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Esterio M, Osorio-Navarro C, Rodriguez-Meza D, Copier C, Azócar M, Rubilar M, Estrada V, Auger J. Chilean Botrytis cinerea isolates with reduced sensitivity to fludioxonil exhibit low to null fitness penalties. Plant Dis 2024. [PMID: 38301218 DOI: 10.1094/pdis-10-23-2015-sc] [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] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
The main phytosanitary problem for table grapes production in Chile is the gray mold caused by the fungus Botrytis cinerea. To manage this issue, the primary method utilized is chemical control. Fludioxonil, a phenylpyrrole, is highly effective in controlling B. cinerea and other plant pathogens. Consistently, there have been no field reports of reduced efficacy to fludioxonil; however, some isolates with reduced sensitivity to fludioxonil are on the rise globally, as per increasing reports. Our study involved a large-scale evaluation of B. cinerea's sensitivity to fludioxonil in the Central Valley of Chile's primary table grape production area during 2015-2016, 2016-2017, and 2017-2018 growing seasons. Out of 2207 isolates, only 1.04% of the isolates (n=23) exceeded the sensitivity threshold value of 1 µg/mL. Remarkably, 95.7% of them are concentrated in a geographic region (Valparaíso Region). Isolates with reduced sensitivity to fludioxonil showed growth comparable to sensitive isolates and even more robust growth under nutritional deficit, temperature or osmotic stress, suggesting greater environmental adaptation. When table grape detached berries were stored at 0°C, isolates less sensitive to fludioxonil caused larger lesions than sensitive isolates (2.82 mm compared to 1.48 mm). However, the lesions generated by both types of isolates were equivalent at room temperature. This study found no cross-resistance between fludioxonil and fenhexamid, an essential fungicide integrated with fludioxonil in Chilean B. cinerea control programs. All the Chilean isolates with reduced sensitivity to fludioxonil were controlled by the fludioxonil/cyprodinil mixture, a commonly employed form of fludioxonil. Cyprodinil sensitivity clarified the reduced frequency of these isolates in the field despite their null fitness penalties. However, the emergence of fludioxonil-resistant isolates inside the Chilean B. cinerea population demands a comprehensive analysis of their genetic bases, accompanied by monitoring tools that allow the permanence of field fludioxonil efficacy.
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Affiliation(s)
- Marcela Esterio
- Universidad de Chile, Sanidad Vegetal, Santa Rosa 11.315, Santiago, Chile, 8820808;
| | - Claudio Osorio-Navarro
- Universidad de Chile, Sanidad Vegetal , Avenida Santa Rosa 11315 La Pintana, Santiago de Chile, Chile, 8820808
- Universidad de Chile, 14655, Biología, Santiago de Chile, Chile, 1025000;
| | | | - Charleen Copier
- Universidad de Chile, 14655, Sanidad Vegetal, Santiago de Chile, Chile;
| | - Madelaine Azócar
- Universidad de Chile, 14655, Sanidad Vegetal, Santiago de Chile, Chile;
| | | | - Veronica Estrada
- Universidad de Chile, 14655, Sanidad Vegetal, Santiago de Chile, Chile;
| | - Jaime Auger
- Universidad de Chile, Avenida Santa Rosa 11.315, Santiago, Chile, 882-0808;
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2
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Schira-Heinen J, Agrelo IS, Estrada V, Küry P. Functional in vivo assessment of stem cell-secreted pro-oligodendroglial factors. Neural Regen Res 2022; 17:2194-2196. [PMID: 35259828 PMCID: PMC9083155 DOI: 10.4103/1673-5374.335800] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jessica Schira-Heinen
- Department of Neurology, Neuroregeneration Laboratory, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Iria Samper Agrelo
- Department of Neurology, Neuroregeneration Laboratory, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Veronica Estrada
- Department of Neurology, Neuroregeneration Laboratory, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Patrick Küry
- Department of Neurology, Neuroregeneration Laboratory, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
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3
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Estrada V, Oldenburg E, Popa O, Muller HW. Mapping the long rocky road to effective spinal cord injury therapy - A meta-review of pre-clinical and clinical research. J Neurotrauma 2022; 39:591-612. [PMID: 35196894 DOI: 10.1089/neu.2021.0298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Spinal cord injury (SCI) is a rare condition, which even after decades of research, to date still presents an incurable condition with a complex symptomatology. SCI can result in paralysis, pain, loss of sensation, bladder and sexual dysfunction, and muscle degeneration to name but a few. The large number of publications makes it difficult to keep track of current progress in the field and of the many treatment options, which have been suggested and are being proposed with increasing frequency. Scientific databases with user-oriented search options will offer possible solutions, but they are still mostly in the development phase. In this meta-analysis, we summarize and narrow down SCI therapeutic approaches applied in pre-clinical and clinical research. Statistical analyses of treatment clusters - assorted after counting annual publication numbers in PubMed and ClinicalTrials.gov databases - were performed to allow the comparison of research foci and of their translation efficacy into clinical therapy. Using the example of SCI research, our findings demonstrate the challenges that come with the accelerating research progress - an issue, which many research fields are faced with today. The analyses point out similarities and differences in the prioritization of SCI research in pre-clinical versus clinical therapy strategies. Moreover, the results demonstrate the rapidly growing importance of modern (bio-)engineering technologies.
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Affiliation(s)
- Veronica Estrada
- Heinrich Heine University Düsseldorf, 9170, Neurology, Molecular Neurobiology Laboratory, Düsseldorf, Germany;
| | - Ellen Oldenburg
- Heinrich Heine University Düsseldorf, 9170, Institute of Quantitative and Theoretical Biology, Düsseldorf, Germany;
| | - Ovidiu Popa
- Heinrich Heine University Düsseldorf, 9170, Institute of Quantitative and Theoretical Biology, Düsseldorf, Germany;
| | - Hans W Muller
- Heinrich Heine University Düsseldorf, 9170, Neurology, Düsseldorf, Germany;
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Estrada V, González Del Castillo J. [Predicting COVID-19 progress with clinical scales]. Rev Clin Esp 2022; 222:42-43. [PMID: 34483348 PMCID: PMC8407954 DOI: 10.1016/j.rce.2021.08.001] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- V Estrada
- Servicio de Medicina Interna/Infecciosas, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
| | - J González Del Castillo
- Servicio de Urgencias, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
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Estrada V, González Del Castillo J. Predicting COVID-19 progress with clinical scales. Rev Clin Esp 2022; 222:42-43. [PMID: 34756571 PMCID: PMC8529257 DOI: 10.1016/j.rceng.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 08/03/2021] [Indexed: 11/25/2022]
Affiliation(s)
- V Estrada
- Servicio de Medicina Interna/Infecciosas, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
| | - J González Del Castillo
- Servicio de Urgencias, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Podzamczer D, Micán R, Tiraboschi J, Portilla J, Domingo P, Llibre JM, Ribera E, Vivancos MJ, Morano L, Masiá M, Gómez C, Fanjul F, Payeras A, Inciarte A, Estrada V, Rivero A, Castro Á, Bernal E, Vinuesa D, Knobel H, Troya J, Macías J, Montero M, Sanz J, Navarro-Alcaraz A, Caicedo A, Fernández G, Martínez E, Moreno S. Darunavir/Cobicistat/Emtricitabine/Tenofovir Alafenamide Versus Dolutegravir/Abacavir/Lamivudine in Antiretroviral-Naive Adults (SYMTRI): A Multicenter Randomized Open-Label Study (PReEC/RIS-57). Open Forum Infect Dis 2021; 9:ofab595. [PMID: 35237700 PMCID: PMC8883591 DOI: 10.1093/ofid/ofab595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background Darunavir/cobicistat/emtricitabine/tenofovir alafenamide (D/C/F/TAF) is the reference for combination therapy based on protease inhibitors due to its efficacy, tolerability, and convenience. Head-to-head randomized comparisons between D/C/F/TAF and combination therapy based on integrase inhibitors in antiretroviral-naive patients are lacking. Methods Adult (>18 years old) human immunodeficiency virus-infected antiretroviral-naive patients (HLA-B∗5701 negative and hepatitis B virus negative), with viral load (VL) ≥500 c/mL, were centrally randomized to initiate D/C/F/TAF or dolutegravir/abacavir/lamivudine (DTG/3TC/ABC) after stratifying by VL and CD4 count. Clinical and analytical assessments were performed at weeks 0, 4, 12, 24, and 48. The primary endpoint was VL <50 c/mL at week 48 in the intention-to-treat (ITT)-exposed population (US Food and Drug Administration snapshot analysis, 10% noninferiority margin). Results Between September 2018 and 2019, 316 patients were randomized and 306 patients were included in the ITT-exposed analysis (151 D/C/F/TAF and 155 DTG/3TC/ABC). Almost all (94%) participants were male and their median age was 35 years. Forty percent had a baseline VL >100 000 copies/mL, and 13% had <200 CD4 cells/μL. Median weight was 73 kg and median body mass index was 24 kg/m2. At 48 weeks, 79% (D/C/F/TAF) versus 82% (DTG/3TC/ABC) had VL <50 c/mL (difference, −2.4%; 95% confidence interval [CI], −11.3 to 6.6). Eight percent versus four percent experienced virologic failure but no resistance-associated mutations emerged. Four percent versus six percent had drug discontinuation due to adverse events. In the per-protocol analysis, 94% versus 96% of patients had VL <50 c/mL (difference, −2%; 95% CI, −8.1 to 3.5). There were no differences in CD4 cell count or weight changes. Conclusions We could not demonstrate the noninferiority of D/C/F/TAF relative to DTG/ABC/3TC as initial antiretroviral therapy, although both regimens were similarly well tolerated.
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Affiliation(s)
- D Podzamczer
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | - R Micán
- Hospital La Paz, Madrid, Spain
| | - J Tiraboschi
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | - J Portilla
- Hospital General Universitario de Alicante, Alicante, Spain
| | - P Domingo
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - J M Llibre
- Hospital Germans Trias i Pujol, Barcelona, Spain
| | - E Ribera
- Hospital Universitario de la Vall d’Hebrón, Barcelona, Spain
| | - M J Vivancos
- Hospital Universitario Ramón y Cajal, Madrid, Universidad de Alcalá, IRYCIS, Madrid, Spain
| | - L Morano
- Hospital Universitario Álvaro Cunqueiro, Vigo, Spain
| | - M Masiá
- Hospital General Universitario de Elche, Elche, Spain
| | - C Gómez
- Hospital Universitario Virgen de la Victoria-IBIMA, Málaga, Spain
| | - F Fanjul
- Hospital Universitario Son Espases, Palma, Spain
| | - A Payeras
- Hospital Universitario Son Llàtzer, Palma, Spain
| | | | - V Estrada
- Hospital Clínico San Carlos-IdiSSC, Madrid, Spain
| | - A Rivero
- Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Á Castro
- Complejo Hospitalario Universitario, A Coruña, Spain
| | - E Bernal
- Hospital Universitario Reina Sofía, Murcia, Spain
| | - D Vinuesa
- Hospital Universitario Clínico San Cecilio, Granada, Spain
| | - H Knobel
- Hospital del Mar, Barcelona, Spain
| | - J Troya
- Hospital Universitario Infanta Leonor, Madrid, Spain
| | - J Macías
- Hospital Universitario Virgen de Valme, Sevilla, Spain
| | - M Montero
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - J Sanz
- Hospital Universitario de La Princesa, Madrid, Spain
| | | | - A Caicedo
- RIS Red de Investigación en SIDA, Madrid, Spain
| | - G Fernández
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | - S Moreno
- Hospital Universitario Ramón y Cajal, Madrid, Universidad de Alcalá, IRYCIS, Madrid, Spain
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Mejia-Renteria H, Travieso A, Sagir A, Martinez-Gomez E, Carrascosa-Granada A, Nunez-Gil I, Estrada V, Lerman A, Escaned J. Assessment of vascular endothelial function in COVID-19 patients. Eur Heart J 2021. [PMCID: PMC8767623 DOI: 10.1093/eurheartj/ehab724.2017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) uses angiotensin-converting enzyme 2 (ACE2) receptor as a means to enter the host. High density of ACE2 receptor in vascular endothelial cells may explain why vascular complications related to endothelial dysfunction occur in COVID-19. However, in vivo assessment of vascular endothelial function during COVID-19 has not been reported. Objective To investigate the vascular endothelial function and its temporal changes in COVID-19 patients. Methods In this prospective blinded study, systemic endothelial function was assessed using plethysmography-derived peripheral arterial tonometry (PAT). The reactive hyperemia index (LnRHI), a measure of endothelium-mediated hyperaemia, and the augmentation index, a measure of arterial vascular stiffness, were measured in 102 individuals across three study groups using PAT: group 1 (active infection), constituted by 20 patients hospitalised due to acute COVID-19; group 2 (past infection), constituted by 52 patients who had recovered from COVID-19; and group 3 (controls), constituted by 30 healthcare workers not infected by SARS-CoV-2. Additionally, among group 1, PAT assessment was repeated in 14 patients several weeks after recovery from acute COVID-19. PAT studies were analysed at a blinded fashion with respect to the assigned study group. Results Lower resting PAT amplitude was found in acute COVID-19 patients compared to the other groups (ratio of arterial tone signal between hyperemia to resting condition was 1.5 [interquartile range, 1.1] in group 1, 1.3 [0.3] in group 2 and 1.2 [0.3] in group 3, p=0.041). On the contrary, no significant differences between groups were found with respect to the hyperemic PAT amplitude (867.9 [486.1] in group 1, 944.7 [748.1] in group 2 and 819.3 [639.6] in group 3, p=0.444). Due to the lower resting PAT amplitude, there was a paradoxically significantly increased LnRHI during acute COVID-19 compared to past infection and controls (0.73 [0.32] vs. 0.53 [0.31] vs. 0.44 [0.23], respectively; p=0.013) (Figure A). Furthermore, among group 1 patients, LnRHI normalised markedly from acute COVID-19 to past infection stage (0.73 [0.32] vs. 0.49 [0.28], respectively; p=0.005) (Figure B). Augmentation index was significantly higher during acute COVID-19 compared to past COVID-19 and controls (9.6 [19.1] in group 1, 6.97 [18.6] in group 2 and −0.35 [20.53] in group 3; p=0.045 for COVID groups vs. controls). Conclusions Non-invasive assessment of systemic vascular endothelial function with PAT revealed significant differences between subjects with acute COVID-19, past COVID-19 and controls. Lower baseline PAT amplitude and high augmentation index suggest vasoconstriction at rest during the acute phase of COVID-19. These findings open new research opportunities to investigate the prognostic value of PAT in COVID-19 patients. Funding Acknowledgement Type of funding sources: None.
