As a thoracic surgeon in Japan, I would often see and treat patients with a past history of chronic obstructive pulmonary disease (COPD). Deep inside, I would always think “Not again…”. Even if the patient wasn’t formally diagnosed with COPD and just had a long (sometimes extremely long) history of smoking, it would raise a flag in my mind. I knew that this person had a high risk of adhesion in their thorax and would probably suffer severe post-operative pneumonia. This pneumonia would cause a huge deterioration in their quality of life, and, even worse, could be life-threatening.
It was therefore quite exciting for me to have the chance to join HLI as a postdoctoral fellow, working on a new project aiming to develop a non-invasive treatment for emphysema. Emphysema is a specific type of COPD that involves damage to the alveoli (air sacs) in the lungs. While in Japan, I had dreamed of studying abroad someday, and had been asking my professor if there was any chance to do so. Fortunately, my university has a long-standing relationship with HLI (more than 30 years!), and in 2025, I was chosen to visit the HLI as an international researcher.
In my experience, most patients with emphysema take medicine to control their symptoms without seeing actual improvement of their disease. Those who have severe symptoms may be candidates for lung volume reduction surgery, but as a surgeon, I have never seen a patient undergo this procedure. Here at HLI, we are working with an industry partner, Ikomed Technologies, to develop a treatment for emphysema and test it in animal models. We started with rodents and, over the past several years, have been conducting studies in pigs as we move closer to first-in-human trials.
As a first step, I am evaluating lung function in these animals. Since they are pigs, we cannot ask them (!) if they are feeling any symptoms or having difficulty breathing, nor can we do spirometry (a test to determine how well the lungs work).
Next, I am learning how to objectively analyze my results without bias. This is a great challenge as pig lungs are huge. If we wanted to evaluate the morphological features of the lung through a microscope, realistically we would have to collect specific areas to analyze. With the lungs being so large, how can we collect specimens uniformly? How many samples should we collect to be able to capture the characteristics for the entire lung? All of these questions are completely new to me and would never have been brought up when I was in Japan.
HLI members have given me the support and advice I need to measure histology features, such as the mean distance between each alveoli, as well as lung compliance (through plethysmography). This is a technique to measure the change in lung volume following a change in pressure. A patient/animal breathes into a mouthpiece while inside an airtight box. The change in air pressure is measured as the chest expands. There are many experts at HLI who have been working on evaluating lung function in large animals, and they have given me guidance.
Green lines are placed randomly, and the number of intersections with alveolar walls is counted.
In reality most days as a researcher are not about having great ideas that can change the world or discovering one of the true mysteries of science. Instead, working with diverse team members with different backgrounds can sometimes bring unexpected viewpoints not yet considered, and lead to new ways of understanding. This process is very satisfying and can bring great joy. Coworkers can also help with presenting results in a more easily understood manner.
A year ago, while working as a physician in Japan, I could have never imagined that I would have the opportunity to work at HLI. I am grateful to have the chance to work with a great team and to be surrounded with new discoveries. This is a once-in-a-lifetime opportunity, and I hope I can make great progress that can help me reach new milestones in my career. While research often leads to incremental step-by-step discoveries, I hope my contributions within the next year to discovery in the realm of COPD can make a difference in disease treatment.