scattershot. Well, I [138:06] appreciate the rational grounding in all [138:07] of it. I I think uh thread throughout [138:09] today's conversation. I think that um I [138:11] picked up on, you know, I the fact that [138:13] we covered things like peptides and [138:15] things like that. And I'm not certain [138:16] about the peptide question across the [138:19] board. It's clear some are beneficial. [138:20] It's clear some are still experimental. [138:22] I'm just a big fan of more data and more [138:24] data collected the right ways and [138:26] communicated the right ways as the same [138:27] way with vaccines and all the rest. You [138:30] have an amazing substack. I know that [138:32] because I've spent time there. [138:33] >> No, thanks. [138:34] >> Part of the reason we invited you here [138:36] today is to learn about the immune [138:37] system and we barely talked about [138:39] cancer. I realize we're going to have to [138:40] get you back to talk about that, but [138:41] you've done an amazing job of educating [138:44] us on the immune system. I really want [138:45] to thank you and speak on behalf of [138:47] many, many people for that. Never before [138:50] has somebody presented in in the ways [138:53] that you have and uh as somebody who [138:55] thinks in analogy I and likes to teach [138:58] in analogy. I really appreciate that [139:00] that uh that stance. What inspired you [139:03] to get into [139:05] >> public education about science and [139:07] health before coming on this podcast? [139:08] And by the way, everyone should check [139:10] out Max's uh Substack. We'll put a link [139:13] to it in the in the show notes. It's [139:15] it's so thoughtful, so nuanced, so [139:18] relevant to all the issues that we're [139:20] talking about, if not directly, then in [139:22] in the general contour, and in some [139:25] cases directly, and I I imagine you're [139:27] going to continue doing this. So, what [139:28] inspired you to do it, and um how can we [139:31] make sure that you continue to do it? [139:32] >> Yeah. Well, thank you for the call out. [139:34] Um it is it's something I've been trying [139:36] to work on for about 10 years and it it [139:39] really started when um a group of us you [139:42] know were were hanging around after a [139:45] conference and we were talking about [139:48] some of the issues with science in [139:50] society and there were many you know [139:52] there's many there's there's we've [139:54] surfaced a few of them today but I think [139:56] something that you guys are working on [139:57] is is the capacity for everyone else to [139:59] think as a scientist like why you can [140:01] ask yourself you know oh why don't [140:03] people agree agree with this data that [140:05] you show and take the action that seems [140:06] logical but then you present it in such [140:09] a way that they can't you know that two [140:11] things two things are important about it [140:13] I think one of them is you if you [140:14] present the information in a format that [140:16] isn't you know familiar you're not going [140:18] to be able to teach anything anybody [140:20] anything about what's important but the [140:22] other thing is that you know we were [140:23] talking we we spent some time talking [140:24] about this and we consulted some other [140:26] folks that are in science comms and we [140:28] realized you know the other thing is [140:29] that that that if you say you're a [140:31] scientist [140:33] it's not a neutral statement. Science [140:36] has a history and history is stronger [140:38] than science actually. So the history [140:40] like you know there's there's hesitancy [140:42] among African-American for example to [140:44] take drugs because of things of history [140:46] of Tuskegee which is like 80 years ago [140:48] or however long ago 60 years ago. Wow. [140:51] It's it's it's it's not in their [140:52] lifetime in many of these people. And so [140:54] part of the realization was like maybe [140:56] part of what we really should be doing [140:58] as scientists is one of part of our job [141:01] should be to figure out how we relate to [141:03] other humans. And it's you know that [141:05] there's a painting of this and you [141:06] obviously the media and and things help [141:09] this happen because it makes it [141:10] interesting to have a you know kind of a [141:12] nerdy scientist and and we all you can [141:14] be a nerdy scientist. I heard you and [141:16] you know but also you're a human. You're [141:17] a human being. You have you know there's [141:19] foibless to you know loves and hates and [141:21] and um [141:22] >> certainly foibless. I have plenty of [141:24] those. [laughter] [141:25] >> We can get in that off the podcast. But [141:27] you know that this concept of if we want [141:30] to relate um you know if we want to have [141:33] impact of the work you do if you want it [141:35] to be relevant at some point you have to [141:37] the science science as a field needs to [141:39] make sure that it doesn't ostracize [141:41] itself from people and I think one of [141:43] the issues there I just use the word o [141:46] you know is separate is is this concept [141:48] that we speak in our our vocabulary that [141:51] is gets very precise and we forget that [141:53] you know if you hear a foreign language [141:54] and you hear