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Buesa J, Lizaran M, Almansa B, Ghosn F, Campos-Berga L, Hervás D, Andreu J, Sierra P, Livianos L, Vento M, Diago V, García-Blanco A. Understanding the course of attention deficit hyperactivity disorder in children born after a threatened preterm labor: a 6-year cohort study. Am J Obstet Gynecol MFM 2024; 6:101289. [PMID: 38280551 DOI: 10.1016/j.ajogmf.2024.101289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND Recent research suggests that children born after suspected preterm labor may observe a potential cluster with different attention deficit hyperactivity disorder features, depending on the time of birth. However, the evolution of symptoms and their predictors remain unknown in this population. OBJECTIVE This study aimed to examine the trajectories of attention deficit hyperactivity disorder symptoms of children born after suspected preterm labor, between ages 2 and 6 years, considering prematurity condition and comparing with controls. In addition, this study aimed to find potential modifiable predictors of evolution to enhance prognosis. STUDY DESIGN In this prospective cohort study, 119 mother-child pairs who experienced suspected preterm labor and 60 controls were included. Patients were divided according to prematurity condition in full term (n=27), late preterm (n=55), and very preterm (n=37). Attention deficit hyperactivity disorder symptoms were assessed at ages 2 and 6 years. The association between potential modifying factors (group, time of assessment, sex, birthweight percentile, maternal history of trauma, maternal anxiety at diagnosis, and maternal anxiety during the children's assessments) and disorder trajectories was assessed by adjusting the Bayesian mixed linear models. All analyses were performed in R (version 4.3.0; R Foundation for Statistical Computing, Vienna, Austria). RESULTS An interaction emerged between time and group, with late-preterm neonates born after suspected preterm labor being the only group to improve from ages 2 to 6 years (-2.26 points in Conners scale per percentile decrease and 0.98 probability of effect). Another interaction between time and maternal anxiety at postnatal time assessments intensified over time (0.07 and 0.84). Predictors of symptom severity included lower weight percentile at birth (-0.2 and 0.96), male sex (-2.99 and <0.99), higher maternal anxiety at diagnosis (+0.08 and 0.99), and maternal history of trauma (+0.23 and 0.98). CONCLUSION Unlike very-preterm and full-term children, those born late preterm showed an improvement over time, probably because late-preterm children do not carry the sequelae derived from severe prematurity but benefit from close monitoring. As maternal psychopathology emerged as a determinant modifier of course and severity, it is crucial to develop targeted psychological interventions for pregnant individuals and reevaluate monitoring programs for their offspring, regardless of prematurity.
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Affiliation(s)
- Julia Buesa
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Buesas, Campos-Berga, Andreu, Sierra, Livianos, and García-Blanco)
| | - Marta Lizaran
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); University of Valencia, Valencia, Spain (Mses Lizaran, Almansa, and Ghosn and Drs Sierra, Livianos, and García-Blanco)
| | - Belén Almansa
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); University of Valencia, Valencia, Spain (Mses Lizaran, Almansa, and Ghosn and Drs Sierra, Livianos, and García-Blanco)
| | - Farah Ghosn
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); University of Valencia, Valencia, Spain (Mses Lizaran, Almansa, and Ghosn and Drs Sierra, Livianos, and García-Blanco)
| | - Laura Campos-Berga
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Buesas, Campos-Berga, Andreu, Sierra, Livianos, and García-Blanco)
| | - David Hervás
- Department of Applied Statistics, Operations Research, and Quality, Universitat Politècnica de Valencia, Valencia, Spain (Dr Hervás)
| | - Julia Andreu
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Buesas, Campos-Berga, Andreu, Sierra, Livianos, and García-Blanco)
| | - Pilar Sierra
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Buesas, Campos-Berga, Andreu, Sierra, Livianos, and García-Blanco); University of Valencia, Valencia, Spain (Mses Lizaran, Almansa, and Ghosn and Drs Sierra, Livianos, and García-Blanco)
| | - Lorenzo Livianos
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Buesas, Campos-Berga, Andreu, Sierra, Livianos, and García-Blanco); University of Valencia, Valencia, Spain (Mses Lizaran, Almansa, and Ghosn and Drs Sierra, Livianos, and García-Blanco)
| | - Máximo Vento
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Neonatology Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Vento)
| | - Vicente Diago
- Division of Obstetrics and Gynecology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Diago)
| | - Ana García-Blanco
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Buesas, Campos-Berga, Andreu, Sierra, Livianos, and García-Blanco); University of Valencia, Valencia, Spain (Mses Lizaran, Almansa, and Ghosn and Drs Sierra, Livianos, and García-Blanco).
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López-Morales MA, Castelló-Ruiz M, Burguete MC, Hervás D, Pérez-Pinzón MA, Salom JB. Effect and mechanisms of resveratrol in animal models of ischemic stroke: A systematic review and Bayesian meta-analysis. J Cereb Blood Flow Metab 2023; 43:2013-2028. [PMID: 37802493 PMCID: PMC10925864 DOI: 10.1177/0271678x231206236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/03/2023] [Accepted: 09/20/2023] [Indexed: 10/10/2023]
Abstract
Resveratrol (RSV) holds promise as cerebroprotective treatment in cerebral ischemia. This systematic review aims to assess the effects and mechanisms of RSV in animal models of ischemic stroke. We searched Medline, Embase and Web of Science to identify 75 and 57 eligible rodent studies for qualitative and quantitative syntheses, respectively. Range of evidence met 10 of 13 STAIR criteria. Median (Q1, Q3) quality score was 7 (5, 8) on the CAMARADES 15-item checklist. Bayesian meta-analysis showed SMD estimates (95% CI) favoring RSV: infarct size (-1.72 [-2.03; -1.41]), edema size (-1.61 [-2.24; -0.98]), BBB impairment (-1.85 [-2.54; -1.19]), neurofunctional impairment (-1.60 [-1.92; -1.29]), and motor performance (1.39 [0.64; 2.08]); and less probably neuronal survival (0.63 [-1.40; 2.48]) and apoptosis (-0.96 [-2.87; 1.02]). Species (rat vs mouse) was associated to a larger benefit. Sensitivity analyses confirmed robustness of the estimates. Reduction of oxidative stress, inflammation, and apoptosis underlie these effects. Our results quantitatively state the beneficial effects of RSV on structural and functional outcomes in rodent stroke models, update the evidence on the mechanisms of action, and provide an exhaustive list of targeted signaling pathways. Current evidence highlights the need for conducting further high-quality preclinical research to better inform clinical research.
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Affiliation(s)
- Mikahela A López-Morales
- Unidad Mixta de Investigación Cerebrovascular, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - María Castelló-Ruiz
- Unidad Mixta de Investigación Cerebrovascular, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
- Departamento de Biología Celular, Biología Funcional y Antropología Física, Universidad de Valencia, Valencia, Spain
| | - María C Burguete
- Unidad Mixta de Investigación Cerebrovascular, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
- Departamento de Fisiología, Universidad de Valencia, Valencia, Spain
| | - David Hervás
- Departamento de Estadística e Investigación Operativa Aplicadas y Calidad, Universitat Politècnica de València, Valencia, Spain
| | - Miguel A Pérez-Pinzón
- Peritz Scheinberg Cerebral Vascular Disease Research Laboratories, Department of Neurology, Miller School of Medicine, University of Miami, Miami, USA
| | - Juan B Salom
- Unidad Mixta de Investigación Cerebrovascular, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
- Departamento de Fisiología, Universidad de Valencia, Valencia, Spain
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Pitarch-Castellano I, Hervás D, Cattinari MG, Ibáñez Albert E, López Lobato M, Ñungo Garzón NC, Rojas J, Puig-Ram C, Madruga-Garrido M. Pain in Children and Adolescents with Spinal Muscular Atrophy: A Longitudinal Study from a Patient Registry. Children (Basel) 2023; 10:1880. [PMID: 38136082 PMCID: PMC10742134 DOI: 10.3390/children10121880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/23/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023]
Abstract
Spinal muscular atrophy (SMA) is a devastating genetic neurodegenerative disease caused by the insufficient production of Survival Motor Neuron (SMN) protein. It presents different phenotypes with frequent contractures and dislocations, scoliosis, and pain. This study aims to report the prevalence and description of pain and how it affects daily life by analyzing a new ad hoc questionnaire. An observational study of patients under 18 years of age with SMA was conducted at two referral centers in Spain. Data were analyzed using a descriptive analysis and a Bayesian ordinal regression model to assess the association with clinical and demographic variables. Fifty-one individuals were included in this study, 27% of whom reported pain with a median duration of 5.2 years and a mean Visual Analogic Scale (VAS) score of 5. Notably, 77% were receiving disease-modifying treatment, with more than 50% receiving analgesic treatment. The Bayesian model showed that functional status, lower limb contractures, and number of visits have a high probability (>90%) of influencing pain. Thus, the prevalence of pain in the SMA population under 18 years is substantial, and its presence could be associated with lower limb contractures, better functional status, and higher RULM (Revised Upper Limb Module) scores.
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Affiliation(s)
| | - David Hervás
- Department of Applied Statistics and Operations Research and Quality, Universitat Politècnica de València, 46022 Valencia, Spain;
| | | | - Eugenia Ibáñez Albert
- Rehabilitation Department, Hospital Universitario y Politécnico la Fe, 46026 Valencia, Spain
| | - Mercedes López Lobato
- Neuropediatric Department, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain
| | - Nancy Carolina Ñungo Garzón
- Neuromuscular Diseases Unit, Hospital Universitario y Politécnico la Fe, Institute for Health Research La Fe (IISLAFE), 46026 Valencia, Spain;
- Faculty of Medicine, Universitat de València, 46010 Valencia, Spain
| | - Juan Rojas
- Rehabilitation Department, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain
| | - Cristina Puig-Ram
- Neuromuscular Diseases Unit, Institut de Recerca Sant Joan de Déu, Santa Rosa 39-57, 08950 Esplugues de Llobregat, Spain
| | - Marcos Madruga-Garrido
- Sección de Neurología Pediátrica, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain
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4
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Méndez R, González-Jiménez P, Latorre A, Mengot N, Zalacain R, Ruiz LA, Serrano L, España PP, Uranga A, Cillóniz C, Hervás D, Torres A, Menéndez R. Is the long-term mortality similar in COVID-19 and community-acquired pneumonia? Front Med (Lausanne) 2023; 10:1236142. [PMID: 37886363 PMCID: PMC10598770 DOI: 10.3389/fmed.2023.1236142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/18/2023] [Indexed: 10/28/2023] Open
Abstract
Introduction There are no data on the association of type of pneumonia and long-term mortality by the type of pneumonia (COVID-19 or community-acquired pneumonia [CAP]) on long-term mortality after an adjustment for potential confounding variables. We aimed to assess the type of pneumonia and risk factors for long-term mortality in patients who were hospitalized in conventional ward and later discharged. Methods Retrospective analysis of two prospective and multicentre cohorts of hospitalized patients with COVID-19 and CAP. The main outcome under study was 1-year mortality in hospitalized patients in conventional ward and later discharged. We adjusted a Bayesian logistic regression model to assess associations between the type of pneumonia and 1-year mortality controlling for confounders. Results The study included a total of 1,693 and 2,374 discharged patients in the COVID-19 and CAP cohorts, respectively. Of these, 1,525 (90.1%) and 2,249 (95%) patients underwent analysis. Until 1-year follow-up, 69 (4.5%) and 148 (6.6%) patients from the COVID-19 and CAP cohorts, respectively, died (p = 0.008). However, the Bayesian model showed a low probability of effect (PE) of finding relevant differences in long-term mortality between CAP and COVID-19 (odds ratio 1.127, 95% credibility interval 0.862-1.591; PE = 0.774). Conclusion COVID-19 and CAP have similar long-term mortality after adjusting for potential confounders.
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Affiliation(s)
- Raúl Méndez
- Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
- Respiratory Infections, Health Research Institute La Fe (IISLAFE), Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
| | - Paula González-Jiménez
- Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
- Respiratory Infections, Health Research Institute La Fe (IISLAFE), Valencia, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
| | - Ana Latorre
- Respiratory Infections, Health Research Institute La Fe (IISLAFE), Valencia, Spain
| | - Noé Mengot
- Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
- Respiratory Infections, Health Research Institute La Fe (IISLAFE), Valencia, Spain
| | - Rafael Zalacain
- Pneumology Department, Cruces University Hospital, Barakaldo, Spain
| | - Luis A. Ruiz
- Pneumology Department, Cruces University Hospital, Barakaldo, Spain
- Department of Immunology, Microbiology and Parasitology, Facultad de Medicina y Enfermería, Universidad del País Vasco/Euskal Herriko Unibertsitatea UPV/EHU, Leioa, Spain
| | - Leyre Serrano
- Pneumology Department, Cruces University Hospital, Barakaldo, Spain
- Department of Immunology, Microbiology and Parasitology, Facultad de Medicina y Enfermería, Universidad del País Vasco/Euskal Herriko Unibertsitatea UPV/EHU, Leioa, Spain
| | - Pedro P. España
- Pneumology Department, Galdakao-Usansolo Hospital, Galdacano, Spain
| | - Ane Uranga
- Pneumology Department, Galdakao-Usansolo Hospital, Galdacano, Spain
| | - Catia Cillóniz
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Faculty of Health Sciences, Continental University, Huancayo, Peru
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - David Hervás
- Data Science, Biostatistics and Bioinformatics, Health Research Institute La Fe (IISLAFE), Valencia, Spain
- Department of Applied Statistics and Operational Research and Quality, Universitat Politècnica de València, Valencia, Spain
| | - Antoni Torres
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
- Pneumology Department, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Rosario Menéndez
- Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
- Respiratory Infections, Health Research Institute La Fe (IISLAFE), Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, University of Valencia, Valencia, Spain
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Agulló L, Muriel J, Margarit C, Escorial M, Garcia D, Herrero MJ, Hervás D, Sandoval J, Peiró AM. Sex Differences in Opioid Response Linked to OPRM1 and COMT genes DNA Methylation/Genotypes Changes in Patients with Chronic Pain. J Clin Med 2023; 12:jcm12103449. [PMID: 37240556 DOI: 10.3390/jcm12103449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/10/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
Analgesic-response variability in chronic noncancer pain (CNCP) has been reported due to several biological and environmental factors. This study was undertaken to explore sex differences linked to OPRM1 and COMT DNA methylation changes and genetic variants in analgesic response. A retrospective study with 250 real-world CNCP outpatients was performed in which data from demographic, clinical, and pharmacological variables were collected. DNA methylation levels (CpG island) were evaluated by pyrosequencing, and their interaction with the OPRM1 (A118G) and COMT (G472A) gene polymorphisms was studied. A priori-planned statistical analyses were conducted to compare responses between females and males. Sex-differential OPRM1 DNA methylation was observed to be linked to lower opioid use disorder (OUD) cases for females (p = 0.006). Patients with lower OPRM1 DNA methylation and the presence of the mutant G-allele reduced opioid dose requirements (p = 0.001), equal for both sexes. Moreover, COMT DNA methylation levels were negatively related to pain relief (p = 0.020), quality of life (p = 0.046), and some adverse events (probability > 90%) such as constipation, insomnia, or nervousness. Females were, significantly, 5 years older with high anxiety levels and a different side-effects distribution than males. The analyses demonstrated significant differences between females and males related to OPRM1 signalling efficiency and OUD, with a genetic-epigenetic interaction in opioid requirements. These findings support the importance of sex as a biological variable to be factored into chronic pain-management studies.
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Affiliation(s)
- Laura Agulló
- Pharmacogenetic Unit, Alicante Institute for Health and Biomedical Research (ISABIAL), Dr. Balmis General University Hospital, Pintor Baeza, 12, 03010 Alicante, Spain
- Clinical Pharmacology, Toxicology and Chemical Safety Unit, Institute of Bioengineering, Miguel Hernández University, Avda. de la Universidad s/n, 03202 Elche, Spain
| | - Javier Muriel
- Pharmacogenetic Unit, Alicante Institute for Health and Biomedical Research (ISABIAL), Dr. Balmis General University Hospital, Pintor Baeza, 12, 03010 Alicante, Spain
| | - César Margarit
- Pain Unit, Department of Health of Alicante, Dr. Balmis General University Hospital, c/Pintor Baeza, 12, 03010 Alicante, Spain
| | - Mónica Escorial
- Pharmacogenetic Unit, Alicante Institute for Health and Biomedical Research (ISABIAL), Dr. Balmis General University Hospital, Pintor Baeza, 12, 03010 Alicante, Spain
- Clinical Pharmacology, Toxicology and Chemical Safety Unit, Institute of Bioengineering, Miguel Hernández University, Avda. de la Universidad s/n, 03202 Elche, Spain
| | - Diana Garcia
- Epigenomics Core Facility, La Fe Health Research Institute, Ave. Fernando Abril Martorell, 106, 46026 Valencia, Spain
| | - María José Herrero
- Pharmacogenetics Unit, La Fe Health Research Institute, Ave. Fernando Abril Martorell, 106, 46026 Valencia, Spain
| | - David Hervás
- Department of Applied Statistics and Operations Research and Quality, Universitat Politècnica de Valéncia, 46022 Valencia, Spain
| | - Juan Sandoval
- Epigenomics Core Facility, La Fe Health Research Institute, Ave. Fernando Abril Martorell, 106, 46026 Valencia, Spain
| | - Ana M Peiró
- Pharmacogenetic Unit, Alicante Institute for Health and Biomedical Research (ISABIAL), Dr. Balmis General University Hospital, Pintor Baeza, 12, 03010 Alicante, Spain
- Clinical Pharmacology, Toxicology and Chemical Safety Unit, Institute of Bioengineering, Miguel Hernández University, Avda. de la Universidad s/n, 03202 Elche, Spain
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González-Jiménez P, Méndez R, Latorre A, Piqueras M, Balaguer-Cartagena MN, Moscardó A, Alonso R, Hervás D, Reyes S, Menéndez R. Neutrophil Extracellular Traps and Platelet Activation for Identifying Severe Episodes and Clinical Trajectories in COVID-19. Int J Mol Sci 2023; 24:ijms24076690. [PMID: 37047662 PMCID: PMC10094814 DOI: 10.3390/ijms24076690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/31/2023] [Accepted: 03/31/2023] [Indexed: 04/07/2023] Open
Abstract
The role of NETs and platelet activation in COVID-19 is scarcely known. We aimed to evaluate the role of NETs (citrullinated histone H3 [CitH3], cell-free DNA [cfDNA]) and platelet activation markers (soluble CD40 ligand [CD40L] and P-selectin) in estimating the hazard of different clinical trajectories in patients with COVID-19. We performed a prospective study of 204 patients, categorized as outpatient, hospitalized and ICU-admitted. A multistate model was designed to estimate probabilities of clinical transitions across varying states, such as emergency department (ED) visit, discharge (outpatient), ward admission, ICU admission and death. Levels of cfDNA, CitH3 and P-selectin were associated with the severity of presentation and analytical parameters. The model showed an increased risk of higher levels of CitH3 and P-selectin for ED-to-ICU transitions (Hazard Ratio [HR]: 1.35 and 1.31, respectively), as well as an elevated risk of higher levels of P-selectin for ward-to-death transitions (HR: 1.09). Elevated levels of CitH3 (HR: 0.90), cfDNA (HR: 0.84) and P-selectin (HR: 0.91) decreased the probability of ward-to-discharge transitions. A similar trend existed for elevated levels of P-selectin and ICU-to-ward transitions (HR 0.40); In conclusion, increased NET and P-selectin levels are associated with more severe episodes and can prove useful in estimating different clinical trajectories.
