Talk:Immune system

FA review needed

A plea for simplicity.

Greetings, Authors:

I am here because I just found out that I have several immune deficiencies and will probably have to start IgG infusions soon (immunogammaglobulin G, a type of front-line immune cell that fights disease). I am trying to understand the subject and the specific terms the immunologists used when they spoke to me (doctors who specialize in the diagnosis, treatment, and research into the immune system). I was double-teamed; I asked questions and took notes as fast as I could but was overwhelmed. Immunology seems to be an infinitely complex, forever unfolding subject! And I was an RN for many years.....

• "Writing for the wrong audience" - https://en.wikipedia.org/wiki/Wikipedia:Manual_of_Style/Medicine-related_articles#Writing_for_the_wrong_audience
• "Make technical articles understandable" - https://en.wikipedia.org/wiki/Wikipedia:Make_technical_articles_understandable
• "Technical language" - https://en.wikipedia.org/wiki/Wikipedia:Manual_of_Style#Technical_language
• "Wikipedia is not a manual, guidebook, textbook, or scientific journal" - https://en.wikipedia.org/wiki/Wikipedia:What_Wikipedia_is_not#Wikipedia_is_not_a_manual,_guidebook,_textbook,_or_scientific_journal

Anything the Wikipedia authors can do to keep it simple, especially for laypersons, will be welcomed, at least when a subtopic is first introduced. Then go into more detail in the next few paragraphs. Simple definitions (perhaps parenthetically?) right in the article would also be enormously helpful. Mouse-over windows do not accomplish the same thing. Include a Wikipedia link, of course, but to be forced away from this page to article hop, trying to find a simple meaning for a term (and what the terms used to define that term mean), quickly becomes a real morass.

Another stumbling block is the alphabet soup that exists in the field: NK this, CD4+ that. An immunology glossary that each related article could link to would also be helpful, at least to me. (There is a Glossary of biology, but immune system terms are not included in it.)

Distilling and presenting knowledge is a skill. But to make the writing accessible to interested laypersons is an art. Otherwise, everyone would be a science writer. The real fun in education is to see the light go on in a student's eyes when they understand, not to see the light go out in frustration.

Thank you for your consideration, Wordreader (talk) 17:36, 8 February 2020 (UTC)

Not an expert, but an interested spectator. I am really sorry to hear about your condition. Hopefully Wikipedia at least provide some useful background information so that you can understand why your physicians have chosen the treatment that they have. Immunology is an incredibly complex and broad discipline and it would be difficult to provide an adequate lay description of the entire field. More useful would be to narrow your request to what is most immediately relevant to your interest. This would appear to be gamma globulin treatment. I can already see that the introductions to Natural killer (NK) and T helper (CD4+) cells could be improved. An immunology glossary, given the enormous breadth of the field, would be very difficult to construct. Glossaries that have been constructed for other fields (see for example {{Restriction enzyme glossary}} and {{Docking glossary}}). Perhaps an analogous glossary based on {{Lymphocytic immune system}} navbox could be assembled. Would that help? Boghog (talk) 18:37, 8 February 2020 (UTC)

Boghog, thank you for the speedy reply and your valuable tips. Very kind of you.

I've spent the day reading websites about immune dysfunction and also Crohn's Disease (the immunologists told me that a Crohn's-like condition can accompany one of the deficiencies I have). I found a book online at the Immune Deficiency Foundation website called IDF Patient & Family Handbook or Primary Immunodeficiency Diseases, 5th Edition - https://primaryimmune.org/idf-patient-family-handbook-individual-chapters . It has a glossary chapter for those who are interested in seeing one - https://primaryimmune.org/wp-content/uploads/2016/03/IDF-Patient-Family-Handbook-5th-Edition-2015-Reprint-Glossary.pdf .

My plea for simplicity does not only apply to the subject of the immune system, but to all Wikipedia science and technical articles. Some articles succeed better than others in this regard. B^)

Thank you again, Wordreader (talk) 01:28, 9 February 2020 (UTC)

The opening paragraph could use simplification. This appears to be written with way too many technical terms, unnecessary words and over-complication. For example I'm sure 99% of the readers don't care about non-human immune system. Though interesting doesn't belong in the opening. This is a clear example of the Curse of knowledge. — Preceding unsigned comment added by Oglebing (talk • contribs) 13:22, 21 March 2020 (UTC)

Other issues

Version before rewrite: [1]

This is a 2007 Featured article that has not been edited by its two main editors (User:DO11.10 and User:TimVickers) for almost a decade. It has fallen into disrepair and has a number of issues. With COVID-19 upon us, this is regrettable. This article receives about 5,500 views per day, and is a level-3 Vital article. User:Iridescent has proposed that the article run at WP:TFA because of the pending launch of a COVID vaccine,[2] so it would be grand if this article could be brought back to standard this month, because featuring it on the main page as the vaccine is launched would be a great way to highlight Wikipedia's medical content.

