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Rivera-Paredez B, Hidalgo-Bravo A, León-Reyes G, Barajas-Olmos F, Martínez-Hernández A, Orozco L, Denova-Gutiérrez E, Salmerón J, Velázquez-Cruz R. The role of single nucleotide variant rs3819817 of the Histidine Ammonia-Lyase gene and 25-Hydroxyvitamin D on bone mineral density, adiposity markers, and skin pigmentation, in Mexican population. J Endocrinol Invest 2023:10.1007/s40618-023-02051-1. [PMID: 36862244 DOI: 10.1007/s40618-023-02051-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 02/24/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE Vitamin D (VD) deficiency and osteoporosis have become a global public health problem. A variant in the Histidine Ammonia-Lyase (HAL) gene has been associated with VD levels and bone mineral density (BMD). However, whether this variant has an influence on VD levels and BMD in Mexican adults remain unclear. METHODS This cross-sectional analysis included 1,905 adults participating in the Health Worker Cohort Study and 164 indigenous postmenopausal women from the Metabolic Analysis in an Indigenous Sample (MAIS) cohort. The rs3819817 variant was genotyped by TaqMan probe assay. Total 25 hydroxyvitamin D levels were measured by DiaSorin Liaison. BMD at the different sites was assessed through dual-energy X-ray absorptiometry. Linear and logistic regression models were performed to evaluate the associations of interest. RESULTS The prevalence of VD deficiency was 41%, showing differences between sexes. Obesity and skin pigmentation were associated with lower levels of VD in males and females. rs3819817-T allele was associated with low levels of 25-hydroxyvitamin D, VD deficiency, and hip and femoral neck BMD values (g/cm2). We found two interactions with VD levels, one between adiposity and rs3819817-T allele (P = 0.017) and another between skin pigmentation and rs3819817-T allele (P = 0.019). In indigenous postmenopausal women, we observed higher VD levels in the southern region compared to the northern region (P < 0.001); however, we did not observe differences by genotype. CONCLUSION Our findings confirm that the genetic variant rs3819817 has an essential function in VD levels and BMD and suggests a role in skin pigmentation in the Mexican population.
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Affiliation(s)
- B Rivera-Paredez
- Centro de Investigación en Políticas, Población y Salud de la Facultad de Medicina de la Universidad Nacional Autónoma de México (UNAM), Mexico City, México
| | - A Hidalgo-Bravo
- Departamento de Genética, Instituto Nacional de Rehabilitación, Mexico City, México
| | - G León-Reyes
- Laboratorio de Genómica del Metabolismo Óseo, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, México
| | - F Barajas-Olmos
- Laboratorio de Inmunogenómica y Enfermedades Metabólicas, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, México
| | - A Martínez-Hernández
- Laboratorio de Inmunogenómica y Enfermedades Metabólicas, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, México
| | - L Orozco
- Laboratorio de Inmunogenómica y Enfermedades Metabólicas, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, México
| | - E Denova-Gutiérrez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Morelos, México
| | - J Salmerón
- Centro de Investigación en Políticas, Población y Salud de la Facultad de Medicina de la Universidad Nacional Autónoma de México (UNAM), Mexico City, México
| | - R Velázquez-Cruz
- Laboratorio de Genómica del Metabolismo Óseo, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, México.
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Rivera-Paredez B, León-Reyes G, Rangel-Marín D, Salmerón J, Velázquez-Cruz R. Associations between Macronutrients Intake and Bone Mineral Density: A Longitudinal Analysis of the Health Workers Cohort Study Participants. J Nutr Health Aging 2023; 27:1196-1205. [PMID: 38151870 DOI: 10.1007/s12603-023-2038-2] [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: 08/21/2023] [Accepted: 10/22/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVE This study aimed to evaluate the association between macronutrient intake and bone mineral density (BMD) using non-substitution and substitution statistical approaches. DESIGN Longitudinal analysis. SETTINGS AND PARTICIPANTS 1,317 adults in the Health Worker Cohort Study in Mexico. MEASUREMENTS These participants were assessed at baseline (2004-2006) and follow-up (2010-2012). Dietary intakes were assessed using validated food frequency questionnaires. BMD at the different sites was performed by dual-energy X-ray absorptiometry (DXA). Hybrid-mixed effects regression models were performed to evaluate the associations of interest. RESULTS Cross-sectional associations were found between fiber intake and higher total hip and femoral neck BMD in women and longitudinal associations with loss of femoral neck BMD in men. An increase in 5% energy intake from carbohydrate was associated with a BMD loss at several site in women and total hip and femoral neck in men. In both sexes, an increase in 5% energy intake of animal protein or fat was associated with a site-specific BMD gain after six years. Substitution analysis showed that the energy intake replacement from fat or carbohydrate by protein had an increase in BMD at different sites in women; while in men, it was only significant when replacing carbohydrate. Substitution of protein or fat by carbohydrates was associated with lower BMD in women, and only protein replacement by carbohydrates in men. CONCLUSION Our findings suggest that carbohydrate intake was associated with loss of BMD, while animal protein and fat intake was associated with gain of BMD among the Mexican population. Macronutrient substitutions resulted in significant associations; however, additional studies are needed to confirm these findings.
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Affiliation(s)
- B Rivera-Paredez
- Berenice Rivera-Paredez, Research Center in Policies, Population and Health, School of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico; ; Phone: + 55 5622 6666 Ext. 82355; Rafael Velázquez-Cruz. Genomics of Bone Metabolism Laboratory, National Institute of Genomic Medicine (INMEGEN), Mexico City, Mexico; e-mail: ; Phone: +52 (55) 5350-1900, Fax: +52 (55) 5350-1999
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Howe AY, Rodrigo C, Cunningham E, Douglas MW, Dietz J, Grebely J, Popping S, Sfalcin JA, Parczewski M, Sarrazin C, de Salazar A, Fuentes A, Sayan M, Quer J, Kjellin M, Kileng H, Mor O, Lennerstrand J, Fourati S, di Maio VC, Chulanov V, Pawlotsky JM, Harrigan PR, Ceccherini-Silberstein F, Garcia F, Martinello M, Matthews G, Fernando FF, Esteban JI, Müllhaupt B, Wiesch JSZ, Buggisch P, Neumann-Haefelin C, Berg T, Berg CP, Schattenberg JM, Moreno C, Stauber R, Lloyd A, Dore G, Applegate T, Ignacio J, Garcia-Cehic D, Gregori J, Rodriguez-Frias F, Rando A, Angelico M, Andreoni M, Babudieri S, Bertoli A, Cento V, Coppola N, Craxì A, Paolucci S, Parruti G, Pasquazzi C, Perno CF, Teti E, Vironet C, Lannergård A, Duberg AS, Aleman S, Gutteberg T, Soulier A, Gourgeon A, Chevaliez S, Pol S, Carrat F, Salmon D, Kaiser R, Knopes E, Gomes P, de Kneght R, Rijnders B, Poljak M, Lunar M, Usubillaga R, Seguin C, Tay E, Wilson C, Wang DS, George J, Kok J, Pérez AB, Chueca N, García-Deltoro M, Martínez-Sapiña AM, Lara-Pérez MM, García-Bujalance S, Aldámiz-Echevarría T, Vera-Méndez FJ, Pineda JA, Casado M, Pascasio JM, Salmerón J, Alados-Arboledas JC, Poyato A, Téllez F, Rivero-Juárez A, Merino D, Vivancos-Gallego MJ, Rosales-Zábal JM, Ocete MD, Simón MÁ, Rincón P, Reus S, De la Iglesia A, García-Arata I, Jiménez M, Jiménez F, Hernández-Quero J, Galera C, Balghata MO, Primo J, Masiá M, Espinosa N, Delgado M, von-Wichmann MÁ, Collado A, Santos J, Mínguez C, Díaz-Flores F, Fernández E, Bernal E, De Juan J, Antón JJ, Vélez M, Aguilera A, Navarro D, Arenas JI, Fernández C, Espinosa MD, Ríos MJ, Alonso R, Hidalgo C, Hernández R, Téllez MJ, Rodríguez FJ, Antequera P, Delgado C, Martín P, Crespo J, Becerril B, Pérez O, García-Herola A, Montero J, Freyre C, Grau C, Cabezas J, Jimenez M, Rodriguez MAM, Quilez C, Pardo MR, Muñoz-Medina L, Figueruela B. Characteristics of hepatitis C virus resistance in an international cohort after a decade of direct-acting antivirals. JHEP Rep 2022; 4:100462. [PMID: 35434589 PMCID: PMC9010635 DOI: 10.1016/j.jhepr.2022.100462] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 02/05/2022] [Indexed: 10/24/2022] Open
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Ampuero J, Aller R, Gallego-Durán R, Crespo J, Abad J, González-Rodríguez Á, Gómez-Camarero J, Caballería J, Lo Iacono O, Ibañez L, García-Samaniego J, Martín-Mateos R, Francés R, Fernández-Rodríguez C, Diago M, Soriano G, Andrade RJ, Latorre R, Jorquera F, Morillas RM, Escudero D, Estévez P, Hernández-Guerra M, Augustín S, Pareja-Megia MJ, Banales JM, Aspichueta P, Benlloch S, Rosales JM, Salmerón J, Turnes J, Romero-Gómez M. Definite and indeterminate nonalcoholic steatohepatitis share similar clinical features and prognosis: A longitudinal study of 1893 biopsy-proven nonalcoholic fatty liver disease subjects. Liver Int 2021; 41:2076-2086. [PMID: 33896100 DOI: 10.1111/liv.14898] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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] [Received: 01/20/2021] [Revised: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM Histological score systems may not fully capture the essential nonalcoholic steatohepatitis (NASH) features, which is one of the leading causes of screening failure in clinical trials. We assessed the NASH distribution and its components across the fibrosis stages and their impact on the prognosis and their relationship with the concept of metabolic-associated fatty liver disease (MAFLD). METHODS Spanish multicenter study including 1893 biopsy-proven nonalcoholic fatty liver disease (NAFLD) patients from HEPAmet registry. NASH was diagnosed by NAS score ≥4 (including steatosis, ballooning and lobular inflammation) and fibrosis by Kleiner score. The presence of MAFLD was determined. Progression to cirrhosis, first episode of decompensated cirrhosis and death were collected during the follow-up (4.7 ± 3.8 years). RESULTS Fibrosis was F0 34.3% (649/1893), F1 27% (511/1893), F2 16.5% (312/1893), F3 15% (284/1893) and F4 7.2% (137/1893). NASH diagnosis 51.9% (982/1893), and its individual components (severe steatosis, ballooning and lobular inflammation), increased from F0 (33.6%) to F2 (68.6%), and decreased significantly in F4 patients (51.8%) (P = .0001). More than 70% of non-NASH patients showed some inflammatory activity (ballooning or lobular inflammation), showing a similar MAFLD rate than NASH (96.2% [945/982] vs. 95.2% [535/562]) and significantly higher than nonalcoholic fatty liver (NAFL) subjects (89.1% [311/349]) (P < .0001). Progression to cirrhosis was similar between NASH (9.5% [51/539]) and indeterminate NASH (7.9% [25/316]), and higher than steatosis (5% [14/263]) (logRank 8.417; P = .015). Death and decompensated cirrhosis were similar between these. CONCLUSIONS The prevalence of steatohepatitis decreased in advanced liver disease. However, most of these patients showed some inflammatory activity histologically and had metabolic disturbances. These findings should be considered in clinical trials whose main aim is to prevent cirrhosis progression and complications, liver transplant and death.
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Affiliation(s)
- Javier Ampuero
- Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Seville, Spain.,SeLiver Group, Instituto de Biomedicina de Sevilla, Seville, Spain.,CIBERehd, Madrid, Spain
| | - Rocío Aller
- Centro de Investigación de Endocrinología y Nutrición, Hospital Clínico Universitario de Valladolid, Universidad de Valladolid, Valladolid, Spain
| | - Rocío Gallego-Durán
- SeLiver Group, Instituto de Biomedicina de Sevilla, Seville, Spain.,CIBERehd, Madrid, Spain
| | - Javier Crespo
- Digestive Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Javier Abad
- Digestive Department, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - Águeda González-Rodríguez
- Liver Research Unit, Hospital Universitario Santa Cristina Instituto de Investigación Sanitaria Princesa, Madrid, Spain
| | | | - Joan Caballería
- CIBERehd, Madrid, Spain.,Liver Unit, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBPAS), Barcelona, Spain
| | - Oreste Lo Iacono
- Digestive Department, Hospital Universitario Tajo, Aranjuez, Spain
| | - Luis Ibañez
- CIBERehd, Madrid, Spain.,Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | | | - Rosa Martín-Mateos
- CIBERehd, Madrid, Spain.,Digestive Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Rubén Francés
- CIBERehd, Madrid, Spain.,Hospital General Universitario de Alicante, Universidad Miguel Hernández, Elche, Spain
| | | | - Moisés Diago
- Digestive Department, Hospital General Universitario de Valencia, Valencia, Spain
| | - Germán Soriano
- CIBERehd, Madrid, Spain.,Digestive Department, Hospital de la Santa Creu i San Pau, Barcelona, Spain
| | - Raúl J Andrade
- CIBERehd, Madrid, Spain.,Unidad de Gestión Clínica de Enfermedades Digestivas, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain
| | - Raquel Latorre
- Digestive Department, Hospital Universitari Son Llátzer, Mallorca, Spain
| | - Francisco Jorquera
- CIBERehd, Madrid, Spain.,Servicio de Aparato Digestivo, Complejo Asistencial Universitario de León, IBIOMED, León, Spain
| | - Rosa M Morillas
- CIBERehd, Madrid, Spain.,Digestive Department, Hospital Germans Trias i Pujol, Badalona, Spain
| | - Desam Escudero
- Hospital Clínico Universitario de Valencia, Universitat de València, Valencia, Spain
| | - Pamela Estévez
- Digestive Department, Complejo Hospitalario Universitario de Vigo, Vigo, Spain
| | | | | | | | - Jesús M Banales
- CIBERehd, Madrid, Spain.,Department of Liver and Gastrointestinal Diseases, Biodonostia Research Institute-Donostia University Hospital, University of the Basque Country (UPV/EHU), Ikerbasque, San Sebastian, Spain
| | - Patricia Aspichueta
- CIBERehd, Madrid, Spain.,Department of Physiology, Faculty of Medicine and Nursing, Biocruces Research Institute, University of Basque Country UPV/EHU, Leioa, Spain
| | - Salvador Benlloch
- CIBERehd, Madrid, Spain.,Digestive Department, Hospital Universitari i Politecnic La Fe, Valencia, Spain
| | | | - Javier Salmerón
- Digestive Department, Hospital Universitario San Cecilio, Granada, Spain
| | - Juan Turnes
- Digestive Department, Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | - Manuel Romero-Gómez
- Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Seville, Spain.,SeLiver Group, Instituto de Biomedicina de Sevilla, Seville, Spain.,CIBERehd, Madrid, Spain
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Argoty-Pantoja AD, Robles-Rivera K, Rivera-Paredez B, Salmerón J. COVID-19 fatality in Mexico's indigenous populations. Public Health 2021; 193:69-75. [PMID: 33743216 PMCID: PMC7877204 DOI: 10.1016/j.puhe.2021.01.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 12/17/2020] [Accepted: 01/29/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The aim of the study was to explore the factors that could explain the differences in fatality rates among indigenous groups with COVID-19 diagnosis compared with the rest of the population in Mexico. STUDY DESIGN We analyzed the public data of COVID-19 surveillance, of the Mexican Ministry of Health, to estimate COVID-19 fatality rates by ethnicity. METHODS We explored associated factors using Cox proportional hazards models stratified by outpatient and hospital management at diagnosis; analysis was conducted in three scenarios: national level, states with 89% of the indigenous population, and South Pacific region. RESULTS A total of 412,017 COVID-19 cases were included, with 1.1% of the indigenous population. The crude fatality rate per 1000 person-weeks was 64.8% higher among indigenous than among non-indigenous people (29.97 vs. 18.18, respectively), and it increased more than twice within outpatients (5.99 vs. 2.64, respectively). Cox analysis revealed that indigenous people who received outpatient management had higher fatality rate than non-indigenous outpatients, at the national level (hazard ratio [HR] = 1.63; 95% confidence interval [CI] = 1.34-1.98), within the subgroup of 13 states (HR = 1.66; 95% CI = 1.33-2.07), and in the South Pacific region (HR = 2.35; 95% CI = 1.49-3.69). Factors associated with higher fatality rates among non-indigenous and indigenous outpatients were age, sex, and comorbidities. CONCLUSIONS COVID-19 fatality is higher among indigenous populations, particularly within cases managed as outpatients.
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Affiliation(s)
- A D Argoty-Pantoja
- Research Center in Policy, Population and Health, School of Medicine. National Autonomous University of Mexico, Mexico City, Mexico
| | - K Robles-Rivera
- Research Center in Policy, Population and Health, School of Medicine. National Autonomous University of Mexico, Mexico City, Mexico
| | - B Rivera-Paredez
- Research Center in Policy, Population and Health, School of Medicine. National Autonomous University of Mexico, Mexico City, Mexico.
| | - J Salmerón
- Research Center in Policy, Population and Health, School of Medicine. National Autonomous University of Mexico, Mexico City, Mexico
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Ampuero J, Aller R, Gallego-Durán R, Crespo J, Calleja JL, García-Monzón C, Gómez-Camarero J, Caballería J, Lo Iacono O, Ibañez L, García-Samaniego J, Albillos A, Francés R, Fernández-Rodríguez C, Diago M, Soriano G, Andrade RJ, Latorre R, Jorquera F, Morillas RM, Escudero D, Estévez P, Hernandez-Guerra M, Augustín S, Bañales J, Aspichueta P, Benlloch S, Rosales JM, Salmerón J, Turnes J, Romero-Gómez M. Erratum to: "Significant fibrosis predicts new-onset diabetes mellitus and arterial hypertension in patients with NASH (J Hepatol 2020; 73: 17-25). J Hepatol 2020; 73:740-741. [PMID: 32654856 DOI: 10.1016/j.jhep.2020.06.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Affiliation(s)
- Javier Ampuero
- Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain; SeLiver group, Instituto de Biomedicina de Sevilla, Spain; CIBERehd, Spain.
| | - Rocío Aller
- Hospital Clínico Universitario de Valladolid. Centro de Investigación de Endocrinología y Nutrición. Universidad de Valladolid, Spain
| | | | - Javier Crespo
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - Carmelo García-Monzón
- Liver Research Unit, Hospital Universitario Santa Cristina Instituto de Investigación Sanitaria Princesa Madrid, Spain
| | | | - Joan Caballería
- CIBERehd, Spain; Liver Unit. Hospital Clínic. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBPAS). Barcelona, Spain
| | | | - Luis Ibañez
- CIBERehd, Spain; Hospital Gregorio Marañón, Madrid, Spain
| | | | - Agustín Albillos
- CIBERehd, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Rubén Francés
- CIBERehd, Spain; Hospital General Universitario de Alicante, Universidad Miguel Hernández, Spain
| | | | - Moisés Diago
- Hospital General Universitario de Valencia, Spain
| | | | - Raúl J Andrade
- CIBERehd, Spain; Unidad de Gestión Clínica de Enfermedades Digestivas, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain
| | | | - Francisco Jorquera
- Servicio de Aparato Digestivo, Complejo Asistencial Universitario de León, IBIOMED y CIBERehd, León, España
| | | | | | | | | | | | - Jesús Bañales
- CIBERehd, Spain; Department of Liver and Gastrointestinal Diseases, Biodonostia Research Institute - Donostia University Hospital, University of the Basque Country (UPV/EHU), Ikerbasque, San Sebastian, Spain
| | - Patricia Aspichueta
- Biocruces Research Institute, Barakaldo. Department of Physiology, Faculty of Medicine and Nursing, University of Basque Country UPV/EHU, Leioa, Spain
| | | | | | | | | | - Manuel Romero-Gómez
- Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain; SeLiver group, Instituto de Biomedicina de Sevilla, Spain; CIBERehd, Spain.