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Affiliation(s)
| | - A Travieso
- Hospital Clinico San Carlos, Cardiology, Madrid, Spain
| | - A Sagir
- Bar-Ilan University, Safed, Israel
| | | | | | - I Nunez-Gil
- Hospital Clinico San Carlos, Cardiology, Madrid, Spain
| | - V Estrada
- Hospital Clinico San Carlos, Cardiology, Madrid, Spain
| | - A Lerman
- Mayo Clinic, Cardiology, Rochester, United States of America
| | - J Escaned
- Hospital Clinico San Carlos, Cardiology, Madrid, Spain
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Pérez-Segura P, Paz-Cabezas M, Núñez-Gil IJ, Arroyo-Espliguero R, Maroun Eid C, Romero R, Fernández Rozas I, Uribarri A, Becerra-Muñoz VM, García Aguado M, Huang J, Rondano E, Cerrato E, Rodríguez EA, Ortega-Armas ME, Raposeiras Roubin S, Pepe M, Feltes G, Gonzalez A, Cortese B, Buzón L, El-Battrawy I, Estrada V. Prognostic factors at admission on patients with cancer and COVID-19: Analysis of HOPE registry data. ACTA ACUST UNITED AC 2021; 157:318-324. [PMID: 34632069 PMCID: PMC8489183 DOI: 10.1016/j.medcle.2021.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/24/2021] [Indexed: 01/08/2023]
Abstract
Background Previous works seem to agree in the higher mortality of cancer patients with COVID-19. Identifying potential prognostic factors upon admission could help identify patients with a poor prognosis. Methods We aimed to explore the characteristics and evolution of COVID-19 cancer patients admitted to hospital in a multicenter international registry (HOPE COVID-19). Our primary objective is to define those characteristics that allow us to identify cancer patients with a worse prognosis (mortality within 30 days after the diagnosis of COVID-19). Results 5838 patients have been collected in this registry, of whom 770 had cancer among their antecedents. In hospital mortality reached 258 patients (33.51%). The median was 75 years (65–82). Regarding the distribution by sex, 34.55% of the patients (266/770) were women. The distribution by type of cancer: genitourinary 238/745 (31.95%), digestive 124/745 (16.54%), hematologic 95/745 (12.75%). In multivariate regression analysis, factors that are independently associated with mortality at admission are: renal impairment (OR 3.45, CI 97.5% 1.85–6.58), heart disease (2.32, 1.47–3.66), liver disease (4.69, 1.94–11.62), partial dependence (2.41, 1.34–4.33), total dependence (7.21, 2.60–21.82), fatigue (1.84, 1.16–2.93), arthromialgias (0.45, 0.26–0.78), SatO2 < 92% (4.58, 2.97–7.17), elevated LDH (2.61, 1.51–4.69) and abnormal decreased Blood Pressure (3.57, 1.81–7.15). Analitical parameters are also significant altered. Conclusion In patients with cancer from the HOPE registry, 30-day mortality from any cause is high and is associated with easily identifiable clinical factors upon arrival at the hospital. Identifying these patients can help initiate more intensive treatments from the start and evaluate the prognosis of these patients.
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Affiliation(s)
| | - M Paz-Cabezas
- Medical Oncology Dpt. Hospital Clinico San Carlos, Madrid, Spain
| | | | | | - C Maroun Eid
- Hospital Universitario La Paz. Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - R Romero
- Hospital Universitario Getafe, Madrid, Spain
| | | | - A Uribarri
- Hospital Clinico Universitario de Valladolid, Valladolid, Spain
| | | | - M García Aguado
- Hospital Puerta de Hierro de Majadahonda. Majadahonda, Madrid, Spain
| | - J Huang
- The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - E Rondano
- Sant'Andrea Hospital, Vercelli, Italy
| | - E Cerrato
- San Luigi Gonzaga University Hospital, Orbassano and Rivoli Infermi Hospital, Rivoli, Turin, Italy
| | | | - M E Ortega-Armas
- Hospital General del Norte de Guayaquil IESS Los Ceibos, Guayaquil, Ecuador
| | | | - M Pepe
- Azienda ospedaliero-universitaria consorziale policlinico di Bari, Bari, Italy
| | - G Feltes
- Nuestra Señora de América, Madrid, Spain
| | - A Gonzalez
- Hospital Universitario Infanta Sofia. San Sebastian de los Reyes, Madrid, Spain
| | | | - L Buzón
- Hospital Universitario de Burgos, Burgos, Spain
| | - I El-Battrawy
- First Department of Medicine, Medical Faculty Mannheim, University Heidelberg, Mannheim, 68167, Germany, DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Mannheim, Germany
| | - V Estrada
- Hospital Clinico San Carlos, Madrid, Spain
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Camps-Vilaro A, Perez-Fernandez S, Teira R, Estrada V, Domingo P, R Degano I, Marrugat J. Standardized comparison of cardiovascular risk factors prevalence in Spanish women and men living with HIV and in the general population. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Spain’s Ministry of Science and Innovation (Madrid, Spain), co-financed with European Union European Regional Development Funds –ERDF- [CIBERCV CB16/11/00229]; the Health Department of the Generalitat de Catalunya (Barcelona, Spain) through the Agència de Gestió d’Ajuts Universitaris de Recerca de Catalunya (AGAUR) (Barcelona, Spain) [2017SGR222].
OnBehalf
DARIOS and VACH investigators
Background
People living with HIV (PLWH) have an increased risk of cardiovascular (CV) disease, likely due to a higher prevalence of CV risk factors. We compared age-standardized prevalence and management of CV risk factors in PLWH to that of general population in Spain.
Methods
Blood pressure, lipid, glucose and anthropometric profile were cross-sectionally compared along with treatment of hypertension, dyslipidemia, and diabetes in a general population cohort and a PLWH cohort. Prevalence rates were standardized by the direct method by 10-year age groups in European standard populations by gender.
Results
We included 39,598 individuals aged 35 to 74 years: 28,360 from the general population cohort and 11,238 from the PLWH cohort. Compared to general population, PLWH had a higher concentration of triglycerides (>35mg/dL in women and >26mg/dL in men), and a higher prevalence of metabolic syndrome (>10% and >7.8%) and diabetes (>8.5% and >5.3%) (Table). The proportion of treated diabetes, dyslipidemia, and hypertension were up to 3-fold lower in both women and men living with HIV than in general population (Table).
Conclusions
Lipid, gluco-metabolic profiles were significantly worse in PLWH compared to general population. In addition, PLWH were less often treated for diagnosed diabetes, dyslipidemia, and hypertension.
CV risk factor standardized prevalence Cardiovascular risk factor WOMEN MEN General population People living with HIV p-Value General population People living with HIV p-Value N = 15,159 N = 2,171 N = 13,201 N = 9,067 Hypertension, % 27.4 (26.7 - 28.0) 24.8 (21.6 - 28.1) 0.136 29.0 (28.2 - 29.7) 22.9 (21.4 - 24.4) <0.001 Treated hypertension, % a 62.7 (60.7 - 64.7) 18.9 (13.5 - 24.4) <0.001 59.3 (57.5 - 61.1) 24.1 (21.0 - 27.1) <0.001 Triglycerides, mg/dL b 99 (99 - 100) 134 (134 - 148) <0.001 122 (121 - 122) 148 (148 - 164) <0.001 Total cholesterol, mg/dL 214 (213 - 215) 207 (199 - 215) 0.111 214 (213 - 216) 195 (191 - 198) <0.001 Treated dyslipidaemia, % c 14.0 (13.5 - 14.6) 7.80 (5.60 - 10.0) <0.001 15.1 (14.5 - 15.7) 7.8 (6.8 - 8.7) <0.001 Glucose, mg/dL 97 (96 - 97) 103 (98 - 107) 0.007 104 (103 - 105) 106 (104 - 109) 0.122 Diabetes, % 10.6 (10.1 - 11.1) 19.1 (16.0 - 22.1) <0.001 15.4 (14.8 - 16.0) 20.7 (19.2 - 22.2) <0.001 Treated diabetes, % d 34.4 (31.5 - 37.2) 12.8 (8.00 - 17.5) <0.001 40.0 (37.1 - 42.9) 16.6 (13.9 - 19.3) <0.001 Metabolic Syndrome, % 20.5 (19.8 - 21.1) 31.1 (25.8 - 36.4) <0.001 27.9 (27.1 - 28.7) 35.7 (33.1 - 38.2) <0.001 Values are expressed as mean (95% confidence interval). a Among patients with history of hypertension. b Mean (95% confidence interval) were obtained with log-transformed values. c Among all cohort participants. d Among patients with history of diabetes. HDL-c, high density lipoprotein cholesterol; LDL-c, low density lipoprotein cholesterol
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Affiliation(s)
- A Camps-Vilaro
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - S Perez-Fernandez
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - R Teira
- Hospital Sierrallana, Infectious Diseases Unit, Torrelavega, Spain
| | - V Estrada
- Hospital Clinico San Carlos, Infectious Diseases Unit, Madrid, Spain
| | - P Domingo
- Hospital de la Santa Creu i Sant Pau, Department of Infectious Diseases, Barcelona, Spain
| | - I R Degano
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - J Marrugat
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
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10
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Pérez-Segura P, Paz-Cabezas M, Núñez-Gil IJ, Arroyo-Espliguero R, Maroun Eid C, Romero R, Fernández Rozas I, Uribarri A, Becerra-Muñoz VM, García Aguado M, Huang J, Rondano E, Cerrato E, Rodríguez EA, Ortega-Armas ME, Raposeiras Roubin S, Pepe M, Feltes G, Gonzalez A, Cortese B, Buzón L, El-Battrawy I, Estrada V. Prognostic factors at admission on patients with cancer COVID-19: Analysis of hope registry data. Med Clin (Barc) 2021; 157:318-324. [PMID: 34154809 PMCID: PMC8101784 DOI: 10.1016/j.medcli.2021.02.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 02/08/2023]
Abstract
Background Previous works seem to agree in the higher mortality of cancer patients with COVID-19. Identifying potential prognostic factors upon admission could help identify patients with a poor prognosis. Methods We aimed to explore the characteristics and evolution of COVID-19 cancer patients admitted to hospital in a multicenter international registry (HOPE COVID-19). Our primary objective is to define those characteristics that allow us to identify cancer patients with a worse prognosis (mortality within 30 days after the diagnosis of COVID-19). Results 5838 patients have been collected in this registry, of whom 770 had cancer among their antecedents. In hospital mortality reached 258 patients (33.51%). The median was 75 years (65–82). Regarding the distribution by sex, 34.55% of the patients (266/770) were women. The distribution by type of cancer: genitourinary 238/745 (31.95%), digestive 124/745 (16.54%), hematologic 95/745 (12.75%). In multivariate regression analysis, factors that are independently associated with mortality at admission are: renal impairment (OR 3.45, CI 97.5% 1.85–6.58), heart disease (2.32, 1.47–3.66), liver disease (4.69, 1.94–11.62), partial dependence (2.41, 1.34–4.33), total dependence (7.21, 2.60–21.82), fatigue (1.84, 1.16–2.93), arthromialgias (0.45, 0.26–0.78), SatO2 < 92% (4.58, 2.97–7.17), elevated LDH (2.61, 1.51–4.69) and abnormal decreased Blood Pressure (3.57, 1.81–7.15). Analitical parameters are also significant altered. Conclusion In patients with cancer from the HOPE registry, 30-day mortality from any cause is high and is associated with easily identifiable clinical factors upon arrival at the hospital. Identifying these patients can help initiate more intensive treatments from the start and evaluate the prognosis of these patients.