one word that you don't [141:56] recog recognize it. It throws you off [141:57] for a few sentences and next thing you [141:59] know you don't know what people are [142:00] talking about. And I I think that [142:02] concept that that you know and again [142:04] this is where I think bringing it down a [142:06] level and saying let's give it analogy, [142:08] let's give it that [clears throat] [142:09] strikes me as really really important to [142:12] the impact that you can have with with [142:14] your science and and that science can [142:16] have in in terms of teaching people what [142:19] we could do better which I think we all [142:21] want to do. But if you end up thinking [142:23] that science is a distrusted weird [142:26] collection of people that have different [142:27] motivations and u designs, then then [142:30] you've lost that that that the potential [142:33] for it to do good is is gone. So the [142:35] Substack came about it because I was [142:37] like, well, I need to write as a person [142:38] a little bit more and and tell about [142:40] some of the, you know, the time that you [142:43] spend on this and why it matters and [142:44] what it's like to to do this work and [142:47] and in some respects also what it's like [142:49] to to lose in this, which happens way [142:52] more often than the, you know, it's like [142:54] a casino, right, in science. Science you [142:56] hear the bells and some cool device [142:58] comes out and it's but but there's a [143:00] bunch of people pulling the arm, you [143:01] know, and they're they're not winning. [143:04] And so, [laughter] [143:05] you know, so I feel like that's kind of [143:06] an important part of this that that [143:08] again, it's not the glory story always. [143:11] >> Um, you know, the best some of the [143:12] bestselling books about science or are [143:14] the winds, but um, you know, it's might [143:17] be more relatable at some point to get [143:19] all of it. So, that's kind of what what [143:20] I was trying to put together. And and at [143:22] the same time, I think the immune system [143:23] is also just so relevant and so [143:25] important and it's got all these [143:26] different facets and these archetypes [143:28] and these sorts of things that it's [143:28] doing that we kind of scratch the [143:30] surface today. So, anyway, thanks for [143:32] calling it out. been [143:33] >> working on for a bit. [143:35] >> Well, I hope you continue to and um [143:38] >> thank you so much for the work you've [143:40] been doing in your laboratory and all [143:41] the people in your laboratory doing that [143:43] work because now you're the one calling [143:45] the shots while other people do [143:46] experiments. But [143:47] >> um for your advocacy for science and [143:50] public education, it's huge. Uh we need [143:53] more people like you. But you've [143:54] certainly put your own unique signature [143:56] on it and the Substack reflects that. [143:59] It's an incredibly interesting set of [144:00] reads and um and people will really [144:02] learn. So that's essential especially in [144:05] this day and age. But even not in this [144:07] day and age, science is is just really [144:08] cool. And with all the meaningless dril [144:10] out there, it's nice to go to a place [144:12] like your Substack and I'm speaking to [144:15] the audience now. You you will learn if [144:17] you read Max's Substack. You will be [144:20] inspired by certain things. And I [144:22] promise you, so I'm saying this [144:23] intentionally, mark my words, at some [144:25] point some somebody's going to contact [144:26] you that they decided to study the [144:28] immune system or they learned something [144:29] or they explored a a novel treatment [144:33] with their physician in a in a given [144:35] unfortunate or maybe even fortunate [144:37] situation that bettered their lives. [144:38] It's it's incredible what um Substacks [144:42] and conversations like the one you've [144:44] been willing to have today and going [144:46] forward can can really do. So, thank you [144:49] so much. should definitely come back [144:50] again and tell us about cancer and other [144:53] other things because I I took us off [144:55] course quite a lot but I I had a great [144:57] time talking about all of this and I'm [144:58] going to be thinking about a lot of it [145:00] and really appreciate you. [145:02] >> Yeah. Well, same here. Thanks so much. [145:03] >> Thank you for joining me for today's [145:05] discussion with Dr. Max Crumbl. To learn [145:07] more about his work and to find a link [145:09] to his superb substack, please see the [145:11] links in the show not caption. If you're [145:13] learning from and or enjoying this [145:14] podcast, please subscribe to our YouTube [145:16] channel. That's a terrific zerocost way [145:18] to support us. In addition, please [145:20] follow the podcast by clicking the [145:22] follow button on both Spotify and Apple. [145:24] And on both Spotify and Apple, you can [145:26] leave us up to a five-star review. And [145:28] you can now leave us comments at both [145:30] Spotify and Apple. Please also check out [145:32] the sponsors mentioned at the beginning [145:33] and throughout today's episode. That's [145:35] the best way to support this podcast. 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