Clinical Experience as the Starting Point for Research
“There were no effective treatments at the time… all we could do was watch.” It was during his student years, in a hospital clinical rotation, that Associate Professor Satoshi Watanabe encountered a patient suffering from pulmonary fibrosis—an experience that ultimately guided him toward a career in research. Today, while serving as a clinician in the Department of Respiratory Medicine at Kanazawa University Hospital, he also works as a Specially Appointed Associate Professor in the Graduate School of Medical Sciences, focusing primarily on research related to pulmonary diseases. The sense of helplessness he felt as a student—unable to intervene as a patient’s condition rapidly worsened—became a powerful motivation to understand disease mechanisms at a deeper level and to contribute to the development of new therapies and medicines. “Why does this disease occur?” “How can we treat it?” These questions, born at the bedside, nurtured in him the determination to pursue research while continuing to work on the front lines of clinical medicine.
Interstitial Pneumonia —Exploring the Relationship between Macrophages and Pulmonary Fibrosis—
Professor Watanabe’s current research focuses on interstitial pneumonia, a group of diseases in which inflammation and fibrosis (hardening of tissue) occur in the interstitium—the connective tissue that supports the structure of the lungs. As the condition progresses, it can lead to respiratory failure and is considered a difficult?to?treat disorder. The main symptoms include cough and shortness of breath, which resemble pneumonia or asthma, but public awareness of the disease remains low, and it is classified in Japan as a designated intractable disease. Although the full pathophysiology has yet to be elucidated, researchers are gradually uncovering potential factors involved in its onset. In recent years, attention to the disease has grown significantly, particularly following the global outbreak of COVID?19, which highlighted the role of lung inflammation and fibrosis. According to Professor Watanabe, collaborations with researchers in Japan and abroad have also advanced rapidly as interest in this field has expanded.
Professor Watanabe is particularly focused on macrophages, immune cells that reside in the lungs. Macrophages play a key role in eliminating foreign substances—such as bacteria and viruses—that enter the body, and in regulating inflammatory responses. Through these functions, they are essential for protecting the body from various infections and inflammatory conditions. Recent studies have revealed that certain types of macrophages can actually promote lung fibrosis. This finding has drawn increasing attention to their involvement in the progression of interstitial pneumonia. By investigating how macrophages function, Professor Watanabe aims to clarify the disease mechanisms of interstitial pneumonia and contribute to the development of new therapeutic strategies.
“Always Questioning, Always Seeking” — Research that can be Returned to Clinical Practice—
Professor Watanabe says, “My guiding principle is to always question and continue pursuing answers.” In his daily clinical practice, he faces patients directly, discovering hidden challenges and clues that he then connects to research aimed at unraveling disease mechanisms. “What causes this disease?” “What lies behind it?” This spirit of inquiry is what drives his research. His approach is grounded in the practical insights that emerge through constant interaction with patients. “Seeing patients right in front of me is my greatest motivation,” he says. For him, the clinical setting is both the starting point and the ultimate destination of research. “I learn from my patients, gain questions and hints from them, apply those insights to research, and then bring the results back to clinical care. I value this cycle above all.” This cycle represents his identity as a physician and embodies Professor Watanabe’s conviction as a researcher.
In current medical practice, treatments for interstitial pneumonia focus mainly on slowing the progression of the disease. However, Professor Watanabe is looking beyond this conventional framework. His goal is to reverse fibrosis and restore respiratory function. Driven by the desire to create a future in which patients can truly regain hope, Professor Watanabe continues to take on new challenges.
(Science writer: Yuko MITERA, English translation:Md Abul Kalam SIDDIKE)
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