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Balaguer F, Barrena M, Enrique M, Maicas M, Álvarez B, Tortajada M, Chenoll E, Ramón D, Martorell P. Bifidobacterium animalis subsp. lactis BPL1™ and Its Lipoteichoic Acid Modulate Longevity and Improve Age/Stress-Related Behaviors in Caenorhabditis elegans. Antioxidants (Basel) 2023; 12:2107. [PMID: 38136226 PMCID: PMC10740966 DOI: 10.3390/antiox12122107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 11/30/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
Life expectancy has increased globally in recent decades, driving interest in maintaining a healthy life that includes preservation of physical and mental abilities, particularly in elderly people. The gut microbiome becomes increasingly perturbed with aging so the use of probiotics can be a strategy for maintaining a balanced gut microbiome. A previous report showed that Bifidobacterium animalis subsp. lactis BPL1™ induces through its lipoteichoic acid (LTA) fat reduction activities via the insulin/IGF-1 signaling pathway. Here, we have delved into the mechanism of action, eliminating alternative pathways as putative mechanisms. Furthermore, we have identified that BPL1™, its heat treated form (BPL1™ HT) and its LTA prolong longevity in Caenorhabditis elegans (C. elegans) in an insulin/IGF-1-dependent mechanism, and its consumption improves the oxidative stress response, gut permeability and protection against pathogenic infections. Furthermore, positive effects on C. elegans stress-related behaviors and in the Alzheimer's Disease model were found, highlighting the potential of the strain in improving the cognitive functions and proteotoxicity in the nematode. These results indicate the pivotal role of the IGF-1 pathway in the activity of the strain and pave the way for potential applications of BPL1™, BPL1™ HT and its LTA in the field of longevity and age-related markers.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Patricia Martorell
- Archer Daniels Midland, Nutrition, Health & Wellness, Biopolis S.L. Parc Científic Universitat de València, C/Catedrático Agustín Escardino Benlloch, 9, 46980 Paterna, Spain (M.B.); (M.E.); (M.T.); (E.C.)
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Rodriguez Hernandez A, Martinez Saez O, Brasó-Maristany F, Pastor B, Potrony M, Moreno L, Grau E, Puig-Butille J, Sánchez A, Schettini F, Conte B, Chic N, Vidal Losada M, Munoz M, Balaguer F, Prat A, Adamo B. 263P Clinical outcomes in patients with germline pathogenic variants in homologous recombination repair (HRR) genes treated with CDK4/6 inhibitors (CDK4/6i) and endocrine therapy (ET). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Rodriguez Hernandez A, Braso Maristany F, Pastor B, Potrony M, Moreno L, Grau E, Puig-Butille J, Martinez Saez O, Conte B, Chic N, Vidal Losada M, Munoz M, Balaguer F, Prat A, Adamo B. 147P Breast cancer in women with germline pathogenic variants: Frequency, clinical behavior, and outcomes of a consecutive series of patients from Spain. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Malagón M, Oliver L, Ramió-Pujol S, Guardiola J, Balaguer F. Returning to endoscopy normality through the support of a new non-invasive faecal test based on microbial signatures. Dig Liver Dis 2021; 53:1666-1668. [PMID: 34470723 PMCID: PMC8403525 DOI: 10.1016/j.dld.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 08/05/2021] [Indexed: 12/11/2022]
Affiliation(s)
| | | | | | - J Guardiola
- Digestive Diseases Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - F Balaguer
- Department of Gastroenterology, Hospital Clínic Barcelona, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBEREHD), IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), University of Barcelona, Barcelona, Spain.
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Bayó C, Castellano G, Ocaña T, Moreira L, Carballal S, Sánchez A, Moreira R, Ortiz O, Castells A, Pellisé M, Juan-Otero M, Benitez-Ribas D, Balaguer F. SO-26 In-silico Lynch syndrome-related neoantigens prediction for a dendritic cell-based cancer prevention vaccine. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.050] [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: 10/20/2022] Open
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Balaguer F, Enrique M, Llopis S, Barrena M, Navarro V, Álvarez B, Chenoll E, Ramón D, Tortajada M, Martorell P. Lipoteichoic acid from Bifidobacterium animalis subsp. lactis BPL1: a novel postbiotic that reduces fat deposition via IGF-1 pathway. Microb Biotechnol 2021; 15:805-816. [PMID: 33620143 PMCID: PMC8913875 DOI: 10.1111/1751-7915.13769] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [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: 10/28/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 02/06/2023] Open
Abstract
Obesity and its related metabolic disorders, such as diabetes and cardiovascular disease, are major risk factors for morbidity and mortality in the world population. In this context, supplementation with the probiotic strain Bifidobacterium animalis subsp. lactis BPL1 (CECT8145) has been shown to ameliorate obesity biomarkers. Analyzing the basis of this observation and using the pre-clinical model Caenorhabditis elegans, we have found that lipoteichoic acid (LTA) of BPL1 is responsible for its fat-reducing properties and that this attribute is preserved under hyperglycaemic conditions. This fat-reducing capacity of both BPL1 and LTA-BPL1 is abolished under glucose restriction, as a result of changes in LTA chemical composition. Moreover, we have demonstrated that LTA exerts this function through the IGF-1 pathway, as does BPL1 strain. These results open the possibility of using LTA as a novel postbiotic, whose beneficial properties can be applied therapeutically and/or preventively in metabolic syndrome and diabetes-related disorders.