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Affiliation(s)
| | - M Paz-Cabezas
- Medical Oncology Dpt. Hospital Clinico San Carlos, Madrid, Spain
| | | | | | - C Maroun Eid
- Hospital Universitario La Paz. Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - R Romero
- Hospital Universitario Getafe, Madrid, Spain
| | | | - A Uribarri
- Hospital Clinico Universitario de Valladolid, Valladolid, Spain
| | | | - M García Aguado
- Hospital Puerta de Hierro de Majadahonda. Majadahonda, Madrid, Spain
| | - J Huang
- The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - E Rondano
- Sant'Andrea Hospital, Vercelli, Italy
| | - E Cerrato
- San Luigi Gonzaga University Hospital, Orbassano and Rivoli Infermi Hospital, Rivoli, Turin, Italy
| | | | - M E Ortega-Armas
- Hospital General del Norte de Guayaquil IESS Los Ceibos, Guayaquil, Ecuador
| | | | - M Pepe
- Azienda ospedaliero-universitaria consorziale policlinico di Bari, Bari, Italy
| | - G Feltes
- Nuestra Señora de América, Madrid, Spain
| | - A Gonzalez
- Hospital Universitario Infanta Sofia. San Sebastian de los Reyes, Madrid, Spain
| | | | - L Buzón
- Hospital Universitario de Burgos, Burgos, Spain
| | - I El-Battrawy
- First Department of Medicine, Medical Faculty Mannheim, University Heidelberg, Mannheim, 68167, Germany, DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Mannheim, Germany
| | - V Estrada
- Hospital Clinico San Carlos, Madrid, Spain
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11
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Ribas VT, Vahsen BF, Tatenhorst L, Estrada V, Dambeck V, Almeida RA, Bähr M, Michel U, Koch JC, Müller HW, Lingor P. AAV-mediated inhibition of ULK1 promotes axonal regeneration in the central nervous system in vitro and in vivo. Cell Death Dis 2021; 12:213. [PMID: 33637688 PMCID: PMC7910615 DOI: 10.1038/s41419-021-03503-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/12/2021] [Accepted: 01/15/2021] [Indexed: 01/31/2023]
Abstract
Axonal damage is an early step in traumatic and neurodegenerative disorders of the central nervous system (CNS). Damaged axons are not able to regenerate sufficiently in the adult mammalian CNS, leading to permanent neurological deficits. Recently, we showed that inhibition of the autophagic protein ULK1 promotes neuroprotection in different models of neurodegeneration. Moreover, we demonstrated previously that axonal protection improves regeneration of lesioned axons. However, whether axonal protection mediated by ULK1 inhibition could also improve axonal regeneration is unknown. Here, we used an adeno-associated viral (AAV) vector to express a dominant-negative form of ULK1 (AAV.ULK1.DN) and investigated its effects on axonal regeneration in the CNS. We show that AAV.ULK1.DN fosters axonal regeneration and enhances neurite outgrowth in vitro. In addition, AAV.ULK1.DN increases neuronal survival and enhances axonal regeneration after optic nerve lesion, and promotes long-term axonal protection after spinal cord injury (SCI) in vivo. Interestingly, AAV.ULK1.DN also increases serotonergic and dopaminergic axon sprouting after SCI. Mechanistically, AAV.ULK1.DN leads to increased ERK1 activation and reduced expression of RhoA and ROCK2. Our findings outline ULK1 as a key regulator of axonal degeneration and regeneration, and define ULK1 as a promising target to promote neuroprotection and regeneration in the CNS.
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Affiliation(s)
- Vinicius Toledo Ribas
- Department of Morphology, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte, 31270-901, Brazil.
- Department of Neurology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
| | - Björn Friedhelm Vahsen
- Department of Neurology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Lars Tatenhorst
- Department of Neurology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
- Center for Biostructural Imaging of Neurodegeneration (BIN), University Medical Center Göttingen, Von-Siebold-Straße 3a, 37075, Göttingen, Germany
- DFG Cluster of Excellence Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Veronica Estrada
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Center Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Vivian Dambeck
- Department of Neurology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
- Center for Biostructural Imaging of Neurodegeneration (BIN), University Medical Center Göttingen, Von-Siebold-Straße 3a, 37075, Göttingen, Germany
- DFG Cluster of Excellence Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Raquel Alves Almeida
- Department of Morphology, Universidade Federal de Minas Gerais, Avenida Presidente Antônio Carlos, 6627, Belo Horizonte, 31270-901, Brazil
| | - Mathias Bähr
- Department of Neurology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
- DFG Cluster of Excellence Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Uwe Michel
- Department of Neurology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Jan Christoph Koch
- Department of Neurology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
- DFG Cluster of Excellence Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Hans Werner Müller
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Center Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Germany
| | - Paul Lingor
- Department of Neurology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
- Center for Biostructural Imaging of Neurodegeneration (BIN), University Medical Center Göttingen, Von-Siebold-Straße 3a, 37075, Göttingen, Germany
- DFG Cluster of Excellence Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
- Department of Neurology, Rechts der Isar Hospital of the Technical University Munich, Ismaninger Straße 22, 81675, Munich, Germany
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12
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Roca B, Teira R, Domingo P, Geijo P, Galindo MJ, Lozano F, Terron A, Garrido M, Suarez-Lozano I, Vidal F, Muñoz-Sanchez P, Viciana P, Ribera E, Castaño M, Martinez E, Puig T, Estrada V, Deig E, de la Fuente B, Montero M, Muñoz-Sanz A, Sanchez T, Romero-Palacios A, Lacalle JR. Factors Associated with Nonsuppression of HIV Infection in the Spanish VACH Cohort. AIDS Res Hum Retroviruses 2020; 36:927-932. [PMID: 32772710 DOI: 10.1089/aid.2020.0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We aim to determine the prevalence of HIV nonsuppression and factors associated with it. This is a cross-sectional multicenter study carried out in January 2016 with data of the VACH Cohort, a registry participated by 23 hospitals from most regions of Spain. The prevalence of HIV nonsuppression, defined as HIV RNA ≥200 copies/mL, is documented. The possible association of HIV nonsuppression with sociodemographic and clinical variables is assessed with a logistic regression analysis. A total of 30,843 adult patients are included; 7,358 of them (23.86%) have nonsuppressed HIV. An association is found between nonsuppression of HIV and the following variables: lower body mass index, lower age of patients in their last registered visit, lower number of visits carried out during follow-up, lower last available CD4 cell count, higher age of patients at the time of their HIV infection diagnosis, higher lowest available CD4 cell count, higher highest available HIV RNA, enrolment in the Cohort in first years of the HIV epidemic, region of Spain where the patient is attended other than Andalusia, HIV risk factor other than sexual, occurrence of death during follow-up, hepatitis C coinfection, being a smoker, pertaining to groups A1 or A2 of the CDC groups classification, and not taking antiretroviral treatment, p < .001 in all cases. HIV nonsuppression is still common with the effective antiretroviral treatment nowadays available. HIV nonsuppression is associated with HIV risk factor other than sexual, hepatitis C coinfection, and being a smoker, among other factors.
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Affiliation(s)
- Bernardino Roca
- Department of Medicine, Hospital General of Castellon, University of Valencia, Castellon, Spain
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13
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Boyd MA, Boffito M, Castagna A, Estrada V. Rapid initiation of antiretroviral therapy at HIV diagnosis: definition, process, knowledge gaps. HIV Med 2020; 20 Suppl 1:3-11. [PMID: 30724450 DOI: 10.1111/hiv.12708] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [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: 11/29/2018] [Indexed: 01/14/2023]
Abstract
Initiating antiretroviral therapy (ART) as early as the day of HIV diagnosis is a strategy of increasing global interest to control the HIV epidemic and optimize the health of people living with HIV (PLWH). No detrimental effects of rapid-start ART have been identified in randomized controlled trials undertaken in low- or middle-income countries, or in cohort studies performed in high-income countries. Rapid-start ART may be a key approach in reaching the 2020 Joint United Nations Programme on HIV/AIDS goal of 90% of all PLWH knowing their status, 90% of those diagnosed receiving sustained ART, and 90% of those receiving ART achieving viral suppression; it may also be important for achieving the suggested fourth "90%" goal: improving health-related quality-of-life in PLWH. Presently there is insufficient broad evidence for guidelines to recommend universal test-and-treat strategies for all people, in all settings, at HIV diagnosis; consequently, there is a pressing need to conduct high-quality studies that investigate immediate ART initiation. This article evaluates global evidence regarding rapid-start ART, including same-day start, with particular focus on the implementation of this strategy in high-income countries.
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Affiliation(s)
- M A Boyd
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia.,Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - M Boffito
- Chelsea and Westminster Hospital, London, UK.,Imperial College London, London, UK
| | - A Castagna
- Clinic of Infectious Diseases, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - V Estrada
- Hospital Clinico San Carlos, Universidad Complutense, Madrid, Spain
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14
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Lathouwers E, Wong EY, Brown K, Baugh B, Ghys A, Jezorwski J, Mohsine EG, Van Landuyt E, Opsomer M, De Meyer S, De Wit S, Florence E, Vandekerckhove L, Vandercam B, Brunetta J, Klein M, Murphy D, Rachlis A, Walmsley S, Ajana F, Cotte L, Girard PM, Katlama C, Molina JM, Poizot-Martin I, Raffi F, Rey D, Reynes J, Teicher E, Yazdanpanah Y, Arastéh K, Bickel M, Bogner J, Esser S, Faetkenheuer G, Jessen H, Kern W, Rockstroh J, Spinner C, Stellbrink HJ, Stoehr A, Antinori A, Castelli F, Chirianni A, De Luca A, Di Biagio A, Galli M, Lazzarin A, Maggiolo F, Maserati R, Mussini C, Garlicki A, Gasiorowski J, Halota W, Horban A, Parczewski M, Piekarska A, Belonosova E, Chernova O, Dushkina N, Kulagin V, Ryamova E, Shuldyakov A, Sizova N, Tsybakova O, Voronin E, Yakovlev A, Antela A, Arribas JR, Berenguer J, Casado J, Estrada V, Galindo MJ, Garcia Del Toro M, Gatell JM, Gorgolas M, Gutierrez F, Gutierrez MDM, Negredo E, Pineda JA, Podzamczer D, Portilla Sogorb J, Rivero A, Rubio R, Viciana P, De Los Santos I, Clarke A, Gazzard BG, Johnson MA, Orkin C, Reeves I, Waters L, Benson P, Bhatti L, Bredeek F, Crofoot G, Cunningham D, DeJesus E, Eron J, Felizarta F, Franco R, Gallant J, Hagins D, Henry K, Jayaweera D, Lucasti C, Martorell C, McDonald C, McGowan J, Mills A, Morales-Ramirez J, Prelutsky D, Ramgopal M, Rashbaum B, Ruane P, Slim J, Wilkin A, deVente J, De Wit S, Florence E, Moutschen M, Van Wijngaerden E, Vandekerckhove L, Vandercam B, Brunetta J, Conway B, Klein M, Murphy D, Rachlis A, Shafran S, Walmsley S, Ajana F, Cotte L, Girard PM, Katlama C, Molina JM, Poizot-Martin I, Raffi F, Rey D, Reynes J, Teicher E, Yazdanpanah Y, Gasiorowski J, Halota W, Horban A, Piekarska A, Witor A, Arribas JR, Perez-Valero I, Berenguer J, Casado J, Gatell JM, Gutierrez F, Galindo MJ, Gutierrez MDM, Iribarren JA, Knobel H, Negredo E, Pineda JA, Podzamczer D, Portilla Sogorb J, Pulido F, Ricart C, Rivero A, Santos Gil I, Blaxhult A, Flamholc L, Gisslèn M, Thalme A, Fehr J, Rauch A, Stoeckle M, Clarke A, Gazzard BG, Johnson MA, Orkin C, Post F, Ustianowski A, Waters L, Bailey J, Benson P, Bhatti L, Brar I, Bredeek UF, Brinson C, Crofoot G, Cunningham D, DeJesus E, Dietz C, Dretler R, Eron J, Felizarta F, Fichtenbaum C, Gallant J, Gathe J, Hagins D, Henn S, Henry KW, Huhn G, Jain M, Lucasti C, Martorell C, McDonald C, Mills A, Morales-Ramirez J, Mounzer K, Nahass R, Olivet H, Osiyemi O, Prelutsky D, Ramgopal M, Rashbaum B, Richmond G, Ruane P, Scarsella A, Scribner A, Shalit P, Shamblaw D, Slim J, Tashima K, Voskuhl G, Ward D, Wilkin A, de Vente J. Week 48 Resistance Analyses of the Once-Daily, Single-Tablet Regimen Darunavir/Cobicistat/Emtricitabine/Tenofovir Alafenamide (D/C/F/TAF) in Adults Living with HIV-1 from the Phase III Randomized AMBER and EMERALD Trials. AIDS Res Hum Retroviruses 2020; 36:48-57. [PMID: 31516033 PMCID: PMC6944133 DOI: 10.1089/aid.2019.0111] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Darunavir/cobicistat/emtricitabine/tenofovir alafenamide (D/C/F/TAF) 800/150/200/10 mg is being investigated in two Phase III trials, AMBER (NCT02431247; treatment-naive adults) and EMERALD (NCT02269917; treatment-experienced, virologically suppressed adults). Week 48 AMBER and EMERALD resistance analyses are presented. Postbaseline samples for genotyping/phenotyping were analyzed from protocol-defined virologic failures (PDVFs) with viral load (VL) ≥400 copies/mL at failure/later time points. Post hoc analyses were deep sequencing in AMBER, and HIV-1 proviral DNA from baseline samples (VL <50 copies/mL) in EMERALD. Through week 48 across both studies, no darunavir, primary PI, or tenofovir resistance-associated mutations (RAMs) were observed in HIV-1 viruses of 1,125 participants receiving D/C/F/TAF or 629 receiving boosted darunavir plus emtricitabine/tenofovir-disoproxil-fumarate. In AMBER, the nucleos(t)ide analog reverse transcriptase inhibitor (N(t)RTI) RAM M184I/V was identified in HIV-1 of one participant during D/C/F/TAF treatment. M184V was detected pretreatment as a minority variant (9%). In EMERALD, in participants with prior VF and genoarchive data (N = 140; 98 D/C/F/TAF and 42 control), 4% had viruses with darunavir RAMs, 38% with emtricitabine RAMs, mainly at position 184 (41% not fully susceptible to emtricitabine), 4% with tenofovir RAMs, and 21% ≥ 3 thymidine analog-associated mutations (24% not fully susceptible to tenofovir) detected at screening. All achieved VL <50 copies/mL at week 48 or prior discontinuation. D/C/F/TAF has a high genetic barrier to resistance; no darunavir, primary PI, or tenofovir RAMs were observed through 48 weeks in AMBER and EMERALD. Only one postbaseline M184I/V RAM was observed in HIV-1 of an AMBER participant. In EMERALD, baseline archived RAMs to darunavir, emtricitabine, and tenofovir in participants with prior VF did not preclude virologic response.
