Breaking the Deadlock in Pulmonary Fibrosis Diagnosis and Treatment: Professor Su Jin’s Translational Research Pathway and Anti-“Involution” Strategy

Su Jin—Distinguished Researcher at Guangzhou Laboratory, Professor at the State Key Laboratory of Respiratory Disease, Guangzhou Medical University, Chair of the Committee on Integrated Diagnosis and Treatment of Fibrosis under the Guangdong Association of Respiration and Health. He holds a Ph.D. in Biochemistry and Molecular Biology from the Fourth Military Medical University and was fully funded by the China Scholarship Council for graduate studies at the La Jolla Institute for Allergy and Immunology in the United States. He has long been dedicated to research on innovative diagnostic and therapeutic technologies related to organ fibrosis.

Therefore, Professor Su Jin shifted his research focus to a more critical area—pulmonary fibrosis. To crack this “cancer that is not cancer,” it is first necessary to clarify its essential nature and the diagnostic and therapeutic challenges associated with it.

Pulmonary fibrosis is a chronic, progressive disease characterized primarily by scarring and fibrosis of lung tissue. Its essence lies in the replacement of normal lung architecture with abnormal fibrous tissue (similar to "scar tissue"), leading to gradual decline in lung function, impaired gas exchange, and ultimately severe symptoms such as dyspnea.

The causes of pulmonary fibrosis are complex and diverse, primarily categorized into the following groups:

• Autoimmune diseases: such as rheumatoid arthritis, systemic sclerosis, etc.

• Drug Toxicity: Some antineoplastic agents can induce interstitial pneumonia and may lead to pulmonary fibrosis.

• Organ Transplant Rejection: Taking hematopoietic stem cell transplantation as an example, graft-versus-host disease (GVHD), a common postoperative complication, can readily progress to pulmonary fibrosis when it involves the lungs.

• Idiopathic Pulmonary Fibrosis: The etiology is unknown, but it is highly age-related, with a significantly increased incidence in the elderly population.

Despite differing etiologies, the clinical management of pulmonary fibrosis faces two core dilemmas that result in suboptimal therapeutic outcomes. The first is the prevalent delay in diagnosis. Current clinical diagnostics rely primarily on pulmonary function tests or CT imaging, which can only detect established fibrotic lesions. By this stage, the optimal window for pharmacological intervention has often been missed. Even with potent medications, it is difficult to reverse established pathological damage. The second challenge is significant lesion heterogeneity, which hinders precise pharmacological intervention. Within the same patient’s lungs, the severity of lesions may vary across different regions; some areas may already be sclerotic, while others remain in an early, active phase. However, existing targeted therapies mostly address a single pathological mechanism and are subject to compensatory mechanisms, making it difficult to effectively cover and intervene in lesions at varying stages.

These critical constraints underscore the urgent need for early diagnosis and precision intervention in the field of pulmonary fibrosis.

In response to these two major challenges, Professor Su Jin’s team embarked on an eight-year specialized research program focused on pulmonary fibrosis. Their core objective was to secure a critical window for clinical intervention by precisely monitoring the initiation and progression of fibrosis in the early stages of the disease.

What makes this study unique is that it transforms the organ-specific nature of pulmonary fibrosis into a research advantage. Compared to organs such as the kidneys, obtaining research samples for pulmonary fibrosis is less challenging. For instance, in kidney transplantation, the diseased native kidneys are typically not removed; whereas in lung transplantation, the patient’s original fibrotic lungs are completely explanted, providing valuable human lung tissue sections for research.

More importantly, the fibrotic processes in different organs share numerous commonalities in their pathological mechanisms. Therefore, research advancements in pulmonary fibrosis can provide valuable references for the study and treatment of fibrosis in other organs (such as the liver and kidneys), creating a cross-organ spillover effect.

Guided by this clear research framework, Professor Su Jin’s team has established an innovative technical platform: a synergistic diagnostic approach combining “biomarker detection + molecular imaging.”

The core logic of this strategy is to first determine the nature of the disease and then localize it. Initially, early screening using high-sensitivity blood biomarker tests captures early repair signals at the onset of fibrosis, thereby identifying high-risk populations from the general public with needle-in-a-haystack precision. Subsequently, PET-CT scanning is employed for precise localization in these high-risk individuals. By leveraging specific molecular probes that accurately recognize and bind to pathological tissue targets, in situ "molecular imaging" is achieved, thus clarifying the exact location, spatial distribution, and metabolic activity of pulmonary fibrosis lesions.