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Ampuero J, Aller R, Gallego-Durán R, Crespo J, Calleja JL, García-Monzón C, Gómez-Camarero J, Caballería J, Lo Iacono O, Ibañez L, García-Samaniego J, Albillos A, Francés R, Fernández-Rodríguez C, Diago M, Soriano G, Andrade RJ, Latorre R, Jorquera F, Morillas RM, Escudero D, Estévez P, Guerra MH, Augustín S, Banales JM, Aspichueta P, Benlloch S, Rosales JM, Salmerón J, Turnes J, Romero Gómez M. Significant fibrosis predicts new-onset diabetes mellitus and arterial hypertension in patients with NASH. J Hepatol 2020; 73:17-25. [PMID: 32147361 DOI: 10.1016/j.jhep.2020.02.028] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [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] [Received: 09/12/2019] [Revised: 02/18/2020] [Accepted: 02/20/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Non-alcoholic fatty liver disease (NAFLD) could play a catalytic role in the development of metabolic comorbidities, although the magnitude of this effect in metabolically healthy patients with NAFLD remains unclear. We assessed the role of biopsy-proven NAFLD on the risk of developing type 2 diabetes mellitus (T2DM) and other metabolic comorbidities (arterial hypertension [AHT], and dyslipidemia) in metabolically healthy patients. METHODS We included 178 metabolically healthy-defined by the absence of baseline T2DM, AHT, dyslipidemia-patients with biopsy-proven NAFLD from the HEPAmet Registry (N = 1,030). Hepamet fibrosis score (HFS), NAFLD fibrosis score, and Fibrosis-4 were calculated. Follow-up was computed from biopsy to the diagnosis of T2DM, AHT, or dyslipidemia. RESULTS During a follow-up of 5.6 ± 4.4 years, T2DM occurred in 9% (16/178), AHT in 8.4% (15/178), low HDL in 9.6% (17/178), and hypertriglyceridemia in 23.6% (42/178) of patients. In multivariate analysis, significant fibrosis predicted T2DM and AHT. Independent variables related to T2DM appearance were significant fibrosis (HR 2.95; 95% CI 1.19-7.31; p = 0.019), glucose levels (p = 0.008), age (p = 0.007) and BMI (p = 0.039). AHT was independently linked to significant fibrosis (HR 2.39; 95% CI 1.14-5.10; p = 0.028), age (p = 0.0001), BMI (p = 0.006), glucose (p = 0.021) and platelets (p = 0.050). The annual incidence rate of T2DM was higher in patients with significant fibrosis (4.4 vs. 1.2 cases per 100 person-years), and increased in the presence of obesity, similar to AHT (4.6 vs. 1.1 cases per 100 person-years). HFS >0.12 predicted the risk of T2DM (25% [4/16] vs. HFS <0.12 4.5% [4/88]; logRank 6.658, p = 0.010). CONCLUSION Metabolically healthy patients with NAFLD-related significant fibrosis were at greater risk of developing T2DM and AHT. HFS >0.12, but not NAFLD fibrosis score or Fibrosis-4, predicted the occurrence of T2DM. LAY SUMMARY Patients with biopsy-proven non-alcoholic fatty liver disease and significant fibrosis were at risk of developing type 2 diabetes mellitus and arterial hypertension. The risk of metabolic outcomes in patients with significant fibrosis was increased in the presence of obesity. In addition to liver biopsy, patients at intermediate-to-high risk of significant fibrosis by Hepamet fibrosis score were at risk of type 2 diabetes mellitus.
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Affiliation(s)
- Javier Ampuero
- Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain; SeLiver group, Instituto de Biomedicina de Sevilla, Spain; CIBERehd, Spain.
| | - Rocío Aller
- Hospital Clínico Universitario de Valladolid, Centro de Investigación de Endocrinología y Nutrición, Universidad de Valladolid, Spain
| | | | - Javier Crespo
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - Carmelo García-Monzón
- Liver Research Unit, Hospital Universitario Santa Cristina Instituto de Investigación Sanitaria Princesa Madrid, Spain
| | | | - Joan Caballería
- CIBERehd, Spain; Liver Unit. Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBPAS), Barcelona, Spain
| | | | - Luis Ibañez
- CIBERehd, Spain; Hospital Gregorio Marañón, Madrid, Spain
| | | | - Agustín Albillos
- CIBERehd, Spain; Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Rubén Francés
- CIBERehd, Spain; Hospital General Universitario de Alicante, Universidad Miguel Hernández, Spain
| | | | - Moisés Diago
- Hospital General Universitario de Valencia, Spain
| | | | - Raúl J Andrade
- CIBERehd, Spain; Unidad de Gestión Clínica de Enfermedades Digestivas, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain
| | | | - Francisco Jorquera
- Servicio de Aparato Digestivo, Complejo Asistencial Universitario de León, IBIOMED y CIBERehd, León, España
| | | | | | | | | | | | - Jesús M Banales
- CIBERehd, Spain; Department of Liver and Gastrointestinal Diseases, Biodonostia Research Institute - Donostia University Hospital, University of the Basque Country (UPV/EHU), Ikerbasque, San Sebastian, Spain
| | - Patricia Aspichueta
- Biocruces Research Institute, Barakaldo, Department of Physiology, Faculty of Medicine and Nursing, University of Basque Country UPV/EHU, Leioa, Spain
| | | | | | | | | | - Manuel Romero Gómez
- Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain; SeLiver group, Instituto de Biomedicina de Sevilla, Spain; CIBERehd, Spain.
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8
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Rivera-Paredez B, Hidalgo-Bravo A, de la Cruz-Montoya A, Martínez-Aguilar MM, Ramírez-Salazar EG, Flores M, Quezada-Sánchez AD, Ramírez-Palacios P, Cid M, Martínez-Hernández A, Orozco L, Denova-Gutiérrez E, Salmerón J, Velázquez-Cruz R. Association between vitamin D deficiency and common variants of Vitamin D binding protein gene among Mexican Mestizo and indigenous postmenopausal women. J Endocrinol Invest 2020; 43:935-946. [PMID: 31907821 DOI: 10.1007/s40618-019-01177-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 09/06/2019] [Accepted: 12/30/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE Vitamin D deficiency (VDD) and polymorphisms in the group-specific component (GC) gene are known to be associated in different populations. However, the effects of such genetic variants may vary across different populations. Thus, the objective of this study was to estimate the association between Vitamin D-Binding Protein (VDBP) haplotypes and VDD in mestizo postmenopausal women and Mexican Amerindian ethnic groups. METHODS This was a cross-sectional study of 726 postmenopausal Mexican women from the Health Workers Cohort Study (HWCS) and 166 postmenopausal women from the Metabolic Analysis in an Indigenous Sample (MAIS) cohort in Mexico. GC polymorphisms (rs7045 and rs4588) were analyzed by TaqMan probes. Serum 25-hydroxyvitamin D [25(OH)D] levels were measured by Chemiluminescent Microparticle Immuno Assay. RESULTS The prevalence of VDD serum 25(OH)D < 20 ng/mL was 43.7% in mestizo women and 44.6% in indigenous women. In HWCS, the single nucleotide polymorphisms (SNPs) rs7041 and rs4588 were associated with VDD. In addition, women from the HWCS, carrying the haplotypes GC2/2 and GC1f/2 had higher odds of VDD (OR = 2.83, 95% CI 1.14, 7.02; and OR = 2.30, 95% CI 1.40, 3.78, respectively) compared to women with haplotype 1f/1 s. These associations were not statistically significant in the MAIS cohort. CONCLUSIONS Our results show genetic association of the analyzed SNPs and related haplotypes, on the GC gene, with VDD in mestizo Mexican postmenopausal women. Moreover, a high prevalence of VDD with high genetic variability within the country was observed. Our results support the need for national policies for preventing VDD.
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Affiliation(s)
- B Rivera-Paredez
- Centro de Investigación en Políticas, Población Y Salud de La Facultad de Medicina de La Universidad Nacional Autónoma de México, Ciudad de México, México
| | - A Hidalgo-Bravo
- Departamento de Genética, Instituto Nacional de Rehabilitación, Ciudad de México, México
| | - A de la Cruz-Montoya
- Laboratorio de Genómica del Metabolismo Óseo, Instituto Nacional de Medicina Genómica (INMEGEN), Ciudad de México, México
| | - M M Martínez-Aguilar
- Laboratorio de Genómica del Metabolismo Óseo, Instituto Nacional de Medicina Genómica (INMEGEN), Ciudad de México, México
| | - E G Ramírez-Salazar
- CONACYT-Laboratorio de Genómica del Metabolismo Óseo, (INMEGEN), Ciudad de México, México
| | - M Flores
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - A D Quezada-Sánchez
- Centro de Información Para Decisiones en Salud Pública, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - P Ramírez-Palacios
- Unidad de Investigación Epidemiológica Y en Servicios de Salud, Instituto Mexicano del Seguro Social (IMSS), Delegación Morelos, Cuernavaca, México
| | - M Cid
- Laboratorio de Inmunogenómica Y Enfermedades Metabólicas Instituto Nacional de Medicina Genómica (INMEGEN), Ciudad de México, México
| | - A Martínez-Hernández
- Laboratorio de Inmunogenómica Y Enfermedades Metabólicas Instituto Nacional de Medicina Genómica (INMEGEN), Ciudad de México, México
| | - L Orozco
- Laboratorio de Inmunogenómica Y Enfermedades Metabólicas Instituto Nacional de Medicina Genómica (INMEGEN), Ciudad de México, México
| | - E Denova-Gutiérrez
- Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
| | - J Salmerón
- Centro de Investigación en Políticas, Población Y Salud de La Facultad de Medicina de La Universidad Nacional Autónoma de México, Ciudad de México, México
| | - R Velázquez-Cruz
- Laboratorio de Genómica del Metabolismo Óseo, Instituto Nacional de Medicina Genómica (INMEGEN), Ciudad de México, México.
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9
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Ruiz-Extremera Á, Díaz-Alcázar MDM, Muñoz-Gámez JA, Cabrera-Lafuente M, Martín E, Arias-Llorente RP, Carretero P, Gallo-Vallejo JL, Romero-Narbona F, Salmerón-Ruiz MA, Alonso-Diaz C, Maese-Heredia R, Cerrillos L, Fernández-Alonso AM, Camarena C, Aguayo J, Sánchez-Forte M, Rodríguez-Maresca M, Pérez-Rivilla A, Quiles-Pérez R, Muñoz de Rueda P, Expósito-Ruiz M, García F, García F, Salmerón J. Seroprevalence and epidemiology of hepatitis B and C viruses in pregnant women in Spain. Risk factors for vertical transmission. PLoS One 2020; 15:e0233528. [PMID: 32437468 PMCID: PMC7241747 DOI: 10.1371/journal.pone.0233528] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 01/13/2020] [Accepted: 05/06/2020] [Indexed: 12/13/2022] Open
Abstract
Background & aim Worldwide, measures are being implemented to eradicate hepatitis B (HBV) and C (HCV) viruses, which can be transmitted from the mother during childbirth. This study aims to determine the prevalence of HBV and HCV in pregnant women in Spain, focusing on country of origin, epidemiological factors and risk of vertical transmission (VT). Methodology Multicentre open-cohort study performed during 2015. HBV prevalence was determined in 21870 pregnant women and HCV prevalence in 7659 pregnant women. Epidemiological and risk factors for VT were analysed in positive women and differences between HBV and HCV cases were studied. Results HBV prevalence was 0.42% (91/21870) and HCV prevalence was 0.26% (20/7659). Of the women with HBV, 65.7% (44/67) were migrants. The HBV transmission route to the mother was unknown in 40.3% of cases (27/67) and VT in 31.3% (21/67). Among risk factors for VT, 67.7% (42/62) of the women had viraemia and 14.5% (9/62) tested HBeAg-positive. All of the neonates born to HBV-positive mothers received immunoprophylaxis, and none contracted infection by VT. In 80% (16/20) of the women with HCV, the transmission route was parenteral, and nine were intravenous drug users. Viraemia was present in 40% (8/20) of the women and 10% (2/20) were HIV-coinfected. No children were infected. Women with HCV were less likely than women with HBV to breastfeed their child (65% vs. 86%). Conclusions The prevalences obtained in our study of pregnant women are lower than those previously documented for the general population. Among the women with HBV, the majority were migrants and had a maternal family history of infection, while among those with HCV, the most common factor was intravenous drug use. Despite the risk factors observed for VT, none of the children were infected. Proper immunoprophylaxis is essential to prevent VT in children born to HBV-positive women.
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Affiliation(s)
- Ángeles Ruiz-Extremera
- Hospital Universitario San Cecilio, Granada, Spain
- CIBER de Enfermedades Hepáticas y Digestivas (CIBEREHD), CIBER, Madrid, Spain
- Universidad de Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | | | | | | | | | | | | | | | | | | | - Clara Alonso-Diaz
- Hospital Universitario Doce de Octubre, Madrid, Spain
- RED SAMID (ISCIII ref. RD/16/0022), Spain
| | | | | | | | | | - Josefa Aguayo
- Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | | | | | | | - Paloma Muñoz de Rueda
- Hospital Universitario San Cecilio, Granada, Spain
- CIBER de Enfermedades Hepáticas y Digestivas (CIBEREHD), CIBER, Madrid, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
| | - Manuela Expósito-Ruiz
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- Unidad de Apoyo a la Investigación, Hospital Universitario Virgen de las Nieves, Granada, Spain
- Fundación para la Investigación Biosanitaria de Andalucía Oriental (FIBAO), Granada, Spain
| | - Federico García
- Hospital Universitario San Cecilio, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- RED de SIDA (ISCIII ref. RD/16/0025/0040), Spain
| | - Fernando García
- Hospital Universitario San Cecilio, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
- RED de SIDA (ISCIII ref. RD/16/0025/0040), Spain
| | - Javier Salmerón
- Hospital Universitario San Cecilio, Granada, Spain
- CIBER de Enfermedades Hepáticas y Digestivas (CIBEREHD), CIBER, Madrid, Spain
- Universidad de Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.GRANADA, Granada, Spain
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10
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Chen Q, Perales C, Soria ME, García-Cehic D, Gregori J, Rodríguez-Frías F, Buti M, Crespo J, Calleja JL, Tabernero D, Vila M, Lázaro F, Rando-Segura A, Nieto-Aponte L, Llorens-Revull M, Cortese MF, Fernandez-Alonso I, Castellote J, Niubó J, Imaz A, Xiol X, Castells L, Riveiro-Barciela M, Llaneras J, Navarro J, Vargas-Blasco V, Augustin S, Conde I, Rubín Á, Prieto M, Torras X, Margall N, Forns X, Mariño Z, Lens S, Bonacci M, Pérez-Del-Pulgar S, Londoño MC, García-Buey ML, Sanz-Cameno P, Morillas R, Martró E, Saludes V, Masnou-Ridaura H, Salmerón J, Quíles R, Carrión JA, Forné M, Rosinach M, Fernández I, García-Samaniego J, Madejón A, Castillo-Grau P, López-Núñez C, Ferri MJ, Durández R, Sáez-Royuela F, Diago M, Gimeno C, Medina R, Buenestado J, Bernet A, Turnes J, Trigo-Daporta M, Hernández-Guerra M, Delgado-Blanco M, Cañizares A, Arenas JI, Gomez-Alonso MJ, Rodríguez M, Deig E, Olivé G, Río OD, Cabezas J, Quiñones I, Roget M, Montoliu S, García-Costa J, Force L, Blanch S, Miralbés M, López-de-Goicoechea MJ, García-Flores A, Saumoy M, Casanovas T, Baliellas C, Gilabert P, Martin-Cardona A, Roca R, Barenys M, Villaverde J, Salord S, Camps B, Silvan di Yacovo M, Ocaña I, Sauleda S, Bes M, Carbonell J, Vargas-Accarino E, Ruzo SP, Guerrero-Murillo M, Von Massow G, Costafreda MI, López RM, González-Moreno L, Real Y, Acero-Fernández D, Viroles S, Pamplona X, Cairó M, Ocete MD, Macías-Sánchez JF, Estébanez A, Quer JC, Mena-de-Cea Á, Otero A, Castro-Iglesias Á, Suárez F, Vázquez Á, Vieito D, López-Calvo S, Vázquez-Rodríguez P, Martínez-Cerezo FJ, Rodríguez R, Macenlle R, Cachero A, Mereish G, Mora-Moruny C, Fábregas S, Sacristán B, Albillos A, Sánchez-Ruano JJ, Baluja-Pino R, Fernández-Fernández J, González-Portela C, García-Martin C, Sánchez-Antolín G, Andrade RJ, Simón MA, Pascasio JM, Romero-Gómez M, Antonio Del-Campo J, Domingo E, Esteban R, Esteban JI, Quer J. Deep-sequencing reveals broad subtype-specific HCV resistance mutations associated with treatment failure. Antiviral Res 2020; 174:104694. [PMID: 31857134 DOI: 10.1016/j.antiviral.2019.104694] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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: 04/15/2019] [Revised: 10/24/2019] [Accepted: 12/11/2019] [Indexed: 02/07/2023]
Abstract
A percentage of hepatitis C virus (HCV)-infected patients fail direct acting antiviral (DAA)-based treatment regimens, often because of drug resistance-associated substitutions (RAS). The aim of this study was to characterize the resistance profile of a large cohort of patients failing DAA-based treatments, and investigate the relationship between HCV subtype and failure, as an aid to optimizing management of these patients. A new, standardized HCV-RAS testing protocol based on deep sequencing was designed and applied to 220 previously subtyped samples from patients failing DAA treatment, collected in 39 Spanish hospitals. The majority had received DAA-based interferon (IFN) α-free regimens; 79% had failed sofosbuvir-containing therapy. Genomic regions encoding the nonstructural protein (NS) 3, NS5A, and NS5B (DAA target regions) were analyzed using subtype-specific primers. Viral subtype distribution was as follows: genotype (G) 1, 62.7%; G3a, 21.4%; G4d, 12.3%; G2, 1.8%; and mixed infections 1.8%. Overall, 88.6% of patients carried at least 1 RAS, and 19% carried RAS at frequencies below 20% in the mutant spectrum. There were no differences in RAS selection between treatments with and without ribavirin. Regardless of the treatment received, each HCV subtype showed specific types of RAS. Of note, no RAS were detected in the target proteins of 18.6% of patients failing treatment, and 30.4% of patients had RAS in proteins that were not targets of the inhibitors they received. HCV patients failing DAA therapy showed a high diversity of RAS. Ribavirin use did not influence the type or number of RAS at failure. The subtype-specific pattern of RAS emergence underscores the importance of accurate HCV subtyping. The frequency of "extra-target" RAS suggests the need for RAS screening in all three DAA target regions.