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Stjepanovic N, Moreira L, Carneiro F, Balaguer F, Cervantes A, Balmaña J, Martinelli E. Hereditary gastrointestinal cancers: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up†. Ann Oncol 2019; 30:1558-1571. [PMID: 31378807 DOI: 10.1093/annonc/mdz233] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- N Stjepanovic
- Medical Oncology Department, University Hospital Vall d'Hebron, Barcelona, Spain
| | - L Moreira
- Gastroenterology Department, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
| | - F Carneiro
- Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal; Instituto de Investigação e Inovação em Saúde (i3S), Porto, Portugal; Medical Faculty of the University of Porto, Porto, Portugal; Centro Hospitalar Universitário São João, Porto, Portugal
| | - F Balaguer
- Gastroenterology Department, Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Barcelona, Spain
| | - A Cervantes
- CIBERONC, Department of Medical Oncology, Biomedical Research Institute INCLIVA, University of Valencia, Valencia, Spain
| | - J Balmaña
- Medical Oncology Department, University Hospital Vall d'Hebron, Barcelona, Spain
| | - E Martinelli
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania Luigi Vanvitelli, Napoli, Italy
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Esteban I, Vilaró M, Adrover E, Angulo A, Carrasco E, Gadea N, Sánchez A, Ocaña T, Llort G, Jover R, Cubiella J, Servitja S, Herráiz M, Cid L, Martínez S, Oruezábal-Moreno MJ, Garau I, Khorrami S, Herreros-de-Tejada A, Morales R, Cano JM, Serrano R, López-Ceballos MH, González-Santiago S, Juan-Fita MJ, Alonso-Cerezo C, Casas A, Graña B, Teulé A, Alba E, Antón A, Guillén-Ponce C, Sánchez-Heras AB, Alés-Martínez JE, Brunet J, Balaguer F, Balmaña J. Psychological impact of multigene cancer panel testing in patients with a clinical suspicion of hereditary cancer across Spain. Psychooncology 2018; 27:1530-1537. [PMID: 29498768 DOI: 10.1002/pon.4686] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 01/16/2018] [Accepted: 02/16/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Patients' psychological reactions to multigene cancer panel testing might differ compared with the single-gene testing reactions because of the complexity and uncertainty associated with the different possible results. Understanding patients' preferences and psychological impact of multigene panel testing is important to adapt the genetic counselling model. METHODS One hundred eighty-seven unrelated patients with clinical suspicion of hereditary cancer undergoing a 25-gene panel test completed questionnaires after pretest genetic counselling and at 1 week, 3 months, and 12 months after results to elicit their preferences regarding results disclosure and to measure their cancer worry and testing-specific distress and uncertainty. RESULTS A pathogenic variant was identified in 38 patients (34 high penetrance and 4 moderate penetrance variants), and 54 patients had at least one variant of uncertain significance. Overall, cancer panel testing was not associated with an increase in cancer worry after results disclosure (P value = .87). Twelve months after results, carriers of a moderate penetrance variant had higher distress and uncertainty scores compared with carriers of high penetrance variants. Cancer worry prior to genetic testing predicted genetic testing specific distress after results, especially at long term (P value <.001). Most of the patients reported the wish to know all genetic results. CONCLUSIONS Our results suggest that patients can psychologically cope with cancer panel testing, but distress and uncertainty observed in carriers of moderate penetrance cancer variants in this cohort warrant further research.