Below is a list of some of the issues that should be cleaned up to FA standard: SandyGeorgia (Talk) 16:44, 20 November 2020 (UTC)

Done, SandyGeorgia (Talk) 02:20, 28 November 2020 (UTC)

Reviewing this version: The article is at 7,800 words of readable prose, with a rambling Table of Contents and numerous short, stubby sections that have been added since the version that passed FAC in 2007 with 5,300 words of readable prose and a compact Table of Contents. From the stubby, one-paragraph sections, we can see text that has been added haphazardly. The article was not fully cited in 2007 (requirements for inline citation were less strict then), and it still has large amounts of uncited text. There are dated statements and sources throughout, example, To date, ten functional members of the TLR family have been described in humans.[18] cited to a 2003 source. There is an odd "See also"-ish section labeled "Organs", needs to be worked in. The See also section is out of control. Citations are inconsistent: the article uses the Diberri-Boghog Vancouver style, but random citations have been added in other styles, eg R.M. Suskind, C.L. Lachney, J.N. Udall, Jr., "Malnutrition and the Immune Response", in: Dairy products in human health and nutrition, M. Serrano-Ríos, ed., CRC Press, 1994, pp. 285–300 See the section above about the technical language. I haven't done a full check for primary sources or WP:MEDDATE, but will undertake this work if others are on board to upgrade the article.

This important article has very good bones, was written by some of Wikipedia's finest, and I do not believe it would take a huge amount of work to bring it back to standard. But I do not have the knowledge to know how to restructure the article to either remove as UNDUE the new sections, or where to merge them. @Wehwalt: to watch for progress here, as he has the ability to swap this article in to TFA towards the end of December, if we get the work done, perhaps as the December Medical Collaboration of the Month. SandyGeorgia (Talk) 16:59, 20 November 2020 (UTC)

I've begun working on this and should have some time over the following evenings, and the American holiday. Pardon my dust. Happy to discuss any changes here. So far, mostly removing undue bits that have crept in over the years. I'm hoping to reduce the complexity for the reader by removing/merging some of the small subsections. I did a bit of rearranging in the Innate Immunity section, and will have to do some trimming to make the text flow again. Sorry for the piecemeal work! Ajpolino (talk) 06:27, 23 November 2020 (UTC)

Not to worry ... I can get to some citation and MOS cleanup in a few days, SandyGeorgia (Talk) 06:33, 23 November 2020 (UTC)

Oh, also I've removed pending changes protection. After nearly 8 years protected, and with several of us now watching the page, I thought it was worth a try. Ajpolino (talk) 16:50, 23 November 2020 (UTC)

My only remaining major concern with the article is the age of some of the citations. I'll see what can be done, Graham Beards (talk) 17:19, 23 November 2020 (UTC)

 Done I'm still concerned about some of the short stubby sections, but I think Ajpolino is slowly chipping away at those, SandyGeorgia (Talk) 17:26, 23 November 2020 (UTC)

 Done Graham, I can convert the existing rps to sfns when you are finished, leave any citation cleanup for me so you can work on content, SandyGeorgia (Talk) 15:12, 24 November 2020 (UTC)

I'm not sure I understand. I added new citations where there were none. Graham Beards (talk) 15:31, 24 November 2020 (UTC)

Yes, there are some other (pre-existing) rps that I will fix ... did not want you to have to take time on those, SandyGeorgia (Talk) 15:33, 24 November 2020 (UTC)

Books converted to SFNs, missing some page nos. SandyGeorgia (Talk) 18:25, 24 November 2020 (UTC)

Accessibility review

Topic	Comments	MoS link
Text	Size: No text is below 85% of the basic font size.	MOS:FONTSIZE
Colour	Information: No information is given by colour alone. Contrast: All text, except for the table headers, meets WCAG AAA standard. The table headers are just below AAA standard for colour difference, and a little below AAA for contrast.	MOS:COLOUR
Tables	Caption: There is a concise, informative caption. Structure: The table is arranged as simply as possible. Headers, Scopes: The table has column headers, and the scope is correctly indicated. Row headers are not appropriate for this table.	MOS:DTAB
Images	Alt text: All images have descriptive alt text, although several images have very descriptive captions and need no alt text. No fixed size: No images have fixed size, so can benefit from scaling via users' preferences.	MOS:ACCIM

A quick accessibility review. --RexxS (talk) 00:47, 2 December 2020 (UTC)

Further notes

•  Done Which of these adding to WP:CITATION OVERKILL can be removed ? The immune system, particularly the innate component, plays a decisive role in tissue repair after an insult.[101][102][103][104][105]

All except the last one. I have made the edit. Graham Beards (talk) 14:52, 27 November 2020 (UTC)

•  Done I am working on the WP:OVERLINKing, but have left a number of duplicate links because of the complexity of the topic. More de-linking may be needed ... unsure. SandyGeorgia (Talk) 14:26, 27 November 2020 (UTC)

•  Done Layreaders could benefit from some brief parenthetical definitions here: The immune system is a remarkably effective structure that incorporates specificity, inducibility and adaptation. SandyGeorgia (Talk) 15:13, 27 November 2020 (UTC)

Those are general terms.Graham Beards (talk) 15:16, 27 November 2020 (UTC)

The lead is awesome. (I know those terms, we know those terms, will other layreaders need more help?) SandyGeorgia (Talk) 15:30, 27 November 2020 (UTC)

The statement is redundant. The whole article is about the specificity, inducibility, and adaptability of the immune system. And it's not a "structure" − it can't be cut out with a knife. It's a "network". Those magnificent little uni-cellular macrophages lead quite independent "lives"; patrolling our bodies on the look out for intruders. Graham Beards (talk) 15:46, 27 November 2020 (UTC)

