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你可能不知道,許多生病時令人討厭的症狀,其實是免疫系統而不是病菌造成的;人類史上第一劑疫苗,是從年輕的擠奶女工身上採集來的;而直到19世紀以前,人們都還以為是地水火風在影響人體的健康,聽起來好像是魔法與巫術。
1、擠奶女工莎拉提供人類史上第一劑疫苗
人類史上第一個疫苗是在18世紀發展出來,但你知道是怎麼發明的嗎?18世紀天花仍然肆虐著人類社會,人們擔心受怕之餘,也流傳著擠牛奶的女工不會得到天花的傳說。這個傳說引起英國醫師愛德華金納(Edward Jenner)的注意,他假設牛身上的牛痘疾病跟人類的天花應該有關係。
1796年5月,他找到一個年輕擠奶女工莎拉小姐身上有著從牛隻感染來的牛痘病變痕跡,他收集了一些膿液,並把膿液接種在一位8歲小男孩身上。小男孩生了一點小病就痊癒了,接著金納又給他接種當時預防天花的「人痘」。「人痘」其實是毒性較弱的天花,所以是會生病的,但小男孩並沒有得病,證實金納的疫 苗是成功的。
就像本文開版圖的漫畫描述當時的社會一樣,那時的人們對於接種牛痘存有很大疑慮,原因是他們認為種牛痘會長出牛角與牛毛。人類對於未知的恐懼,從未間斷。
▲誰要去照顧得了天花的病人?(圖片來源: Wikimedia Commons)
2、兩千年前人類就知道免疫作用
金納在18世紀末發明人類史上第一個疫苗,但人類認知到免疫作用存在的時間遠遠早過18世紀。根據先前的研究顯示,西元前430年的雅典時代,希臘人就瞭解已經生過一次天花並存活下來的人,不會再得第二次天花,因此他們常被叫去照顧其他受到天花感染的病人。
在 10世紀時,中國的醫師把天花的結痂磨成粉末,吹入健康人的鼻孔使其輕微感染,當成類似種牛痘的「人痘」,當人從輕微的症狀恢復後,就會對天花產生免疫力。這種方法於1700年代傳到歐洲與美洲。
3、流傳兩千年之久的四體液傳說學說
雖然兩千多年前的希臘人就有免疫的概念,但不代表他們的醫學知識就是正確的。細菌這種微生物讓人生病的道理,人類一直到19世紀才瞭解,科技新報之前報導「微生物學之父巴斯德的未竟之業: 狂犬病預防的過去與未來」,便讓我們知道巴斯德的研究讓人類對微生物的影響有了更多瞭解。那麼在這之前,人們都是怎麼看待生病這件事?答案是持續了兩千年的「四體液學說」(Humoriam, Humoralism)。
這種學說認為人體是由四種體液構成:血液、黏液、黃膽汁、黑膽汁,分別對應氣、水、火、土四種元素,當四種體液不平衡時,人就會生病。這種理論其實 是被譽為「醫學之父」的希波克拉底(Hippocrates)所提出的,雖然隨著現代醫學發展已被證實是錯誤的理論,但它畢竟也歷經了兩千年,不但流傳到 整個歐洲,中東、波斯、印度、西藏、中醫不同程度上都受到它的影響。
▲(順時針左起)血液、黃膽汁、黑膽汁、黏液被認為是組成人體的四種體液。(圖片來源: Wikimedia Commons)
4、生病的症狀其實是免疫系統造成
我們常聽到疾病是細菌、病毒與真菌造成的,但技術上這個說法並不正確,因為許多疾病的症狀是免疫系統在對抗外敵時產生的。例如感冒,當鼻病毒 (rhinovirus)入侵上呼吸道上皮細胞,免疫細統開始作用,一種化學物質會擴張血管及增加滲透作用的效率,讓更多白血球與相關的蛋白質到達被感染的部位,這些都是所謂的「發炎」的其中一些過程,這樣子的結果就是讓你開始鼻塞。也就是說,鼻塞並不是鼻病毒造成,而是免疫系統在備戰時造成的,就好像軍 隊走一般瀝青鋪面馬路緊急趕往戰區時,把馬路壓壞了。
