Leading Medical Scientist in Korea Explores the Link Between Vascular Health and Dementia

Gyuyoung Ko, director of the Institute for Basic Science (IBS) Vascular Research Center (KAIST Distinguished Professor), is a leading medical scientist in Korea. He has researched blood vessels and lymphatic vessels and published several papers in international academic journals Nature and Science. In 2020, he was recognized as a leader researcher to the point where he was selected as president of the world’s highest-level International Society of Vascular Society (IVBM). At the same time, he took the lead in training doctor-scientists by producing 35 doctorates and 3 master’s degrees at the Korea Advanced Institute of Science and Technology (KAIST) Graduate School of Medical Science and IBS.

Professor Go, who mainly studied capillaries and lymphatic vessels related to cancer, suddenly turned his attention to the field of dementia a few years ago. In the field of dementia, Professor Goh also produced research results that surprised the world. He was the first in the world to identify that the meningeal lymphatic vessels in the lower part of the brain are the main route through which waste products in the brain that cause degenerative brain diseases such as dementia are discharged out of the brain.

We also confirmed that as we age, our ability to excrete waste decreases. Just as foreign substances accumulated in sewer pipes are not cleared in time, the pipes become clogged and malfunction, and if wastes are not discharged properly, brain diseases such as dementia can occur. Professor Koh’s research is evaluated as suggesting a new direction in the treatment of degenerative brain diseases.

On October 24th, I met Professor Go at the IBS campus of KAIST in Daejeon. As he is a world-class scholar, he was very nervous ahead of the interview, but after returning to the lab after the seminar, Professor Go invited the reporter to eat first.

Professor Go personally drove the car to the lunch location. Researchers and administrators who had lunch that day said, “Eating lunch in the car driven by the professor is routine.” The researchers said with a smile, “Unlike other professors who engage in a lot of outside activities, Professor Ko still goes to the lab every day. It’s nice to talk about research every day, but I have no choice but to research hard.” Professor Ko just laughed ‘huh’ while hearing this story.

Ko Gyu-young, director of the IBS Vascular Research Center (KAIST Distinguished Professor), is one of the world’s leading researchers in the field of vascular biology. Professor Koh is seeking treatments for not only cancer but also degenerative brain diseases such as dementia through vascular biology research./Ministry of Science and ICT

-Regarded as an authority in the field of vascular biology. What kind of research is done in vascular biology?

“Just as there are different types of roads, there are many different types of blood vessels throughout our body. There are places that transport materials, such as highways, and there are also thin capillaries, such as neighborhood alleys. The field that studies this is vascular biology. “In the lab, we are studying capillaries and lymph vessels that act as a kind of sewage system.”

-Since when has vascular biology research been active?

“It is a field that has been studied consistently since the time of Hippocrates. It is said that one-third of all diseases are related to blood vessels. As it has become known that the progression of dementia, diabetes, and brain disease is mostly related to vascular damage, it is being considered an essential field for research. “With the novel coronavirus infection (COVID-19), the interaction between blood vessels and immunity is also being intensively addressed.”

-The main discharge route of cerebrospinal fluid waste that causes dementia has been revealed for the first time in the world.

“It has been known for 150 years that cerebrospinal fluid will come out through lymphatic vessels in the meninges. Due to limitations in technology, the main drainage route had not been revealed, but the route through which the spinal fluid, which serves the back of the brain, drains was revealed. What is important here is that we discovered that that part degenerates with age. This means that dementia can worsen due to the inability to excrete waste products in time. “This study was published four years ago, and is recognized in the field of dementia research, with over 500 citations.”

-I understand that development of treatments and new drugs is also in progress.

“Lymphatic vessels that carry out waste products pass through the neck. There are two ways to treat dementia using this. The easiest way is to gently massage your neck. You can see the effect by dividing the massage into 15 minutes in the morning and 15 minutes in the afternoon. The lab is collaborating with ergonomics experts to find ways to effectively massage more precise areas. Another drug is one that helps the activity of lymphatic vessels. “We are testing a drug that stimulates the muscle cells and pump parts around lymphatic vessels to facilitate smooth flow.”

-Research on new drugs for dementia is underway in various places, but results are not coming easily.

“Generally, the standard is whether 20% of cognitive function is recovered, but this standard is ambiguous and the side effects of new drugs must be taken into consideration. Recently, some say that the target for dementia treatment should be phosphorylated tau rather than beta-amyloid. As such, various discussions are still ongoing. A limitation of the study is that there are no experimental animals that can reproduce dementia in humans. As a result, even when testing a new drug, its efficacy appears to be different in each laboratory. “There is also no proper way to biochemically test whether dementia is cured.”

