Fragility Platform

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Coordinators: Alberto Castelli, Cristina Giaroni, Elena Maggi, Roberto Papait, Luigi Testa, Alessandra Vicentini

The rapid and profound economic, political, social and technological transitions currently underway tend to generate insecurity, a loss of shared cultural horizons, and difficulties in managing everyday life. In some cases, these issues overlap with individual challenges relating to a person’s physical and mental health.

Main objectives

The effects of the processes mentioned above are not one-sided: the transformations we are witnessing also open up new opportunities and new spaces of freedom, but these very positive developments, in turn, tend to trigger new problems and disparities of various kinds (among others, consider the inequalities caused by the technological divide and technological ‘vulnerability’). One of the most critical areas is undoubtedly healthcare, given that such inequalities can affect access to essential levels of care, particularly for people who are particularly vulnerable to illness, complications or a deterioration in health due to physical, psychological or social conditions.

The aim of this University scientific platform is to create a broad research network on vulnerability/frailty, involving groups within the University, including in collaboration with groups from external research institutions or bodies, active in the fields of the humanities, social sciences, law, economics, biology and medicine. Building on the established experience of the University’s various research groups active in the biomedical field, and whilst keeping open the possibility of extending the investigation to other conditions of fragility in the healthcare sector, the platform aims to consolidate and/or initiate new collaborations aimed at developing studies on fragility in the pre-, peri- and postnatal periods, in the elderly population and in the field of oncology.

Research on these topics is expected to yield various outcomes:

  1. The ability to identify individuals lacking recognition through a continuous examination of the forms of social, economic, political and cultural fragility.
  2. The development of a general concept of fragility and the identification of legal, social, linguistic and cultural measures suitable for rebuilding bonds of mutual recognition.
  3. A rethinking, in the light of a clearer understanding of fragility, of the concepts of equality, the individual, autonomy and empowerment.
  4. The identification of institutional models, legal practices, public policies and cultural approaches that address the new dimensions of fragility in a way that is neither stigmatising nor paternalistic.
  5. Identification of health inequalities and the social determinants of health that influence access to antenatal care and obstetric outcomes, thereby increasing the risk of complications.
  6. Development of predictive models, using cross-sectoral data and AI, to enable the creation of tailor-made models of pre-, peri- and postnatal care
  7. Identification of factors contributing to the onset of rare genetic diseases, sleep and respiratory disorders in the neonatal period, and early-onset gastrointestinal and neuropsychiatric conditions, with a view to enhancing understanding of pathogenic mechanisms and identifying potential targeted preventive strategies
  8. Understanding the impact of substances such as cannabis on adolescent neurodevelopment.
  9. Identification of the molecular factors governing ageing in different tissues.
  10. Development of new therapeutic approaches for age-related diseases.
  11. Identification of physical activity as key to successful ageing.
  12. Activities in lifelong learning, community care, horticultural therapy, communication and linguistic-cultural mediation to boost self-esteem and personal satisfaction in active ageing.
  13. Development of targeted treatments in oncology through the study of interactions between the various cellular components of the tumour microenvironment, with positive economic implications as well, as this would help reduce healthcare costs associated with less effective and more prolonged treatments.
  14. Development of new diagnostic and therapeutic approaches to combat the growth and spread of tumours, adopting a multidisciplinary approach in the biomedical field to accelerate the transfer of results into clinical practice.
The themes and working groups that make up the platform
1. Frailty in older adults

Ageing is not, in itself, a disease. However, it is often associated with a decline in the body’s motor, physical and sensory functions. Functional decline in older adults is a multifactorial process involving cellular, biochemical and molecular aspects, and is closely dependent on the complex interrelationships between environmental and genetic factors. The environmental factors that most influence this physiological process are intellectual and motor activities, diet and stress. A multidisciplinary approach is key to studying the ageing process in depth and in an integrated manner, whilst facilitating the transfer of academic knowledge to society.