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Affiliation(s)
- I Esteban
- Hereditary Cancer Unit, Vall d'Hebron Institute of Oncology, Barcelona, Spain.,Genetics Department, Universidad Autònoma de Barcelona, Barcelona, Spain
| | - M Vilaró
- Oncology Data Science, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - E Adrover
- Medical Oncology Department, Hospital General de Albacete, Albacete, Spain
| | - A Angulo
- Myriad Genetics Spain, Alcobendas, Spain
| | - E Carrasco
- Hereditary Cancer Unit, Vall d'Hebron Institute of Oncology, Barcelona, Spain
| | - N Gadea
- Medical Oncology Department, Vall d'Hebron Hospital, Barcelona, Spain
| | - A Sánchez
- Gastroenterology Department, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd)-Institut Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - T Ocaña
- Gastroenterology Department, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd)-Institut Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - G Llort
- Medical Oncology Department, Hospital Sabadell-Parc Taulí, Sabadell, Spain
| | - R Jover
- Gastroenterlogy Department, Hospital General Universitario de Alicante, Alicante, Spain
| | - J Cubiella
- Gastroenterology Department, Complejo Hospitalario Universitario de Ourense, Instituto de Investigación Sanitaria Galicia Sur, CIBERehd, Ourense, Spain
| | - S Servitja
- Medical Oncology Department, Hospital del Mar, Barcelona, Spain
| | - M Herráiz
- Gastroenterology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - L Cid
- Gastroenterology Department, Instituto Investigación Biomédica, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
| | - S Martínez
- Medical Oncology Department, Hospital de Mataró, Madrid, Spain
| | | | - I Garau
- Medical Oncology Department, Hospital Son Llatzer, Palma de Mallorca, Spain
| | - S Khorrami
- Gastroenterology Department, Hospital Son Espases, Palma de Mallorca, Spain
| | - A Herreros-de-Tejada
- Gastroenterlogy Department, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - R Morales
- Medical Oncology Department, Hospital La Mancha Centro, Alcázar de San Juan, Spain
| | - J M Cano
- Medical Oncology Department, Hospital General de Ciudad Real, Ciudad Real, Spain
| | - R Serrano
- Medical Oncology Department, Hospital Reina Sofia de Córdoba, Córdoba, Spain
| | - M H López-Ceballos
- Medical Oncology Department, Hospital San Pedro de Alcántara, Cáceres, Spain
| | - S González-Santiago
- Medical Oncology Department, Hospital San Pedro de Alcántara, Cáceres, Spain
| | - M J Juan-Fita
- Medical Oncology Department, Instituto Valencia de Oncología, Valencia, Spain
| | | | - A Casas
- Medical Oncology Department, Hospital Virgen del Rocío de Sevilla, Seville, Spain
| | - B Graña
- Medical Oncology Department, Hospital Universitario de A Coruña, La Coruña, Spain
| | - A Teulé
- Hereditary Cancer Program, Catalan Institute of Oncology, L'Hospitalet, Spain
| | - E Alba
- Medical Oncology Department, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - A Antón
- Medical Oncology Department, Hospital Miguel Servet de Zaragoza, Zaragoza, Spain
| | - C Guillén-Ponce
- Medical Oncology Department, Hospital Ramón y Cajal, Madrid, Spain
| | - A B Sánchez-Heras
- Medical Oncology Department, Hospital General Universitario de Elche, Elche, Spain
| | - J E Alés-Martínez
- Medical Oncology Department, Hospital de Nuestra Señora de Sonsoles, Ávila, Spain
| | - J Brunet
- Hereditary Cancer Program, Catalan Institute of Oncology, IDIBGI, Girona, Spain
| | - F Balaguer
- Gastroenterology Department, Centro de Investigación Biomédica en Red en Enfermedades Hepáticas y Digestivas (CIBERehd)-Institut Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - J Balmaña
- Hereditary Cancer Unit, Vall d'Hebron Institute of Oncology, Barcelona, Spain.,Genetics Department, Universidad Autònoma de Barcelona, Barcelona, Spain.,Medical Oncology Department, Vall d'Hebron Hospital, Barcelona, Spain
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IJspeert JEG, Bevan R, Senore C, Kaminski MF, Kuipers EJ, Mroz A, Bessa X, Cassoni P, Hassan C, Repici A, Balaguer F, Rees CJ, Dekker E. Detection rate of serrated polyps and serrated polyposis syndrome in colorectal cancer screening cohorts: a European overview. Gut 2017; 66:1225-1232. [PMID: 26911398 DOI: 10.1136/gutjnl-2015-310784] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 12/14/2015] [Accepted: 01/16/2016] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The role of serrated polyps (SPs) as colorectal cancer precursor is increasingly recognised. However, the true prevalence SPs is largely unknown. We aimed to evaluate the detection rate of SPs subtypes as well as serrated polyposis syndrome (SPS) among European screening cohorts. METHODS Prospectively collected screening cohorts of ≥1000 individuals were eligible for inclusion. Colonoscopies performed before 2009 and/or in individuals aged below 50 were excluded. Rate of SPs was assessed, categorised for histology, location and size. Age-sex-standardised number needed to screen (NNS) to detect SPs were calculated. Rate of SPS was assessed in cohorts with known colonoscopy follow-up data. Clinically relevant SPs (regarded as a separate entity) were defined as SPs ≥10 mm and/or SPs >5 mm in the proximal colon. RESULTS Three faecal occult blood test (FOBT) screening cohorts and two primary colonoscopy screening cohorts (range 1.426-205.949 individuals) were included. Rate of SPs ranged between 15.1% and 27.2% (median 19.5%), of sessile serrated polyps between 2.2% and 4.8% (median 3.3%) and of clinically relevant SPs between 2.1% and 7.8% (median 4.6%). Rate of SPs was similar in FOBT-based cohorts as in colonoscopy screening cohorts. No apparent association between the rate of SP and gender or age was shown. Rate of SPS ranged from 0% to 0.5%, which increased to 0.4% to 0.8% after follow-up colonoscopy. CONCLUSIONS The detection rate of SPs is variable among screening cohorts, and standards for reporting, detection and histopathological assessment should be established. The median rate, as found in this study, may contribute to define uniform minimum standards for males and females between 50 and 75 years of age.