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Affiliation(s)
| | - Eric Y Wong
- Janssen Scientific Affairs, LLC, Titusville, New Jersey
| | | | - Bryan Baugh
- Janssen Research & Development LLC, Raritan, New Jersey
| | - Anne Ghys
- Janssen Pharmaceutica NV, Beerse, Belgium
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15
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Estrada V, Domingo P, Suarez-Lozano I, Gutiérrez F, Knobel H, Palacios R, Antela A, Blanco JR, Refoyo E. Risk of cardiovascular disease in patients with HIV infection undergoing antiretroviral therapy. Rev Clin Esp 2019; 220:149-154. [PMID: 31690452 DOI: 10.1016/j.rce.2019.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 05/12/2019] [Accepted: 05/14/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND The increased survival of patients with HIV infection thanks to antiretroviral therapy (ART) is accompanied by a higher rate of cardiovascular disease (CVD). We analysed the prevalence of the cardiovascular risk factors (CRFs) and estimated the risk of CVD in a cohort of patients with HIV in Spain. METHODS We conducted a cross-sectional, observational study of CRFs in the Spanish VACH cohort of patients with HIV who undergo ART. RESULTS The study assessed 15,559 patients with HIV (76% men; mean age, 46 years). Some 3.7% had experienced at least 1 CVD event. The prevalence of CRFs was high (hyperlipidaemia, 64%; tobacco use, 47%; arterial hypertension, 22%; and diabetes, 16%). According to the Framingham scale, 10.9% of the patients presented a high CVD risk, and 28.8% presented a moderate risk. Of the patients with a high CVD risk, 49% took protease inhibitors and 43% took abacavir. Fifty-three percent of the patients diagnosed with arterial hypertension took antihypertensive drugs, and 2.6% of the patients with diabetes took antidiabetic agents. CONCLUSIONS Classical CRFs are common in patients with HIV undergoing ART in Spain, and a large proportion of them have a moderate-high risk of CVD. Therefore, controlling the modifiable CRFs in patients with HIV should be improved, and the use of drugs with a better cardiovascular risk profile should be assessed.
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Affiliation(s)
- V Estrada
- Hospital Clínico San Carlos-IdiSSC, Universidad Complutense de Madrid, Madrid, España.
| | - P Domingo
- Hospital Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España
| | | | - F Gutiérrez
- Hospital General Universitario de Elche, Universidad Miguel Hernández, Elche, Alicante, España
| | - H Knobel
- Hospital del Mar, Barcelona, España
| | - R Palacios
- Hospital Universitario Virgen de la Victoria, Málaga, España
| | - A Antela
- Hospital Clínico Universitario, Santiago de Compostela, España
| | - J R Blanco
- Hospital San Pedro-CIBIR, Logroño, España
| | - E Refoyo
- Hospital Universitario La Paz, Madrid, España
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16
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Carr A, Grund B, Schwartz AV, Avihingsanon A, Badal-Faesen S, Bernadino JI, Estrada V, La Rosa A, Mallon P, Pujari S, White D, Wyman Engen N, Ensrud K, Hoy JF. The rate of bone loss slows after 1-2 years of initial antiretroviral therapy: final results of the Strategic Timing of Antiretroviral Therapy (START) bone mineral density substudy. HIV Med 2019; 21:64-70. [PMID: 31642586 DOI: 10.1111/hiv.12796] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Initial antiretroviral therapy (ART) causes loss of bone mineral density (BMD) over the first 1-2 years. Whether this loss continues with longer therapy is unclear. We determined changes in bone and spine BMD over 5 years in adults receiving immediate or deferred initial ART. METHODS In the Strategic Timing of Antiretroviral Therapy (START) BMD substudy, ART-naïve adults with CD4 counts > 500 cells/μL were randomized to immediate or deferred ART. Deferred group participants not yet on ART were offered ART after May 2015. Mean per cent changes in total hip and lumbar spine BMD (measured annually by dual-energy X-ray absorptiometry) were compared between groups using longitudinal mixed models. Fracture rates were also compared between groups for all START participants. RESULTS Substudy participants (immediate group, n = 201; deferred group, n = 210; median age 32 years; 80% non-white; 24% female) were followed for a mean 4.5 years until December 2016. In the immediate group, > 96% used ART throughout. In the deferred group, 16%, 58% and 94% used ART at years 1, 3 and 5, respectively. BMD decreased more in the immediate group initially; groups had converged by year 3 at the spine and year 4 at the hip by intent-to-treat (ITT). BMD changes after year 1 were similar in the immediate group and in those off ART in the deferred group [mean difference: spine, 0.03% per year; 95% confidence interval (CI) -0.4, 0.4; P = 0.88; hip, -0.2% per year; 95% CI -0.7, 0.3; P = 0.37]. Fracture incidence did not differ significantly between groups (immediate group, 0.86/100 person-years versus deferred group, 0.85/100 person-years; hazard ratio 1.01; 95% CI 0.76, 1.35; P = 0.98). CONCLUSIONS Significant ART-induced bone loss slowed after the first year of ART and became similar to that in untreated HIV infection.
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Affiliation(s)
- A Carr
- St Vincent's Hospital, Sydney, Australia
| | - B Grund
- University of Minnesota, Minneapolis, MN, USA
| | - A V Schwartz
- University of California San Francisco, San Francisco, CA, USA
| | - A Avihingsanon
- Thai Red Cross AIDS Research Center and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - S Badal-Faesen
- Clinical HIV Research Unit, University of Witwatersrand, Johannesburg, South Africa
| | - J I Bernadino
- Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - V Estrada
- Hospital Clinico San Carlos, Madrid, Spain
| | - A La Rosa
- Asociacion Civil Impacta Salud y Educacion, Lima, Peru
| | - Pwg Mallon
- University College Dublin, Dublin, Ireland
| | - S Pujari
- Institute of Infectious Diseases, Pune, India
| | - D White
- Heart of England NHS Foundation Trust, Birmingham, UK
| | | | - K Ensrud
- University of Minnesota, Minneapolis, MN, USA.,Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - J F Hoy
- The Alfred Hospital, Monash University, Melbourne, VIC, Australia
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17
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Beyer F, Jadasz J, Samper Agrelo I, Schira-Heinen J, Groh J, Manousi A, Bütermann C, Estrada V, Reiche L, Cantone M, Vera J, Viganò F, Dimou L, Müller HW, Hartung HP, Küry P. Heterogeneous fate choice of genetically modulated adult neural stem cells in gray and white matter of the central nervous system. Glia 2019; 68:393-406. [PMID: 31633850 DOI: 10.1002/glia.23724] [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] [Received: 03/25/2019] [Revised: 09/10/2019] [Accepted: 09/11/2019] [Indexed: 12/16/2022]
Abstract
Apart from dedicated oligodendroglial progenitor cells, adult neural stem cells (aNSCs) can also give rise to new oligodendrocytes in the adult central nervous system (CNS). This process mainly confers myelinating glial cell replacement in pathological situations and can hence contribute to glial heterogeneity. Our previous studies demonstrated that the p57kip2 gene encodes an intrinsic regulator of glial fate acquisition and we here investigated to what degree its modulation can affect stem cell-dependent oligodendrogenesis in different CNS environments. We therefore transplanted p57kip2 knockdown aNSCs into white and gray matter (WM and GM) regions of the mouse brain, into uninjured spinal cords as well as in the vicinity of spinal cord injuries and evaluated integration and differentiation in vivo. Our experiments revealed that under healthy conditions intrinsic suppression of p57kip2 as well as WM localization promote differentiation toward myelinating oligodendrocytes at the expense of astrocyte generation. Moreover, p57kip2 knockdown conferred a strong benefit on cell survival augmenting net oligodendrocyte generation. In the vicinity of hemisectioned spinal cords, the gene knockdown led to a similar induction of oligodendroglial features; however, newly generated oligodendrocytes appeared to suffer more from the hostile environment. This study contributes to our understanding of mechanisms of adult oligodendrogenesis and glial heterogeneity and further reveals critical factors when considering aNSC mediated cell replacement in injury and disease.
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Affiliation(s)
- Felix Beyer
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Janusz Jadasz
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Iria Samper Agrelo
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Jessica Schira-Heinen
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Janos Groh
- Department of Neurology, Developmental Neurobiology, University Hospital Würzburg, Würzburg, Germany
| | - Anastasia Manousi
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Christine Bütermann
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Veronica Estrada
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Laura Reiche
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Martina Cantone
- Laboratory of Systems Tumor Immunology, Department of Dermatology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Julio Vera
- Laboratory of Systems Tumor Immunology, Department of Dermatology, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Francesca Viganò
- Physiological Genomics, Institute of Physiology, Ludwig-Maximilians Universität München, München, Germany
| | - Leda Dimou
- Physiological Genomics, Institute of Physiology, Ludwig-Maximilians Universität München, München, Germany
| | - Hans Werner Müller
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Hans-Peter Hartung
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Patrick Küry
- Department of Neurology, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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18
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Lee P, Ullevig S, Sosa E, Estrada V, Yin Z. Adequacy of Nutrient Intake Among Preschoolers at Head Start Centers in San Antonio, Texas. J Acad Nutr Diet 2019. [DOI: 10.1016/j.jand.2019.06.235] [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: 10/26/2022]
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19
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Estrada V, Sagastagoitia I. Hepatitis C is a risk factor for cardiovascular disease. Rev Clin Esp 2019. [DOI: 10.1016/j.rceng.2019.03.005] [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: 02/07/2023]
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20
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Estrada V, Sagastagoitia I. La hepatitis C es un factor de riesgo para enfermedad cardiovascular. Rev Clin Esp 2019; 219:322-323. [DOI: 10.1016/j.rce.2019.01.012] [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] [Received: 01/30/2019] [Accepted: 01/31/2019] [Indexed: 11/24/2022]
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21
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Affiliation(s)
- Veronica Estrada
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Center Düsseldorf, Düsseldorf, Germany
| | - Hans Werner Müller
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Center Düsseldorf, Düsseldorf, Germany
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22
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Estrada V, Krebbers J, Voss C, Brazda N, Blazyca H, Illgen J, Seide K, Jürgens C, Müller J, Martini R, Trieu HK, Müller HW. Low-pressure micro-mechanical re-adaptation device sustainably and effectively improves locomotor recovery from complete spinal cord injury. Commun Biol 2018; 1:205. [PMID: 30511019 PMCID: PMC6255786 DOI: 10.1038/s42003-018-0210-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 12/08/2017] [Accepted: 10/31/2018] [Indexed: 12/16/2022] Open
Abstract
Traumatic spinal cord injuries result in impairment or even complete loss of motor, sensory and autonomic functions. Recovery after complete spinal cord injury is very limited even in animal models receiving elaborate combinatorial treatments. Recently, we described an implantable microsystem (microconnector) for low-pressure re-adaption of severed spinal stumps in rat. Here we investigate the long-term structural and functional outcome following microconnector implantation after complete spinal cord transection. Re-adaptation of spinal stumps supports formation of a tissue bridge, glial and vascular cell invasion, motor axon regeneration and myelination, resulting in partial recovery of motor-evoked potentials and a thus far unmet improvement of locomotor behaviour. The recovery lasts for at least 5 months. Despite a late partial decline, motor recovery remains significantly superior to controls. Our findings demonstrate that microsystem technology can foster long-lasting functional improvement after complete spinal injury, providing a new and effective tool for combinatorial therapies.
