"Science is the protagonist, the pandemic has shown its importance" - Dr. Antonio Giordano

The following is a translation of the interview that was published in Italian for 'Dottor Semplice'.

Antonio Giordano is one of the best-known Italian scientists in the world: his passion for research led him to the United States, where he is a professor of Molecular Biology at the Temple University of Philadelphia and director of the Sbarro Institute for Cancer Reasearch and Molecular Medicine. But he never really abandoned Italy, as evidenced by the chair at the University of Siena and the honors of Knight of the Republic and Commander of the Order of Merit of the Italian Republic. A life for research and for the fight against cancer, with complaints of environmental factors as the cause of an increase in cancer pathologies.

The world of medicine made an incredible effort during the pandemic period and the vaccines were made with extraordinary timing: in short, if you invest in research, will the results arrive?

Science has played a leading role. Obviously, being engaged in research, I have never doubted its centrality, even if, currently, due to the pandemic, the whole world is aware of the importance of scientific research and the need to encourage it. By coordinating various research groups both in Italy and in America, I realize that the USA has long understood the importance of research. It is no coincidence that the work of young researchers there benefits from a series of incentives that push many foreign researchers to "flee" from their countries of origin and move to America.

In fact, you represent Italian excellence abroad when will we be able to hold back our finest minds?

The Covid-19 pandemic has imposed a new lifestyle on us and introduced new ways of working. Italy has also re-appropriated some excellent minds who had been forced to emigrate elsewhere in order to shine. The pandemic, in fact, forced them to work from home and many workers took the opportunity to return to Italy. According to the Italian Ministry of Foreign Affairs, in the last year the number of Italians aged between 18 and 34 who returned home has increased by 20% compared to the previous year. In October, the Italian Minister for Technological Innovation declared that Italy had the opportunity to benefit from the skills and innovations that the "returning Italians" have brought with them. To make these beneficial effects lasting, however, Italy will have to do its part, committing itself,

In recent years it has often been said that the world would have learned from the pandemic, but after two years the historical criticalities of health have returned to appear with arrogance. Since many problems are not solved in a short time, have we not learned our lesson?

Unfortunately no, I believe we are facing a boomerang effect. The pandemic has caused a major shock on public finances, many of which have been used to adapt the health system to pandemic management and to address staff shortages. Even if the fundamental problems with the propagation and symptomatology of viral transmission for Covid 19 have been resolved, the crisis in the healthcare system still exists and requires radical reform.

You live in two realities and two very different health services, the American one and the Italian one. And if in our country many are pushing for a more privatized system, in the United States in recent years there has been an attempt to strengthen the public system amid numerous obstacles

The privatization of the US health system has always been at the center of heated debates, having never developed comprehensive health coverage and this is because there are no taxes to support health care as in Italy. This means that the expense for the care of a person is entirely borne by the citizen, who can only be treated if he has previously taken out insurance coverage, or if he has enough money to cover the visit, operation, or hospitalization they need. In Italy, on the other hand, health care is guaranteed to everyone by the state, therefore each citizen is protected and has the right and the possibility to receive adequate care.

We said before about the role of research: in recent years the fight against cancer has made great strides and survival rates are clearly improving. Where are we at? But the incidence always remains high: why do we continue to get sick today?

Scientific advances are extremely cutting edge; new technologies offer the possibility of studying thousands of genes at the same time. Today we treat many cancers that have been inauspicious for years and we know how to identify the right therapy for that particular patient. By now, we can define cancer as a "genetic pathology of environmental origin", for which the undoubted improvement of scientific progress is necessary to associate effective primary prevention, which foresees, first of all, the correction of some erroneous lifestyles and limits the Environmental pollution exposure may be a first, effective weapon in the fight against the rise in the prevalence of numerous illnesses. Improvements in oncological therapy as a result of scientific progress

An effective health system, substantial policy changes, and health education are all required to minimize the incidence of cancer

Then there are some realities where you get sick more. Pollution, environment, nutrition: what impact do these components have on cancer prevention?