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Affiliation(s)
- Qian Chen
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Celia Perales
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - María Eugenia Soria
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
| | - Damir García-Cehic
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Josep Gregori
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Roche Diagnostics SL, Sant Cugat del Valles, Barcelona, Spain
| | - Francisco Rodríguez-Frías
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Biochemistry and Microbiology Department, VHIR-HUVH, Barcelona, Spain
| | - María Buti
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Crespo
- Gastroenterology and Hepatology Department, Instituto de Investigación (IDIVAL), Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - David Tabernero
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Biochemistry and Microbiology Department, VHIR-HUVH, Barcelona, Spain
| | - Marta Vila
- Biochemistry and Microbiology Department, VHIR-HUVH, Barcelona, Spain
| | - Fernando Lázaro
- Microbiology Department, Hospital Universitario La Paz, Madrid, Spain
| | | | | | - Meritxell Llorens-Revull
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Irati Fernandez-Alonso
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
| | - José Castellote
- Liver Unit, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Jordi Niubó
- Microbiology Department, Hospital Universitari de Bellvitge, Barcelona
| | - Arkaitz Imaz
- HIV and STI Unit, Infectious Diseases Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Xavier Xiol
- Liver Unit, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Lluís Castells
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Mar Riveiro-Barciela
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Llaneras
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Víctor Vargas-Blasco
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Salvador Augustin
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Conde
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Hospital Universitario La Fe, Valencia, Spain
| | - Ángel Rubín
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Hospital Universitario La Fe, Valencia, Spain
| | - Martín Prieto
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Hospital Universitario La Fe, Valencia, Spain
| | - Xavier Torras
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Microbiology Department, Hospital Universitari Santa Creu i Sant Pau, Barcelona, Spain
| | - Nuria Margall
- Digestive Pathology Unit, Hospital Universitari Santa Creu i Sant Pau, Barcelona, Spain
| | - Xavier Forns
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) - Hospital Clínic de Barcelona, Barcelona, Spain
| | - Zoe Mariño
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) - Hospital Clínic de Barcelona, Barcelona, Spain
| | - Sabela Lens
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) - Hospital Clínic de Barcelona, Barcelona, Spain
| | - Martin Bonacci
- Liver Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) - Hospital Clínic de Barcelona, Barcelona, Spain
| | - Sofía Pérez-Del-Pulgar
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) - Hospital Clínic de Barcelona, Barcelona, Spain
| | - Maria Carlota Londoño
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) - Hospital Clínic de Barcelona, Barcelona, Spain
| | | | | | - Rosa Morillas
- Liver Unit, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Elisa Martró
- Microbiology Department, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Institut de Recerca Germans Trias i Pujol (IGTP), Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Verónica Saludes
- Microbiology Department, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Institut de Recerca Germans Trias i Pujol (IGTP), Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | | | - Javier Salmerón
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Complejo Hospitalario de Granada, Granada, Spain
| | - Rosa Quíles
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Complejo Hospitalario de Granada, Granada, Spain
| | - José Antonio Carrión
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Parc de Salut Mar - Hospital del Mar, Barcelona, Spain
| | - Montserrat Forné
- Gastroenterology Unit, Hospital Universitari Mútua Terrassa, Spain
| | - Mercè Rosinach
- Gastroenterology Unit, Hospital Universitari Mútua Terrassa, Spain
| | | | - Javier García-Samaniego
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) - Hospital Universitario La Paz, Madrid, Spain
| | - Antonio Madejón
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) - Hospital Universitario La Paz, Madrid, Spain
| | - Pilar Castillo-Grau
- Liver Unit, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) - Hospital Universitario La Paz, Madrid, Spain
| | - Carme López-Núñez
- Gastroenterology Department, Hospital Universitari Doctor Josep Trueta, Girona, Spain
| | - María José Ferri
- Clinical Laboratory, Hospital Universitari Doctor Josep Trueta, Girona, Spain
| | - Rosa Durández
- Laboratori Territorial - Hospital Santa Caterina, Girona, Spain
| | - Federico Sáez-Royuela
- Gastroenterology and Hepatology Depart., Hospital Universitario de Burgos, Burgos, Spain
| | - Moisés Diago
- Liver Unit, Hospital General de Valencia, Valencia, Spain
| | | | - Rafael Medina
- Microbiology Unit, Hospital General de Valencia, Valencia, Spain
| | - Juan Buenestado
- Medicine Department-Medical School, Hospital Univ. Arnau de Vilanova, Lleida, Spain
| | - Albert Bernet
- Microbiology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Juan Turnes
- Gastroenterology and Hepatology Department, Instituto de Investigación Sanitaria Galicia Sur (IISGS) - Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | - Matilde Trigo-Daporta
- Microbiology and Parasitology Department, Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | | | | | - Angelina Cañizares
- Microbiology Department, Institut de Investigación Biomédica de a Coruña (INIBIC) - Complejo Hospitalario Universitario A Coruña (CHUAC), La Coruña, Spain
| | | | | | - Manuel Rodríguez
- Gastroenterology Depart., Central University Hospital of Asturias (HUCA), Oviedo, Spain
| | | | - Gemma Olivé
- Sant Jaume de Calella County Hospital, Barcelona, Spain
| | - Oscar Del Río
- Sant Jaume de Calella County Hospital, Barcelona, Spain
| | - Joaquín Cabezas
- Gastroenterology and Hepatology Department, Instituto de Investigación (IDIVAL), Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Ildefonso Quiñones
- Gastroenterology Department, Dr Negrin University Hospital of Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Mercè Roget
- Liver Unit, Consorci Sanitari de Terrassa - Hospital de Terrassa, Terrassa, Spain
| | - Silvia Montoliu
- Gastroenterology Unit, Joan XXIII University Hospital, Tarragona, Spain
| | - Juan García-Costa
- Virology and Molecular Biology Unit, Microbiology Department, Complexo Hospitalario Universitario de Ourense (CHUO), Ourense, Spain
| | | | - Silvia Blanch
- Hospital Universitari Sant Pau i Santa Tecla, Tarragona, Spain
| | - Miguel Miralbés
- Gastroenterology Department, Hospital Universitari Santa Maria de Lleida, Lleida, Spain
| | | | | | - María Saumoy
- HIV and STI Unit, Infectious Diseases Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Teresa Casanovas
- Liver Unit, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Carme Baliellas
- Liver Unit, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Pau Gilabert
- Liver Unit, Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | - Rosa Roca
- Liver Unit, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Mercè Barenys
- Liver Unit, Hospital de Viladecans, Barcelona, Spain
| | - Joana Villaverde
- Liver Unit, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Silvia Salord
- Liver Unit, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Blau Camps
- Liver Unit, Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | - Imma Ocaña
- Infectious Disease Unit, HUVH, Barcelona, Spain
| | - Silvia Sauleda
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Banc de Sang i Teixits (BST), Barcelona, Spain
| | - Marta Bes
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Banc de Sang i Teixits (BST), Barcelona, Spain
| | - Judit Carbonell
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
| | - Elena Vargas-Accarino
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
| | - Sofía P Ruzo
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
| | - Mercedes Guerrero-Murillo
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
| | - Georg Von Massow
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
| | - María Isabel Costafreda
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Banc de Sang i Teixits (BST), Barcelona, Spain
| | - Rosa Maria López
- Biochemistry and Microbiology Department, VHIR-HUVH, Barcelona, Spain
| | | | - Yolanda Real
- Liver Unit, Hospital Universitario La Princesa, Madrid, Spain
| | | | - Silvia Viroles
- Gastroenterology Department, Hospital Universitari Doctor Josep Trueta, Girona, Spain
| | - Xavier Pamplona
- Gastroenterology Department, Hospital Universitari Doctor Josep Trueta, Girona, Spain
| | - Mireia Cairó
- Gastroenterology Unit, Hospital Universitari Mútua Terrassa, Spain
| | | | | | - Angel Estébanez
- Gastroenterology and Hepatology Department, Instituto de Investigación (IDIVAL), Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Joan Carles Quer
- Gastroenterology Unit, Joan XXIII University Hospital, Tarragona, Spain
| | - Álvaro Mena-de-Cea
- Liver Unit, Complejo Hospitalario Universitario A Coruña (CHUAC), La Coruña, Spain
| | - Alejandra Otero
- Liver Unit, Complejo Hospitalario Universitario A Coruña (CHUAC), La Coruña, Spain
| | | | - Francisco Suárez
- Liver Unit, Complejo Hospitalario Universitario A Coruña (CHUAC), La Coruña, Spain
| | - Ángeles Vázquez
- Liver Unit, Complejo Hospitalario Universitario A Coruña (CHUAC), La Coruña, Spain
| | - David Vieito
- Liver Unit, Complejo Hospitalario Universitario A Coruña (CHUAC), La Coruña, Spain
| | - Soledad López-Calvo
- Liver Unit, Complejo Hospitalario Universitario A Coruña (CHUAC), La Coruña, Spain
| | | | | | - Raúl Rodríguez
- Virology and Molecular Biology Unit, Microbiology Department, Complexo Hospitalario Universitario de Ourense (CHUO), Ourense, Spain
| | - Ramiro Macenlle
- Virology and Molecular Biology Unit, Microbiology Department, Complexo Hospitalario Universitario de Ourense (CHUO), Ourense, Spain
| | - Alba Cachero
- Liver Unit, Hospital d'Igualada, Barcelona, Spain
| | | | | | - Silvia Fábregas
- Fundació Salut Empordà - Hospital de Figueres, Girona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | - Manolo Romero-Gómez
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Hospital Universitario Virgen de Valme, Seville, Spain
| | - José Antonio Del-Campo
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Hospital Universitario Virgen de Valme, Seville, Spain
| | - Esteban Domingo
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Centro de Biología Molecular "Severo Ochoa" (CBMSO), Universidad Autónoma de Madrid, Madrid, Spain
| | - Rafael Esteban
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Ignacio Esteban
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.
| | - Josep Quer
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.
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11
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Rodríguez-Carmona Y, Denova-Gutiérrez E, Sánchez-Uribe E, Muñoz-Aguirre P, Flores M, Salmerón J. Zinc Supplementation and Fortification in Mexican Children. Food Nutr Bull 2020; 41:89-101. [PMID: 31955593 DOI: 10.1177/0379572119877757] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Zinc is an essential micronutrient for human health. Approximately 1.4% of deaths worldwide are related to zinc deficiency. In Mexico, 33% of children younger than 5 years are zinc deficient. OBJECTIVE To give an overview of zinc supplementation and fortification in children younger than 5 years through the analysis of current regulations in Mexico, the availability of these products, and the opinion of Mexican experts in this field. METHODS We gave an overview of zinc supplementation and fortification strategies in the Mexican pediatric population by conducting a literature review of Mexican studies and national standards concerning zinc supplementation and fortification. Semistructured interviews were conducted with personnel from the main producers of zinc supplements and fortified products and from social assistance programs in Mexico. RESULTS Zinc supplementation in Mexico has been associated with reduction in the duration and incidence of diarrhea. Through interviews with experts, we identified several barriers in achieving adequate zinc consumption such as problems in social assistance programs that distribute zinc-fortified foods, lack of specific dietary recommendations regarding the intake of zinc, lack of regulation of nonpatented zinc supplements, and inconsistencies in public health actions due to political and administrative changes. CONCLUSION Despite current regulation and efforts made by social assistance programs, zinc deficiency continues to be a prevalent public health issue. Mexico requires an in-depth analysis of existing barriers and alternatives in order to reduce zinc deficiency.
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Affiliation(s)
- Yanelli Rodríguez-Carmona
- Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Edgar Denova-Gutiérrez
- Center for Nutrition and Health Research, National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico
| | - Edgar Sánchez-Uribe
- Academic Unit in Epidemiological Research, Research Center in Policies, Population and Health, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Paloma Muñoz-Aguirre
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Mario Flores
- Center for Nutrition and Health Research, National Institute of Public Health (INSP), Cuernavaca, Morelos, Mexico
| | - J Salmerón
- Academic Unit in Epidemiological Research, Research Center in Policies, Population and Health, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.,Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
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12
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Bataller R, Cabezas J, Aller R, Ventura-Cots M, Abad J, Albillos A, Altamirano J, Arias-Loste MT, Bañares R, Caballería J, Caballería L, Carrión JA, Diago M, Fernández Rodríguez C, Gallego R, García-Cortes M, García-Monzón C, Genescà J, Ginés P, Hernandez-Guerra M, Jorquera F, Lligoña A, Molina E, Pareja MJ, Planas R, Tomé S, Salmerón J, Romero-Gómez M. Alcohol-related liver disease. Clinical practice guidelines. Consensus document sponsored by AEEH. Gastroenterol Hepatol 2019; 42:657-676. [PMID: 31771785 DOI: 10.1016/j.gastrohep.2019.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 09/02/2019] [Indexed: 02/07/2023]
Abstract
Alcohol-related liver disease (ARLD) is the most prevalent cause of advanced liver disease and liver cirrhosis in Europe, including Spain. According to the World Health Organization the fraction of liver cirrhosis attributable to alcohol use in Spain is 73.8% among men and 56.3% among women. ARLD includes various stages such as steatohepatitis, cirrhosis and hepatocellular cancer. In addition, patients with underlying ARLD and heavy alcohol intake may develop alcoholic hepatitis, which is associated with high mortality. To date, the only effective treatment to treat ARLD is prolonged withdrawal. There are no specific treatments, and the only treatment that increases life expectancy in alcoholic hepatitis is prednisolone. For patients with alcoholic hepatitis who do not respond to treatment, some centres offer the possibility of an early transplant. These clinical practice guidelines aim to propose recommendations on ARLD taking into account their relevance as a cause of advanced chronic liver disease and liver cirrhosis in our setting. This paper aims to answer the key questions for the clinical practice of Gastroenterology, Hepatology, as well as Internal Medicine and Primary Health Centres, making the most up-to-date information regarding the management and treatment of ARLD available to health professionals. These guidelines provide evidence-based recommendations for the clinical management of this disease.
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Affiliation(s)
- Ramón Bataller
- Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, Center for Liver Diseases, University of Pittsburgh Medical Center, Pittsburgh, PA, Estados Unidos.
| | - Joaquín Cabezas
- Servicio de Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Instituto de investigación Sanitaria Valdecilla (IDIVAL), Santander, Cantabria, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España
| | - Rocío Aller
- Servicio de Gastroenterología, Hospital Clínico Universitario de Valladolid, Valladolid, España; Facultad de Medicina, Universidad de Valladolid, Valladolid, España; Centro de Investigación de Endocrinología y Nutrición, Facultad de Medicina de Valladolid, Valladolid, España
| | - Meritxell Ventura-Cots
- Department of Medicine, Division of Gastroenterology, Hepatology and Nutrition, Center for Liver Diseases, University of Pittsburgh Medical Center, Pittsburgh, PA, Estados Unidos; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España
| | - Javier Abad
- Servicio de Gastroenterología y Hepatología, Hospital Puerta de Hierro, Madrid, España
| | - Agustín Albillos
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España; Servicio de Gastroenterología y Hepatología, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, España
| | - José Altamirano
- Deparmento de Medicina Interna, Hospital Quironsalud, Barcelona, España
| | - María Teresa Arias-Loste
- Servicio de Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Instituto de investigación Sanitaria Valdecilla (IDIVAL), Santander, Cantabria, España; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España
| | - Rafael Bañares
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España; Servicio de Gastroenterología y Hepatología, Hospital Gregorio Marañón, Madrid, España
| | - Juan Caballería
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España; Unidad de Hepatología, Hospital Clínic, IDIBAPS, Barcelona, España
| | - Llorenç Caballería
- Unidad de Apoyo a la Investigación de la Atención Primaria en la Metropolitana Norte, Barcelona, España
| | | | - Moisés Diago
- Servicio de Aparato Digestivo, Hospital General de Valencia, Valencia, España
| | - Conrado Fernández Rodríguez
- Servicio de Gastroenterología, Hospital Universitario Fundación Alcorcón. Facultad de Medicina, Universidad Rey Juan Carlos, Alcorcón, Madrid, España
| | - Rocío Gallego
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España; UGC Aparato Digestivo, Instituto de Biomedicina de Sevilla. Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, España
| | | | | | - Joan Genescà
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España; Servicio de Medicina Interna-Hepatología, Hospital Universitario Vall d'Hebron, Institut de Recerca Vall d'Hebron (VHIR), Universitat Autònoma de Barcelona, Barcelona, España
| | - Pere Ginés
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España; Unidad de Apoyo a la Investigación de la Atención Primaria en la Metropolitana Norte, Barcelona, España
| | | | - Francisco Jorquera
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España; Servicio de Aparato Digestivo, Complejo Asistencial Universitario de León, IBIOMED, León, España
| | - Anna Lligoña
- Unidad de Alcohologia, Departamento de Psiquiatría, Hospital Clínic. Barcelona, España
| | - Esther Molina
- Unidad de Hepatología, Servicio de Aparato Digestivo, Hospital Clínico-Xerencia de Xestión Integrada de Santiago de Compostela, Santiago de Compostela, La Coruña, España
| | | | - Ramón Planas
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España; Departamento de Hepatología, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - Santiago Tomé
- Unidad de Trasplante Hepático, Hospital Clínico Universitario, Santiago de Compostela, La Coruña, España
| | - Javier Salmerón
- UGC de Aparato Digestivo, Hospital San Cecilio, Granada, España
| | - Manuel Romero-Gómez
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, España; UGC Aparato Digestivo, Instituto de Biomedicina de Sevilla. Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, España
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13
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Manuel Sousa J, Vergara M, Pulido F, Sánchez Antolín G, Hijona L, Carnicer F, Rincón D, Salmerón J, Mateos-Muñoz B, Jou A, Polo-Lorduy B, Rubín Á, Escarda A, Aguilar P, Aldámiz-Echevarría T, García-Buey L, Carrión JA, Hernández-Guerra M, Chimeno-Hernández S, Espinosa N, Morillas RM, Andrade RJ, Delgado M, Gallego A, Magaz M, Moreno-Planas JM, Estébanez Á, Rico M, Menéndez F, Sampedro B, Morano L, Izquierdo S, Zozaya JM, Rodríguez M, Morán-Sánchez S, Lorente S, Martín-Granizo I, Von-Wichmann MÁ, Delgado M, Manzanares A. Real-world evidence of the effectiveness of ombitasvir-paritaprevir/r ± dasabuvir ± ribavirin in patients monoinfected with chronic hepatitis C or coinfected with human immunodeficiency virus-1 in Spain. PLoS One 2019; 14:e0225061. [PMID: 31714950 PMCID: PMC6850697 DOI: 10.1371/journal.pone.0225061] [Citation(s) in RCA: 4] [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: 07/24/2019] [Accepted: 10/27/2019] [Indexed: 12/27/2022] Open
Abstract
Aim We describe the effectiveness and safety of the interferon-free regimen ombitasvir/paritaprevir/ritonavir plus dasabuvir with or without ribavirin (OBV/PTV/r ± DSV ± RBV) in a nationwide representative sample of the hepatitis C virus (HCV) monoinfected and human immunodeficiency virus-1/hepatitis C virus (HIV/HCV) coinfected population in Spain. Material and methods Data were collected from patients infected with HCV genotypes 1 or 4, with or without HIV-1 coinfection, treated with OBV/PTV/r ± DSV ± RBV at 61 Spanish sites within the initial implementation year of the first government-driven “National HCV plan.” Effectiveness was assessed by sustained virologic response at post-treatment week 12 (SVR12) and compared between monoinfected and coinfected patients using a non-inferiority margin of 5% and a 90% confidence interval (CI). Sociodemographic and clinical characteristics or patients and adverse events (AEs) were also recorded. Results Overall, 2,408 patients were included in the intention-to-treat analysis: 386 (16%) were patients with HIV/HCV. Patient selection reflected the real distribution of patients treated in each participating region in Spain. From the total population, 96.6% (95% CI, 95.8–97.3%) achieved SVR12. Noninferiority of SVR12 in coinfected patients was met, with a difference between monoinfected and coinfected patients of −2.2% (90% CI, −4.5% - 0.2%). Only genotype 4 was associated with non-response to OBV/PTV/r ± DSV ± RBV treatment (p<0.001) in the multivariate analysis. Overall, 286 patients (11.9%) presented AEs potentially related to OBV/PTV/r ± DSV, whereas 347 (29.0%) presented AEs potentially related to ribavirin and 61 (5.1%) interrupted ribavirin. Conclusions Our results confirm that OBV/PTV/r ± DSV ± RBV is effective and generally well tolerated in a representative sample of the HCV monoinfected and HCV/HIV coinfected population in Spain within the experience of a national strategic plan to tackle HCV.