Lecturers
Tiziana Alberio (Department of Science and High Technology), Antonino Bruno, Francesco Acquati, Maurizio Bignami, Paola Campomenosi, Marzia Gariboldi, Rosalba Gornati, Lorenzo Mortara, Roberto Papait, Christina Pagiatakis, Gianpaolo Perletti, Simona Rimoldi, Genciana Terova (Department of Biotechnology and Life Sciences), Davide Tosi (Department of Theoretical and Applied Sciences), Luigina Guasti, Francesco Gianfagna, Giovanni Veronesi, Matteo Tozzi (Department of Medicine and Surgery)

Specific objectives

  1. Epigenetic control of tissue ageing
  2. Inflammaging: inflammatory ageing involves many systems and organs
  3. Optimisation of gut health in older adults: the role of the microbiota and targeted diets.
  4. Identification of circulating microRNA biomarkers for the screening, diagnosis and prognosis of oncological diseases in older adults
  5. Identification of new biomarkers to be used for predicting disease risk (chronic diseases in general, or cancer and neurodegenerative diseases) or as potential targets for preventive interventions.

Keywords
Heart, muscle, liver, p300, inflammation, immunology, Functional foods; Agri-food; Nutrition for older adults; Nutrition for older adults with cardiovascular diseases; Biomarkers, Screening, Diagnosis, microRNA, Cancer, Prevention, chronic diseases

Main funding
Ministry of Enterprise and Made in Italy - Incentives from the Fund for Sustainable Growth; PRIN2022 LuCamiR project (ID: 20225AZ22F); BaC CN3 (National Centre for Gene Therapy and Drugs based on RNA Technology) spoke 2 (Cancer)

Lecturers
Francesco Acquati, Nicolò Baranzini, Francesca Berini, Raffaella Bombelli, Elena Bossi, Marcella Bracale, Antonino Bruno, Guido Domingo, Lia Forti, Marzia Gariboldi, Rosalba Gornati, Stefano Giovannardi, Annalisa Grimaldi, Flavia Marinelli, Milena Marsoni, Lorenzo Mortara, Viviana Orlandi, Cristina Roseti, Tiziana Rubino, Anna Di Spirito, Gianluca Tettamanti, Candida Vannini, Erica Zamberletti (Department of Biotechnology and Life Sciences), Leonardo Campiotti, Daniela Gallo, Eliana Piantanida, Maria Laura Tanda (Department of Medicine and Surgery)

Specific objectives:

  1. Modulation of the endocannabinoid system for successful ageing
  2. Scaffolds functionalised with bioactive molecules and hirudotherapy for the treatment of pressure ulcers: a personalised regenerative medicine approach
  3. New antibiotic formulations to combat microbial infections in the elderly population
  4. New antibiotics and bioactive natural products to combat infections and other conditions in the elderly population
  5. Control of excitotoxicity as a means of preventing neurodegenerative diseases
  6. Plants as a source of molecules with therapeutic potential in the treatment of age-related diseases
  7. Effect of Vitamin D on the inflammatory state in the elderly.

Keywords: Cannabinoids, brain, Hirudinea, leech, nanoantibiotics, biofilm, natural product discovery, antimicrobial resistance, insect infection model, GABA, betaine, excitatory/inhibitory balance, phytotherapeutic compound, anti-ageing herbs, natural killer cells, inflammation, ageing

Main funding sources:

DiGlycAn: “From genome-guided discovery to production of novel glycopeptide antibiotics by an integrative technological platform”, funded by the Ministry of University and Research (MUR) under the call for proposals for Research Projects of Significant National Interest – PRIN 2022 (ID 2022J7W7LW) BIO-ITA-3D-SWISS: “Innovative 3D-printed biomaterials functionalised with natural antimicrobial products: cross-border synergy for bone regeneration and the prevention of orthopaedic infections”, funded by the European Union under the Interreg 2024-2027 programme (ID 0200167)

MICRO-COLORS: “Unravelling Actinomadura lepetitiana’s colour palette: an in-depth analysis of carotenoid production by a ‘rare’ filamentous actinomycete”, funded by the University of Insubria under the FAR programme for fixed-term researchers

Lecturers
Tiziana Alberio (Department of Science and Advanced Technology), Giorgio Ferriero, Damiano Formenti, Marzia Gariboldi, Francesca Mauri, Giampiero Merati, Gianpaolo Perletti (Department of Biotechnology and Life Sciences)

