Lives of the fellows

Nicolas Bruce Myant

b.26 October 1917 d.17 January 2015
BA BM BCh Oxon(1943) BSc(1944) DM(1950) MRCP(1964) FRCP(1971)

Nicolas (‘Nick’) Bruce Myant was widely acknowledged as the doyen of lipid research in Britain. He had a lifelong passion for science, publishing his first paper whilst a 23-year-old undergraduate and his last, posthumously, in 2015.

Nick Myant was born in Cardiff of a Belgian father and English mother. He went to school at Blundell’s and then read medicine at Balliol College, Oxford, and University College Hospital (UCH), London.

During the first part of the Second World War he was house physician to Sir Thomas Lewis [Munk’s Roll, Vol.IV, p.531] at UCH. It was there he met his future wife, Audrey, also a doctor and they married in 1943. He served in India as an Army doctor between 1944 and 1946, and after demobilisation became a house physician to John McMichael [Munk’s Roll, Vol.IX, p.341] at Hammersmith Hospital. In 1948 he returned to UCH to evaluate the use of radioiodine to investigate the pathophysiology of the thyroid gland.

In 1953 he joined the Medical Research Council’s (MRC) experimental radiopathology unit at the Hammersmith, directed by George Popjack, who stimulated his interest in cholesterol. In 1962 he became a member of the external staff of the MRC at the Hammersmith and, together with Barry Lewis [Munk’s Roll, Vol.XII, web], set up the first lipid clinic in Britain. They also undertook a series of radio-labelled cholesterol turnover studies in patients with essential hypercholesterolaemia, later renamed familial hypercholesterolaemia (FH) (‘Studies in the metabolism of cholesterol in subjects with normal plasma cholesterol levels and in patients with essential hypercholesterolaemia.’ Clin Sci. 1967 Apr;32[2]:201-13).

Nick Myant’s interest in FH dated from 1963 when the seven-year-old daughter of the Iraqi ambassador to Britain was referred to him by a physician in Harley Street. At the time of her referral she had a serum cholesterol of 24 mmol/l and extensive cutaneous xanthomas. In retrospect she was probably the first FH homozygote to be diagnosed in Britain. Her hypercholesterolaemia was resistant to diet and drugs, so he and Barry Lewis undertook manual plasmapheresis on four consecutive occasions, which lowered her cholesterol but only temporarily, as did the ileal bypass, which she underwent subsequently (‘Ileal by-pass in the management of familial hypercholesterolaemia.’ Proc R Soc Med. 1967 Aug;60[8]: 746-8). She died from myocardial ischaemia a few months later, aged ten.

In 1970 Nick Myant concluded that over-synthesis rather than defective removal of cholesterol was the underlying abnormality in FH (‘The regulation of cholesterol metabolism as related to familial hypercholesterolaemia.’ Sci Basis Med Annu Rev. 1970: 230-59). However, he later accepted Joseph Goldstein and Michael Brown’s evidence that increased cholesterol synthesis was secondary to defective removal of cholesterol in FH, due to an inherited lack of LDL (low-density lipoprotein receptors). He greatly admired the Nobel prize-winning Dallas workers and they too thought highly of him. After his death 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 who worked with him. By the time he retired in 1983 his unit had made significant contributions to knowledge of the metabolic basis, genetic diagnosis and therapeutic management of FH, especially homozygotes (‘Plasma exchange in the management of homozygous familial hypercholesterolaemia.’ Lancet. 1975 May 31;1[7918]:1208-11). After his retirement from the MRC, he co-edited the journal Atherosclerosis for three years and then embarked on a second career, this time in molecular biology. After learning the basic technology in Oxford, he worked in the MRC lipoprotein team laboratory at the Hammersmith, where he focused on various aspects of familial defective apolipoprotein B (FDB), publishing more than a dozen papers on this disorder between 1991 and 1997.

Nick’s preeminent 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 until 2002, and subsequently at the annual meetings of HEART UK, the successor to the BHA. This eponymous lecture is a fitting tribute to a British clinical scientist who ranks alongside his American contemporaries of 20th century lipid research.

Nick was modest to a fault and his abilities were sometimes overlooked on this account. As a scientist he was scrupulously honest and objective, traits illustrated by a passage in the preface to his book The biology of cholesterol and related steroids (London, Heinemann Medical Books): ‘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 raison d’étre was summed up by his son Christopher in the oration he gave at his funeral. ‘He seemed quite unable to stop asking questions, to stop being curious about the why and the what in life, whether it was the biochemistry of the human body, the workings of an 18th century clock, where the name of an ancient manor house came from or how the Greeks rowed their galleys, or whether, at 87, he could make it back up to the Green Lake beside Kangchenjunga’s Zemu glacier.’ He was survived by Audrey, his wife for 72 years, their three children, eight grandchildren and seven great-grandchildren.

Gilbert Thompson

[Myant NB. ‘Plasma cholesterol as a cause of coronary heart disease (CHD); the cholesterol-CHD hypothesis’. In Reynolds LA, Tansey EM (eds) Wellcome witnesses to twentieth century medicine, vol.27. ‘Cholesterol, atherosclerosis and coronary disease in the UK, 1950-2000’ London, the Wellcome Trust Centre for the History of Medicine at UCL, 2006; ‘In Memoriam: Nick Myant (1917-2015).’ J Lipid Res. 2015 Jun; 56[6]: 1081-84 www.ncbi.nlm.nih.gov/pmc/articles/PMC4442866/ – accessed 30 August 2016; ‘Obituary of Dr N B Myant.’ Atherosclerosis. 2015;240:437-8]

(Volume XII, page web)

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