Sounds good to me, you do it :) SandyGeorgia (Talk) 16:14, 27 November 2020 (UTC)

•  Done This, cited to 2003, still needs updating, or at least an "as of" date ... To date, ten functional members of the TLR family have been described in humans.[28] SandyGeorgia (Talk) 15:30, 27 November 2020 (UTC)

There are still ten in humans (twelve in mice). I would just delete "To date". Graham Beards (talk) 15:51, 27 November 2020 (UTC)

I have made the edit and added a recent citation. Graham Beards (talk) 16:04, 27 November 2020 (UTC)

@Iridescent and Wehwalt: what do you think so far? SandyGeorgia (Talk) 19:36, 27 November 2020 (UTC)

Did you want an outsiders' opinion of the lead? -Roxy the inedible dog . wooF 20:20, 27 November 2020 (UTC)

No outsiders here ... shoot. SandyGeorgia (Talk) 20:50, 27 November 2020 (UTC)

Are we discussing the lede? It reads reasonably well, though medicine is not my wheelhouse. I'm not a big fan of footnotes in the lede. Why can't those things be sourced in the body?--Wehwalt (talk) 01:06, 28 November 2020 (UTC)

@Wehwalt: Yea ... those have subsided since the ArbCase dealt with personal preferences being installed across all medical articles, but we still have stragglers. Is there still a possibility of scheduling this TFA if a vaccine is launched in December? Roxy has comments on the lead, so we can delete those once done ... SandyGeorgia (Talk) 01:09, 28 November 2020 (UTC)

My concern with lede footnotes is it can be hard to tell what material is being footnoted, unless it's obvious, a quote, say.--Wehwalt (talk) 01:19, 28 November 2020 (UTC)

If everyone feels it's up to snuff, you could have December 30.--Wehwalt (talk) 01:17, 28 November 2020 (UTC)

• I had been drinking when I commented here last night. I read it twice earlier on after glancing at this thread. I'm not a medic, this is on my watchlist, though I don't normally stray into real medical areas. I learned things I didn't know in the first para, the concept of innate/adaptive, and nothing went over my head. If I came here to find out wtf the immune system was, the lead would be a good intro. I do feel a bit of an intruder here, where the real work is rather co-operatively and smoothly going on though. I shall return to the dark dank corrupt basement of the project now. -Roxy the inedible dog . wooF 11:39, 28 November 2020 (UTC)

• Glad you approve after all! SandyGeorgia (Talk) 18:42, 28 November 2020 (UTC)

•  Done Add Ehrlich photo to history. SandyGeorgia (Talk) 02:19, 28 November 2020 (UTC)

To do

See also:

• Can hapten be worked in to article? Ditto cataphylaxis.

 Done for hapten; cataphylaxis is a dubious term that I would not include — soupvector (talk) 14:43, 6 December 2020 (UTC)

• Is Clonal selection undue? Could it be converted to a hatnote?

clonal selection is at the absolute heart of current models of the adaptive immune system - indispensible conceptually. — soupvector (talk) 14:44, 6 December 2020 (UTC)

Then it should be worked in to the article somewhere. SandyGeorgia (Talk) 15:41, 6 December 2020 (UTC)

• Ditto for Immune network theory ... if they have broad acceptance, should they be worked in; if they don't, what do we do with them?

 Done Immune Network Theory - should go in History (Niels Jerne got a a Nobel Prize for it.) Graham Beards (talk) 16:09, 27 November 2020 (UTC)

OK, let me see if I can work on that one, to save you all the effort. SandyGeorgia (Talk) 16:13, 27 November 2020 (UTC)

Done, [3] SandyGeorgia (Talk) 16:37, 27 November 2020 (UTC)

• Immune receptor seems like something that should be linked in the article somewhere. Ditto immunostimulator.
• Not sure what to do with these: Polyclonal response, and Tumor antigens

SandyGeorgia (Talk) 15:41, 27 November 2020 (UTC)

• These are mentioned in the lead, not in the body: Common autoimmune diseases include Hashimoto's thyroiditis, rheumatoid arthritis, diabetes mellitus type 1, and systemic lupus erythematosus. SandyGeorgia (Talk) 01:14, 28 November 2020 (UTC)

  I will work the missing in ... maybe tomorrow, SandyGeorgia (Talk) 21:13, 2 December 2020 (UTC)

   Done please check [4] SandyGeorgia (Talk) 14:39, 3 December 2020 (UTC)

• Can we add "Scale bar, 5 µm" in the correct formatting to the caption of the first pic? It makes me sad how few micrographs on wp have scale bars, so seeing one without the label is doubly frustrating. Adrian J. Hunter^{(talk•contribs)} 01:36, 28 November 2020 (UTC)

  Done. The point about the lack of label is that pictures hosted on Commons are meant for use in all languages, where possible, so language-specific text will be placed in the image descriptions. Labels are often omitted so that each language can add its own in the caption. --RexxS (talk) 19:03, 2 December 2020 (UTC)

  Thanks. By "label" I meant "note in caption" – my error. Adrian J. Hunter^{(talk•contribs)} 05:45, 4 December 2020 (UTC)

• Add alt text. SandyGeorgia (Talk) 18:52, 28 November 2020 (UTC)

