Research

The health and disease states of individuals are highly variable and multifaceted, and such diversity must be considered in medical research. Simplifying, underrepresenting, or excluding these differences has led to significant knowledge gaps over time. Conducting research through a gender lens aims to centre the individual, with all their nuances and variables, rather than focusing solely on the diseases to be treated. This political commitment underpins our research laboratory, where we strive to approach pharmacology differently from the traditional focus on male bodies and binary, exclusionary models. While we do not claim to overhaul an entire system in need of change, we are laying the groundwork for a new vision in pharmacology.

Research activities within the Clinical Pharmacology Service of the Department of Clinical and Biological Sciences (DSCB) at the University of Turin (UniTO) are closely linked to the service's routine clinical work. The Clinical Pharmacology unit primarily handles hospital routine tasks related to Therapeutic Drug Monitoring (TDM). As a hospital service, the unit offers TDM analyses for a broad panel of drugs used in treating patients with various conditions. The service analyses, quantifies, and reports circulating levels of anticancer, antileukemic, cardiological, anticonvulsant, antibiotic, and iron-chelating drugs to optimise therapies in an individualised manner. These analyses are performed using High-Performance Liquid Chromatography coupled with UV detection (HPLC-UV), following validated methodologies according to Eurachem guidelines. TDM analyses encompass different patient groups, addressing emerging clinical needs. To support the hospital service and meet specialists' requests, the Clinical Pharmacology unit is actively involved in developing and validating all methods used for routine drug level analysis. These methods are original, and chromatographic separation, except in a few cases, does not rely on commercial kits.

Building upon TDM data from patients, the Clinical Pharmacology group at DSCB conducts retrospective analyses of pharmacokinetics and pharmacodynamics (PK/PD), publishing disaggregated data by sex and gender to assess the impact of these variables on treatment response. To determine if therapy is effective, circulating drug levels are correlated with therapy efficacy/toxicity, administered dosage, and key PK parameters (e.g., Ctrough, Cmax, Cmin, AUC). Additionally, the group is developing a pharmacogenetic component (using Real-Time PCR) to correlate TDM data with genetic analysis of patients' DNA, aiming to retrospectively assess treatment efficacy/failure through specific genetic polymorphisms. Some correlations have already been made for specific patient clusters, with identified mutations partly explaining the failure to reach the drug's therapeutic window, thus providing useful analyses to optimise care.

Looking ahead, the goal is to provide specialised TDM analyses coupled with genetic polymorphism analyses, moving from retrospective to prospective studies. This approach aims to improve the overall quality of patient care by incorporating gender and sex considerations into pharmacological research and practice.

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Projects