July 2024
Eric Felner received his Bachelor of Chemical Engineering at Georgia Tech, but shortly prior to graduation, he decided to pivot to medical school. To avoid following in his father’s footsteps as a physician, along with his interest in math and science, he initially chose to become an engineer. Despite his love for the curriculum at Georgia Tech, he did not want to live in a remote area of the country, with little human contact, along with working in a chemical plant. That was the description of the job that he would be applying for as a chemical engineering graduate in 1990. At Georgia Tech, with his undergraduate research focusing on fluid flow through prosthetic heart valves, he sought out his father, a cardiologist, and Associate Dean for clinical education at Emory University School of Medicine, for suggestions regarding a career in medicine. Dr. Eric Felner was able to shadow cardiology fellows at Grady Hospital and the frequent human interaction along with the idea of helping those in need, helped sway him to a career in medicine. Despite leaving his comfort zone of working in a math and science environment, he remained hopeful that he could use those skills in some fashion as a physician.
From his start in cardiovascular bench research as an undergraduate in Dr. Ajit Yoganathan’s lab at Georgia Tech in 1987, Dr. Felner, now a pediatric endocrinologist for 24 years, has had the opportunity to study type 1 diabetes, congenital adrenal hyperplasia (CAH), Prader-Willi syndrome, and many areas of biomedical technology at the molecular, pre-clinical, and clinical research level.
His medical research career took off during his pediatric fellowship, under the mentorship of Dr. Perrin White at the University of Texas Southwestern Medical Center. Dr. White was and still is a renowned adrenal gland researcher who cloned the genes responsible for CAH. Despite Dr. White’s expertise in CAH and adrenal gland disorders, Dr. Felner wanted to focus on type 1 diabetes (T1D). Dr. Felner was diagnosed with T1D in 1978, and at the start of his fellowship, was interested in discovering improvements for the condition. Dr. White agreed to mentor Dr. Felner in T1D, however, he wanted Dr. Felner to focus on molecular mechanisms, specifically genetic differences between those diagnosed with T1D at a very early age (< 4-years) versus those diagnosed at the older end (> 12-years). Nearly seven years after collecting blood samples from and testing of more than 200 children (and their parents) with T1D, Dr. Felner and his team discovered significant molecular differences between the groups at the CTLA-4 marker, and published the work in Pediatric Diabetes in 2005. After taking his first faculty position at Tulane University in 2000, and serving as the Chief of the division from 2001 – 2003, Dr. Felner arrived at Emory University to have a greater impact in teaching and research. Shortly after Dr. Felner arrived at Emory University, he led clinical trials designed to prevent and improve T1D. He developed a collegial relationship with renowned drug delivery expert, Dr. Mark Prausnitz at Georgia Tech, and since 2006, they have worked together on administering insulin and collecting glucose samples from patients with T1D using tiny needles (microneedles) that were painless compared to conventional methods. In 2008, Dr. Felner led his first clinical trial designed to prevent the autoimmune destruction of insulin-producing cells in patients with T1D using an immunomodulating agent. Since 2008, Dr. Felner has studied many different immunomodulators (e.g., ATG, Imatinib, Gleevac, Golimumab, Alpha-i-Antitrypsin, etc.) with hopes of halting the progression of T1D. He is currently the Emory site investigator for the DESIGNATE trial, sponsored by the Immune Tolerance Network of the NIH. He is evaluating the effect Siplizumab has on patients recently diagnosed with T1D and determine if their insulin-producing cells can avoid autoimmune destruction.
In addition to his diabetes research, Dr. Felner is also studying patients with CAH due to 21-hydroxylase deficiency. In this form of CAH (accounting for 95% of CAH), individuals are born missing or having significantly reduced function of the 21-hydroxylase enzyme, resulting in an inability to produce an adequate amount of cortisol and in 75% of patients, an inadequate amount of aldosterone. To survive, individuals must produce and utilize both hormones. Through five different clinical trials (two different drugs in children and adults) over the past three years, Dr. Felner has led clinical research at Emory for two corticotropin-releasing-factor 1 (CRF-1) antagonists, Crinecerfont and Tildacerfont, with the goal of reducing the amount of hydrocortisone these patients require. Using a CRF-1 antagonist to help lower the dose of hydrocortisone, yet still provides enough cortisol to meet the body’s cortisol demands, reduces the risk these patients have in developing serious long-term complications (e.g., osteoporosis, skin atrophy, and weight gain) due to the high dose of cortisol patients with CAH take.
Despite his jump from engineering to medicine nearly 35 years ago, Dr. Felner claims that he still operates like an engineer, as efficiency in caring for patients is important as is understanding and developing novel ways to care for patients. He says, “I think about how to take care of patients the way an engineer would. I think about systems and efficiency.” Even though it is not related to endocrinology, he is currently running a biomedical study using STAR particles. These micro-size particles are laser cut from titanium sheets, sterilized, mixed with an inert topical agent, and rubbed on the skin to open micro-sized holes, allowing a topical agent to enter the skin more rapidly and more effectively. Dr. Felner and his engineering research team recently submitted their work to a peer-reviewed journal on the effect these STAR particles have on improving topical lidocaine delivery and reducing pain that children experience when undergoing a subcutaneous injection or placement of an intravenous catheter.
The variety of research Dr. Felner is involved in makes him well-rounded and eager to help improve the pediatric community. He says, “I like helping people. It’s a cliché answer, but I know what the problem is for the patients that are seeing me, and at least I can give them advice on different options for treating their medical condition.”