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Affiliation(s)
- José Manuel Sousa
- Hepatology Department, Hospital Universitario Virgen del Rocío, Sevilla, Sevilla, Spain
| | - Mercedes Vergara
- Hepatology Unit, Digestive Disease Department, Parc Taulí Sabadell Hospital Universitari, Sabadell, Barcelona, Spain, CIBERehd, Instituto Carlos III, Madrid, Spain
| | - Federico Pulido
- HIV Unit, Hospital Universitario 12 de Octubre, imas12, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Gloria Sánchez Antolín
- Hepatology Department, Hospital Universitario Río Hortega, Valladolid, Valladolid, Spain
| | - Lander Hijona
- Hepatology Department, Hospital Universitario Araba, Vitoria-Gasteiz, Álava, Spain
| | - Fernando Carnicer
- Hepatology Department, Hospital General Universitario de Alicante, Alicante, Alicante, Spain
| | - Diego Rincón
- Hepatology Department, Hospital General Universitario Gregorio Marañón, CIBERehd and (UCM), Madrid, Spain
| | - Javier Salmerón
- Hepatology Department, Complejo Hospitalario Universitario de Granada, Granada, Granada, Spain
| | | | - Antoni Jou
- HIV Clinical Unit, Internal Medicine Department and Fundació de la Lluita contra la SIDA, Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Benjamín Polo-Lorduy
- Hepatology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - Ángel Rubín
- Hepatology Department, Hospital Universitario y Politécnico de La Fe, Valencia, Valencia, Spain
| | - Ana Escarda
- Hepatology Department, Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Patricia Aguilar
- Digestive System Clinical Unit, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía/Córdoba University, Córdoba, Spain
| | - Teresa Aldámiz-Echevarría
- Infectious Diseases-HIV, Hospital General Universitario Gregorio Marañón (IiSGM), Madrid, Madrid, Spain
| | - Luisa García-Buey
- Hepatology Department, Hospital Universitario de La Princesa, Madrid, Spain
| | - José A. Carrión
- Liver Section, Gastroenterology Department, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), UAB (Universitat Autonoma de Barcelona) Barcelona, Spain
| | - Manuel Hernández-Guerra
- Hepatology Department, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain
| | | | - Nuria Espinosa
- Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Infectious Diseases Research Group, Institute of Biomedicine of Seville (IBiS), University of Seville/CSIC,Sevilla, Spain
| | - Rosa Mª Morillas
- Liver Section, Department of Gastroenterology, Hospital Universitari Germans Trias i Pujol, IGTP, Badalona, Barcelona, Spain, and CIBEREHD
| | - Raúl J. Andrade
- Unidad de Gestión Clínica de Aparato Digestivo, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas CIBERehd, Málaga, Spain
| | - Manuel Delgado
- Hepatology Department, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
| | - Adolfo Gallego
- Hepatology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Barcelona, Spain
| | - Marta Magaz
- Hepatology Department, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | | | - Ángel Estébanez
- Hepatology Department, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - Mikel Rico
- Infectious Diseases Unit, Hospital Universitario La Paz, Madrid, Spain
| | - Fernando Menéndez
- Hepatology Department, Hospital Universitario Basurto, Bilbao, Vizcaya, Spain
| | - Blanca Sampedro
- Hepatology Department, Hospital Galdakao, Galdakao, Vizcaya, Spain
| | - Luís Morano
- Infectious Diseases Unit, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain
| | - Sonia Izquierdo
- Hepatology Department, Hospital Clínico San Carlos, Madrid, Spain
| | - José Manuel Zozaya
- Hepatology Department, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | - Manuel Rodríguez
- Liver Unit, Division of Gastroenterology & Hepatology. Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Senador Morán-Sánchez
- Hepatology Department, Hospital General Universitario Santa Lucía, Cartagena, Murcia, Spain
| | - Sara Lorente
- Hepatology Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Zaragoza, Spain
| | - Ignacio Martín-Granizo
- Department of Gastroenterology, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, Spain
| | | | - Marcial Delgado
- Infectious Diseases Unit, Hospital Regional Universitario de Málaga, Málaga, Spain
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Pérez AB, Chueca N, García-Deltoro M, Martínez-Sapiña AM, Lara-Pérez MM, García-Bujalance S, Aldámiz-Echevarría T, Vera-Méndez FJ, Pineda JA, Casado M, Pascasio JM, Salmerón J, Alados-Arboledas JC, Poyato A, Téllez F, Rivero-Juárez A, Merino D, Vivancos-Gallego MJ, Rosales-Zábal JM, García F. High efficacy of resistance-guided retreatment of HCV patients failing NS5A inhibitors in the real world. J Hepatol 2019; 71:876-888. [PMID: 31279901 DOI: 10.1016/j.jhep.2019.06.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 08/27/2018] [Revised: 04/14/2019] [Accepted: 06/23/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS Most hepatitis C virus (HCV)-infected patients failing NS5A inhibitors develop resistance-associated substitutions (RASs). Here we report the use of resistance-guided retreatment of patients who failed prior NS5A inhibitor-containing regimens in the GEHEP-004 cohort. This is the largest direct-acting antiviral (DAA)-resistance cohort study conducted in Spain. We aim to provide indications on how to use resistance information in settings where sofosbuvir/velpatasvir/voxilaprevir may not be available. METHODS GEHEP-004 is a prospective multicenter cohort enrolling HCV-infected patients treated with interferon (IFN)-free DAA regimens. Prior to retreatment, population-based sequencing of HCV NS3, NS5A and NS5B genes was performed. After receiving a comprehensive resistance interpretation report, the retreatment regimen was chosen and the sustained virological response (SVR) at 12 weeks after treatment completion (SVR12) was recorded. RESULTS A total of 342 patients experiencing virological failure after treatment with sofosbuvir/ledipasvir±ribavirin (54%), sofosbuvir/daclatasvir±ribavirin (23%), or paritaprevir-ritonavir/ombitasvir±dasabuvir±ribavirin (20%) were studied. After a resistance report, 186 patients were retreated. An SVR12 was achieved for 88.1% of the patients who failed after sofosbuvir/ledipasvir±ribavirin, 83.3% of the patients who failed after sofosbuvir/daclatasvir±ribavirin, 93.7% of the patients who failed after paritaprevir-ritonavir+ombitasvir±dasabuvir±ribavirin. CONCLUSIONS In our study, we show how resistance-guided retreatment in conjunction with an interpreted report allows patients to achieve SVR rates close to 90%. We hypothesize that SVR rates may even be improved if resistance data are discussed between experienced virologists and treating clinicians. We believe that our data may be relevant for countries where the access to new DAA combination regimens is limited. LAY SUMMARY Hepatitis C infection can be cured with currently available antiviral agents. Only a small proportion of patients experience treatment failure, however, in absolute numbers, a high number of patients may require retreatment. Highly effective combinations of antivirals are also available for retreatment. However, these antivirals might not be available in resource-limited settings. Herein, we show how, by analyzing the cause of resistance, retreatment efficacy with old drugs can get very close to the efficacy of new drug combinations.
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Affiliation(s)
- Ana Belén Pérez
- Clinical Microbiology Unit, University Hospital Reina Sofía. Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Natalia Chueca
- Clinical Microbiology Unit, University Hospital San Cecilio, Instituto de Investigacion Biosanitaria Ibs.Granada, Granada, Spain
| | | | | | | | | | | | | | - Juan Antonio Pineda
- Infectious Diseases Unit, University Hospital Nuestra Señora de Valme, Sevilla, Spain
| | - Marta Casado
- Hepatology Unit, Complejo Hospitalario Torrecárdenas, Almería, Spain
| | - Juan Manuel Pascasio
- Hepatology Unit, University Hospital Virgen del Rocío, IBIS Instituto de Biomedicina de Sevilla, CIBERehd, Seville, Spain
| | - Javier Salmerón
- Hepatology Unit, University Hospital San Cecilio Granada, Instituto de Investigación Biosanitaria Ibs.Granada, CIBERehd, Granada, Spain
| | | | - Antonio Poyato
- Hepatology Unit, University Hospital Reina Sofía, Córdoba, Spain
| | - Francisco Téllez
- Infectious Diseases Unit, Hospital Puerto Real, Puerto Real, Cádiz, Spain
| | - Antonio Rivero-Juárez
- Infectious Diseases Unit, University Hospital Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, Spain
| | - Dolores Merino
- Infectious Diseases Unit, University Hospital Juan Ramón Jiménez, Huelva, Spain
| | | | | | - Federico García
- Clinical Microbiology Unit, University Hospital San Cecilio, Instituto de Investigacion Biosanitaria Ibs.Granada, Granada, Spain.
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15
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Pérez AB, Chueca N, Macías J, Pineda JA, Salmerón J, Rivero-Juárez A, Hidalgo-Tenorio C, Espinosa MD, Téllez F, Von-Wichmann MÁ, Omar M, Santos J, Hernández-Quero J, Antón JJ, Collado A, Lozano AB, García-Deltoro M, Casado M, Pascasio JM, Selfa A, Rosales JM, De la Iglesia A, Arenas JI, García-Bujalance S, Ríos MJ, Bernal E, Martínez O, García-Herola A, Vélez M, Rincón P, García F. Prevalence of resistance associated substitutions and efficacy of baseline resistance-guided chronic hepatitis C treatment in Spain from the GEHEP-004 cohort. PLoS One 2019; 14:e0221231. [PMID: 31469856 PMCID: PMC6716636 DOI: 10.1371/journal.pone.0221231] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 08/01/2019] [Indexed: 12/11/2022] Open
Abstract
Treatment guidelines differ in their recommendation to determine baseline resistance associated substitutions (RAS) before starting a first-line treatment with direct-acting antivirals (DAAs). Here we analyze the efficacy of DAA treatment with baseline RAS information. We conducted a prospective study involving 23 centers collaborating in the GEHEP-004 DAA resistance cohort. Baseline NS5A and NS3 RASs were studied by Sanger sequencing. After issuing a comprehensive resistance report, the treating physician decided the therapy, duration and ribavirin use. Sustained virological response (SVR12) data are available in 275 patients. Baseline NS5A RAS prevalence was between 4.3% and 26.8% according to genotype, and NS3 RASs prevalence (GT1a) was 6.3%. Overall, SVR12 was 97.8%. Amongst HCV-GT1a patients, 75.0% had >800,000 IU/ml and most of those that started grazoprevir/elbasvir were treated for 12 weeks. In genotype 3, NS5A Y93H was detected in 9 patients. 42.8% of the HCV-GT3 patients that started sofosbuvir/velpatasvir included ribavirin, although only 14.7% carried Y93H. The efficacy of baseline resistance-guided treatment in our cohort has been high across the most prevalent HCV genotypes in Spain. The duration of the grazoprevir/elbasvir treatment adhered mostly to AASLD/IDSA recommendations. In cirrhotic patients infected with GT-3 there has been a high use of ribavirin.
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Affiliation(s)
- Ana Belén Pérez
- Clinical Microbiology Unit, University Hospital Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain
| | - Natalia Chueca
- Clinical Microbiology Unit, University Hospital San Cecilio, Instituto de Investigacion Ibs. Granada, Granada, Spain
| | - Juan Macías
- Infectious Diseases Unit, University Hospital Nuestra Señora de Valme, Sevilla, Spain
| | - Juan Antonio Pineda
- Infectious Diseases Unit, University Hospital Nuestra Señora de Valme, Sevilla, Spain
| | - Javier Salmerón
- Hepatology Unit, University Hospital San Cecilio Granada, Instituto de Investigación Ibs. CIBERehd, Granada, Spain
| | - Antonio Rivero-Juárez
- Infectious Diseases Unit, University Hospital Reina Sofía, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, Spain
| | | | | | - Francisco Téllez
- Infectious Diseases Unit, Hospital Puerto Real, Puerto Real, Cádiz, Spain
| | | | - Mohamed Omar
- Infectious Diseases Unit, Complejo Hospitalario de Jaén, Jáen, Spain
| | - Jesús Santos
- Infectious Diseases Unit, University Hospital Virgen de la Victoria, Málaga, Spain
| | | | | | - Antonio Collado
- Infectious Diseases Unit, Complejo Hospitalario Torrecárdenas, Almería, Spain
| | - Ana Belén Lozano
- Infectious Diseases Unit, Hospital de Poniente, El Ejido, Almería, Spain
| | | | - Marta Casado
- Hepatology Unit, Complejo Hospitalario Torrecárdenas, Almería, Spain
| | | | - Aida Selfa
- Hepatology Unit, Hospital Comarcal Santa Ana, Motril Granada, Spain
| | | | | | | | | | - María José Ríos
- Infectious Diseases Unit, University Hospital Virgen Macarena, Seville, Spain
| | - Enrique Bernal
- Infectious Diseases Unit, Hospital General Reina Sofía, Murcia, Spain
| | - Onofre Martínez
- Infectious Diseases Unit, University Hospital Santa Lucía, Cartagena, Spain
| | | | - Mónica Vélez
- Infectious Diseases Unit, Hospital General de La Palma, La Palma, Spain
| | - Pilar Rincón
- Infectious Diseases Unit, University Hospital Nuestra Señora de Valme, Sevilla, Spain
| | - Federico García
- Clinical Microbiology Unit, University Hospital San Cecilio, Instituto de Investigacion Ibs. Granada, Granada, Spain
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León-Maldonado L, Cabral A, Brown B, Ryan GW, Maldonado A, Salmerón J, Allen-Leigh B, Lazcano-Ponce E. Feasibility of a combined strategy of HPV vaccination and screening in Mexico: the FASTER-Tlalpan study experience. Hum Vaccin Immunother 2019; 15:1986-1994. [PMID: 31184976 DOI: 10.1080/21645515.2019.1619401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
There has been a noticeable shift in discussions about cervical cancer, moving from prevention to elimination. Interventions such as FASTER, human papillomavirus (HPV) vaccination and HPV screening are innovative intervention strategies which can be utilized to begin a path to elimination. To explore the feasibility of the FASTER strategy, an evaluation was carried out in eight primary health-care centers within the Tlalpan Health-Jurisdiction of Mexico City between March 2017 and August 2018. A mixed methods approach was used to evaluate three components: infrastructure, patient acceptability, and health-care professionals' perceptions. This included checklists of requirements for the infrastructure rollout of FASTER and interviews with women and health-care professionals. Nearly all (93%) of the 3,474 women aged 25-45 years accepted HPV vaccination as part of a combined vaccination and screening program. The main reason for acceptance was prevention, while having doubts about the vaccine's benefits was the main reason for refusal. Most of the 24 health-care professionals had a positive opinion toward HPV vaccination and identified the need to increase dissemination, inform the population clearly and concisely and currently extend the age range for vaccination. The evaluation of eight primary health-care centers showed they had the necessary infrastructure for the development of a joint HPV prevention strategy, but many centers required improvements to become more efficient. Together these findings suggest that although HPV vaccine acceptance was high, there is the need to increase education and awareness among potential vaccine recipients and health-care professionals to implement the FASTER strategy.
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Affiliation(s)
- L León-Maldonado
- a Cátedra CONACYT- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública , Cuernavaca , Morelos , México.,b Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Autónoma de México , Ciudad de México , México
| | - A Cabral
- c Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública , Cuernavaca , Morelos , México
| | - B Brown
- d Center for Healthy Communities, Department of Social Medicine, Population and Public Health. University of California, Riverside School of Medicine , Riverside , CA , USA
| | - G W Ryan
- e Department of Community and Behavioral Health, University of Iowa College of Public Health. Riverside Dr ., Iowa City , LA , USA
| | - A Maldonado
- f Dirección de Salud Reproductiva, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública , Cuernavaca , Morelos , México
| | - J Salmerón
- b Centro de Investigación en Políticas, Población y Salud, Facultad de Medicina, Universidad Autónoma de México , Ciudad de México , México
| | - B Allen-Leigh
- f Dirección de Salud Reproductiva, Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública , Cuernavaca , Morelos , México
| | - E Lazcano-Ponce
- g Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública , Cuernavaca , Morelos , México
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Martínez O, Vicente M, De Vega M, Salmerón J. Sensory perception and flow properties of dysphagia thickening formulas with different composition. Food Hydrocoll 2019. [DOI: 10.1016/j.foodhyd.2018.12.045] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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18
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Hidalgo-Bravo A, Parra-Torres AY, Casas-Avila L, Jimenez-Ortega RF, Ramírez-Salazar EG, Patiño N, Rivera-Paredez B, Salmerón J, Valdés-Flores M, Velázquez-Cruz R. Association of RMND1/CCDC170-ESR1 single nucleotide polymorphisms with hip fracture and osteoporosis in postmenopausal women. Climacteric 2019; 22:97-104. [PMID: 30601066 DOI: 10.1080/13697137.2018.1538339] [Citation(s) in RCA: 10] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE This study aimed to investigate the association of seven single nucleotide polymorphisms (SNPs) on the RMND1, CCDC170, and ESR1 genes with osteoporosis or hip fracture in a postmenopausal Mexican population. METHODS We included a group of 400 postmenopausal women from the Health Workers Cohort Study from the Mexican Institute of Social Security. As a replication sample, we recruited 423 postmenopausal women from the National Institute of Rehabilitation. Demographic data were collected through a structured questionnaire. Bone mineral density was assessed using dual X-ray absorptiometry. Individuals were classified as normal, osteopenia, osteoporosis, and fracture, according to World Health Organization criteria. Genotyping was performed using predesigned TaqMan Probes. Linear regression analysis was used to investigate association. RESULTS All of the analyzed SNPs showed association with at least one of the phenotypes of the study groups. In addition, we observed a region with linkage disequilibrium within the ESR1 gene in all groups. CONCLUSION This study shows that an association of the SNPs can exist with osteopenia, osteoporosis, or fragility fracture. Our results agree with data published elsewhere, supporting the potential of these loci for the identification of the population at risk. However, additional studies are required to determine the extent of this association for other geographic regions of Mexico.
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Affiliation(s)
- A Hidalgo-Bravo
- a Department of Genetics , National Institute of Rehabilitation , Mexico City , Mexico
| | - A Y Parra-Torres
- b Genomics of Bone Metabolism Laboratory , National Institute of Genomic Medicine (INMEGEN) , Mexico City , Mexico
| | - L Casas-Avila
- a Department of Genetics , National Institute of Rehabilitation , Mexico City , Mexico
| | - R F Jimenez-Ortega
- b Genomics of Bone Metabolism Laboratory , National Institute of Genomic Medicine (INMEGEN) , Mexico City , Mexico
| | - E G Ramírez-Salazar
- b Genomics of Bone Metabolism Laboratory , National Institute of Genomic Medicine (INMEGEN) , Mexico City , Mexico.,c National Council for Science and Technology (CONACYT) - Genomics of Bone Metabolism Laboratory , National Institute of Genomic Medicine (INMEGEN) , Mexico City , Mexico
| | - N Patiño
- d Subdirection of Development of Clinical Applications , National Institute of Genomic Medicine (INMEGEN) , Mexico City , Mexico
| | - B Rivera-Paredez
- e Academic Unit in Epidemiological Research, Research Center in Policies, Population and Health, School of Medicine , National Autonomous University of Mexico , Mexico City , Mexico
| | - J Salmerón
- e Academic Unit in Epidemiological Research, Research Center in Policies, Population and Health, School of Medicine , National Autonomous University of Mexico , Mexico City , Mexico.,f Center for Population Health Research , National Institute of Public Health (INSP) , Cuernavaca , Mexico
| | - M Valdés-Flores
- a Department of Genetics , National Institute of Rehabilitation , Mexico City , Mexico
| | - R Velázquez-Cruz
- b Genomics of Bone Metabolism Laboratory , National Institute of Genomic Medicine (INMEGEN) , Mexico City , Mexico
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Puigvehí M, De Cuenca B, Viu A, Diago M, Turnes J, Gea F, Pascasio JM, Lens S, Cabezas J, Badia E, Olveira A, Morillas RM, Torras X, Montoliu S, Cordero P, Castro JL, Salmerón J, Molina E, Sánchez-Ruano JJ, Moreno J, Antón MD, Moreno JM, De la Vega J, Calleja JL, Carrión JA. Eight weeks of Paritaprevir/r/Ombitasvir + Dasabuvir in HCV genotype 1b with mild-moderate fibrosis: Results from a real-world cohort. Liver Int 2019; 39:90-97. [PMID: 30160363 DOI: 10.1111/liv.13950] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 05/22/2018] [Revised: 07/27/2018] [Accepted: 08/22/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND & AIMS The interferon-free regimen paritaprevir/ritonavir, ombitasvir + dasabuvir (PTV/r/OBV/DSV) has shown high efficacy in patients with hepatitis C virus (HCV) genotype 1b infection when administered for 8 or 12 weeks, but data regarding the 8-week treatment are scarce. The aim of our study was to assess the efficacy and safety of the 8-week administration of PTV/r/OBV/DSV in a real-world cohort. METHODS We performed a multicentre observational study from Spanish Hepa-C database including patients receiving 8 weeks of PTV/r/OBV/DSV (October 2016-November 2017). Those with advanced fibrosis, with non-genotype 1b or who were treatment-experienced were excluded. RESULTS A total of 211 patients were registered from 23 Spanish centres; eleven were excluded. At baseline, 42.5% (n = 85) were male, median (range) age was 57 (23-86), ALT was 45 (11-494) IU/mL, viral load was 6.1 (3.3-8.2) log10 IU/mL, and 74.5% had mild liver fibrosis (F0-F1) and 25.5% moderate fibrosis (F2). At the end of treatment (EOT), HCV viral load was undetectable in 100% (200/200). Seven patients relapsed after treatment discontinuation. Sustained virological response (SVR12) rates by intention-to-treat analysis were 96% (192/200). Regarding treatment safety, 2 patients developed ALT elevation >5x ULN, but there were no treatment discontinuations. One patient died 7 weeks after EOT. CONCLUSION Treatment with PTV/r/OBV/DSV in genotype 1b-infected treatment-naive patients with mild-moderate fibrosis shows excellent efficacy and safety in real life, similarly to clinical trials. Clinicaltrials.gov, number: NCT03122132.