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Affiliation(s)
- J E G IJspeert
- Department of Gastroenterology and Hepatology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - R Bevan
- Department of Gastroenterology and Hepatology, South Tyneside District Hospital, South Shields, UK
| | - C Senore
- Department of Gastroenterology and Hepatology, Piemonte Reference Centre for Epidemiology and Cancer Prevention, Turin, Italy
| | - M F Kaminski
- Department of Gastroenterological Oncology, Maria Sklodowska-Curie Memorial Cancer Centre and Medical Centre for Postgraduate Education, Warsaw, Poland.,Institute of Health and Society, University of Oslo, Oslo, Norway
| | - E J Kuipers
- Department of Gastroenterology and Hepatology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - A Mroz
- Department of Gastroenterology, Hepatology and Oncology, Medical Centre for Postgraduate Education, Warsaw, Poland
| | - X Bessa
- Department of Gastroenterology, Digestive Service, Hospital del Mar de Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - P Cassoni
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - C Hassan
- Department of Gastroenterology and Hepatology, 'Nuovo regina Margherita' Hospital, Rome, Italy
| | - A Repici
- Department of Gastroenterology and Hepatology, Humanitas Research Hospital, Humanitas University, Milan, Italy
| | - F Balaguer
- Department of Gastroenterology, Hospital Clínic de Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - C J Rees
- Department of Gastroenterology and Hepatology, South Tyneside District Hospital, South Shields, UK
| | - E Dekker
- Department of Gastroenterology and Hepatology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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Adrover E, Esteban I, Llort G, Servitja S, Peralta SM, Garau I, Cano J, Serrano R, Fita MJ, Casas A, Graña B, Teulé A, Marquez A, Martínez JA, Antón A, Brunet J, Balaguer F, Gonzalez S, Balmaña J, Alonso C. Famosa: Evaluation of a multigene panel in patients with suspected HBOC. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw364.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Perez-Carbonell L, Sinicrope FA, Alberts SR, Oberg AL, Balaguer F, Castells A, Boland CR, Goel A. MiR-320e is a novel prognostic biomarker in colorectal cancer. Br J Cancer 2015; 113:83-90. [PMID: 26035698 PMCID: PMC4647533 DOI: 10.1038/bjc.2015.168] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [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: 01/20/2015] [Revised: 04/14/2015] [Accepted: 04/21/2015] [Indexed: 02/07/2023] Open
Abstract
Background: Advances in early detection and treatment have improved outcomes in patients with colorectal cancer (CRC). However, there remains a need for robust prognostic and predictive biomarkers. We conducted a systematic discovery and validation of microRNA (miRNA) biomarkers in two clinical trial cohorts of CRC patients. Methods: We performed an initial ‘discovery' phase using Affymetrix miRNA expression arrays to profile stage III CRC patients with and without tumour recurrence (n=50 per group) at 3-years of follow-up. All patients received adjuvant 5-fluorouracil (5-FU) plus oxaliplatin, that is, FOLFOX, treatment. During ‘validation', we analysed miRNAs using qRT–PCR in an independent cohort of 237 stage II–IV CRC patients treated with 5-FU-based chemotherapy, as well as in normal colonic mucosa from 20 healthy subjects. Association with disease recurrence, disease-free survival (DFS) and overall survival (OS) was examined using Cox proportional hazard models. Results: In the discovery cohort, miR-320e expression was significantly elevated in stage III colon cancers from patients with vs without recurrence (95% confidence interval (CI)=1.14–1.42; P<0.0001). These results were then independently validated in stage II and III tumours. Specifically, increased miR-320e expression was associated with poorer DFS (hazard ratio (HR)=1.65; 95% CI=1.27–2.13; P=0.0001) and OS (HR=1.78; 95% CI=1.31–2.41; P=0.0003) in stage III CRC patients. Conclusions: In two clinical trial cohorts, a systematic biomarker discovery and validation approach identified miR-320e to be a novel prognostic biomarker that is associated with adverse clinical outcome in stage III CRC patients treated with 5-FU-based adjuvant chemotherapy. These findings have important implications for the personalised management of CRC patients.