Cancer is a multifactorial disease, so pollution and lifestyles certainly influence its development. Numerous scientific studies have been aimed at identifying a correlation between exposure to a certain agent and the onset of various pathologies (including tumors) and numerous substances have been identified and classified as toxic (more than 100 according to the International Agency of Cancer Research_IARC). The information coming from the environment "triggers" complex and specific cellular pathways that modify the epigenetic structure of the genome in a way that is more and more stable and transmissible from one cell generation to another. Therefore the concept that environmental factors understood as those to which each of us is involuntarily or voluntarily exposed, represent an oncogenic risk is no longer negligible. For many years, as regards the development of neoplasms of environmental origin, I have been conducting studies that aim to identify new therapies, new diagnostic and prognostic markers, for example, for pleural mesothelioma. This cancer is caused by exposure to asbestos fibers and, although this material has been banned, it continues to be dispersed into the environment causing a steady increase in the incidence of mesothelioma. I have conducted a series of studies in which I demonstrate how reactivating the function of tumor suppressors can be a useful strategy to fight this tumor. Another clear example of environmental toxicity is the well-known exposure to UV rays, which causes extensive damage to DNA. In a very recent study, conducted by my research group and published in an authoritative scientific journal, I highlight the discovery of a new protein involved in DNA repair. The ability is crucial for cells to be able to fix damaged DNA in order to stop the occurrence of mutations and illnesses like cancer from developing. As far as correct lifestyles are concerned, the relationship between diet and the development of pathologies has long been the subject of basic and epidemiological research. Taking into consideration the "eating habits", strong scientific evidence emerged: a healthy diet and regular physical activity can reduce the onset of tumors. The ability of cells to repair damaged DNA is essential to prevent the accumulation of mutations and the onset of diseases such as cancer. Regarding healthy lifestyles, basic and epidemiological research has long focused on the connection between diet and the emergence of illnesses. Strong scientific evidence developed when the "eating habits" were taken into account: a healthy diet and regular physical activity can reduce the chances of tumors. In order to stop the accumulation of mutations and the genesis of illnesses like cancer, cells must be able to repair damaged DNA. As far as correct lifestyles are concerned, the relationship between diet and the development of pathologies has long been the subject of basic and epidemiological research. Taking into consideration the "eating habits", strong scientific evidence emerged: a healthy diet and regular physical activity can reduce the chances of tumors.

In this sense, the American Cancer Society released in 2002 guidelines on nutrition and physical activity for cancer prevention.

Among the various guidelines on the foods to be consumed, a key role of the tomato emerged, considered the "king" of the Mediterranean diet. I decided to study its possible beneficial effects on a tumor closely related to food intake: gastric cancer. More specifically, I tested the effect of two tomato extracts, both of Campania origin, Corbarino and San Marzano, on three cell lines from three patients with gastric cancer. The results obtained show how these extracts have the ability to slow down and stop the growth of these tumor cells, acting on numerous proteins involved in the regulation of the cell cycle, such as the oncosuppressant p130 / pRB2.

And the use of Campania products is linked to its roots ...

I am a "Neapolitan" on loan to the United States and I consider Campania, like many other regions of Italy, an excellence not only as regards the quality of doctors, but also for the excellent universities and the conduct of research activities.

In conclusion, how does one become Antonio Giordano? And what would you recommend to a boy today, perhaps at the beginning of his career in medicine?

Without a doubt, I inherited my passion for medicine and research from my father, Professor Giovan Giacomo Giordano, who throughout his life has always promoted ethics in the profession. My father discovered the very serious damage caused by asbestos fibre exposure - respiratory diseases such as asbestosis, lung cancer, and mesothelioma: as a result of his research, asbestos was banned in Italy in 1992. As a result, my desire to study is to give hope to thousands of cancer patients, to cure them or at the very least improve their quality of life.

I advise young people to pursue research only if they are driven by a strong desire. An arduous commitment is required, as well as a deep determination combined with perseverance: most hypotheses are not proven, and endless hours of work are not always able to produce the desired results.

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