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Affiliation(s)
- Veronica Estrada
- 1Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Centre Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Julia Krebbers
- 1Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Centre Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Christian Voss
- 2Institute of Microsystems Technology, Hamburg University of Technology, Eißendorfer Str. 42, 21073 Hamburg, Germany.,BG Trauma Centre Hamburg, Bergedorfer Str. 10, 21033 Hamburg, Germany
| | - Nicole Brazda
- 1Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Centre Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Heinrich Blazyca
- 4Developmental Neurobiology, Department of Neurology, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
| | - Jennifer Illgen
- 1Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Centre Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Klaus Seide
- BG Trauma Centre Hamburg, Bergedorfer Str. 10, 21033 Hamburg, Germany
| | - Christian Jürgens
- BG Trauma Centre Hamburg, Bergedorfer Str. 10, 21033 Hamburg, Germany
| | - Jörg Müller
- 2Institute of Microsystems Technology, Hamburg University of Technology, Eißendorfer Str. 42, 21073 Hamburg, Germany
| | - Rudolf Martini
- 4Developmental Neurobiology, Department of Neurology, University Hospital Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
| | - Hoc Khiem Trieu
- 2Institute of Microsystems Technology, Hamburg University of Technology, Eißendorfer Str. 42, 21073 Hamburg, Germany
| | - Hans Werner Müller
- 1Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Centre Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.,CNR (Center for Neuronal Regeneration), Merowinger Platz 1a, 40225 Düsseldorf, Germany.,6Biomedical Research Center, Heinrich-Heine-University Düsseldorf, Universitätsstr. 1, 40225 Düsseldorf, Germany
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23
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Serrano-Villar S, Vázquez-Castellanos JF, Vallejo A, Latorre A, Sainz T, Ferrando-Martínez S, Rojo D, Martínez-Botas J, Del Romero J, Madrid N, Leal M, Mosele JI, Motilva MJ, Barbas C, Ferrer M, Moya A, Moreno S, Gosalbes MJ, Estrada V. The effects of prebiotics on microbial dysbiosis, butyrate production and immunity in HIV-infected subjects. Mucosal Immunol 2017; 10:1279-1293. [PMID: 28000678 DOI: 10.1038/mi.2016.122] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [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: 08/10/2016] [Accepted: 11/19/2016] [Indexed: 02/06/2023]
Abstract
Altered interactions between the gut mucosa and bacteria during HIV infection seem to contribute to chronic immune dysfunction. A deeper understanding of how nutritional interventions could ameliorate gut dysbiosis is needed. Forty-four subjects, including 12 HIV+ viremic untreated (VU) patients, 23 antiretroviral therapy-treated (ART+) virally suppressed patients (15 immunological responders and 8 non-responders) and 9 HIV- controls (HIV-), were blindly randomized to receive either prebiotics (scGOS/lcFOS/glutamine) or placebo (34/10) over 6 weeks in this pilot study. We assessed fecal microbiota composition using deep 16S rRNA gene sequencing and several immunological and genetic markers involved in HIV immunopathogenesis. The short dietary supplementation attenuated HIV-associated dysbiosis, which was most apparent in VU individuals but less so in ART+ subjects, whose gut microbiota was found more resilient. This compositional shift was not observed in the placebo arm. Significantly, declines in indirect markers of bacterial translocation and T-cell activation, improvement of thymic output, and changes in butyrate production were observed. Increases in the abundance of Faecalibacterium and Lachnospira strongly correlated with moderate but significant increases of butyrate production and amelioration of the inflammatory biomarkers soluble CD14 and high-sensitivity C-reactive protein, especially among VU. Hence, the bacterial butyrate synthesis pathway holds promise as a viable target for interventions.
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Affiliation(s)
- S Serrano-Villar
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá (IRYCIS), Madrid, Spain
| | - J F Vázquez-Castellanos
- Unidad Mixta de Investigación en Genómica y Salud de la Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO-Salud Pública) y el Instituto Cavanilles de Biodiversidad y Biología Evolutiva (Universidad de Valencia), Valencia, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - A Vallejo
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá (IRYCIS), Madrid, Spain
| | - A Latorre
- Unidad Mixta de Investigación en Genómica y Salud de la Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO-Salud Pública) y el Instituto Cavanilles de Biodiversidad y Biología Evolutiva (Universidad de Valencia), Valencia, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - T Sainz
- Department of Pediatric Infectious Diseases, University Hospital La Paz, and La Paz Research Institute, Madrid, Spain
| | - S Ferrando-Martínez
- Laboratory of Immunovirology, Biomedicine Institute of Seville (IBIS), Department of Infectious Diseases, University Hospital Virgen del Rocío, Sevilla, Spain
| | - D Rojo
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, CEU San Pablo University, Madrid, Spain
| | - J Martínez-Botas
- Department of Biochemistry, University Hospital Ramón y Cajal-IRYCIS, Madrid, Spain
- CIBER of Obesity and Nutrition Pathophysiology (CIBEROBN), Madrid, Spain
| | | | - N Madrid
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá (IRYCIS), Madrid, Spain
| | - M Leal
- Laboratory of Immunovirology, Biomedicine Institute of Seville (IBIS), Department of Infectious Diseases, University Hospital Virgen del Rocío, Sevilla, Spain
| | - J I Mosele
- Food Technology Department, Agrotecnio Center, University of Lleida, Spain
| | - M J Motilva
- Food Technology Department, Agrotecnio Center, University of Lleida, Spain
| | - C Barbas
- Centro de Metabolómica y Bioanálisis (CEMBIO), Facultad de Farmacia, CEU San Pablo University, Madrid, Spain
| | - M Ferrer
- Institute of Catalysis, Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - A Moya
- Unidad Mixta de Investigación en Genómica y Salud de la Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO-Salud Pública) y el Instituto Cavanilles de Biodiversidad y Biología Evolutiva (Universidad de Valencia), Valencia, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - S Moreno
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Facultad de Medicina, Universidad de Alcalá (IRYCIS), Madrid, Spain
| | - M J Gosalbes
- Unidad Mixta de Investigación en Genómica y Salud de la Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO-Salud Pública) y el Instituto Cavanilles de Biodiversidad y Biología Evolutiva (Universidad de Valencia), Valencia, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - V Estrada
- HIV Unit, Department of Internal Medicine, University Hospital Clínico San Carlos, Madrid, Spain
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24
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Affiliation(s)
- Veronica Estrada
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Center Düsseldorf, Düsseldorf, Germany
| | - Hans Werner Müller
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Center Düsseldorf, Düsseldorf, Germany
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25
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Ingenwerth M, Estrada V, Stahr A, Müller HW, von Gall C. HSF1-deficiency affects gait coordination and cerebellar calbindin levels. Behav Brain Res 2016; 310:103-8. [DOI: 10.1016/j.bbr.2016.05.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 05/02/2016] [Accepted: 05/06/2016] [Indexed: 12/27/2022]
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26
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Teira R, Vidal F, Muñoz-Sánchez P, Geijo P, Viciana P, Ribera E, Domingo P, Castaño M, Martínez E, Roca B, Puig T, Estrada V, Deig E, Galindo MJ, de la Fuente B, Lozano F, Montero M, Muñoz-Sanz A, Sanchez T, Terrón A, Romero-Palacios A, Lacalle JR, Garrido M, Suárez-Lozano I. Very low level viraemia and risk of virological failure in treated HIV-1-infected patients. HIV Med 2016; 18:196-203. [PMID: 27476742 DOI: 10.1111/hiv.12413] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of the study was to investigate whether very low level viraemia (VLLV) (20-50 HIV-1 RNA copies/mL) was associated with increased risk of virological failure (VF) as compared with persistent full suppression (< 20 copies/mL). METHODS From the VACH Cohort database, we selected those patients who started antiretroviral therapy (ART) after January 1997 and who achieved effective viral suppression [two consecutive viral loads (VLs) < 50 copies/mL] followed by full suppression (at least one VL <20 copies/mL). We carried out survival analyses to investigate whether the occurrence of VLLV rather than maintaining full suppression at < 20 copies/mL was associated with virological failure (two consecutive VLs > 200 copies/mL or one VL > 200 copies/mL followed by a change of ART regimen, administrative censoring or loss to follow-up), adjusted for nadir CD4 cell count, sex, age, ethnicity, transmission group, type of ART and time on effective suppression at < 50 copies/mL. RESULTS Of 21 480 patients who started ART, 13 674 (63.7%) achieved effective suppression at < 50 copies/mL, of whom 4289 (31.4%) further achieved full suppression at < 20 copies/mL after May 2009. A total of 2623 patients (61.1%) remained fully suppressed thereafter, while 1666 had one or more episodes of VL detection > 20 copies/mL (excluding virological failure). A total of 824 patients had VLLV after suppression at < 20 copies/mL. VLLV was not associated with virological failure as compared with persistent full suppression [hazard ratio (HR) 0.67; 95% confidence interval (CI) 0.44-1.00], independently of the number of blips recorded (from one to 18). CONCLUSIONS In our population of HIV-infected patients on ART who achieved viral suppression at < 20 copies/mL, the risk of virological failure was no different for patients who remained fully suppressed compared with those who experienced subsequent episodes of VLLV.
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Affiliation(s)
- R Teira
- Sierrallana Hospital, Torrelavega, Spain
| | - F Vidal
- Tarragona University Hospital Joan XXIII, Tarragona, Spain
| | | | - P Geijo
- Virgen de la Luz Hospital, Cuenca, Spain
| | - P Viciana
- Virgen del Rocío Hospital, Sevilla, Spain
| | - E Ribera
- Vall d'Hebrón Hospital, Barcelona, Spain
| | - P Domingo
- Santa Creu i Sant Pau Hospital, Barcelona, Spain
| | | | | | - B Roca
- General Hospital, Castellón, Spain
| | - T Puig
- Arnau de Vilanova Hospital, Lleida, Spain
| | - V Estrada
- San Carlos Clinical Hospital, Madrid, Spain
| | - E Deig
- General Hospital, Granollers, Spain
| | | | | | | | | | | | - T Sanchez
- Virgen de Rosell Hospital, Cartagena, Spain
| | - A Terrón
- SAS Hospital, Jérez de la Frontera, Spain
| | | | | | - M Garrido
- VACH Medical Association, Cartaya, Spain
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27
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Brazda N, Estrada V, Voss C, Seide K, Trieu HK, Müller HW. Experimental Strategies to Bridge Large Tissue Gaps in the Injured Spinal Cord after Acute and Chronic Lesion. J Vis Exp 2016:e53331. [PMID: 27077921 DOI: 10.3791/53331] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
After a spinal cord injury (SCI) a scar forms in the lesion core which hinders axonal regeneration. Bridging the site of injury after an insult to the spinal cord, tumor resections, or tissue defects resulting from traumatic accidents can aid in facilitating general tissue repair as well as regenerative growth of nerve fibers into and beyond the affected area. Two experimental treatment strategies are presented: (1) implantation of a novel microconnector device into an acutely and completely transected thoracic rat spinal cord to readapt severed spinal cord tissue stumps, and (2) polyethylene glycol filling of the SCI site in chronically lesioned rats after scar resection. The chronic spinal cord lesion in this model is a complete spinal cord transection which was inflicted 5 weeks before treatment. Both methods have recently achieved very promising outcomes and promoted axonal regrowth, beneficial cellular invasion and functional improvements in rodent models of spinal cord injury. The mechanical microconnector system (mMS) is a multi-channel system composed of polymethylmethacrylate (PMMA) with an outlet tubing system to apply negative pressure to the mMS lumen thus pulling the spinal cord stumps into the honeycomb-structured holes. After its implantation into the 1 mm tissue gap the tissue is sucked into the device. Furthermore, the inner walls of the mMS are microstructured for better tissue adhesion. In the case of the chronic spinal cord injury approach, spinal cord tissue - including the scar-filled lesion area - is resected over an area of 4 mm in length. After the microsurgical scar resection the resulting cavity is filled with polyethylene glycol (PEG 600) which was found to provide an excellent substratum for cellular invasion, revascularization, axonal regeneration and even compact remyelination in vivo.