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Affiliation(s)
- L Perez-Carbonell
- Center for Gastrointestinal Research; Center for Epigenetics, Cancer Prevention and Cancer Genomics, Baylor Research Institute, Charles A Sammons Cancer Center, Baylor University Medical Center, Dallas, TX, USA
| | - F A Sinicrope
- 1] Division of Oncology, Mayo Clinic, Rochester, MN, USA [2] Division Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - S R Alberts
- 1] Division of Oncology, Mayo Clinic, Rochester, MN, USA [2] Division Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - A L Oberg
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - F Balaguer
- Department of Gastroenterology, Hospital Clinic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - A Castells
- Department of Gastroenterology, Hospital Clinic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - C R Boland
- Center for Gastrointestinal Research; Center for Epigenetics, Cancer Prevention and Cancer Genomics, Baylor Research Institute, Charles A Sammons Cancer Center, Baylor University Medical Center, Dallas, TX, USA
| | - A Goel
- Center for Gastrointestinal Research; Center for Epigenetics, Cancer Prevention and Cancer Genomics, Baylor Research Institute, Charles A Sammons Cancer Center, Baylor University Medical Center, Dallas, TX, USA
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Rodríguez de Miguel C, Serradesanferm A, López-Cerón M, Carballal S, Pozo A, Balaguer F, Cárdenas A, Fernández-Esparrach G, Ginés A, González-Suárez B, Moreira L, Ordás I, Ricart E, Sendino O, Vaquero E, Ubré M, del Manzano S, Grau J, Llach J, Castells A, Pellisé M. Ascorbic acid PEG-2L is superior for early morning colonoscopies in colorectal cancer screening programs: A prospective non-randomized controlled trial. Gastroenterología y Hepatología 2015; 38:62-70. [DOI: 10.1016/j.gastrohep.2014.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 09/14/2014] [Accepted: 09/16/2014] [Indexed: 01/10/2023]
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Brea-Fernández A, Cameselle-Teijeiro J, Alenda C, Fernández-Rozadilla C, Cubiella J, Clofent J, Reñé J, Anido U, Milá M, Balaguer F, Castells A, Castellvi-Bel S, Jover R, Carracedo A, Ruiz-Ponte C. High incidence of large deletions in thePMS2gene in Spanish Lynch syndrome families. Clin Genet 2013; 85:583-8. [DOI: 10.1111/cge.12232] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Revised: 07/04/2013] [Accepted: 07/04/2013] [Indexed: 12/24/2022]
Affiliation(s)
- A.J. Brea-Fernández
- Grupo de Medicina Xenómica-USC; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER); Santiago de Compostela Spain
- Unidad de Investigación; Hospital General Universitario; Alicante Spain
| | - J.M. Cameselle-Teijeiro
- Servicio de Anatomía Patológica, Hospital Clínico Universitario, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS); Universidad de Santiago de Compostela; Santiago de Compostela Spain
| | - C. Alenda
- Servicio de Anatomía Patológica; Hospital General Universitario; Alicante Spain
| | - C. Fernández-Rozadilla
- Fundación Pública Galega de Medicina Xenómica (FPGMX)-SERGAS, Grupo de Medicina Xenómica; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER); Santiago de Compostela Spain
| | - J. Cubiella
- Servicio de Gastroenterología; Complexo Hospitalario Universitario de Ourense; Ourense Spain
| | - J. Clofent
- Sección Aparato Digestivo, Servicio de Medicina Interna; Hospital de Sagunto; Sagunto Spain
- Servicio de Gastroenterología; Complexo Hospitalario Universitario de Vigo; Spain
| | - J.M. Reñé
- Servicio de Gastroenterología; Hospital Arnau de Vilanova; Lleida Spain
| | - U. Anido
- Servicio de Oncología Clínica; Complexo Hospitalario Universitario de Santiago; Santiago de Compostela Spain
| | - M. Milá
- Servicio de Bioquímica y Genética Molecular, Hospital Clínic, IDIBAPS; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER); Barcelona Spain
| | - F. Balaguer
- Servicio de Gastroenterología, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, IDIBAPS; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Universitat de Barcelona; Barcelona Spain