  Done. --RexxS (talk) 19:04, 2 December 2020 (UTC)

• Books missing page numbers. SandyGeorgia (Talk) 18:56, 28 November 2020 (UTC)

@Graham Beards and Ajpolino: most of what is left is beyond me; are we going to be able to wrap this up soon? Also, is there any place in the article that we can mention the differences between the RNA-based vaccine and traditional vaccines, as to how they work on the immune system? Or is that off-topic here ? Are the principles the same? SandyGeorgia (Talk) 22:07, 1 December 2020 (UTC)

Sandy, it is not off-topic but a topic in its own right. It's all to do with antigen presentation by macrophages. Traditional vaccines "give" the macrophages the antigens to present to the cells of the immune system; mRNA vaccines get the macrophages to make them. We can add a paragraph about this, but I am still concerned about the age of some of the references although few of the facts are out of date. I have been thinking that this article needs and "introduction to" article. It is such a complex subject. Graham Beards (talk) 22:38, 1 December 2020 (UTC)

Thanks; are you suggesting the article won't be good enough in time? SandyGeorgia (Talk) 22:43, 1 December 2020 (UTC)

I think it's OK to go now, but we should admit that there is still work needed. Graham Beards (talk) 22:46, 1 December 2020 (UTC)

Certainly the para on how the RNA vaccine operates on the immune system will be of critical interest ... also, I'm not concerned if some work is still needed. Raul used the mainpage TFA as a recruitment tool. Imagine if some researcher reads it and is motivated to become an editor to make it even better! SandyGeorgia (Talk) 22:58, 1 December 2020 (UTC)

Apologies I've not had the time to devote to this that I'd hoped. Per WAID's post at WT:MED, I do have PDFs of those two textbooks, though different editions. I have Molec. Bio. of Cell, 6th ed. and Janeway's 8th ed. If anyone would like copies to verify those references and update page numbers, feel free to email me. Ajpolino (talk) 00:35, 2 December 2020 (UTC)

@Natureium: it sounds like you could get a PDF of the 8th edition from Ajpolino, which would be searchable and easier than using your 7th edition. I would offer to do this myself, but the content is over my head and I wouldn't know what to look for. SandyGeorgia (Talk) 02:15, 2 December 2020 (UTC)

@Ajpolino: see my post at WT:MED. Adrian J. Hunter^{(talk•contribs)} 09:05, 2 December 2020 (UTC)

@SandyGeorgia: Spending time on trying to keep the COVID-19 articles clean has increased my awareness of the difference between anti-viral vaccines (1) that use deactivated virus; (2) that splice the gene for an antigen into a different, harmless virus; (3) the new technique of splicing the gene for an antigen into mRNA. I guess that Vaccine is the right place to discuss fine detail, but I wonder how much detail on that would be expected by readers here? --RexxS (talk) 19:12, 2 December 2020 (UTC)

I was hoping for something even very brief that we can work in to the TFA blurb to make it topical. A two or three-sentence summary ?? SandyGeorgia (Talk) 19:16, 2 December 2020 (UTC)

The immune system is about so much more than "fooling" it with vaccines. I think there's a danger of us looking like we are jumping on the covid bandwagon just to publicise an article. We don't mention that smallpox was eradicated by vaccination here, which is exponentially more of an achievement. Do we really need a hook? This is not Did You Know. I'm a bit concerned. Graham Beards (talk) 21:34, 2 December 2020 (UTC)

No prob, you are the expert, I am just trying to shepherd the work, SandyGeorgia (Talk) 23:35, 2 December 2020 (UTC)

• Do we not need to work cytokine storms in here somewhere? I think that is topical (?) and people will find it missing. Not an expert ... SandyGeorgia (Talk) 14:41, 3 December 2020 (UTC)

If anywhere, it should go under "disorders". But bear in mind this is a biology article not a medical one.Graham Beards (talk) 15:33, 3 December 2020 (UTC)

• Is it appropriate to add RNA vaccine to See also? Ditto for cytokine storm. I don't mean to be obtuse; where we draw the line here between medical and biology is not something I am up on. Just thinking of what mainpage readers may be looking for when they visit on TFA day ... SandyGeorgia (Talk) 18:07, 10 December 2020 (UTC)

Prose review

@Spicy and Colin: might we get your prose expertise in the next few weeks? It looks like we are in shape for December 30 TFA. @Iridescent: this was your idea ... time for you to have a look. SandyGeorgia (Talk) 14:55, 3 December 2020 (UTC)

This is purely from a prose comprehension point of view (to the "bright 14-year-old who has enough sense to click links when they come to a word they don't understand" standard), with no commentary at all as to accuracy, sourcing, bias etc. I'm reviewing the prose as if it were a new submission at FAC, with nitpicking turned up to maximum. Special:PermanentLink/992111640 is the version on which I'm commenting:

• The caption on the lead image could possibly be clarified. "Neutrophil" isn't defined until quite a way further down the article, and it's a term with which most readers won't be familiar. Because the TOC creates a broad field of white space, the caption can be as long as we want without it causing any layout issues—something like "A scanning electron microscope image of a single neutrophil yellow/right (a type of white blood cell that protects the body by engulfing and digesting harmful particles and bacteria), engulfing anthrax bacteria orange/left – scale bar is 5 µm" would work. I'd be inclined to push the lead image size up to upright=2 or at least 1.5, as well—the way in which leukocytes and antibodies actually work is the key concept to communicate to readers. (The scientific knowledge of most of the world's population comes only from hugely simplified diagrams if half-remembered books, and even more simplified animations on news media. I can guarantee to you that at least 90% of readers are under the impression that white cells and antibodies are perfect spheres that roam the bloodstream gobbling up bacteria and viruses like Pac-Man, and a vaccine operates by convincing the immune system that smallpox/polio/covid/whatever tastes nice in roughly the same manner you'd teach a dog to hunt rabbits.)
• Regarding components of host's cells that are released during cell damage or death, are we talking about the death of a cell or the potential death of the host?
• TLRs share a typical structural motif, the Leucine rich repeats (LRR), which give them their specific appearance—what is the specific appearance?
• Cells in the innate immune system have pattern recognition receptors that detect infection or cell damage in the cytosol—nowhere in the article is "cytosol" defined or even wikilinked;
• The first paragraph of the Innate immune system section says that the IIS is the dominant system in most organisms, but most of it talks about systems that are exclusive to animals. This is understandable—animal systems are both more complex and more likely to be what the reader is looking for—but it should probably explicitly say which mechanisms are also found in plants. The article does briefly touch on plants towards the end, but bell after the point by which most readers have stopped reading;
• Given the context of the times, I'd strongly recommend the lead paragraph of the "Adaptive immune system" section include a sentence about vaccination, to serve as a "this is the part you probably want to pay attention to" flag for people skim-reading. (I wouldn't think it a bad idea to find a pretext to shove an image of a SARS-CoV-2 virus in there as well. It's as good a visual representation of "an example of a pathogen" as any, and it again serves as a signpost to readers. It can always be taken out again once the panic has died down.);
• Is there any particular reason the images in the "Humoral immune response" and "Vaccination" sections are left-aligned but every other image is right-aligned? I'm no great admirer of the MOS, but this does look a little jarring to me;
• I'm not very keen on may also involve contact dermatitis (poison ivy). Poison ivy doesn't grow in any English-speaking country outside North America, so is going to mean nothing to most readers—are there any other examples that could be used? (Nickel allergy maybe? I'm not sure what falls under Type IV.)
• Does the single sentence Cancer immunotherapy covers the medical ways to stimulate the immune system to attack cancer tumours. really need to be an entire section on its own?
• Do we really need that A doctor vaccinating a small girl, other girls with loosened blouses wait their turn apprehensively image? (The work in question was actually called A Conscientious Objector to Vaccination; this is yet another case of Fae on Commons not knowing what the actual title of a painting is and just making one up.) If we really need to illustrate the concept of "injection", there are much better ways to show it than a poor-quality black-and-white reproduction of a bad Victorian painting;
• Clearly, some tumors evade the immune system and go on to become cancers reads a bit lecture-y to me. Never assume anything is clear to the reader;
• Larger drugs (>500 Da) can provoke a neutralizing immune response, meaning that the immune system produces neutralizing antibodies that counteract the action of the drugs is going to confuse any reader who doesn't understand that the Dalton is a measurement of the size of individual molecules. Most readers will understand "larger drugs" to mean "high dosage", and worry that the 1500mg pill they take each morning is potentially going to damage their immune system;
• Why does Ehrlich get a photo, but not Pasteur or Jenner (indeed, Jenner isn't even mentioned)? I have no strong opinions on this, but I guarantee somebody will complain.

Hope that helps. As I say, this is a topic well outside my comfort zone, so don't take anything I say too seriously. ‑ Iridescent 17:42, 3 December 2020 (UTC)

Thanks, Iri ... well, I am a failure at images :) SandyGeorgia (Talk) 18:51, 3 December 2020 (UTC)

Yes thanks. I have made some changes in the light of your comments. [5]. As I have said somewhere else on this page, I am most reluctant to jump on the covid bandwagon. It would be okay in vaccination, but not here. It would look opportunist and cheap.Graham Beards (talk) 19:00, 3 December 2020 (UTC)

PS. Jenner and Pasteur belong in Vaccination, not here. I think some are conflating two related, but separate topics. Graham Beards (talk) 19:05, 3 December 2020 (UTC)

Graham, I leave image fixing (and any other messes I make) in your competent hands :) Do not hesitate to fix anything I messed up. SandyGeorgia (Talk) 19:13, 3 December 2020 (UTC)

I wouldn't say that I have any prose expertise. However, I had a look at the article and made a few minor changes. It is well written overall... there are a few other things (not strictly prose) that I noticed:

• What variant of English is the article written in? We have both "tumors" and "tumours" in the same paragraph.
• In the "Manipulation in medicine" section, the passage "Their use is tightly controlled. Lower doses of anti-inflammatory drugs are often used in conjunction with cytotoxic or immunosuppressive drugs such as methotrexate or azathioprine." is unsourced. Is it true that prescription of glucocorticoids is "tightly controlled"? I thought they were pretty common drugs.
• The "nutrition and diet" section could use an update. I am sure more has been learned about this since 1994-2006.
• "The emerging field of bioinformatics-based studies of immunogenicity is referred to as immunoinformatics." Is it still emerging... the source is from 2002.