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Affiliation(s)
- Nicole Brazda
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Center
| | - Veronica Estrada
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Center
| | - Christian Voss
- Institute of Microsystems Technology, Hamburg University of Technology; Biomechanical Laboratory, BG Trauma Center Hamburg
| | - Klaus Seide
- Biomechanical Laboratory, BG Trauma Center Hamburg
| | - Hoc Khiem Trieu
- Institute of Microsystems Technology, Hamburg University of Technology
| | - Hans Werner Müller
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Center;
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28
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Estrada V, Monge S, Gómez-Garre MD, Sobrino P, Masiá M, Berenguer J, Portilla J, Viladés C, Martínez E, Blanco JR. Relationship between plasma bilirubin level and oxidative stress markers in HIV-infected patients on atazanavir- vs. efavirenz-based antiretroviral therapy. HIV Med 2016; 17:653-61. [PMID: 26935006 DOI: 10.1111/hiv.12368] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2015] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Chronic oxidative stress (OS) may play a role in cardiovascular disease in HIV-infected patients, and increased bilirubin levels may have a beneficial role in counteracting OS. Atazanavir (ATV) inhibits UDP-glucuronosyl-transferase 1A1 (UGT1A1), thus increasing unconjugated bilirubin levels. We aimed to compare changes in OS markers in patients on ATV/ritonavir (ATV/r)- vs. efavirenz (EFV)-based first-line antiretroviral therapy (ART). METHODS A multicentre, prospective cohort study of HIV-infected patients who started first-line ART with either ATV/r or EFV was conducted. Lipoprotein-associated phospholipase A2 (Lp-PLA2), myeloperoxidase (MPO) and oxidized low-density lipoprotein (oxLDL) were measured for 145 patients in samples obtained at baseline and after at least 9 months of ART during which the initial regimen was maintained and the patient was virologically suppressed. The change in OS markers was modelled using multiple linear regressions adjusting for baseline values and confounders. RESULTS After adjustment for baseline variables, patients on ATV/r had a significantly greater decrease in Lp-PLA2 [estimated difference -16.3; 95% confidence interval (CI) -31.4, -1.25; P = 0.03] and a significantly smaller increase in OxLDL (estimated difference -21.8; 95% CI -38.0, -5.6; P < 0.01) relative to those on EFV, whereas changes in MPO were not significantly different (estimated difference 1.2; 95% CI -14.3, 16.7; P = 0.88). Adjusted changes in bilirubin were significantly greater for the ATV/r group than for the EFV group (estimated difference 1.33 mg/dL; 95% CI 1.03, 1.52 mg/dL; P < 0.01). Changes in bilirubin and changes in OS markers were significantly correlated. CONCLUSIONS When compared with EFV, ATV/r-based therapy was associated with lower levels of oxidative stress biomarkers, which was in part attributable to increased bilirubin levels.
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Affiliation(s)
- V Estrada
- Hospital Clínico San Carlos-IdiSSC, Universidad Complutense, Madrid, Spain
| | - S Monge
- Universidad de Alcalá de Henares, CIBERESP, Spain
| | - M D Gómez-Garre
- Hospital Clínico San Carlos-IdiSSC, Universidad Complutense, Madrid, Spain
| | - P Sobrino
- Universidad de Alcalá de Henares, CIBERESP, Spain
| | - M Masiá
- Hospital General de Elche, Elche, Spain
| | - J Berenguer
- Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - J Portilla
- Hospital General Universitario de Alicante, Alicante, Spain
| | - C Viladés
- Hospital Universitari de Tarragona Joan XXIII, Universitat Rovira i Virgili, Tarragona, Spain
| | | | - J R Blanco
- Hospital San Pedro-CIBIR, Logroño, Spain
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29
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Reartes SR, Estrada V, Bazán R, Larrosa N, Cossavella A, López A, Busso F, Diaz M. Evaluation of ecological effects of anthropogenic nutrient loading scenarios in Los Molinos reservoir through a mathematical model. Ecol Modell 2016. [DOI: 10.1016/j.ecolmodel.2015.10.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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30
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Ochoa MP, Estrada V, Di Maggio J, Hoch PM. Dynamic global sensitivity analysis in bioreactor networks for bioethanol production. Bioresour Technol 2016; 200:666-679. [PMID: 26556401 DOI: 10.1016/j.biortech.2015.10.069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/17/2015] [Accepted: 10/20/2015] [Indexed: 06/05/2023]
Abstract
Dynamic global sensitivity analysis (GSA) was performed for three different dynamic bioreactor models of increasing complexity: a fermenter for bioethanol production, a bioreactors network, where two types of bioreactors were considered: aerobic for biomass production and anaerobic for bioethanol production and a co-fermenter bioreactor, to identify the parameters that most contribute to uncertainty in model outputs. Sobol's method was used to calculate time profiles for sensitivity indices. Numerical results have shown the time-variant influence of uncertain parameters on model variables. Most influential model parameters have been determined. For the model of the bioethanol fermenter, μmax (maximum growth rate) and Ks (half-saturation constant) are the parameters with largest contribution to model variables uncertainty; in the bioreactors network, the most influential parameter is μmax,1 (maximum growth rate in bioreactor 1); whereas λ (glucose-to-total sugars concentration ratio in the feed) is the most influential parameter over all model variables in the co-fermentation bioreactor.
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Affiliation(s)
- M P Ochoa
- Planta Piloto de Ingeniería Química, CONICET, 8000 Bahía Blanca, Argentina; Universidad Nacional del Sur, Departamento de Ingeniería Química, 8000 Bahía Blanca, Argentina
| | - V Estrada
- Planta Piloto de Ingeniería Química, CONICET, 8000 Bahía Blanca, Argentina; Universidad Nacional del Sur, Departamento de Ingeniería Química, 8000 Bahía Blanca, Argentina.
| | - J Di Maggio
- Planta Piloto de Ingeniería Química, CONICET, 8000 Bahía Blanca, Argentina; Universidad Nacional del Sur, Departamento de Ingeniería Química, 8000 Bahía Blanca, Argentina
| | - P M Hoch
- Planta Piloto de Ingeniería Química, CONICET, 8000 Bahía Blanca, Argentina; Universidad Nacional del Sur, Departamento de Ingeniería Química, 8000 Bahía Blanca, Argentina
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Rojas J, Lonca M, Imaz A, Estrada V, Asensi V, Miralles C, Domingo P, Montero M, del Rio L, Fontdevila J, Perez I, Cruceta A, Gatell JM, Arnedo M, Martínez E. Improvement of lipoatrophy by switching from efavirenz to lopinavir/ritonavir. HIV Med 2015; 17:340-9. [PMID: 27089862 DOI: 10.1111/hiv.12314] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2015] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To assess whether changes in antiretroviral drugs other than thymidine nucleoside reverse transcriptase inhibitors (NRTI) may have a body fat impact in HIV-infected patients with lipoatrophy. METHODS Ninety-six-week phase IV, open-label, multicentre, pilot randomized trial. HIV-infected patients with moderate/severe lipoatrophy at one or more body sites despite long-term thymidine NRTI-free therapy were randomized to continue their efavirenz (EFV)-based antiretroviral regimen or to switch from EFV to lopinavir/ritonavir (LPV/r). The primary endpoint was the absolute change in limb fat mass measured by dual X-ray absorptiometry from baseline to 96 weeks. Changes in other body fat measurements, subjective perception of lipoatrophy, subcutaneous fat gene expression and plasma lipids were also assessed. RESULTS Thirty-three patients (73% men, median age 52 years) were recruited. At 96 weeks, absolute limb fat mass increased in the LPV/r arm vs. the EFV arm (estimated difference +1082.1 g; 95% CI +63.7 to +2103.5; P = 0.04); this difference remained significant after adjustment by gender, age, fat mass, body mass index and CD4 cell count at baseline. Subjective lipoatrophy perception scores also improved in the LPV/r arm relative to the EFV arm. Adipogenesis, glucose and lipid metabolism, and mitochondrial gene expression increased in the LPV/r arm compared with the EFV arm at 96 weeks. HDL cholesterol decreased in the LPV/r arm relative to the EFV arm. CONCLUSIONS Switching from EFV to LPV/r in HIV-infected patients with lipoatrophy may offer further limb fat gain beyond thymidine NRTI discontinuation, although this strategy decreased plasma HDL cholesterol and caused changes in subcutaneous fat gene expression that may be associated with increased insulin resistance.
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Affiliation(s)
- J Rojas
- Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - M Lonca
- Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - A Imaz
- Hospital Universitari de Bellvitge, Universitat de Barcelona, L'Hospitalet de Llobregat, Spain
| | - V Estrada
- Hospital Clínico San Carlos, Universidad Complutense de Madrid, Madrid, Spain
| | - V Asensi
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | - C Miralles
- Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - P Domingo
- Hospital de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Montero
- Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - J Fontdevila
- Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - I Perez
- Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - A Cruceta
- Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - J M Gatell
- Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - M Arnedo
- Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - E Martínez
- Hospital Clínic-IDIBAPS, Universitat de Barcelona, Barcelona, Spain
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Vázquez-Castellanos JF, Serrano-Villar S, Latorre A, Artacho A, Ferrús ML, Madrid N, Vallejo A, Sainz T, Martínez-Botas J, Ferrando-Martínez S, Vera M, Dronda F, Leal M, Del Romero J, Moreno S, Estrada V, Gosalbes MJ, Moya A. Altered metabolism of gut microbiota contributes to chronic immune activation in HIV-infected individuals. Mucosal Immunol 2015; 8:760-72. [PMID: 25407519 DOI: 10.1038/mi.2014.107] [Citation(s) in RCA: 209] [Impact Index Per Article: 23.2] [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: 04/30/2014] [Accepted: 10/06/2014] [Indexed: 02/07/2023]
Abstract
Altered interplay between gut mucosa and microbiota during treated HIV infection may possibly contribute to increased bacterial translocation and chronic immune activation, both of which are predictors of morbidity and mortality. Although a dysbiotic gut microbiota has recently been reported in HIV+ individuals, the metagenome gene pool associated with HIV infection remains unknown. The aim of this study is to characterize the functional gene content of gut microbiota in HIV+ patients and to define the metabolic pathways of this bacterial community, which is potentially associated with immune dysfunction. We determined systemic markers of innate and adaptive immunity in a cohort of HIV-infected individuals on successful antiretroviral therapy without comorbidities and in healthy non-HIV-infected subjects. Metagenome sequencing revealed an altered functional profile, with enrichment of the genes involved in various pathogenic processes, lipopolysaccharide biosynthesis, bacterial translocation, and other inflammatory pathways. In contrast, we observed depletion of genes involved in amino acid metabolism and energy processes. Bayesian networks showed significant interactions between the bacterial community, their altered metabolic pathways, and systemic markers of immune dysfunction. This study reveals altered metabolic activity of microbiota and provides novel insight into the potential host-microbiota interactions driving the sustained inflammatory state in successfully treated HIV-infected patients.