| | - A. Castells
- Servicio de Gastroenterología, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, IDIBAPS; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Universitat de Barcelona; Barcelona Spain
| | - S. Castellvi-Bel
- Servicio de Gastroenterología, Institut de Malalties Digestives i Metabòliques, Hospital Clínic, IDIBAPS; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Universitat de Barcelona; Barcelona Spain
| | - R. Jover
- Unidad de Investigación; Hospital General Universitario; Alicante Spain
| | - A. Carracedo
- Grupo de Medicina Xenómica-USC; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER); Santiago de Compostela Spain
- Fundación Pública Galega de Medicina Xenómica (FPGMX)-SERGAS, Grupo de Medicina Xenómica; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER); Santiago de Compostela Spain
| | - C. Ruiz-Ponte
- Fundación Pública Galega de Medicina Xenómica (FPGMX)-SERGAS, Grupo de Medicina Xenómica; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER); Santiago de Compostela Spain
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Balmaña J, Balaguer F, Cervantes A, Arnold D. Familial risk-colorectal cancer: ESMO Clinical Practice Guidelines. Ann Oncol 2013; 24 Suppl 6:vi73-80. [PMID: 23813931 DOI: 10.1093/annonc/mdt209] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- J Balmaña
- Department of Medical Oncology, Hospital Vall d'Hebron, Vall d'Hebron Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Barcelona
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Menéndez M, Castellví-Bel S, Pineda M, De Cid R, Muñoz J, González S, Teulé À, Balaguer F, Ramón y Cajal T, Reñé JM, Blanco I, Castells A, Capellà G. Founder effect of a pathogenic MSH2 mutation identified in Spanish families with Lynch syndrome. Clin Genet 2010; 78:186-90. [DOI: 10.1111/j.1399-0004.2009.01346.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Balmaña J, Balaguer F, Castellví-Bel S, Steyerberg EW, Andreu M, Llor X, Jover R, Castells A, Syngal S. Comparison of predictive models, clinical criteria and molecular tumour screening for the identification of patients with Lynch syndrome in a population-based cohort of colorectal cancer patients. J Med Genet 2008; 45:557-63. [PMID: 18603628 DOI: 10.1136/jmg.2008.059311] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Several models have recently been developed to predict mismatch repair (MMR) gene mutations. Their comparative performance with clinical criteria or universal molecular screening in a population based colorectal cancer (CRC) cohort has not been assessed. METHODS All 1222 CRC from the EPICOLON cohort underwent tumour MMR testing with immunohistochemistry and microsatellite instability, and those with MMR deficiency (n = 91) underwent MLH1/MSH2 germline testing. Sensitivity, specificity and positive predictive value (PPV) of the PREMM(1,2) and the Barnetson models for identification of MLH1/MSH2 mutation carriers were evaluated and compared with the revised Bethesda guidelines (RBG), Amsterdam II criteria, and tumour analysis for MMR deficiency. Overall discriminative ability was quantified by the area under the ROC curve (AUC), and calibration was assessed by comparing the average predictions versus the observed prevalence. RESULTS Both models had similar AUC (0.93 and 0.92, respectively). Sensitivity of the RBG and a PREMM(1,2) score > or =5% was 100% (95% CI 71% to 100%); a Barnetson score >0.5% missed one mutation carrier (sensitivity 87%, 95% CI 51% to 99%). PPVs of all three strategies were 2-3%. Presence of MMR deficiency increased specificity and PPV of predictive scores (97% and 21% for PREMM(1,2) score > or =5%, and 98% and 21% for Barnetson > or =0.5%, respectively). CONCLUSIONS The PREMM(1,2) and the Barnetson models offer a quantitative systematic approach to select CRC patients for identification of MLH1/MSH2 mutation carriers with a similar performance to the RBG.
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Affiliation(s)
- J Balmaña
- Department of Medical Oncology, Hospital Vall d'Hebron, Medical Department of Universitat Autónoma de Barcelona, Spain.
