Finkel one of first to identify immature T-cells as active players shaping immune response to infection 

By BECKY GILLETTE

Pediatric Rheumatologist Terri H. Finkel, MD, PhD, has done groundbreaking research on immunology, pediatric rheumatology and genomic sequencing of rare diseases in children. She has 11 patents — including five that have been licensed and brought to market. Finkel has been awarded about $17 million in grant research funding over a career focused on investigating how infection sparks autoimmune disease.

Finkel made the cover of the Rolling Stone during the height of the HIV epidemic and has published more than 168 manuscripts in peer-reviewed medical journals. She has worked at some of the most highly regarded children’s hospitals in the country, diagnosing, treating and easing the suffering of infants and children with rheumatological diseases.

Finkel also devotes time to teaching and mentoring medical students, residents and faculty, and played a lead role in organizing and directing COVID-19 testing at the Tiger Lane tents when she first came to Memphis in 2020 after being recruited as professor and Associate Chair of the Department of Pediatrics at the University of Tennessee Health Science Center (UTHSC) and Vice Chair of Clinical Affairs for Le Bonheur Children’s Hospital. In 2024 Finkel was appointed Interim Chair of the Department of Pediatrics at UTHSC and Pediatrician in Chief at Le Bonheur Children’s Hospital.

Finkel’s passion for investigating medical clues that help advance medical science is combined with a dedication to healing children, particularly those with rare, hard-to-diagnose diseases. She isn’t bothered by long hours in research, teaching, collaborating with other scientists and physicians and seeing patients.

“I love everything about what I do,” Finkel said. “I love research. I love teaching. I love hands-on medical care. There are not enough hours in the day.” 

A lot of her research has been investigating “the most important organ you have never heard of,” the thymus gland in the chest that shrinks as people age. It is even hard to find the thymus after the teenage years.

“The thymus is a critical part of our immune system,” Finkel said. “My work on the thymus at National Jewish Medical and Research Center (now National Jewish Health)—a nationally regarded immunology, rheumatology and pulmonary center in Denver, CO—is what established my scientific career. I did my postdoctoral fellowship there after my pediatric residency. I had world famous mentors there and was grateful to be part of their world.”

Finkel was the first to identify that immature T-cells could go rogue, leading to autoimmune disease. “The thymus is where T-cells grow up and mature,” Finkel said. “T-cells guide a lot of what happens to train our immune system to fight infection without triggering autoimmune disease.”

That discovery led her into the HIV arena. “It was earlier thought that HIV kills T-cells by infecting them,” she said. “But what I showed through my work, published in Nature Medicine, was that HIV-infected T-cells don’t die for a while because HIV turns on the cell’s survival genes. I discovered that it’s when these infected cells touch other uninfected cells, that’s the ‘kiss of death’ that could lead to AIDS.”

She considers her 12 years with National Jewish a remarkable time. She was doing well, had a big lab, and her husband led the neuromuscular program at Denver Children's Hospital (now Colorado Children's Hospital). In 1999 she was recruited to the Children’s Hospital of Philadelphia (CHOP), one of the top children’s hospitals in the country, as Chief of the Division of Rheumatology and awarded the Endowed Chair of Pediatric Rheumatology at the University of Pennsylvania, also in Philadelphia.

She was there for 12 years, and was quite happy with running a big lab and directing several large NIH grants. Then she was recruited to build a new children’s hospital, Nemours Children’s Hospital (part of what is now Nemours Children’s Health) in Orlando, Fla.

“That was too much of an adventure to not pursue,” she said. “My husband was willing to come with me and that is where his research career exploded. His work furthered the development of a genetic therapy to treat babies with spinal muscular atrophy, a disease that, in its most severe form, leads to death by two years of age if untreated.”

While at Nemours as Chair of Pediatrics, Pediatrician in Chief and Chief Scientific Officer, she was executive lead on two projects: PedsAcademy, a bedside teaching program for patients, in partnership with the College of Education at the University of Central Florida, and PEDSnet, a national online database and children’s research network, partnering with children’s hospitals across the U.S. to discover and deliver the best possible medical care to children. In 2014, Finkel’s work was honored in the U.S. Congressional Record.

She moved to Memphis after her husband, pediatric neurologist Richard S. Finkel, MD, was recruited by St. Jude Children’s Research Hospital to lead a pioneering translational neuroscience program.

Both have thrived in Memphis. In addition to her other roles, Finkel is also an adjunct faculty member and Faculty Liaison for Le Bonheur at St. Jude. She recently hired a new Chief of Rheumatology who is an expert in chronic pain syndrome or fibromyalgia in adults.

“If we can get children with chronic pain syndrome into intensive physical and occupational therapy combined with good sleep habits, 85 percent of them get better,” Finkel said. “We try to get the children off pain killing drugs after they come to us. Pain medications treat pain but not the underlying problem. There is lots we don’t understand about chronic pain in children, but we do have ways to treat it. If families accept the regimen, children can be much better in a month and get to the point of no pain within three months.”

Finkel is particularly drawn to diagnostic work.

“That is the source of my interest and love for genetic and genomic exploration,” Finkel said. “I work to find the root cause of a child’s disease through genomic sequencing. It helps define if the illness is heritable. Curiously, you can have the same gene in parents, children, aunts, uncles and cousins. But some people are affected and some are not. I’ve been working in this area to find the triggers for heritable diseases ever since I was at CHOP. There are 7,000 known genetic diseases. We have validated about 450 that are treatable. There is still a lot of work to do, clearly, since most of the diseases we’re able to identify are not yet treatable. But there has been such an explosion in the rare disease community, hand in hand with pharmaceutical companies working to discover treatments for those diseases, that we’re going to scale that mountain in a decade. We are going to learn how to treat many more of these diseases.”

Another project she is very proud of is All Kids Academy, an educational program for hospitalized children, especially those hospitalized long term. That program is the result of a partnership with the University of Memphis Early Childhood Education Program and their College of Education.

Another significant accomplishment was successfully advocating for legislation to provide TennCare coverage for rapid whole genome sequencing of newborns and children exhibiting signs of rare genetic diseases. This allows physicians to diagnose and treat rare childhood illnesses sooner.

“This will save the lives of many children in Tennessee over the years,” she said. “It also affirms the importance of access to rapid whole genome sequencing.”

For health and recreation, Finkel loves to hike the beautiful paths at Shelby Farms.

“Memphis is my favorite of all the places we’ve lived, and Le Bonheur my favorite children’s hospital for its great comradery,” Finkle said. “I’m very positive about Memphis and where we are headed.”

The Finkels have two children. Valerie, 40, is a farmer, after earning two degrees in philosophy. Paul, 35, is an electrical and computer engineer.