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Affiliation(s)
- Paula González-Jiménez
- Pneumology Department, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain
- Respiratory Infections, Health Research Institute La Fe, 46026 Valencia, Spain
- Medicine Department, University of Valencia, 46010 Valencia, Spain
| | - Raúl Méndez
- Pneumology Department, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain
- Respiratory Infections, Health Research Institute La Fe, 46026 Valencia, Spain
| | - Ana Latorre
- Respiratory Infections, Health Research Institute La Fe, 46026 Valencia, Spain
| | - Mónica Piqueras
- Medicine Department, University of Valencia, 46010 Valencia, Spain
- Laboratory Department, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain
| | | | - Antonio Moscardó
- Platelet Function Unit, Health Research Institute La Fe, 46026 Valencia, Spain
| | - Ricardo Alonso
- Laboratory Department, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain
| | - David Hervás
- Data Science, Biostatistics & Bioinformatics, Health Research Institute La Fe, 46026 Valencia, Spain
- Department of Applied Statistics and Operational Research and Quality, Universitat Politècnica de València, 46022 Valencia, Spain
| | - Soledad Reyes
- Pneumology Department, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain
- Respiratory Infections, Health Research Institute La Fe, 46026 Valencia, Spain
| | - Rosario Menéndez
- Pneumology Department, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain
- Respiratory Infections, Health Research Institute La Fe, 46026 Valencia, Spain
- Medicine Department, University of Valencia, 46010 Valencia, Spain
- Center for Biomedical Research Network in Respiratory Diseases (CIBERES), 28029 Madrid, Spain
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Herreros-Pomares A, Hervás D, Bagan-Debon L, Proaño A, Garcia D, Sandoval J, Bagan J. Oral cancers preceded by proliferative verrucous leukoplakia exhibit distinctive molecular features. Oral Dis 2023. [PMID: 36892444 DOI: 10.1111/odi.14550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 03/10/2023]
Abstract
OBJECTIVE Proliferative verrucous leukoplakia (PVL) has high rates of malignant transformation into oral squamous cell carcinoma (OSCC), but the clinical and evolutionary pattern of OSCC from PVL (PVL-OSCC) is more favorable than that of OSCC not preceded by PVL (OSCC). Here, we aimed to explore the pathophysiologic differences between PVL-OSCC and OSCC through transcriptomic and DNA methylation analyses. MATERIALS AND METHODS In this case-control study, oral biopsies from 8 PVL-OSCC and 10 OSCC patients were obtained for global sequencing using RNAseq and a genome-wide DNA methylation analysis via the Infinium EPIC Platform (graphical abstract). RESULTS One hundred and thirty-three differentially expressed genes (DEGs) were detected, 94 of them upregulated in OSCC. Most of these genes were previously described in cancer and associated with prognosis. The integrative analysis revealed 26 DEGs, corresponding to 37 CpGs, whose promoters were regulated by DNA methylation. Twenty-nine of the CpGs were found as hypermethylated in PVL-OSCC. Only 5 of the genes that were aberrantly methylated and differentially expressed were upregulated in PVL-OSCC patients, whereas 21 were underexpressed. CONCLUSIONS PVL-OSCC patients presented lower expression of cancer-related genes. Hypermethylation of the promoter region of many genes was also noticed, indicating that DNA methylation could be a regulatory mechanism.
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Affiliation(s)
- Alejandro Herreros-Pomares
- Department of Biotechnology, Universitat Politècnica de València, Valencia, Spain
- Centro de Investigación Biomédica en Red Cáncer, CIBERONC, Madrid, Spain
| | - David Hervás
- Departamento de Estadística e Investigación Operativa Aplicadas y Calidad, Universitat Politècnica de València, Valencia, Spain
| | - Leticia Bagan-Debon
- Medicina Oral Unit, Stomatology Department, Valencia University, Valencia, Spain
| | - Alex Proaño
- Medicina Oral Unit, Stomatology Department, Valencia University, Valencia, Spain
| | - Diana Garcia
- Epigenomics Unit, Health Research Institute La Fe, Valencia, Spain
| | - Juan Sandoval
- Epigenomics Unit, Health Research Institute La Fe, Valencia, Spain
- Biomarkers and Precision Medicine Unit, Health Research Institute La Fe, Valencia, Spain
| | - Jose Bagan
- Centro de Investigación Biomédica en Red Cáncer, CIBERONC, Madrid, Spain
- Medicina Oral Unit, Stomatology Department, Valencia University, Valencia, Spain
- Department of Stomatology and Maxillofacial Surgery, Hospital General Universitario de Valencia, Valencia, Spain
- Precancer and oral cancer research group of Valencia University, Valencia, Spain
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Urtasun A, Olivera GG, Sendra L, Aliño SF, Berlanga P, Gargallo P, Hervás D, Balaguer J, Juan-Ribelles A, Andrés MDM, Cañete A, Herrero MJ. Personalized Medicine in Infant Population with Cancer: Pharmacogenetic Pilot Study of Polymorphisms Related to Toxicity and Response to Chemotherapy. Cancers (Basel) 2023; 15:cancers15051424. [PMID: 36900216 PMCID: PMC10000841 DOI: 10.3390/cancers15051424] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/05/2023] [Accepted: 02/21/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Pharmacogenetics is a personalized medicine tool that aims to optimize treatments by adapting them to each individual's genetics, maximizing their efficacy while minimizing their toxicity. Infants with cancer are especially vulnerable, and their co-morbidities have vital repercussions. The study of their pharmacogenetics is new in this clinical field. METHODS A unicentric, ambispective study of a cohort of infants receiving chemotherapy (from January 2007 to August 2019). The genotypes of 64 patients under 18 months of age were correlated with severe drug toxicities and survival. A pharmacogenetics panel was configured based on PharmGKB, drug labels, and international experts' consortiums. RESULTS Associations between SNPs and hematological toxicity were found. Most meaningful were: MTHFR rs1801131 GT increasing the anemia risk (OR 1.73); rs1517114 GC, XPC rs2228001 GT, increasing neutropenia risk (OR 1.50 and 4.63); ABCB1 rs1045642 AG, TNFRSF11B rs2073618 GG, CYP2B6 rs4802101 TC and SOD2 rs4880 GG increasing thrombocytopenia risk (OR 1.70, 1.77, 1.70, 1.73, respectively). Regarding survival, MTHFR rs1801133 GG, TNFRSF11B rs2073618 GG, XPC rs2228001 GT, CYP3A4 rs2740574 CT, CDA rs3215400 del.del, and SLC01B1 rs4149015 GA were associated with lower overall survival probabilities (HR 3.12, 1.84, 1.68, 2.92, 1.90, and 3.96, respectively). Lastly, for event-free survival, SLC19A1 rs1051266 TT and CDA rs3215400 del.del increased the relapse probability (HR 1.61 and 2.19, respectively). CONCLUSIONS This pharmacogenetic study is a pioneer in dealing with infants under 18 months of age. Further studies are needed to confirm the utility of the findings in this work to be used as predictive genetic biomarkers of toxicity and therapeutic efficacy in the infant population. If confirmed, their use in therapeutic decisions could improve the quality of life and prognosis of these patients.
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Affiliation(s)
- Andrea Urtasun
- Pediatrics Department, Pediatric Oncology Unit, University Clinic of Navarra, Av. de Pío XII, 36, 31008 Pamplona, Spain
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Av. Fernando Abril Martorell 106, 46026 Valencia, Spain
| | - Gladys G. Olivera
- Department of Pharmacology, Faculty of Medicine, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain
- Pharmacogenetics and Gene Therapy Platform, IIS La Fe, Torre A-Lab 4.03, Av. Fernando Abril Martorell 106, 46026 Valencia, Spain
| | - Luis Sendra
- Department of Pharmacology, Faculty of Medicine, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain
- Pharmacogenetics and Gene Therapy Platform, IIS La Fe, Torre A-Lab 4.03, Av. Fernando Abril Martorell 106, 46026 Valencia, Spain
- Correspondence: (L.S.); (S.F.A.)
| | - Salvador F. Aliño
- Department of Pharmacology, Faculty of Medicine, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain
- Pharmacogenetics and Gene Therapy Platform, IIS La Fe, Torre A-Lab 4.03, Av. Fernando Abril Martorell 106, 46026 Valencia, Spain
- Correspondence: (L.S.); (S.F.A.)
| | - Pablo Berlanga
- Department of Pediatric and Adolescent Oncology, Institute Gustave Roussy Center, Rue Edouard Vaillant 114, 94800 Villejuif, France
| | - Pablo Gargallo
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Av. Fernando Abril Martorell 106, 46026 Valencia, Spain
- Health in Code Group, Oncology Department, 46980 Paterna, Spain
| | - David Hervás
- Department of Applied Statistics and Operations Research and Quality, Universitat Politècnica de València, Camino de Vera, s/n, 46022 Valencia, Spain
| | - Julia Balaguer
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Av. Fernando Abril Martorell 106, 46026 Valencia, Spain
| | - Antonio Juan-Ribelles
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Av. Fernando Abril Martorell 106, 46026 Valencia, Spain
| | - María del Mar Andrés
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Av. Fernando Abril Martorell 106, 46026 Valencia, Spain
| | - Adela Cañete
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, Av. Fernando Abril Martorell 106, 46026 Valencia, Spain
| | - María José Herrero
- Department of Pharmacology, Faculty of Medicine, Universitat de València, Av. Blasco Ibáñez 15, 46010 Valencia, Spain
- Pharmacogenetics and Gene Therapy Platform, IIS La Fe, Torre A-Lab 4.03, Av. Fernando Abril Martorell 106, 46026 Valencia, Spain
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9
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Herreros-Pomares A, Hervás D, Bagan-Debón L, Jantus-Lewintre E, Gimeno-Cardona C, Bagan J. On the Oral Microbiome of Oral Potentially Malignant and Malignant Disorders: Dysbiosis, Loss of Diversity, and Pathogens Enrichment. Int J Mol Sci 2023; 24:ijms24043466. [PMID: 36834903 PMCID: PMC9961214 DOI: 10.3390/ijms24043466] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/03/2023] [Accepted: 02/06/2023] [Indexed: 02/12/2023] Open
Abstract
The role of dysbiosis in the development and progression of oral potentially malignant disorders (OPMDs) remains largely unknown. Here, we aim to characterize and compare the oral microbiome of homogeneous leucoplakia (HL), proliferative verrucous leukoplakia (PVL), oral squamous cell carcinoma (OSCC), and OSCC preceded by PVL (PVL-OSCC). Fifty oral biopsies from HL (n = 9), PVL (n = 12), OSCC (n = 10), PVL-OSCC (n = 8), and healthy (n = 11) donors were obtained. The sequence of the V3-V4 region of the 16S rRNA gene was used to analyze the composition and diversity of bacterial populations. In the cancer patients, the number of observed amplicon sequence variants (ASVs) was lower and Fusobacteriota constituted more than 30% of the microbiome. PVL and PVL-OSCC patients had a higher abundance of Campilobacterota and lower Proteobacteria than any other group analyzed. A penalized regression was performed to determine which species were able to distinguish groups. HL is enriched in Streptococcus parasanguinis, Streptococcus salivarius, Fusobacterium periodonticum, Prevotella histicola, Porphyromonas pasteri, and Megasphaera micronuciformis; PVL is enriched in Prevotella salivae, Campylobacter concisus, Dialister pneumosintes, and Schaalia odontolytica; OSCC is enriched in Capnocytophaga leadbetteri, Capnocytophaga sputigena, Capnocytophaga gingivalis, Campylobacter showae, Metamycoplasma salivarium, and Prevotella nanceiensis; and PVL-OSCC is enriched in Lachnospiraceae bacterium, Selenomonas sputigena, and Prevotella shahii. There is differential dysbiosis in patients suffering from OPMDs and cancer. To the best of our knowledge, this is the first study comparing the oral microbiome alterations in these groups; thus, additional studies are needed.
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Affiliation(s)
- Alejandro Herreros-Pomares
- Department of Biotechnology, Universitat Politècnica de València, 46022 Valencia, Spain
- Centro de Investigación Biomédica en Red Cáncer (CIBERONC), 28029 Madrid, Spain
- Correspondence: (A.H.-P.); (J.B.)
| | - David Hervás
- Department of Applied Statistics and Operational Research, and Quality, Universitat Politècnica de València, 46022 Valencia, Spain
| | - Leticia Bagan-Debón
- Medicina Oral Unit, Stomatology Department, Valencia University, 46010 Valencia, Spain
| | - Eloísa Jantus-Lewintre
- Department of Biotechnology, Universitat Politècnica de València, 46022 Valencia, Spain
- Centro de Investigación Biomédica en Red Cáncer (CIBERONC), 28029 Madrid, Spain
| | | | - José Bagan
- Centro de Investigación Biomédica en Red Cáncer (CIBERONC), 28029 Madrid, Spain
- Medicina Oral Unit, Stomatology Department, Valencia University, 46010 Valencia, Spain
- Department of Stomatology and Maxillofacial Surgery, Hospital General Universitario de Valencia, 46014 Valencia, Spain
- Precancer and Oral Cancer Research Group, Valencia University, 46010 Valencia, Spain
- Correspondence: (A.H.-P.); (J.B.)
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10
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Vázquez‐Costa JF, Povedano M, Nascimiento‐Osorio AE, Moreno Escribano A, Kapetanovic Garcia S, Dominguez R, Exposito JM, González L, Marco C, Medina Castillo J, Muelas N, Natera de Benito D, Ñungo Garzón NC, Pitarch Castellano I, Sevilla T, Hervás D. Validation of motor and functional scales for the evaluation of adult patients with 5q spinal muscular atrophy. Eur J Neurol 2022; 29:3666-3675. [PMID: 36047967 PMCID: PMC9826246 DOI: 10.1111/ene.15542] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 08/04/2022] [Accepted: 08/18/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND PURPOSE Mos scales currently used to evaluate spinal muscular atrophy (SMA) patients have only been validated in children. The aim of this study was to assess the construct validity and responsiveness of several outcome measures in adult SMA patients. METHODS Patients older than 15 years and followed up in five referral centres for at least 6 months, between October 2015 and August 2020, with a motor function scale score (Hammersmith Functional Motor Scale Expanded [HFMSE], Revised Upper Limb module [RULM]) were included. Bedside functional scales (Egen Klassification [EK2], Revised Amyotrophic Lateral Sclerosis Functional Rating Scale [ALSFRS-R]) were also collected when available. Spearman's rho correlations (rs) and Bangdiwala's concordance test (B) were used to evaluate the scales' construct validity. Monthly slopes of change were used to calculate their responsiveness of the scales. RESULTS The study included 79 SMA patients, followed up for a mean of 16 months. All scales showed strong correlations with each other (rs > 0.70). A floor effect in motor function scales was found in the weakest patients (HFMSE < 5 and RULM < 10), and a ceiling effect was found in stronger patients (HFMSE > 60 and RULM > 35). The ALSFRS-R (B = 0.72) showed a strong ability to discriminate between walkers, sitters and non-sitters, and the HFMSE (B = 0.86) between walkers and sitters. The responsiveness was low overall, although in treated patients a moderate responsiveness was found for the ALSFRS-R and HFMSE in walkers (0.69 and 0.61, respectively) and for EK2 in sitters (0.65) and non-sitters (0.60). CONCLUSIONS This study shows the validity and limitations of the scales most frequently used to assess adult SMA patients. Overall, bedside functional scales showed some advantages over motor scales, although all showed limited responsiveness.
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Affiliation(s)
- Juan F. Vázquez‐Costa
- Neuromuscular Unit, Department of NeurologyIIS La Fe, Hospital Universitario y Politécnico la FeValenciaSpain,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)ValenciaSpain,Department of MedicineUniversitat de ValènciaValenciaSpain
| | - Mónica Povedano
- Motor Neuron Unit, Neurology DepartmentBellvitge Hospital‐IDIBELLBarcelonaSpain
| | - Andrés E. Nascimiento‐Osorio
- Neuromuscular Unit, Neuropediatric DepartmentInstitut de Recerca Pediàtrica Hospital Sant Joan de DéuBarcelonaSpain,Center for the Biomedical Research on Rare Diseases (CIBERER), ISCIIIBarcelonaSpain
| | - Antonio Moreno Escribano
- Neuromuscular Unit, Neurology DepartmentHospital Clínico Universitario Virgen de la ArrixacaMurciaSpain
| | | | - Raul Dominguez
- Motor Neuron Unit, Neurology DepartmentBellvitge Hospital‐IDIBELLBarcelonaSpain
| | - Jessica M. Exposito
- Neuromuscular Unit, Neuropediatric DepartmentInstitut de Recerca Pediàtrica Hospital Sant Joan de DéuBarcelonaSpain
| | - Laura González
- Motor Neuron Unit, Neurology DepartmentBellvitge Hospital‐IDIBELLBarcelonaSpain
| | - Carla Marco
- Motor Neuron Unit, Neurology DepartmentBellvitge Hospital‐IDIBELLBarcelonaSpain
| | | | - Nuria Muelas
- Neuromuscular Unit, Department of NeurologyIIS La Fe, Hospital Universitario y Politécnico la FeValenciaSpain,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)ValenciaSpain
| | - Daniel Natera de Benito
- Neuromuscular Unit, Neuropediatric DepartmentInstitut de Recerca Pediàtrica Hospital Sant Joan de DéuBarcelonaSpain
| | - Nancy Carolina Ñungo Garzón
- Neuromuscular Unit, Department of NeurologyIIS La Fe, Hospital Universitario y Politécnico la FeValenciaSpain,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)ValenciaSpain
| | - Inmaculada Pitarch Castellano
- Neuromuscular Unit, Department of NeurologyIIS La Fe, Hospital Universitario y Politécnico la FeValenciaSpain,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)ValenciaSpain
| | - Teresa Sevilla
- Neuromuscular Unit, Department of NeurologyIIS La Fe, Hospital Universitario y Politécnico la FeValenciaSpain,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)ValenciaSpain,Department of MedicineUniversitat de ValènciaValenciaSpain
| | - David Hervás
- Department of Applied Statistics and Operational Research and QualityUniversitat Politècnica de ValènciaValenciaSpain
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Fuente D, Hervás D, Rebollo M, Conejero JA, Oliver N. COVID-19 outbreaks analysis in the Valencian Region of Spain in the prelude of the third wave. Front Public Health 2022; 10:1010124. [PMID: 36466513 PMCID: PMC9713945 DOI: 10.3389/fpubh.2022.1010124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/02/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction The COVID-19 pandemic has led to unprecedented social and mobility restrictions on a global scale. Since its start in the spring of 2020, numerous scientific papers have been published on the characteristics of the virus, and the healthcare, economic and social consequences of the pandemic. However, in-depth analyses of the evolution of single coronavirus outbreaks have been rarely reported. Methods In this paper, we analyze the main properties of all the tracked COVID-19 outbreaks in the Valencian Region between September and December of 2020. Our analysis includes the evaluation of the origin, dynamic evolution, duration, and spatial distribution of the outbreaks. Results We find that the duration of the outbreaks follows a power-law distribution: most outbreaks are controlled within 2 weeks of their onset, and only a few last more than 2 months. We do not identify any significant differences in the outbreak properties with respect to the geographical location across the entire region. Finally, we also determine the cluster size distribution of each infection origin through a Bayesian statistical model. Discussion We hope that our work will assist in optimizing and planning the resource assignment for future pandemic tracking efforts.
