Research Spotlight: The truth is in the tissue – Associate Professor Jason Bennett talks about his new research stream for Endometriosis Awareness Month

Jason Bennett is an Associate Professor in Molecular Pharmacology at University of Limerick. His research aims to advance our understanding of the underlying mechanisms that drive both cancer cell survival and immune dysfunction in the tumour microenvironment.

This cancer expertise has led Jason to his new research stream in endometriosis, a disease that is estimated to affect 10% of women of reproductive age worldwide according to the World Health Organisation (WHO). Endometriosis is a debilitating condition that can have a negative impact on all aspects of a woman's life. Infertility and chronic pelvic pain represent the two primary clinical signs, with endometriosis detected in upwards of 50% of women seeking infertility treatment. Despite its prevalence, it remains poorly understood and seldom openly addressed. The term "endometriosis" derives from "endometrium" (the uterine lining), indicating the presence of similar tissue outside the uterus.  Jason believes there are similarities between the diseases that can help him along in his research journey.

“Through my initial research, it became evident that endometriosis was this kind of a-typical benign disease that shared some characteristics and some of the hallmarks of cancer. These endometrial-like tissues or lesions are seeded into the abdominal pelvic cavity, where they survive and are not cleared by the body, so this indicates that there is some level of immune dysfunction involved. I could see that there were certain parallels between the work I was doing in cancer in terms of cell survival pathways, immune dysfunction and endometriosis.”

It wasn’t just the similarities between the diseases that brought endometriosis into frame for Jason, as his wife was diagnosed with the condition when they were trying to start a family.

“Endometriosis is an example of a classic condition where people are suffering in silence. It takes on average eight years to get accurately diagnosed because this is only possible by undergoing surgery. My wife had to have surgery twice to remove these endometriotic lesions and thankfully we were lucky enough to be able to conceive, but since then the condition has reemerged and is affecting her day-to-day life.”

Living with endometriosis is a difficult proposition according to Jason as treatment options are limited and research into the disease is poorly funded.

“There are very few therapies out there at the moment to help with the condition and your GP will just treat the symptoms, for example, with painkillers or anti-inflammatory medication. In certain cases, your doctor may advise you to undergo hormone treatment which is far from ideal if you are looking to conceive. We want to get to a stage with this research where there is a targeted therapy to try to clear the lesions rather than just treat the symptoms. In 2022, endometriosis-related research received just 0.03% of the National Institutes of Health (NIH) budget in America. If 10% of women of reproductive age worldwide actually suffer from this disease, there's a huge disparity there and an attitude change is required across the board when it comes to addressing this condition.”

Jason has had some success in the past working in the field of cancer. During his time as a postdoctoral researcher at the Imperial College London, he was part of a drug discovery team trying to develop a cancer selective targeting strategy for Multiple Myeloma.

“Multiple Myeloma is an incurable malignancy of plasma cells and has a low five-year survival rate depending on its stage. We were developing a drug to target a downstream effector of the NF-kappa B cell survival pathway and had gotten to the trial stage where patients were being administered the drug. We took samples from the patients, analysed them, and I remember that you could see the drug was killing the cancer cells and leaving the normal cells alone. This was a watershed moment for me. To think you could take a hypothesis, work on it in the lab and create something tangible that you could administer to patients and see it have a real impact.”

As for his endometriosis research, although it is only at its genesis, Jason is hopeful for the future.  

 “There is an obvious need for new therapeutic avenues for endometriosis. If we can figure out exactly how these endometrial-like cells are surviving, then we could potentially apply previous strategies to block these survival mechanisms and induce cell death and lesion clearance. In terms of understanding the immune environment within endometriotic lesions – the truth will be in the tissue. If we can identify the type and activation state of immune cells that infiltrate these chronic lesions, then we can gain new insights into the role of immune cells in promoting this debilitating condition.”

Associate Professor Jason Bennett is a member of the Endometriosis Association of Ireland. For more information or support with endometriosis visit the Endometriosis Association of Ireland website.