I would try to help more but I've been a bit busy lately and this is not really my area of expertise. Excellent work by everyone so far. Spicy (talk) 23:24, 3 December 2020 (UTC)

Spicy, don't look now, but you've turned into a very solid and thorough reviewer at FAC. I was unsure on the English variant, and checked the featured version (because Tim Vickers is Scottish), and found no tumours there ... so AmEng it seems to be. SandyGeorgia (Talk) 00:05, 4 December 2020 (UTC)

Sandy I've read through this. If Tim Vickers is Scottish then we should certainly replace "wood splinter" with "skelf" :-). I agree with Graham that the topic is complex and it would certainly be wonderful to have a "Introduction to" version that was more accessible but necessarily would need to be limited in coverage and likely oversimplify to the point of annoying immunologically advanced readers.

Two bits struck me as not warranted. The first is the sentence on antibiotics leading to thrush. The reader may not even have picked up what "commensal flora" are (i.e. include the normally beneficial fungi that are left behind to over-multiply in the absence of beneficial bacteria). If we want to explain that antibiotics can disrupt the balance of protective bacteria and fungi in our bodies, leading to a side-effect of treatment, then that needs to be introduced better. The second is the Covid - vitamin D sentence. It is fine to keep the first sentence on severe respiratory disease (are there any infectious diseases or outcomes associated with deficiency?). -- Colin°^Talk 17:23, 13 December 2020 (UTC)

Thanks, Colin ... I will leave these to the expert, Graham Beards. Could you also glance at blurb 3 below? Unless anyone has anything to add, I plan to tell Wehwalt on Tuesday that we are ready to swap it in to TFA. SandyGeorgia (Talk) 17:48, 13 December 2020 (UTC)

I have deleted the reference to fungal infections. I'm not sure about second. I am considering deleting the whole of that paragraph. Graham Beards (talk) 20:27, 13 December 2020 (UTC)

Graham, deleting the whole of that paragraph is fine too. -- Colin°^Talk 08:49, 14 December 2020 (UTC)

It's gone.Graham Beards (talk) 09:23, 14 December 2020 (UTC)

Image review

Sleep deprivation affects the immune system.

Bronze statue of Eros sleeping; sleep deprivation affects the immune system.

@Nikkimaria: Wehwalt has agreed to swap this in to December 30 TFA per launch of COVID vaccine ... might you do the honor of an image review? Thank you so much as always (RexxS will add the missing alt text). SandyGeorgia (Talk) 15:00, 3 December 2020 (UTC)

Concerned that the article has a lot of dry graphs and images, what do people think of adding one of these to the "Sleep and rest" section, where we have a long spell of text? I think we could use one more of something to break up the long spell of text there, and would prefer it not be another graph or diagram ... SandyGeorgia (Talk) 16:50, 3 December 2020 (UTC)

I don't like that image at all. It implies the immune system is just the lymph nodes in the neck and armpits.Graham Beards (talk) 16:59, 3 December 2020 (UTC)

Can we find something for that stretch of the article? Do you like Eros? SandyGeorgia (Talk) 17:01, 3 December 2020 (UTC)

Frankly, no. It's just decoration. It provides zero information. Graham Beards (talk) 17:04, 3 December 2020 (UTC)

I concur, that isn't useful. Jo-Jo Eumerus (talk) 17:19, 3 December 2020 (UTC)

Images are appropriately licensed but File:Immune_response_of_Lymphocytes.svg and File:Immune_response2.svg could both use sourcing. Nikkimaria (talk) 00:30, 4 December 2020 (UTC)

I looked at File:Immune response of Lymphocytes.svg and this image's issues go far deeper than sourcing - it's poorly labeled and factually incorrect. It seems to be an attempt to describe the function of CD4+ T cells, which do recognize antigen presented by APC in the context of MHC class II, however:

1. the third cell (below the two CD4+ T cells) seems intended to be a CD8+ T cell (because it becomes a "killer cell") but it's unlabeled and CD8+ T cells don't recognize MHC class II (they bind to MHC class I); and
2. the B cell should be presenting antigen to the CD4+ T cell while also binding to antigen via its B cell receptor (BCR); and
3. the caption would clarify if the arrows described were present.

If I cannot find a suitable figure I can create one. — soupvector (talk) 01:36, 4 December 2020 (UTC)

Looking just a little higher on the page is File:Primary immune response 1.png - which is much more accurate but still has its own issues (it neglects CD4+ T cells when one could've been included on the right providing help to the macrophage, cell on the far left should really be a dendritic cell, and the png format should've been svg) but my inclination would be to remove File:Immune_response_of_Lymphocytes.svg and decide what details to elucidate in a new SVG that I'd be happy to compose. For a Featured Article, it is tempting to consider a series of svgs with similar layout, starting with basic concepts and progressively adding detail (with a coherent graphical vocabulary). For expedience, though, we could simply design one image to illustrate the roles of CD4+ T cells (e.g. licensing of CD8+ cytotoxic T cells via 4-1BBL upregulation on dendritic cell, activation of macrophages in DTH reaction as in a granulomatous response, as T follicular helper cells in germinal center reaction of B cells, and as T regulatory cells with high-level CD25 expression). — soupvector (talk) 01:53, 4 December 2020 (UTC)

