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Rodríguez Sánchez J, Enguita-Germán M, Montori S, Albéniz E. Response. Gastrointest Endosc 2023; 98:680-682. [PMID: 37734823 DOI: 10.1016/j.gie.2023.06.008] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/08/2023] [Accepted: 06/08/2023] [Indexed: 09/23/2023]
Affiliation(s)
- Joaquín Rodríguez Sánchez
- Endoscopy Unit, Gastroenterology Department, Hospital Universitario de Navarra, Navarrabiomed, Universidad Pública de Navarra, Pamplona, Spain
| | - Mónica Enguita-Germán
- Methodology Unit, Gastroenterology Department, Hospital Universitario de Navarra, Navarrabiomed, Universidad Pública de Navarra, Pamplona, Spain
| | - Sheyla Montori
- Gastrointestinal Endoscopy Research Unit, Gastroenterology Department, Hospital Universitario de Navarra, Navarrabiomed, Universidad Pública de Navarra, Pamplona, Spain
| | - Eduardo Albéniz
- Endoscopy Unit, Gastroenterology Department, Hospital Universitario de Navarra, Navarrabiomed, Universidad Pública de Navarra, Pamplona, Spain
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López-Ilundain J, Prados AB, Enriquez ÁSR, Enguita-Germán M, Rosquil EU, Gil JL, Fábrega AM, Martinez de Zabarte Moraza E, Maughan AR, Yoldi-Murillo J. Does Lidocaine Shorten Seizure Duration in Electroconvulsive Therapy? Pharmacopsychiatry 2023; 56:197-203. [PMID: 37643731 DOI: 10.1055/a-2114-4327] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
BACKGROUND Electroconvulsive therapy (ECT) is an effective short-term treatment for schizophrenia and depression, amongst other disorders. Lidocaine is typically added to reduce pain from intravenous propofol injection. However, depending on the dose used in the ECT setting, it can shorten seizure duration. The aim of this study was to investigate the effect of lidocaine dose on seizure duration. METHODS This retrospective, naturalistic cohort study included 169 patients treated with ECT. We examined 4714 ECT sessions with propofol or propofol plus lidocaine. Ictal quality was manually rated by visual inspection. The main outcome of this study was the relation of lidocaine with seizure duration after controlling for socio-demographic, ECT, and other anesthetic variables. RESULTS There was a significant negative association between lidocaine usage and seizure duration. Multivariate analyses showed that seizure duration was shortened by an average of 3.21 s in sessions with lidocaine. Moreover, in this subgroup, there was a significant negative dose-dependent association between lidocaine dose and seizure length. Complementarily, a significant positive association between preictal BIS and seizure length was found in the subgroup of sessions where preictal was used. CONCLUSIONS We provide additional evidence highlighting the importance of caution regarding lidocaine dosing due to the effect on seizure length in the ECT setting. It is advisable for clinicians to exercise caution when administering lidocaine regarding its dosing and seizure length in ECT settings. Future investigation is needed to assess causal relationships by studying certain vulnerable groups or employing other charge calculation techniques, such as the titration method.
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Affiliation(s)
- Jose López-Ilundain
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain. Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Alejandro Ballesteros Prados
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba Mental Health Network, Araba Psychiatric Hospital, Vitoria-Gasteiz, Spain
| | - Ángela S Rosero Enriquez
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain. Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Mónica Enguita-Germán
- Navarrabiomed-HUN-UPNA, Unidad de Metodología. Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | | | - Jose López Gil
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain. Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Ana Marmol Fábrega
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain. Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | | | | | - Javier Yoldi-Murillo
- Department of Anaesthesiology, Hospital Universitario de Navarra, Pamplona, Spain
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Sánchez-Torres AM, Amoretti S, Enguita-Germán M, Mezquida G, Moreno-Izco L, Panadero-Gómez R, Rementería L, Toll A, Rodriguez-Jimenez R, Roldán A, Pomarol-Clotet E, Ibáñez Á, Usall J, Contreras F, Vieta E, López-Ilundain JM, Merchán-Naranjo J, González-Pinto A, Berrocoso E, Bernardo M, Cuesta MJ. Relapse, cognitive reserve, and their relationship with cognition in first episode schizophrenia: a 3-year follow-up study. Eur Neuropsychopharmacol 2023; 67:53-65. [PMID: 36495858 DOI: 10.1016/j.euroneuro.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/18/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022]
Abstract
Schizophrenia is frequently characterized by the presence of multiple relapses. Cognitive impairments are core features of schizophrenia. Cognitive reserve (CR) is the ability of the brain to compensate for damage caused by pathologies such as psychotic illness. As cognition is related to CR, the study of the relationship between relapse, cognition and CR may broaden our understanding of the course of the disease. We aimed to determine whether relapse was associated with cognitive impairment, controlling for the effects of CR. Ninety-nine patients with a remitted first episode of schizophrenia or schizophreniform disorder were administered a set of neuropsychological tests to assess premorbid IQ, attention, processing speed, working memory, verbal and visual memory, executive functions and social cognition. They were followed up for 3 years (n=53) or until they relapsed (n=46). Personal and familial CR was estimated from a principal component analysis of the premorbid information gathered. Linear mixed-effects models were applied to analyse the effect of time and relapse on cognitive function, with CR as covariate. Patients who relapsed and had higher personal CR showed less deterioration in attention, whereas those with higher CR (personal and familial CR) who did not relapse showed better performance in processing speed and visual memory. Taken together, CR seems to ameliorate the negative effects of relapse on attention performance and shows a positive effect on processing speed and visual memory in those patients who did not relapse. Our results add evidence for the protective effect of CR over the course of the illness.