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Affiliation(s)
- David Fuente
- Instituto Universitario de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas, Universitat Politècnica de València, València, Spain
| | - David Hervás
- Departamento de Estadística e Investigación Operativa Aplicadas y Calidad, Universitat Politècnica de València, València, Spain
| | - Miguel Rebollo
- Valencia Research Institute on Artificial Intelligence, Universitat Politècnica de València, València, Spain
| | - J. Alberto Conejero
- Instituto Universitario de Matemática Pura y Aplicada, Universitat Politècnica de València, València, Spain,*Correspondence: J. Alberto Conejero
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12
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Vázquez‐Costa JF, Povedano M, Nascimiento‐Osorio AE, Moreno Escribano A, Kapetanovic Garcia S, Dominguez R, Exposito J, González L, Marco C, Medina Castillo J, Muelas N, Natera de Benito D, Ñungo Garzón NC, Pitarch Castellano I, Sevilla T, Hervás D. Nusinersen in adult patients with 5q spinal muscular atrophy: A multicenter observational cohorts' study. Eur J Neurol 2022; 29:3337-3346. [PMID: 35872571 PMCID: PMC9796289 DOI: 10.1111/ene.15501] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/18/2022] [Accepted: 07/07/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND PURPOSE The aim was to assess the safety and efficacy of nusinersen in adult 5q spinal muscular atrophy (SMA) patients. METHODS Patients older than 15 years and followed for at least 6 months with one motor scale (Hammersmith Functional Motor Scale Expanded, HFMSE; Revised Upper Limb Module, RULM) in five referral centers were included. The clinical and patients' global impression of change (CGI-C and PGI-C) were recorded in treated patients at the last visit. Functional scales (Egen Klassification, EK2; Revised Amyotrophic Lateral Sclerosis Functional Rating Scale, ALSFRS-R) and the percentage predicted forced vital capacity were collected when available. RESULTS Seventy-nine SMA patients (39 treated with nusinersen) were included. Compared with untreated patients, treated patients showed a significant improvement of 2 points (±0.46) in RULM (p < 0.001) after 6 months. After a mean follow-up of 16 months, nusinersen treatment was associated with a significant improvement in HFMSE (odds ratio [OR] 1.15, p = 0.006), the 6-min walk test (OR = 1.07, p < 0.001) and the EK2 (OR = 0.81, p = 0.001). Compared with untreated patients, more treated patients experienced clinically meaningful improvements in all scales, but these differences were statistically significant only for RULM (p = 0.033), ALSFRS-R (p = 0.005) and EK2 (p < 0.001). According to the CGI-C and PGI-C, 64.1% and 61.5% of treated patients improved with treatment. Being a non-sitter was associated with less response to treatment, whilst a longer time of treatment was associated with better response. Most treated patients (77%) presented at least one adverse event, mostly mild. CONCLUSIONS Nusinersen treatment is associated with some improvements in adult SMA patients. Most severely affected patients with complex spines are probably those with the most unfavorable risk-benefit ratio.
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Affiliation(s)
- Juan F. Vázquez‐Costa
- Neuromuscular Unit, Department of NeurologyHospital Universitario y Politécnico la FeValenciaSpain,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)ValenciaSpain,Department of MedicineUniversitat de ValènciaValenciaSpain
| | - Mónica Povedano
- Motor Neuron Unit, Neurology DepartmentBellvitge Hospital‐IDIBELLBarcelonaSpain
| | - Andrés E. Nascimiento‐Osorio
- Neuromuscular Unit, Neuropediatric DepartmentInstitut de Recerca Pediàtrica Hospital Sant Joan de DéuBarcelonaSpain,Center for the Biomedical Research on Rare Diseases (CIBERER), ISCIIIMadridSpain
| | - Antonio Moreno Escribano
- Neuromuscular Unit, Neurology DepartmentHospital Clínico Universitario Virgen de la ArrixacaMurciaSpain
| | | | - Raul Dominguez
- Motor Neuron Unit, Neurology DepartmentBellvitge Hospital‐IDIBELLBarcelonaSpain
| | - Jessica M. Exposito
- Neuromuscular Unit, Neuropediatric DepartmentInstitut de Recerca Pediàtrica Hospital Sant Joan de DéuBarcelonaSpain
| | - Laura González
- Motor Neuron Unit, Neurology DepartmentBellvitge Hospital‐IDIBELLBarcelonaSpain
| | - Carla Marco
- Motor Neuron Unit, Neurology DepartmentBellvitge Hospital‐IDIBELLBarcelonaSpain
| | | | - Nuria Muelas
- Neuromuscular Unit, Department of NeurologyHospital Universitario y Politécnico la FeValenciaSpain,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)ValenciaSpain
| | - Daniel Natera de Benito
- Neuromuscular Unit, Neuropediatric DepartmentInstitut de Recerca Pediàtrica Hospital Sant Joan de DéuBarcelonaSpain
| | - Nancy Carolina Ñungo Garzón
- Neuromuscular Unit, Department of NeurologyHospital Universitario y Politécnico la FeValenciaSpain,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)ValenciaSpain
| | - Inmaculada Pitarch Castellano
- Neuromuscular Unit, Department of NeurologyHospital Universitario y Politécnico la FeValenciaSpain,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)ValenciaSpain
| | - Teresa Sevilla
- Neuromuscular Unit, Department of NeurologyHospital Universitario y Politécnico la FeValenciaSpain,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)ValenciaSpain,Department of MedicineUniversitat de ValènciaValenciaSpain
| | - David Hervás
- Department of Applied Statistics and Operational Research and QualityUniversitat Politècnica de ValènciaValenciaSpain
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13
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Lago V, Segarra-Vidal B, Cappucio S, Angeles MA, Fotopoulou C, Muallem MZ, Manzanedo I, Iglesias JLS, Chacón E, Padilla-Iserte P, Fagotti A, Ferron G, Kluge L, Vargiu V, Del M, Scambia G, Minig L, Tejerizo Á, Segovia MG, Cascales-Campos PA, Hervás D, Domingo S. OVA-LEAK: Prognostic score for colo-rectal anastomotic leakage in patients undergoing ovarian cancer surgery. Gynecol Oncol 2022; 167:22-27. [PMID: 36058743 DOI: 10.1016/j.ygyno.2022.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/31/2022] [Accepted: 08/07/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The objective of the present study was to define and validate an anastomotic leak prognostic score based on previously described and reported anastomotic leak risk factors (OVA-LEAK: https://n9.cl/ova-leakscore) and to establish if the use of OVA-LEAK score is better than clinical criteria (surgeon's choice) selecting anastomosis to be protected with a diverting ileostomy. MATERIAL & METHODS This is a retrospective, multicentre cohort study that included patients who underwent cytoreductive surgery for primary advanced or relapsed ovarian cancer with colorectal resection and anastomosis between January 2011 and June 2021. Data from patients already included in the previous predictive model were not considered in the present analysis. To validate the performance of our logistic regression model, we used the OVA-LEAK formula (Annex I: https://n9.cl/ova-leakscore) for estimating leakage probabilities in a new independent cohort. Then, receiver operating characteristic (ROC) analysis was performed and area under the curve (AUC) was used to measure the performance of the model. Additionally, the Brier score was also estimated. 95% confidence intervals (CI) for each of the estimated performance measures were also calculated. RESULTS 848 out of 1159 recruited patients were finally included in the multivariable logistic regression model validation. The AUC of the new cohort was 0.63 for predicting anastomotic leak. Considering a cut-off point of 22.1% to be 'positive' (to get a leak) this would provide a sensitivity of 0.45, specificity of 0.80, positive predictive value of 0.09 and negative predictive value of 0.97 for anastomotic leak. If we consider this cut-off point to select patients at risk of leak for bowel diversion, up to 22.5% of the sampled patients would undergo a diverting ileostomy and 47% (18/40) of the anastomotic leaks would be 'protected' with the stoma. Nevertheless, if we consider only the 'clinical criteria' for performing or not a diverting ileostomy, only 12.5% (5/40) of the leaks would be 'protected' with a stoma, with a rate of diverting ileostomy of up to 24.3%. CONCLUSIONS Compared with subjective clinical criteria, the use of a predictive model for anastomotic leak improves the selection of patients who would benefit from a diverting ileostomy without increasing the rate of stoma use.
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Affiliation(s)
- Víctor Lago
- Department of Gynecologic Oncology Department, University Hospital La Fe, Valencia, Spain; CEU Cardenal Herrera, Spain.
| | - Blanca Segarra-Vidal
- Department of Gynecologic Oncology Department, University Hospital La Fe, Valencia, Spain
| | - Serena Cappucio
- Fondazione Policlinico Universitario A. Gemelli, IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
| | - Martina Aida Angeles
- Department of Surgical Oncology, Institut Claudius Regaud - Institut Universitaire du Cancer de Toulouse - Oncopole, Toulouse, France
| | - Christina Fotopoulou
- Department of Gynecologic Oncology, Imperial College London, London, United Kingdom
| | - Mustafa Zelal Muallem
- Department of Gynecology with Centre for Oncological Surgery, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Virchow Campus Clinic, Charité Medical University, Berlin, Germany
| | - Israel Manzanedo
- Department of General and Digestive Surgery, Peritoneal Carcinomatosis Unit, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | - Enrique Chacón
- Department of Obstetrics and Gynecology, University Clinic of Navarra, Madrid, Navarre, Spain
| | - Pablo Padilla-Iserte
- Department of Gynecologic Oncology Department, University Hospital La Fe, Valencia, Spain
| | - Anna Fagotti
- Fondazione Policlinico Universitario A. Gemelli, IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gwenael Ferron
- Department of Surgical Oncology, Institut Claudius Regaud - Institut Universitaire du Cancer de Toulouse - Oncopole, Toulouse, France
| | - Luisa Kluge
- Department of Gynecology with Centre for Oncological Surgery, Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Virchow Campus Clinic, Charité Medical University, Berlin, Germany
| | - Virginia Vargiu
- Fondazione Policlinico Universitario A. Gemelli, IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mathilde Del
- Department of Surgical Oncology, Institut Claudius Regaud - Institut Universitaire du Cancer de Toulouse - Oncopole, Toulouse, France
| | - Giovanni Scambia
- Fondazione Policlinico Universitario A. Gemelli, IRCCS and Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lucas Minig
- Department of Gynecology, IMED Hospitales, Valencia, Spain
| | - Álvaro Tejerizo
- Department of Obstetrics and Gynecology, Hospital 12 de Octubre, Madrid, Spain
| | | | | | | | - David Hervás
- Department of Applied Statistics and Operational Research and Quality, Universitat Politècnica de València, Valencia, Spain
| | - Santiago Domingo
- Department of Gynecologic Oncology Department, University Hospital La Fe, Valencia, Spain
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14
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Martínez-Payá J, Ríos-Díaz J, del Baño-Aledo M, Hervás D, Tembl-Ferrairó J, Sevilla-Mantecón T, Vázquez-Costa J. The cross-sectional area of the median nerve: An independent prognostic biomarker in amyotrophic lateral sclerosis. Neurologia 2022. [DOI: 10.1016/j.nrl.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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15
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Olivares-González L, Salom D, González-García E, Hervás D, Mejía-Chiqui N, Melero M, Velasco S, Muresan BT, Campillo I, Vila-Clérigues N, López-Briz E, Merino-Torres JF, Millán JM, Soriano Del Castillo JM, Rodrigo R. NUTRARET: Effect of 2-Year Nutraceutical Supplementation on Redox Status and Visual Function of Patients With Retinitis Pigmentosa: A Randomized, Double-Blind, Placebo-Controlled Trial. Front Nutr 2022; 9:847910. [PMID: 35387197 PMCID: PMC8979249 DOI: 10.3389/fnut.2022.847910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 02/22/2022] [Indexed: 11/25/2022] Open
Abstract
Oxidative stress plays a major role in the pathogenesis of retinitis pigmentosa (RP). The main goal of this study was to evaluate the effect of 2-year nutritional intervention with antioxidant nutraceuticals on the visual function of RP patients. Secondly, we assessed how nutritional intervention affected ocular and systemic redox status. We carried out a randomized, double-blind, placebo-controlled study. Thirty-one patients with RP participated in the study. RP patients randomly received either a mixture of nutraceuticals (NUT) containing folic acid, vitamin B6, vitamin A, zinc, copper, selenium, lutein, and zeaxanthin or placebo daily for 2 years. At baseline and after 2-year of the nutritional supplementation, visual function, dietetic-nutritional evaluations, serum concentration of nutraceuticals, plasma and aqueous humor concentration of several markers of redox status and inflammation were assessed. Retinal function and structure were assessed by multifocal electroretinogram (mfERG), spectral domain-optical coherence tomography (SD-OCT) and automated visual field (VF) tests. Nutritional status was estimated with validated questionnaires. Total antioxidant capacity, extracellular superoxide dismutase (SOD3), catalase (CAT), and glutathione peroxidase (GPx) activities, protein carbonyl adducts (CAR) content, thiobarbituric acid reactive substances (TBARS) formation (as indicator of lipid peroxidation), metabolites of the nitric oxide (NOX) and cytokine (interleukin 6 and tumor necrosis factor alpha) concentrations were assessed by biochemical and immunological techniques in aqueous humor or/and blood. Bayesian approach was performed to determine the probability of an effect. Region of practical equivalence (ROPE) was used. At baseline, Bayesian analysis revealed a high probability of an altered ocular redox status and to a lesser extent systemic redox status in RP patients compared to controls. Twenty-five patients (10 in the treated arm and 15 in the placebo arm) completed the nutritional intervention. After 2 years of supplementation, patients who received NUT presented better retinal responses (mfERG responses) compared to patients who received placebo. Besides, patients who received NUT showed better ocular antioxidant response (SOD3 activity) and lower oxidative damage (CAR) than those who received placebo. This study suggested that long-term NUT supplementation could slow down visual impairment and ameliorate ocular oxidative stress.
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Affiliation(s)
- Lorena Olivares-González
- Pathophysiology and Therapies for Vision Disorders, Principe Felipe Research Center (CIPF), Valencia, Spain
- Joint Research Unit on Rare Diseases CIPF-Health Research Institute Hospital La Fe (IIS-La Fe), Valencia, Spain
| | - David Salom
- Department of Ophthalmology, Manises Hospital, Manises, Spain
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Madrid, Spain
| | | | - David Hervás
- Department of Applied Statistics, Operations Research and Quality, Universitat Politècnica de València, Valencia, Spain
| | - Natalia Mejía-Chiqui
- Pathophysiology and Therapies for Vision Disorders, Principe Felipe Research Center (CIPF), Valencia, Spain
| | - Mar Melero
- Service of Pharmacy, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Sheyla Velasco
- Pathophysiology and Therapies for Vision Disorders, Principe Felipe Research Center (CIPF), Valencia, Spain
| | - Bianca Tabita Muresan
- Service of Endocrinology and Nutrition, University General Hospital, Valencia, Spain
| | - Isabel Campillo
- Pathophysiology and Therapies for Vision Disorders, Principe Felipe Research Center (CIPF), Valencia, Spain
| | | | - Eduardo López-Briz
- Service of Pharmacy, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Juan Francisco Merino-Torres
- Service of Endocrinology and Nutrition, La Fe University and Polytechnic Hospital, Valencia, Spain
- Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics UV-IIS La Fe, Valencia, Spain
| | - José María Millán
- Joint Research Unit on Rare Diseases CIPF-Health Research Institute Hospital La Fe (IIS-La Fe), Valencia, Spain
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Madrid, Spain
- Molecular, Cellular and Genomic Biomedicine, IIS-La Fe, Valencia, Spain
| | - José Miguel Soriano Del Castillo
- Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics UV-IIS La Fe, Valencia, Spain
- Food & Health Laboratory, Institute of Materials Science, University of Valencia (UV), Valencia, Spain
| | - Regina Rodrigo
- Pathophysiology and Therapies for Vision Disorders, Principe Felipe Research Center (CIPF), Valencia, Spain
- Joint Research Unit on Rare Diseases CIPF-Health Research Institute Hospital La Fe (IIS-La Fe), Valencia, Spain
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Madrid, Spain
- Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics UV-IIS La Fe, Valencia, Spain
- Department of Physiology, University of Valencia (UV), Valencia, Spain
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16
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Moret-Tatay I, Cerrillo E, Hervás D, Iborra M, Sáez-González E, Forment J, Tortosa L, Nos P, Gadea J, Beltrán B. Specific Plasma MicroRNA Signatures in Predicting and Confirming Crohn's Disease Recurrence: Role and Pathogenic Implications. Clin Transl Gastroenterol 2021; 12:e00416. [PMID: 34695034 PMCID: PMC8547914 DOI: 10.14309/ctg.0000000000000416] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 08/22/2021] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION MicroRNAs (miRNAs) are important epigenetic regulators in Crohn's disease (CD); however, their contribution to postoperative recurrence (POR) is still unknown. We aimed to characterize the potential role of miRNAs in predicting POR in patients with CD and to identify their pathogenic implications. METHODS Of 67 consecutively operated patients with CD, we included 44 with pure ileal CD. Peripheral blood samples were taken before surgery and during follow-up. The patients were classified according to the presence or absence of POR assessed by ileocolonoscopy or magnetic resonance imaging enterography. The miRNAs were profiled by reverse transcription polymerase chain reaction before surgery and during morphological POR or, for those who remained in remission, 1 year after surgery. R software and mirWalk were used. RESULTS Five human miRNAs (miR-191-5p, miR-15b-5p, miR-106b-5p, miR-451a, and miR-93-5p) were selected for discriminating between the 2 patient groups at presurgery (PS), with an area under the curve of 0.88 (95% confidence interval [0.79, 0.98]). Another 5 (miR-15b-5p, miR-451a, miR-93-5p, miR-423-5p, and miR-125b-5p) were selected for 1 year, with an area under the curve of 0.96 (95% confidence interval [0.91, 1.0]). We also created nomograms for POR risk estimation. CCND2 and BCL9L genes were related to PS miRNA profiles; SENP5 and AKT3 genes were related to PS and 1 year; and SUV39H1 and MAPK3K10 were related to 1 year. DISCUSSION Different plasma miRNA signatures identify patients at high POR risk, which could help optimize patient outcomes. We developed nomograms to facilitate the clinical use of these results. The identified miRNAs participate in apoptosis, autophagy, proinflammatory immunological T-cell clusters, and reactive oxygen species metabolism.
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Affiliation(s)
- Inés Moret-Tatay
- Inflammatory Bowel Disease Research Group, Health Research Institute, Hospital La Fe (IIS La Fe), Valencia, Spain
- Biomedical Research Centre, Hepatic and Digestive Diseases Network [Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD)], Madrid, Spain
| | - Elena Cerrillo
- Inflammatory Bowel Disease Research Group, Health Research Institute, Hospital La Fe (IIS La Fe), Valencia, Spain
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - David Hervás
- Biostatistics Unit, Health Research IIS La Fe, Valencia, Spain
| | - Marisa Iborra
- Inflammatory Bowel Disease Research Group, Health Research Institute, Hospital La Fe (IIS La Fe), Valencia, Spain
- Biomedical Research Centre, Hepatic and Digestive Diseases Network [Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD)], Madrid, Spain
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Esteban Sáez-González
- Inflammatory Bowel Disease Research Group, Health Research Institute, Hospital La Fe (IIS La Fe), Valencia, Spain
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Javier Forment
- The Institute for Plant Molecular and Cellular Biology (IBMCP), Polytechnic University of Valencia- Spanish Research Council (CSIC), Valencia, Spain
| | - Luis Tortosa
- Inflammatory Bowel Disease Research Group, Health Research Institute, Hospital La Fe (IIS La Fe), Valencia, Spain
- Biomedical Research Centre, Hepatic and Digestive Diseases Network [Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD)], Madrid, Spain
| | - Pilar Nos
- Inflammatory Bowel Disease Research Group, Health Research Institute, Hospital La Fe (IIS La Fe), Valencia, Spain
- Biomedical Research Centre, Hepatic and Digestive Diseases Network [Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD)], Madrid, Spain
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Jose Gadea
- The Institute for Plant Molecular and Cellular Biology (IBMCP), Polytechnic University of Valencia- Spanish Research Council (CSIC), Valencia, Spain
| | - Belén Beltrán
- Inflammatory Bowel Disease Research Group, Health Research Institute, Hospital La Fe (IIS La Fe), Valencia, Spain
- Biomedical Research Centre, Hepatic and Digestive Diseases Network [Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD)], Madrid, Spain
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
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17
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Méndez R, Feced L, Alcaraz-Serrano V, González-Jiménez P, Bouzas L, Alonso R, Martínez-Dolz L, Hervás D, Fernández-Barat L, Torres A, Menéndez R. Cardiovascular Events during and after Bronchiectasis Exacerbations and Long-Term Mortality. Chest 2021; 161:629-636. [PMID: 34656526 DOI: 10.1016/j.chest.2021.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 10/04/2021] [Accepted: 10/05/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Population-based and retrospective studies have shown that risk for cardiovascular events such as arrythmias, ischemic episodes or heart failure, increase during and after bronchiectasis exacerbations. RESEARCH QUESTION What are the risk factors for cardiovascular events (CVE) during and after bronchiectasis exacerbations and its impact on mortality? STUDY DESIGN AND METHODS This was a post-hoc retrospective analysis of a prospective observational study of 250 patients with bronchiectasis at two tertiary care hospitals. Only the first exacerbation was considered for each patient, collecting demographic, comorbidity, and severity data. The main outcomes were the appearance of CVE and mortality. Risk factors for CVE were analyzed using a semi-competing risks model. RESULTS During a median follow-up of 35 months, 74 (29.6%) patients had a CVE and 93 (37.2%) died. Semi-competing risks analysis indicated that age, arterial hypertension, chronic obstructive pulmonary disease, and potentially the severe exacerbations significantly increased the risk for developing CVE. Compared to patients without CVE, those with CVE had higher mortality. INTERPRETATION Demographic factors and comorbidities are risk factors for the development of CVE after an acute exacerbation of bronchiectasis. The appearance of CVE worsens long-term prognosis.
