cOMMentArY Immunology in India: an emerging story Kanury V S Rao Although immunological research is of only recent origin in India, it is nevertheless rapidly becoming an area of choice for young researchers in this country. he perennial appeal of immunology lies Tin the fact that it provides a window for almost every aspect of biological and biomedi- cal research. The plasticity of lymphocytes as http://www.nature.com/natureimmunology they switch among quiescence, active prolif- eration and various differentiation programs encapsulates the essence of both cell biology and the gene expression events that drive cell fate ‘decisions’. The structural and functional diversity of immunity-related receptors elicits questions in evolutionary biology, genetics, biochemistry, biophysics and structural biol- ogy. Although belated, this universe of excit- ing opportunities offered by immunological research is also rapidly being increasingly rec- Nature Publishing Group Group Nature Publishing 8 ognized by researchers in India. And with the present availability of resources and educated 200 manpower, the country is geared to mature © into an important contributor to this field. A historical perspective The history of medicine in India goes back to Susruta, the father of plastic surgery, is considered the originator of the rhinoplasty technique that remote antiquity, to a period between 4,000 has been practiced since 600 BCE. A detailed description of the procedure is provided in the Susruta and 900 BCE known as the ‘Vedic period’. Samhita. The procedure later spread from India to Persia and Egypt and, many centuries later, to Although early Vedic medicine represented an Europe and is still practiced today by some families in India and Nepal. Reprinted from ref. 18 with amalgamation of religious, magical and empir- permission from the author. ical elements, a more rational approach known as ‘Ayurveda’ (or ‘the art of healing’) gained a from perturbations of this equilibrium. The the human body. It also discusses the etiology, foothold by around 1,000 BCE. Ayurveda Susruta Samhita (the treatise of Susruta) and diagnosis and treatment of several human dis- continues to flourish even today as an alter- the Charaka Samhita (the treatise of Charaka) eases, including autoimmune diseases. native system of medicine. It was founded on represent two important pillars of Ayurveda The roots of modern immunology in India, the principle that the equilibrium among the and were compiled between 800 and 600 however, were established only recently, occur- bodily humors (or ‘Doshas’) defines the overall BCE. The Susruta Samhita provided the first ring through the conversion of a small group of homeostasis of the body, which is reflected in systematic division of surgery into separate biochemists at the All India Institute of Medical the natural immunity of the host. Atopic and fields. The highlight of Susruta’s achievement Sciences (AIIMS) in Delhi. This conversion other chronic diseases, as well as susceptibil- was the operation of rhinoplasty; Susruta is was the direct result of a series of courses in ity to pathogens, were all thought to derive internationally regarded as the father of plastic immunology sponsored by the World Health surgery. The Charaka Samhita, in contrast, rep- Organization and organized by G.P. Talwar Kanury V.S. Rao is with the Immunology Group of resents a treatise on medicine. It deals in elabo- in the biochemistry department, first held in the International Centre for Genetic Engineering rate detail with subjects such as fetal generation 1968. The consequent exposure to the work and Biotechnology, New Delhi 110067, India. and development, the anatomy of the human of leading international experts in the field e-mail: [email protected] body, and the function and malfunction of prompted several of the participants to enter NATURE IMMUNOLOGY VOLUME 9 NUMBER 12 DECEMBER 2008 1319 cOMMentarY this unfamiliar but exciting area. Research not ‘new’ proteins but instead represented research in various aspects of biology, includ- programs founded on immunology-oriented post-translationally modified isoforms of well- ing immunology. themes soon materialized. These themes known ‘housekeeping’ gene products4. Education has always occupied a preeminent included the development of contraceptive Studies of the thresholds that regulate acti- place in Indian history, and the earliest known vaccines (G.P. Talwar), major histocompat- vation versus anergy and proliferation versus universities of Nalanda and Taxila flourished ibility complex (MHC) polymorphism (M.C. differentiation of T cells were jointly initiated here as far back as in the fifth century BCE. Vaidya) and an examination of immune by Satyajit Rath and Vineeta Bal at the