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17
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Balmaña J, Balaguer F, Steyerberg EW, Stoffel EM, Castellví-Bel S, Andreu M, Castells A, Syngal S. Validation of the PREMM 1,2 model for the prediction of MLH1/MSH2 germline mutation carriers in a population- based cohort of colorectal cancer (CRC) patients. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.10545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10545 Background: PREMM1,2 is a predictive model for estimating the likelihood of finding a mutation in the MLH1 and MSH2 genes developed in a population at risk of Lynch syndrome (Balmaña et al. JAMA 2006). The EPICOLON cohort is a Spanish population-based series of 1222 patients with CRC (Piñol et al. JAMA 2005). Methods: All 1222 individuals underwent microsatellite instability (MSI) and immunohistochemistry (IHC) analysis for MLH1/MSH2. Patients whose tumours exhibited MSI or altered IHC underwent MLH1/MSH2 analysis (n=91). Sensitivity (Se), specificity, positive predictive value (PPV), and the areas under the receiver operating characteristics curves (AUC) for the PREMM1,2 model were calculated and compared with the Edinburgh model (Barnetson et al. NEJM 2006) and the Revised Bethesda guidelines (RBG). Results: Three-hundred and ninety six individuals (32%) had a PREMM1,2 score =5%, 287 (23%) fulfilled the RBG, and 75 (6%) had a Barnetson score =5%. A PREMM1,2 score =5% and the RBG identified all carriers with deleterious mutations (n=8, Se=100%), while a Barnetson score =5% missed 2 mutation carriers (Se= 75%). For PREMM1,2 and Barnetson scores =5% and fulfilment of the RBG, specificities were 68%, 94%, and 77%, respectively; and PPV were 2%, 8%, and 2.8%, respectively. The AUC was 0.93 (95% CI: 0.86–0.99) for the PREMM1,2 model and 0.86 (95% CI: 0.66–1.04) for the Barnetson model. The predictions of carrying a mutation stratified into five groups based on PREMM1,2 scores (<5%, 5–9%, 10–19%, 20–39%, =40%) correlated reasonably with the presence of mutations (0%, 1%, 1%, 13%, and 22%, respectively). Conclusions: In a population of CRC patients, the PREMM1,2 model identifies all mutation carriers of MSH2 and MLH1 using a cutoff of =5%. In addition, it provides quantification of risk that is useful to decide the strategy used for molecular evaluation and risk counselling of patients. No significant financial relationships to disclose.
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Affiliation(s)
- J. Balmaña
- Hospital Vall d'Hebrón, Barcelona, Spain; Hospital Clínic, Barcelona, Spain; Erasmus Medical Center, Rotterdam, The Netherlands; Dana-Farber Cancer Institute, Boston, MA; Hospital del Mar, Barcelona, Spain
| | - F. Balaguer
- Hospital Vall d'Hebrón, Barcelona, Spain; Hospital Clínic, Barcelona, Spain; Erasmus Medical Center, Rotterdam, The Netherlands; Dana-Farber Cancer Institute, Boston, MA; Hospital del Mar, Barcelona, Spain
| | - E. W. Steyerberg
- Hospital Vall d'Hebrón, Barcelona, Spain; Hospital Clínic, Barcelona, Spain; Erasmus Medical Center, Rotterdam, The Netherlands; Dana-Farber Cancer Institute, Boston, MA; Hospital del Mar, Barcelona, Spain
| | - E. M. Stoffel
- Hospital Vall d'Hebrón, Barcelona, Spain; Hospital Clínic, Barcelona, Spain; Erasmus Medical Center, Rotterdam, The Netherlands; Dana-Farber Cancer Institute, Boston, MA; Hospital del Mar, Barcelona, Spain
| | - S. Castellví-Bel
- Hospital Vall d'Hebrón, Barcelona, Spain; Hospital Clínic, Barcelona, Spain; Erasmus Medical Center, Rotterdam, The Netherlands; Dana-Farber Cancer Institute, Boston, MA; Hospital del Mar, Barcelona, Spain
| | - M. Andreu
- Hospital Vall d'Hebrón, Barcelona, Spain; Hospital Clínic, Barcelona, Spain; Erasmus Medical Center, Rotterdam, The Netherlands; Dana-Farber Cancer Institute, Boston, MA; Hospital del Mar, Barcelona, Spain
| | - A. Castells
- Hospital Vall d'Hebrón, Barcelona, Spain; Hospital Clínic, Barcelona, Spain; Erasmus Medical Center, Rotterdam, The Netherlands; Dana-Farber Cancer Institute, Boston, MA; Hospital del Mar, Barcelona, Spain
| | - S. Syngal
- Hospital Vall d'Hebrón, Barcelona, Spain; Hospital Clínic, Barcelona, Spain; Erasmus Medical Center, Rotterdam, The Netherlands; Dana-Farber Cancer Institute, Boston, MA; Hospital del Mar, Barcelona, Spain
