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Martin-Rojas T, Sastre-Oliva T, Esclarín-Ruz A, Gil-Dones F, Mourino-Alvarez L, Corbacho-Alonso N, Moreno-Luna R, Hernandez-Fernandez G, Lopez JA, Oliviero A, Barderas MG. Effects of Growth Hormone Treatment and Rehabilitation in Incomplete Chronic Traumatic Spinal Cord Injury: Insight from Proteome Analysis. J Pers Med 2020; 10:jpm10040183. [PMID: 33096745 PMCID: PMC7720149 DOI: 10.3390/jpm10040183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/17/2020] [Accepted: 10/19/2020] [Indexed: 11/16/2022] Open
Abstract
Despite promising advances in the medical management of spinal cord injury (SCI), there is still no available effective therapy to repair the neurological damage in patients who experience this life-transforming condition. Recently, we performed a phase II/III placebo-controlled randomized trial of safety and efficacy of growth hormone (GH) treatment in incomplete chronic traumatic spinal cord injury. The main findings were that the combined treatment of GH plus rehabilitation treatment is feasible and safe, and that GH but not placebo slightly improves the SCI individual motor score. Moreover, we found that an intensive and long-lasting rehabilitation program per se increases the functional outcome of SCI individuals. To understand the possible mechanisms of the improvement due to GH treatment (motor score) and due to rehabilitation (functional outcome), we used a proteomic approach. Here, we used a multiple proteomic strategy to search for recovery biomarkers in blood plasma with the potential to predict response to somatropin treatment and to delayed intensive rehabilitation. Forty-six patients were recruited and followed for a minimum period of 1 year. Patients were classified into two groups based on their treatment: recombinant somatropin (0.4 mg) or placebo. Both groups received rehabilitation treatment. Our strategy allowed us to perform one of the deepest plasma proteomic analyses thus far, which revealed two proteomic signatures with predictive value: (i) response to recombinant somatropin treatment and (ii) response to rehabilitation. The proteins implicated in these signatures are related to homeostasis, inflammation, and coagulation functions. These findings open novel possibilities to assess and therapeutically manage patients with SCI, which could have a positive impact on their clinical response.
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Affiliation(s)
- Tatiana Martin-Rojas
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos (HNP), SESCAM, 45071 Toledo, Spain; (T.M.-R.); (T.S.-O.); (F.G.-D.); (L.M.-A.); (N.C.-A.); (R.M.-L.); (G.H.-F.)
| | - Tamara Sastre-Oliva
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos (HNP), SESCAM, 45071 Toledo, Spain; (T.M.-R.); (T.S.-O.); (F.G.-D.); (L.M.-A.); (N.C.-A.); (R.M.-L.); (G.H.-F.)
| | - Ana Esclarín-Ruz
- Department of Physical Medicine and Rehabilitation, Hospital Nacional de Parapléjicos, SESCAM, 45071 Toledo, Spain;
| | - Felix Gil-Dones
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos (HNP), SESCAM, 45071 Toledo, Spain; (T.M.-R.); (T.S.-O.); (F.G.-D.); (L.M.-A.); (N.C.-A.); (R.M.-L.); (G.H.-F.)
- Department of Genetic, Facultad de Ciencias Biológicas, UCM, 28040 Madrid, Spain
| | - Laura Mourino-Alvarez
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos (HNP), SESCAM, 45071 Toledo, Spain; (T.M.-R.); (T.S.-O.); (F.G.-D.); (L.M.-A.); (N.C.-A.); (R.M.-L.); (G.H.-F.)
| | - Nerea Corbacho-Alonso
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos (HNP), SESCAM, 45071 Toledo, Spain; (T.M.-R.); (T.S.-O.); (F.G.-D.); (L.M.-A.); (N.C.-A.); (R.M.-L.); (G.H.-F.)
| | - Rafael Moreno-Luna
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos (HNP), SESCAM, 45071 Toledo, Spain; (T.M.-R.); (T.S.-O.); (F.G.-D.); (L.M.-A.); (N.C.-A.); (R.M.-L.); (G.H.-F.)
