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T-cell responses are major players in host de-fence or protagonists of various diseases in-cluding autoimmunity/atopy. Since many ofthose diseases are not only treated with steroidhormones, but may also be related to defectsin endogenous steroid biology, it is evidentthat the knowledge of how steroid hormonesand T cells interact would be of primary inter-est. In this respect, this book is long overdue.

In contrast to the dogma that endogen-ous cortisol acts to suppress immunity or to restrain the immune system from over-reacting, the current concept that has evolvedsuggests that the physiological cortisol response serves to pre-set and orchestrateimmune reactions; this involves suppres-sion, and, possibly even more important, en-hancing and directing immune functions.Furthermore, it has become increasinglyclear that the actions of endogenous gluco-corticoids, in contrast with most syntheticglucocorticoids, are subject to complex andspecific mechanisms that regulate their ac-tion. These latter aspects have been highlydisregarded by most immunologists.

In their book, Rook and Lightman putcortisol, its metabolism and its natural an-tagonists in the centre of the discussion, pro-viding an example for steroid hormones ingeneral. This is certainly justified inasmuchas cortisol is one, if not the only, essentialhormone (director) of a highly complexsymphony called host defence. The bookstarts with some very comprehensive intro-ductory chapters that elegantly review thecomplex interactions between mediators ofinflammation and the hypothalamo–pituitary adrenal axis, which will ultimatelylead to the synthesis and release of cortisolfrom the adrenal cortex, provided an appro-priate stimulus is given.

A most intriguing section discusses anew concept, comprising tissue specificsteroid metabolism and its effect on thedichotomy between T helper 1 (Th1)- andTh2-like responses; the impact of cortisolbiology on the development of diseases,including autoimmunity and tuberculosis;and the interaction of cortisol with othersteroids or their natural antagonist. Theimportance of cortisol biology is impressivelydocumented in various disease models asbeing highly relevant for immunity.

However, in taking everything into con-sideration, the authors are confronted with aproblem that scientists often face: how to fitthe new data with those obtained by the majority of earlier experimental approachesthat often did not reflect physiological con-ditions or disregarded the growing knowl-edge on glucocorticoid physiology. Thus,since it is not only a futile but possibly a po-litically dangerous task to re-evaluate the

existing work, the authors are often left toconform to the unjustified dogma that glu-cocorticoids are in general immunosup-pressive. The struggle to comply with thisdogma provides a fascinating battle that willintrigue many readers, not only those fam-iliar with this field. The data presented aresometimes open to interpretations that mayappear quite rebellious, despite being closerto the actual physiology.

In summary, keeping that last caveat inmind, this book certainly provides enlight-enment for all scientists. In general, it raisesimportant questions and shows interestingnew perspectives, although these some-times could have been made clearer andmore specific. On one hand it tells a story ofhow a dogma starts to crumble if one readsbetween the lines, on the other, it adds notjust one, but many pieces to the puzzle ofhow host defence might be organized – it isup to the reader to play with these pieces.The book should provide very valuableinformation not only for those in the fieldbut also, and even more importantly, itshould attract those from fields rangingfrom physiology and molecular biology, toimmunology and endocrinology, since itmight help them to appreciate new chal-lenges, which will open new avenues to tar-get disease.

Thomas WilckensCEVIS Corporation, 4186 M Sorrento Valley Blvd,San Diego,CA 92121,USA.

b o o k r e v i e w sSteroidHormones andthe T-CellCytokine Profile

edited byG.A.W. Rook andS. Lightman,Springer-Verlag, 1997. £69.50/$119.00/DM184.00(xi + 227 pages)

When Donald Weir’s little textbook of Immunology first appeared, nearly 30 years

ago, it had the field largely to itself and wasthe ‘bible’ for a generation of medical andbiology students. Since then, immunologyhas been transformed by advances in cellu-lar and molecular biology – and there is amuch wider range of textbooks in themarketplace. Consequently, the book, now inits 8th edition, seeks to cater for a new gener-ation of students. Has Weir’s book, now co-authored by John Stewart, moved withthe times sufficiently for it to remain com-petitive? The answer is a qualified yes. Thebook is split into two sections. The first, en-titled ‘Basic immunology’, occupies slightly

less than half the book, and is divided intofour chapters – an ‘Introduction’, ‘Innate im-munity’, ‘Antigens and antigen recognition’,and ‘Acquired immunity’, the last two beingmuch longer than the first two. The secondsection is entitled ’Immunology in action’,and contains five chapters dealing with in-fection, immunohaematology, transplan-tation, cancer, immunopathology and anti-body–antigen interactions in laboratoryinvestigations. This last chapter is perhapssymptomatic of the book’s venerable ori-gins; much of it is devoted to detailed de-scriptions of largely forgotten assays, such

Immunology(8th edn)

byD.M. Weir and J. Stewart,Churchill Livingstone, 1995.£17.00(362 pages)

ISBN 3 540 76057 1

ISBN 0 443 05452 5