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Affiliation(s)
- J F Vázquez-Castellanos
- 1] Unidad Mixta de Investigación en Genómica y Salud de la Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO-Salud Pública) y el Instituto Cavanilles de Biodiversitad y Biología Evolutiva (Universitat de València), Valencia, Spain [2] CIBER on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - S Serrano-Villar
- Department of Infectious Diseases, University Hospital Ramón y Cajal-IRYCIS, Madrid, Spain
| | - A Latorre
- 1] Unidad Mixta de Investigación en Genómica y Salud de la Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO-Salud Pública) y el Instituto Cavanilles de Biodiversitad y Biología Evolutiva (Universitat de València), Valencia, Spain [2] CIBER on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - A Artacho
- Unidad Mixta de Investigación en Genómica y Salud de la Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO-Salud Pública) y el Instituto Cavanilles de Biodiversitad y Biología Evolutiva (Universitat de València), Valencia, Spain
| | - M L Ferrús
- Unidad Mixta de Investigación en Genómica y Salud de la Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO-Salud Pública) y el Instituto Cavanilles de Biodiversitad y Biología Evolutiva (Universitat de València), Valencia, Spain
| | - N Madrid
- Department of Infectious Diseases, University Hospital Ramón y Cajal-IRYCIS, Madrid, Spain
| | - A Vallejo
- Department of Infectious Diseases, University Hospital Ramón y Cajal-IRYCIS, Madrid, Spain
| | - T Sainz
- 1] Laboratory of Molecular Immune Biology, University Hospital Gregorio Marañón and Gregorio Marañón Research Institute, Madrid, Spain [2] CIBER on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
| | - J Martínez-Botas
- 1] Department of Biochemistry, University Hospital Ramón y Cajal-IRYCIS, Madrid, Spain [2] CIBER on Obesity and Nutrition Pathophysiology (CIBEROBN), Madrid, Spain
| | - S Ferrando-Martínez
- 1] Laboratory of Molecular Immune Biology, University Hospital Gregorio Marañón and Gregorio Marañón Research Institute, Madrid, Spain [2] CIBER on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain [3] Laboratory of Immunovirology, Department of Infectious Diseases, Biomedicine Institute of Seville (IBIS), University Hospital Virgen del Rocío, Sevilla, Spain
| | - M Vera
- Centro Sandoval, Madrid, Spain
| | - F Dronda
- Department of Infectious Diseases, University Hospital Ramón y Cajal-IRYCIS, Madrid, Spain
| | - M Leal
- Laboratory of Immunovirology, Department of Infectious Diseases, Biomedicine Institute of Seville (IBIS), University Hospital Virgen del Rocío, Sevilla, Spain
| | | | - S Moreno
- Department of Infectious Diseases, University Hospital Ramón y Cajal-IRYCIS, Madrid, Spain
| | - V Estrada
- HIV Unit, Department of Internal Medicine, University Hospital Clínico San Carlos, Madrid, Spain
| | - M J Gosalbes
- 1] Unidad Mixta de Investigación en Genómica y Salud de la Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO-Salud Pública) y el Instituto Cavanilles de Biodiversitad y Biología Evolutiva (Universitat de València), Valencia, Spain [2] CIBER on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - A Moya
- 1] Unidad Mixta de Investigación en Genómica y Salud de la Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunidad Valenciana (FISABIO-Salud Pública) y el Instituto Cavanilles de Biodiversitad y Biología Evolutiva (Universitat de València), Valencia, Spain [2] CIBER on Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Pulido F, Estrada V, Baril J, Logue K, Schewe K, Plettenberg A, Duiculescu D, Yau L, Vavro C, Lim M, Pharo C. Long-Term Efficacy and Safety of Fosamprenavir plus Ritonavir Versus Lopinavir/Ritonavir in Combination with Abacavir/Lamivudine over 144 Weeks. HIV Clinical Trials 2015; 10:76-87. [DOI: 10.1310/hct1002-76] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Martínez E, Ribera E, Clotet B, Estrada V, Sanz J, Berenguer J, Rubio R, Pulido F, Larrousse M, Curran A, Negredo E, Arterburn S, Ferrer P, Álvarez ML. Switching from zidovudine/lamivudine to tenofovir/emtricitabine improves fat distribution as measured by fat mass ratio. HIV Med 2014; 16:370-4. [PMID: 25496141 DOI: 10.1111/hiv.12210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 09/10/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Fat mass ratio (FMR) has been suggested as an objective indicator of abnormal body fat distribution in HIV infection. Although it could provide more comprehensive information on body fat changes than limb fat mass, FMR has scarcely been used in clinical trials examining body fat distribution in HIV-infected patients. METHODS A subanalysis of a controlled, randomized clinical trial in virologically suppressed HIV-1-infected men switching from zidovudine (ZDV)/lamivudine (3TC) to emtricitabine (FTC)/tenofovir (TDF) versus continuing on ZDV/3TC was carried out. FMR was assessed by dual X-ray absorptiometry (DEXA) for a period of 72 weeks. Lipoatrophy was defined as FMR ≥ 1.5. Multivariate linear regression models for the change in FMR from baseline were fitted. RESULTS Sixty-five men were randomized and treated (28 in the FTC/TDF arm and 37 in the ZDV/3TC arm), and 57 completed the study (25 and 32 in each arm, respectively). In the FTC/TDF arm, adjusted mean FMR decreased by 0.52 at week 72 (P = 0.014), and in the ZDV/3TC arm it increased by 0.13 (P = 0.491; P between arms = 0.023). Among subjects with lipoatrophy (baseline FMR ≥ 1.5), adjusted FMR decreased by 0.76 (P = 0.003) in the FTC/TDF arm and increased by 0.21 (P = 0.411; P between arms = 0.009) in the ZDV/3TC arm. Baseline FMR and treatment group were significant predictors (P < 0.05) of post-baseline changes in FMR. CONCLUSIONS Switching from ZDV/3TC to FTC/TDF led to an improvement in FMR, compared with progressive worsening of FMR in subjects receiving ZDV/3TC, showing that fat mass not only increased but was also distributed in a healthier way after the switch.
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Affiliation(s)
- E Martínez
- Hospital Clinic IDIBAPS, University of Barcelona, Barcelona, Spain
| | - E Ribera
- Hospital Universitari Vall d'Hebron, Infectious Diseases Division, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - B Clotet
- IrsiCaixa Foundation, Institut Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | - V Estrada
- Instituto de Investigación Biomédica del Hospital Clínico San Carlos, Hospital Clínico San Carlos, Madrid, Spain
| | - J Sanz
- Hospital Universitario de la Princesa, Instituto de Investigación Princesa, Madrid, Spain
| | - J Berenguer
- Infectious Diseases/HIV Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - R Rubio
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | - F Pulido
- Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - A Curran
- Hospital Universitari Vall d'Hebron, Infectious Diseases Division, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - E Negredo
- IrsiCaixa Foundation, Institut Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain
| | | | - P Ferrer
- Gilead Sciences SL, Madrid, Spain
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Abstract
In the last century, research in the field of spinal cord trauma has brought insightful knowledge which has led to a detailed understanding of mechanisms that are involved in injury- and recovery-related processes. The quest for a cure for the yet generally incurable condition as well as the exponential rise in gained information has brought about the development of numerous treatment approaches while at the same time the abundance of data has become quite unmanageable. Owing to an enormous amount of preclinical therapeutic approaches, this report highlights important trends rather than specific treatment strategies. We focus on current advances in the treatment of spinal cord injury and want to further draw attention to arising problems in spinal cord injury (SCI) research and discuss possible solutions.
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Affiliation(s)
- Veronica Estrada
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Center Düsseldorf Moorenstr. 5, 40225 Düsseldorf Germany
| | - Hans Werner Müller
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Center Düsseldorf Moorenstr. 5, 40225 Düsseldorf Germany
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Estrada V, Brazda N, Schmitz C, Heller S, Blazyca H, Martini R, Müller HW. Long-lasting significant functional improvement in chronic severe spinal cord injury following scar resection and polyethylene glycol implantation. Neurobiol Dis 2014; 67:165-79. [PMID: 24713436 DOI: 10.1016/j.nbd.2014.03.018] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 03/17/2014] [Accepted: 03/28/2014] [Indexed: 01/04/2023] Open
Abstract
We identified a suitable biomatrix that improved axon regeneration and functional outcome after partial (moderate) and complete (severe) chronic spinal cord injury (SCI) in rat. Five weeks after dorsal thoracic hemisection injury the lesion scar was resected via aspiration and the resulting cavity was filled with different biopolymers such as Matrigel™, alginate-hydrogel and polyethylene glycol 600 (PEG) all of which have not previously been used as sole graft-materials in chronic SCI. Immunohistological staining revealed marked differences between these compounds regarding axon regeneration, invasion/elongation of astrocytes, fibroblasts, endothelial and Schwann cells, revascularization, and collagen deposition. According to axon regeneration-supporting effects, the biopolymers could be ranked in the order PEG>>alginate-hydrogel>Matrigel™. Even after complete chronic transection, the PEG-bridge allowed long-distance axon regeneration through the grafted area and for, at least, 1cm beyond the lesion/graft border. As revealed by electron microscopy, bundles of regenerating axons within the matrix area received myelin ensheathment from Schwann cells. The beneficial effects of PEG-implantation into the resection-cavity were accompanied by long-lasting significant locomotor improvement over a period of 8months. Following complete spinal re-transection at the rostral border of the PEG-graft the locomotor recovery was aborted, suggesting a functional role of regenerated axons in the initial locomotor improvement. In conclusion, scar resection and subsequent implantation of PEG into the generated cavity leads to tissue recovery, axon regeneration, myelination and functional improvement that have not been achieved before in severe chronic SCI.
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Affiliation(s)
- Veronica Estrada
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Center Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Nicole Brazda
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Center Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Christine Schmitz
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Center Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Silja Heller
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Center Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany
| | - Heinrich Blazyca
- Department of Neurology, Developmental Neurobiology, University Medical Center Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
| | - Rudolf Martini
- Department of Neurology, Developmental Neurobiology, University Medical Center Würzburg, Josef-Schneider-Str. 11, 97080 Würzburg, Germany
| | - Hans Werner Müller
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Center Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
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Abstract
The consequence of numerous neurological disorders is the significant loss of neural cells, which further results in multilevel dysfunction or severe functional deficits. The extracellular matrix (ECM) is of tremendous importance for neural regeneration mediating ambivalent functions: ECM serves as a growth-promoting substrate for neurons but, on the other hand, is a major constituent of the inhibitory scar, which results from traumatic injuries of the central nervous system. Therefore, cell and tissue replacement strategies on the basis of ECM mimetics are very promising therapeutic interventions. Numerous synthetic and natural materials have proven effective both in vitro and in vivo. The closer a material's physicochemical and molecular properties are to the original extracellular matrix, the more promising its effectiveness may be. Relevant factors that need to be taken into account when designing such materials for neural repair relate to receptor-mediated cell-matrix interactions, which are dependent on chemical and mechanical sensing. This chapter outlines important characteristics of natural and synthetic ECM materials (scaffolds) and provides an overview of recent advances in design and application of ECM materials for neural regeneration, both in therapeutic applications and in basic biological research.
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Affiliation(s)
- Veronica Estrada
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Center Düsseldorf, Düsseldorf, Germany
| | - Ayse Tekinay
- UNAM-National Nanotechnology Research Center, Institute of Materials Science and Nanotechnology, Bilkent University, Ankara, Turkey
| | - Hans Werner Müller
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Center Düsseldorf, Düsseldorf, Germany.
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Brazda N, Voss C, Estrada V, Lodin H, Weinrich N, Seide K, Müller J, Müller HW. A mechanical microconnector system for restoration of tissue continuity and long-term drug application into the injured spinal cord. Biomaterials 2013; 34:10056-64. [PMID: 24090837 DOI: 10.1016/j.biomaterials.2013.09.057] [Citation(s) in RCA: 10] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 09/17/2013] [Indexed: 11/18/2022]
Abstract
Complete transection of the spinal cord leaves a gap of several mm which fills with fibrous scar tissue. Several approaches in rodent models have used tubes, foams, matrices or tissue implants to bridge this gap. Here, we describe a mechanical microconnector system (mMS) to re-adjust the retracted spinal cord stumps. The mMS is a multi-channel system of polymethylmethacrylate (PMMA), designed to fit into the spinal cord tissue gap after transection, with an outlet tubing system to apply negative pressure to the mMS thus sucking the spinal cord stumps into the honeycomb-structured holes. The stumps adhere to the microstructure of the mMS walls and remain in the mMS after removal of the vacuum. We show that the mMS preserves tissue integrity and allows axonal regrowth at 2, 5 and 19 weeks post lesion with no adverse tissue effects like in-bleeding or cyst formation. Preliminary assessment of locomotor function in the open field suggested beneficial effects of the mMS. Additional inner micro-channels enable local substance delivery into the lesion center via an attached osmotic minipump. We suggest that the mMS is a suitable device to adapt and stabilize the injured spinal cord after surgical resection of scar tissue (e.g., for chronic patients) or traumatic injuries with large tissue and bone damages.
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Affiliation(s)
- Nicole Brazda
- Molecular Neurobiology Laboratory, Neurology, Heinrich Heine University Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
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Serrano-Villar S, Moreno S, Fuentes-Ferrer M, Sánchez-Marcos C, Avila M, Sainz T, de Villar NGP, Fernández-Cruz A, Estrada V. The CD4:CD8 ratio is associated with markers of age-associated disease in virally suppressed HIV-infected patients with immunological recovery. HIV Med 2013; 15:40-9. [PMID: 24007533 DOI: 10.1111/hiv.12081] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2013] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Inversion of the CD4:CD8 ratio (< 1) has been identified as a hallmark of inmmunosenescence and an independent predictor of mortality in the general population. We aimed to assess the association between the CD4:CD8 ratio and markers of age-associated disease in treated HIV-infected patients with good immunovirological response. METHODS A cross-sectional analysis was conducted in 132 HIV-infected adults on antiretroviral therapy (ART), with plasma HIV RNA < 50 HIV-1 RNA copies/mL for at least 1 year, CD4 count > 350 cells/μL and age < 65 years. We analysed the associations between the CD4:CD8 ratio and subclinical atherosclerosis [assessed using carotid intima-media thickness (IMT)], arterial stiffness [assessed using the augmentation index (AIx)], the estimated glomerular filtration rate (eGFR), muscle wasting and sarcopenia [assessed using appendicular lean mass/height(2) (ALM) measured by dual-energy X-ray absorptiometry (DEXA)]. RESULTS CD4:CD8 ratio inversion was associated with higher IMT, lower eGFR and lower ALM (all values P < 0.05), but not with AIx. In multivariate analyses adjusted for age, sex, hypertriglyceridaemia, tobacco use and cumulative ART exposure, inversion of the CD4:CD8 ratio was independently associated with higher IMT [odds ratio (OR) 2.9; 95% confidence interval (CI) 1.2-7.1], arterial stiffness (OR 4.8; 95% CI 1.0-23.5) and lower eGFR (OR 5.2; 95% CI 1.0-64.4), but not sarcopenia (OR 0.7; 95% CI 0.2-2.7). These associations persisted when models were applied to subjects with nadir CD4 counts > 200 cells/μL and those with CD4 counts > 500 cells/μL. CONCLUSIONS The CD4:CD8 ratio in treated HIV-infected subjects with good immunovirological response is independently associated with markers of age-associated disease. Hence, it might be a clinically useful predictor of non-AIDS-defining conditions.