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Affiliation(s)
- Ana M Sánchez-Torres
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR); Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Mónica Enguita-Germán
- Navarra Institute of Health Research (IdiSNA), Pamplona, Spain; Unidad de Metodología. Navarrabiomed-CHN -UPNA. Pamplona
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Lucía Moreno-Izco
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain
| | - Rocío Panadero-Gómez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Lide Rementería
- BIOARABA Health Research Institute. OSI Araba. University Hospital. University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Alba Toll
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Hospital del Mar Medical Research Institute (IMIM)
| | - Roberto Rodriguez-Jimenez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry. Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12); Universidad Complutense de Madrid (UCM), Plaza Ramón y Cajal, s/n, 28040 Madrid, Spain
| | - Alexandra Roldán
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Edith Pomarol-Clotet
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Ángela Ibáñez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychiatry, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - Judith Usall
- Parc Sanitari Sant Joan de Déu, Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat
| | - Fernando Contreras
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Psychiatric Department. Bellvitge Universitary Hospital. IDIBELL
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic of Barcelona, Institute of Neurosciences, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Jose M López-Ilundain
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain
| | - Jessica Merchán-Naranjo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; BIOARABA Health Research Institute. OSI Araba. University Hospital. University of the Basque Country, CIBERSAM, Vitoria, Spain
| | - Esther Berrocoso
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Psychology, University of Cadiz, Spain, Biomedical Research and Innovation Institute of Cádiz (INiBICA), Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, University of Barcelona, August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain; Navarra Institute of Health Research (IdiSNA), Pamplona, Spain.
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Tamayo I, Librero-Lopez J, Galbete A, Cambra K, Enguita-Germán M, Forga L, Goñi MJ, Lecea O, Gorricho J, Olazarán Á, Arnedo L, Moreno-Iribas C, Lafita J, Ibañez-Beroiz B. Cohort Profile: CArdiovascular Risk in patients with DIAbetes in NAvarra (CARDIANA cohort). BMJ Open 2023; 13:e066052. [PMID: 36669840 PMCID: PMC9872484 DOI: 10.1136/bmjopen-2022-066052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 01/04/2023] [Indexed: 01/22/2023] Open
Abstract
PURPOSE The CArdiovascular Risk in patients with DIAbetes in Navarra (CARDIANA cohort) cohort was established to assess the effects of sociodemographic and clinical variables on the risk of cardiovascular events in patients with type 1 (T1D) or type 2 (T2D) diabetes, with a special focus on socioeconomic factors, and to validate and develop cardiovascular risk models for these patients. PARTICIPANTS The CARDIANA cohort included all patients with T1D and T2D diabetes registered in the Public Health Service of Navarra with prevalent disease on 1 January 2012. It consisted of 1067 patients with T1D (ages 2-88 years) and 33842 patients with T2D (ages 20-105 years), whose data were retrospectively extracted from the Health and Administrative System Databases. FINDINGS TO DATE The follow-up period for wave 1 was from 1 January 2012 to 31 December 2016. During these 5 years, 9 patients (0.8%; 95% CI (0.4% to 1.6%)) in the T1D cohort developed a cardiovascular disease event, whereas for the T2D cohort, 2602 (7.7%; 95% CI (7.4% to 8.0%)) had an event. For the T2D cohort, physical activity was associated with a reduced risk of cardiovascular events, with adjusted estimated ORs equal to 0.84 (95% CI 0.66 to 1.07) for the partially active group and 0.71 (95% CI 0.56 to 0.91) for the active group, compared with patients in the non-active group. FUTURE PLANS The CARDIANA cohort is currently being used to assess the effect of sociodemographic risk factors on CV risk at 5 years and to externally validate cardiovascular predictive models. A second wave is being conducted in late 2022 and early 2023, to extend the follow-up other 5 years, from 1 January 2016 to 31 December 2021. Periodic data extractions are planned every 5 years.