Specific objectives

  1. Physical activity as the key to successful ageing
  2. Ageing without falling: physical and cognitive aspects of neuromuscular control of balance in older adults

Key words
Exercise, neuroplasticity, elderly, balance, fall prevention, ageing

Lecturers
Stefano Bonometti, Daniele Crotti, Letizia Ferri, Federico Pasquaré Mariotto, Daniel Russo, Alessandra Vicentini (Department of Human Sciences and Innovation for the Territory), Marcella Bracale, Bruno Cerabolini, Silvia Ceruti, Guido Domingo, Elena Ferioli, Marta Licata, Roberta Fusco, Antonio Montagnoli, Chiara Tesi, Mario Picozzi, Nicol Rossetti, Candida Vannini (Department of Biotechnology and Life Sciences), Daniele Grechi (Department of Law, Economics and Culture), Elena Maggi, Andrea Riganti (Department of Economics), Arianna Vanni (Department of Medicine and Surgery)

Specific objectives:

  1. Shared care planning as a tool for personalised care
  2. Effective planning of resources and access to National Health Service facilities
  3. Communication and linguistic-cultural mediation in care for older people
  4. Active mobility, health and wellbeing in older age
  5. Lifelong learning and community care for active ageing
  6. Communication for older people, foreign carers of older people, multilingual communication, elderly identity, communication policies for ageing.
  7. Hortotherapy as a multisensory activity to boost older people’s self-esteem and personal satisfaction
  8. From remains to life stories: biological anthropology of ageing

Key words

End of life, shared decision-making, proportionality of care, ageing Active ageing, health policies, transport policies, accessibility, sustainability, well-being, caregiver, knot working, horticultural therapy, garden therapy, Skeletal markers, Paleopathology, Physical anthropology, Senescence, Ancient populations, ageing

Main funding sources:

SUITABLE (2023–25; local unit grant €67,000); MOVEON (2021–25; local unit grant €184,000); HAPPY (2019–21; grant €90,000)

Age.Vol.A. (Cariplo Foundation) 2018–2022 (grant: €192,461); WBE (PRIN 2022 (2023–2025, Insubria unit grant: €62,900)

2. Cancer and Vulnerability: Between Biology and Care

The incidence of cancer is on the rise and poses a challenge to healthcare systems. Cancer patients exhibit biological, psychological and social vulnerability, which requires personalised and integrated care. The project analyses the mechanisms of the tumour microenvironment to develop innovative diagnostic and therapeutic approaches. The aim is to combat tumour growth through multidisciplinary strategies, facilitating the transfer of findings into clinical practice. The study of these interactions enables more targeted and sustainable treatments, with effects that also have social, legal and economic implications, influencing healthcare policies and the protection of patients’ rights.

Lecturers
Andreina Baj, Stella Carro, Greta Forlani, Stefano La Rosa (Department of Medicine and Technological Innovation)

Specific objectives

  1. The role of adaptive immunity in the formation and modulation of the tumour microenvironment;
  2. The role of oncogenic viruses in tumourigenesis;
  3. Immune regulation of tumourigenesis: the significance of lymphocytic infiltration;
  4. Development of oncolytic vaccines.

Key words
Regulation of tumour-cell microenvironment interaction, intratumour lymphocytic infiltration, PD-L1, immune response, tumour immunophenotype, inflammation, local immunosuppression, viral oncoproteins, apoptosis, immortalisation, oncolytic viruses, oncogenic viruses, tumourigenesis.

Lecturers
Andreina Baj, Giulio Carcano, Daniela Dalla Gasperina, Daniela Furlan, Giuseppe Ietto, Davide Inversini (Department of Medicine and Technological Innovation)

Specific objectives

  1. Study of the epigenetic mechanisms underlying tumour evolution in inflammatory bowel diseases;
  2. Study of the genetic mechanisms underlying the development of neoplasms in organ donors;
  3. Role of immunosuppression in the development of neoplasms in organ donors.

