Research

The mission of the Department is to carry out research:

• biological in vitro;

• biological and preclinical in vivo on animal models;

• in the field of public health and epidemiology, in compliance with GCP standards, in the context of both observational and interventional clinical studies.

The research topics identified as priorities by the team include:

• Cardio-neuro-vascular and metabolic diseases

• Proliferative diseases

• Transplant Medicine

• Critical Care, Emergency and Urgent Care Medicine

• Public Health and Statistical Methodology.

The modus operandi of Translational Medicine represents the "glue" connecting the research activity of project members in the various research fields.

The main research topics are briefly described below.

Cardio-Neuro-Vascular and Metabolic Diseases

This broad field of research includes purely biological, preclinical and clinical studies, united by translational methodology, which provide for close interaction between basic and clinical researchers for the development of analytical, diagnostic and therapeutic approaches to high social impact and high penetrance such as cardiovascular, metabolic and neurodegenerative diseases. Some of the lines of research that are currently active concern:

1. the use of innovative imaging techniques to monitor cardiac activity
2. studies on cardiovascular effects and platelet function, in relation to prethrombotic and thrombotic states of molecules with hormonal activity and antiplatelet drugs and inhibitors of megakaryocytopoiesis in cellular, animal, and patient models
3. Investigations into the role of inflammatory mechanisms in the pathogenesis of cardiovascular, neurological and neurodenerative, and dysmetabolic diseases

The existence of specific skills in the field of biological mechanisms of thrombosis, as well as clinical and interventional cardiology and clinical neurology and neurophysiology represents an important basis for the scientific activity of the Department in this area.

Proliferative Diseases

The translational approach represented a fundamental turning point in the understanding of the molecular pathogenesis of tumours and, therefore, in the identification of innovative diagnostic strategies, the construction of prognostic models and algorithms based on biological markers, and the design of therapies aimed at specific molecular lesions of the tumour (so-called "target therapies"). In the Department, the translational approach to cancer research is concretely favoured by the integration between:

1. molecular skills applied both to the identification of new pathogenetic mechanisms of tumours (with particular regard to gynaecological tumours, lymphoproliferative diseases, and brain tumours) and to the molecular diagnosis of neoplasms
2. skills in the field of descriptive epidemiology and molecular epidemiology of tumours
3. skills of morphological and immuno-histochemical diagnostics
4. medical skills in the haematological field (with particular regard to lymphomas, chronic lymphatic leukemia and other lymphoproliferative disorders)
5. medical expertise in the field of virus-associated tumours (with particular regard to hepatocellular carcinoma and skin cancers) and conditions causing predisposition to liver cancer (chronic viral hepatitis)
6. medical expertise in the field of endocrinological tumours (with particular regard to thyroid tumours)
7. expertise in other solid tumours
8. advanced diagnostic skills, both imaging and molecular, of haematological tumours and solid neoplasms
9. expertise in innovative surgical therapies in the field of cancers of the gynaecological system, digestive system, lung, kidney, and prostate
10. skills in the field of innovative radiotherapy methods.

Based on the "Comprehensive Cancer Centers" model, the comprehensive scientific approach to the oncological and haematological patient envisaged by the Department of Translational Medicine also includes the search for new forms of psychiatric counselling aimed at both patients and their families.

Transplant Medicine

Our researchers possess specific scientific and welfare skills in the area of Transplant Medicine. In particular, at present, these skills concern:

1. kidney transplants
2. hematopoietic stem cell transplantation

These contexts represent a well-established model of organ and cell transplantation, respectively. Translational research on renal transplantation concerns the identification of biomarkers (cytokines, genetic markers) predicting rejection and other complications related to iatrogenic immunosuppression. One particularly important area is the potential development of post-transplant cancer, post-transplant lymphoma (associated with immunosuppressive therapy) including post-transplant lymphomas and skin cancers associated with HPV infection. In the Department of Translational Medicine, the clinical-biological study of lymphomas and skin neoplasms in kidney transplant patients is particularly facilitated by the coexistence of nephrological, hematological, dermatological and advanced morphological and molecular diagnostic skills within the research team. Regarding the transplantation of haemopietic stem cells, both autologous and allogeneic from family donors, the translational research focuses on the identification of molecular markers (for example: single nucleotide polymorphisms) predicting peritransplant complications in the different transplant contexts. Furthermore, a particular sector of interest already consolidated among the research proposers is represented by the interconnections between stem cell transplantation and neurological diseases. Within our research areas, these interconnections are bidirectional, and concern:

1. the study of neurological diseases arising as a complication of transplants and immunosuppressive therapy
2. the use of mesenchymal stem cell transplantation as a therapeutic strategy for amyotrophic lateral sclerosis

These studies are facilitated by the existence, in the department, of molecular and cellular biology, transplantology, neurology and clinical neurophysiology skills and knowledge.

Critical Care, Emergency Care and Urgent Care Medicine

The area of ​​Critical, Emergency and Urgency Medicine deals with a wide spectrum of pathologies, from life-threatening to less evolutionary ones. In particular, Emergency-Urgency Medicine is entrusted with the task of framing, reanimating, stabilising and treating any patient with criticality that occurs in local or hospital structures, establish priorities for intervention and plan a correct "action plan" and / or follow-up; Critical Area Medicine or Intensive Care, on the other hand, is designated for patients who need life support or organ support systems because they are seriously ill, i.e. patients who require intensive monitoring but who are likely to overcome the critical conditions in which they find themselves. Both specialties are amenable to translational research as very often they are the subject of scientific investigations on physiopathological, biochemical or bio-molecular aspects, also conducted on animal or cellular models, with important implications in the diagnostic and therapeutic field whose results are not rarely directly applicable to patients. Among our researchers, one particular field of translational interest in this context is represented by sepsis.

Public Health and Epidemiology

This research area, which brings together professors and researchers of Public Hygiene and Medical Statistics, has double significance for the Department:

1. scientific activity of Public Health;
2. contribution and methodological support to the research activities of the Department.

Transactional research in the area of Public Health aims to identify the determinants, constraints and mechanisms of transferring knowledge gained from research into medical practice. This is expressed both in the context of etiological epidemiology, in which the identification of risk factors must be accompanied by adequate environmental interventions aimed at their removal, and in the context of prevention, treatment and rehabilitation interventions, in which the identification of new effective interventions must be accompanied by dissemination mechanisms within the system. A fundamentally operational component is then engaged in the production of transfer tools (from systematic reviews, to guidelines, to care profiles), and in the evaluation of the impact that these tools can generate in the health system. The most relevant work areas of the Public Health Area are the following:

1. primary prevention interventions of risky behaviours, in which the Public Health Area is engaged, with research activity and the systematic review of literature with construction of dissemination tools (for example, guidelines)
2. the estimation of environmental risks at population level, in which the Public Health Area is engaged in identifying and measuring the risks, and evaluating the effect of interventions aimed at their prevention/removal
3. the control strategies of infectious diseases, in particular relating to the prevention and treatment of tuberculosis
4. primary and secondary cancer prevention measures
5. the study of clinical variability and its determinants
6. the development of methodologies with a high multidisciplinary component (e.g. care profiles) and the evaluation of their effect on the formulation of clinical decisions and on diagnostic-therapeutic variability
7. the study of organisational models that optimise dissemination of effective technologies, both at hospital and territorial level
8. evaluation of the effectiveness, impact and cost/effectiveness ratio of new technologies in the care sector, including biomarkers and biotechnological drugs.