This integrated technological solution successfully addresses the pain points of traditional diagnostics. Although conventional blood tests can reflect the concentration of protein biomarkers released into the bloodstream, they are unable to localize in situ lesions and lack the capability for dynamic monitoring. In contrast, PET-CT leverages molecular imaging to convert invisible molecular activities into imaging signals, thereby enabling precise localization and dynamic monitoring of fibrotic lesions.

Notably, regardless of whether small-molecule drugs, antibody-based therapeutics, or cell therapies are employed, effective intervention in pulmonary fibrosis must address a primary challenge: the “precise delivery” of drugs. This entails not merely delivering the drug to the affected organ, but also ensuring its penetration into the lesion core and targeting sites that are in an active pathological state.

Taking cell therapy for solid tumors as an example, activated fibroblasts in the tumor microenvironment secrete a dense collagenous matrix, forming a physical barrier. Even potent CAR-T cells may become entrapped by this “barrier,” struggling to penetrate it. Cell therapy for pulmonary fibrosis likewise faces such “microenvironmental barrier” challenges.

Professor Su Jin’s team has developed this innovative solution specifically to address this challenge. By leveraging PET-CT for precise localization, clinicians can monitor lesion activity in real time, predict whether drugs or cells will successfully reach the target site, and assess whether the expected molecular-level effects have been achieved. This provides a solid foundation for subsequent treatment, shifting interventions away from reliance on vague subjective sensations or delayed pulmonary function tests toward precise, molecular-level evaluation.

Currently, the radiopharmaceutical products developed by Professor Su Jin’s team are poised to enter the Investigator-Initiated Trial (IIT) phase. Compared with traditional drugs, radiopharmaceuticals offer the advantages of low dosage and high sensitivity, requiring only 1% of the dose needed for conventional medications. This significantly simplifies the prerequisites for clinical research and accelerates the translation of findings into clinical practice.

From scientific breakthroughs to clinical translation and commercial implementation, the practice of Professor Su Jin’s team offers a replicable pathway for research groups transitioning from technology to industry, with its core lying in a commercialization mindset anchored by “clinical needs as the anchor and original technologies as the foundation.”

According to Professor Su Jin, clarifying the fundamental differences between scientific research and industry is the primary prerequisite for technology translation. The core of scientific research is “proof of concept,” focusing on addressing whether a technology is feasible. For instance, in animal experiments, even if probe labeling efficiency succeeds only three times, it is sufficient to support the conclusions of a paper. However, the core of product development is “clinical adaptation,” which must overcome bottlenecks in stability and reproducibility. In clinical trials, the coupling efficiency of radionuclide labeling with probe precursors must be consistently maintained at 90%–95% to ensure consistent performance with each use and mitigate clinical risks.

This clear understanding sets the standard for technology translation: the scientific research phase focuses on breaking through technological blind spots, while the research and development phase focuses on solving practical clinical problems. The two are closely interlinked, with well-defined objectives.

Furthermore, the technology transfer efforts of Professor Su Jin’s team are not confined to their initial direction; instead, they adopt a strategy of leveraging core advancements to drive broader applications, exploring the expansion of single-target therapies for pulmonary fibrosis into multiple indications. Simultaneously, by strategically securing patent portfolios, they maintain initiative and control. This approach offers valuable lessons for research teams seeking to mitigate the risk of being constrained by critical technological bottlenecks.

In her discussions with physicians specializing in amyotrophic lateral sclerosis (ALS), Professor Su Jin observed that neurological research has predominantly focused on anti-inflammatory mechanisms or genetic mutations, largely overlooking the potential role of “fibrosis.” In her view, fibrosis is theoretically not organ-specific; the core pathological logic underlying fibrosis resulting from chronic injury should be highly similar across any organ. Through bioinformatics analysis of international neurodegenerative disease data conducted by her team’s experts, it was revealed that fibrosis markers are highly expressed in both Alzheimer’s disease (AD) and ALS. Furthermore, review articles published since 2021 have already highlighted the pathological features of “neurofibrosis” in AD and ALS.