Key words
Cell genetics, LINE-1 hypomethylation; LINE-1 retrotransposition; coeliac disease; immune-mediated disorders; small bowel adenocarcinomas; tumour inflammation signature; regulation of the tumour-cell microenvironment, transplantation, immunosuppression, organoids, tumourigenesis

Lecturers
Marina Borgese, Petra Basso, Marina Protasoni, Mario Raspanti, Marcella Reguzzoni (Department of Medicine and Technological Innovation), Jenny Karousou, Alberto Passi, Davide Vigetti, Manuela Viola (Department of Medicine and Surgery), Piero A. Zecca (Department of Biotechnology and Life Sciences)

Specific objectives

  1. The role of collagen and hyaluronic acid in the development of the tumour microenvironment;
  2. Micro- and nanoplastics: potential risk factors for the development of tumour lesions;
  3. Microcalcifications and tumourigenesis;
  4. Three-dimensional reconstructions of the tumour microenvironment and artificial intelligence.

Key words
Extracellular matrix, collagen, cell-matrix interaction, micro- and nanoplastics, calcification processes, angiogenesis, artificial intelligence and three-dimensional reconstructions, hyaluronan, HASs, CD44, extracellular matrix, proteoglycan, cancer aggressiveness, neoangiogenesis, tumourigenesis

Lecturers
Jvan Casarin (Department of Medicine and Technological Innovation), Fabio Ghezzi (Department of Medicine and Surgery)

Specific objectives

  1. Molecular classification of endometrial cancer;
  2. Stratification of patients into groups with different levels of risk with regard to specific outcomes;
  3. Possibility of guiding patients towards targeted and adjuvant therapy.

Key words
Endometrial cancer, molecular classification, risk stratification, clear cell, advanced disease, adjuvant treatment. 

FAR INDAGA (SL); AIRC-IG 2021–2026 (GF); European CARES project (AP); PRIN 2022 code 20223YYXY5 (JC); FAR proposers;

3. Vulnerability in early life

During the pre-, peri- and postnatal periods, vulnerability stems from the interaction between biological, environmental and social factors. The project analyses health inequalities and the social determinants that influence obstetric care and complications, promoting predictive models and personalised preventive strategies. It also examines neurodevelopmental alterations in rare genetic diseases, the role of the microbiota-gut-brain axis in early-onset conditions, and the impact of sleep, immunity and the respiratory environment on neonatal fragility. Finally, it explores the therapeutic use of cannabinoids in autism spectrum disorders and the effects of adolescent cannabis exposure on neurocognitive development.

Lecturers
Ilia Bresesti, Antonella Cromi (Department of Medicine and Surgery)

Specific objectives

  1. Identification of factors linked to social determinants of health (SDOH) that influence differences in pregnancy-related complications;
  2. Assessment of the impact of inequalities in access to and provision of healthcare on neonatal health, the incidence of preterm birth, maternal health and the occurrence of complications;
  3. Development of early predictive models and definition of personalised preventive strategies, aimed not only at survival but also at optimal developmental quality, whilst respecting each child’s specific trajectory.

Key words
Health disparities; social determinants of health (SDOH); obstetric outcomes; antenatal care; biological embedding; preterm birth; neonatal care

Lecturers
Andreina Baj, Cristina Giaroni, Luana Nosetti (Department of Medicine and Technological Innovation)

Specific objectives

  1. The role of the microbiota-gut-brain axis in the development of early-onset inflammatory and functional bowel diseases.
  2. Contribution of factors such as sleep, immunity and the respiratory environment to the development of neonatal fragility

Key words
Early-onset inflammatory bowel disease, irritable bowel syndrome, microbiota, enteric nervous system, gut-brain dysfunction, sleep-disordered breathing, asthma, immunity, microbiome.

Lecturers
Isabella Barbiero, Charlotte-Kilstrup Nielsen, Tiziana Rubino, Erica Zamberletti (Department of Biotechnology and Life Sciences)

Specific objectives

  1. Identification of the correlation between rare genetic diseases and neurodevelopmental disorders;
  2. Substance abuse in adolescence and brain vulnerability;
  3. The role of cannabinoids in the development of autism spectrum disorder.