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Affiliation(s)
- Ibai Tamayo
- Unidad de Metodología, Navarrabiomed-HUN-UPNA, Pamplona, Navarra, Spain
- Instituto de Investigación Biomédica de Navarra (IdISNA), Pamplona, Spain
- Red de Invesitigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Pamplona, Spain
- Red de Investigacion en Servicios de Salud en Enfermedades Cronicas (REDISSEC), Pamplona, Spain
| | - Julian Librero-Lopez
- Unidad de Metodología, Navarrabiomed-HUN-UPNA, Pamplona, Navarra, Spain
- Instituto de Investigación Biomédica de Navarra (IdISNA), Pamplona, Spain
- Red de Invesitigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Pamplona, Spain
- Red de Investigacion en Servicios de Salud en Enfermedades Cronicas (REDISSEC), Pamplona, Spain
| | - Arkaitz Galbete
- Instituto de Investigación Biomédica de Navarra (IdISNA), Pamplona, Spain
- Red de Invesitigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Pamplona, Spain
- Red de Investigacion en Servicios de Salud en Enfermedades Cronicas (REDISSEC), Pamplona, Spain
- Departamento de Estadística, Universidad Pública de Navarra, Pamplona, Spain
| | - Koldo Cambra
- Red de Investigacion en Servicios de Salud en Enfermedades Cronicas (REDISSEC), Pamplona, Spain
- Departamento de Sanidad, Gobierno Vasco, Pamplona, Spain
| | - Mónica Enguita-Germán
- Unidad de Metodología, Navarrabiomed-HUN-UPNA, Pamplona, Navarra, Spain
- Instituto de Investigación Biomédica de Navarra (IdISNA), Pamplona, Spain
- Red de Invesitigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Pamplona, Spain
- Red de Investigacion en Servicios de Salud en Enfermedades Cronicas (REDISSEC), Pamplona, Spain
| | - Luis Forga
- Instituto de Investigación Biomédica de Navarra (IdISNA), Pamplona, Spain
- Servicio de Endocrinología y Nutrición - HUN, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - María José Goñi
- Instituto de Investigación Biomédica de Navarra (IdISNA), Pamplona, Spain
- Servicio de Endocrinología y Nutrición - HUN, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Oscar Lecea
- Red de Invesitigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Pamplona, Spain
- Atención Primaria, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Javier Gorricho
- Red de Investigacion en Servicios de Salud en Enfermedades Cronicas (REDISSEC), Pamplona, Spain
- Servicio de Evaluación y Difusión de resultados en Salud, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Álvaro Olazarán
- Servicio Tecnologías de la Salud, Departamento de Universidad, Innovación y Transformación, Pamplona, Spain
| | - Laura Arnedo
- Instituto de Estadística de Navarra, Pamplona, Spain
| | - Conchi Moreno-Iribas
- Instituto de Investigación Biomédica de Navarra (IdISNA), Pamplona, Spain
- Red de Investigacion en Servicios de Salud en Enfermedades Cronicas (REDISSEC), Pamplona, Spain
- Instituto de Salud Pública y Laboral de Navarra, Pamplona, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Pamplona, Spain
| | - Javier Lafita
- Red de Invesitigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Pamplona, Spain
- Servicio de Efectividad y Seguridad Asistencial, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Berta Ibañez-Beroiz
- Unidad de Metodología, Navarrabiomed-HUN-UPNA, Pamplona, Navarra, Spain
- Instituto de Investigación Biomédica de Navarra (IdISNA), Pamplona, Spain
- Red de Invesitigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Pamplona, Spain
- Red de Investigacion en Servicios de Salud en Enfermedades Cronicas (REDISSEC), Pamplona, Spain
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Leache L, Gutiérrez-Valencia M, Enguita-Germán M, Librero J, Gorricho J, Jericó C, García-Erce JA. COVID-19 infection and complications according to ABO blood group in the elderly: A population-based subcohort and meta-analysis. Vox Sang 2022; 117:1230-1234. [PMID: 35843888 PMCID: PMC9349979 DOI: 10.1111/vox.13334] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/24/2022] [Accepted: 06/12/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVES It is reported that ABO antibodies have a role in COVID-19 infection and severity; however, ABO antibody titres vary with advanced age. The aim was to analyse the association between ABO blood group and risk of COVID-19 infection and complications in elderly patients, and to contrast this data with findings in the overall adult population. MATERIALS AND METHODS A prospective cohort study of the Navarre (Spain) population aged ≥60 years and a meta-analysis of published studies including participants of ≥60 years were carried out. RESULTS In the Navarre elderly population, a higher risk of COVID-19 infection was identified in the A versus non-A and O group and lower risk in O versus non-O, with no significant association between hospitalization, intensive care unit admission or mortality and any of the blood groups, results that coincide with those of the overall Navarre adult population. The meta-analyses using studies that included participants of ≥60 years demonstrated a higher risk of hospitalization and mortality in A versus non-A and a lower mortality risk with B versus non-B. Similar mortality results were found in the meta-analyses of the overall adult population. CONCLUSION There are no relevant differences between the overall adult population and population aged ≥60 years in the risk of COVID-19 infection and severity according to ABO blood groups, suggesting that age-related changes in ABO would be of limited clinical significance.
