Research Spotlight: Steven D. Shapiro, M.D.

As an American Lung Association Edward Livingston Trudeau Scholar, Dr. Shapiro studied the role of immune cells called macrophages and proteases in the development of emphysema. "The grant helped us find a critical molecule produced by macrophages called MMP-12, that when knocked out in mice, allowed them to smoke and not develop the disease," he says. Further research revealed MMP-12 is a critical factor in the development of human emphysema as well.

He continued to study macrophages, proteases and emphysema with an American Lung Association Career Investigator Award in 1994. What he discovered is that MMP-12 has many roles in the lung, both good and bad. "It causes emphysema, but it also keeps lung tumors in check. That means it is difficult to target for emphysema, because it has good aspects as well," Dr. Shapiro explains.

Emphysema, which along with chronic bronchitis are collectively known as chronic obstructive pulmonary disease (COPD), is a very difficult disease to treat, he notes. In emphysema, the elasticity of the lungs is reduced and the walls between the air sacs are destroyed, causing the airways— which are normally held open by the elastic elements in the walls of the alveoli—to collapse. "We still don’t know how to repair the elastic fibers in the lung," he says. "If we could do that, we could reverse emphysema. We’re learning more and more all the time, but progress has been slow."

Preparing for His Current Role

Dr. Shapiro’s career has taken him from Washington University in St. Louis, to Brigham and Women’s Hospital in Boston, to his current position in Pittsburgh. Although he is now an administrator, he says his background in research has informed his approach to hospital administration, where he oversees health services for the largest academic medical center in the country, with a $14 billion budget. "I am data driven," he says. "Hospitals have a history of shooting from the hip, and now we are taking a much more critical scientific approach."

His experience with the Lung Association prepared him for his current role in another way. While he was in St. Louis, he was appointed to the Board of Directors of the local Lung Association. "We debated how to direct our resources, which is a question I deal with daily in running a healthcare institution," he notes. The ability to combine research, clinical medicine and administration in his career has been especially rewarding. Dr. Shapiro says, "I see medicine from so many different angles."

Receiving grants early in his career was critical to his success, Dr. Shapiro says. The findings from his Lung Association grants allowed him to get a large grant from the National Institutes of Health to continue his research. With research funding harder than ever to obtain, Lung Association grants are more important than ever to young researchers, he says. Physician scientists are especially in need of research funding, he adds. "People who come from the bedside not only know the problems that need to be solved, but they have a passion for solving those problems," he says.

Now is a particularly exciting time to be studying lung disease, according to Dr. Shapiro. "Young researchers today will learn more about the biology of lung disease in their career than we have learned so far in the history of medicine," he says."

The marriage of technology, genetics (the study of specific, individual genes) and genomics (the study of an organism’s entire genetic makeup) is allowing for more personalized medicine. But much more research is needed, Dr. Shapiro says. "We still don’t’ know fundamentally how cells work," he says. "We have more data than ever before, and we can do more to help patients, but we still need to invest in basic science."

That is why supporting research is so important right now, he says. "The Lung Association catapults the careers of young scientists," he says. "You can’t underestimate the importance of this. By supporting a young investigator, you are helping the career of a future superstar who may find a cure for lung disease. They will be able to take advantage of the next generation of advances. Lung disease needs a new generation of superstars."