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Affiliation(s)
- Raúl Méndez
- Pneumology Department. La Fe University and Polytechnic Hospital. Valencia, Spain; Respiratory Infections Research Group. Health Research Institute La Fe. Valencia, Spain.
| | - Laura Feced
- Pneumology Department. La Fe University and Polytechnic Hospital. Valencia, Spain; Respiratory Infections Research Group. Health Research Institute La Fe. Valencia, Spain; University of Valencia. Valencia, Spain
| | - Victoria Alcaraz-Serrano
- Pneumology Department. University Hospital Clínic of Barcelona. August Pi i Sunyer Biomedical Research Institute (IDIBAPS). Barcelona, Spain; Center for Biomedical Research Network in Respiratory Diseases (CIBERES). Madrid, Spain
| | - Paula González-Jiménez
- Pneumology Department. La Fe University and Polytechnic Hospital. Valencia, Spain; Respiratory Infections Research Group. Health Research Institute La Fe. Valencia, Spain; University of Valencia. Valencia, Spain
| | - Leyre Bouzas
- Pneumology Department. La Fe University and Polytechnic Hospital. Valencia, Spain; Respiratory Infections Research Group. Health Research Institute La Fe. Valencia, Spain
| | - Ricardo Alonso
- Laboratory Department. La Fe University and Polytechnic Hospital. Valencia, Spain
| | - Luis Martínez-Dolz
- Cardiology Department. La Fe University and Polytechnic Hospital. Health Research Institute La Fe. Valencia, Spain; Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV). Madrid, Spain
| | - David Hervás
- Data Science, Biostatistics & Bioinformatics. Health Research Institute La Fe. Valencia, Spain; Department of Applied Statistics and Operational Research and Quality. Universitat Politècnica de València. Valencia, Spain
| | - Laia Fernández-Barat
- Pneumology Department. University Hospital Clínic of Barcelona. August Pi i Sunyer Biomedical Research Institute (IDIBAPS). Barcelona, Spain; Center for Biomedical Research Network in Respiratory Diseases (CIBERES). Madrid, Spain
| | - Antoni Torres
- Pneumology Department. University Hospital Clínic of Barcelona. August Pi i Sunyer Biomedical Research Institute (IDIBAPS). Barcelona, Spain; Center for Biomedical Research Network in Respiratory Diseases (CIBERES). Madrid, Spain
| | - Rosario Menéndez
- Pneumology Department. La Fe University and Polytechnic Hospital. Valencia, Spain; Respiratory Infections Research Group. Health Research Institute La Fe. Valencia, Spain; University of Valencia. Valencia, Spain; Center for Biomedical Research Network in Respiratory Diseases (CIBERES). Madrid, Spain
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18
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Méndez R, Balanzá-Martínez V, Luperdi SC, Estrada I, Latorre A, González-Jiménez P, Feced L, Bouzas L, Yépez K, Ferrando A, Hervás D, Zaldívar E, Reyes S, Berk M, Menéndez R. Short-term neuropsychiatric outcomes and quality of life in COVID-19 survivors. J Intern Med 2021; 290:621-631. [PMID: 33533521 PMCID: PMC8013333 DOI: 10.1111/joim.13262] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/21/2020] [Accepted: 01/08/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND The general medical impacts of coronavirus (COVID-19) are increasingly appreciated. However, its impact on neurocognitive, psychiatric health and quality of life (QoL) in survivors after the acute phase is poorly understood. We aimed to evaluate neurocognitive function, psychiatric symptoms and QoL in COVID-19 survivors shortly after hospital discharge. METHODS This was a cross-sectional analysis of a prospective study of hospitalized COVID-19 survivors followed up for 2 months after discharge. A battery of standardized instruments evaluating neurocognitive function, psychiatric morbidity and QoL (mental and physical components) was administered by telephone. RESULTS Of the 229 screened patients, 179 were included in the final analysis. Amongst survivors, the prevalence of moderately impaired immediate verbal memory and learning was 38%, delayed verbal memory (11.8%), verbal fluency (34.6%) and working memory (executive function) (6.1%), respectively. Moreover, 58.7% of patients had neurocognitive impairment in at least one function. Rates of positive screening for anxiety, depression and post-traumatic stress disorder were 29.6%, 26.8% and 25.1%, respectively. In addition, 39.1% of the patients had psychiatric morbidity. Low QoL for physical and mental components was detected in 44.1% and 39.1% of patients respectively. Delirium and psychiatric morbidity were associated with neurocognitive impairment, and female gender was related with psychiatric morbidity. CONCLUSION Hospitalized COVID-19 survivors showed a considerable prevalence of neurocognitive impairment, psychiatric morbidity and poor QoL in the short term. It is uncertain if these impacts persist over the long term.
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Affiliation(s)
- R Méndez
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain.,University of Barcelona, Barcelona, Spain
| | - V Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
| | - S C Luperdi
- Psychiatry Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,University of Valencia, Valencia, Spain
| | - I Estrada
- University of Valencia, Valencia, Spain
| | - A Latorre
- Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - P González-Jiménez
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - L Feced
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - L Bouzas
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - K Yépez
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - A Ferrando
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - D Hervás
- Data Science, Biostatistics & Bioinformatics, Health Research Institute La Fe, Valencia, Spain
| | - E Zaldívar
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - S Reyes
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain
| | - M Berk
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - R Menéndez
- From the, Pneumology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Respiratory Infections Research Group, Health Research Institute La Fe, Valencia, Spain.,University of Valencia, Valencia, Spain.,Center for Biomedical Research Network in Respiratory Diseases (CIBERES), Madrid, Spain
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19
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Oto J, Herranz R, Plana E, Sánchez-González JV, Pérez-Ardavín J, Hervás D, Fernández-Pardo Á, Cana F, Vera-Donoso CD, Martínez-Sarmiento M, Medina P. Identification of miR-20a-5p as Robust Normalizer for Urine microRNA Studies in Renal Cell Carcinoma and a Profile of Dysregulated microRNAs. Int J Mol Sci 2021; 22:7913. [PMID: 34360679 PMCID: PMC8347250 DOI: 10.3390/ijms22157913] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/15/2021] [Accepted: 07/20/2021] [Indexed: 12/12/2022] Open
Abstract
Renal cell carcinoma (RCC) is the third most frequent urinary malignancy and one of the most lethal. Current diagnostic and follow-up techniques are harmful and unspecific in low-grade tumors. Novel minimally invasive markers such as urine microRNAs (miRNAs) are under study. However, discrepancies arise among studies in part due to lack of consent regarding normalization. We aimed to identify the best miRNA normalizer for RCC studies performed in urine samples together with a miRNA profile with diagnostic value and another for follow-up. We evaluated the performance of 120 candidate miRNAs in the urine of 16 RCC patients and 16 healthy controls by RT-qPCR followed by a stability analysis with RefFinder. In this screening stage, miR-20a-5p arose as the most stably expressed miRNA in RCC and controls, with a good expression level. Its stability was validated in an independent cohort of 51 RCC patients and 32 controls. Using miR-20a-5p as normalizer, we adjusted and validated a diagnostic model for RCC with three miRNAs (miR-200a-3p, miR-34a-5p and miR-365a-3p) (AUC = 0.65; Confidence Interval 95% [0.51, 0.79], p = 0.043). let-7d-5p and miR-205-5p were also upregulated in patients compared to controls. Comparing RCC samples before surgery and fourteen weeks after, we identified let-7d-5p, miR-152-3p, miR-30c-5p, miR-362-3p and miR-30e-3p as potential follow-up profile for RCC. We identified validated targets of most miRNAs in the renal cell carcinoma pathway. This is the first study that identifies a robust normalizer for urine RCC miRNA studies, miR-20a-5p, which may allow the comparison of future studies among laboratories. Once confirmed in a larger independent cohort, the miRNAs profiles identified may improve the non-invasive diagnosis and follow-up of RCC.
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Affiliation(s)
- Julia Oto
- Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (J.O.); (R.H.); (E.P.); (Á.F.-P.); (F.C.)
| | - Raquel Herranz
- Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (J.O.); (R.H.); (E.P.); (Á.F.-P.); (F.C.)
| | - Emma Plana
- Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (J.O.); (R.H.); (E.P.); (Á.F.-P.); (F.C.)
- Angiology and Vascular Surgery Service, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain
| | - José Vicente Sánchez-González
- Department of Urology, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (J.V.S.-G.); (J.P.-A.); (C.D.V.-D.); (M.M.-S.)
| | - Javier Pérez-Ardavín
- Department of Urology, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (J.V.S.-G.); (J.P.-A.); (C.D.V.-D.); (M.M.-S.)
| | - David Hervás
- Data Science, Biostatistics and Bioinformatics Unit, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain;
- Department of Applied Statistics, Operations Research, and Quality, Universitat Politècnica de València, 46022 Valencia, Spain
| | - Álvaro Fernández-Pardo
- Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (J.O.); (R.H.); (E.P.); (Á.F.-P.); (F.C.)
| | - Fernando Cana
- Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (J.O.); (R.H.); (E.P.); (Á.F.-P.); (F.C.)
| | - César David Vera-Donoso
- Department of Urology, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (J.V.S.-G.); (J.P.-A.); (C.D.V.-D.); (M.M.-S.)
| | - Manuel Martínez-Sarmiento
- Department of Urology, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain; (J.V.S.-G.); (J.P.-A.); (C.D.V.-D.); (M.M.-S.)
| | - Pilar Medina
- Haemostasis, Thrombosis, Arteriosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (J.O.); (R.H.); (E.P.); (Á.F.-P.); (F.C.)
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Lorenzo JB, García-Blanco A, Moreno-Giménez A, Berga LC, Sahuquillo-Leal R, Nowak A, Hervás D, Diago V, Vento M. Does maternal age or related factors influence the appearance of psychopathology in children? Eur Psychiatry 2021. [PMCID: PMC9471647 DOI: 10.1192/j.eurpsy.2021.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction Maternal age and related factors, such as social vulnerability, are associated with neurodevelopmental and behavioral disorders in offspring. Objectives To examine the influence of maternal age and its related factors on the appearance of autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), alterations in executive functions and behavioral syndromes of the offspring. Methods A prospective study was conducted, consisting of 131 healthy pregnant women aged 20 to 41 years, recruited at 38 weeks’ gestation. Their offspring were followed up to 2 years after birth, when psychopatology was assessed. Maternal age and possible related factors were considered predictors. Bayesian ordinal regression models were performed for each outcome variable. Results Symptoms of ASD in children were associated with an older maternal age (OR = 0.188; 95% CI[1.062, 1.401]) and a lower educational level of the parents (OR = -0.879; 95% CI[0.202, 0.832]), meanwhile poor social support predicted most ADHD symptoms OR = -0.086; 95% CI[0.838, 1]) and executive dysfunctions OR = -0.661; 95% CI[0.313, 0.845]. Lower parental education predicted both externalizing and internalizing behavior. Conclusions Maternal age-related factors were the main predictors of neurodevelopmental disorders in offspring, rather than maternal age. The performance of prenatal interventions in pregnant women with advanced age and anxious depressive symptoms or adverse social situation, is crucial to reduce the risk of neurodevelopmental disorders in the offspring. Likewise, being able to carry out an early detection of childhood psychopathology would allow the implementation of resources that improve their long-term prognosis. Disclosure No significant relationships.
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Garcés Iñigo E, Llorens Salvador R, Escrig R, Hervás D, Vento M, Martí-Bonmatí L. Quantitative Evaluation of Neonatal Brain Elasticity Using Shear Wave Elastography. J Ultrasound Med 2021; 40:795-804. [PMID: 32876366 DOI: 10.1002/jum.15464] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/09/2020] [Accepted: 07/12/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To demonstrate the feasibility of 2-dimensional brain ultrasound shear wave elastography (SWE) and to define the average elasticity values of the gray and white matter in term neonates. METHODS This work was a prospective observational single-center study including 55 healthy term neonates consecutively recruited in the maternity ward between the second and third postnatal days. All were successfully evaluated with a cerebral SWE examination performed with a multifrequency 4-9-MHz transducer. Bilateral sagittal planes of the thalamus and corona radiata were used to measure stiffness using a quantitative SWE method. Several elastograms with 5 to 15 nonoverlapping areas were obtained from the 2 different anatomic locations. The 5 most central measurements were averaged as representative values. RESULTS The 55 neonates ranged from 37 to 40 weeks' gestation. The estimated mean velocity values of the thalamus (1.17 m/s; 95% confidence interval, 1.13, 1.22 m/s) and corona radiata (1.60 m/s; 95% confidence interval, 1.57, 1.64 m/s) were statistically different (P < .001). There was no significant influence of laterality, gestational age, cephalic perimeter, sex, length, or type of delivery on the stiffness measurements. CONCLUSIONS Brain ultrasound SWE is feasible and allows measurements of neonatal brain elasticity. The elasticity of the thalamus and corona radiata at the frontal white matter in healthy term neonates is different. The knowledge of normal SWE ranges in term neonates allows comparative studies under pathologic conditions.
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Affiliation(s)
| | | | - Raquel Escrig
- Department of Pediatrics, Neonatal Research Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - David Hervás
- Data Science, Biostatistics, and Bioinformatics Platform, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Máximo Vento
- Department of Pediatrics, Neonatal Research Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Luis Martí-Bonmatí
- Department of Radiology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Research Group on Biomedical Imaging, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
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22
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Lorenzo JB, García-Blanco A, Vento M, Moreno-Giménez A, Berga LC, Diago V, Hervás D, Cháfer-Pericás C, González PS. Can stress predict delivery date?: Role of chronic and acute stress to the threatened preterm labor as predictors of delivery date. Eur Psychiatry 2021. [PMCID: PMC9480012 DOI: 10.1192/j.eurpsy.2021.1619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Threatened preterm labor (TPL) is a traumatic event during pregnancy that involves a threat to the physical integrity of the upcoming baby. Despite biomarkers would be the strongest delivery date predictors, an assessment of chronic and acute stress response to TPL diagnosis may improve this prediction. Objectives The objective is to predict delivery date in women with TPL based on their response to this diagnosis and chronic stressors, along with relevant obstetric variables. Methods A prospective cohort study was conducted with a sample was formed by 157 pregnant women with TPL diagnosis between 24 and 31 weeks. Determination of salivary cortisol, α-amylase levels, along with anxiety and depression symptoms were measured to estimate stress response to TPL. Cumulative life stressors as traumas, social and familiar functioning were also registered. To examine the effect of the possible predictor variables of delivery date, linear regression models were used. Results A correlation was found between the variables of response to chronic stress and between the variables of psychological response to stress. The main predictors of preterm delivery were low family adaptation, higher BMI, higher cortisol levels, and the week of diagnosis of TPL (<29 weeks of gestation). Conclusions The best predictor of delivery date was the combination of the stress response to the diagnosis of TPL measured by cortisol in saliva, cumulative life stressors (mainly family adaptation) and obstetric factors (week TPL and BMI). Through psychosocial therapeutic intervention programs, it is possible to influence this modifiable predictive factors of preterm birth in symptomatic women.
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23
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Aliena-Valero A, Baixauli-Martín J, Castelló-Ruiz M, Torregrosa G, Hervás D, Salom JB. Effect of uric acid in animal models of ischemic stroke: A systematic review and meta-analysis. J Cereb Blood Flow Metab 2021; 41:707-722. [PMID: 33210575 PMCID: PMC7983496 DOI: 10.1177/0271678x20967459] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Addition of uric acid (UA) to thrombolytic therapy, although safe, showed limited efficacy in improving patients' stroke outcome, despite alleged neuroprotective effects of UA in preclinical research. This systematic review assessed the effects of UA on brain structural and functional outcomes in animal models of ischemic stroke. We searched Medline, Embase and Web of Science to identify 16 and 14 eligible rodent studies for qualitative and quantitative synthesis, respectively. Range of evidence met 10 of a possible 13 STAIR criteria. Median (Q1, Q3) quality score was 7.5 (6, 10) on the CAMARADES 15-item checklist. For each outcome, we used standardised mean difference (SMD) as effect size and random-effects modelling. Meta-analysis showed that UA significantly reduced infarct size (SMD: -1.18; 95% CI [-1.47, -0.88]; p < 0.001), blood-brain barrier (BBB) impairment/oedema (SMD: -0.72; 95% CI [-0.97, -0.48]; p < 0.001) and neurofunctional deficit (SMD: -0.98; 95% CI [-1.32, -0.63]; p < 0.001). Overall, there was low to moderate between-study heterogeneity and sizeable publication bias. In conclusion, published rodent data suggest that UA improves outcome following ischemic stroke by reducing infarct size, improving BBB integrity and ameliorating neurofunctional condition. Specific recommendations are given for further high-quality preclinical research required to better inform clinical research.
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Affiliation(s)
- Alicia Aliena-Valero
- Unidad Mixta de Investigación Cerebrovascular, Instituto de Investigación Sanitaria La Fe - Universidad de Valencia, Valencia, Spain
| | | | - María Castelló-Ruiz
- Unidad Mixta de Investigación Cerebrovascular, Instituto de Investigación Sanitaria La Fe - Universidad de Valencia, Valencia, Spain.,Departamento de Biología Celular, Biología Funcional y Antropología Física, Universidad de Valencia, Valencia, Spain
| | - Germán Torregrosa
- Unidad Mixta de Investigación Cerebrovascular, Instituto de Investigación Sanitaria La Fe - Universidad de Valencia, Valencia, Spain
| | - David Hervás
- Unidad de Bioestadística, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Juan B Salom
- Unidad Mixta de Investigación Cerebrovascular, Instituto de Investigación Sanitaria La Fe - Universidad de Valencia, Valencia, Spain.,Departamento de Fisiología, Universidad de Valencia, Valencia, Spain
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24
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Moreno-Giménez A, Campos-Berga L, Nowak A, Sahuquillo-Leal R, D'Ocon A, Hervás D, Navalón P, Vento M, García-Blanco A. Impact of maternal age on infants' emotional regulation and psychomotor development. Psychol Med 2021; 52:1-12. [PMID: 33663627 DOI: 10.1017/s0033291721000568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Maternal age has progressively increased in industrialized countries. Most studies focus on the consequences of delayed motherhood for women's physical and mental health, but little is known about potential effects on infants' neurodevelopment. This prospective study examines the association between maternal age and offspring neurodevelopment in terms of both psychomotor development (Ages & Stages Questionnaires-3) and emotional competences (Early Childhood Behavior Questionnaire). METHODS We evaluated a cohort of healthy pregnant women aged 20-41 years and their offspring, assessed at 38 weeks gestation (n = 131) and 24 months after birth (n = 101). Potential age-related variables were considered (paternal age, education level, parity, social support, maternal cortisol levels, and maternal anxiety and depressive symptoms). Bayesian ordinal regression models were performed for each neurodevelopmental outcome. RESULTS Maternal age was negatively associated with poor child development in terms of personal-social skills [odds ratio (OR) -0.13, 95% confidence interval (CI) 0.77-0.99] and with difficult temperament in terms of worse emotional regulation (OR -0.13, 95% CI 0.78-0.96) and lower positive affect (OR 0.16, 95% CI 0.75-0.95). As for age-related variables, whereas maternal anxiety symptoms and cortisol levels were also correlated with poor child development and difficult temperament, maternal social support and parental educational level were associated with better psychomotor and emotional competences. CONCLUSION Increasing maternal age may be associated with child temperament difficulties and psychomotor delay in terms of social interaction skills. Early detection of neurodevelopment difficulties in these babies would allow preventive psychosocial interventions to avoid future neuropsychiatric disorders.
