Dr. Yow-Pin Lim has received federal authorization to begin human clinical trials of a drug developed by his company to treat sepsis, the 10th-leading cause of death in the United States.

The Providence Journal Bob Thayer

EAST PROVIDENCE — The long journey that brought scientist Dr. Yow-Pin Lim to the frontiers of biomedicine began in his native Indonesia four decades ago, when a childhood fascination with American cowboy movies begot dreams of living in the land where they were made. After 11 years of medical studies in Germany, he arrived.

And now, an American citizen finally, Lim is utilizing two decades of research in developing a therapy that could save hundreds of thousands of lives annually.

This is not Hollywood, this place where we find Lim on a recent afternoon: a drab cinderblock building next to an empty lot where an old dump truck sits rusting. But it is here, in cramped confines made smaller still by an abundance of equipment, that Lim and his small staff are preparing for human trials of a promising new treatment for sepsis, the 10th-leading cause of death in the U.S.

“Sepsis is very, very tough,” Lim says. “It’s a major problem. It’s a medical need.”

It is, he explains, a response by a person’s immune system in which the entire body becomes inflamed –– leading, roughly half of the time, to multiple organ and system failure and death. The “trigger” for sepsis, Lim says, can be infection, toxins, or massive trauma resulting from severe injury –– a car accident or shooting, for example. Patients in hospital intensive-care units are among those particularly at risk.

The exact mechanism by which the immune system fails so disastrously during sepsis is not known, Lim says. Nor is it possible to predict who will survive –– or whether the sort of small wound that one person will easily tolerate can send another to the grave.

“You can have a paper cut –– a very, very harmless thing,” Lim says. “A paper cut can become infected. Some people heal and that’s it. But in other people, that can cause sepsis, meaning it goes to the bloodstream and the body’s reaction to that bacteria is overwhelming.”

The immune system, in essence, goes crazy. Lim uses a cinematic metaphor to describe what happens:

“The way I figure it is: There’s a fly in the room –– and then you grab a machine gun. In the end, it’s not the fly. The damage is done by the immune system.”

According to Lim, some 30 sepsis treatments have been developed over the last two decades but only one has been approved by the federal Food and Drug Administration –– and its efficacy is minimal. It’s better than nothing, barely.

Lim’s therapy holds sufficient promise that ProThera Biologics, the company he cofounded and now heads, has received more than $3 million in federal support and $600,000 in grants from Providence-based Slater Technology Fund. In laboratory mice, Lim said, his sepsis treatment has achieved 90 percent success.

“It’s incredible that we can save the animal 90 percent,” he says. A modest man of significant achievement, he becomes excited when discussing his life’s work.

He is not alone. The federal government has approved human testing: clinical trials, expected to begin next year. If the results confirm the promise, ProThera’s treatment could be widely available in five years, Lim estimates.

ONE OF FOUR children of parents of Chinese descent, Lim, 49, grew up in a small town in West Java, Indonesia. His father died when he was 2, leaving his shopkeeper mother to raise the children. He was about 10 years old when he discovered the subtitled American movies that played at a nearby cinema. He was smitten.

“I watched movies like crazy,” he says. “Too many movies!”

Hollywood Westerns were his favorites. The boy yearned for America.

“My dream was to come to the United States,” he says, “but it was just too expensive.”

The young Lim had another aspiration: becoming a doctor. “That was the only thing,” he says.

Four decades later, he cannot explain the origin of his calling; no relatives or friends were doctors, and, he says, “I was not particularly fond to see blood.”

Believing he was unlikely to earn a medical degree in his native country, Lim studied German in high school and was accepted at the Free University of Berlin, where he earned his M.D. and a doctoral degree. He supported himself by working nights and weekends in a hospital. He decided research, not medical practice, was for him.

Toward the end of his 11 years in Berlin, Lim met a visiting scientist: Douglas C. Hixson, prominent Rhode Island Hospital liver-cancer researcher. Lim’s thesis impressed Hixson. Lim applied for a one-year post-doctoral position with Hixson at Rhode Island Hospital and Hixson accepted him, in 1990.

One year became two and then three and more and Lim remained with Hixson. He was learning English –– in part by watching a popular TV series. The Cosby Show, he says. “That’s what’s so funny!”

Lim’s research led him to a complex molecule produced by the liver and found in the blood: Inter-Alpha Inhibitor Proteins, or IAIP. Lim discovered that levels of the molecule dropped when people began to become septic. Would replenishing it be therapeutic?

Experiments with mice demonstrated that it would. In 2001, Lim and Hixson co-founded ProThera, in hope of bringing IAIP therapy to the market. Last year, Lim, who along with Hixson is on the faculty of Brown’s Warren Alpert Medical School, left Rhode Island Hospital to work full-time at ProThera.

ProTHERA SEES a potential worldwide market of more than $15 billion for its sepsis treatment –– which, among other applications, Lim says, could be used to defend against biological weapons. Animal studies have shown IAIP combined with antibiotics to be an effective antidote to anthrax.

In this cinderblock building in East Providence, the city where Lim and his wife live, Lim and his staff are perfecting methods of extracting and purifying IAIP from blood –– methods that an outside manufacturer would use to produce the protein in safe and large quantities.

Meanwhile, plans proceed to begin clinical trials next year in conjunction with other scientists, including Dr. Steven M. Opal, a sepsis expert and director of Memorial Hospital of Rhode Island’s Infectious Disease Division. Lim has high hopes for the trials –– and for bringing IAIP to the market.

“We are very optimistic,” he says.

Four decades later, Hollywood has not lost its appeal to Lim, who became a U.S. citizen last year.

“I like all kind of movies,” he says. “My all-time favorites include The Sting, Breakfast at Tiffany’s and The Magnificent Seven.”

He’s even gone West.

“I have been to Hollywood to visit and see the movie factory,” he says, “but I have to say that I don’t embrace the ‘Hollywood lifestyle.’  ”

He was, however, delighted to be videotaped for this story.

“My first movie!” he said.

Lim’s company is at www.protherabiologics.com

gwmiller@projo.com