So, if I am understanding ... for someone who knows what the images are supposed to mean, they are wrong. While for someone like me, the images are completely useless gibberish. So, from both angles, they should be deleted :) If you can come up with something better, that would be so very kind of you. SandyGeorgia (Talk) 02:00, 4 December 2020 (UTC)

Well said! I have started a discussion below, intend to create fig by Saturday (intending to use inkscape to create as SVG). — soupvector (talk) 02:39, 4 December 2020 (UTC)

Blurb

In time for Wehwalt to swap it in to Wikipedia:Today's featured article/December 30, 2020 , we have to rewrite this blurb. (By the way, we are able to do this because Wehwalt scheduled one of his own FAs for that date, so that no one will complain if he swaps it out. And swapping it out invokes a cascade of other pages that have to be changed ...) On the blurb

• We use one paragraph only, with no reference tags or alternative names; the only thing bolded is the first link to the article title. The length when previewed (including spaces) is between 925 and 1025 characters, or more when no free-use image can be found. Fair use images are not allowed.

SandyGeorgia (Talk) 19:21, 2 December 2020 (UTC)

How about (to get the ball rolling):

The immune system is a network of biological processes that protects an organism against disease. It detects and responds to a wide variety of pathogens, from viruses to parasitic worms, as well as objects such as wood splinters, distinguishing them from the organism's own healthy tissue. Many species have two major subsystems of the immune system. The innate immune system provides a preconfigured response to broad groups of situations and stimuli. The adaptive immune system provides a tailored response to each stimulus by learning to recognize molecules it has previously encountered. Both use molecules and cells to perform their functions. Humans, have a sophisticated defense mechanisms, including the ability to adapt to recognize pathogens more efficiently. Adaptive (or acquired) immunity creates an immunological memory leading to an enhanced response to subsequent encounters with that same pathogen. This process of acquired immunity is the basis of vaccination.

Graham Beards (talk) 20:07, 2 December 2020 (UTC)

It reads fine to me but ... need to choose an image, and it seems underlinked. SandyGeorgia (Talk) 14:43, 3 December 2020 (UTC)

I like the phagocyte image at the top.Graham Beards (talk) 15:35, 3 December 2020 (UTC)

So, unless anyone has issues with Graham’s blurb, I will work in the image and links to present to Wehwalt next week. SandyGeorgia (Talk) 14:06, 4 December 2020 (UTC)

Blurb 2

Copy of Graham's blurb, with image and wikilinks added – 978 characters. SandyGeorgia (Talk) 23:15, 4 December 2020 (UTC)

The immune system is a network of biological processes that protects an organism against disease. It detects and responds to a wide variety of pathogens, from viruses to parasitic worms, as well as objects such as wood splinters, distinguishing them from the organism's own healthy tissue. Many species have two major subsystems of the immune system. The innate immune system provides a preconfigured response to broad groups of situations and stimuli. The adaptive immune system provides a tailored response to each stimulus by learning to recognize molecules it has previously encountered. Both use molecules and cells to perform their functions. Humans have sophisticated defense mechanisms, including the ability to adapt to recognize pathogens more efficiently. Adaptive (or acquired) immunity creates an immunological memory leading to an enhanced response to subsequent encounters with that same pathogen. This process of acquired immunity is the basis of vaccination. (Full article...)

This is excellent. One thing I note is that it's very pathogen-focused, whereas we know that immune suppression is associated with increased cancer risk, e.g. "Immunosuppression is a key factor for cancer development, although many other transplant-related and traditional risk factors also play a role." The article (under Tumor immunology) does a nice job of summarizing the immune surveillance theory, and perhaps that could inform this blurb - at least by mention? A key element is recognition of cellular stress and downregulation of antigen presentation molecules by the innate arm (esp NK cells) and the recognition of de novo antigen in error-prone cancers by the adaptive response (esp T cells). — soupvector (talk) 14:12, 5 December 2020 (UTC)

We have room for only a few more words, so something would have to go ... leaving it to Graham and you, SandyGeorgia (Talk) 14:19, 5 December 2020 (UTC)

Blurb 3

How about:

The immune system is a network of biological processes that protects an organism against disease. It detects and responds to a wide variety of pathogens, from viruses to parasitic worms, as well as cancer cells and objects such as wood splinters, distinguishing them from the organism's own healthy tissue. Many species have two major subsystems of the immune system. The innate immune system provides a preconfigured response to broad groups of situations and stimuli. The adaptive immune system provides a tailored response to each stimulus by learning to recognize molecules it has previously encountered. Both use molecules and cells to perform their functions. Humans have sophisticated defense mechanisms, including the ability to adapt to recognize pathogens more efficiently. Adaptive (or acquired) immunity creates an immunological memory leading to an enhanced response to subsequent encounters with that same pathogen. This process of acquired immunity is the basis of vaccination. (Full article...)

148 words, 845 characters, (993 including spaces). Thoughts? Graham Beards (talk) 15:07, 5 December 2020 (UTC)

Nice! Thanks for doing that. — soupvector (talk) 19:07, 5 December 2020 (UTC)

Allright, I've bumped this over to Wehwalt for scheduling, here.