-Is there a breakthrough?

“Now that we have discovered a new lymphatic pathway associated with dementia, we are testing the drug in human-like primates. Because this lymphatic vessel can be treated outside the skull, it is expected to be more accessible than existing techniques. “The goal is to find a method that can be visibly used within a few years.”

-So far, I have done cancer-related research. Was there a sudden change to dementia research?

“I achieved results and received an award through cancer vascular research. However, since COVID-19, I have focused on research on blood vessels and lymphatic vessels in the head and neck. Since not much research has been done on vascular biology related to dementia, I began research in this field with the expectation that I would be able to discover something new. “At the time, I was working with researchers from neurosurgery, otolaryngology, and brain engineering, so I started focusing on the dementia field.”

Professor Goh is an internationally renowned expert in cancer blood vessels. He was the first in the world to identify that cancer cells use fatty acids as core fuel to metastasize to lymph nodes. Previous research assumed that most cancer cells use glucose as their main energy source, but Professor Goh revealed the survival strategy of cancer cells using a different approach than previous research.

One wall of the lab summarizes Professor Ko Gyu-young’s research life. The far left is decorated with awards received and thesis cover art./Reporter Hong Ah-reum

◇My nickname is ‘Debt Guy’… I owe hundreds of millions of won for research.

-I received many awards, including the Scientist of the Year Award, the Ho-Am Award, the Asan Medical Award, the Kyung-Am Award, and the 2023 Korea Best Scientist and Technology Award in July of this year.

“I think I received a lot of awards because I worked my way up from the bottom. Don’t people who have walked a solid path since they were young quickly receive big rewards? However, I seem to have won many different awards as I rose up step by step. They say that there are cases where research results do not continue after receiving a major award, but I actually achieved more research results after receiving the Ho-Am Prize.”

-Why do you think you came up from the bottom?

“I was a liberal arts student until high school. Then, during his first year of high school, he went on a radio trip and contracted tuberculosis, so he took a year off from school. With this as an opportunity, he decided that he wanted to heal patients himself, so he moved to the science department and went on to Chonbuk National University School of Medicine. However, due to the December 12 incident, he took another half year to a year off from school. In many ways, it was not easy for him to continue his studies. At this time, people around me encouraged me to experiment, so I started by chance, and I even won an award at a national medical school competition. At that time, I thought it would be a good idea to do research. He graduated first in medical school and went on to graduate school, where he worked so many jobs that there was nothing he didn’t do, from managing money to cleaning floors. “I remember conducting research in a situation where there was insufficient infrastructure.”

-Now you are called a scholar, but I can’t imagine that you had a difficult time.

“There was a time when I was in debt of up to 500 million won due to lack of research funds. I wonder how he got the nickname ‘debt guy’. In the past, when research results didn’t come out, I would blame myself and think a lot about why it didn’t come out. Now, I focus my mind by going to church, riding a bike, and walking. Sometimes, when I walk around KAIST, I meet a lot of similar people. Now, even when difficult times come, I just quietly do my job. Aren’t they conducting research with better equipment, reagents, and human resources than foreign countries while receiving taxpayer money? “There is no need to be negligent.”

-What is the driving force behind your continued research?

“I think I have a bit of an odd temperament. In research, there is a desire to cover only the core and important things. That’s why I often attend academic conferences and constantly analyze other people’s research. As you do so, the knowledge you have accumulated naturally comes to mind in complex ways, and ideas come to mind. “Continuing communication with young researchers and sharing stories about research is also very helpful.”

-Is it because of your quirkiness that you became a scientist instead of a doctor who makes a lot of money?

“When I was in medical school, everyone around me said I was a doctor, but I went to graduate school to do basic science research. This is also true of the fact that we entered the dementia field instead of cancer and vascular research, which we had been doing well. It seems like I’m boldly betting on what others haven’t done and what has potential among the paths not taken. As a researcher, this seems to be important in identifying the good and bad and determining the direction of research. “I think this can be a capability that sets me apart from others.”

-I heard that my son is also following the same path.

“I am not a medical scientist, but I am researching life science. When I look back on my life, I say it was difficult, but I think I lived it with pride and fun. So he actively supported his son’s choice.”

-How long do you plan to conduct research?

“When it comes to research, I always say I’m hungry. For the past year or two, all I can think about is cerebrospinal fluid when I go home. My greatest desire is to help people by making important discoveries and developing new drugs or treatments. I would like to receive good evaluations and continue research so that I can maintain research opportunities in the future. Also, isn’t research funding a national tax? Because of that, I want to continue researching steadily until I close my eyes.