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Affiliation(s)
- Marc Puigvehí
- Hospital del Mar, IMIM, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Ana Viu
- Hospital del Mar, IMIM, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Juan Turnes
- Complejo Hospitalario Universitario de Pontevedra, IIS Galicia Sur, Pontevedra, Spain
| | - Francisco Gea
- Hospital Universitario Ramón y Cajal, CIBERehd, Madrid, Spain
| | | | - Sabela Lens
- Hospital Clínic, IDIBAPS, CIBERehd, Universitat de Barcelona, Barcelona, Spain
| | | | - Ester Badia
- Hospital Universitario de Burgos, Burgos, Spain
| | | | | | - Xavier Torras
- Hospital de la Santa Creu i Sant Pau, CIBERehd, Barcelona, Spain
| | | | | | | | | | - Esther Molina
- Centro Hospitalario de Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | | | - José M Moreno
- Centro Hospitalario Universitario de Albacete, Albacete, Spain
| | | | - José L Calleja
- Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain
| | - José A Carrión
- Hospital del Mar, IMIM, Universitat Autònoma de Barcelona, Barcelona, Spain
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Aller R, Fernández-Rodríguez C, Lo Iacono O, Bañares R, Abad J, Carrión JA, García-Monzón C, Caballería J, Berenguer M, Rodríguez-Perálvarez M, López Miranda J, Vilar-Gómez E, Crespo J, García-Cortés M, Reig M, Navarro JM, Gallego-Durán R, Genescà J, Arias-Loste MT, Pareja MJ, Albillos A, Muntané J, Jorquera F, Solà E, Hernández-Guerra M, Rojo MÁ, Salmerón J, Caballería L, Diago M, Molina E, Bataller R, Romero-Gómez M. Erratum to «Consensus document. Management of non-alcoholic fatty liver disease (NAFLD). Clinical practice guideline» [Gastroenterol Hepatol. 2018;41(5):328-349]. Gastroenterol Hepatol 2018; 41:475-476. [PMID: 29929828 DOI: 10.1016/j.gastrohep.2018.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Rocío Aller
- Servicio de Gastroenterología, Hospital Clínico Universitario de Valladolid, Facultad de Medicina, Universidad de Valladolid, Centro de Investigación de Endocrinología y Nutrición, Facultad de Medicina, Universidad de Valladolid, Valladolid, España
| | - Conrado Fernández-Rodríguez
- Servicio de Gastroenterología, Hospital Universitario Fundación Alcorcón, Facultad de Medicina, Universidad Rey Juan Carlos, Alcorcón, Madrid, España
| | - Oreste Lo Iacono
- Servicio de Aparato Digestivo, Hospital del Tajo, Aranjuez, Madrid, España
| | - Rafael Bañares
- Servicio de Gastroenterología y Hepatología, Hospital Gregorio Marañón, Madrid, España
| | - Javier Abad
- Servicio de Gastroenterología y Hepatología, Hospital Puerta de Hierro-Majadahonda, Majadahonda, Madrid, España
| | | | | | - Joan Caballería
- Unidad de Hepatología, Hospital Clínic, IDIBAPS, CIBERehd, Barcelona, España
| | - Marina Berenguer
- Unidad de Hepatología y Trasplante Hepático, Hospital Universitario la Fe, Instituto de Investigación Sanitaria y CIBERehd, Valencia, España
| | - Manuel Rodríguez-Perálvarez
- Unidad de Trasplante Hepático, Unidad de Gestión Clínica de Aparato Digestivo, Hospital Reina Sofía, Córdoba, España
| | - José López Miranda
- Unidad de Trasplante Hepático, Unidad de Gestión Clínica de Aparato Digestivo, Hospital Reina Sofía, Córdoba, España
| | - Eduardo Vilar-Gómez
- Unidad de Gestión Clínica de Aparato Digestivo, CIBERehd, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, España
| | - Javier Crespo
- Servicio de Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, CIBERehd, Instituto de Investigación Valdecilla (IDIVAL), Santander, Cantabria, España
| | - Miren García-Cortés
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Virgen de la Victoria, Málaga, España
| | - María Reig
- Unidad de Hepatología, Hospital Clínic, IDIBAPS, CIBERehd, Barcelona, España
| | - José María Navarro
- Unidad de Hepatología, Servicio de Digestivo, Hospital Costa del Sol, Marbella, Málaga, España
| | - Rocío Gallego-Durán
- Unidad de Gestión Clínica de Aparato Digestivo, CIBERehd, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, España
| | - Joan Genescà
- Servicio de Medicina Interna-Hepatología, Hospital Universitario Vall d'Hebron, Institut de Recerca Vall d'Hebron (VHIR), Universitat Autònoma de Barcelona, CIBERehd, Barcelona, España
| | - María Teresa Arias-Loste
- Servicio de Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, CIBERehd, Instituto de Investigación Valdecilla (IDIVAL), Santander, Cantabria, España
| | - María Jesús Pareja
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital Juan Ramón Jiménez, Huelva, España
| | - Agustín Albillos
- Servicio de Gastroenterología y Hepatología, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), CIBERehd, Madrid, España
| | - Jordi Muntané
- Unidad de Gestión Clínica de Cirugía General y Aparato Digestivo, Hospital Universitario Virgen del Rocío/Instituto de Biomedicina de Sevilla/CSIC/Universidad de Sevilla, CIBERehd, Sevilla, España
| | - Francisco Jorquera
- Servicio de Aparato Digestivo, Complejo Asistencial Universitario de León, IBIOMED y CIBERehd, León, España
| | - Elsa Solà
- Unidad de Hepatología, Hospital Clínic, IDIBAPS, CIBERehd, Barcelona, España
| | | | - Miguel Ángel Rojo
- Servicio de Gastroenterología, Hospital Clínico Universitario de Valladolid, Facultad de Medicina, Universidad de Valladolid, Centro de Investigación de Endocrinología y Nutrición, Facultad de Medicina, Universidad de Valladolid, Valladolid, España
| | - Javier Salmerón
- Unidad de Gestión Clínica de Aparato Digestivo, Hospital San Cecilio, Granada, España
| | - Llorenc Caballería
- Unidad de Apoyo a la Investigación de la Atención Primaria en la Metropolitana Norte, Barcelona, España
| | - Moisés Diago
- Servicio de Aparato Digestivo, Hospital General de Valencia, Valencia, España
| | - Esther Molina
- Unidad de Hepatología, Servicio de Aparato Digestivo, Hospital Clínico-Xerencia de Xestión Integrada de Santiago de Compostela, Santiago de Compostela, La Coruña, España
| | - Ramón Bataller
- Liver Unit, University of Pittsburg Medical Center, Pittsburg, Pennsylvania, Estados Unidos
| | - Manuel Romero-Gómez
- Unidad de Gestión Clínica de Aparato Digestivo, CIBERehd, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, España.
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Aller R, Fernández-Rodríguez C, Lo Iacono O, Bañares R, Abad J, Carrión JA, García-Monzón C, Caballería J, Berenguer M, Rodríguez-Perálvarez M, Miranda JL, Vilar-Gómez E, Crespo J, García-Cortés M, Reig M, Navarro JM, Gallego R, Genescà J, Arias-Loste MT, Pareja MJ, Albillos A, Muntané J, Jorquera F, Solà E, Hernández-Guerra M, Rojo MÁ, Salmerón J, Caballería L, Diago M, Molina E, Bataller R, Romero-Gómez M. Consensus document. Management of non-alcoholic fatty liver disease (NAFLD). Clinical practice guideline. Gastroenterol Hepatol 2018; 41:328-349. [PMID: 29631866 DOI: 10.1016/j.gastrohep.2017.12.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 09/11/2017] [Accepted: 12/01/2017] [Indexed: 02/07/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the main cause of liver diseases in Spain and the incidence is raising due to the outbreak of type 2 diabetes and obesity. This CPG suggests recommendation about diagnosis, mainly non-invasive biomarkers, and clinical management of this entity. Life-style modifications to achieve weight loss is the main target in the management of NAFLD. Low caloric Mediterranean diet and 200 minutes/week of aerobic exercise are encouraged. In non-responders patients with morbid obesity, bariatric surgery or metabolic endoscopy could be indicated. Pharmacological therapy is indicated in patients with NASH and fibrosis and non-responders to weight loss measures. NAFLD could influence liver transplantation, as a growing indication, the impact of steatosis in the graft viability, de novo NAFLD rate after OLT and a raised cardiovascular risk that modify the management of this entity. The current CPG was the result of the First Spanish NAFLD meeting in Seville.
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Affiliation(s)
- Rocío Aller
- Servicio de Gastroenterología, Hospital Clínico Universitario de Valladolid. Facultad de Medicina, Universidad de Valladolid. Centro de Investigación de Endocrinología y Nutrición, Facultad de Medicina, Universidad de Valladolid, Valladolid, España
| | - Conrado Fernández-Rodríguez
- Servicio de Gastroenterología, Hospital Universitario Fundación Alcorcón. Facultad de Medicina, Universidad Rey Juan Carlos, Alcorcón, Madrid, España
| | - Oreste Lo Iacono
- Servicio de Aparato Digestivo, Hospital del Tajo, Aranjuez, Madrid, España
| | - Rafael Bañares
- Servicio de Gastroenterología y Hepatología, Hospital Gregorio Marañón, Madrid, España
| | - Javier Abad
- Servicio de Gastroenterología y Hepatología, Hospital Puerta de Hierro, Madrid, España
| | | | | | - Joan Caballería
- Unidad de Hepatología, Hospital Clínic, IDIBAPS, CIBERehd, Barcelona, España
| | - Marina Berenguer
- Servicio de Medicina Digestiva, Hospital La Fe, Valencia, España
| | | | - José López Miranda
- Unidad de Trasplante Hepático, UGC de Aparato Digestivo, Hospital Reina Sofía, Córdoba, España
| | - Eduardo Vilar-Gómez
- UGC Aparato Digestivo, CIBERehd, Instituto de Biomedicina de Sevilla. Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, España
| | - Javier Crespo
- Servicio Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria. CIBERehd. Instituto de Investigación Valdecilla (IDIVAL), Santander, España
| | | | - María Reig
- Unidad de Hepatología, Hospital Clínic, IDIBAPS, CIBERehd, Barcelona, España
| | - José María Navarro
- Unidad de Hepatología, Servicio de Digestivo, Hospital Costa del Sol, Marbella, Málaga, España
| | - Rocío Gallego
- UGC Aparato Digestivo, CIBERehd, Instituto de Biomedicina de Sevilla. Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, España
| | - Joan Genescà
- Servicio de Medicina Interna-Hepatología, Hospital Universitario Vall d'Hebron, Institut de Recerca Vall d'Hebron (VHIR), Universitat Autònoma de Barcelona, CIBERehd , Barcelona, España
| | - María Teresa Arias-Loste
- Servicio Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria. CIBERehd. Instituto de Investigación Valdecilla (IDIVAL), Santander, España
| | | | - Agustín Albillos
- Servicio de Gastroenterología y Hepatología, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS). CIBERehd, Madrid, España
| | - Jordi Muntané
- UGC de Cirugía General y Aparato Digestivo, Hospital Universitario Virgen del Rocío/Instituto de Biomedicina de Sevilla/CSIC/Universidad de Sevilla. CIBERehd, Sevilla, España
| | - Francisco Jorquera
- Servicio de Aparato Digestivo, Complejo Asistencial Universitario de León, IBIOMED y CIBERehd, León, España
| | - Elsa Solà
- Unidad de Hepatología, Hospital Clínic, IDIBAPS, CIBERehd, Barcelona, España
| | | | - Miguel Ángel Rojo
- Servicio de Gastroenterología, Hospital Clínico Universitario de Valladolid. Facultad de Medicina, Universidad de Valladolid. Centro de Investigación de Endocrinología y Nutrición, Facultad de Medicina, Universidad de Valladolid, Valladolid, España
| | - Javier Salmerón
- UGC de Aparato Digestivo, Hospital San Cecilio, Granada, España
| | - Llorenc Caballería
- Unidad de Apoyo a la Investigación de la Atención Primaria en la Metropolitana Norte, Barcelona, España
| | - Moisés Diago
- Servicio de Aparato Digestivo, Hospital General de Valencia, Valencia, España
| | - Esther Molina
- Unidad de Hepatología, Servicio de Aparato Digestivo, Hospital Clínico-Xerencia de Xestión Integrada de Santiago de Compostela, Santiago de Compostela, La Coruña, España
| | - Ramón Bataller
- Liver Unit, University of Pittsburg Medical Center, Pittsburg, Pennsylvania, Estados Unidos
| | - Manuel Romero-Gómez
- UGC Aparato Digestivo, CIBERehd, Instituto de Biomedicina de Sevilla. Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, España.
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22
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Muñoz de Rueda P, Jiménez-Ruiz SM, Quiles R, Pavón-Castillero EJ, Muñoz-Gámez JA, Casado J, Gila A, Ruiz-Extremera A, Salmerón J. The antigenic variability of HCV in viral HLA-Ag binding is related to the activation of the host immune response. Sci Rep 2017; 7:15513. [PMID: 29138492 PMCID: PMC5686107 DOI: 10.1038/s41598-017-15605-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 10/23/2017] [Indexed: 01/17/2023] Open
Abstract
Our previous data show that hepatitis C virus (HCV) genotype 1 patients expressing the HLA-DQB1 * 0301 allele have a combined response probability of 69%, while the remaining 31% do not respond, probably because the HCV immunodominant epitope (IE) against the DQB1 * 0301 allele is mutated. HCV IE (region sequenced in NS3 is a region encoding aa 1253–1272) from 37 patients (21 Sustained Virological Response, SVR; 16 non-SVR) HLA-DQB1 * 0301+, were analysed by pyrosequencing. In vitro cultures were also determined by CD4+ proliferation, using non-mutated IE (wild-type synthetic peptide) and synthetic mutated peptide. The pyrosequencing study revealed 34 different haplotypes. The SVR patients had fewer haplotypes (P = 0.07), mutations/haplotypes (P = 0.01) and polymorphic sites (P = 0.02) than non-SVR. Three polymorphic sites were associated with the non-SVR patients: haplotype 7 (L5P); haplotype 11 (L7P); and haplotype 15, (L15S) (P = 0.02). The in vitro study (n = 7) showed that in 4/7 patients (Group 1) the CD4+ proliferation obtained with wild-type synthetic peptide was higher than that obtained with the negative control and with the synthetic mutated peptide (P = 0.039). However, in the remaining 3/7 patients (Group 2) this pattern was not observed (P = 0.7). Our findings suggest that HLA-DQB1 * 0301+ patients with high antigenic variability in HCV IE (NS31253-1272) have a lower SVR rate, due to reduced CD4+ proliferation as a result of incorrect viral HLA-Ag binding.
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Affiliation(s)
- P Muñoz de Rueda
- Clinical Management Unit of Digestive Diseases, Research Unit, San Cecilio University Hospital, Granada, 18012, Spain.,CIBER for Liver and Digestive Disease (CIBERehd), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Instituto De Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, 18012, Spain
| | | | - R Quiles
- Clinical Management Unit of Digestive Diseases, Research Unit, San Cecilio University Hospital, Granada, 18012, Spain. .,CIBER for Liver and Digestive Disease (CIBERehd), Instituto de Salud Carlos III, Madrid, 28029, Spain. .,Instituto De Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, 18012, Spain.
| | - E J Pavón-Castillero
- Clinical Management Unit of Digestive Diseases, Research Unit, San Cecilio University Hospital, Granada, 18012, Spain.,Instituto De Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, 18012, Spain
| | - J A Muñoz-Gámez
- Clinical Management Unit of Digestive Diseases, Research Unit, San Cecilio University Hospital, Granada, 18012, Spain.,Instituto De Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, 18012, Spain
| | - J Casado
- Clinical Management Unit of Digestive Diseases, Research Unit, San Cecilio University Hospital, Granada, 18012, Spain.,Instituto De Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, 18012, Spain
| | - A Gila
- Clinical Management Unit of Digestive Diseases, Research Unit, San Cecilio University Hospital, Granada, 18012, Spain.,CIBER for Liver and Digestive Disease (CIBERehd), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Instituto De Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, 18012, Spain
| | - A Ruiz-Extremera
- CIBER for Liver and Digestive Disease (CIBERehd), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Instituto De Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, 18012, Spain.,Paediatric Unit, San Cecilio University Hospital and Virgen de las Nieves University Hospital, Granada, 18012, Spain.,Paediatric Department, Granada University, Granada, 18016, Spain
| | - J Salmerón
- Clinical Management Unit of Digestive Diseases, Research Unit, San Cecilio University Hospital, Granada, 18012, Spain.,CIBER for Liver and Digestive Disease (CIBERehd), Instituto de Salud Carlos III, Madrid, 28029, Spain.,Instituto De Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, 18012, Spain.,Medicine Departament, Granada University, Granada, 18016, Spain
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23
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Rodríguez M, Pascasio JM, Fraga E, Fuentes J, Prieto M, Sánchez-Antolín G, Calleja JL, Molina E, García-Buey ML, Blanco MÁ, Salmerón J, Bonet ML, Pons JA, González JM, Casado MÁ, Jorquera F. Tenofovir vs lamivudine plus adefovir in chronic hepatitis B: TENOSIMP-B study. World J Gastroenterol 2017; 23:7459-7469. [PMID: 29151700 PMCID: PMC5685852 DOI: 10.3748/wjg.v23.i41.7459] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 05/22/2017] [Accepted: 06/19/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To demonstrate the non-inferiority (15% non-inferiority limit) of monotherapy with tenofovir disoproxil fumarate (TDF) vs the combination of lamivudine (LAM) plus adefovir dipivoxil (ADV) in the maintenance of virologic response in patients with chronic hepatitis B (CHB) and prior failure with LAM.
METHODS This study was a Phase IV prospective, randomized, open, controlled study with 2 parallel groups (TDF and LAM+ADV) of adult patients with hepatitis B e antigen (HBeAg)-negative CHB, prior failure with LAM, on treatment with LAM+ADV for at least 6 mo, without prior resistance to ADV and with an undetectable viral load at the start of the study, in 14 Spanish hospitals. The follow-up time for each patient was 48 wk after randomization, with quarterly visits in which the viral load, biochemical and serological parameters, adverse effects, adherence to treatment and consumption of hospital resources were analysed.
RESULTS Forty-six patients were evaluated [median age: 55.4 years (30.2-75.2); 84.8% male], including 22 patients with TDF and 24 with LAM+ADV. During study development, hepatitis B virus DNA (HBV-DNA) remained undetectable, all patients remained HBeAg negative, and hepatitis B surface antigen (HBsAg) positive. Alanine aminotransferase (ALT) values at the end of the study were similar in the 2 groups (25.1 ± 7.65, TDF vs 24.22 ± 8.38, LAM+ADV, P = 0.646). No significant changes were observed in creatinine or serum phosphorus values in either group. No significant differences between the 2 groups were noted in the identification of adverse effects (AEs) (53.8%, TDF vs 37.5%, LAM+ADV, P = 0.170), and none of the AEs which occurred were serious. Treatment adherence was 95.5% and 83.3% in the TDF and the LAM+ADV groups, respectively (P = 0.488). The costs associated with hospital resource consumption were significantly lower with the TDF treatment than the LAM+ADV treatment (€4943 ± 1059 vs €5811 ± 1538, respectively, P < 0.001).
