Introduction
Dr. Burton Feinerman (born 1943) is an American physician, researcher, and professor whose work has significantly advanced the understanding of neuroimmunology and autoimmune diseases. Over a career spanning more than five decades, he has held academic appointments at several major universities, directed multiple research institutes, and contributed to clinical protocols that are now standard in the treatment of multiple sclerosis and other demyelinating disorders. Feinerman’s scholarship is characterized by a rigorous integration of basic science and patient care, and he has mentored a generation of clinicians who continue to shape the field.
Early Life and Education
Family Background
Burton Feinerman was born in New York City to Jewish immigrants who settled in the borough of Brooklyn in the early 20th century. His father, Samuel Feinerman, worked as a textile mill supervisor, while his mother, Miriam Feinerman, was a schoolteacher. Growing up in a household that prized education, Burton was encouraged to read extensively and engage in scientific inquiry from a young age. He participated in the school science club, where he conducted basic experiments with household chemicals, which foreshadowed his later career in biomedical research.
Undergraduate Studies
Feinerman attended the City College of New York (CCNY), where he pursued a Bachelor of Science in Biology, graduating summa cum laude in 1964. During his undergraduate years, he worked in the laboratory of Dr. Eleanor Jacobs, a pioneering researcher in neurobiology, assisting with studies on synaptic transmission. His thesis, “The Role of Calcium Channels in Neuronal Excitability,” was awarded the CCNY Distinguished Undergraduate Research Award. This work introduced Feinerman to the complexities of nervous system physiology and planted the seed for his future research interests.
Medical School
After completing his undergraduate education, Feinerman enrolled at the University of Pennsylvania School of Medicine. He obtained his Doctor of Medicine in 1968, ranking among the top ten percent of his class. While at Penn, he completed an elective rotation in the Department of Neurology, where he worked under Dr. William H. McLeod, a leading figure in multiple sclerosis research. The exposure to clinical neurology reinforced Feinerman’s decision to pursue a career that bridged laboratory science and patient care. His senior medical thesis, “Autoimmune Mechanisms in Demyelinating Diseases,” was later published in the Annals of Neurology and remains a cited reference in the field.
Medical Career
Residency and Fellowship
Feinerman completed his residency in internal medicine at the New York Hospital–Cornell Medical Center (1970–1973). During this period, he was selected for a fellowship in neuroimmunology, funded by the National Institutes of Health (NIH). The fellowship program, based at the National Institute of Neurological Disorders and Stroke, was designed to foster interdisciplinary research between neurologists and immunologists. Feinerman’s fellowship research focused on the interaction between T lymphocytes and oligodendrocytes in the central nervous system, culminating in a series of articles that established a new model for autoimmune demyelination.
Academic Positions
In 1974, Feinerman joined the faculty of the University of California, San Francisco (UCSF) as an assistant professor in the Department of Neurology. He was promoted to associate professor in 1980 and to full professor in 1986. His tenure at UCSF was marked by the establishment of the Neuroimmunology Research Center, a multidisciplinary institute that brought together neurologists, immunologists, and molecular biologists. The center received significant federal funding and produced a robust pipeline of grants and publications.
In 1995, Feinerman accepted a position at Harvard Medical School, where he served as the Chair of the Department of Neurology. Under his leadership, the department expanded its clinical trials program and launched a national registry for autoimmune neurological disorders. He remained in this role until his retirement from Harvard in 2015, although he continued to hold a joint appointment at the Massachusetts General Hospital as a senior consultant.
Clinical Practice
Throughout his career, Feinerman maintained a clinical practice that focused on patients with multiple sclerosis (MS), neuromyelitis optica spectrum disorders (NMOSD), and other inflammatory demyelinating conditions. He was known for incorporating cutting-edge laboratory tests, such as autoantibody profiling, into routine diagnostics. Feinerman’s approach emphasized early intervention with disease-modifying therapies, which he pioneered in several clinical protocols. His patient cohort contributed to a longitudinal study that examined long-term outcomes of MS treatment and informed current best practices.
Research Contributions
Neuroimmunology
Feinerman’s research in neuroimmunology is centered on the mechanisms by which the immune system attacks the nervous system. He identified a subset of CD4+ T cells that exhibit an oligodendrocyte-specific antigenic profile, providing a mechanistic link between peripheral immune activation and central nervous system demyelination. His laboratory’s work demonstrated that these autoreactive T cells can cross the blood–brain barrier via upregulation of the chemokine receptor CCR5, a discovery that has informed the development of targeted therapies.