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Affiliation(s)
- Alba Moreno-Giménez
- Department of Personality, Assessment and Psychological Treatment, University of Valencia, Valencia, Spain
| | | | - Alicja Nowak
- Department of Health Psychology and Clinical Psychology, Adam Mickiewicz University, Poznań, Poland
| | - Rosa Sahuquillo-Leal
- Department of Personality, Assessment and Psychological Treatment, University of Valencia, Valencia, Spain
| | - Ana D'Ocon
- Department of Personality, Assessment and Psychological Treatment, University of Valencia, Valencia, Spain
| | - David Hervás
- Department of Personality, Assessment and Psychological Treatment, University of Valencia, Valencia, Spain
- Health Research Institute La Fe, Valencia, Spain
| | - Pablo Navalón
- University and Polytechnic Hospital La Fe, Valencia, Spain
- Health Research Institute La Fe, Valencia, Spain
| | - Máximo Vento
- University and Polytechnic Hospital La Fe, Valencia, Spain
- Health Research Institute La Fe, Valencia, Spain
| | - Ana García-Blanco
- Department of Personality, Assessment and Psychological Treatment, University of Valencia, Valencia, Spain
- University and Polytechnic Hospital La Fe, Valencia, Spain
- Health Research Institute La Fe, Valencia, Spain
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25
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Vázquez-Costa JF, Hervás D. Minimal detectable change and minimal clinically important difference in spinal muscular atrophy patients. Eur J Neurol 2021; 28:e40-e41. [PMID: 33604967 DOI: 10.1111/ene.14780] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 02/15/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Juan F Vázquez-Costa
- Neuromuscular Research Unit, Instituto de Investigación Sanitaria la Fe, Valencia, Spain.,Motor Neuron Disease Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain.,Department of Medicine, University of Valencia, Valencia, Spain
| | - David Hervás
- Department of Applied Statistics and Operational Research and Quality, Universitat Politècnica de València, Valencia, Spain
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26
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Martínez-Molina M, Argente-Escrig H, Polo MF, Hervás D, Frasquet M, Cortés V, Sevilla T, Vázquez-Costa JF. Early Referral to an ALS Center Reduces Several Months the Diagnostic Delay: A Multicenter-Based Study. Front Neurol 2020; 11:604922. [PMID: 33391167 PMCID: PMC7775542 DOI: 10.3389/fneur.2020.604922] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/01/2020] [Indexed: 01/10/2023] Open
Abstract
Objective: To analyze those factors contributing to the diagnostic delay in ALS. Methods: Consecutive ALS patients were categorized as those studied in departmental hospitals and those studied in a referral ALS center. Demographic and clinical variables, together with data of the diagnostic pathway were collected. Multivariable models were used to assess their effect in the time between symptoms onset and the first neurologist visit (time symptoms-neurologist), in the time between the first neurologist visit and the diagnosis (time neurologist-diagnosis) and in the diagnostic delay. Results: 166 ALS patients with a median diagnostic delay of 11.53 months (IQR: 6.68, 15.23) were included. The median diagnostic delay was 8.57 months (5.16, 11.61) in the referral center vs. 12.08 months (6.87, 16.8) in departmental centers. Bulbar onset, fast progression rate, upper motor neuron predominant phenotype and an early referral to the neurologist were associated with a shorter time between symptoms-neurologist. Being studied in a referral center was associated with a shorter time between neurologist-diagnosis. Comorbidities, familial ALS, bulbar onset, early referral to the neurologist and being studied in a referral center were associated with a shorter diagnostic delay. For patients studied in departmental hospitals, fast progression rate was also strongly associated with a shorter time between neurologist-diagnosis and diagnostic delay. Conclusion: Unmodifiable factors (comorbidities, familial ALS, bulbar onset, and progression rate) as well as modifiable factors (early referral to the neurologist and the evaluation in an ALS referral center) have an independent effect in the diagnostic delay. The universalization of ALS Units is probably the most efficient measure to reduce the diagnostic delay.
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Affiliation(s)
- Marina Martínez-Molina
- Neuromuscular Research Unit, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
- Amyotrophic Lateral Sclerosis (ALS) Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Herminia Argente-Escrig
- Neuromuscular Research Unit, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
- Amyotrophic Lateral Sclerosis (ALS) Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Margarita F. Polo
- Amyotrophic Lateral Sclerosis (ALS) Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - David Hervás
- Biostatistics Unit, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Marina Frasquet
- Neuromuscular Research Unit, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
- Amyotrophic Lateral Sclerosis (ALS) Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Victoria Cortés
- Department of Neurophysiology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Teresa Sevilla
- Neuromuscular Research Unit, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
- Amyotrophic Lateral Sclerosis (ALS) Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Madrid, Spain
- Department of Medicina, University of Valencia, Valencia, Spain
| | - Juan F. Vázquez-Costa
- Neuromuscular Research Unit, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
- Amyotrophic Lateral Sclerosis (ALS) Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras, Madrid, Spain
- Department of Medicina, University of Valencia, Valencia, Spain
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27
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Serrano-Pastor L, Hervás D, Simarro AM, Gomila A, Vázquez-Costa JF. Moral reasoning and moral conflict in patients of the amyotrophic lateral sclerosis - Frontotemporal dementia spectrum. Soc Neurosci 2020; 15:668-677. [PMID: 33323037 DOI: 10.1080/17470919.2020.1850521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The aim of this study was to investigate the moral reasoning and moral conflict in patients of the amyotrophic lateral sclerosis - frontotemporal dementia (ALSFTD) spectrum. Ten ALS patients without cognitive impairment, 10 ALS patients with cognitive or behavioral impairment, 10 ALSFTD patients and 23 controls were examined with neuropsychological and behavioral tests as well as with a set of eight well -designed moral dilemmas. The responses to the moral dilemmas were used as proxies to evaluate interpersonal moral reasoning. Reactivity to change, reaction time and arousal were used as markers of moral conflict. ALSFTD patients showed more "utilitarian" responses and less moral conflict than control participants. ALS patients without dementia showed a trend toward slower reaction time, which could be largely attributed to physical disability. No significant changes in arousal were found in ALS patients compared with control participants. Behavioral changes (apathy and dysexecutive symptoms) were partly responsible for the changes found in patients of the ALSFTD spectrum. Our results suggest that most ALS patients without dementia, but not those with concomitant dementia, would be able to deal with the conflict of complex moral decisions, such as end-of-life decisions, at least in mild to moderate stages of the disease.
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Affiliation(s)
- Lucas Serrano-Pastor
- Psychology, Evolution and Cognition (IFISC-CSIC), University of the Balearic Islands , Palma, Spain
| | - David Hervás
- Biostatistics Unit, Instituto de Investigación Sanitaria la Fe , Valencia, Spain
| | - Amparo Martínez Simarro
- Neuromuscular Research Unit, Instituto de Investigación Sanitaria La Fe (IIS La Fe) , Valencia, Spain
| | - Antoni Gomila
- Psychology, Evolution and Cognition (IFISC-CSIC), University of the Balearic Islands , Palma, Spain
| | - Juan F Vázquez-Costa
- Neuromuscular Research Unit, Instituto de Investigación Sanitaria La Fe (IIS La Fe) , Valencia, Spain.,ALS Unit, Department of Neurology, Hospital Universitario y Politécnico La Fe , Valencia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) , Valencia, Spain.,Department of Medicine, University of Valencia , Valencia, Spain
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28
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Salvador-Coloma C, Santaballa A, Sanmartín E, Calvo D, García A, Hervás D, Cordón L, Quintas G, Ripoll F, Panadero J, Font de Mora J. Immunosuppressive profiles in liquid biopsy at diagnosis predict response to neoadjuvant chemotherapy in triple-negative breast cancer. Eur J Cancer 2020; 139:119-134. [DOI: 10.1016/j.ejca.2020.08.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/07/2020] [Accepted: 08/18/2020] [Indexed: 12/11/2022]
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29
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Sebastià N, Olivares-González L, Montoro A, Barquinero JF, Canyada-Martinez AJ, Hervás D, Gras P, Villaescusa JI, Martí-Bonmatí L, Muresan BT, Soriano JM, Campayo JM, Andani J, Alonso O, Rodrigo R. Redox Status, Dose and Antioxidant Intake in Healthcare Workers Occupationally Exposed to Ionizing Radiation. Antioxidants (Basel) 2020; 9:antiox9090778. [PMID: 32825731 PMCID: PMC7554777 DOI: 10.3390/antiox9090778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/14/2020] [Accepted: 08/18/2020] [Indexed: 12/28/2022] Open
Abstract
The purpose of this study was to evaluate the relationship between blood redox status, dose and antioxidant dietary intake of different hospital staff groups exposed to low doses of ionizing radiation (LDIR) (Interventional Radiology and Cardiology, Radiation Oncology, and Nuclear Medicine) and non-exposed. Personal dose equivalent (from last year and cumulative), plasma antioxidant markers (total antioxidant capacity, extracellular superoxide dismutase activity, and glutathione/oxidized glutathione ratio), oxidative stress markers (nitrites and nitrates, and lipid peroxidation) and dietary intake (antioxidant capacity using ORAC values) were collected and analyzed from 28 non-exposed healthcare workers and 42 healthcare workers exposed to LDIR. Hospital staff exposed to LDIR presented a redox imbalance in blood that seems to correlate with dose. Workers from the Nuclear Medicine Unit were the most affected group with the lowest value of plasma antioxidant response and the highest value of plasma thiobarbituric acid reactive substances, TBARS (indicator of lipid peroxidation) of all four groups. Cumulative personal dose equivalent positively correlated with nitrites and negatively correlated with total antioxidant capacity in blood. The diet of healthcare workers from Nuclear Medicine Unit had higher ORAC values than the diet of non-exposed. Therefore, occupational exposure to LDIR, especially for the Nuclear Medicine Unit, seems to produce an imbalanced redox status in blood that would correlate with cumulative personal dose equivalent.
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Affiliation(s)
- Natividad Sebastià
- Service of Radiological Protection, Clinical Area of Medical Image, Avda. Fernando Abril Martorell, 106, Hospital U. P. La Fe, 46026 Valencia, Spain; (N.S.); (A.M.); (P.G.); (J.I.V.); (B.T.M.); (J.M.C.); (O.A.)
- Biomedical Imaging Research Group GIBI230, Avda. Fernando Abril Martorell, 106, Health Research Institute Hospital La Fe (IISLaFe), 46026 Valencia, Spain;
| | - Lorena Olivares-González
- Pathophysiology and Therapies for Visual Disorders, Eduardo Primo Yúfera, 3, Research Center Príncipe Felipe (CIPF), 46012 Valencia, Spain;
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain
| | - Alegría Montoro
- Service of Radiological Protection, Clinical Area of Medical Image, Avda. Fernando Abril Martorell, 106, Hospital U. P. La Fe, 46026 Valencia, Spain; (N.S.); (A.M.); (P.G.); (J.I.V.); (B.T.M.); (J.M.C.); (O.A.)
- Biomedical Imaging Research Group GIBI230, Avda. Fernando Abril Martorell, 106, Health Research Institute Hospital La Fe (IISLaFe), 46026 Valencia, Spain;
| | - Joan-Francesc Barquinero
- Biological Anthropology Unit Animal Biology, Plant Biology and Ecology Department, Universitat Autònoma de Barcelona (UAB), 08193 Bellaterra, Spain;
| | - Antonio José Canyada-Martinez
- Biostatistics Unit, Avda. Fernando Abril Martorell, 106, Health Research Institute Hospital La Fe (IISLaFe), 46026 Valencia, Spain; (A.J.C.-M.); (D.H.)
| | - David Hervás
- Biostatistics Unit, Avda. Fernando Abril Martorell, 106, Health Research Institute Hospital La Fe (IISLaFe), 46026 Valencia, Spain; (A.J.C.-M.); (D.H.)
| | - Pilar Gras
- Service of Radiological Protection, Clinical Area of Medical Image, Avda. Fernando Abril Martorell, 106, Hospital U. P. La Fe, 46026 Valencia, Spain; (N.S.); (A.M.); (P.G.); (J.I.V.); (B.T.M.); (J.M.C.); (O.A.)
| | - Juan Ignacio Villaescusa
- Service of Radiological Protection, Clinical Area of Medical Image, Avda. Fernando Abril Martorell, 106, Hospital U. P. La Fe, 46026 Valencia, Spain; (N.S.); (A.M.); (P.G.); (J.I.V.); (B.T.M.); (J.M.C.); (O.A.)
- Biomedical Imaging Research Group GIBI230, Avda. Fernando Abril Martorell, 106, Health Research Institute Hospital La Fe (IISLaFe), 46026 Valencia, Spain;
| | - Luis Martí-Bonmatí
- Biomedical Imaging Research Group GIBI230, Avda. Fernando Abril Martorell, 106, Health Research Institute Hospital La Fe (IISLaFe), 46026 Valencia, Spain;
- Service of Radiology, Clinical Area of Medical Image, Avda. Fernando Abril Martorell, 106, Hospital U. P. La Fe, 46026 Valencia, Spain
| | - Bianca Tabita Muresan
- Service of Radiological Protection, Clinical Area of Medical Image, Avda. Fernando Abril Martorell, 106, Hospital U. P. La Fe, 46026 Valencia, Spain; (N.S.); (A.M.); (P.G.); (J.I.V.); (B.T.M.); (J.M.C.); (O.A.)
| | - José Miguel Soriano
- Food & Health Lab, Institute of Materials Science, Parc Científic, Catedrático Agustín Escardino, Paterna (Valencia), University of Valencia, 46980 Valencia, Spain;
- Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia, Avda. Fernando Abril Martorell, 106, Health Research Institute Hospital La Fe (IISLaFe), 46026 Valencia, Spain
| | - Juan Manuel Campayo
- Service of Radiological Protection, Clinical Area of Medical Image, Avda. Fernando Abril Martorell, 106, Hospital U. P. La Fe, 46026 Valencia, Spain; (N.S.); (A.M.); (P.G.); (J.I.V.); (B.T.M.); (J.M.C.); (O.A.)
| | - Joaquin Andani
- Service of Occupational Risk Prevention, Avda. Fernando Abril Martorell, 106, Hospital U. P. La Fe, 46026 Valencia, Spain;
| | - Oscar Alonso
- Service of Radiological Protection, Clinical Area of Medical Image, Avda. Fernando Abril Martorell, 106, Hospital U. P. La Fe, 46026 Valencia, Spain; (N.S.); (A.M.); (P.G.); (J.I.V.); (B.T.M.); (J.M.C.); (O.A.)
| | - Regina Rodrigo
- Pathophysiology and Therapies for Visual Disorders, Eduardo Primo Yúfera, 3, Research Center Príncipe Felipe (CIPF), 46012 Valencia, Spain;
- Center for Biomedical Network Research on Rare Diseases (CIBERER), Monforte de Lemos, 3-5. Pabellón 11, 28029 Madrid, Spain
- Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia, Avda. Fernando Abril Martorell, 106, Health Research Institute Hospital La Fe (IISLaFe), 46026 Valencia, Spain
- Joint Research Unit of Rare Diseases, CIPF-Health Research Institute La Fe, Eduardo Primo Yúfera, 3, 46012 Valencia, Spain
- Correspondence: ; Tel.: +34-96-328-9680
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Gómez-Escribano AP, Bono-Yagüe J, García-Gimeno MA, Sequedo MD, Hervás D, Fornés-Ferrer V, Torres-Sánchez SC, Millán JM, Sanz P, Vázquez-Manrique RP. Synergistic activation of AMPK prevents from polyglutamine-induced toxicity in Caenorhabditis elegans. Pharmacol Res 2020; 161:105105. [PMID: 32739430 PMCID: PMC7755709 DOI: 10.1016/j.phrs.2020.105105] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/14/2020] [Accepted: 07/21/2020] [Indexed: 12/29/2022]
Abstract
Expression of abnormally long polyglutamine (polyQ) tracks is the source of a range of dominant neurodegenerative diseases, such as Huntington disease. Currently, there is no treatment for this devastating disease, although some chemicals, e.g., metformin, have been proposed as therapeutic solutions. In this work, we show that metformin, together with salicylate, can synergistically reduce the number of aggregates produced after polyQ expression in Caenorhabditis elegans. Moreover, we demonstrate that incubation polyQ-stressed worms with low doses of both chemicals restores neuronal functionality. Both substances are pleitotropic and may activate a range of different targets. However, we demonstrate in this report that the beneficial effect induced by the combination of these drugs depends entirely on the catalytic action of AMPK, since loss of function mutants of aak-2/AMPKα2 do not respond to the treatment. To further investigate the mechanism of the synergetic activity of metformin/salicylate, we used CRISPR to generate mutant alleles of the scaffolding subunit of AMPK, aakb-1/AMPKβ1. In addition, we used an RNAi strategy to silence the expression of the second AMPKβ subunit in worms, namely aakb-2/AMPKβ2. In this work, we demonstrated that both regulatory subunits of AMPK are modulators of protein homeostasis. Interestingly, only aakb-2/AMPKβ2 is required for the synergistic action of metformin/salicylate to reduce polyQ aggregation. Finally, we showed that autophagy acts downstream of metformin/salicylate-related AMPK activation to promote healthy protein homeostasis in worms.
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Affiliation(s)
- A P Gómez-Escribano
- Laboratory of Molecular, Cellular and Genomic Biomedicine, Instituto De Investigación Sanitaria La Fe, Valencia, Spain; Centro De Investigación Biomédica En Red De Enfermedades Raras (CIBERER), Madrid, Spain; Joint Unit for Rare Diseases IIS La Fe-CIPF, Valencia, Spain
| | - J Bono-Yagüe
- Laboratory of Molecular, Cellular and Genomic Biomedicine, Instituto De Investigación Sanitaria La Fe, Valencia, Spain; Joint Unit for Rare Diseases IIS La Fe-CIPF, Valencia, Spain
| | - M A García-Gimeno
- Department of Biotechnology, Escuela Técnica Superior De Ingeniería Agronómica y Del Medio Natural (ETSIAMN), Universitat Politécnica De València, Valencia, Spain
| | - M D Sequedo
- Laboratory of Molecular, Cellular and Genomic Biomedicine, Instituto De Investigación Sanitaria La Fe, Valencia, Spain; Centro De Investigación Biomédica En Red De Enfermedades Raras (CIBERER), Madrid, Spain; Joint Unit for Rare Diseases IIS La Fe-CIPF, Valencia, Spain
| | - D Hervás
- Department of Biostatistics, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - V Fornés-Ferrer
- Tau Analytics, Parc Científic De La Universitat De València, Paterna, Spain
| | - S C Torres-Sánchez
- Laboratory of Molecular, Cellular and Genomic Biomedicine, Instituto De Investigación Sanitaria La Fe, Valencia, Spain
| | - J M Millán
- Laboratory of Molecular, Cellular and Genomic Biomedicine, Instituto De Investigación Sanitaria La Fe, Valencia, Spain; Centro De Investigación Biomédica En Red De Enfermedades Raras (CIBERER), Madrid, Spain; Joint Unit for Rare Diseases IIS La Fe-CIPF, Valencia, Spain
| | - P Sanz
- Centro De Investigación Biomédica En Red De Enfermedades Raras (CIBERER), Madrid, Spain; Instituto De Biomedicina De València, CSIC, Valencia, Spain
| | - R P Vázquez-Manrique
- Laboratory of Molecular, Cellular and Genomic Biomedicine, Instituto De Investigación Sanitaria La Fe, Valencia, Spain; Centro De Investigación Biomédica En Red De Enfermedades Raras (CIBERER), Madrid, Spain; Joint Unit for Rare Diseases IIS La Fe-CIPF, Valencia, Spain.
