Citta Metropolitana Di Milano

Preeclampsia (PE) is a serious condition affecting 3-8% of pregnancies and causing significant maternal and fetal health problems, including high blood pressure and organ damage or fetal growth restriction. There are two main types: placental PE, caused by abnormal placental development leading to early pregnancy complications and growth restriction, and metabolic PE, linked to maternal metabolic issues like obesity and inflammation. Recent research suggests that changes in the maternal gut microbiota may influence immune responses and contribute to these distinct PE types. This study aims to better understand the maternal gut microbiota in these two PE forms to improve prediction and prevention. The study includes pregnant women with a single fetus at 11-13 weeks gestation who are identified as high-risk during first-trimester screening for preeclampsia. Researchers will observe the maternal gut microbiota characteristics related to placental and metabolic PE phenotypes. They will use non-invasive monitoring of cardiovascular and hemodynamic functions with a device called USCOM, which tracks heart and blood flow parameters in real time. The study focuses on distinguishing the two PE types by combining fetal growth data, maternal cardiovascular adaptation, and placental examination after delivery. Participants will be monitored through pregnancy with assessments of fetal growth, maternal cardiovascular health, and immune system markers. The study will track outcomes related to clinical phenotypes of preeclampsia over about one year. Researchers aim to identify biomarkers that predict PE types, which could lead to better targeted prevention and treatments. Participants will provide consent and undergo evaluations including blood pressure measurements, urine tests, and fetal ultrasounds as part of regular prenatal care alongside study assessments.

Researchers are evaluating the effectiveness and safety of ACR-368 alone or combined with ultra-low dose gemcitabine (ULDG) sensitization in people with endometrial cancer. This is an open-label Phase 2 study involving participants with high-grade endometrial adenocarcinoma. Participants are grouped based on a test called OncoSignature, which predicts sensitivity to ACR-368, or by tumor subtype without requiring the test. Participants in Arm 1 and Arm 4 receive ACR-368 as a single treatment, while those in Arms 2 and 3 receive ACR-368 combined with ULDG sensitization. Arms 1 and 2 are for participants selected by OncoSignature status, while Arms 3 and 4 include participants with serous carcinoma regardless of OncoSignature results. Treatment continues until the disease progresses, unacceptable side effects occur, or the participant withdraws. Participants will have tumor response assessed every 8 weeks from the start of treatment through two years or until death. To join, participants must have measurable metastatic cancer that progressed after prior therapies, provide tumor tissue samples, and meet health and organ function requirements. Safety and response will be closely monitored throughout the study.

Researchers are investigating preeclampsia (PE), a serious pregnancy complication characterized by high blood pressure and protein in the urine, which can lead to significant health risks for both mother and baby. This condition has two main types: one caused by placental damage and the other linked to metabolic factors such as obesity. The study focuses on understanding differences in maternal gut bacteria between these two forms of preeclampsia to improve prevention strategies. The study includes women with pregnancies affected by hypertensive disorders and fetal growth issues, as well as those at high and low risk for these conditions based on early pregnancy screening. Researchers will examine the maternal gut microbiota, immune cells like NK and B cells, and metabolic profiles over the course of pregnancy. Advanced non-invasive monitoring methods, such as ultrasound cardiac output measurement, may be utilized to assess maternal cardiovascular function. Participants will be followed for about one year, with various assessments including immune system and metabolic studies and microbiota analysis. The study aims to clarify how changes in gut bacteria relate to immune responses and metabolic changes in hypertensive pregnancies, potentially leading to better diagnostic and therapeutic approaches. Safety and health data will be collected throughout the study period to monitor outcomes for both mother and fetus.