San Raffaele Institute is relentlessly pursuing its three interrelated lines of clinics, research and education since 1971 when it was established and represented one of the first examples of a fully independent private hospital in Italy. Shortly after its foundation San Raffaele was granted the status of IRCCS (Research Hospital), which favored its development as a site for clinical research, originally specialized in diabetes and metabolic disorders.

In 1992 San Raffaele expanded further with the inauguration of DIBIT, a building dedicated to basic science, with a research space of about 12,000 square meters where at present 250 people are employed in basic, translational and clinical research, including scientists, technicians and administrative personnel, along with additional 300 fellows, consultants, trainees and graduate students. DIBIT is part of the largest biomedical science park in Italy, which includes San Raffaele Hospital with more than 1300 beds, Science Park Raf, created to support the Foundation's development objectives, and the University Vita-Salute San Raffaele.

Within 2007, the DIBIT-2 project will expand almost three-fold the floor space devoted to research and will substantially increase and empower research in the different fields where San Raffaele has become highly renowned. Considering the interactions that DIBIT entails with San Raffaele Hospital, Science Park Raf and the University it is highly plausible to believe that in turn this expansion will allow to improve logistic and organization, to rationalize clinical activity, to catalyse industrial attention and to attract the best students.

Much effort and many resources have been invested in basic, preclinical and clinical research. Our scientific production continues to show quite an impressive progress in terms of both number of publications and overall quality. In 2006, 678 scientific papers were published, with a total impact factor of 3400. These figures confirm the Institute's leading position in Italy, strongly support the ability to attract support from public (Ministry of Health, Superior Institute of Health, Ministry of University and Research, European Community, NIH and, for a small amount, CNR) and from private sources as well including charity foundations (mainly Telethon, the Italian Association for Cancer Research and Bank Foundations) and are the basis for the solid international reputation acquired over the years. Telethon is funding two research centers at San Raffaele: the San Raffaele-Telethon Institute for Gene Therapy of Genetic Disease (HSR-TIGET) which is pioneering the clinical application of gene transfer technology and the Stem Cell Research Institute (SCRI), which studies the biology and the potential clinical applications of stem cells, a field in which San Raffaele Institute is a world leader.

Emerging Bacterial Pathogens Unit:

The EBP Unit hosts a TB Supranational Reference laboratory recognized by the World Health Organization under the direction of D. Cirillo with the mandate to provide training, technical assistance and quality assurance to national TB network to selected endemic Countries.

Research Objectives:

1. Control of Multidrug resistant Tuberculosis (TB): from public health to basic and applied research 
   • The rapid DR diagnosis allowed by molecular approaches remains one of the most powerful tools to rapidly improve patient management, and therefore helps to control the spread of drug-resistant TB. Thus, we aim to identify mutations involved in resistant phenotypes, particularly to second-line and new drugs, through the analysis of genomic regions outside the well-characterized genes. Easy-to-perform assays to detect mutations will be developed through the best technology available and transferable to low-income high-incidence settings in order to improve MDR-diagnosis by molecular tools.
     
   • Tubercle bacilli sense the host environment and switch to a persistent (non-replicating) form, which exhibits reduced susceptibility to physical and chemical insult, and to most antimicrobial drugs. We hypothesize that this switch, which involves changes in growth rate, substrate uptake, intracellular fluxes, and respiratory pathway utilization, makes tubercle bacilli also resistant to macrophage killing. We investigate (i) the transcriptional program, small non-coding RNA (sRNA) profile, and metabolic state of the pathogen before, during and after the switch; (ii) regulatory events associated with the switching process; and (iii) phenotypic consequences. Since sRNAs regulate bacterial virulence, stress resistance, and iron homeostasis, we hypothesize that they contribute to modulating the switch to persistence.
2. Molecular characterization of MDR microorganisms for infection control and epidemiological studies in selected population