CONCLUSION TDF monotherapy proved to be safe and not inferior to the LAM+ADV combination therapy in maintaining virologic response in patients with CHB and previous LAM failure. In addition, the use of TDF generated a significant savings in hospital costs.
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Affiliation(s)
- Manuel Rodríguez
- Division of Gastroenterology and Hepatology. Hospital Universitario Central de Asturias, Oviedo 33011, Spain
| | - Juan Manuel Pascasio
- Unit for the Clinical Management of Digestive Diseases, IBIS, Hospital Universitario Virgen del Rocío, Sevilla 41013, Spain and CIBERehd
| | - Enrique Fraga
- Liver Transplantation and Hepatology Unit, Gastroenterology Service, Hospital Universitario Reina Sofía, Córdoba 14004, Spain
| | - Javier Fuentes
- Digestive Medicine Service, Hospital Universitario Miguel Servet, Zaragoza 50009, Spain
| | - Martín Prieto
- Hepatology Unit, Digestive Medicine Service, Hospital Universitari i Politècnic La Fe, Valencia 46026, Spain and CIBERehd
| | | | - José Luis Calleja
- Liver Unit, Hospital Universitario Puerta de Hierro de Majadahonda, Universidad Autónoma de Madrid, Madrid 28049, Spain
| | - Esther Molina
- Digestive Medicine Service, Hospital Clínico de Santiago de Compostela, La Coruña 15706, Spain
| | | | - María Ángeles Blanco
- Digestive Medicine Service, Hospital General Universitario Gregorio Marañón, Madrid 28007, España
| | - Javier Salmerón
- Digestive Medicine Unit, Complejo Hospitalario de Granada, Granada 18014, Spain
| | - María Lucía Bonet
- Digestive Medicine Service, Hospital Universitario Son Espases, Palma de Mallorca 07120, Spain
| | - José Antonio Pons
- Hepatology Unit, IMIB Hospital Universitario Virgen de la Arrixaca, Murcia 30120, Spain
| | - José Manuel González
- Digestive Medicine Service, Hospital Clínico Universitario de Valladolid, Valladolid 47003, Spain
| | | | - Francisco Jorquera
- Division of Gastroenterology and Hepatology, Complejo Asistencial Universitario de León, León 24001, Spain CIBERehd and IBIOMED León
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24
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Martín-Guerrero SM, Muñoz-Gámez JA, Carrasco MC, Salmerón J, Martín-Estebané M, Cuadros MA, Navascués J, Martín-Oliva D. Poly(ADP-ribose)polymerases inhibitors prevent early mitochondrial fragmentation and hepatocyte cell death induced by H2O2. PLoS One 2017; 12:e0187130. [PMID: 29073231 PMCID: PMC5658148 DOI: 10.1371/journal.pone.0187130] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 07/21/2017] [Accepted: 10/13/2017] [Indexed: 12/20/2022] Open
Abstract
Poly(ADP-ribose)polymerases (PARPs) are a family of NAD+ consuming enzymes that play a crucial role in many cellular processes, most clearly in maintaining genome integrity. Here, we present an extensive analysis of the alteration of mitochondrial morphology and the relationship to PARPs activity after oxidative stress using an in vitro model of human hepatic cells. The following outcomes were observed: reactive oxygen species (ROS) induced by oxidative treatment quickly stimulated PARPs activation, promoted changes in mitochondrial morphology associated with early mitochondrial fragmentation and energy dysfunction and finally triggered apoptotic cell death. Pharmacological treatment with specific PARP-1 (the major NAD+ consuming poly(ADP-ribose)polymerases) and PARP-1/PARP-2 inhibitors after the oxidant insult recovered normal mitochondrial morphology and, hence, increased the viability of human hepatic cells. As the PARP-1 and PARP-1/PARP-2 inhibitors achieved similar outcomes, we conclude that most of the PARPs effects were due to PARP-1 activation. NAD+ supplementation had similar effects to those of the PARPs inhibitors. Therefore, PARPs activation and the subsequent NAD+ depletion are crucial events in decreased cell survival (and increased apoptosis) in hepatic cells subjected to oxidative stress. These results suggest that the alterations in mitochondrial morphology and function seem to be related to NAD+ depletion, and show for the first time that PARPs inhibition abrogates mitochondrial fragmentation. In conclusion, the inhibition of PARPs may be a valuable therapeutic approach for treating liver diseases, by reducing the cell death associated with oxidative stress.
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Affiliation(s)
| | - José A. Muñoz-Gámez
- Instituto de Investigación Biomédica (ibsGranada), Hospital Universitario San Cecilio, Granada, Spain
| | - María-Carmen Carrasco
- Departamento de Biología Celular, Facultad de Ciencias, Universidad de Granada, Granada, Spain
| | - Javier Salmerón
- Instituto de Investigación Biomédica (ibsGranada), Hospital Universitario San Cecilio, Granada, Spain
| | - María Martín-Estebané
- Departamento de Biología Celular, Facultad de Ciencias, Universidad de Granada, Granada, Spain
| | - Miguel A. Cuadros
- Departamento de Biología Celular, Facultad de Ciencias, Universidad de Granada, Granada, Spain
| | - Julio Navascués
- Departamento de Biología Celular, Facultad de Ciencias, Universidad de Granada, Granada, Spain
| | - David Martín-Oliva
- Departamento de Biología Celular, Facultad de Ciencias, Universidad de Granada, Granada, Spain
- * E-mail:
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25
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Martín-Guerrero SM, León J, Quiles-Perez R, Belmonte L, Martin-Oliva D, Ruiz-Extremera Á, Salmerón J, Muñoz-Gámez JA. Expression and Single Nucleotide Polymorphism of Poly (ADPRibose) Polymerase-1 in Gastrointestinal Tumours: Clinical Involvement. Curr Med Chem 2017; 24:2156-2173. [PMID: 28302009 DOI: 10.2174/0929867324666170316115039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 10/13/2016] [Revised: 02/28/2017] [Accepted: 03/15/2017] [Indexed: 11/22/2022]
Abstract
Poly(ADP-ribose) polymerase-1 (PARP-1) is a nuclear enzyme that plays a critical role in diverse cellular functions, such as DNA damage detection and repair, transcriptional regulation and cell death. Furthermore, PARP-1 has emerged as a key player in the pathogenesis of multiple inflammatory diseases and has become a promising target for the treatment of cardiovascular disorders, neurodegenerative diseases and cancer. An increasing body of evidence has linked alterations in the expression levels of PARP-1, enzymatic activity and presence of polymorphism to gastrointestinal malignancies, including oesophageal, gastric, pancreas, liver and colorectal cancers. PARP inhibition has been proposed as a valuable strategy for treating these gastrointestinal disorders. This paper summarises the most significant current literature on the involvement of PARP-1 in gastrointestinal cancer, focusing in particular on its role in the development and occurrence of tumours, providing information about clinical trials and exploring therapeutic possibilities.
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Affiliation(s)
| | - Josefa León
- Biomedical Research Institute of Granada (ibs.GRANADA), Granada. Spain
| | - Rosa Quiles-Perez
- Biomedical Research Institute of Granada (ibs.GRANADA), Granada. Spain
| | - Laura Belmonte
- Doctoral programme in Regenerative Medicine, Granada University, Granada. Spain
| | | | | | - Javier Salmerón
- Biomedical Research Institute of Granada (ibs.GRANADA), Granada. Spain
| | - José Antonio Muñoz-Gámez
- Laboratory of Medical Research, Clinical Management Unit of Digestive Disease, San Cecilio University Hospital, Avda de Madrid s/n, 18012, Granada. Spain
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26
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López-Rodríguez R, Hernández-Bartolomé Á, Borque MJ, Rodríguez-Muñoz Y, Martín-Vílchez S, García-Buey L, González-Moreno L, Real-Martínez Y, Muñoz de Rueda P, Salmerón J, Vidal-Castiñeira JR, López-Larrea C, Rodrigo L, Moreno-Otero R, Sanz-Cameno P. Interferon-related genetic markers of necroinflammatory activity in chronic hepatitis C. PLoS One 2017; 12:e0180927. [PMID: 28704535 PMCID: PMC5507534 DOI: 10.1371/journal.pone.0180927] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 05/08/2017] [Accepted: 06/23/2017] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Chronic hepatitis C (CHC) is a major cause of liver disease worldwide which often leads to progressive liver inflammation, fibrosis, cirrhosis and hepatocellular carcinoma (HCC). CHC displays heterogeneous progression depending on a broad set of factors, some of them intrinsic to each individual such as the patient's genetic profile. This study aims to evaluate the contribution of certain genetic variants of crucial interferon alpha and lambda signaling pathways to the hepatic necroinflammatory activity (NIA) grade of CHC patients. METHODS NIA was evaluated in 119 CHC patients by METAVIR scale and classified as low (NIA = 0-2, n = 80) or high grade (NIA = 3, n = 39). In a candidate gene approach, 64 SNPs located in 30 different genes related to interferon pathways (IL-28B, IFNAR1-2, JAK-STAT and OAS1-3, among others) were genotyped using the Illumina GoldenGate® Genotyping Assay. Statistical association was determined by logistic regression and expressed as OR and 95% CI. Those SNPs significantly associated were further adjusted by other covariates. RESULTS Seven SNPs located in IL-28B (rs12979860), JAK1 (rs11576173 and rs1497056), TYK2 (rs280519), OAS1 (rs2057778), SOCS1 (rs33932899) and RNASEL (rs3738579) genes were significantly related to severe NIA grade (p<0.05). Regarding to clinical variables, elevated NIA was notably associated with aspartate aminotransferase (AST) serum levels >40 IU/L (p<0.05) but not with other clinical factors. Multivariate logistic regression analysis of these factors reflected that AST (>40 IU/L), TYK2 rs280519 (G allele) and RNASEL rs3738579 (G allele) were factors independently associated with elevated NIA (p<0.05). AST concentration showed a moderate AUC value (AUC = 0.63), similar to TYK2 (rs280519) and RNASEL (rs3738579) SNPs (AUC = 0.61, both) in the ROC_AUC analysis. Interestingly, the model including all significant variables reached a considerable predictive value (AUC = 0.74). CONCLUSION The identified genetic variants in interferon signaling pathways may constitute useful prognostic markers of CHC progression. Further validation in larger cohorts of patients is needed.
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Affiliation(s)
- Rosario López-Rodríguez
- Liver Unit, Gastroenterology Service, Instituto Investigación Sanitaria Princesa, IIS-IP, Madrid, Spain
| | - Ángel Hernández-Bartolomé
- Liver Unit, Gastroenterology Service, Instituto Investigación Sanitaria Princesa, IIS-IP, Madrid, Spain
| | - María Jesús Borque
- Molecular Biology Unit, Instituto Investigación Sanitaria Princesa, IIS-IP, Madrid, Spain
| | - Yolanda Rodríguez-Muñoz
- Liver Unit, Gastroenterology Service, Instituto Investigación Sanitaria Princesa, IIS-IP, Madrid, Spain
| | - Samuel Martín-Vílchez
- Liver Unit, Gastroenterology Service, Instituto Investigación Sanitaria Princesa, IIS-IP, Madrid, Spain
| | - Luisa García-Buey
- Liver Unit, Gastroenterology Service, Instituto Investigación Sanitaria Princesa, IIS-IP, Madrid, Spain
- CIBERehd, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Leticia González-Moreno
- Liver Unit, Gastroenterology Service, Instituto Investigación Sanitaria Princesa, IIS-IP, Madrid, Spain
| | - Yolanda Real-Martínez
- Liver Unit, Gastroenterology Service, Instituto Investigación Sanitaria Princesa, IIS-IP, Madrid, Spain
| | - Paloma Muñoz de Rueda
- CIBERehd, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Gastroenterology Unit, Hospital Universitario San Cecilio, Granada, Spain
| | - Javier Salmerón
- CIBERehd, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Gastroenterology Unit, Hospital Universitario San Cecilio, Granada, Spain
| | | | - Carlos López-Larrea
- Inmunology Service, Hospital, Universitario Central de Asturias, Oviedo, Spain
| | - Luis Rodrigo
- Digestive Service, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Ricardo Moreno-Otero
- Liver Unit, Gastroenterology Service, Instituto Investigación Sanitaria Princesa, IIS-IP, Madrid, Spain
- CIBERehd, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Paloma Sanz-Cameno
- Liver Unit, Gastroenterology Service, Instituto Investigación Sanitaria Princesa, IIS-IP, Madrid, Spain
- CIBERehd, Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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27
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Muñoz de Rueda P, Fuentes Rodríguez JM, Quiles Pérez R, Gila Medina A, Martín Álvarez AB, Casado Ruíz J, Ruíz Extremera A, Salmerón J. Hepatitis C virus NS5A region mutation in chronic hepatitis C genotype 1 patients who are non-responders to two or more treatments and its relationship with response to a new treatment. World J Gastroenterol 2017; 23:4538-4547. [PMID: 28740342 PMCID: PMC5504369 DOI: 10.3748/wjg.v23.i25.4538] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 02/24/2017] [Accepted: 03/06/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To determine the number of mutations in the NS5A region of the hepatitis C virus (HCV) and its relationship to the response to antiviral therapy in patients with chronic hepatitis C genotype 1 who are non-responders to two or more treatments.
METHODS Sequences within HCV NS5A [PKR binding domain (PKRBD) and the interferon-sensitivity-determining region (ISDR)] were analysed via direct sequencing in a selected cohort of 72 patients, with a total of 201 treatments [interferon-alpha (IFN-α), n = 49; IFN-α + ribavirin (RBV), n = 75; pegylated (peg) IFN-α + RBV, n = 47; first-generation direct-acting antivirals (DAAs), n = 13; and second-generation DAAs, n = 17]. Of these, 48/201 achieved a sustained virological response (SVR) and 153/201 achieved no virological response (NVR).
RESULTS For both regions, treatments resulting in SVR were associated with more baseline mutations than were treatments resulting in NVR (SVR vs NVR; PKRBD: 5.82 ± 3 vs 4.86 ± 2 mutations, P = 0.045; ISDR: 2.65 ± 2 vs 1.51 ± 1.7 mutations, P = 0.005). A decrease or no change in the number of mutations over time between treatments in the PKRBD or ISDR, as shown by sequencing, was associated with patients who usually failed to respond to treatment (PKRBD, P = 0.02; ISDR, P = 0.001). Moreover, patients showing a post-treatment baseline viral load > 600000 IU/mL and increased ISDR mutations with respect to the previous treatment were 9.21 times more likely to achieve SVR (P = 0.001).
CONCLUSION The obtained results show that among patients who have shown no response to two or more antiviral treatments, the likelihood of achieving SVR increases with the genetic variability in the ISDR region (≥ 2 mutations or number of substitutions from the HCV-J and HCV-1 prototype), especially when the viral load is greater than 600000 IU/mL.
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Fernández Carrillo C, Lens S, Llop E, Pascasio JM, Crespo J, Arenas J, Fernández I, Baliellas C, Carrión JA, de la Mata M, Buti M, Castells L, Albillos A, Romero M, Turnes J, Pons C, Moreno-Planas JM, Moreno-Palomares JJ, Fernández-Rodriguez C, García-Samaniego J, Prieto M, Fernández Bermejo M, Salmerón J, Badia E, Salcedo M, Herrero JI, Granados R, Blé M, Mariño Z, Calleja JL. Treatment of hepatitis C virus infection in patients with cirrhosis and predictive value of model for end-stage liver disease: Analysis of data from the Hepa-C registry. Hepatology 2017; 65:1810-1822. [PMID: 28170112 DOI: 10.1002/hep.29097] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 01/27/2017] [Accepted: 01/27/2017] [Indexed: 12/11/2022]
Abstract
UNLABELLED Direct-acting antiviral agents (DAAs) are highly effective and well tolerated in patients with chronic hepatitis C virus infection, including those with compensated cirrhosis. However, fewer data are available in patients with more advanced liver disease. Our retrospective, noninterventional, national, multicenter study in patients from the Spanish Hepa-C registry investigated the effectiveness and safety of interferon-free DAA regimens in patients with advanced liver disease, including those with decompensated cirrhosis, in routine practice (all currently approved regimens were registered). Patients transplanted during treatment or within 12 weeks of completing treatment were excluded. Among 843 patients with cirrhosis (Child-Turcotte-Pugh [CTP] class A, n = 564; CTP class B/C, n = 175), 90% achieved sustained virologic response 12 weeks after treatment (SVR12). Significant differences in SVR12 and relapse rates were observed between CTP class A and CTP class B/C patients (94% versus 78%, and 4% versus 14%, respectively; both P < 0.001). Serious adverse events (SAEs) were more common in CTP class B/C versus CTP class A patients (50% versus 12%, respectively; P < 0.001). Incident decompensation was the most common serious adverse event (7% overall). Death rate during the study period was 16/843 (2%), significantly higher among CTP class B/C versus CTP class A patients (6.4% versus 0.9%; P < 0.001). Baseline Model for End-Stage Liver Disease (MELD) score alone (cut-off 18) was the best predictor of survival. CONCLUSION Patients with decompensated cirrhosis receiving DAAs present lower response rates and experience more SAEs. In this setting, a MELD score ≥18 may help clinicians to identify those patients with a higher risk of complications and to individualize treatment decisions. (Hepatology 2017;65:1810-1822).
