Immune Response in the Critically Ill

Volume 31 of the series Update in Intensive Care Medicine pp 1-11

The Four Ds of the Danger Model: Distress, Damage, Destruction, and Death

  • P. MatzingerAffiliated withNational Institutes of Health

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For three quarters of a century, immunologists have based their theories and experiments on the fundamental belief that the primary function of the immune system is to discriminate between self and non-self and that, if the system were perfect, it would attack everything that is non-self and be totally tolerant of anything that is self. I have abandoned this belief. Over the years too many immunological findings have accumulated that do not fit and too many questions have been raised that cannot be answered.