Interview with Akiko Iwasaki – Winner of the Else Kröner Fresenius Prize for Medical Research 2023

Else Kröner-Fresenius-Stiftung (EKFS) is honoring Akiko Iwasaki’s groundbreaking contributions in the area of “Diseases of worldwide significance” and acknowledging her research work on immune responses to viral infections with the prize endowed with 2.5 million euros.
Image Akiko Iwasaki

Dear Professor Iwasaki, congratulations on receiving the Else Kröner Fresenius Prize for Medical Research 2023. Part of your work focuses on post-acute infection syndromes (PAIS). Among others, they include long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). What kinds of research findings were you able to achieve in these areas?

I have been working with talented and dedicated collaborators to better understand the underlying pathobiology of long COVID. We examine deep immune phenotyping in people with long COVID, comparing it to those who recovered from COVID, and those who never had COVID and are healthy. After looking at thousands of different factors, we are seeing interesting differences in the immune signatures. For example, people with long COVID have lower levels of circulating cortisol, altered T and B cell responses, and reactivation of EBV. What we want to do is to expand this analysis to ME/CFS and understand what people with ME/CFS have in terms of their immune phenotypes, which tell us a lot about the history and story behind how they got there, and can help us better understand the underlying disease pathogenesis. Ultimately, we want to bring therapies that would help people with long COVID, ME/CFS and other post-acute infection syndromes.

The prize is endowed with 2.5 million euros. What will you use the prize money for?

We want to determine the underlying mechanisms of post-acute infection syndromes. We are considering several potential hypotheses, including persistent pathogens, autoimmunity, reactivation of herpesviruses, and inflammatory changes in tissue functions. Even if you clear the virus from the nose and throat, there may be a reservoir of virus somewhere in the body that continues to replicate and trigger chronic inflammation. We have begun a clinical trial to see if antiviral treatment can help alleviate long COVID. The second hypothesis is autoimmunity. There may be some link between autoimmunity that is triggered by a viral infection and long COVID. The third hypothesis is the reactivation of latent viruses. We see evidence of EBV reactivation in people with long COVID. Finally, we showed that even a mild COVID confined to the lung can result in long-term inflammation in the brain. By studying long COVID and ME/CFS together, we hope to understand common and distinct mechanisms of disease.

The foundation Else Kröner-Fresenius-Stiftung supports research projects, which include projects from up-and-coming scientists. What advice would you give to the “next generation in science”?

I have always been passionate about cultivating the next generations of scientists. As a society, if we want to ensure a more sustainable and healthier future, we must invest in basic science, and for that, we must invest in people who will carry out our future science. My advice to young scientists is to find the scientific area that really excites them and devote themselves fully to its pursuit. As with any career, but particularly science, it takes everything I have to begin to chip away at the mystery. In the long run, to be successful in anything, you have to enjoy it and enjoy yourself while doing it. 

What do you enjoy doing most in your leisure time?  

My time away from science is very precious to me. I enjoy most spending it with my family, whether it is going on a trip together or just enjoying a meal together at home. I love spending time with my two teenage daughters and learning from them about the world from their own perspectives. I love spending time with my husband. We enjoy discussing not just science, but everything else from politics to psychology. Whenever possible, I love visiting my parents and sister and her family in Japan. Even though I left Japan in my teens, it still forms the core of who I am. I am lucky to have another sister who lives in the U.S., whom I get to see at least once a year. Aside from that, I enjoy reading novels, watching movies, and doing yoga.    

A sincerely meant thank you for your time!