For Betty Lewis, 1979 was a big year: she got married, was diagnosed with a progressive liver disease, and had a liver transplant. But two years later, she had a new baby, was getting divorced, and hated the way her immunosuppressive drugs made her feel. So, against her doctors' advice, she ditched the drugs. Today, she has confounded medical opinion and is still alive and well. Immunologists are working to understand why some patients naturally achieve this state of tolerance, in which the immune system learns to accept a target that it would ordinarily attack. It's an important endeavour, because if doctors could induce tolerance at will, the prospects for transplant patients would greatly improve― immunosuppressive drugs may prevent organ rejection, but by damping down the entire immune system, they render patients susceptible to infections and cancer. Selective immune tolerance might also be used to combat debilitating allergies, or autoimmune conditions such as type 1 diabetes and multiple sclerosis.
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