If you think medicine is full of indecipherable jargon, imagine how Dr Jon Lieff feels. His book, The Secret Language of Cells, compiles 12 years of research into how the body knows what to do. He had to find needles in haystacks – mentions of signals emanating from cells – and piece together their significance himself. The result is the first book that assembles it all – and not just human bodies, but also plants. The conversations are mind boggling. The insights are groundbreaking. You will witness the birth of a new science.

What Lieff describes is an entire cosmopolitan society inside the body, with cops and bad guys, plotters, conspirators, terrorists, hostage takers, street gangs, fraudsters and Trojans. But also caretakers, gardeners, neighborhood watchers, guards, builders, shippers, receivers, inspectors, rescuers, bouncers, cleaners and monitors. There is national, regional and local government. And everyone is broadcasting in their own language, all the time. The whole society is on high alert, all the time. Everyone is a town crier. Overnight garbage crews clean up the mess from the day, and it all begins again in the morning. This is life in the human body.

Lieff systematically plows through the body, describing the various cells, molecules, proteins and viruses that have roles in the drama. Then he steps out way farther, because everything in the book is about how these components converse. And they do converse, ceaselessly. They warn of intruders, give directions on their location, ask for more or less help, order more or less production, and provide each other with goods and services. This is a completely different view of the body at work. It is striking, shocking, fascinating and eye-opening. It absolutely forces new ways of thinking.

Just one example is the creation of neurons in the brain. For decades it was standard, unassailable knowledge that the brain stopped producing neurons at an early age, say 20, and then just deteriorated. Lieff shows that with communications, monitoring cells order the building of new neurons to replace old ones that are worn and inefficient. The result is a clutch of fresh neurons that have been trained to assume the memories of the old ones, and even upgraded to accept more detail because they have been used and useful for so long. It’s respect and reward for seniority. This, Lieff says, is part of why the elderly can recite every little aspect of an event 70 years ago, but cannot remember what they had for lunch today. If that doesn’t change the way medicine looks at gerontology and neuropsychiatry, nothing will. The book is full of such revelations.

Cancers get a thorough look, and so do viruses, including the COVID-19 virus. Cancers, like viruses, use subterfuge to get past the guards and establish themselves. Cancers co-opt cells meant to kill them, turning them into zombies doing their bidding. They force the good cells to help them build and spread cancer. One of the ways they do it is by communicating as if they were the good guys, fooling the T cells. Once established they can fool other cells into providing transport or bloodlfow to build themselves up.

Viruses are possibly even more remarkable, because there is basically nothing to them. A seven gene virus like Ebola earns Lieff’s respect. Just one of its handful of proteins can do five different jobs damaging other cells, redirecting others, using the internal transport system to travel throughout the body undetected, preventing cells from attaching tags to it, and basically taking over completely. How one protein can accomplish five so very different tasks is as amazing to Lieff as it is to us.

Leprosy is unique in that it can turn cells back into stem cells that it can reprogram to do its damage. This is a holy grail of medicine, and after 3000 years of leprosy, we still don’t know how the virus does it. Viruses have been around so long that 8% of human DNA comes from viruses implanted there, Lieff says.

The body is filled with communication channels. Nanotubes allow cells to bypass local traffic and get where they’re supposed to be. Fluids like the cerebrospinal fluid connect the critical functions of the nerves in the spine with critical neurons across the brain with a superhighway of conductive fluid. Neurons in the brain can have has many as 100,000 connections – synapses - giving the brain a good ten thousand trillion possible connections, all of which are constantly reporting status and making decisions. There are more than a thousand kinds of neurons and astrocytes, showing specialization that medicine knows next to nothing about. Microglia, the only brain cells not physically connected, patrol and regulate. They determine things like the emotional response to pain. They signal differently according to diseases they encounter or experience or hear about. inflammation can turn them into aggressive immune cells, as everything that can, pitches in to the fight. There three types of glial cells (“glue” that sticks to other cells): astrocytes, the most common, microglia and myelin, which coats pathways and tubes. The quality and patterns laid down by myelin determine the connection and the speed of the pathway. It provides entries and exits to passing cells. It’s not just insulation as we have assumed for 200 years.