NII. So To reexamine the educational requirements responses in patients with leprosy (G.P. Talwar far, several previously unknown pathways have of an independent India, however, the Indian and Indira Nath). Although the early phase of been delineated; examples of these include the government set up a University Education the leprosy program concentrated on humoral function of protein kinase A in mediating the Commission in 1948. The report of this responses1, Nath subsequently expanded its commitment of activated T cells to second- committee led to the establishment of the scope to include a detailed study of cell-me- ary responsiveness, as well as the function University Grants Commission in 1953. This diated immunity2. Her work showed that the of inducible nitric oxide synthase in regulat- commission was charged with the mandate of generalized immune suppression in Indian ing T cell death and immune memory5,6. My promoting and coordinating university educa- patients was due to the secretion of soluble group at the International Centre for Genetic tion and research in India; so far, there are over factors such as leukotrienes, prostaglandins Engineering and Biotechnology (ICGEB) in 230 universities spread across the country. In and interleukin 10 by monocytes. In a similar Delhi has pursued studies of antigen recog- addition, the Indian government has recently vein, N.K. Mehra augmented the program on nition by primary B lymphocytes and their announced the creation of thirty new central HLA polymorphisms at AIIMS, and the HLA- subsequent activation and differentiation in universities, five new Indian institutes of sci- specific associations now being investigated T cell–dependent responses. A highlight of ence education and research, eight new Indian range from transplantation to susceptibility to this research has been the identification of a institutes of technology and twenty new insti- many infectious and chronic diseases. Notably, previously unknown subset of receptors for tutes of information technology. nuclei for immunological research also began immunoglobulin D on primary cells and the Research in India is also actively pursued http://www.nature.com/natureimmunology to emerge in other parts of the country during elucidation of their function in defining anti- in national research and development insti- this period. Thus, R.S. Kamat at the Haffkine gen-affinity thresholds for memory B cell dif- tutions. These institutes, such as the Council Institute in Bombay began to look at immune ferentiation7. of Scientific and Industrial Research, are sup- responses generated against bacterial infections, The Indian Immunology Society was ported by various governmental branches. whereas V.R. Muthukkaruppan and colleagues established in 1971 and began to hold annual Another organizational structure for health-re- at the Madurai Kamaraj University added fur- meetings in 1973. It now boasts about 1,000 lated research is the Indian Council of Medical ther strength to the leprosy program. registered members and has recently launched Research (ICMR), formed in 1949 and funded The growing interest in immunology soon new initiatives to increase active participation by the Ministry of Health. The ICMR directly led to the establishment of the National from its student community. To promote the supports over 25 research institutes in the coun- Institute of Immunology (NII) in Delhi in exchange of ideas, an informal platform known try covering all aspects of biomedical sciences, 1986, with G.P. Talwar as its founding direc- as the ‘Molecular Immunology Forum’ was also including infectious disease, autoimmune dis- Nature Publishing Group Group Nature Publishing 8 tor. At that time, Talwar was at the forefront conceived in 1993. Its membership is restricted ease, oncology, nutrition, epidemiology and of international research aimed at developing to active researchers who meet once a year. The medical statistics. The now-famous Chingleput 200 antifertility vaccines, and his demonstration objective of this forum is to serve as a peer- trials for bacille Calmette-Guerin vaccination, © that β-human chorionic gonadotropin, a self review group for ongoing work so investiga- which first established the principles of dou- antigen, could be used as a contraceptive vac- tors may benefit from this collective input. The ble-blind randomized trials in humans, was cine in women remains a landmark contribu- Molecular Immunology Forum has contrib- conducted by ICMR’s Tuberculosis Research tion to the field3. Talwar is also credited with uted considerably toward enhancing the qual- Centre (Chennai). Notably, this study also the first isolation of a new strain of mycobac- ity of Indian research efforts in immunology. highlighted the inadequacy