Art by Mila Colizza.
The Flannery lab, whose research is focused on the intersection between endocrinology and obstetrics at both the molecular and clinical levels, is special for being an all-female research group.
Dr. Clare Flannery was not always planning on going down the path of medical research. In fact, she was a doctor prior to starting her research group. Her divergence from a career working as a doctor in a clinical setting to a researcher studying the conjunction between endocrinology and reproductive medicine began as a way to address the “number of problems that were not solved.” As an endocrinology fellow, she realized there was a gap in knowledge in the field: no one really understood how the hormone levels in women affected their intrauterine environment. Flannery’s turning point came when she encountered a young woman with type II diabetes and a pre-cancer in the uterus, but could not find answers in the literature on how to treat her patient. This horrified her. “It was obvious that we had no idea of the solutions, so the problem begged to be dissected out, figured out.” So, Flannery took it upon herself to start investigating the relationship between the two. “My goal was never to be a scientist; it was to be a better physician,” Flannery said.
Flannery describes her lab as a cyclical project. Her lab collects tissue samples from a patient, studies this tissue on a molecular level, and then returns to the patient in the clinic with insights. By studying numerous cells under a microscope, members of the lab begin to have a sense of what is normal and abnormal. Through this understanding, they are able to contrast the normal cell to its reaction to hormones. Flannery also sequences the DNA and RNA in the tissue, looking for a genetic marker that indicates “pre-pre- cancer,” or endometrial hyperplasia—an overgrowth of cells that have not yet become cancerous. Endometrial cancer develops over decades. By looking at a 20-year-old woman’s tissue, Flannery can predict whether the patient will have endometrial cancer in thirty years.
Anika Anam, an endocrinology fellow at the lab, works with human samples to understand the pathophysiology of endometrial cancer. She is studying how obese women with endometrial cancer may differ in their underlying metabolism. In particular, she is examining the hypothesis that women with obesity have a different intrauterine environment, and that their placenta works as a metabolic organ. “The fetus in turn will have long term risk of metabolic disease, such as diabetes. We found that the placenta in obese women has a higher level of triglycerides (fat), but the real question is: what regulates it? Since we know the placenta has insulin receptors, does insulin actually regulate the fat content in the placenta?” Anam said.
The lab also looks to mice as a model, particularly those that have become overweight with time. The researchers aim to study how the mouse endometrium changes in terms of metabolism and DNA damage. Katie Cook, an undergraduate research assistant at the lab, has been analyzing mouse uteri at the molecular level, to discover how exposure to the hormone estrogen affects mice that are resistant to insulin, in the hopes of untangling yet another connection among different components of the endocrine system. “These mice were exposed to estradiol, a potent form of estrogen for 6 months, and I’m currently looking for markers of pre-pre-cancer, including differential RNA expression and DNA damage,” she said.
When asked about her favorite aspects of her research program, Flannery said, “it’s the unexpected result that shakes my theories and makes me take the research in a new direction.” For Flannery, this process of pondering new hypotheses is addictive. Her ultimate goal as a researcher is to make endometrial cancer a preventable disease. “This is going to take my entire career and lifespan as well as the careers and lifespans of some of my mentees,” Flannery said.
The women-led lab
One of the most interesting aspects of Flannery’s lab is the all-female environment. All of the lab’s members at the moment are women, and, since they are studying obstetrics, all of the patients are women too. Her research’s focus on obstetrics and endocrinology has led Flannery to inadvertently surround herself with female peers and create a welcoming environment for women scientists, which is often rare. “It wasn’t a specific decision on my behalf; it was because women are the majority of the people who show interest in working in the lab,” Flannery said.
Flannery believes that what led the lab to become all-female was that women were the ones most interested in her area of research. “There have been men in the lab, and I look forward to them joining again,” she emphasized. “I am open to all gender identities.” She also hypothesized that it had something to do with her mentoring style. In medicine specifically, the importance of a mentor who aligns with your research interests and learning style is immeasurable. According to Flannery, she believes she has created an environment conducive to learning, where members support each other instead of competing.
Anam praised Claire’s strengths as a mentor. “Women tend to be more cognizant of other people’s perspectives,” Anam said. “I’ve been working in the lab since July 2017, and I’ve found it to be a very supportive environment.” She also emphasized that one of the greatest strengths of the lab was the collaborative relationship between members. “We do a lot of cross-teaching on all levels; it is not hierarchical.” After learning about the lab’s research from a second-year medical student, Anam understood that Clare helped foster this collaborative environment. “Clare has been incredibly open and supportive,” Anam said. “She thinks very broadly, which is one thing I struggle with because I’m very detail-oriented.”
Cook explains that Flannery chooses the lab members, evaluating how each individual will contribute to the lab environment. Cook also emphasized the strong relationships between lab members: “Each one of us is working on our own projects, but the collaboration is constant,” Cook said. In her previous lab, Cook felt she was often compared to male counterparts or seen as “less of a scientist” because of her gender. Her experience in the Flannery lab is incredibly different. Members of the lab understand the importance of sticking together, as women in STEM have all faced discrimination at some point in their careers. “I have worked in scientific settings before where I felt the need to prove my value as a scientist to other people, especially men, over and over again,” she said.
The researchers in the Flannery lab are particularly proud of their work on the clinical front, which requires that researchers be especially aware of their subjects’ needs. The women believe that being an all-female lab has given them an advantage in understanding and supporting their (female) patients, contributing to a safe environment where they feel comfortable being treated.
The part of Flannery’s research that brings her the most pleasure is watching “people develop in their ideas and launch in their own careers.” For Flannery, success is defined by mentoring a future generation and watching them blossom as they discover their own passions.