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Affiliation(s)
- Leire Leache
- Unit of Innovation and Organization, Navarre Health Service, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Marta Gutiérrez-Valencia
- Unit of Innovation and Organization, Navarre Health Service, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Mónica Enguita-Germán
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Unit of Methodology, Navarrabiomed, Pamplona, Spain.,University Hospital of Navarra (HUN), Pamplona, Spain.,Public University of Navarre (UPNA), Pamplona, Spain.,Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - Julián Librero
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain.,Unit of Methodology, Navarrabiomed, Pamplona, Spain.,University Hospital of Navarra (HUN), Pamplona, Spain.,Public University of Navarre (UPNA), Pamplona, Spain.,Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - Javier Gorricho
- Service of Evaluation and Dissemination of Results, Navarre Health Service, Pamplona, Spain
| | - Carlos Jericó
- Department of Internal Medicine, Hospital Sant Joan Despí-Moisès Broggi, Consorci Sanitari Integral, Barcelona, Spain
| | - Jose Antonio García-Erce
- Blood and Tissue Bank of Navarre, Navarre Health Service, Pamplona, Spain.,Grupo Español de Rehabilitación Multimodal (GERM), Aragon Health Sciences Institute (IACS), Zaragoza, Spain.,PBM Group, Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
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Enguita-Germán M, Librero J, Leache L, Gutiérrez-Valencia M, Tamayo I, Jericó C, Gorricho J, García-Erce JA. Role of the AB0 blood group in COVID-19 infection and complications: A population-based study. Transfus Apher Sci 2022; 61:103357. [PMID: 35148968 PMCID: PMC8762836 DOI: 10.1016/j.transci.2022.103357] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/05/2022] [Accepted: 01/15/2022] [Indexed: 12/16/2022]
Abstract
Since the beginning of the COVID-19 pandemic, the ABO blood group has been described as a possible biological marker of susceptibility for the disease. This study evaluates the role of ABO group on the risk of SARS-CoV-2 infection and related complications in a population-based cohort including 87,090 subjects from the Navarre population (Northern Spain) with no history of SARS-CoV-2 infection and with known ABO blood group, after one year of the pandemic (May 2020 - May 2021). The risk of infection, hospitalization, Intensive Care Unit (ICU) admission and death was analyzed using multivariate logistic regression, adjusting for possible confounding variables. A lower risk of infection was observed in group 0 vs non-0 groups [OR 0.94 (95 %CI 0.90-0.99)], a higher risk of infection in group A vs non-A groups [OR 1.09 (95 %CI 1.04-1.15)] and a higher risk of infection in group A vs group 0 [OR 1.08 (95CI 1.03-1.14)] (when the 4 groups are analyzed separately). No association was observed between blood groups and hospitalization, ICU admission, or death in SARS-CoV-2 infected subjects. Regarding the risk of SARS-CoV-2 infection, we observed a protective role of group O and a greater risk in the A group.