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Peña-Bautista C, Álvarez L, Durand T, Vigor C, Cuevas A, Baquero M, Vento M, Hervás D, Cháfer-Pericás C. Clinical Utility of Plasma Lipid Peroxidation Biomarkers in Alzheimer's Disease Differential Diagnosis. Antioxidants (Basel) 2020; 9:antiox9080649. [PMID: 32707935 PMCID: PMC7464465 DOI: 10.3390/antiox9080649] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/15/2020] [Accepted: 07/21/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Differential diagnosis of Alzheimer's disease (AD) is a complex task due to the clinical similarity among neurodegenerative diseases. Previous studies showed the role of lipid peroxidation in early AD development. However, the clinical validation of potential specific biomarkers in minimally invasive samples constitutes a great challenge in early AD diagnosis. METHODS Plasma samples from participants classified into AD (n = 138), non-AD (including MCI and other dementias not due to AD) (n = 70) and healthy (n = 50) were analysed. Lipid peroxidation compounds (isoprostanes, isofurans, neuroprostanes, neurofurans) were determined by ultra-performance liquid chromatography coupled with tandem mass spectrometry. Statistical analysis for biomarkers' clinical validation was based on Elastic Net. RESULTS A two-step diagnosis model was developed from plasma lipid peroxidation products to diagnose early AD specifically, and a bootstrap validated AUC of 0.74 was obtained. CONCLUSION A promising AD differential diagnosis model was developed. It was clinically validated as a screening test. However, further external validation is required before clinical application.
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Affiliation(s)
- Carmen Peña-Bautista
- Neonatal Research Unit, Health Research Institute La Fe, 46026 Valencia, Spain; (C.P.-B.); (M.V.)
| | - Lourdes Álvarez
- Neurology Unit, University and Polytechnic Hospital La Fe, 46026 Valencia, Spain; (L.A.); (A.C.); (M.B.)
| | - Thierry Durand
- Institut des Biomolécules Max Mousseron, IBMM, University of Montpellier, CNRS ENSCM, 34093 Montpellier, France; (T.D.); (C.V.)
| | - Claire Vigor
- Institut des Biomolécules Max Mousseron, IBMM, University of Montpellier, CNRS ENSCM, 34093 Montpellier, France; (T.D.); (C.V.)
| | - Ana Cuevas
- Neurology Unit, University and Polytechnic Hospital La Fe, 46026 Valencia, Spain; (L.A.); (A.C.); (M.B.)
| | - Miguel Baquero
- Neurology Unit, University and Polytechnic Hospital La Fe, 46026 Valencia, Spain; (L.A.); (A.C.); (M.B.)
| | - Máximo Vento
- Neonatal Research Unit, Health Research Institute La Fe, 46026 Valencia, Spain; (C.P.-B.); (M.V.)
| | - David Hervás
- Biostatistical Unit, Health Research Institute La Fe, 46026 Valencia, Spain;
| | - Consuelo Cháfer-Pericás
- Neonatal Research Unit, Health Research Institute La Fe, 46026 Valencia, Spain; (C.P.-B.); (M.V.)
- Correspondence: ; Tel.: +34-961-246-721; Fax: +34-961-246-620
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Muresan BT, Sánchez Juan C, Artero A, Montoro A, Garcia Miragll E, Ruiz Y, Soriano del Castillo JM, Ríos Ríos J, Hervás D, López-Torrecilla J. Tomografía computarizada a nivel de C3 y dinamometría como técnicas de diagnóstico de sarcopenia en pacientes con cáncer de cabeza y cuello. Rev Esp Nutr Hum Diet 2020. [DOI: 10.14306/renhyd.24.2.927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introducción: Estudio piloto que determina el diagnóstico de sarcopenia mediante tomografía computarizada (TC) a nivel de la tercera vértebra cervical (C3) y dinamometría en pacientes con cáncer de cabeza y cuello. Comparación de la masa magra (MM) determinada mediante TC con técnicas clásicas de antropometría y dinamometría.Material y métodos: Se analizó la MM y el tejido adiposo mediante TC a nivel de C3 en 37 pacientes oncológicos mediante Unidades Hounsfield (UH). Posteriormente, se calculó el índice musculoesquelético (IME) y se determinó la fuerza prensora de mano para la determinación de sarcopenia. Por último, se comparó el IME mediante técnicas de valoración antropométrica clásica y dinamometría. Resultados: El 59,46% de los pacientes presentaron un IME (cm2/m2) disminuido, el 64,86% dinapenia, el 54,05% sarcopenia, el 32,43% sarcopenia dentro del sobrepeso y obesidad. Por otro lado, la media de la masa grasa intermuscular fue 6,69 (3,8) cm2, y la masa grasa intramuscular 2,06 (1,11) cm2. Además, se encontró una asociación estadísticamente significativa entre la fuerza tanto en la mano fuerte (estimado = 0,412, IC95% [0,219; 0,605], p-valor <0,001) como en la mano débil (estimado =0,289, IC95% [0,123; 0,454], p-valor <0,001) y el IME cm2/m2. Respecto a la circunferencia muscular braquial), no alcanzamos a mostrar correlación positiva.Conclusiones: Nuestro estudio muestra que en el paciente con cáncer de cabeza y cuello la prevalencia de sarcopenia es elevada. Además, la depleción muscular evaluada mediante TC a nivel de C3 y dinamometría presenta cierta correlación, por lo que, aquellos pacientes con mayor depleción muscular a nivel de C3 presentan menor funcionalidad.
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Oto J, Plana E, Solmoirago MJ, Fernández-Pardo Á, Hervás D, Cana F, España F, Artoni A, Bucciarelli P, Carrabba G, Navarro S, Merati G, Medina P. microRNAs and Markers of Neutrophil Activation as Predictors of Early Incidental Post-Surgical Pulmonary Embolism in Patients with Intracranial Tumors. Cancers (Basel) 2020; 12:cancers12061536. [PMID: 32545233 PMCID: PMC7353032 DOI: 10.3390/cancers12061536] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 02/06/2023] Open
Abstract
Venous thromboembolism (VTE) is a common complication of cancer that severely increases morbidity and mortality. Patients with intracranial tumors are more likely to develop VTE than patients with cancers at other sites. Conversely, limited tools exist to identify patients with high thrombotic risk. Upon activation, neutrophils release their content through different mechanisms triggering thrombosis. We explored the ability of microRNAs (miRNAs) and plasma markers of neutrophil activation measured before surgery to predict the risk of early post-surgical pulmonary embolism (PE) in glioma and meningioma patients. We recruited and prospectively followed 50 patients with glioma and 50 with meningioma, 34% of whom in each group developed an early objectively-diagnosed post-surgical PE. We measured miRNA expression and neutrophil markers (cell-free DNA, nucleosomes, calprotectin and myeloperoxidase) before surgery. In glioma patients, we adjusted and validated a predictive model for post-surgical PE with 6 miRNAs: miR-363-3p, miR-93-3p, miR-22-5p, miR-451a, miR-222-3p and miR-140-3p (AUC = 0.78; 95% Confidence Interval (CI) [0.63, 0.94]) and another with cfDNA and myeloperoxidase as predictors (AUC = 0.71; 95% CI [0.52, 0.90]). Furthermore, we combined both types of markers and obtained a model with myeloperoxidase and miR-140-3p as predictors (AUC = 0.79; 95% CI [0.64, 0.94]). In meningioma patients we fitted and validated a predictive model with 6 miRNAs: miR-29a-3p, miR-660-5p, miR-331-3p, miR-126-5p, miR-23a-3p and miR-23b-3p (AUC = 0.69; 95% CI [0.52, 0.87]). All our models outperformed the Khorana score. This is the first study that analyzes the capability of plasma miRNAs and neutrophil activation markers to predict early post-surgical PE in glioma and meningioma patients. The estimation of the thrombotic risk before surgery may promote a tailored thromboprophylaxis in a selected group of high-risk patients, in order to minimize the incidence of PE and avoid bleedings.
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Affiliation(s)
- Julia Oto
- Haemostasis, Thrombosis, Atherosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (J.O.); (E.P.); (M.J.S.); (Á.F.-P.); (F.C.); (F.E.); (S.N.)
| | - Emma Plana
- Haemostasis, Thrombosis, Atherosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (J.O.); (E.P.); (M.J.S.); (Á.F.-P.); (F.C.); (F.E.); (S.N.)
- Angiology and Vascular Surgery Service, La Fe University and Polytechnic Hospital, 46026 Valencia, Spain
| | - María José Solmoirago
- Haemostasis, Thrombosis, Atherosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (J.O.); (E.P.); (M.J.S.); (Á.F.-P.); (F.C.); (F.E.); (S.N.)
| | - Álvaro Fernández-Pardo
- Haemostasis, Thrombosis, Atherosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (J.O.); (E.P.); (M.J.S.); (Á.F.-P.); (F.C.); (F.E.); (S.N.)
| | - David Hervás
- Data Science, Biostatistics and Bioinformatics Unit, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain;
| | - Fernando Cana
- Haemostasis, Thrombosis, Atherosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (J.O.); (E.P.); (M.J.S.); (Á.F.-P.); (F.C.); (F.E.); (S.N.)
| | - Francisco España
- Haemostasis, Thrombosis, Atherosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (J.O.); (E.P.); (M.J.S.); (Á.F.-P.); (F.C.); (F.E.); (S.N.)
| | - Andrea Artoni
- A. Bianchi Bonomi Hemophilia and Thrombosis Centre, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.A.); (P.B.); (G.M.)
| | - Paolo Bucciarelli
- A. Bianchi Bonomi Hemophilia and Thrombosis Centre, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.A.); (P.B.); (G.M.)
| | - Giorgio Carrabba
- Neurosurgery Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Silvia Navarro
- Haemostasis, Thrombosis, Atherosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (J.O.); (E.P.); (M.J.S.); (Á.F.-P.); (F.C.); (F.E.); (S.N.)
| | - Giuliana Merati
- A. Bianchi Bonomi Hemophilia and Thrombosis Centre, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (A.A.); (P.B.); (G.M.)
| | - Pilar Medina
- Haemostasis, Thrombosis, Atherosclerosis and Vascular Biology Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), 46026 Valencia, Spain; (J.O.); (E.P.); (M.J.S.); (Á.F.-P.); (F.C.); (F.E.); (S.N.)
- Correspondence:
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Peña-Bautista C, Baquero M, López-Nogueroles M, Vento M, Hervás D, Cháfer-Pericás C. Isoprostanoids Levels in Cerebrospinal Fluid Do Not Reflect Alzheimer's Disease. Antioxidants (Basel) 2020; 9:antiox9050407. [PMID: 32397687 PMCID: PMC7278667 DOI: 10.3390/antiox9050407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/04/2020] [Accepted: 05/07/2020] [Indexed: 01/24/2023] Open
Abstract
Previous studies showed a relationship between lipid oxidation biomarkers from plasma samples and Alzheimer's Disease (AD), constituting a promising diagnostic tool. In this work we analyzed whether these plasma biomarkers could reflect specific brain oxidation in AD. In this work lipid peroxidation compounds were determined in plasma and cerebrospinal fluid (CSF) samples from AD and non-AD (including other neurological pathologies) participants, by means of an analytical method based on liquid chromatography coupled with mass spectrometry. Statistical analysis evaluated correlations between biological matrices. The results did not show satisfactory correlations between plasma and CSF samples for any of the studied lipid peroxidation biomarkers (isoprostanes, neuroprostanes, prostaglandines, dihomo-isoprostanes). However, some of the analytes showed correlations with specific CSF biomarkers for AD and with neuropsychological tests (Mini-Mental State Examination (MMSE), Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)). In conclusion, lipid peroxidation biomarkers in CSF samples do not reflect their levels in plasma samples, and no significant differences were observed between participant groups. However, some of the analytes could be useful as cognitive decline biomarkers.
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Affiliation(s)
- Carmen Peña-Bautista
- Neonatal Research Unit, Health Research Institute La Fe, 46026 Valencia, Spain; (C.P.-B.); (M.V.)
| | - Miguel Baquero
- Neurology Unit, University and Polytechnic Hospital La Fe, 46026 Valencia, Spain;
| | | | - Máximo Vento
- Neonatal Research Unit, Health Research Institute La Fe, 46026 Valencia, Spain; (C.P.-B.); (M.V.)
| | - David Hervás
- Biostatistical Unit, Health Research Institute La Fe, 46026 Valencia, Spain;
| | - Consuelo Cháfer-Pericás
- Neonatal Research Unit, Health Research Institute La Fe, 46026 Valencia, Spain; (C.P.-B.); (M.V.)
- Correspondence: ; Tel.: +34-96-124-67-21
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35
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Mateos B, Sáez-González E, Moret I, Hervás D, Iborra M, Cerrillo E, Tortosa L, Nos P, Beltrán B. Plasma Oncostatin M, TNF-α, IL-7, and IL-13 Network Predicts Crohn's Disease Response to Infliximab, as Assessed by Calprotectin Log Drop. Dig Dis 2020; 39:1-9. [PMID: 32325460 DOI: 10.1159/000508069] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 04/22/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Cytokines emerge as possible biomarkers of response in Crohn's disease (CD). We aimed to determine the plasmatic cytokine profiles of active CD patients who started infliximab (IFX) treatment and their capacity to predict the response to IFX. METHODS A total of 30 active CD patients receiving an induction therapy of IFX were enrolled in the study. Peripheral blood samples pretreatment were collected. Concentrations of 15 cytokines were measured by Luminex technology. Responses to IFX were evaluated by the drop in fecal calprotectin based on its logarithm-transformed values. A random forest (RF) predictive model was used for data analyses. RESULTS Samples of 22 patients were analyzed. The RF model ranked the following cytokines as the top predictors of the response: tumor necrosis factor alpha (TNFα), interleukin (IL)-13, oncostatin M (OSM), and IL-7 (p < 0.005). Partial dependency plots showed that high levels of IL-13 pretreatment, low TNFα levels, and low IL-7 levels were associated with a favorable IFX response. Increased levels of OSM and TNFα predicted unfavorable responses to IFX. CONCLUSIONS We here show that a log drop in calprotectin strongly correlates with clinical parameters and it can be proposed as a useful objective clinical response predictor. Plasma TNFα, IL-13, Il-7, and OSM network could predict CD response to IFX before induction therapy, as assessed by calprotectin log drop.
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Affiliation(s)
- Beatriz Mateos
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Esteban Sáez-González
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Inflammatory Bowel Disease Research Group, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
| | - Inés Moret
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Inflammatory Bowel Disease Research Group, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | - David Hervás
- Biostatictics Unit, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
| | - Marisa Iborra
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Inflammatory Bowel Disease Research Group, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | - Elena Cerrillo
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Inflammatory Bowel Disease Research Group, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
| | - Luis Tortosa
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Inflammatory Bowel Disease Research Group, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | - Pilar Nos
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Inflammatory Bowel Disease Research Group, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades hepáticas y Digestivas (CIBEREHD), Madrid, Spain
| | - Belén Beltrán
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain, .,Inflammatory Bowel Disease Research Group, Health Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain, .,Centro de Investigación Biomédica en Red de Enfermedades hepáticas y Digestivas (CIBEREHD), Madrid, Spain,
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Olivera GG, Yáñez Y, Gargallo P, Sendra L, Aliño SF, Segura V, Sanz MÁ, Cañete A, Castel V, Font De Mora J, Hervás D, Berlanga P, Herrero MJ. MTHFR and VDR Polymorphisms Improve the Prognostic Value of MYCN Status on Overall Survival in Neuroblastoma Patients. Int J Mol Sci 2020; 21:E2714. [PMID: 32295184 PMCID: PMC7215604 DOI: 10.3390/ijms21082714] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/27/2020] [Accepted: 04/10/2020] [Indexed: 12/26/2022] Open
Abstract
Single nucleotide polymorphisms (SNPs) in Pharmacogenetics can play an important role in the outcomes of the chemotherapy treatment in Neuroblastoma, helping doctors maximize efficacy and minimize toxicity. Employing AgenaBioscience MassArray, 96 SNPs were genotyped in 95 patients looking for associations of SNP with response to induction therapy (RIT) and grade 3-4 toxicities, in High Risk patients. Associations of SNPs with overall (OS) and event-free (EFS) survival in the whole cohort were also explored. Cox and logistic regression models with Elastic net penalty were employed. Association with grade 3-4 gastrointestinal and infectious toxicities was found for 8 different SNPs. Better RIT was correlated with rs726501 AG, rs3740066 GG, rs2010963 GG and rs1143684 TT (OR = 2.87, 1.79, 1.23, 1.14, respectively). EFS was affected by rs2032582, rs4880, rs3814058, rs45511401, rs1544410 and rs6539870. OS was influenced by rs 1801133, rs7186128 and rs1544410. Remarkably, rs1801133 in MTHFR (p = 0.02) and rs1544410 in VDR (p = 0.006) also added an important predictive value for OS to the MYCN status, with a more accurate substratification of the patients. Although validation studies in independent cohorts will be required, the data obtained supports the utility of Pharmacogenetics for predicting Neuroblastoma treatment outcomes.
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Affiliation(s)
- Gladys G. Olivera
- Pharmacogenetics Platform, Instituto de Investigación Sanitaria La Fe, 46026 Valencia, Spain; (G.G.O.); (M.J.H.)
- Department of Pharmacology, University of Valencia, 46010 Valencia, Spain
| | - Yania Yáñez
- Clinical and Translational Research in Cancer, Instituto de Investigación Sanitaria La Fe, 46026 Valencia, Spain; (Y.Y.)
| | - Pablo Gargallo
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain (A.C.)
| | - Luis Sendra
- Pharmacogenetics Platform, Instituto de Investigación Sanitaria La Fe, 46026 Valencia, Spain; (G.G.O.); (M.J.H.)
- Department of Pharmacology, University of Valencia, 46010 Valencia, Spain
| | - Salvador F. Aliño
- Pharmacogenetics Platform, Instituto de Investigación Sanitaria La Fe, 46026 Valencia, Spain; (G.G.O.); (M.J.H.)
- Department of Pharmacology, University of Valencia, 46010 Valencia, Spain
- Clinical Pharmacology Unit, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain
| | - Vanessa Segura
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain (A.C.)
| | - Miguel Ángel Sanz
- Hematology and Hemotherapy Service, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain
| | - Adela Cañete
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain (A.C.)
| | - Victoria Castel
- Pediatric Oncology Unit, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain (A.C.)
| | - Jaime Font De Mora
- Clinical and Translational Research in Cancer, Instituto de Investigación Sanitaria La Fe, 46026 Valencia, Spain; (Y.Y.)
| | - David Hervás
- Data Science, Biostatistics and Bioinformatics Platform, Instituto de Investigación Sanitaria La Fe, 46026 Valencia, Spain
| | - Pablo Berlanga
- Department of Pediatric and Adolescent Oncology, Institute Gustave Roussy Center, 94800 Villejuif, France;
| | - María José Herrero
- Pharmacogenetics Platform, Instituto de Investigación Sanitaria La Fe, 46026 Valencia, Spain; (G.G.O.); (M.J.H.)
