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Previous Volume 348:1017-1026 March 13, 2003 Number 11 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Since the midpoint of the 20th century, medical advances in economically developed countries have exceeded all expectations. In 1950, the year I entered medical school, the average life expectancy in the United States was 68 years. By 2000, it was 77 years (80 years for women).¹ In 1957, when I began my fellowship in hematology, there was no combination chemotherapy, the choice of antibiotics was limited, computed tomography and magnetic resonance imaging did not exist, and most neoplasms were incurable. And in 1958, the year I began my research on immunosuppressive drugs, the role of the lymphocyte was unclear, and . . . [Full Text of this Article]

Clonal Selection

The Generation of Diversity

Recombination of Variable-Region Genes

Complementarity-Determining Regions

Somatic Mutation of Variable-Region Genes

How T Cells Recognize Antigens

Dendritic Cells

The MHC Molecule and Self Peptides

Immunoregulation by Positive and Negative Selection of T Cells

T-Cell Differentiation in the Thymus

Ectopic Autoantigens in the Thymus

Degeneracy of Antigen Receptors

Activation of Lymphocytes

Control of T-Cell Activation

CTLA-4

Inducible Costimulator

Regulatory T Cells

The CD2–LFA3 System

Rational Medical Control of the Immune System

Immunosuppressive Chemicals

Monoclonal Antibodies

Recombinant Fusion Molecules

Conclusions

Source Information

Presented as the 112th Shattuck Lecture to the Annual Meeting of the Massachusetts Medical Society, Boston, June 1, 2002.

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