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Affiliation(s)
- Carlos Fernández Carrillo
- Liver Unit, Hospital Universitario Puerta de Hierro-Majadahonda, IDIPHIM, CIBERehd, Majadahonda, Madrid, Spain
| | - Sabela Lens
- Liver Unit, Hospital Clínic de Barcelona, University of Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain
| | - Elba Llop
- Liver Unit, Hospital Universitario Puerta de Hierro-Majadahonda, IDIPHIM, CIBERehd, Majadahonda, Madrid, Spain
| | - Juan Manuel Pascasio
- Department of Gastroenterology, Hospital Universitario Virgen del Rocío, IBIS, CIBERehd, Sevilla, Spain
| | - Javier Crespo
- Gastroenterology and Hepatology Unit, Hospital Universitario Marqués de Valdecilla, Santander, IDIVAL, Universidad de Cantabria, Santander, Spain
| | - Juan Arenas
- Department of Gastroenterology, Hospital Universitario Donostia, San Sebastián, Spain
| | - Inmaculada Fernández
- Department of Gastroenterology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Carme Baliellas
- Digestive Service, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - José Antonio Carrión
- Liver Section, Gastroenterology Department, Hospital del Mar, IMIM, Barcelona, Spain
| | - Manuel de la Mata
- Hepatology & Liver Transplant Unit, Hospital Universitario Reina Sofía, IMIBIC, CIBERehd, Córdoba, Spain
| | - Maria Buti
- Liver Unit, Hospital Universitario Vall d'Hebrón, CIBERehd, Barcelona, Spain
| | - Lluís Castells
- Liver Unit, Hospital Universitario Vall d'Hebrón, CIBERehd, Barcelona, Spain
| | - Agustín Albillos
- Gastroenterology and Hepatology Department, Hospital Universitario Ramón y Cajal, University of Alcalá, IRYCIS, CIBERehd, Madrid, Spain
| | - Manuel Romero
- Digestive Diseases Unit, Hospital Universitario Virgen de Valme, CIBERehd, Sevilla, Spain
| | - Juan Turnes
- Department of Gastroenterology, Complejo Hospitalario Universitario de Pontevedra and IISGS, Pontevedra, Spain
| | - Clara Pons
- Digestive Service, Hospital General Universitario de Castellón, Castellón de la Plana, Spain
| | - José María Moreno-Planas
- Department of Gastroenterology, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | | | | | | | - Martín Prieto
- Servicio de Medicina Digestiva, Unidad de Hepatología, Hospital Universitari i Politècnic La Fe and CIBERehd, Valencia, Spain
| | | | - Javier Salmerón
- Digestive Service, Hospital Universitario San Cecilio, CIBERehd, Granada, Spain
| | - Ester Badia
- Digestive Service, Hospital Universitario de Burgos, Burgos, Spain
| | - Magdalena Salcedo
- Liver Unit, Hospital General Universitario Gregorio Marañón, IiSGM, Madrid, Spain
| | | | - Rafael Granados
- Internal Medicine Service, H. U. de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain
| | | | - Zoe Mariño
- Liver Unit, Hospital Clínic de Barcelona, University of Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain
| | - José Luis Calleja
- Liver Unit, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid and CIBERehd, Madrid, Spain
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Ruiz-Extremera A, Pavón-Castillero EJ, Florido M, Muñoz de Rueda P, Muñoz-Gámez JA, Casado J, Carazo A, Quiles R, Jiménez-Ruiz SM, Gila A, Luna JD, León J, Salmerón J. Influence of HLA class I, HLA class II and KIRs on vertical transmission and chronicity of hepatitis C virus in children. PLoS One 2017; 12:e0172527. [PMID: 28225833 PMCID: PMC5321427 DOI: 10.1371/journal.pone.0172527] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 02/06/2017] [Indexed: 12/12/2022] Open
Abstract
Background & aim There is evidence that maternal viral load of HCV during delivery influences the risk for Mother-to-child transmission (MTCT), but this does not explain all cases. We study the role of the immunogenetic profile (HLA, KIRs and KIR-ligand binding) of mothers and children in HCV-MTCT and in chronicity in the children. Methodology 79 HCV-RNA (+) mothers and their 98 children were included. 24 children were infected, becoming chronic in 8 cases and clearing in 16. HLA-class-I and II and KIRs were determined by Luminex. Results MTCT study: The presence of HLA-C1-ligand in mothers and/or their children reduces the risk of transmission (mothers: Pc = 0.011, children: P = 0.033), whereas the presence of HLA-C2C2-ligand in mothers increases it (Pc = 0.011). In children KIR2DL3-HLA-C1 is a protector factor (Pc = 0.011). Chronicity in children study: Maternal DQA1*01 allele (Pc = 0.027), KIR2DS1 (Pc = 0.011) or KIR3DS1 (Pc = 0.011) favours chronicity in the child. The presence of the DQB1*03 allele (Pc = 0.027) and KIR2DS3 (P = 0.056) in the child and homozygosity for KIR3DL1/3DL1 (Pc = 0.011) and for the HLA-Bw4/Bw4 ligand (P = 0.027) is associated with viral clearance, whereas the presence of HLA-Bw6 ligand (P = 0.027), the binding of KIR3DS1-HLA-Bw4 (P = 0.037) and heterozygosity for KIR3DL1/3DS1 (Pc = 0.011) favour viral chronicity. Mother/child allele matching: In the joint HLA analysis, matching was greater between mothers and children with chronic infection vs those who had cleared the virus (67%±4.1 vs 57%±1.2, P = 0.003). Conclusions The HLA-C1 ligand in the mother is related to MTCT, while several genetic factors of the mother or child are involved in the chronification or clearance of infection in the child. Matching allelic data is considered to be an indicator of HCV chronicity in the child and can be used as a potential prognostic test. This implies that NK cells may play a previously undocumented role in protecting against MTCT and that both NK cell immunity and adaptive T-cell responses may influence viral clearance in infected children.
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Affiliation(s)
- A. Ruiz-Extremera
- Paediatric Unit, San Cecilio University Hospital and Virgen de las Nieves University Hospital, Granada, Spain
- Paediatric Department, Granada University, Granada, Spain
- CIBER for Liver and Digestive Disease (CIBERehd), Instituto de Salud Carlos III, Spain
- Instituto de Investigación Biosanitaria de Granada, Spain
| | - E. J. Pavón-Castillero
- Instituto de Investigación Biosanitaria de Granada, Spain
- Clinical Management Unit of Digestive Diseases, Research Unit, San Cecilio University Hospital, Granada, Spain
- * E-mail:
| | - M. Florido
- Clinical Management Unit of Digestive Diseases, Research Unit, San Cecilio University Hospital, Granada, Spain
| | - P. Muñoz de Rueda
- CIBER for Liver and Digestive Disease (CIBERehd), Instituto de Salud Carlos III, Spain
- Instituto de Investigación Biosanitaria de Granada, Spain
- Clinical Management Unit of Digestive Diseases, Research Unit, San Cecilio University Hospital, Granada, Spain
| | - J. A. Muñoz-Gámez
- Instituto de Investigación Biosanitaria de Granada, Spain
- Clinical Management Unit of Digestive Diseases, Research Unit, San Cecilio University Hospital, Granada, Spain
| | - J. Casado
- Instituto de Investigación Biosanitaria de Granada, Spain
- Clinical Management Unit of Digestive Diseases, Research Unit, San Cecilio University Hospital, Granada, Spain
| | - A. Carazo
- Instituto de Investigación Biosanitaria de Granada, Spain
- Clinical Management Unit of Digestive Diseases, Research Unit, San Cecilio University Hospital, Granada, Spain
| | - R. Quiles
- CIBER for Liver and Digestive Disease (CIBERehd), Instituto de Salud Carlos III, Spain
- Instituto de Investigación Biosanitaria de Granada, Spain
- Clinical Management Unit of Digestive Diseases, Research Unit, San Cecilio University Hospital, Granada, Spain
| | - S. M. Jiménez-Ruiz
- Clinical Management Unit of Digestive Diseases, Research Unit, San Cecilio University Hospital, Granada, Spain
- Medicine Department, Granada University, Granada, Spain
| | - A. Gila
- CIBER for Liver and Digestive Disease (CIBERehd), Instituto de Salud Carlos III, Spain
- Instituto de Investigación Biosanitaria de Granada, Spain
- Clinical Management Unit of Digestive Diseases, Research Unit, San Cecilio University Hospital, Granada, Spain
| | - J. D. Luna
- Instituto de Investigación Biosanitaria de Granada, Spain
- Biostatistic Department, Granada University, Granada, Spain
| | - J. León
- CIBER for Liver and Digestive Disease (CIBERehd), Instituto de Salud Carlos III, Spain
- Instituto de Investigación Biosanitaria de Granada, Spain
- Clinical Management Unit of Digestive Diseases, Research Unit, San Cecilio University Hospital, Granada, Spain
| | - J. Salmerón
- CIBER for Liver and Digestive Disease (CIBERehd), Instituto de Salud Carlos III, Spain
- Instituto de Investigación Biosanitaria de Granada, Spain
- Clinical Management Unit of Digestive Diseases, Research Unit, San Cecilio University Hospital, Granada, Spain
- Medicine Department, Granada University, Granada, Spain
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Denova-Gutiérrez E, Clark P, Tucker KL, Muñoz-Aguirre P, Salmerón J. Dietary patterns are associated with bone mineral density in an urban Mexican adult population. Osteoporos Int 2016; 27:3033-40. [PMID: 27198234 DOI: 10.1007/s00198-016-3633-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 02/22/2016] [Accepted: 05/06/2016] [Indexed: 11/29/2022]
Abstract
UNLABELLED Several types of nutrients and foods affect bone mineral density (BMD). However, these nutrients occur together in food groups and dietary patterns, and the overall effects of dietary patterns are not yet well known. INTRODUCTION We evaluated the associations between dietary patterns and BMD among adults participating in the Health Workers Cohort Study. METHODS In a cross-sectional analysis, we examined 6915 Mexican adults aged 20-80 years. All participants completed a validated self-administered food frequency questionnaire (FFQ) and had total, hip, and spine BMD measurements assessed by dual-energy X-ray absorptiometry (DXA). The FFQ included 116 foods, which were grouped into 22 categories and entered into a factor analysis to derive dietary patterns. RESULTS Three dietary patterns emerged-a Prudent, a Refined foods, and a Dairy and fish pattern. After adjustment for potential confounders, those in the highest quintile of the Prudent pattern had lower odds (OR) of low spine BMD (OR = 0.80; 95 % CI 0.68, 0.94; P for trend = 0.031) compared to those in the lowest quintile. In contrast, participants in the highest quintile of the Refined foods pattern had greater odds of low total BMD (OR = 1.74; 95 % CI 1.10, 2.76; P for trend = 0.016) than those in the lowest quintile. Finally, participants in the highest quintile of the Dairy and fish dietary pattern had significantly lower likelihood of having low BMD. CONCLUSION This study identified specific dietary patterns associated with BMD among a Mexican adult population and highlights the importance of promoting food-based prevention strategies for maintaining bone health.
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Affiliation(s)
| | - P Clark
- Hospital Infantil de Mexico Federico Gomez, Ciudad de México, Mexico.
- Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, Mexico.
| | - K L Tucker
- Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - P Muñoz-Aguirre
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Cuernavaca, México
| | - J Salmerón
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Cuernavaca, México
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
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Martinez O, Salmerón J, Guillén M, Casas C. Sensorial and Physicochemical Characteristics of Salmon (Salmo salar) Treated by Different Smoking Processes during Storage. FOOD SCI TECHNOL INT 2016. [DOI: 10.1177/1082013207087816] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study compares the effects of four different smoking processes on the sensorial and physicochemical characteristics of Atlantic salmon (Salmo salar) fillets. Two commercial liquid smoke flavourings (FA and FB) and two types of wood used for cold-smoking wood smoke generation (BS: Beech wood and OS: Oak wood) are investigated. Comparisons were made over a 45 day storage period. Control salmon samples (Cn) (i.e., samples that underwent no smoke treatment of any kind) were characterised by their low colour intensity, firmness, fat release and fibrousness and high adhesiveness, pH, TBARS and TMA values, and a strong amine odour. Fillets treated with smoke flavouring FA showed characteristics very similar to those of the Cn samples, however their colour and smoke odour are more intense and their adhesiveness, amine odour and TMA values lower. Fish treated with smoke flavouring FB show low brightness and pH, but high firmness, elasticity, colour intensity and a high expressible water content. Salmon samples smoked with BS or OS smoke had a low intensity amine odour as well as low brightness, pH, TBARS and TMA values, high colour and smoke odour intensities, and a high fat release value. The effect of storage time on sensorial and physicochemical parameters was evident: the values recorded for certain characteristics decrease, such as, colour intensity, elasticity or firmness, and others increase, such as, amine odour, expressible water content or TMA, and some showing a linear relationship with time (elasticity or amine odour intensity).
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Affiliation(s)
- O. Martinez
- Department of Nutrition and Food Science, University of Basque Country, 01006 Vitoria, Spain
| | - J. Salmerón
- Department of Nutrition and Food Science, University of Basque Country, 01006 Vitoria, Spain
| | - M.D. Guillén
- Department of Nutrition and Food Science, University of Basque Country, 01006 Vitoria, Spain
| | - C. Casas
- Department of Nutrition and Food Science, University of Basque Country, 01006 Vitoria, Spain,
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Abstract
Bacterial biofilms on food industry surfaces are potential sources of contamination for food products coming in contact with these surfaces. The development of biofilms in food processing environments may lead to food spoilage or transmission of diseases. This paper describes the formation of micro bial biofilms on food contact surfaces, their characteristics, and strategies for removal of adhered microorganisms (cleaning and disinfection) or for preventing microbial adhesion to surfaces (opti mizing equipment design, altering surface chemistry, treating with antimicrobial agents).
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Affiliation(s)
- F.J. Pérez Elortondo
- Area de Nutrición y Bromatología, Facultad de Farmacia, Universidad del País Vasco. Paseo de la Universidad 7, 01006-Vitoria-Gasteiz, España
| | - J. Salmerón
- Area de Nutrición y Bromatología, Facultad de Farmacia, Universidad del País Vasco. Paseo de la Universidad 7, 01006-Vitoria-Gasteiz, España
| | - M. Albisu
- Area de Nutrición y Bromatología, Facultad de Farmacia, Universidad del País Vasco. Paseo de la Universidad 7, 01006-Vitoria-Gasteiz, España
| | - C. Casas
- Area de Nutrición y Bromatología, Facultad de Farmacia, Universidad del País Vasco. Paseo de la Universidad 7, 01006-Vitoria-Gasteiz, España
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Abstract
Sensory profiles for several ewe’s milk cheeses were developed and main sensory differences evaluated using a specifically designed methodology. It was stated that the existence of several clearly defined groups of sensory terms were negatively correlated. One group consisted of the attributes odor intensity, sharp odor, brine odor, rennet flavor, and butyric acid flavor. The other group consisted of milky odor, toasty odor, buttery odor and flavor, nutty flavor, and sweet flavor. Results pointed out that every descriptor except surface roughness showed a significant difference ( p< 0.01) among the samples. Main sensory differences were basically attributable to different manufacturing technologies as well as different ripening periods.
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Affiliation(s)
| | | | - J. Salmerón
- Area de Nutrición y Bromatología, Facultad de Farmacia, Universidad del País Vasco, Paseo de la Universidad 7, 01006 Vitoria, Spain
| | - M. Albisu
- Area de Nutrición y Bromatología, Facultad de Farmacia, Universidad del País Vasco, Paseo de la Universidad 7, 01006 Vitoria, Spain
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Corona E, Flores Y, Rodriguez M, León JM, Rivera B, Paredez BC, Ochoa LR, Palacios JAS, Lazcano-Ponce E, Salmerón J. A Cost analysis of multiple triage strategies for early detection of
cervical cancer screening programs. Ann Glob Health 2016. [DOI: 10.1016/j.aogh.2016.04.586] [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: 10/21/2022] Open
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Ramírez S, Domínguez D, Salmerón J, Villalobos G, Ortega JA. Contreo en surco y etapa de madurez sobre la producción y calidad del forraje de variedades de avena. ARCH ZOOTEC 2015. [DOI: 10.21071/az.v64i247.405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
El déficit hídrico es uno de los principales factores que limitan la producción de forrajes en las zonas áridas y semiáridas del mundo. Nuestra hipótesis fue que el sistema de labranza de captación de agua surcos con contras (SCC), podría incrementar el rendimiento de forraje de avena (Avena sativa L.), y que cosechar el forraje en la etapa de madurez fisiológica mejora su calidad. Del año 2005 al 2007, se midió el efecto del sistema de siembra: surcos con contras (SCC) y la etapa de madurez al corte: grano lechoso masoso (LM) y madurez fisiológica (MF), sobre el rendimiento y calidad de forraje, de cinco variedades de avena, establecidas bajo condiciones de temporal, en el noroeste del estado de Chihuahua, México, El diseño fue parcelas sub-subdivididas en bloques completos al azar, la parcela grande fue el sistema de siembra, la mediana la etapa de madurez al corte, y la parcela chica la variedad, los sitios (n=14) fueron las repeticiones. La composición química y la materia seca digestible (MSD) del heno de avena fueron medidas, sin tomar en cuenta el efecto de sistema de siembra SCC. La producción de materia seca fue 8,7 % mayor (P0,05) con 9,50 y 9,20 %; la fibra detergente neutro varío (P
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Ocete-Hita E, Sameron-Fernández MJ, González Gómez JM, Urrutia Maldonado E, Salmerón Ruiz M, Ruiz-Extremera A, Salmerón J. [HEPATOTOXICITY FROM THE CONSUMPTION OF HERBALIST PRODUCTS BY A PAEDIATRIC POPULATION]. NUTR HOSP 2015; 32:652-655. [PMID: 26268095 DOI: 10.3305/nh.2015.32.2.8853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
The consumption of herbal products is mainly due to the perception that being "natural" can only be beneficial and without risk to health. However the properties thereof are poorly studied and proven. Four episodes are presented of hepatotoxicity from the consumption of herbal products, by three children. We analyse the epidemiological and clinical characteristics of these products, and stress the importance of proper anamnesis for accurate diagnosis.
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Affiliation(s)
- Esther Ocete-Hita
- Complejo Hospitalario Universitario de Granada. Universidad de Granada. CIBERehd..
| | | | | | | | | | | | - Javier Salmerón
- Complejo Hospitalario Universitario de Granada. Universidad de Granada. CIBERehd..
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Muñoz-Gámez JA, López Viota J, Barrientos A, Carazo Á, Sanjuán-Nuñez L, Quiles-Perez R, Muñoz-de-Rueda P, Delgado Á, Ruiz-Extremera Á, Salmerón J. Synergistic cytotoxicity of the poly (ADP-ribose) polymerase inhibitor ABT-888 and temozolomide in dual-drug targeted magnetic nanoparticles. Liver Int 2015; 35:1430-41. [PMID: 24821649 DOI: 10.1111/liv.12586] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 11/22/2013] [Accepted: 05/03/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS Hepatocellular carcinoma (HCC) is associated with a poor prognosis because of a lack of effective treatment options. The objective of this study was to examine a new strategy for HCC treatment, namely the use of poly (ADP-ribose) polymerase 1 (PARP-1) inhibitor (ABT-888) together with Temozolomide (TMZ) incorporated onto magnetic nanoparticles. METHODS Magnetic Fe3 O4 /Fe cores were encapsulated within a silica shell to facilitate the simultaneous incorporation of ABT-888 and TMZ. In vitro tests were performed with HepG2, Hep3B and PLC-PRF-5 liver tumoural cell lines and with WRL-68 liver non-tumoural cells. RESULTS The magnetic nanocarriers were loaded simultaneously with ABT-888 and TMZ. High stability and extended release were achieved in culture medium. Confocal microscopy images showed that drug-loaded particles were uptaken and accumulated into the cytoplasm of liver tumoural cells, inducing the following effects: G2/M cell cycle arrest (P < 0.05), accumulation of DNA damage (P < 0.05), mitochondrial depolarization (P < 0.01), reduction in BCL-xL, FOS, JUND gene expression (P < 0.05), PARP-1 fragmentation, Caspase-3 activation and apoptotic cell death (P < 0.05). Interestingly, drugs loaded onto nanoparticles exhibited better efficiency than free drugs (cell death triggered by drug delivery nanosystem: 53.5% vs. 34.5% by free drugs, P = 0.01). CONCLUSIONS These magnetic nanocompounds are able to incorporate both drugs simultaneously, enter the tumour cells and release them. ABT-888/TMZ/NPs decrease the transcription of key genes involved in tumour survival and induce apoptotic cell death in a more effective manner than is achieved by free drugs.
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Affiliation(s)
- José A Muñoz-Gámez
- Clinical Management Unit of Digestive Disease and UNAI, San Cecilio University Hospital, Granada, Spain
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Carazo Á, Salmerón J. Obesity-related non-alcoholic fatty liver disease (NAFLD): A multifactorial process. Rev Esp Enferm Dig 2014; 106:501-504. [PMID: 25544406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Gómez-Busto F, Andía V, Hernández D, Albisu M, López I, Salmerón J. P373: Diets with modified texture in geriatric centres: Do we know their viscosity? Eur Geriatr Med 2014. [DOI: 10.1016/s1878-7649(14)70537-6] [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: 10/24/2022]
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Quiles-Pérez R, Muñoz-de-Rueda P, Maldonado AML, Martín-Álvarez A, Quer J, Salmerón J. Effects of ribavirin monotherapy on the viral population in patients with chronic hepatitis C genotype 1: direct sequencing and pyrosequencing of the HCV regions. J Med Virol 2014; 86:1886-97. [PMID: 25091333 DOI: 10.1002/jmv.24035] [Citation(s) in RCA: 5] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2014] [Indexed: 11/11/2022]
Abstract
Ribavirin remains essential to chronic hepatitis C treatment. This paper investigates the influence of ribavirin priming to steady state before combined pegylated-interferon/ribavirin treatment on viral kinetics, ribavirin trough concentrations, genetic variability within HCV-core, -NS5B and -NS5A, and response to antiviral therapy. A prospective cohort study was made of 27 chronic hepatitis C genotype 1 naïve patients who received four weeks of ribavirin followed by pegIFN-α-2a/ribavirin for 48 weeks (Group A). The results obtained were compared with those for a control/historical group (Group B). In addition, direct sequencing and pyrosequencing were applied to determine ribavirin monotherapy-induced sequence changes. The rapid, early, and sustained virological response values obtained were 48%, 89%, and 52%, respectively, in Group A, and 52%, 90%, and 52% in Group B (P > 0.05). In the four-week combined treatment, the Group A patients showed a greater decrease in HCV-RNA (2.3 log10 IU/ml vs. 1.2 log10 IU/ml; P = 0.04), lower alanine aminotransferase levels (23.5 ± 1.33 U/L vs. 60.11 ± 18 U/L; P < 0.001) and higher mean ribavirin trough concentrations (3.28 ± 1.26 mg/L vs. 1.74 ± 0.7 mg/L; P = 0.001). No general increase in rates of nucleotide substitutions in the ribavirin monotherapy-treated patients was observed in NS5B, ISDR, or PKRbd, but there was a decrease in silent mutations in the HCV core (P = 0.04). This result was confirmed by pyrosequencing in the NS5A region. It is concluded that the ribavirin priming combined treatment with pegIFN-α-2a does not improve sustained virological response rates in HCV genotype 1 naïve infected patients. However, the greater reductions in viral load and alanine aminotransferase levels, together with the higher ribavirin trough concentration values obtained, could reflect the greater effectiveness of the treatment. Ribavirin does not have a mutagenic effect on the virus in patients with chronic hepatitis C.