I am currently a Distinguished Professor at KAIST, and I think that Distinguished Professors are professors who need special training. “IBS has a retirement age of 70, but KAIST said they will provide support so that you can work as a professor even after retirement age, as long as you want to.”

-What are your future goals in research?

“I do not aim for papers or awards. However, I think that what I have accumulated should be passed on to the next generation. Even now, we are creating team leaders in the lab and providing them with personal connections and research know-how. I also go to academic conferences and introduce other researchers. “I think it is especially important to communicate with domestic and foreign researchers and raise awareness of the institution and ourselves.”

A research team led by Ko Gyu-young, director of the Institute for Basic Science (IBS) Vascular Research Center, discovered that the cause of infants and young children’s vulnerability to meningitis is an immature meningeal immune barrier. The photo is the cover art of this paper and shows the blood vessels (yellow) within the ‘dura’, which is part of the meninges, and the macrophage MHCII (red), which is responsible for immunity. This photo could also be seen at the entrance of the research center./Institute for Basic Science (IBS)

◇Consistency is more important than speed

-Why did you move from POSTECH to KAIST?

“Professor Wookjun Yoo (Director of the Korea Academy of Science and Technology), who founded the KAIST Graduate School of Medical Sciences, said he needed researchers who were doctors, so I moved there. It wasn’t easy to make a decision, but Professor Yoo came to me 3 or 4 times to persuade me. In addition, POSTECH was located in a relatively remote location and there were few researchers in the biomedical field, so communication was not easy.”

-Voices from the scientific community calling for an increase in the number of medical scientists are growing.

“It’s a lot better than before. About 270 people have come forward so far, but the number is decreasing. Before, there were about 22 to 23 people, but now the number is around 10. There are two reasons for the decrease in the number of students: other universities have similar systems, and the military alternative service system has some room for improvement. I think there should be 50 people a year.

Recently, new drug blockbusters are developed by a single team from basic fields to clinical trials. Without this method, a global new drug cannot be developed. In Korea, these teams are all divided. Eventually, even medical staff, who are the end users of the drug, must participate in the development process. Looking more broadly, fund managers and health administrators are also needed. “If you don’t do that, development won’t be easy.”

-Four out of ten Nobel Prize winners in Physiology or Medicine are physician scientists. Will training physician scientists bring Nobel Prizes to the Korean scientific community?

“As the purpose of the Nobel Prize in Medicine is to help patients, people with medical insight will have an advantage. However, it is unfortunate that all the talented people are now focused on medical school. If you do scientific research, you can achieve great results. On the one hand, I think there is no difference between medical scientists and life scientists when it comes to winning the Nobel Prize. Engineers sometimes receive Nobel Prizes. “I think we need to strike a balance rather than investing in specific areas.”

-When will there be a Nobel Prize winner from Korea?

“I think it will come out. Personally, I see people like Park Nam-gyu, Hyun Taek-hwan, and Professor Kim Bit-nae-ri as candidates. In the end, I believe that if you build up what you have been doing well, opportunities will come. I think research that opens up new fields is important. Just because you didn’t get nominated for the Nobel Prize this year doesn’t mean you should be upset. The timing should be right. “Social phenomena and atmosphere cannot be ignored.”

-Would you like to say something to junior scientists?

“It’s been 40 years since I’ve done proper research, but I think there’s nothing left to do in the field of life sciences but to follow one path. You need to find a field that you are curious about, do the research you want to do, and make many small discoveries. If you build it up steadily, you will gain recognition among scientists. Scientists these days are anxious and want to produce results quickly, but this makes collaboration difficult. “It would be better to focus on gaining experience rather than speed.”

Ko Gyu-young, director of the IBS Vascular Research Center and KAIST Distinguished Professor

Bachelor of Medicine, Chonbuk National University College of Medicine, 1983

Master of Medicine, Chonbuk National University Graduate School, 1985

Doctor of Medicine, Chonbuk National University Graduate School, 1991

1995~2001 Assistant/Associate Professor, Chonbuk National University College of Medicine

2001~2003 Associate Professor, Department of Life Sciences, POSTECH

2003~present Distinguished Professor, KAIST Graduate School of Medical Sciences

2011 7th Kyung-Am Academic Award, Life Science Category

2012 5th Asan Medical Awards

2015-present: Director of the Vascular Research Group, Institute for Basic Science (IBS)

2018 28th Hoam Award, Medical Category

2020 2020 Science Journalism Awards