Nearly one in 10 people assigned female at birth suffer from endometriosis, a chronic disease associated with extreme pain, especially during menstruation, sexual intercourse, bowel movements and urination. Despite its widespread impact worldwide, endometriosis has been severely understudied and the causes and mechanisms underlying the disease remain poorly understood. In 2022, .04% of the National Institutes of Health’s budget went towards studying the disease. Assistant Professor of Biomedical Engineering Juan Gnecco is working to better understand endometriosis.
Although initially interested in pursuing a career in medicine, Gnecco credits a class he took in college with sparking his interest in biomedical research.
“I was pre-med at the time, so I was very much into trying to do something with human health, so I thought I was going to be going down the doctor route,” Gnecco said. “But then I took a class at community college that was basically making cells fluoresce green, and that was the click [for what] I wanted to do … Rather than doing the patient component of it, I wanted to do the research-track of understanding and identifying how we cure some of these diseases.”
Following this initial exposure to biomedical research, Gnecco completed his undergraduate degree in biotechnology at Rutgers University and went on to complete his PhD in cellular and molecular pathology at Vanderbilt University. While earning his PhD, Gnecco was exposed to women’s health and engineering, two disciplines which would come to play important roles in his career as a researcher.
“I joined a lab that was working on a disease called endometriosis and [studied] the uterus and environmental factors and how they impact the reproductive tract,” Gnecco said. “I came out thinking, how do we not know how this reproductive tract functions?”
While working in a lab at Vanderbilt University Medical Center, he helped to create an organ-on-a-chip model of the uterus. These artificial devices mimic the human uterine environment, enabling comprehensive study of uterine function and disease. Unlike animals — like cattle or mice — that lack the same menstrual cycle or reproductive system as humans, this model enables a more nuanced understanding of cell-cell communication in female reproductive organs. After graduating, he completed his postdoctoral work in biological engineering with the endometrium team at MIT with Dr. Linda Griffith.
Since joining the Tufts faculty in 2022, Gnecco has continued to explore the field of reproductive biology, serving as the principal investigator of the Gnecco Laboratory of Reproductive Engineering, colloquially known as the Gnecco lab. In explaining his rationale behind this research group, he expressed his interest in applying models to better understand physiological and pathological conditions.
“When I was ready to move on to my faculty position, I really wanted to utilize the tools that we had created for a more biological purpose, to try to understand the mechanisms that regulate these processes,” Gnecco said. “Rather than just creating these models, I wanted to apply some of these models.”
The lab studies many different topics related to reproductive health, including endometriosis, fertility and infertility, and the role of nerve fibers in disease progression.
He shared that the guiding principle of the lab is to understand tissues and how they regulate inflammation. Endometriosis occurs when tissues similar to those inside the uterus grow outside the uterus. He explained that while tissue inflammation can sometimes be very harmful, it is also essential for biological processes like pregnancy.
“We think of inflammation as this really bad thing … it’s also a necessary thing to maintain normal tissue function,” Gnecco said.
He further emphasized the importance of understanding these tissues.
“How does a tissue know and regulate that inflammatory process? That’s still a black box we do not know … but if we can unlock them, then we can start to think about how we can utilize that to treat diseases … both in the reproductive track but also systemically,” Gnecco said.
Significantly, the university’s support for Gnecco’s research extends beyond research funding. He cited his emotional connections with other faculty and students, as well as the university’s positive learning environment, to be essential factors in his motivation, especially during challenging times in the BME department.
“Tufts in particular is very supportive,” Gnecco said. “In my department, people have been very collaborative … On hard days, it makes it easier … when you have a good community then you thrive even more.”
In addition to his role as the Gnecco lab’s principal investigator, Gnecco also shared that he is looking forward to teaching an introductory engineering class titled Applications in Engineering: Reproductive Engineering. The three credit class — available to all engineering first-years — introduces students to engineering ethics and design processes with a specific focus on reproductive health.
“What I take out of this class the most is that … the next generation are going to be the ones solving these problems, and I think there is a lot of excitement for that,” Gnecco said. “That’s the thing that motivates me the most.”
The future is not entirely certain, however, for the field of reproductive biology. The field has faced uncertainty amidst threats to cut funding for research. Earlier this year, the Trump administration planned to cut funding for the NIH’s Women’s Health Initiative, which has produced groundbreaking research since its founding in the early ’90s. While the move was ultimately reversed, Gnecco maintained that obtaining funding remains a challenge.
“[Reproductive engineering] is an area where [research] hasn’t been very well-funded at the end of the day to really explore some of these processes,” Gnecco said.
Challenges have long plagued the field of women’s health. According to a 2020 study, only 5% of global research and development funding was allocated to women’s health research. However, Gnecco’s research represents a push against the misconceptions and social conventions that have caused reproductive health to remain understudied and underfunded.
“This organ system has been taboo and understudied for many centuries … people don’t want to talk about it,” Gnecco said. “When you look at it biologically it’s really one of the most fascinating tissues that we have in the human body.”
Despite these challenges, at the end of the day, Gnecco envisions an optimistic future for the ever-expanding field of reproductive engineering.
“I suspect an increase [in reproductive research] and a brighter future … especially for younger students,” Gnecco said.
