Prof. Mary Reilly is a consultant neurologist at the National Hospital for Neurology and Neurosurgery and a professor of clinical neurology, heading the division of clinical neurology in the Institute of Neurology of the University College London.

Her area of interest is peripheral neuropathies, in particular genetic neuropathies such as Charcot-Marie-Tooth disease and transthyretin (TTR) amyloidosis. During her career she served as the president of the International Peripheral Nerve Society and of the Association of British Neurologists. In our interview, she tells us about her career, her research projects and how COVID-19 changed her communication with neuropathy patients.

“Excitement for a particular field almost always comes down to an inspiring person”

Prof. Reilly went to medical school and performed her junior doctor training in neurology in her home country Ireland. “Back during my third year in medical school I had a brilliant lecturer in neuropharmacology who got me really interested in neurology,” she states. Later on, when she did her first clinical work at the hospital in Dublin, she felt inspired by the consultant Prof. Michael Hutchinson to follow a career in neurology. “Complex cases in neurology are part of the attraction,” she says with a smile. “I also love the fact that the field is very clinical-based. Examining a patient is still key in the diagnosis,” she adds. After her medical training in Ireland, Prof. Reilly moved to the National Hospital for Neurology and Neurosurgery in London to work on the genetics of hereditary neuropathies, which fuelled her excitement for the specialisation. “In the 90s, things were beginning to change in terms of what we were able to do genetically. From the very first gene being described in my area of research in 1991 to the whole genome being mapped in 2001, the explosion of knowledge enabled us to gain insight into diseases that were not possible before,” Prof. Reilly shares. “A number of things contributed to my interest in neurology, but I think — as also true in my case — the excitement for a particular field almost always comes down to an inspiring person,” she summarises.

“My projects cover the whole spectrum of research”

Besides her clinical position in the hospital, Prof. Reilly is heavily involved in various types of research projects. “My projects span from basic laboratory gene discovery to clinical trials, covering the whole spectrum of research possibilities,” she says. Her research covers the finding of new genetic causes, evaluation of biomarkers and the development of new therapies. “The research always starts and finishes with the patient,” she explains. “When I started in this field in 1991, 0% of patients with inherited neuropathies would get a genetic diagnosis. This percentage is 77 nowadays,” Prof. Reilly says. Patients with a suspected genetic condition are first subjected to a phenotype evaluation, then a workup of the heritage pattern in the family. “Then we would extract the DNA from blood samples and work out the involved gene in the laboratory,” Prof. Reilly elaborates on the typical workflow. “When I started, this step would take years. Now it can a few weeks,” she adds with a smile. Once she and her team find the causative gene of the disease, they try to find out how the gene causes the disease in that patient. “Our aim is to develop candidate therapies that we then bring to clinical trials,” she explains.

“We now have tools that we did not have before”

“There has been an explosion in what you can do genetic therapy-wise, particularly in the last five years. We now have tools that we did not have before,” Prof. Reilly says. Many of the new tools designed for gene therapy are disease agnostic, applying to all types of genetic diseases with minor modifications. “This fact makes it so much more attractive for companies to be interested in these rare diseases,” she explains. “The growth we see in this area in the pharmaceutical industry benefits our patients,” Prof. Reilly adds. Being involved in the development of new therapies has been a major part of Prof. Reilly’s professional career. “When you are able to use new therapies in patients, you have what we call back translation. Questions that arise from the treatment bring you back to the laboratory and then back to the patient. This process is actually one of the major attractions about being a clinical academic for me,” she reports. In her communication with patients about novel therapies, Prof. Reilly recently experienced some interesting positive changes. “Due to COVID, the general population knows about messenger RNA, antibodies and more. We are having different kinds of conversations with our patients now that they know the terminology,” she says.

“To make change happen, you have to take up leadership roles”

Prof. Reilly served as the president of the International Peripheral Nerve Society from 2015 to 2017. During her time as president, she tried to expand people’s interest in this area of neurology. “That was a fantastic experience, I really enjoyed that role. There are clinicians and scientists all around the world interested in the same topic,” she says. “It was a great opportunity to meet people and to put some initiatives in place,” she adds. In addition, she served as the president of the Association of British Neurologists from 2017 to 2019. “I was the first female president in an 83-year-old organisation. It was a very big honour for me to do that,” Prof. Reilly remembers smilingly. “This was a fantastic experience. I think in order to make change happen you have to take up leadership roles. In that case, I was able to put some things in place and set up some initiatives that have hopefully helped and still help British neurology,” she states.

“Neither women nor men do as well alone as they do together”

Prof. Reilly was never confronted with sexism in her professional life. “People talk about sexism as you rank higher in your career, for example about the fact that there are more men than women in certain senior positions. I think there are several reasons for that, but a lot of it probably has to do with lack of support early on in the women’s career,” Prof. Reilly shares. She mentions that mentoring programmes in neurology are already partly addressing this issue. “Things still have to change, but the UK is generally a very fair place to work,” she adds. She further believes that a big part of this debate stems from a societal issue. “We have to make sure that there are family-friendly systems in place. And society has to stop seeing family life as a women’s responsibility alone, it is a societal one. In general, I believe that neither women nor men do as well alone as they do together,” Prof. Reilly says. “I think there is still a lot to do but the issues are being addressed and the situation is improving, looking at the increasing numbers of women progressing in their career in science and medicine,” she concludes.