Nyall London is working to understand whether proteins Arf6 and ARNO play a role in inflammatory diseases of the sinus epithelium.
Nyall London performed his first medical research as an undergraduate at Brigham Young University primarily to strengthen his applications to medical school. But in the course of this seemingly obligatory work, he made a surprise finding: he liked it. His passion for research resulted in him not just pursuing an M.D. but also a Ph.D. concurrently from the University of Utah.
“I wanted to make a difference not only in the patients I saw clinically but in those I’d never meet,” he says. It’s a passion that London is still pursuing as a third-year resident at Johns Hopkins.
While he was still at the University of Utah, London’s work, under the mentorship of cardiologist Dean Li, focused on proteins known as Arf6 and ARNO. These proteins, present in the cells that line blood vessels, cavities, and surfaces throughout the body, play a major role in allowing these cells to gap and let inflammationproducing chemicals and cells into the surrounding tissues. While this type of response is necessary and critical for fighting infections, it’s not regulated well in a variety of diseases, leading to unwanted and runaway inflammatory effects when an infection isn’t present.
As an intern at Johns Hopkins, and already intrigued by the field of otolaryngology–head and neck surgery, London wondered whether he might take his research in another direction: to determine whether these proteins act in the sinus epithelium and if they play a role in inflammatory diseases there, such as chronic rhinosinusitis (CRS).
Passionate about pursuing this line of research, London reached out to Andrew Lane
, director of the rhinology and sinus surgery division and a physician-researcher who has made CRS a focal point of his own clinic and lab. Though Lane had pursued many different avenues to better understand CRS and eventually improve the treatment of his patients, he had not explored the role of barrier leakiness.
Lane invited London to join his lab, where London was soon designing experiments on patient tissue samples and animal models to determine whether the Arf6-ARNO pathway was present in the nasal and sinus epithelium and whether it might play a role in CRS. To fund this research, Lane and London wrote two grants—one to the American Academy of Otolaryngology and the other to the National
Institutes of Health—and had both funded.
“It took an amazing and unusual amount of initiative for a busy resident to do that,” Lane says. “He is the model of a future star in academic otolaryngology.”
London continues to pursue this area of research while seeing patients in the clinic, building his career as a physician-scientist.
“This is the culmination,” he says, “of what I idealized things to be like when I decided to do an M.D./Ph.D.”