Enid Neptune: Courage and Delight in MedicineApril 4, 2017 at 1:53 pm
Enid Neptune, MD, credits much of her success as a physician-scientist to a trait her parents prized: courage. It’s what propelled her on an educational career that took her to some of the most competitive educational institutions in the world: Princeton University, Harvard Medical School, University of California, San Francisco; and Johns Hopkins University.
It is as a researcher that Dr. Neptune, now an associate professor of medicine at Johns Hopkins University, perhaps demonstrates best her parents’ wisdom.
A New Paradigm for Marfans Therapy
When she moved from UCSF to Johns Hopkins, she applied her research interest in G protein-coupled receptors and cell signaling to Marfan syndrome. Being a pulmonologist interested in the rare disorder was, itself, unusual. Only about 15 percent of people with Marfans experience lung problems, she says, “and no one ever thought the lung manifestations were that relevant.”
Dr. Neptune’s research on the role that dysregulation of transforming growth factor (TGF) beta plays in Marfans revealed a pathway that no one had associated with the disease—and not just in the lungs, but in the heart and other organs more often affected by the disease.
“The whole sense of Marfan Syndrome shifted, and the types of therapeutic interventions considered promising were altered,” she explains. TGF beta is now the central target protein for Marfans and related disorders such as Loeys-Dietz Syndrome and Familial Thoracic Aortic Aneurysm Disorders.
As a member of the National Marfan Foundation’s Professional Advisory Board, she spearheaded the expanding focus on Marfan lung diseases and created the Marfan Sleep Initiative to examine the high prevalence of sleep apnea among patients with the disease.
Thinking Differently About Hard Problems
“Enid is not intimidated by dogma or current opinion,” says Dean Sheppard, MD, director of UCSF’s Lung Biology Research Center and chief of pulmonary, critical care, allergy and sleep. “She thinks differently and is willing to work on hard problems.”
Dr. Neptune’s research has also focused on COPD, a disease that she says is particularly daunting because “it’s not just one disease.” Dr. Neptune forged the idea that single gene disorders can reveal non-intuitive pathways that contribute to such complex lung diseases as COPD. In this way, she has extended her findings in Marfans to COPD. Several years ago, her lab also demonstrated that hepatocyte growth factor could regrow alveoli in mice, opening a potential new therapeutic strategy for a disease that “people really had not thought was treatable,” Dr. Sheppard says.
Much of Dr. Neptune’s research has also focused on lung injury early in life, its effects on adult lung function, and whether preventative measures might, for instance, thwart the development of COPD in someone who smoked. For this work, she has teamed up with Sharon Ann McGrath-Morrow, MD, a pediatric pulmonologist at Hopkins.
Their collaboration has resulted in a dozen journal articles. “Enid is a very hard worker and always up to date on the most recent research,” Dr. McGrath-Morrow says, noting that her colleague’s personal qualities may play an even bigger role in their successful collaboration. “Enid is easy to work with. She is so outgoing and friendly and able to bring out the best in people.”
Dr. Neptune now leads the Translational Research Program in COPD at Hopkins to break down the silos that separate researchers, basic scientists, and clinicians and “generate ideas that can fuel the the next generation of therapeutic interventions sorely needed for this disease,” she says. She also hopes to attract younger pulmonologists, as well as researchers outside respiratory medicine, to a disease whose complexity can be intimidating.
Scientific Persistence Begins in the Clinical Heart
Dr. Neptune credits her persistence as a researcher—she currently has two RO1 grants; grants from the Maryland Stem Cell Fund, American Lung Association, and March of Dimes; and a Hopkins Innovation Award—to the passion she feels caring for patients. In her ATS 2014 Diversity Forum address, she offered this advice to would-be researchers: “Find a patient population whose clinical challenges resonate with your clinical heart.”
Over the years, many patients have touched Dr. Neptune’s heart: people with Marfans, gay men coping with AIDS, and patients suffering from COPD. She seems particularly drawn to patients who battle social stigma along with disease.
She finds defending patients socially and culturally deeply humanizing, and, as an African American physician, she feels compelled to point out the inequalities in our health care system, particularly as they affect people of color.
Physician and Advocate
Dr. Neptune explains, noting her involvement with the ATS Tobacco Action Committee, “Many people think tobacco addiction isn’t a problem anymore, but the reality is that smoking has shifted to the populations that are most in need of good medical care—those who are poor, those in the military, the mentally ill, members of LGBT community, and people of color—but are increasingly un- or under-insured.”
Connecting her research interests and activism with her patients has not only made her a more empathetic physician, Dr. Neptune says, it has given her career “delight.”
Despite a busy professional life, Dr. Neptune says that she also finds delight in family life, modern art, opera, and yoga.