Nicolas (Nick) Bruce Myant DM, FRCP, widely acknowledged as the doyen of lipid research in Britain, died on January 17th aged 97. He had a lifelong passion for science, publishing his first paper [
[1]
] while a 23 year old undergraduate and his last in 2010 aged 93 [[2]
].Nick Myant was born in 1917 in Cardiff. He went to school in the West Country and then read Medicine at Balliol College Oxford and University College Hospital (UCH), London. During the Second World War he was house physician to Sir Thomas Lewis at UCH and post-war to Professor John McMichael at Hammersmith Hospital, serving in the army in the interim. In 1948 he was recruited by Eric Pochin at UCH to evaluate the use of radioiodine to investigate the pathophysiology of the thyroid gland and then in 1953 he joined the MRC Experimental Radiopathology Unit at the Hammersmith, which was directed by George Popjack. The latter stimulated his interest in cholesterol and after Popjack's departure in 1962 Nick became a member of the External Staff of the MRC at Hammersmith where he was joined by Barry Lewis. The following year they set up the first lipid clinic in Britain and conducted a series of radio-labelled cholesterol turnover studies in patients with so-called essential hypercholesterolaemia [
[3]
], later known as familial hypercholesterolaemia (FH).Nick's interest in FH dated from 1963 when a young homozygote was referred to him by a physician in Harley Street. Her father was the Iraqi Ambassador to Britain who subsequently became Prime Minister of Iraq until he was imprisoned by Saddam Hussein. At the time of her referral his 7 year old daughter had a cholesterol level of 24 mmol/l and extensive cutaneous xanthomas. Nick obtained permission from the MRC to perform a turnover study on her which demonstrated a markedly increased rate of cholesterol synthesis. Her hypercholesterolaemia was resistant to diet and drugs so he and Barry undertook manual plasmapheresis on 4 consecutive occasions [
[4]
], which lowered her cholesterol but only temporarily and led Nick to comment “This line of treatment was obviously useless.” Unfortunately his comment was equally applicable to the ileal bypass which she underwent subsequently [[5]
] and she died from myocardial ischaemia a few months later, aged 10.Summarising the results of the cholesterol turnover studies, Nick concluded in 1970 that the evidence suggested that over-synthesis rather than defective removal of cholesterol was the underlying abnormality in FH [
[6]
]. However, he accepted without demur Goldstein and Brown's evidence, published 4 years later, that defective removal of cholesterol due to a lack of LDL receptors was the cause of FH and that increased cholesterol synthesis was a secondary phenomenon; he greatly admired the Dallas duo and their Nobel Prize-winning research. Likewise they thought highly of Nick and after his death Michael Brown wrote “When we entered the field we found him to be one of a very small number of linear thinkers. The rest were running around in circles. We held him in the highest regard.”In 1969 Nick became Director of the MRC Lipid Metabolism Unit at Hammersmith Hospital, where he inspired a generation of lipid researchers and gained the respect and affection of all those who worked with him. These included Kostas Mitropoulos, Geoff Gibbons, Brian Knight, Anne Soutar, Leon Simons and the author of this piece. By the time Nick retired in 1983 his unit had made significant contributions towards a better understanding of the metabolic basis, genetic diagnosis and management of FH, especially homozygotes, including the introduction of therapeutic plasma exchange [
[7]
], the forerunner of lipoprotein apheresis.But Nick didn't really retire in 1983. From 1984 to 1987 he co-edited Atherosclerosis and then embarked on a second career, this time in molecular biology, under the tutorship of Carol Shoulders in Tito Baralle's lab in Oxford and Steve Humphries in Charing Cross. He then found a home in Anne Soutar and Brian Knight's laboratory in the MRC Lipoprotein Group at the Hammersmith, where he was loved and respected by all the scientists, young and old, that he encountered. There he and his research assistant John Gallagher focussed on various aspects of familial defective apoB (FDB), publishing more than a dozen papers on this topic between 1991 and 1997. His life-long interest in evolution lead to his final research paper, a review on the role of reelin and the apoE receptor 2 in the brain [
[2]
].Nick was modest to a fault and his abilities were sometimes overlooked by those who value political clout over intellectual nous. As a scientist he was scrupulously honest and objective, traits exemplified by a passage he wrote in the preface to his magnum opus The Biology of Cholesterol and Related Sterols [
[8]
]: “It seems to me that those engaged in the current (cholesterol) controversy should try to emulate Darwin … he kept a special note book for facts that went against his theory.”Nick's pre-eminent role in lipid research in Britain is commemorated by the Myant Lecture, which was inaugurated at the British Hyperlipidaemia Association's (BHA) annual scientific meeting in Oxford in 1989. It was given annually at BHA meetings thereafter until 2002, after which it became the main feature of the annual meetings of HEART UK, the current successor to the BHA. Many renowned lipidologists have been Myant Lecturers including Dan Steinberg, Joe Goldstein, Dick Havel and others (Table 1). This eponymous lecture is a fitting tribute to a British clinical scientist who ranks alongside those American pioneers of 20th century lipid research. It also perpetuates the memory of a unique colleague – a friendly, charming and unassuming man with wide interests, including art, horology and gardening, whose formidable intelligence was enlivened by a quirky sense of humour.
Table 1Myant Lecturers.
| British Hyperlipidaemia Association | HEART UK | ||
|---|---|---|---|
| 1989 | N. Miller | 2003 | J. Chapman |
| 1990 | D. Steinberg | 2004 | P. Barter |
| 1991 | A. Sniderman | 2005 | S. Haffner |
| 1992 | J. Goldstein | 2006 | R. Hegele |
| 1993 | S. Grundy | 2007 | J. Kastelein |
| 1994 | R. Havel | 2008 | C. Sirtori |
| 1995 | A. Gotto | 2009 | J. Shepherd |
| 1996 | R. Lawn | 2010 | P. Durrington |
| 1997 | G. Assmann | 2011 | E. Schaefer |
| 1998 | G. Thompson | 2012 | K. Frayn |
| 1999 | J. Breslow | 2013 | D. Marais |
| 2000 | B. Brewer | 2014 | A. von Eckardstein |
| 2001 | L. Chan | 2015 | S.E. Humphries |
| 2002 | F. Sacks | ||
References
- The influence of histamine on the absorption of sodium sulphate by the stomach.J. Physiol. 1940; 99: 156
- Reelin and apolipoprotein E receptor 2 in the embryonic and mature brain: effects of an evolutionary change in the apoER2 gene.Proc. Biol. Soc. 2010; 277: 345-351
- Studies in the metabolism of cholesterol in subjects with normal plasma cholesterol levels and in patients with essential hypercholesterolaemia.Clin. Sci. 1967; 32: 201-213
- Plasma cholesterol as a cause of coronary heart disease (CHD); the cholesterol-CHD hypothesis.in: Wellcome Witnesses to Twentieth Century Medicine. vol. 27. The Wellcome Trust, London2006: xxi-xxv
- Ileal bypass in the management of familial hypercholesterolaemia.Proc. R. Soc. Med. 1967; 60: 16-18
- The regulation of cholesterol metabolism as related to familial hypercholesterolaemia.Sci. Basis Med. Annu. Rev. 1970; : 230-259
- Plasma exchange in the management of homozygous familial hypercholesterolaemia.Lancet. 1975; 1: 1208-1211
- The Biology of Cholesterol and Related Steroids.William Heinemann Medical Books, London2006
00195-1&id=fx1.jpg){kind=link}