What has not been discovered is the central authority that prioritizes action. Every region seems to be responsible for itself. It reports, but doesn’t seem to take much in the way of orders from the brain. The brain’s main functions appear to lie in external ops like movement, the senses and the mind. The nuts and bolts of existence is apparently a local and regional affair.

Organs are built out by the cells themselves communicating. New cells move into place knowing where the edge must end up being, for example. They find out from the very cells they climb over to get to where they need to be. Cells needed for an emergency repair or to fend off an invasion can even travel upstream, clinging to the wall of an artery and swinging their way forward through the oncoming blood. The myelin lining allows them to exit where they need to. Astrocytes in the brain walk along arteries and squeeze them with their feet pads when fresh blood is needed, and also hold them back to prevent the wrong kind of residents from crossing the blood-brain barrier. Cells slap tags on other cells so they can be identified later. Killer T cells can clear out an invader and then order up a new memory/monitor cell at the location to instantly report any recurrence going forward. T cells can edit their own DNA, disguising themselves from invaders they recognize.

Cells create nets to float over invaders and trap them. Mitochondria dock at another organelle in the cell, endoplasmic reticulum, to converse and determine where they have to deliver energy, pickup supplies, or even shut down. Cells present pieces of microbes to T cells so the T cells can recognize them later and elsewhere. Everything has a supervisor and everything holds nothing back. Knowledge is power and power comes from constant communication.

Microbes are a constant threat. They can hide in cells, hijack cells, and jump into information sacs that certain cells use to report their status, and get a free ride to some other region, safely hidden from inspectors. But with microbes there is another issue. Some are allies. They produce vitamins and minerals out of food, carry out some critical process, or aid in healing. There are cancer meds that will not work unless the body has certain microbes producing certain compounds. Probiotics will play a larger and larger role going forward, Lieff says. Somehow, the body is able to discern the good ones from the bad ones, but we don’t seem to know how. Are good microbes acting with permission? Or do they sneak by the body’s defenses like other foreign bodies try to. How does the body know not to attack these microbes like it does to other foreign bodies?

But then, microbes can switch sides too. What starts out as useful can suddenly damage DNA or, inhibit repairs. It can aid cancer by preventing cell death or allow cells to grow without oxygen. Lieff says a good recipe for cancer is inflammation, obesity, and microbes which can be altered by fat to aid cancer.

At the end of the day (literally), neurons physically retreat – shrink back – allowing the body’s equivalent of street sweepers to clean up the mess – the dead and damaged, the misfolded proteins, the shreds and shards and the half eaten from the cerebrospinal fluid pathways. This critical role of sleep is part of the link between Alzheimer’s and lack of sleep, where amyloid plaques clutter up the brain.

The human body is not alone in harboring a cacophony of communication. Lieff says plants are just as chatty. They communicate with each other using aerial chemical releases and along fungal filaments. Internally, the signals come from water pressure and chemical and electrical signals. Plants invite beneficial microbes to help fix nitrogen, while attacking microbes that are parasitic. They can even grow tumors to physically push insect eggs off its leaves.

Trees signal carbon-eating bacteria through their roots. Root hairs curl up as an inviting entryway into the tree. It also prepares a space inside, protected by a membrane where it wants the bacteria to set up shop. And lights up the path to the new space for the bacteria to follow. The bacteria settle in for decades, a win-win co-operation.

The same process applies to fungi, which also connect different plants together with filaments that can spread for miles. These filaments allow plants to communicate both internally and externally throughout a forest.

Lieff has performed a remarkable service with this book. He puts in plain everyday language the horrific jargon, ten dollar words and abstruse mathematical formulas that modern medicine has become. He is totally focused on the communications. And his chapters are totally focused and tight. Readers will never get tired of one subject going on too long. The result is not just easy to read, but draws a compelling picture of an entire society within the human body as well as in plants.

Numerous times he stops to say things like but we don’t know why, or it is difficult to understand or we’ve barely begun to do the research on this relationship or ability. Because this book is the first of its kind. Lieff has basically started a whole new discipline he calls sociovirology. It raises a lot of questions, but it also opens huge new horizons and perspectives that medicine has not even considered in its hellbent reductionist plunge for a quick fix. Nothing works that way, and The Secret Language of Cells proves it.

David Wineberg

For the images that go with this review, see https://medium.com/the-straight-dope/how-the-body-communicates-to-itself-988c759... ( )