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Balaguer F, Llach J, Castells A, Bordas JM, Ppellisé M, Rodríguez-Moranta F, Mata A, Fernández-Esparrach G, Ginès A, Piqué JM. The European panel on the appropriateness of gastrointestinal endoscopy guidelines colonoscopy in an open-access endoscopy unit: a prospective study. Aliment Pharmacol Ther 2005; 21:609-13. [PMID: 15740545 DOI: 10.1111/j.1365-2036.2005.02359.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The demand for gastrointestinal endoscopy is increasing in most developed countries, resulting in an important rise in overall costs and waiting lists for endoscopic procedures. Therefore, adherence to appropriate indications for these procedures is essential for the rational use of finite resources in an open-access system. AIM To assess indications and appropriateness of colonoscopy according to the European Panel on the Appropriateness of Gastrointestinal Endoscopy (EPAGE) criteria. METHODS From May to June 2004, all consecutive patients referred to our Unit for open-access colonoscopy were considered for inclusion in this prospective study. Appropriateness of each colonoscopy was established according to the EPAGE criteria. In order to evaluate whether appropriateness of use correlated with the diagnostic yield of colonoscopy, relevant endoscopic findings were also recorded. RESULTS A total of 350 consecutive patients were included in the study. In 38 of them, the colonoscopy indication was not listed in the EPAGE guidelines and, consequently, they were not evaluated. In the remaining 312 patients, the indication for the procedure was considered inappropriate in 73 (23%) patients. Both referring doctor characteristics (specialty and health care setting) and patient data (age) correlated with appropriateness of endoscopy. The diagnostic yield was significantly higher for appropriate colonoscopies (42%) than in those judged inappropriate (21%) (P = 0.001). CONCLUSIONS A noteworthy proportion of patients referred for colonoscopy to an open-access endoscopy unit are considered inappropriate because of their indication, with significant differences among specialties. These results suggest that implementation of validated guidelines for its appropriate use could improve this situation and, considering the correlation between appropriateness and diagnostic yield, even contribute to improve the prognosis of patients with colorectal diseases.
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Affiliation(s)
- F Balaguer
- Department of Gastroenterology, Institut de Malalties Digestives, Hospital Clínic, University of Barcelona, Barcelona, Catalonia, Spain
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Mata A, Bordas JM, Feu F, Ginés A, Pellisé M, Fernández-Esparrach G, Balaguer F, Piqué JM, Llach J. Wireless capsule endoscopy in patients with obscure gastrointestinal bleeding: a comparative study with push enteroscopy. Aliment Pharmacol Ther 2004; 20:189-94. [PMID: 15233699 DOI: 10.1111/j.1365-2036.2004.02067.x] [Citation(s) in RCA: 92] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The identification and treatment of lesions located in the small intestine in obscure gastrointestinal bleeding is always a clinical challenge. AIM To examine prospectively the diagnostic precision and the clinical efficacy of capsule endoscopy compared with push enteroscopy in obscure gastrointestinal bleeding. METHODS Forty-two patients (22 men and 20 women) with obscure gastrointestinal bleeding (overt bleeding in 26 cases and occult blood loss with chronic anaemia in 16) and normal oesophagogastroduodenoscopy and colonoscopy were analysed. All patients were instructed to receive the capsule endoscopy and push enteroscopy was performed within the next 7 days. Both techniques were blindly performed by separate examiners. The diagnostic yield for each technique was defined as the frequency of detection of clinically relevant intestinal lesions carrying potential for bleeding. RESULTS A bleeding site potentially related to gastrointestinal bleeding or evidence of active bleeding was identified in a greater proportion of patients using capsule endoscopy (74%; 31 of 42) than enteroscopy (19%; eight of 42) (P = 0.05). The most frequent capsule endoscopy findings were: angiodysplasia (45%), fresh blood (23%), jejunal ulcers (10%), ileal inflammatory mucosa (6%) and ileal tumour (6%). No additional intestinal diagnoses were made by enteroscopy. In seven patients (22%), the results obtained with capsule endoscopy led to a successful change in the therapeutic approach. CONCLUSIONS Compared with push enteroscopy, capsule endoscopy increases the diagnosis yield in patients with obscure gastrointestinal bleeding, and allows modification on therapy strategy in a remarkable proportion of patients.
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Affiliation(s)
- A Mata
- Digestive Endoscopy Unit, Gastroenterology Service, IMD, Hospital Clinic, Barcelona, Spain
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