Wait… the innate immune system can learn?
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When Reggie invited me into this role at BWH Labs, it was an easy yes. He was asking me to do one of the things I love most: take complex physiology, sit with it until the pattern starts to reveal itself, and then help practitioners understand why it matters clinically.
And trained immunity has been one of those topics that made me stop and say, “Hang on a second. What?”
The more I learn about BWH-85®, beta-1,3/1,6-glucan, and trained immunity, the more I keep having this very specific reaction: How have we not all been talking about this? How did I get through medical school, years of practice, years of immune education, and still somehow miss the fact that the innate immune system can learn?
Not learn in the way we were taught that the adaptive immune system does. Not through antigen-specific antibodies or classic T-cell and B-cell memory. But in a more ancient, pattern-based, readiness-based way.
That, to me, is the heart of immune intelligence: the body’s capacity to recognize meaningful patterns, adapt from experience, and respond with greater readiness and coordination.
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The Paper That Gave This Concept a Name |
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I’m intentionally starting this series with a foundational paper from 2011, because this is part of the era when scientists were beginning to realize that the old innate-versus-adaptive framework was incomplete. In this paper, Dr. Mihai Netea, Jessica Quintin, and Jos van der Meer challenged the classic idea that immune memory belongs only to the adaptive immune system. They proposed that mammalian innate immunity can also exhibit memory of past challenges – and they gave that phenomenon a name: trained immunity. Their argument was simple but disruptive: innate immune cells are not merely fast, blunt, short-lived responders. Under certain conditions, they can be functionally shaped by prior exposure and respond differently the next time. Which is, scientifically speaking, a very big deal. Also, personally speaking, a total shift in my concept of immunity. |
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Clinically, this changes the lens too. While many of us were trained to think about immune support through the two-dimensional lever of “boosting” or “suppressing,” trained immunity opens up a more useful conversation: Can we support immune readiness, recognition, coordination, and recovery? For practitioners, trained immunity gives us a better framework for patients who seem to lack immune resilience – the ones who get sick often, recover slowly, flare easily, react to everything, or never quite return to baseline. This is the journey I’m on right now: studying this science deeply, translating it clearly, and exploring what it means for real clinical practice. And I’d like to bring you with me. Next week, I’ll share one of the early experimental papers that helped demonstrate trained immunity in action – and where fungal beta-glucan enters the picture. Reference:
Netea MG, Quintin J, van der Meer JWM. Trained immunity: a memory for innate host defense. Cell Host Microbe. 2011;9(5):355–361. doi:10.1016/j.chom.2011.04.006. PMID: 21575907. |
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