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Affiliation(s)
- S Serrano-Villar
- Infectious Diseases Department, University Hospital Ramón y Cajal, Madrid, Spain; Health Research Institute Ramón y Cajal (IRYCIS), Madrid, Spain
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Ribera E, Larrousse M, Curran A, Negredo E, Clotet B, Estrada V, Sanz J, Berenguer J, Rubio R, Pulido F, Ferrer P, Alvarez ML, Arterburn S, Martínez E. Impact of switching from zidovudine/lamivudine to tenofovir/emtricitabine on lipoatrophy: the RECOMB study. HIV Med 2013; 14:327-36. [DOI: 10.1111/hiv.12011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2012] [Indexed: 11/30/2022]
Affiliation(s)
- E Ribera
- Infectious Diseases Division; Hospital Universitari Vall d'Hebron; Autonomous University of Barcelona; Barcelona; Spain
| | - M Larrousse
- Infectious Diseases Unit; Hospital Clinic-IDIBAPS; University of Barcelona; Barcelona; Spain
| | - A Curran
- Infectious Diseases Division; Hospital Universitari Vall d'Hebron; Autonomous University of Barcelona; Barcelona; Spain
| | - E Negredo
- IrsiCaixa Foundation; Institut Germans Trias i Pujol; Diseases Division; Autonomous University of Barcelona; Badalona; Spain
| | - B Clotet
- IrsiCaixa Foundation; Institut Germans Trias i Pujol; Diseases Division; Autonomous University of Barcelona; Badalona; Spain
| | - V Estrada
- Hospital Clínico San Carlos; Madrid; Spain
| | - J Sanz
- Hospital Universitario de la Princesa; Instituto de Investigación Princesa; Madrid; Spain
| | - J Berenguer
- Infectious Diseases/HIV Unit; Hospital General Universitario Gregorio Marañón; Madrid; Spain
| | - R Rubio
- Hospital Universitario 12 de Octubre; Madrid; Spain
| | - F Pulido
- Hospital Universitario 12 de Octubre; Madrid; Spain
| | - P Ferrer
- Gilead Sciences SL; Madrid; Spain
| | | | - S Arterburn
- Gilead Sciences Inc.; Foster City; California; USA
| | - E Martínez
- Infectious Diseases Unit; Hospital Clinic-IDIBAPS; University of Barcelona; Barcelona; Spain
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Lopez M, Roman JS, Estrada V, Vispo E, Soriano V. Cardiovascular Disease Risk in HIV Infection and Endothelial Progenitor Cells. J Infect Dis 2012; 206:1479-80; author reply 1480-1. [DOI: 10.1093/infdis/jis518] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Schira J, Gasis M, Estrada V, Hendricks M, Schmitz C, Trapp T, Kruse F, Kögler G, Wernet P, Hartung HP, Müller HW. Significant clinical, neuropathological and behavioural recovery from acute spinal cord trauma by transplantation of a well-defined somatic stem cell from human umbilical cord blood. ACTA ACUST UNITED AC 2011; 135:431-46. [PMID: 21903726 DOI: 10.1093/brain/awr222] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Stem cell therapy is a potential treatment for spinal cord injury and different stem cell types have been grafted into animal models and humans suffering from spinal trauma. Due to inconsistent results, it is still an important and clinically relevant question which stem cell type will prove to be therapeutically effective. Thus far, stem cells of human sources grafted into spinal cord mostly included barely defined heterogeneous mesenchymal stem cell populations derived from bone marrow or umbilical cord blood. Here, we have transplanted a well-defined unrestricted somatic stem cell isolated from human umbilical cord blood into an acute traumatic spinal cord injury of adult immune suppressed rat. Grafting of unrestricted somatic stem cells into the vicinity of a dorsal hemisection injury at thoracic level eight resulted in hepatocyte growth factor-directed migration and accumulation within the lesion area, reduction in lesion size and augmented tissue sparing, enhanced axon regrowth and significant functional locomotor improvement as revealed by three behavioural tasks (open field Basso-Beattie-Bresnahan locomotor score, horizontal ladder walking test and CatWalk gait analysis). To accomplish the beneficial effects, neither neural differentiation nor long-lasting persistence of the grafted human stem cells appears to be required. The secretion of neurite outgrowth-promoting factors in vitro further suggests a paracrine function of unrestricted somatic stem cells in spinal cord injury. Given the highly supportive functional characteristics in spinal cord injury, production in virtually unlimited quantities at GMP grade and lack of ethical concerns, unrestricted somatic stem cells appear to be a highly suitable human stem cell source for clinical application in central nervous system injuries.
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Affiliation(s)
- Jessica Schira
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University Medical Centre Düsseldorf, Moorenstr. 5, 40223 Düsseldorf, Germany
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Casado JL, Domingo P, Rubio R, Antela A, Lopez-Ruz MA, Castro A, Portilla J, Ribera E, Podzamczer D, Oteo JA, Galindo J, Otero S, Lozano F, Estrada V, Moltó J, Moreno S. Switching from tipranavir (TPV) 500/ritonavir (RTV) 200 mg to TPV 500/RTV 100 mg in treatment-experienced patients (pts) with HIV RNA <50 copies/mL. J Int AIDS Soc 2010. [PMCID: PMC3113052 DOI: 10.1186/1758-2652-13-s4-p49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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46
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Fuster M, Estrada V, Fernandez-Pinilla MC, Fuentes-Ferrer ME, Tellez MJ, Vergas J, Serrano-Villar S, Fernandez-Cruz A. Smoking cessation in HIV patients: rate of success and associated factors. HIV Med 2009; 10:614-9. [PMID: 19659946 DOI: 10.1111/j.1468-1293.2009.00735.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Smoking is the modifiable cardiovascular (CV) risk factor that contributes most to causing premature CV disease. Prevalence of smoking in patients with HIV infection is double that of the general population. OBJECTIVES To determine the rate of patients succeeding in quitting smoking after 12 months, factors associated with this success, and the characteristics of tobacco consumption and nicotine dependence. METHODS Longitudinal descriptive study. Three hundred and sixty-eight HIV-infected patients were interviewed. Smokers in Prochaska's stage of action began a programme to quit smoking. We registered the variables related to tobacco consumption and the level of success of cessation. RESULTS 63.9% of the patients were active smokers and 14% of them began the cessation programme. Average motivation for cessation was 7.8 +/- 1.4 (Richmond) and nicotine dependence rate 5.5 +/- 3.0 (Fagerström). After 1 year, 25% had quit smoking. Those patients who stopped smoking presented a higher motivation level (8.8 +/- 1.3 vs. 7.5 +/- 1.5, P=0.048). Cessation significantly reduced their CV risk at 12 months [2.5 [interquartile range (IQR) 2.0-5.2] vs. 1.7 [IQR 1.0-3.5], P=0.026]. CONCLUSIONS The prevalence of smokers in our population of HIV-infected patients was 63.9%. Only 14% began a smoking cessation programme. Twelve months after a programme to quit smoking, cessation rate was 25%; this was influenced mostly by the level of motivation of the patient.
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Affiliation(s)
- M Fuster
- Internal Medicine/HIV Unit, Hospital Clínico San Carlos, Madrid, Spain.
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Opatz J, Küry P, Schiwy N, Järve A, Estrada V, Brazda N, Bosse F, Müller HW. SDF-1 stimulates neurite growth on inhibitory CNS myelin. Mol Cell Neurosci 2008; 40:293-300. [PMID: 19084600 DOI: 10.1016/j.mcn.2008.11.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2008] [Revised: 10/31/2008] [Accepted: 11/05/2008] [Indexed: 10/21/2022] Open
Abstract
Impaired axonal regeneration is a common observation after central nervous system (CNS) injury. The stromal cell-derived factor-1, SDF-1/CXCL12, has previously been shown to promote axonal growth in the presence of potent chemorepellent molecules known to be important in nervous system development. Here, we report that treatment with SDF-1alpha is sufficient to overcome neurite outgrowth inhibition mediated by CNS myelin towards cultured postnatal dorsal root ganglion neurons. While we found both cognate SDF-1 receptors, CXCR4 and CXCR7/RDC1, to be coexpressed on myelin-sensitive dorsal root ganglion neurons, the distinct expression pattern of CXCR4 on growth cones and branching points of neurites suggests a function of this receptor in chemokine-mediated growth promotion and/or arborization. These in vitro findings were further corroborated as local intrathecal infusion of SDF-1 into spinal cord injury following thoracic dorsal hemisection resulted in enhanced sprouting of corticospinal tract axons into white and grey matter. Our findings indicate that SDF-1 receptor activation might constitute a novel therapeutic approach to promote axonal growth in the injured CNS.
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Affiliation(s)
- Jessica Opatz
- Molecular Neurobiology Laboratory, Department of Neurology, Heinrich-Heine-University, Moorenstrasse 5, D-40225 Düsseldorf, Germany
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Ribera E, Clotet B, Martínez E, Estrada V, Sanz J, Berenguer J, Rubio R, Pulido F, Larrouse M, Curran A, Negredo E, Ferrer P, Álvarez ML. 48-week outcomes following switch from AZT/3TC to FTC/TDF (TVD) vs. continuing on AZT/3TC: 48-week interim analysis of the RECOMB trial. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p54] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Palacios R, Galindo MJ, Arranz JA, Lozano F, Estrada V, Rivero A, Morales D, Asensi V, del Arco A, Muñoz A, Santos J. Cervical lipomatosis in HIV-infected patients: a case-control study. HIV Med 2007; 8:17-21. [PMID: 17305927 DOI: 10.1111/j.1468-1293.2007.00421.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of the study was to analyse the prevalence of cervical lipomatosis (CL) in HIV-infected patients on highly active antiretroviral therapy (HAART) and the factors associated with its development. METHODS This was a multicentre, observational, 1:1 case-control study. HIV-infected patients with CL (cases) and HIV-infected patients from the same cohort, controlled for age (+/-5 years), sex and body mass index (+/-2.5 kg/m(2)) (controls), were included in the study, and a multiple conditional logistic regression was performed to identify factors related to CL. RESULTS CL was reported in 80 patients (1.8%) from a cohort of 4214 patients on HAART followed up in 10 Spanish hospitals. CL was associated with time of exposure to stavudine [for each 6-month increase, odds ratio (OR) 5.82, 95% confidence interval (CI) 5.70-5.94, P=0.0073] and lipoatrophy (OR 8.04, 95% CI 2.93-22.02, P=0.00001). CONCLUSIONS Although lipodystrophy is very frequent among HIV-infected patients on HAART, CL is an uncommon type of fat redistribution in this population, and in our cohort it was related to time of exposure to stavudine and lipoatrophy.
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Affiliation(s)
- R Palacios
- Infectious Diseases Unit, Hosp. Virgen de la Victoria, 29010 Málaga, Spain.
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Polo R, Gómez-Candela C, Miralles C, Locutura J, Alvarez J, Barreiro F, Bellido D, Câncer E, Cánoves D, Domingo P, Estrada V, Fumaz CR, Galindo MJ, García-Benayas T, Iglesias C, Irles JA, Jiménez-Nacher I, Lozano F, Marqués I, Martínez-Alvarez JR, Mellado MJ, Miján A, Ramos JT, Riobo P. Recommendations from SPNS/GEAM/SENBA/SENPE/AEDN/SEDCA/GESIDA on nutrition in the HIV-infected patient. NUTR HOSP 2007; 22:229-43. [PMID: 17416041] [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: 05/14/2023] Open
Abstract
OBJECTIVE to make recommendations on the approach to nutritional problems (malnutrition, cachexia, micronutrient deficiency, obesity, lipodystrophy) affecting HIV-infected patients. METHODS these recommendations have been agreed upon by a group of expertes in the nutrition and care of HIV-infected patients, on behalf of the different groups involved in drafting them. Therefore, the latest advances in pathophysiology, epidemiology, and clinical care presented in studies published in medical journals or at scientific meetings were evaluated. RESULTS there is no single method of evaluating nutrition, and diferent techniques--CT, MRI, and DXA--must be combined. The energy requirements of symptomatic patients increase by 20-30%. There is no evidence to support the increase in protein or fat intake. Micronutrient supplementation in only necessary in special circumstances (vitamin A in children and pregnant woman). Aerobic and resistance excercise is beneficial both for cardiovascular health and for improving lean mass and muscular strength. It is important to follow the rules of food safety at every stage in the chain. Therapeutic intervention in anorexia and cachexia must be tailored, by combining nutritional and pharmacological support (appetite stimulants, anabolic steroids, and, in some cases, testosterone). Artificial nutrition (oral supplementation, enteral or parenteral nutrition) is safe and efficacious, and improves nutritional status and response to therapy. In children, nutritional recommendations must be made early, and are a necessary component of therapy. CONCLUSION appropriate nutritional evaluation and relevant therapeutic action are an essential part of the care of HIV-infected patients.
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Affiliation(s)
- R Polo
- Plan Nacional sobre el Sida, España
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