- Department of Pharmacology, University of Valencia, 46010 Valencia, Spain
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de Miguel-Gómez L, Ferrero H, López-Martínez S, Campo H, López-Pérez N, Faus A, Hervás D, Santamaría X, Pellicer A, Cervelló I. Stem cell paracrine actions in tissue regeneration and potential therapeutic effect in human endometrium: a retrospective study. BJOG 2020; 127:551-560. [PMID: 31876085 DOI: 10.1111/1471-0528.16078] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Determining genetic and paracrine mechanisms behind endometrial regeneration in Asherman's syndrome and endometrial atrophy (AS/EA) patients after autologous CD133+ bone marrow-derived stem cell (CD133+ BMDSC) transplantation. DESIGN Retrospective study using human endometrial biopsies and mouse models. SETTING Fundación-IVI, IIS-La Fe, Valencia, Spain. SAMPLES Endometrial biopsies collected before and after CD133+ BMDSC therapy, from eight women with AS/EA (NCT02144987) from the uterus of five mice with only left horns receiving CD133+ BMDSC therapy. METHODS In human samples, haematoxylin and eosin (H&E) staining, RNA arrays, PCR validation, and neutrophil elastase (NE) immunohistochemistry (IHQ). In mouse samples, PCR validation and protein immunoarrays. MAIN OUTCOME MEASURES H&E microscopic evaluation, RNA expression levels, PCR, and growth/angiogenic factors quantification, NE IHQ signal. RESULTS Treatment improved endometrial morphology and thickness for all patients. In human samples, Jun, Serpine1, and Il4 were up-regulated whereas Ccnd1 and Cxcl8 were down-regulated after treatment. The significant decrease of NE signal corroborated Cxcl8 expression. Animal model analysis confirmed human results and revealed a higher expression of pro-angiogenic cytokines (IL18, HGF, MCP-1, MIP2) in treated uterine horns. CONCLUSIONS CD133+ BMDSC seems to activate several factors through a paracrine mechanism to help tissue regeneration, modifying endometrial behaviour through an immunomodulatory milieu that precedes proliferation and angiogenic processes. Insight into these processes could bring us one step closer to a non-invasive treatment for AS/EA patients. TWEETABLE ABSTRACT CD133+ BMDSC therapy regenerates endometrium, modifying the immunological milieu that precedes proliferation and angiogenesis.
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Affiliation(s)
- L de Miguel-Gómez
- Fundación Instituto Valenciano de Infertilidad (FIVI), Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - H Ferrero
- Fundación Instituto Valenciano de Infertilidad (FIVI), Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - S López-Martínez
- Fundación Instituto Valenciano de Infertilidad (FIVI), Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - H Campo
- Fundación Instituto Valenciano de Infertilidad (FIVI), Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - N López-Pérez
- Fundación Instituto Valenciano de Infertilidad (FIVI), Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - A Faus
- Fundación Instituto Valenciano de Infertilidad (FIVI), Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - D Hervás
- Data Science, Biostatistics and Bioinformatics, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - X Santamaría
- Igenomix Academy, Valencia, Spain.,IVIRMA, Barcelona, Barcelona, Spain
| | - A Pellicer
- IVIRMA Valencia, Valencia, Spain.,Reproductive Medicine Research Group, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - I Cervelló
- Fundación Instituto Valenciano de Infertilidad (FIVI), Instituto de Investigación Sanitaria La Fe, Valencia, Spain
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Moret-Tatay I, Cerrillo E, Sáez-González E, Hervás D, Iborra M, Sandoval J, Busó E, Tortosa L, Nos P, Beltrán B. Identification of Epigenetic Methylation Signatures With Clinical Value in Crohn's Disease. Clin Transl Gastroenterol 2019; 10:e00083. [PMID: 31663908 PMCID: PMC6919449 DOI: 10.14309/ctg.0000000000000083] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 08/16/2019] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION DNA methylation is an epigenetic mechanism that regulates gene expression and represents an important link between genotype, environment, and disease. It is a reversible and inheritable mechanism that could offer treatment targets. We aimed to assess the methylation changes on specific genes previously associated with Crohn's disease (CD) and to study their possible associations with the pathology. METHODS We included 103 participants and grouped them into 2 cohorts (a first [n = 31] and a second validation [n = 72] cohort), with active CD (aCD) and inactive CD (iCD) and healthy participants (CTR). DNA was obtained from the peripheral blood and analyzed by the Agena platform. The selected genes were catalase (CAT), α-defensin 5 (DEFA5), FasR, FasL, tumor necrosis factor (TNF), TNFRSF1A, TNFRSF1B, PPA2, ABCB1, NOD2, PPARγ, and PKCζ. We used the elastic net algorithm and R software. RESULTS We studied 240 CpGs. Sixteen CpGs showed differential methylation profiles among aCD, iCD, and CTR. We selected for validation those with the greatest differences: DEFA5 CpG_11; CpG_13; CAT CpG_31.32; TNF CpG_4, CpG_12; and ABCB1 CpG_21. Our results validated the genes DEFA5 (methylation gain) and TNF (methylation loss) with P values < 0.001. In both cases, the methylation level was maintained and did not change with CD activity (aCD vs iCD). The subanalysis comparison between aCD and iCD showed significant differential methylation profiles in other CpGs: TNF, FAS, ABCB1, CAT, and TNFRS1BF genes. DISCUSSION The methylation status of DEFA5 and TNF genes provides a signature biomarker that characterizes patients with CD and supports the possible implication of the environment and the immune system in CD pathogenesis.
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Affiliation(s)
- Inés Moret-Tatay
- Inflammatory Bowel Disease Research Group, Health Research Institute La Fe (IIS La Fe), Valencia, Spain
- Biomedical Research Centre, Hepatic and Digestive Diseases Network (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBEREHD]), Madrid, Spain
| | - Elena Cerrillo
- Inflammatory Bowel Disease Research Group, Health Research Institute La Fe (IIS La Fe), Valencia, Spain
- Department of Gastroenterology, Hospital La Fe, Valencia, Spain
| | - Esteban Sáez-González
- Inflammatory Bowel Disease Research Group, Health Research Institute La Fe (IIS La Fe), Valencia, Spain
- Department of Gastroenterology, Hospital La Fe, Valencia, Spain
| | - David Hervás
- Department of Gastroenterology, Hospital La Fe, Valencia, Spain
| | - Marisa Iborra
- Inflammatory Bowel Disease Research Group, Health Research Institute La Fe (IIS La Fe), Valencia, Spain
- Biomedical Research Centre, Hepatic and Digestive Diseases Network (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBEREHD]), Madrid, Spain
- Department of Gastroenterology, Hospital La Fe, Valencia, Spain
| | - Juan Sandoval
- Biomarkers and Precision Medicine Unit, Health Research Institute La Fe (IIS La Fe), Valencia, Spain
| | - Enrique Busó
- Central Unit for Research in Medicine (UCIM),University of Valencia, Valencia, Spain
| | - Luis Tortosa
- Inflammatory Bowel Disease Research Group, Health Research Institute La Fe (IIS La Fe), Valencia, Spain
- Biomedical Research Centre, Hepatic and Digestive Diseases Network (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBEREHD]), Madrid, Spain
| | - Pilar Nos
- Inflammatory Bowel Disease Research Group, Health Research Institute La Fe (IIS La Fe), Valencia, Spain
- Biomedical Research Centre, Hepatic and Digestive Diseases Network (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBEREHD]), Madrid, Spain
- Department of Gastroenterology, Hospital La Fe, Valencia, Spain
| | - Belén Beltrán
- Inflammatory Bowel Disease Research Group, Health Research Institute La Fe (IIS La Fe), Valencia, Spain
- Biomedical Research Centre, Hepatic and Digestive Diseases Network (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBEREHD]), Madrid, Spain
- Department of Gastroenterology, Hospital La Fe, Valencia, Spain
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Cerrillo E, Moret I, Iborra M, Pamies J, Hervás D, Tortosa L, Sáez-González E, Nos P, Beltrán B. A Nomogram Combining Fecal Calprotectin Levels and Plasma Cytokine Profiles for Individual Prediction of Postoperative Crohn's Disease Recurrence. Inflamm Bowel Dis 2019; 25:1681-1691. [PMID: 30925193 DOI: 10.1093/ibd/izz053] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND The aims of this study were to characterize the immune response profile in patients with Crohn's disease (CD) and early postoperative recurrence (POR), to identify predictive biomarkers, and to develop a noninvasive predictive tool for individual estimation of POR risk. METHODS Sixty-one patients who had undergone ileocolonic resection for CD were prospectively included and followed up for 24 months. Fecal calprotectin (FC), analytical parameters, and plasma cytokines were obtained before surgery and at various time points during postoperative follow-up. Morphological recurrence was assessed by ileocolonoscopy or magnetic resonance enterography within 6-12 months after surgery. Clinical activity was scored using the Harvey-Bradshaw Index. RESULTS Twenty-seven patients (44.3%) had morphological recurrence during follow-up. Fecal calprotectin values were significantly associated with POR risk over time. The receiver operating characteristic curve for FC provided an area under the curve (AUC) of 0.88 (95% confidence interval, 0.75-0.96), and morphological recurrence was best predicted by FC ≥160 μg/g at 6 months after surgery (85% sensitivity, 70% specificity, 26% predictive positive value, 98% negative predictive value [NPV]). The plasma cytokine profile showed higher presurgery interleukin (IL)-13 plasma levels and higher IL-6 and interferon (IFN)-γ levels at 6 months after surgery in patients with POR compared with patients without recurrence. The combination of FC, IL-6, and IFN-γ values at 6 months gave an AUC of 0.90 for predicting an early recurrence. CONCLUSIONS FC values <160 μg/g at 6 months have a high NPV to rule out early lesions. Combined values of FC, IL-6, and IFN-γ levels at 6 months postsurgery constitute a prognostic index with a high predictive capacity to assess the risk of early POR.
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Affiliation(s)
- Elena Cerrillo
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Inflammatory Bowel Disease Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain.,Networked Biomedical Research Center for Hepatic and Digestive Diseases (CIBEREHD), Institute of Health Carlos III, Madrid, Spain
| | - Inés Moret
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Inflammatory Bowel Disease Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain.,Networked Biomedical Research Center for Hepatic and Digestive Diseases (CIBEREHD), Institute of Health Carlos III, Madrid, Spain
| | - Marisa Iborra
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Inflammatory Bowel Disease Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain.,Networked Biomedical Research Center for Hepatic and Digestive Diseases (CIBEREHD), Institute of Health Carlos III, Madrid, Spain
| | - José Pamies
- Radiology Department, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - David Hervás
- Biostatistics Unit, Medical Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
| | - Luis Tortosa
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Inflammatory Bowel Disease Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
| | - Esteban Sáez-González
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Inflammatory Bowel Disease Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain
| | - Pilar Nos
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Inflammatory Bowel Disease Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain.,Networked Biomedical Research Center for Hepatic and Digestive Diseases (CIBEREHD), Institute of Health Carlos III, Madrid, Spain
| | - Belén Beltrán
- Inflammatory Bowel Disease Unit, Gastroenterology Department, La Fe University and Polytechnic Hospital, Valencia, Spain.,Inflammatory Bowel Disease Research Group, Medical Research Institute Hospital La Fe (IIS La Fe), Valencia, Spain.,Networked Biomedical Research Center for Hepatic and Digestive Diseases (CIBEREHD), Institute of Health Carlos III, Madrid, Spain
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Peña-Bautista C, Baquero M, Ferrer I, Hervás D, Vento M, García-Blanco A, Cháfer-Pericás C. Neuropsychological assessment and cortisol levels in biofluids from early Alzheimer's disease patients. Exp Gerontol 2019; 123:10-16. [PMID: 31117002 DOI: 10.1016/j.exger.2019.05.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/18/2019] [Accepted: 05/17/2019] [Indexed: 12/12/2022]
Abstract
Cortisol dysregulation is proposed as a factor in the development of Alzheimer's disease (AD). AD patients can show high cortisol levels in prodromal phases of AD, early enough that neuropsychological alterations exist but activities of daily living remain unimpaired. Nevertheless, it is unknown if biofluid cortisol levels can have some AD predictive power together with neuropsychological assessment in prodromal stages in comparison with other cognitive disorders. In this work, an analytical method based on ultra-performance liquid chromatography coupled to tandem mass spectrometry (UPLC-MS/MS) was applied to determine the cortisol levels in different biofluids (urine, plasma, saliva, cerebrospinal fluid). Early AD patients and non-AD patients recruited at out-patient neurological unit were classified from the standard cerebrospinal fluid biomarkers levels (β-amyloid, tau, phosphorylated tau), and studied with an extensive neuropsychological assessment including global, neuropsychological, functional and affective scales. We used a logistic regression model to discriminate between the AD and non-AD groups. Higher plasma cortisol levels were found in the AD group than in the non-AD group (p < 0.001). Regarding neuropsychological evaluation, delayed memory was used as representative of the neuropsychological status, and lower scores were obtained in the AD group (p < 0.001). The prediction model, including plasma cortisol levels and delayed memory scores, achieved an AUC of 0.93, as well as a sensitivity of 97% and a specificity of 69.4%. In conclusion, plasma cortisol levels and delayed memory scores were specifically impaired in early AD, allowing the development of a new diagnostic model which could be employed as a very satisfactory screening system.
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Affiliation(s)
- C Peña-Bautista
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain
| | - M Baquero
- Neurology Unit, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - I Ferrer
- Neurology Unit, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - D Hervás
- Biostatistical Unit Platform, Health Research Institute La Fe, Valencia, Spain
| | - M Vento
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain
| | - A García-Blanco
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain.
| | - C Cháfer-Pericás
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain.
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Peña-Bautista C, Roca M, Hervás D, Cuevas A, López-Cuevas R, Vento M, Baquero M, García-Blanco A, Cháfer-Pericás C. Plasma metabolomics in early Alzheimer's disease patients diagnosed with amyloid biomarker. J Proteomics 2019; 200:144-152. [PMID: 30978462 DOI: 10.1016/j.jprot.2019.04.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/01/2019] [Accepted: 04/07/2019] [Indexed: 12/19/2022]
Abstract
An untargeted metabolomics study has been carried out using plasma samples from patients with Mild Cognitive Impairment due to Alzheimer's disease patients (MCI-AD, n = 29) and healthy people (n = 29)). They have been classified following the National Institute on Aging and Alzheimer's Association (NIA-AA) recommendations and cerebrospinal fluid biomarkers. The analytical method was based on liquid chromatography coupled to high resolution mass spectrometry. The data process from the corresponding metabolic profiles retained 1158 molecular features in positive and 424 in negative ionization mode. Differences between metabolomic profiles from MCI-AD patients and healthy participants were investigated using a penalized logistic regression analysis (ElasticNet), and being able to select automatically the most informative variables (53 molecular features). From the molecular features selected for the elastic net models, 16 variables were preliminarily identified by The Human Metabolome Database (amino acids, lipids…). However, only 4 of these variables were tentatively identified by MS/MS and all ions fragmentation modes, being choline the only confirmed metabolite. Regarding their metabolic pathways, they could be involved in cholinergic system, energy metabolism, amino acids and lipids pathways. To conclude, this is a reliable approach to early AD mechanisms, and choline has been identified as a promising AD diagnosis metabolite. SIGNIFICANCE: The untargeted analysis carried out in human plasma samples from early Alzheimer's disease patients and healthy individuals, and the use of sophisticated statistical tools, identified some metabolic pathways and plasma biomarkers. Preliminarily, cholinergic system, energy metabolism, and aminoacids and lipids pathways may be involved in early Alzheimer's disease development.
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Affiliation(s)
| | - Marta Roca
- Analytical Unit Platform, Health Research Institute La Fe, Valencia, Spain
| | - David Hervás
- Biostatistical Unit, Health Research Institute La Fe, Valencia, Spain
| | - Ana Cuevas
- Neurology Unit, University and Polytechnic Hospital La Fe, Valencia, Spain
| | | | - Máximo Vento
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain
| | - Miguel Baquero
- Neurology Unit, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Ana García-Blanco
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain.
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García-Blanco A, Diago V, Hervás D, Ghosn F, Vento M, Cháfer-Pericás C. Anxiety and depressive symptoms, and stress biomarkers in pregnant women after in vitro fertilization: a prospective cohort study. Hum Reprod 2019; 33:1237-1246. [PMID: 29796614 DOI: 10.1093/humrep/dey109] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 04/30/2018] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Does in vitro fertilization (IVF) affect the course of anxiety and depressive symptoms as well as physiological stress from pregnancy to postpartum period? SUMMARY ANSWER IVF mothers have more anxiety symptoms and higher stress biomarker levels but fewer depression symptoms than natural conception mothers at the third trimester of pregnancy, but these differences are negligible during postpartum period. WHAT IS KNOWN ALREADY Cross-sectional studies have found an association between IVF and high stress levels during the prenatal period. There is, however, no follow-up study about the IVF effect on the mental health status from pregnancy to postpartum, adopting simultaneous measurement of self-reported symptoms and stress biomarkers. STUDY DESIGN, SIZE, DURATION This is a prospective cohort study. A total of 243 eligible women were recruited during the third trimester of pregnancy (60 women after successful IVF and 183 who conceived naturally). The recruitment was performed during a 12-month period, and the follow-up was carried out until 3 months after delivery. PARTICIPANTS/MATERIALS, SETTING, METHODS This study was performed in the Division of Obstetrics in a regional referral center. The State scale of the State-Trait Anxiety Inventory (STAI-S) and the Beck Depression Inventory-Sort Form (BDI/SF) were used as anxiety and depression indicators, respectively; salivary cortisol and α-amylase levels as stress biomarkers. Anxiety, depression and stress biomarkers were measured at the third trimester of pregnancy (T1), at 48 h after birth (T2) and at 3 months after birth (T3). Associations with IVF were assessed using ordinal mixed models for anxiety and depressive symptoms and linear quantile models for stress biomarkers. MAIN RESULTS AND THE ROLE OF CHANCE Relative to natural conception mothers, IVF mothers had higher STAI-S scores at T1 (P = 0.016, odds ratio (OR) = 2.46), and this difference remained steady from T1 to T2 (P = 0.37, OR = 0.70) and from T2 to T3 (P = 0.36, OR = 0.69). In the case of depressive symptoms, the IVF group obtained lower BDI/SF scores at T1 (P < 0.001, OR = 0.192). This difference was apparently reduced from T1 to T2 (P = 0.072, OR = 2.21) and remained constant from T2 to T3 (P = 0.107, OR = 2.09). It is important to note that whereas the mean BDI/SF score was not clinically significant for any group (it was lower than the cut-off 4), the mean STAI-S score of the IVF group at T1 was so (it was higher than the cut-off 19). As for stress biomarkers, IVF mothers had higher cortisol levels at T1 (P = 0.043, Δlog(cortisol) = 0.88) compared to natural conceptions. From T1 to T2 cortisol levels of both groups increased at the relatively same rate (P = 0.81, Δlog(cortisol) = -0.16). However, the progressions tended to be different from T2 to T3, with IVF mothers exhibiting a sharp decrease in cortisol levels (P = 0.059, Δlog(cortisol) = -0.94), while natural conceptions value remained steady. In the case of α-amylase, there were no statistically significant differences between both groups at T1 (P = 0.7, Δlog(α-amylase) = -0.095). On the contrary, while IVF mothers showed sustained α-amylase levels across the time, the progression was different in the natural conception group, who showed a decrease in α-amylase levels from T1 to T2 (P = 0.049, Δlog(α-amylase) = 0.596) and a non-significant increase from T2 to T3 (P = 0.53, Δlog(α-amylase) = -0.283). LIMITATIONS REASON FOR CAUTION Since this follow-up study has been carried out from the third trimester of pregnancy, the findings cannot be generalized to extremely preterm births. WIDER IMPLICATIONS OF THE FINDINGS IVF women may have lower depressive symptoms for being pregnant. However, due to the potential pregnancy complications associated with IVF, they may have higher physiological stress and clinically significant anxiety at the third trimester of pregnancy but not during postpartum. Taking into account that both prenatal high maternal cortisol levels and prenatal clinically significant anxiety increase the risk of disturbance in the fetal neurodevelopment, psychological therapy should be extended during pregnancy in IVF women. STUDY FUNDING/COMPETING INTEREST(S) MV funded by FIS PI17/0131 grant from the Instituto de Salud Carlos III (ISCIII) and RETICS funded by the PN 2018-2011, and the European Regional Development Fund, reference RD16/0022/0001; AG-B funded by a 'Juan Rodés' Grant (JR17/00003) from the ISCIII. CC-P funded by a 'Miguel Servet I' Grant (CP16/00082) from the ISCIII. Authors declare no competing interests.