In light of this, Professor Su Jin’s team applied a pulmonary fibrosis PET probe to imaging in animal models of Alzheimer’s disease (AD) and amyotrophic lateral sclerosis (ALS). They found significant uptake of the probe in cognitive brain regions affected by AD, as well as in the motor cortex and spinal cord areas controlling movement in ALS (commonly known as “Lou Gehrig’s disease”). Furthermore, by integrating bioinformatics analysis with validation using clinical blood samples, they confirmed the correlation between blood biomarkers and pathological lesions.

To address the vulnerability of early-stage domestic biopharmaceutical “fast-follow” strategies to foreign patent restrictions, the team has converted cross-validated original targets into intellectual property. They have expanded the application of a target originally developed for pulmonary fibrosis to Alzheimer’s disease (AD) and amyotrophic lateral sclerosis (ALS), while simultaneously pursuing international patent applications in the United States, Europe, and Japan, thereby establishing a competitive moat around the use of these targets in new indications.

“Even if the current product is not optimal, patent protection buys time for technological optimization. If other teams wish to apply this target to indications covered by the patent, they must obtain authorization, thereby avoiding homogeneous competition.”

In 2019, Professor Su Jin founded Phicell Biosciences, with the core mission of addressing the critical challenge that university technologies struggle to be implemented in clinical settings. Its positioning and launch strategy were highly pragmatic. Professor Su believes that while universities can complete proof-of-concept for scientific research, they lack the capability for stable product development. They can only rely on on-campus researchers to address front-end technical issues, failing to achieve scalable and standardized production from the laboratory to the clinic. In contrast, entrepreneurial platforms can take over the latter stage of technology transfer, bridging the gap between scientific research and clinical application.

Feichuang Bio was founded with a focus on the diagnosis of organ fibrosis. Its core philosophy stems from Academician Zhong Nanshan’s assertion that “without solving diagnostic challenges, treatment remains an empty promise.” Consequently, the team prioritized breakthroughs in molecular diagnostics to develop early screening tools for fibrotic diseases, thereby providing a basis for precise patient selection and therapeutic efficacy evaluation in subsequent treatments. This approach also helped mitigate risks during the early stages of the startup.

The company has currently laid out two product pipelines and one supporting business line. The product pipelines are original-target PET diagnostics and blood test kits. The original-target PET diagnostics cover areas such as pulmonary fibrosis, Alzheimer’s disease (AD), amyotrophic lateral sclerosis (ALS), and organ transplant rejection; the probe precursors have been completed, and animal imaging studies are underway. Methodological optimization of the blood test kits has been completed, with some already in clinical use; currently, collaborations are primarily conducted through the Laboratory Developed Tests (LDT) model with institutions or hospitals possessing medical testing qualifications. In addition, for the nuclear medicine distribution business, the company plans to select positron-emitting nuclides with a 12-hour half-life and achieve cross-regional coverage within two days via air transport, thereby breaking through the 100-kilometer delivery limitation of local nuclear medicine “milk-run” distribution models.

Unlike the industry norm of “assembling star-studded teams and racing to secure financing,” Su Jin’s team prioritizes “complementary skills and shared vision” in its team composition, aligning with the demands of original research from “zero to one.” On the technical front, bioinformatics experts are responsible for building a global database of fibrotic diseases and validating target specificity and clinical value, while a core nuclear chemistry team—comprising three PhD candidates and one postdoctoral researcher—focuses on translating “targets into probes.” On the operational side, the partners bring clinical medical backgrounds and over 20 years of management experience in the biopharmaceutical industry.

From the perspective of Professor Su Jin and his team, the success of translating scientific research into practical applications relies on a collaborative division of labor between the technical and operational sides. In the early stages, R&D personnel produce original achievements, while in the later stages, the commercialization team takes charge of the entire process—from further development, fundraising, and clinical trials to market launch—thereby compensating for researchers’ shortcomings in business thinking and capabilities.

