Interview with Dr. Makoto Ishii

INTERVIEWER: [in progress] … your name, where are you from, and tell me about your research project.

MAKOTO ISHII: Sure. My name is Mak Ishii. I was originally born in Japan, but I grew up in Houston, Texas, before moving to the Northeast, and I’ve been in New York City for about 20 years, where I’ve been affiliated with Weill Cornell as a medical student. Now I’m on the faculty there, where I’m a neurologist and neuroscientist. My research right now is focused on really studying the early features of Alzheimer’s disease. As everyone knows, Alzheimer’s disease is a disease that affects the memory, and it’s very devastating. But what we now know is that Alzheimer’s disease occurs about 10, 20, or even 30 years before the memory declines, so I’ve been focusing on what’s happening in that stage, particularly in weight loss and in metabolism and other changes there that we can identify. We have some pretty exciting research results from it.

INTERVIEWER: What do you hope your research is able to achieve?

MAKOTO ISHII: What we want to do … we’ve been focusing on this weight-loss feature because it is something that we see a lot and, as a physician, it’s something I see in my patients as well. What we hope to do is really identify what’s the underlying mechanism for it. We still don’t know why people lose weight. Initially we thought it’s because patients have, unfortunately, significant memory [loss] and dementia. But that’s not the case in the early stages, so we have to figure out what’s going on. And by doing so, can we maybe reverse the process because <inaudible 1:19> so they can maintain or increase their weight. Can we identify those factors to reverse?

INTERVIEWER: What inspired you to become a researcher?

MAKOTO ISHII: That’s always a good question and a lot of students ask me that; and one thing I always like to say about it is, obviously, we get inspired by many different things. When I was younger, like many of us here, we were very interested in science. I didn’t know quite what to do. Coming from Houston, I was originally a chemical engineer. So there’s a lot of chemical engineers in Houston, and I thought I might pursue that pathway. But my parents moved to Dallas and then I had no friends in Dallas and I had to make myself useful. So I ended up volunteering and working, and got a fellowship to work at the Medical Center in Dallas, and there I got really inspired by clinicians and scientists. We started working on a project and I quickly learned that there’s a lot we don’t know, and we made some pretty important discoveries from that project. And that’s when I decided, hey, chemical engineering is great and all, but there’s a lot of good research we can do in medicine. That’s what got me started.

INTERVIEWER: Great. What message would you like to share about the importance of scientific research?

MAKOTO ISHII: I think people get bogged down with scientific research because it does take time for it to happen, and so I guess my message about scientific research is that a lot of times people say it gets very discouraging because in Alzheimer’s disease, especially in our field, we don’t have any cures. We don’t have any really effective ways of preventing it or even really good treatments. But I think what the research has really shown is that we’ve made a lot of advances in the past 10 or 20 years. We can now identify people much earlier than we could before, and with greater accuracy, and now that we can do that, we can actually start studying the disease at an earlier stage than we could before and then come up with better prevention methods. And so, I think that while the public may not see those immediate advances, I think the scientific field is very, very excited because now we’re at the cusp of making that big discovery.

INTERVIEWER: Would you like to say anything to our donors right now who might be watching this interview?

MAKOTO ISHII: One thing I have to say specifically about the BrightFocus Foundation is that it really helped launch my career. So when I was just coming out of residency, I was just starting this project about studying weight loss in Alzheimer’s disease, and some senior people were saying, “Why are you studying weight loss in Alzheimer’s disease; isn’t it a memory problem?” And that’s when I said, “Look, you know, this is really important because we see it in our patients, and we know the data is there that weight loss really impacts these patients, and we’ve got to figure out what’s going on.” BrightFocus is one of the first ones to really help support my research, and so to the donors out there who are listening, this is something that is critical because a lot of the national government, maybe, or some of these bigger agencies won’t fund that early science that might just be studies that are just trying to come up with a proof-of-concept. So I think something like BrightFocus has really helped to develop this research area that I hope expands further and further.

INTERVIEWER: What excites you most about current trends around your area of research?

MAKOTO ISHII: There’s a lot to be excited about, and I’m sure there’s a lot of people here who will tell you about their stories, but I think in general, Alzheimer’s disease … the idea that it is a continuum, that it is no longer you have memory disorders, you have memory problems, and then you have dementia and, unfortunately, people pass. We know that it starts much earlier, and that concept of being able to identify things that happen earlier and then being able to treat earlier, I think, is what’s going to make a difference. And so I say that our research now is that we can identify patients very, very early. Now we have to figure out a way to treat those patients.

INTERVIEWER: What is something that people may not know about working as a researcher?

MAKOTO ISHII: Being a research scientist is a little bit different than most career paths, I always say. I think it’s very similar to being like an artist, or that’s what I like to think of it as. And so one analogy I use—which may not be a good one—is I think it’s like working in a movie in which you might see this really famous scientist who wins a Nobel Prize or who comes up with a cure, and you read that headline. So that could be that famous director like Steven Spielberg winning a big prize. But there’s a lot of people working under that person who’s really working day to day to make a big difference. And so it is like working on a movie in many other aspects, too. There are smart indie movies, such as my lab, which is a little bit more modest-sized than  some of the bigger-named labs out there. I think that concept of teamwork with a variety of different researchers all with a common goal and that, like movies, some are duds. But you know, by making all of these movies, eventually we hope to make that one major discovery, that big impactful moment. And I think that’s the way I kind of describe our research, at least from my perspective.

INTERVIEWER: Fantastic. I would say that’s primarily how you would probably describe your research to family and friends as well, right?

MAKOTO ISHII: Yeah, definitely. Most of my family members are nonscientists so they are always asking me, “Well, you have an M.D.; why don’t you just see patients all day and really make an impact there?” And I say, “Yes, that’s part of what I do. But I spend most of my time in the research working with this team of great scientists and, hopefully, advancing that mission of trying to come up with the next cure.” And so, that’s what I tell my family and that’s what inspires me to do so.

INTERVIEWER: Excellent. Well, thank you so much for taking the time to speak with us today. To our viewers, we will be back with more from our grantees in a few minutes.* Thank you.

* Dr.Ishii's interview was one of several Facebook Live interviews recorded on June 6, 2018.