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Affiliation(s)
- Ana García-Blanco
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain.,University of Valencia, Valencia, Spain
| | - Vicente Diago
- Division of Obstetrics and Gynecology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - David Hervás
- Biostatistics Unit, Health Research Institute La Fe, Valencia, Spain
| | | | - Máximo Vento
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain.,Division of Neonatology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
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Haya S, Solano C, Cid AR, Argilés B, Hervás D, Querol F, Bonanad S, Casaña P. Predictive factors of immune tolerance treatment response in severe haemophilia A patients with inhibitors: A real‐world report from a single centre, mixed retrospective‐prospective long‐term study. Haemophilia 2019; 25:e97-e100. [PMID: 30604912 PMCID: PMC7078961 DOI: 10.1111/hae.13660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Saturnino Haya
- Hemostasis and Thrombosis Unit, Hematology Service Hospital Universitari i Politècnic La Fe Valencia Spain
| | - Carlos Solano
- Hematology Service Hospital Clínico de Valencia Valencia Spain
- Department of Medicine Universidad de Valencia Valencia Spain
| | - Ana Rosa Cid
- Hemostasis and Thrombosis Unit, Hematology Service Hospital Universitari i Politècnic La Fe Valencia Spain
| | - Bienvenida Argilés
- Pediatric Hematology Unit Hospital Universitari i Politècnic La Fe Valencia Spain
| | - David Hervás
- Unit of Data Science, Biostatistics and Bioinformatics Instituto de Investigación Sanitaria La Fe Valencia Spain
| | - Felipe Querol
- Hemostasis and Thrombosis Unit, Hematology Service Hospital Universitari i Politècnic La Fe Valencia Spain
- Departament of Physiotherapy Universidad de Valencia Valencia Spain
| | - Santiago Bonanad
- Hemostasis and Thrombosis Unit, Hematology Service Hospital Universitari i Politècnic La Fe Valencia Spain
| | - Pilar Casaña
- Hemostasis and Thrombosis Unit, Hematology Service Hospital Universitari i Politècnic La Fe Valencia Spain
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Alonso CM, Llop M, Sargas C, Pedrola L, Panadero J, Hervás D, Cervera J, Such E, Ibáñez M, Ayala R, Martínez-López J, Onecha E, de Juan I, Palanca S, Martínez-Cuadrón D, Rodríguez-Veiga R, Boluda B, Montesinos P, Sanz G, Sanz MA, Barragán E. Clinical Utility of a Next-Generation Sequencing Panel for Acute Myeloid Leukemia Diagnostics. J Mol Diagn 2019; 21:228-240. [DOI: 10.1016/j.jmoldx.2018.09.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 09/06/2018] [Accepted: 09/20/2018] [Indexed: 10/27/2022] Open
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Nuñez-Ramiro A, Benavente-Fernández I, Valverde E, Cordeiro M, Blanco D, Boix H, Cabañas F, Chaffanel M, Fernández-Colomer B, Fernández-Lorenzo JR, Kuligowski J, Loureiro B, Moral-Pumarega MT, Pavón A, Sánchez-Illana A, Tofé I, Hervás D, García-Robles A, Parra-Llorca A, Cernada M, Martinez-Rodilla J, Lorente-Pozo S, Llorens R, Marqués R, Vento M. Topiramate plus Cooling for Hypoxic-Ischemic Encephalopathy: A Randomized, Controlled, Multicenter, Double-Blinded Trial. Neonatology 2019; 116:76-84. [PMID: 31091527 DOI: 10.1159/000499084] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 02/22/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Therapeutic interventions to improve the efficacy of whole-body cooling for hypoxic-ischemic encephalopathy (HIE) are desirable. Topiramate has been effective in reducing brain damage in experimental studies. However, in the clinical setting information is limited to a small number of feasibility trials. We launched a randomized controlled double-blinded topiramate/placebo multicenter trial with the primary objective being to reduce the antiepileptic activity in cooled neonates with HIE and assess if brain damage would be reduced as a consequence. STUDY DESIGN Neonates were randomly assigned to topiramate or placebo at the initiation of hypothermia. Topiramate was administered via a nasogastric tube. Brain electric activity was continuously monitored. Topiramate pharmacokinetics, energy-related and Krebs' cycle intermediates, and lipid peroxidation biomarkers were determined using liquid chromatography-mass spectrometry and MRI for assessing brain damage. RESULTS Out of 180 eligible patients 110 were randomized, 57 (51.8%) to topiramate and 53 (48.2%) to placebo. No differences in the perinatal or postnatal variables were found. The topiramate group exhibited less seizure burden in the first 24 h of hypothermia (topiramate, n = 14 [25.9%] vs. placebo, n = 22 [42%]); needed less additional medication, and had lower mortality (topiramate, n = 5 [9.2%] vs. placebo, n = 10 [19.2%]); however, these results did not achieve statistical significance. Topiramate achieved a therapeutic range in 37.5 and 75.5% of the patients at 24 and 48 h, respectively. A significant association between serum topiramate levels and seizure activity (p < 0.016) was established. No differences for oxidative stress, energy-related metabolites, or MRI were found. CONCLUSIONS Topiramate reduced seizures in patients achieving therapeutic levels in the first hours after treatment initiation; however, they represented only a part of the study population. Our results warrant further studies with higher loading and maintenance dosing of topiramate.
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Affiliation(s)
- Antonio Nuñez-Ramiro
- Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | | | - Eva Valverde
- Division of Neonatology, University Hospital La Paz, Madrid, Spain
| | - Malaika Cordeiro
- Division of Neonatology, University Hospital La Paz, Madrid, Spain
| | - Dorotea Blanco
- Division of Neonatology, University Hospital Gregorio Marañón, Madrid, Spain
| | - Hector Boix
- Department of Neonatology, University Hospital Vall d'Hebrón, Barcelona, Spain
| | - Fernando Cabañas
- Division of Neonatology, University Hospital Quirónsalud Madrid, Madrid, Spain
| | - Mercedes Chaffanel
- Division of Neonatology, Regional University Hospital Málaga, Málaga, Spain
| | | | | | | | - Begoña Loureiro
- Division of Neonatology, University Hospital Cruces, Bilbao, Spain
| | | | - Antonio Pavón
- Division of Neonatology, University Hospital Virgen del Rocío, Sevilla, Spain
| | | | - Inés Tofé
- Division of Neonatology, University Hospital Reina Sofía, Córdoba, Spain
| | - David Hervás
- Department of Biostatistics, Health Research Institute La Fe, Valencia, Spain
| | - Ana García-Robles
- Division of Neonatology, University Hospital Complex of Vigo, Vigo, Spain
| | - Anna Parra-Llorca
- Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Maria Cernada
- Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | | | | | - Roberto Llorens
- Department of Radiology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Remedios Marqués
- Departament of Pharmacy, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Máximo Vento
- Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain, .,Health Research Institute La Fe, Valencia, Spain,
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Ghosn F, Almansa B, Moreno-Giménez A, Sahuquillo-Leal R, Serrano-Lozano E, Hervás D, Diago V, Cháfer-Pericás C, Vento M, García Blanco A. Trajectories of stress biomarkers and anxious-depressive symptoms from pregnancy to postpartum period in women with a trauma history. Eur J Psychotraumatol 2019; 10:1601990. [PMID: 31069025 PMCID: PMC6493226 DOI: 10.1080/20008198.2019.1601990] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/11/2019] [Accepted: 03/15/2019] [Indexed: 01/14/2023] Open
Abstract
Background: Cross-sectional studies have found that a trauma history can be associated with anxious-depressive symptomatology and physiological stress dysregulation in pregnant women. Methods: This prospective study examines the trajectories of both anxiety and depressive symptoms and salivary cortisol and α-amylase biomarkers from women with (n = 42) and without (n = 59) a trauma history at (i) 38th week of gestation (T1), (ii) 48 hours after birth (T2), and (iii) three months after birth (T3). Results: The quantile regression model showed that trauma history was associated with higher cortisol levels at T1 and this difference was sustained along T2 and T3. Conversely, there were no significant differences in α-amylase levels between groups across the three time points and both groups showed an increase in α-amylase levels from T2 to T3. The ordinal mixed model showed that trauma history was associated with higher anxiety symptoms at T1 and this remained constant from T1 to T2 but was reversed from T2 to T3. In contrast, both groups showed similar depressive symptoms across the three time points. Conclusions: Whereas physiological stress dysregulation (in terms of higher cortisol levels) was maintained from pregnancy to postpartum period, pregnancy and childbirth were the most vulnerable stages for developing anxious symptoms in mothers with trauma history.
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Affiliation(s)
- Farah Ghosn
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain
| | - Belén Almansa
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain
| | - Alba Moreno-Giménez
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain
| | - Rosa Sahuquillo-Leal
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain
| | - Elena Serrano-Lozano
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain
| | - David Hervás
- Biostatistics Unit, Health Research Institute La Fe, Valencia, Spain
| | - Vicente Diago
- Division of Obstetrics and Gynaecology, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - Máximo Vento
- Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain
| | - Ana García Blanco
- Department of Personality, Evaluation and Psychological Treatment, University of Valencia, Valencia, Spain.,Neonatal Research Unit, Health Research Institute La Fe, Valencia, Spain
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Lorente-Pozo S, Parra-Llorca A, Núñez-Ramiro A, Cernada M, Hervás D, Boronat N, Sandoval J, Vento M. The Oxygen Load Supplied during Delivery Room Stabilization of Preterm Infants Modifies the DNA Methylation Profile. J Pediatr 2018; 202:70-76.e2. [PMID: 30172427 DOI: 10.1016/j.jpeds.2018.07.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 06/13/2018] [Accepted: 07/03/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To determine whether the amount of oxygen provided during postnatal stabilization changes the DNA methylome in preterm infants. STUDY DESIGN This prospective, observational study included 32 preterm infants ≤32 weeks of gestation who received oxygen in the delivery room. Patients were monitored using a respiratory function monitor to determine the amount of oxygen received upon stabilization. Blood samples were processed for comparison of DNA methylation before and after resuscitation using a DNA methylation high-resolution microarray Infinium Human DNA methylation EPIC 850K BeadChip. RESULTS The median amount oxygen provided to preterm infants during stabilization was 644 mLO2/kg. Male sex and vaginal delivery were associated with increased oxygen needs. There were 2626 differentially methylated CpGs representing 1567 genes that showed an association with oxygen load selected and, of these, 85% were hypomethylated. We found that oxygen loads of >500 mLO2/kg changed the methylation pattern of the selected CpGs. Genes associated with these CpGs were "enriched" in KEGG pathways involved in cell cycle progression, DNA repair, and oxidative stress. CONCLUSIONS The oxygen load provided upon resuscitation modified the DNA methylome. Differential methylation may lead to altered expression of genes related to cell cycle progression, oxidative stress, and DNA repair. The reversibility of these early epigenetic changes is unknown but merits further study.
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Affiliation(s)
| | - Anna Parra-Llorca
- Neonatal Research Group, Health Research Institute La Fe, Valencia, Spain; Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Antonio Núñez-Ramiro
- Neonatal Research Group, Health Research Institute La Fe, Valencia, Spain; Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - María Cernada
- Neonatal Research Group, Health Research Institute La Fe, Valencia, Spain; Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - David Hervás
- Department of Biostatistics, Health Research Institute La Fe, Valencia, Spain
| | - Nuria Boronat
- Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Juan Sandoval
- Biomarkers and Precision Medicine Unit, Health Research Institute La Fe, Valencia, Spain
| | - Maximo Vento
- Neonatal Research Group, Health Research Institute La Fe, Valencia, Spain; Division of Neonatology, University and Polytechnic Hospital La Fe, Valencia, Spain
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Ibáñez M, Carbonell-Caballero J, Such E, García-Alonso L, Liquori A, López-Pavía M, Llop M, Alonso C, Barragán E, Gómez-Seguí I, Neef A, Hervás D, Montesinos P, Sanz G, Sanz MA, Dopazo J, Cervera J. The modular network structure of the mutational landscape of Acute Myeloid Leukemia. PLoS One 2018; 13:e0202926. [PMID: 30303964 PMCID: PMC6179200 DOI: 10.1371/journal.pone.0202926] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 08/10/2018] [Indexed: 02/06/2023] Open
Abstract
Acute myeloid leukemia (AML) is associated with the sequential accumulation of acquired genetic alterations. Although at diagnosis cytogenetic alterations are frequent in AML, roughly 50% of patients present an apparently normal karyotype (NK), leading to a highly heterogeneous prognosis. Due to this significant heterogeneity, it has been suggested that different molecular mechanisms may trigger the disease with diverse prognostic implications. We performed whole-exome sequencing (WES) of tumor-normal matched samples of de novo AML-NK patients lacking mutations in NPM1, CEBPA or FLT3-ITD to identify new gene mutations with potential prognostic and therapeutic relevance to patients with AML. Novel candidate-genes, together with others previously described, were targeted resequenced in an independent cohort of 100 de novo AML patients classified in the cytogenetic intermediate-risk (IR) category. A mean of 4.89 mutations per sample were detected in 73 genes, 35 of which were mutated in more than one patient. After a network enrichment analysis, we defined a single in silico model and established a set of seed-genes that may trigger leukemogenesis in patients with normal karyotype. The high heterogeneity of gene mutations observed in AML patients suggested that a specific alteration could not be as essential as the interaction of deregulated pathways.
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Affiliation(s)
- Mariam Ibáñez
- Hematology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Centro de Investigacion Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, Madrid, Spain
- Departamento de Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad CEU Cardenal Herrera, Valencia, Spain
| | - José Carbonell-Caballero
- ProCURE, Catalan Institute of Oncology, Bellvitge Institute for Biomedical Research (IDIBELL), L’Hospitalet del Llobregat, Barcelona, Spain
| | - Esperanza Such
- Hematology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Centro de Investigacion Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, Madrid, Spain
| | - Luz García-Alonso
- European Molecular Biology Laboratory—European Bioinformatics Institute, Wellcome Genome Campus, Cambridge, United Kingdom
| | - Alessandro Liquori
- Hematology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Centro de Investigacion Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, Madrid, Spain
| | - María López-Pavía
- Hematology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Marta Llop
- Centro de Investigacion Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, Madrid, Spain
- Department of Medical Pathology, Hospital Universitario La Fe, Valencia, Spain
| | - Carmen Alonso
- Hematology Service, Hospital Arnau de Villanoba, Valencia, Spain
| | - Eva Barragán
- Centro de Investigacion Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, Madrid, Spain
- Department of Medical Pathology, Hospital Universitario La Fe, Valencia, Spain
| | - Inés Gómez-Seguí
- Hematology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Centro de Investigacion Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, Madrid, Spain
| | - Alexander Neef
- Hematology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | | | - Pau Montesinos
- Hematology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Centro de Investigacion Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, Madrid, Spain
| | - Guillermo Sanz
- Hematology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Centro de Investigacion Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, Madrid, Spain
| | - Miguel Angel Sanz
- Hematology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Centro de Investigacion Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, Madrid, Spain
| | - Joaquín Dopazo
- Functional Genomics Node, Spanish National Institute of Bioinformatics at CIPF, Valencia, Spain
- Bioinformatics of Rare Diseases (BIER), CIBER de Enfermedades Raras (CIBERER), Valencia, Spain
- Clinical Bioinformatics Area, Fundación Progreso y Salud (FPS), CDCA, Hospital Virgen del Rocio, Sevilla, Spain
- * E-mail: (JC); (JD)
| | - José Cervera
- Hematology Service, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Centro de Investigacion Biomédica en Red de Cáncer (CIBERONC), Instituto Carlos III, Madrid, Spain
- Genetics Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
- * E-mail: (JC); (JD)
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Huguet JM, Iborra M, Bosca-Watts MM, Maroto N, Gil R, Cortes X, Hervás D, Paredes JM. Inflammatory bowel disease in patients over the age of 70 y. Does the disease duration influence its behavior? Scand J Gastroenterol 2018; 53:1079-1084. [PMID: 30189153 DOI: 10.1080/00365521.2018.1501603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION The fastest growing segment of our population is that of people above 70 years of age. Elderly patients with IBD exhibit several specific problems. Our objective was to evaluate the clinical course, the side effects of the treatments and the need for surgery of elderly patients, regardless of the age of onset. MATERIALS AND METHODS This was a cross-sectional study wherein retrospective data were collected from multiple centers from seven hospitals within the Valencia metropolitan area. Data were collected on patients older than 70 y with inflammatory bowel disease. RESULTS We identified a total of 331 patients older than 70 years of age (5.3% of patients monitored at our centers). The mean age at the time of the study was 77.34 y (±5.39). Mesalamine were the most frequently used medications. Corticosteroids were used in 66% of the patients. However, the use of corticosteroids and biologics was less probable in older patients (OR 0.96, p = .06). The longer the disease progressed, the more immunosuppressive medications were used (OR 1.3, p = .052). Neoplasms appeared in 41 patients (13%). Of the 36 patients with tumors that appeared after the onset of the disease, 20 patients had not been treated with immunomodulators or biologics. CONCLUSIONS Mesalamine was the most frequently used medication. There is no increased risk of tumors regarding the medications used. The use of immunosuppressive medications is more prevalent with longer disease progression times, although with a high rate of adverse events.
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Affiliation(s)
- Jose M Huguet
- a Digestive Disease Department , General University Hospital of Valencia , Valencia , Spain
| | - Marisa Iborra
- b Gastroenterology Department and CIBEREHD , Hospital Universitari i Politecnic La Fe , Valencia , Spain
| | - Marta Maia Bosca-Watts
- c Inflammatory Bowel Disease Unit, Digestive Disease Department , University of Valencia, University Clinic Hospital of Valencia , Valencia , Spain
| | - Nuria Maroto
- d Inflammatory Bowel Disease Unit, Digestive Disease Department , Hospital of Manises , Manises , Spain
| | - Rafael Gil
- e Digestive Disease Department , Arnau of Vilanova of Valencia Hospital , Spain Valencia
| | - Xavier Cortes
- f Digestive Disease Department , Hospital of Sagunto , Valencia , Spain
| | - David Hervás
- g Statistics Unit, Hospital Universitari i Politècnic la Fe , Valencia , Spain
| | - Jose M Paredes
- h Digestive Disease Department , Peset University Hospital of Valencia , Valencia , Spain
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Solé A, Olveira C, Pérez I, Hervás D, Valentine V, Baca Yepez AN, Olveira G, Quittner AL. Development and electronic validation of the revised Cystic Fibrosis Questionnaire (CFQ-R Teen/Adult). J Cyst Fibros 2018; 17:672-679. [DOI: 10.1016/j.jcf.2017.10.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 10/28/2017] [Accepted: 10/28/2017] [Indexed: 10/18/2022]
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