When discussing the core bottlenecks in scientific research and industrial innovation during the interview, Professor Su Jin repeatedly emphasized the importance of “anti-involution.” She pointed out that the current involution in the scientific research field is not merely an intensification of competition, but rather a resource drain dominated by “low-level repetition”: many teams flock to known hot tracks (such as the mere dozen or so recognized targets in the field of radiopharmaceuticals), blindly conducting “me-too” or “me-better” style research. This approach neither breaks through core technological barriers nor addresses actual clinical pain points. The direct consequence of this involution is that substantial social capital, scientific manpower, and equipment resources are consumed in repetitive exploration, crowding out resources originally available for “zero-to-one” breakthroughs. This not only makes it difficult to produce genuine innovative outcomes but also slows down the pace of technological iteration across the entire field, ultimately offering no benefit to the sustainable development of the industry or to China’s competitiveness in biomedical innovation.

In Professor Su Jin’s view, the key pathway to escaping the “involution” of scientific research lies in firmly anchoring the deep integration of “source innovation” with “clinical needs.” Innovation must not discuss technology in isolation from clinical reality; instead, it is essential to first precisely identify the core unmet needs in clinical practice. Using these genuine needs as a starting point, researchers should pursue full-chain innovation ranging from “original target discovery” to “technical implementation and validation,” rather than “crowding onto a single-log bridge” in existing competitive tracks. Guided by this logic, she led her team to avoid the trap of “homogeneous competition for nuclear medicine targets,” focusing instead on the early diagnosis of fibrosis-related diseases and expanding from pulmonary fibrosis to areas such as Alzheimer’s disease (AD) and amyotrophic lateral sclerosis (ALS). Through the development of original targets and technologies, the team not only avoided the drain of involution but also ensured that scientific achievements remained aligned with the core objective of “solving patients’ actual problems,” thereby truly achieving the unity of innovative value and clinical demand.

At the conclusion of the dialogue, Professor Su Jin also expressed her expectations for the future development of the radiopharmaceutical market and her team’s next steps. She noted that over the past two years, the biopharmaceutical industry was affected by a “winter,” with bottlenecks in critical areas such as radionuclide supply and radionuclide generators. However, as the industry environment gradually improves this year, China has achieved stable supply of positron-emitting radionuclides, and domestic breakthroughs have been made in the production of radionuclide generators. Coupled with the successive introduction of supportive policies for nuclear medicine at both national and local levels, the financing environment is also expected to recover.

The convergence of these favorable conditions not only lays the foundation for the team’s subsequent work but also creates a more conducive external environment for the sustained development of the entire radiopharmaceutical sector. The team plans to advance in phases: first, raising RMB 10–20 million to expand the scope of Investigator-Initiated Trials (IITs) and propel preclinical regulatory filings; if data meet the required benchmarks, it will then raise over RMB 100 million to build its own production facility. Upon obtaining production qualifications within an estimated three years, the company will distribute its products to nuclear medicine departments in hospitals across China, with future possibilities including licensing patents to radiopharmaceutical companies in developed countries such as the United States.

Guangdong Province is actively promoting the high-quality development of its nuclear medicine industry, positioning it as a key “industrial trump card.” Radiopharmaceuticals constitute a critical component of this sector. By 2030, Guangdong aims to significantly enhance independent innovation capabilities in nuclear medicine, achieve breakthroughs in a number of key technologies, establish several innovation platforms, ensure stable supply of commonly used medical isotopes, and advance a portfolio of radiopharmaceuticals and high-end nuclear medical equipment into or through clinical trials. Meanwhile, the province plans to cultivate three to five leading nuclear medicine enterprises with demonstrative and guiding roles nationwide, along with a cohort of specialized, refined, distinctive, and innovative (“SRDI”) enterprises, ultimately building a globally competitive nuclear medicine industrial cluster.

Shangjun Investment is also closely monitoring the development and innovation trends in this field. In particular, Guangdong Province’s strategic layout for nuclear medicine is systematic and comprehensive, covering the entire industry chain—from R&D innovation, infrastructure, isotope supply, and equipment manufacturing to spatial planning, talent development, and international cooperation. Its core objective is to enhance independent innovation capabilities, ensure supply chain stability, and ultimately build a globally competitive industrial cluster.

Therefore, in terms of industrial investment support, Shangjun Investment is also actively facilitating the deployment of relevant resources to support the development of the nuclear medicine industry through funding, talent, supply chain, and industrial space.