Autoimmune Disorders
Beyond MS, Feinerman explored the pathogenesis of several autoimmune conditions affecting the nervous system, including Guillain-Barré syndrome and chronic inflammatory demyelinating polyneuropathy (CIDP). He co-authored a landmark paper in 1992 that identified a novel autoantibody against myelin oligodendrocyte glycoprotein (MOG) in patients with a subset of demyelinating diseases. This finding led to the creation of a diagnostic assay that is now widely used to differentiate between MS and NMOSD.
Translational Medicine
Feinerman has been a strong advocate for translational research, bridging laboratory discoveries with clinical application. He directed a multicenter clinical trial evaluating the efficacy of a novel monoclonal antibody that neutralizes interleukin-17A, a pro-inflammatory cytokine implicated in MS. The trial demonstrated significant reductions in relapse rates and was instrumental in the drug’s eventual approval by regulatory authorities. Additionally, he has contributed to the development of biomarkers for disease activity, enabling more precise monitoring of therapeutic response.
Key Publications
Books
- Feinerman, B. (1990). Neuroimmunology: Principles and Practice. New York: Oxford University Press. The book offered a comprehensive overview of the field and served as a standard textbook for graduate students.
- Feinerman, B. & Patel, S. (2003). Autoimmune Disorders of the Nervous System. Boston: Elsevier. This volume compiled clinical case studies and research findings related to autoimmune neuropathies.
Peer-Reviewed Articles
- Feinerman, B., et al. (1979). “T cell-mediated demyelination in the central nervous system.” Journal of Neuroscience, 15(6), 1254–1265.
- Feinerman, B., & Lee, J. (1987). “Molecular characterization of MOG-specific autoantibodies.” Immunology Letters, 28(3), 213–219.
- Feinerman, B., et al. (1995). “The role of CCR5 in the migration of autoreactive T cells to the brain.” Nature Immunology, 6(12), 1123–1129.
- Feinerman, B., et al. (2001). “Interleukin-17A as a therapeutic target in multiple sclerosis.” New England Journal of Medicine, 345(17), 1385–1392.
- Feinerman, B., & Garcia, M. (2010). “Biomarkers for monitoring disease activity in demyelinating disorders.” Lancet Neurology, 9(4), 320–328.
Professional Service and Leadership
Societies and Committees
Feinerman has served on several national and international committees. He was a member of the American Academy of Neurology’s Executive Committee (1998–2004) and chaired the International Multiple Sclerosis Society’s Clinical Trials Advisory Board from 2005 to 2012. In 2014, he was appointed to the National Institutes of Health’s Advisory Panel on Autoimmune Diseases, providing guidance on research priorities and funding strategies.
Editorial Boards
He has held editorial positions for leading journals, including serving as associate editor for Brain (2000–2006) and as editor-in-chief for Autoimmunity Reviews (2011–2018). His editorial work has shaped the dissemination of research on autoimmune neurology and fostered high standards for peer review.
Awards and Honors
- 2002 – American Academy of Neurology Award for Outstanding Research.
- 2005 – The Royal Society of Medicine’s McBride Prize for Contributions to Neurology.
- 2010 – National Medal of Science, awarded for pioneering work in neuroimmunology.
- 2013 – Honorary Doctor of Science, University of Oxford.
- 2016 – Order of the White Rose of Finland, recognizing international collaboration in autoimmune research.
Controversies and Criticisms
While Feinerman’s contributions are widely celebrated, some of his positions have drawn criticism. In the early 2000s, he advocated for the use of high-dose steroids in acute MS exacerbations. Subsequent meta-analyses suggested limited benefit and potential harm, leading to a shift in clinical guidelines. Feinerman responded by acknowledging the evolving evidence base and re-evaluating his recommendations. Additionally, his involvement in a clinical trial of an immunosuppressive agent that later exhibited unforeseen adverse effects prompted scrutiny of the trial’s design and informed consent processes. The investigation concluded that the trial adhered to ethical standards, but the incident highlighted the inherent risks of pioneering therapies.
Legacy and Impact
Dr. Burton Feinerman’s influence extends beyond his research findings. He established a mentorship program at UCSF that paired early-career researchers with senior investigators, fostering a collaborative culture that has produced numerous leaders in neurology. His emphasis on interdisciplinary teamwork continues to inform modern research practices. The diagnostic assays and therapeutic protocols he helped develop are now integrated into standard care for patients with demyelinating disorders worldwide. Feinerman’s work laid the foundation for the current understanding of neuroimmune interactions and has directed subsequent research toward precision medicine in neurology.
See Also
- Multiple sclerosis
- Neuroimmunology
- Autoimmune demyelinating diseases
- Interleukin-17A
- Myelin oligodendrocyte glycoprotein
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