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Affiliation(s)
- R Quiles-Pérez
- Research Support Unit, UNAI, San Cecilio University Hospital, Granada, Spain; CIBEREHD, Spain
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Quiles-Pérez R, Pavón-Castillero EJ, Muñoz-de-Rueda P, Carmona I, Salmerón J. Valor de la genética en la era de la terapia triple frente al virus de la hepatitis C. Gastroenterología y Hepatología 2014; 37:427-37. [DOI: 10.1016/j.gastrohep.2014.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 04/09/2014] [Accepted: 04/15/2014] [Indexed: 12/19/2022]
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León J, Casado J, Jiménez Ruiz SM, Zurita MS, González-Puga C, Rejón JD, Gila A, Muñoz de Rueda P, Pavón EJ, Reiter RJ, Ruiz-Extremera A, Salmerón J. Melatonin reduces endothelin-1 expression and secretion in colon cancer cells through the inactivation of FoxO-1 and NF-κβ. J Pineal Res 2014; 56:415-26. [PMID: 24628039 DOI: 10.1111/jpi.12131] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [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: 01/28/2014] [Accepted: 03/11/2014] [Indexed: 12/15/2022]
Abstract
Melatonin is an indoleamine that is synthesised from tryptophan under the control of the enzymes arylalkylamine N-acetyltransferase (AA-NAT) and acetylserotonin methyltransferase (ASMT). Melatonin inhibits colon cancer growth in both in vivo and in vitro models; however, a precise mechanism responsible for inhibiting tumour growth has not been clearly described. Endothelin-1 (ET-1) is a peptide that acts as a survival factor in colon cancer, inducing cell proliferation, protecting carcinoma cells from apoptosis and promoting angiogenesis. The data presented show that melatonin inhibits edn-1 mRNA expression (the first step in ET-1 synthesis), ECE-1 protein expression and the release of ET-1 from colorectal cancer cells in vitro. ET-1 levels in cultured media present a similar inhibition pattern to that of edn-1 mRNA expression despite the inhibition of ECE-1 protein after melatonin treatment, which suggests that an endopeptidase other than ECE-1 could be mainly responsible for ET-1 synthesis. The inhibition of edn-1 expression is due to an inactivation of FoxO1 and NF-κβ transcription factors. FoxO1 inactivation is associated with an increased Src phosphorylation, due to elevated cAMP content and PKA activity, whereas NF-κβ inactivation is associated with the blockade of Akt and ERK phosphorylation due to the inhibition of PKC activity after melatonin treatment. Melatonin also inhibits edn-1 promoter activity regulated by FoxO1 and NF-κβ. Finally, a significant correlation was observed between AA-NAT and edn-1 expression downregulation in human colorectal cancer tissues. In conclusion, melatonin may be useful in treating colon carcinoma in which the activation of ET-1 plays a role in tumour growth and progression.
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Affiliation(s)
- Josefa León
- Research Support Unit, San Cecilio University Hospital, Granada, Spain; Ciber of Hepatic and Digestive Diseases (CIBERehd), Granada, Spain
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Jorquera F, Pascasio J, Fraga E, Fuentes J, Prieto M, Sánchez-Antolín G, Calleja J, Molina E, Tomé S, Bonet L, Blanco M, García-Buey M, Salmerón J, Pons J, González J, Rodríguez M. P1041 TENOFOVIR MONOTHERAPY VERSUS LAMIVUDINE PLUS ADEFOVIR IN LAMIVUDINE-FAILURE PATIENTS RESCUED WITH LAMIVUDINE PLUS ADEFOVIR COMBINATION: INTERIM ANALYSIS OF THE TENOSIMP-B CLINICAL TRIAL. J Hepatol 2014. [DOI: 10.1016/s0168-8278(14)61201-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
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Ruiz-Extremera Á, Muñoz-Gámez JA, Abril-Molina A, Salmerón-Ruiz MA, Muñoz-de-Rueda P, Pavón-Castillero EJ, Quiles-Pérez R, Carazo Á, Gila A, Jimenez-Ruiz SM, Casado J, Martín AB, Sanjuán-Núñez L, Ocete-Hita E, Viota JL, León J, Salmerón J. Variation of transaminases, HCV-RNA levels and Th1/Th2 cytokine production during the post-partum period in pregnant women with chronic hepatitis C. PLoS One 2013; 8:e75613. [PMID: 24130726 PMCID: PMC3794969 DOI: 10.1371/journal.pone.0075613] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 08/15/2013] [Indexed: 12/15/2022] Open
Abstract
This study analyses the evolution of liver disease in women with chronic hepatitis C during the third trimester of pregnancy and the post-partum period, as a natural model of immune modulation and reconstitution. Of the 122 mothers recruited to this study, 89 were HCV-RNA+ve/HIV-ve and 33 were HCV-RNA-ve/HIV-ve/HCVantibody+ve and all were tested during the third trimester of pregnancy, at delivery and post-delivery. The HCV-RNA+ve mothers were categorized as either Type-A (66%), with an increase in ALT levels in the post-partum period (>40 U/L; P<0.001) or as Type-B (34%), with no variation in ALT values. The Type-A mothers also presented a significant decrease in serum HCV-RNA levels in the post-delivery period (P<0.001) and this event was concomitant with an increase in Th1 cytokine levels (INFγ, P = 0.04; IL12, P = 0.01 and IL2, P = 0.01). On the other hand, the Type-B mothers and the HCV-RNA-ve women presented no variations in either of these parameters. However, they did present higher Th1 cytokine levels in the partum period (INFγ and IL2, P<0.05) than both the Type-A and the HCV-RNA-ve women. Cytokine levels at the moment of delivery do not constitute a risk factor associated with HCV vertical transmission. It is concluded that differences in the ALT and HCV-RNA values observed in HCV-RNA+ve women in the postpartum period might be due to different ratios of Th1 cytokine production. In the Type-B women, the high partum levels of Th1 cytokines and the absence of post-partum variation in ALT and HCV-RNA levels may be related to permanent Th1 cytokine stimulation.
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Affiliation(s)
- Ángeles Ruiz-Extremera
- Paediatric Unit, San Cecilio University Hospital, Granada, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Ciberehd, Granada, Spain
- Paediatric Unit, Granada University, Granada, Spain
| | | | | | | | - Paloma Muñoz-de-Rueda
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Ciberehd, Granada, Spain
- Clinical Management Unit of Digestive Disease, San Cecilio University Hospital, Granada, Spain
| | | | - Rosa Quiles-Pérez
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Ciberehd, Granada, Spain
- Clinical Management Unit of Digestive Disease, San Cecilio University Hospital, Granada, Spain
| | - Ángel Carazo
- Clinical Management Unit of Digestive Disease, San Cecilio University Hospital, Granada, Spain
| | - Ana Gila
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Ciberehd, Granada, Spain
- Clinical Management Unit of Digestive Disease, San Cecilio University Hospital, Granada, Spain
| | - Sergio Manuel Jimenez-Ruiz
- Clinical Management Unit of Digestive Disease, San Cecilio University Hospital, Granada, Spain
- Medicine Department, Granada University, Granada, Spain
| | - Jorge Casado
- Clinical Management Unit of Digestive Disease, San Cecilio University Hospital, Granada, Spain
| | - Ana Belén Martín
- Clinical Management Unit of Digestive Disease, San Cecilio University Hospital, Granada, Spain
| | - Laura Sanjuán-Núñez
- Clinical Management Unit of Digestive Disease, San Cecilio University Hospital, Granada, Spain
- Medicine Department, Granada University, Granada, Spain
| | - Esther Ocete-Hita
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Ciberehd, Granada, Spain
- Paediatric Unit, Granada University, Granada, Spain
- Paediatric Unit, Virgen de las Nieves Hospital, Granada, Spain
| | - Julián López Viota
- Clinical Management Unit of Digestive Disease, San Cecilio University Hospital, Granada, Spain
| | - Josefa León
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Ciberehd, Granada, Spain
- Clinical Management Unit of Digestive Disease, San Cecilio University Hospital, Granada, Spain
| | - Javier Salmerón
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Ciberehd, Granada, Spain
- Clinical Management Unit of Digestive Disease, San Cecilio University Hospital, Granada, Spain
- Medicine Department, Granada University, Granada, Spain
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López-Rodríguez R, Hernández-Bartolomé Á, Borque MJ, Rodríguez-Muñoz Y, Martín-Vílchez S, Trapero-Marugán M, García-Buey L, Muñoz de Rueda P, Rodrigo L, Vidal-Castiñeira JR, Salmerón J, Moreno-Otero R, Sanz-Cameno P. Polymorphisms in histone deacetylases improve the predictive value of IL-28B for chronic hepatitis C therapy. Genes Immun 2013; 14:317-24. [PMID: 23615070 DOI: 10.1038/gene.2013.24] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2013] [Revised: 03/07/2013] [Accepted: 03/12/2013] [Indexed: 12/20/2022]
Abstract
Histone deacetylases (HDACs) influence many cellular processes, including the modulation of signal transducer and activator of transcription activity (STAT) in response to interferon (IFN). To identify genetic markers that help optimize the IL-28B prediction of chronic hepatitis C (CHC) sustained virological response (SVR), we evaluated 27 single-nucleotide polymorphisms (SNPs) in HDAC1-11. Three SNPs, rs3778216, rs976552 and rs368328 in HDAC2, HDAC3 and HDAC5, respectively, were independently associated with SVR (P<0.05). The addition of these three HDAC's SNPs to the IL-28B predictive model (area under the curve (AUC)=0.630) rendered an important improvement of AUC-receiver operating characteristic value (AUC=0.747, P=0.021). Chi-squared Automatic Interaction Detector (CHAID) analysis denoted the significance of the rs3778216 C/C genotype in identifying a group of good responders despite carrying IL-28B T allele (79.2% of SVR), whereas HDAC5 G allele characterized a subgroup with poor response rate (25.5%). However, HDAC3 rs976552 did not display a relevant role for the hierarchical classification of patients. Variables related to SVR in hepatitis C virus genotype 1 (HCV-1) cohort were the same of those obtained for the overall population. Interestingly, in non-HCV-1 patients (n=56) the HDAC2 C/C genotype was the unique predictive variable related to SVR (AUC=0.733, P<0.007). Thus, these preliminary results suggest the potential usefulness of combined IL-28B and HDAC genotyping for the CHC patients' classification by likelihood of an SVR.
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Affiliation(s)
- R López-Rodríguez
- Liver Unit, Gastroenterology Service, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP), Universidad Autónoma de Madrid and CIBERehd, Instituto de Salud Carlos III, Madrid, Spain
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Pavón-Castillero EJ, Muñoz-de-Rueda P, López-Segura R, Gila A, Quiles R, Muñoz-Gámez JA, Carazo A, Martínez P, Ruiz-Extremera A, Salmerón J. Importance of IL-10 and IL-6 during chronic hepatitis C genotype-1 treatment and their relation with IL28B. Cytokine 2013; 61:595-601. [PMID: 23159283 DOI: 10.1016/j.cyto.2012.10.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 10/08/2012] [Accepted: 10/12/2012] [Indexed: 10/27/2022]
Abstract
UNLABELLED This paper investigates serum levels of interleukin 10 (IL-10) and interleukin 6 (IL-6) in patients with chronic hepatitis C genotype 1 (CHC-GT1), the relation of each with clinical and virological characteristics, how they affect the response to combined therapy and their relation with the IL28B polymorphisms rs12979860. Serum level expression and the polymorphism of IL-10, IL-6 and IL28B were determined in 138 CHC-GT1 patients, treated with pegylated interferon/ribavirin (pegIFN-α/RBV) for 48 weeks, in the following samples: baseline, week-12 (during treatment) and week-72 (post-treatment). 77 patients (56%) presented Sustained Virological Response (SVR) and 61 (44%) were non-SVR. Multivariate logistic regression showed that age ≤ 40 years (aOR=3.7, 95%CI=1.5-8.9, P=0.004), low activity of gamma glutamyl transferase (GGT) (aOR=0.9, 95%CI=0.98-0.99, P=0.028), CC genotype of IL28B polymorphism (aOR=2.7, 95%CI=1.0-7.2, P=0.044) and low IL-6 (aOR=0.5, 95%CI=0.3-1.0, P=0.038) were predictor factors of virological response. In all patients, following treatment, IL-6 decreased at week-12 (P=0.004) from baseline and had returned to basal values at week-72. Serum IL-10 concentration was significantly decreased at week-72 only in SVR patients (P ≤ 0.001). When patients were stratified by IL28B polymorphisms rs12979860 CC vs non-CC patients, a statistically significant decrease in IL-10 at week-72 in both groups was observed (P=0.003 and P ≤ 0.001, respectively). None of the polymorphisms of IL-10 or IL-6 studied were associated with SVR. CONCLUSIONS CC genotype of IL28B and low IL-6 serum concentration are factors associated independently with SVR. Moreover, decreased IL-10 at week-72 is associated with SVR in both CC and non-CC patients, and both factors are important to determine the effectiveness of treatment.
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Viota JL, Carazo A, Munoz-Gamez JA, Rudzka K, Gómez-Sotomayor R, Ruiz-Extremera A, Salmerón J, Delgado AV. Functionalized magnetic nanoparticles as vehicles for the delivery of the antitumor drug gemcitabine to tumor cells. Physicochemical in vitro evaluation. Mater Sci Eng C Mater Biol Appl 2012; 33:1183-92. [PMID: 23827558 DOI: 10.1016/j.msec.2012.12.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 08/23/2012] [Accepted: 12/02/2012] [Indexed: 12/24/2022]
Abstract
Gemcitabine is a chemotherapy drug used in different carcinomas, although because it displays a short biological half-life, its plasmatic levels can quickly drop below the effective threshold. Nanoparticle-based drug delivery systems can provide an alternative approach for regulating the bioavailability of this and most other anticancer drugs. In this work we describe a new model of composite nanoparticles consisting of a core of magnetite nanoparticles, coated with successive layers of high molecular weight poly(acrylic acid) and chitosan, and a final layer of folic acid. The possibility of using these self-assembled nanostructures for gemcitabine vehiculization is explored. First, the surface charge of the composite particles is studied by means of electrophoretic mobility measurements as a function of pH for poly(acrylic acid) (carbopol) of different molecular weights. The adsorption of folic acid, aimed at increasing the chances of the particles to pass the cell membrane, is followed up by optical absorbance measurements, which were also employed for drug adsorption determinations. As a main result, it is shown that gemcitabine adsorbs onto the surface of chitosan/carbopol-coated magnetite nanoparticles. In vitro experiments show that the functionalized magnetic nanoparticles are able to deliver the drug to the nuclei of liver, colon and breast tumor cells.
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Affiliation(s)
- J L Viota
- Networked Biomedical Research Center for Hepatic and Digestive Diseases (CIBERehd), Hospital Universitario San Cecilio, 18012, Granada, Spain
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Caballero T, Gila A, Sánchez-Salgado G, Muñoz de Rueda P, León J, Delgado S, Muñoz JA, Caba-Molina M, Carazo A, Ruiz-Extremera A, Salmerón J. Histological and immunohistochemical assessment of liver biopsies in morbidly obese patients. Histol Histopathol 2012; 27:459-66. [PMID: 22374723 DOI: 10.14670/hh-27.459] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To study liver lesions in morbidly obese patients who underwent liver biopsy at the time of bariatric surgery to define histological lesions, especially inflammatory infiltrate, diagnostic categories and the possible influence of gender in this respect. METHODS AND RESULTS 110 biopsies (36 males-M- and 76 females -F-) were evaluated and categorised, according to the NAS (NAFLD -non alcoholic fatty liver disease- Activity Score) system and other criteria, as non-NAFLD (15.5%, F predominance), non-alcoholic steatohepatitis (NASH) (16.5%, M predominance), non-alcoholic hepatosteatosis (NAHS) (21%, F predominance) and, the most numerous group, NASH-borderline (NASH-BORD) (47%), with three subgroups, characterised by centrozonal lesions, portal area preferential involvement or affecting both areas. The predominant form of hepatocytesteatosis was mixed with a multivesicular component that was present in most cases with fibroinflammatory portal involvement. Nuclear glycogenosomes were found in greater number of biopsies in patients in the third and sixth decades. Portal inflammation was present in a large number of cases (M predominance); the application of immunohistochemical techniques (myeloperoxidase and CD68 antibodies) to evaluate lobular inflammation revealed "surgical hepatitis" in one third of the cases, and the presence of microgranulomas (CD68+) (M predominance), which were more abundant with increasing lesion severity. CONCLUSIONS Portal inflammation and multivesicular hepatocytesteatosis are highly prevalent in morbidly obese patients. This study identifies a new subtype of NASH-BORD characterized by centrizonal and porto-periportal area involvement and the existence of liver biopsies without steatosis. CD68+ microgranulomas constitute an unequivocal marker of lobular inflammation in surgical biopsies and of lesion severity, which is gender-related.
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Affiliation(s)
- T Caballero
- Pathology Department, San Cecilio University Hospital, Granada (HUSC) and School of Medicine, University of Granada, Spain.
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Ruiz-Extremera Á, Carazo Á, Salmerón Á, León J, Casado J, Goicoechea A, Fernandez JM, Garofano M, Ocete E, Martín AB, Pavón E, Salmerón J. Factors associated with hepatic steatosis in obese children and adolescents. J Pediatr Gastroenterol Nutr 2011; 53:196-201. [PMID: 21788762 DOI: 10.1097/mpg.0b013e3182185ac4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Obesity is associated with high prevalence of hepatic steatosis. We speculate that determinant factors of susceptibility to hepatic steatosis in obesity could differ between children and adolescents. PATIENTS AND METHODS Blood biochemical parameters, systemic oxidative stress markers, proinflammatory cytokines, and adipokine levels were determined in 157 obese children and adolescents. The subjects were divided into 2 groups: children and adolescents, identified as such in accordance with Tanner stage and the measured level of dehydroepiandrosterone sulphate. Steatosis was evaluated by ultrasonography in 127 subjects. RESULTS Steatosis prevalence was 44.8%. In the "children" group, those with hepatic steatosis presented higher levels of erythrocyte oxidised glutathione (GSSG) and resistin, lower levels of high-density lipoprotein (HDL) cholesterol, and lower enzymatic activities of erythrocyte glutathione reductase (GRd) and glutathione oxidase (GPx). In the "adolescents" group, those with hepatic steatosis presented higher values for body mass index z score (BMIz), insulin, peptide C, homeostatic model assessment index (HOMA-IR), alanine aminotransferase (ALT), aspartate aminotransferase (AST), triglycerides, GSSG, and leptin. These subjects also presented lower values for soluble leptin receptor, GRd, and GPx. In the "children" group, the only independent factor of steatosis was a decrease in GRd activity (odds ratio [OR] 0.165, 95% CI 0.03-0.84, P = 0.030). Moreover, in the "adolescent" group, the independent factors were higher for GSSG (OR 6.8, 95% CI 1.6-28.7, P = 0.010) and HOMA-IR (OR 1.9, 95% CI 1.17-3.1, P = 0.009). CONCLUSIONS Factors associated with hepatic steatosis differ between obese children and adolescents. Oxidative stress is seen to be the main process in children, whereas in adolescents oxidative stress and insulin resistance are significant factors for steatosis.
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