更進一步來說,感冒會流鼻涕是因為有太多液態物質在這個過程中不斷產生,例如滲透作用帶來的體液以及化學物質刺激更多呼吸道黏膜生成,這些也都不是病菌造成的。
(圖片來源: Helga Weber via photopin cc)
5、女性相對較容易患自體免疫疾病
自體免疫疾病是指人體內的免疫系統太過活躍,以致於連身體自己的正常細胞都被當成外來敵人看,因而加以攻擊。例如類風濕關節炎、紅斑性狼瘡、第一型 糖尿病、多發性硬化症等。你可能知道這四種疾病,它們的「知名度」算是高的,不過你可能沒有發現,女性患有自體免疫疾病的機率遠大於男性。
根據先前一份刊登在美國病理學期刊(American Journal of Pathology)的研究顯示,大約5%-8%的美國人有自體免疫疾病,其中女性佔78%。
6、腸道細菌高度影響免疫系統健康
人體是數以兆計細菌的家,比我們自己的細胞數量還多10倍。腸道裡的細菌通常是有益的,可以幫助我們消化,以及生成維生素 B 與 K ,不過研究也顯示腸道細菌用不同的方式協助著免疫系統。例如,益菌會把壞菌約束在上皮或黏膜組織,以免它們做怪;益菌也會協助免疫系統分辨誰是敵誰是友, 及一些無害的抗原,它們會協助抑止過敏反應。
益菌同時也可能影響免疫系統對抗原的敏銳度,降低自體免疫疾病發生的機率。益菌也會協助製造一些有用的抗體,並影響一些腸道蛋白質的表現,讓免疫系統更有效地在腸道中運作。
7、人體白血球總容量只有50cc
即使在睡覺的時候,免疫系統仍然在運作中,因此你可能會覺得免疫系統的大軍數量很多,其實並不是。人體中的白血球總容量在全部5公升的血液中只佔1%,大約只有50cc。
雖然量看起來很少,但其實血液中1微升(10−6 公升)裡有5000到10000個白血球,因此整體來說是夠用的。換言之有250億個到500億個白血球在捍衛我們身體系統內的安全。
8、聰明曬太陽提昇抵抗力
幾十年來我們知道不應該曝曬在紫外線(UV)的照射中,除了因為可能引起皮膚病變,科學家也知道這樣會抑制免疫系統對外來細菌、病毒與真菌類侵襲時的反應,讓免疫功能減弱。
但是這不代表我們不應該曬太陽,因為曬太陽時,人體會生產維生素D,根據最近一份研究顯示,如果人體內維生素D含量太少,免疫細胞的一種叫「T細胞」就會很懶散不起來工作,可想而知這會讓我們的免疫系統破了一個不設防的大洞。而且維生素D會促進皮膚產生一種抗微生物肽,幫助人體抵禦外來病菌。
由此看來,大家應該聰明曬太陽:擦防曬油,遠離紫外線,歡迎維生素D,騎車或中午出門吃飯時,儘量不要躲陽光嘍。
9、睡眠不足降低免疫系統功能
過去幾十年來的研究皆指出睡眠不足會抑制免疫系統對抗外來病原的戰鬥能力,其中一個影響就是影響了 T 細胞的生成,而且聽來有些恐怖的是,只要一個晚上沒睡好,就會讓這些殺手細胞的數量降低。
而根據2012年在「睡眠」(SLEEP)雜誌刊登的研究指出,與獲得充份休息的人比較,一天如果睡少於6小時,疫苗的效用也會降低,他們認為原因或許在於缺乏睡眠會降低免疫系統的反應能力。
(封面圖片來源: Wikimedia Commons)
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