Key words
Neurodevelopmental disorders, rare diseases, epilepsy, molecular neurobiology; adolescent brain, cannabis, neurodevelopment, THC:CBD ratio; Cannabinoids, ASD, sex sensitivity.

PRIN 2022, project code 2022S3AZCC (IB); Bank of Italy Project No. 2203193/23_2025 (IB) – FAR 2023–2025 Insubria (IB) – Cariplo Telethon Alliance GJC2021–2022_2025 (IB) – Telethon GGP20024 (CKN); FAR applicants;

4. Cultural, institutional and social fragility

Cultural, institutional and social fragility is generally caused by the exercise of power (which can take various forms and originate from various sources) over individuals and groups. The study of this form of fragility relates to the dimensions of otherness, recognition, interdependence, trust and solidarity. Such a study involves a constant re-examination of the categories that have become established during the twentieth century and beyond, with the aim of proposing solutions to the problems of cultural, institutional and social inclusion in the diverse, pluralistic world in which we live.

Lecturers
Paola Biavaschi, Alberto Castelli, Fabio Zucca (Department of Human Sciences and Innovation for the Territory)

Specific objectives

  1. To examine the concepts that have made varying degrees of political and social inclusion conceivable and possible.
  2. To examine the historical, political and conceptual processes underpinning contemporary democracies.

Key words
Socio-political inclusion, democratic processes, European integration, political symbolism, conflict resolution strategies.

Specific objectives

  1. Study of linguistic and communicative strategies in ethically charged contexts involving vulnerable social actors (e.g., ageing studies, gender studies, migration, etc.), conducted from both a diachronic perspective (with reference to different historical periods) and a synchronic one, and taking into account diatopic, diaphasic and diamesic varieties.
  2. Analytical interpretations concern the various levels of language – lexicon, syntax, phonology, semantics, etc. – and the different registers and communicative situations. The analyses adopt a critical approach and may integrate methodologies from other disciplines. They may also be supported by quantitative methods and the use of digital tools for lexical analysis on digitised corpora.

Key words
Diachronic and synchronic linguistics, critical discourse analysis, sociolinguistics, ethical communication, gender studies, ageing studies, migration, quantitative methods, digital corpora.

Lecturers
Laura Facchin, Massimiliano Ferrario, Elena Valentina Maiolini, Alessandra Vicentini, Daniel Russo (Rita Messori, Laura Rampazzi) – Department of Human Sciences and Innovation for the Territory

Specific objectives

  1. Historical and contemporary investigations into the factors that render the tangible and intangible assets comprising cultural heritage vulnerable, and the monitoring of these factors which alter their potential for use by professionals and the public: natural disasters, armed conflicts, uncontrolled urban development, pollution and climate change, tourist pressure, theft, vandalism and neglect.
  2. Design of interdisciplinary scientific and outreach projects which, through an understanding of data and issues, can help to foster new awareness and approaches to the protection and prevention of the risks to which heritage is exposed, as well as short- and long-term planning strategies for the management and care of heritage assets, with particular attention to the diverse social, religious and, in a broader sense, cultural backgrounds of users.

Keywords
Archaeological heritage, visual arts, library collections, archival collections, diagnostics, conservation, restoration, reuse, education, awareness-raising, inclusion.

Lecturers
Sebastiano Citroni (Department of Law, Economics and Culture) Alessandra Vicentini, Daniel Russo (Department of Human Sciences and Innovation for the Territory)

Specific objectives

The ever-accelerating pace of technological, economic and cultural change has profound repercussions on social life, offering new possibilities whilst simultaneously generating new risks and unprecedented forms of fragility. In particular, at a general level, new forms of social interaction accentuate dynamics of individualisation, polarisation and commodification that jeopardise the stability of social bonds. The nature of interaction is also affected by these dynamics, with a profound redefinition of the ways in which people come together in daily life, in civil society and in care practices. Furthermore, at the local level, the current scenario is characterised by the intensification of dynamics that further weaken those local contexts already disadvantaged in terms of infrastructure, services, or due to their economic or cultural marginalisation.