We do still have some missing page nos for Janeway ... if no one else can do those, I can try ... but much of this content is over my head. SandyGeorgia (Talk) 19:29, 14 December 2020 (UTC)

TFA timing

Wehwalt on your offer to swap this in on December 30, are you able to hold the final decision as late as December 17 per reports like this from the WSJ, and this from the BBC? If there is a delay, it might be wise to hold off. And should that happen, who is scheduling January? Might you ask them to plug in a replaceable slot around the 15th of Jan, depending on what we know by the Dec 10 meeting? SandyGeorgia (Talk) 22:05, 1 December 2020 (UTC)

I'd like to have it done a week in advance, so through the 22nd would be fine. If it is January, you should talk to Jimfbleak. You would have to make arrangements with them.--Wehwalt (talk) 22:49, 1 December 2020 (UTC)

Thanks ... we'll keep you posted, SandyGeorgia (Talk) 22:54, 1 December 2020 (UTC)

Vaccine authorized in UK ... https://www.wsj.com/articles/pfizer-and-biontechs-covid-19-vaccine-wins-u-k-authorization-11606893360 SandyGeorgia (Talk) 07:24, 2 December 2020 (UTC)

The actual press release is at https://www.gov.uk/government/news/uk-medicines-regulator-gives-approval-for-first-uk-covid-19-vaccine - it's "taken under Regulation 174 of the Human Medicine Regulations 2012, which enables rapid temporary regulatory approvals to address significant public health issues such as a pandemic." The core article is BNT162b2, if anybody wants to help key an eye out for sensationalism. --RexxS (talk) 19:17, 2 December 2020 (UTC)

Alberts links

As discussed at WT:MED, I added section links to six of the ten references to the Alberts textbook. Of the other four:

• Three were not readily verified by Alberts, so I used Campbell Biology ("Reece"), another excellent textbook, though not available online. There would be value in replacing or supplementing these citations with online sources, especially the two that concern vaccination.
• The remaining citation was part of a paragraph that needs work:

Leukocytes (white blood cells) act like independent, single-celled organisms and are the second arm of the innate immune system. The innate leukocytes include the phagocytes (macrophages, neutrophils, and dendritic cells), innate lymphoid cells, mast cells, eosinophils, basophils, and natural killer cells. These cells identify and eliminate pathogens, either by attacking larger pathogens through contact or by engulfing and then killing microorganisms.

The problems are that many leukocytes are not parts of the innate immune system (e.g., most lymphocytes), and that the description of how innate leukocytes work does not apply to several of the examples cited.

Sorry to dump those comments and run but I'm low on time for the next few days. Adrian J. Hunter^{(talk•contribs)} 02:38, 6 December 2020 (UTC)

We need to introduce "professional phagocytes" as the subset of white blood cells that are central to the innate system. I'll edit the paragraph accordingly.Graham Beards (talk) 08:04, 6 December 2020 (UTC)

References

MEDDATE

Just leaving a note here about the age of some of the books: WP:MEDDATE prefers recent sources, and anyone who's worked much on medicine-related articles has probably had the experience of someone reverting their additions because the source is more than 5 or 10 years old.

There was a discussion about this at Wikipedia talk:WikiProject Medicine, and we agreed that it was acceptable to cite high-quality older sources for the specific basic, unchanging content (e.g., names of cells) in question, and in one case, to cite a high-quality older source that was freely available to readers than to cite the paywalled newer versions that are available to a couple of editors. This should therefore be considered in compliance with WP:MEDRS's advice on sources. WhatamIdoing (talk) 17:47, 2 December 2020 (UTC)

I think there's an important distinction between an older, quality source that has been in place for a decade, and an older source that someone is trying to add fresh (particularly when newer, updated sources are available). An admirable goal would be to have all of our medical content sourced to recent high-quality sources, but we have limited editor resources and it sometimes feels like sticking your thumb in the dyke: I'd be satisfied if I thought the number of older sources at least wasn't increasing. --RexxS (talk) 19:27, 2 December 2020 (UTC)

Image for "Helper T cells" subsection

Function of T helper cells: Antigen-presenting cells (APCs) present antigen on their Class II MHC molecules (MHC2). Helper T cells recognize these, with the help of their expression of CD4 co-receptor (CD4+). The activation of a resting helper T cell causes it to release cytokines and other stimulatory signals (green arrows) that stimulate the activity of macrophages, killer T cells and B cells, the latter producing antibodies. The stimulation of B cells and macrophages succeeds a proliferation of T helper cells.

This image is problematic for reasons I stated above in Image review. I'm tempted to create a diagram showing a CD4+ T cell at center, with an array of functions depicted around it - in the 4 corners, perhaps - cytotoxic ("killer") CD8+ T cell licensing, delayed type hypersensitivity using interferon gamma and granulomatous inflammation as a really important example (it's the basis of the Mantoux test for latent TB), B cell help in the germinal center reaction (the basis for conjugate vaccines that have been so dramatically effective, and the regulatory T cell role. I'll do my best to make it as simple/accessible as desired. Any thoughts? — soupvector (talk) 02:16, 4 December 2020 (UTC)

Yes. Thanks. Are you considering something like this [6]? Graham Beards (talk) 08:42, 4 December 2020 (UTC)

Yes, figure 2 in that paper is the sort of thing I was thinking of, but is a bit more detailed perhaps than we need for this article. — soupvector (talk) 13:41, 4 December 2020 (UTC)

Excellent. Thanks. Graham Beards (talk) 18:33, 4 December 2020 (UTC)