- Department of Neuroinflammation, Hospital Nacional de Paraplejicos (HNP), SESCAM, 45004 Toledo, Spain
| | - German Hernandez-Fernandez
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos (HNP), SESCAM, 45071 Toledo, Spain; (T.M.-R.); (T.S.-O.); (F.G.-D.); (L.M.-A.); (N.C.-A.); (R.M.-L.); (G.H.-F.)
| | | | - Antonio Oliviero
- FENNSI Group, Hospital Nacional de Parapléjicos, SESCAM, 45071 Toledo, Spain
- Correspondence: (A.O.); (M.G.B.); Fax: +34-925-247-745 (M.G.B.)
| | - María G. Barderas
- Department of Vascular Physiopathology, Hospital Nacional de Paraplejicos (HNP), SESCAM, 45071 Toledo, Spain; (T.M.-R.); (T.S.-O.); (F.G.-D.); (L.M.-A.); (N.C.-A.); (R.M.-L.); (G.H.-F.)
- Correspondence: (A.O.); (M.G.B.); Fax: +34-925-247-745 (M.G.B.)
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Baldan-Martin M, Mourino-Alvarez L, Gonzalez-Calero L, Moreno-Luna R, Sastre-Oliva T, Ruiz-Hurtado G, Segura J, Lopez JA, Vazquez J, Vivanco F, Alvarez-Llamas G, Ruilope LM, de la Cuesta F, Barderas MG. Plasma Molecular Signatures in Hypertensive Patients With Renin–Angiotensin System Suppression. Hypertension 2016; 68:157-66. [DOI: 10.1161/hypertensionaha.116.07412] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 04/27/2016] [Indexed: 01/08/2023]
Abstract
Albuminuria is a risk factor strongly associated with cardiovascular disease, the first cause of death in the general population. It is well established that renin–angiotensin system suppressors prevent the development of new-onset albuminuria in naïf hypertensive patients and diminish its excretion, but we cannot forget the percentage of hypertensive patients who develop de novo albuminuria. Here, we applied multiple proteomic strategy with the purpose to elucidate specific molecular pathways involved in the pathogenesis and provide predictors and chronic organ damage indicators. Briefly, 1143 patients were followed up for a minimum period of 3 years. One hundred and twenty-nine hypertensive patients chronically renin–angiotensin system suppressed were recruited, classified in 3 different groups depending on their albuminuria levels (normoalbuminuria, de novo albuminuria, and sustained albuminuria), and investigated by multiple proteomic strategies. Our strategy allowed us to perform one of the deepest plasma proteomic analysis to date, which has shown 2 proteomic signatures: (1) with predictive value of de novo albuminuria and (2) sustained albuminuria indicator proteins. These proteins are involved in inflammation, immune as well as in the proteasome activation occurring in situations of endoplasmic reticulum stress. Furthermore, these results open the possibility of a future strategy based on anti-immune therapy to treat hypertension which could help to prevent the development of albuminuria and, hence, the progression of kidney damage.
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Affiliation(s)
- Montserrat Baldan-Martin
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Laura Mourino-Alvarez
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Laura Gonzalez-Calero
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Rafael Moreno-Luna
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Tamara Sastre-Oliva
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Gema Ruiz-Hurtado
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Julian Segura
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Juan Antonio Lopez
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Jesus Vazquez
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Fernando Vivanco
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Gloria Alvarez-Llamas
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Luis M. Ruilope
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Fernando de la Cuesta
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
| | - Maria G. Barderas
- From the Departamento de Fisiopatologia Vascular, Hospital Nacional de Paraplejicos (HNP), SESCAM, Toledo, Spain (M.B.-M., L.M.-A., R.M.-L., T.S.-O., F.d.l.C., M.G.B.); Departamento de Inmunologia, IIS-Fundacion JimenezDiaz, Madrid, Spain (L.G.-C., F.V., G.A.-L.); Unidad de Hipertension, Instituto de Investigación i+12, Hospital Universitario 12 de Octubre, Madrid, Spain (G.R.-H., J.S., L.M.R.); Unidad de Proteomica CNIC, Madrid, Spain (J.A.L., J.V.); and Departamento de Bioquimica y Biologia
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