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Affiliation(s)
- Mónica Enguita-Germán
- Unidad de Metodología. Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain; Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Bilbao, Spain.
| | - Julián Librero
- Unidad de Metodología. Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain; Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Bilbao, Spain.
| | - Leire Leache
- Sección de Innovación y Organización, Servicio Navarro de Salud-Osasunbidea, Spain.
| | | | - Ibai Tamayo
- Unidad de Metodología. Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain; Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Bilbao, Spain.
| | - Carlos Jericó
- Department of Internal Medicine, Hospital Sant Joan Despí-Moisès Broggi, Consorci Sanitari Integral, Sant Joan Despí, Barcelona, Spain.
| | - Javier Gorricho
- Servicios de Evaluación y Difusión de Resultados, Servicio Navarro de Salud-Osasunbidea, Spain.
| | - José Antonio García-Erce
- Banco de Sangre y Tejidos de Navarra, Servicio Navarro de Salud, Osasunbidea, Pamplona, Spain; Grupo Español de Rehabilitación Multimodal (GERM), Instituto Aragonés de Ciencias de la Salud, Zaragoza, Spain; Grupo idiPAZ de «Investigación en PBM», Madrid, Spain.
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Galbete A, Tamayo I, Librero J, Enguita-Germán M, Cambra K, Ibáñez-Beroiz B. Cardiovascular risk in patients with type 2 diabetes: A systematic review of prediction models. Diabetes Res Clin Pract 2022; 184:109089. [PMID: 34648890 DOI: 10.1016/j.diabres.2021.109089] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 09/29/2021] [Accepted: 10/07/2021] [Indexed: 12/23/2022]
Abstract
AIMS To identify all cardiovascular disease risk prediction models developed in patients with type 2 diabetes or in the general population with diabetes as a covariate updating previous studies, describing model performance and analysing both their risk of bias and their applicability METHODS: A systematic search for predictive models of cardiovascular risk was performed in PubMed. The CHARMS and PROBAST guidelines for data extraction and for the assessment of risk of bias and applicability were followed. Google Scholar citations of the selected articles were reviewed to identify studies that conducted external validations. RESULTS The titles of 10,556 references were extracted to ultimately identify 19 studies with models developed in a population with diabetes and 46 studies in the general population. Within models developed in a population with diabetes, only six were classified as having a low risk of bias, 17 had a favourable assessment of applicability, 11 reported complete model information, and also 11 were externally validated. CONCLUSIONS There exists an overabundance of cardiovascular risk prediction models applicable to patients with diabetes, but many have a high risk of bias due to methodological shortcomings and independent validations are scarce. We recommend following the existing guidelines to facilitate their applicability.
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Affiliation(s)
- Arkaitz Galbete
- Navarrabiomed-Hospital Universitario de Navarra (HUN)-Universidad Pública de Navarra (UPNA), Pamplona, Spain; Departamento de Estadística, Universidad Pública de Navarra (UPNA), Pamplona, Spain; Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Bilbao, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), IdiSNA, Pamplona, Spain
| | - Ibai Tamayo
- Navarrabiomed-Hospital Universitario de Navarra (HUN)-Universidad Pública de Navarra (UPNA), Pamplona, Spain; Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Bilbao, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), IdiSNA, Pamplona, Spain
| | - Julián Librero
- Navarrabiomed-Hospital Universitario de Navarra (HUN)-Universidad Pública de Navarra (UPNA), Pamplona, Spain; Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Bilbao, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), IdiSNA, Pamplona, Spain
| | - Mónica Enguita-Germán
- Navarrabiomed-Hospital Universitario de Navarra (HUN)-Universidad Pública de Navarra (UPNA), Pamplona, Spain; Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Bilbao, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), IdiSNA, Pamplona, Spain
| | - Koldo Cambra
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Bilbao, Spain; Dirección de Salud Pública y Adicciones, Departamento de Sanidad, Gobierno Vasco, Vitoria, Spain
| | - Berta Ibáñez-Beroiz
- Navarrabiomed-Hospital Universitario de Navarra (HUN)-Universidad Pública de Navarra (UPNA), Pamplona, Spain; Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), Bilbao, Spain; Instituto de Investigación Sanitaria de Navarra (IdiSNA), IdiSNA, Pamplona, Spain; Departamento de Ciencias de la Salud, Universidad Pública de Navarra (UPNA), Pamplona, Spain.
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Enguita-Germán M, Tamayo I, Galbete A, Librero J, Cambra K, Ibáñez-Beroiz B. Effect of Physical Activity on Cardiovascular Event Risk in a Population-Based Cohort of Patients with Type 2 Diabetes. Int J Environ Res Public Health 2021; 18:ijerph182312370. [PMID: 34886096 PMCID: PMC8657417 DOI: 10.3390/ijerph182312370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 12/01/2022]
Abstract
Cardiovascular disease (CVD) is the most common cause of morbidity and mortality among patients with type 2 diabetes (T2D). Physical activity (PA) is one of the few modifiable factors that can reduce this risk. The aim of this study was to estimate to what extent PA can contribute to reducing CVD risk and all-cause mortality in patients with T2D. Information from a population-based cohort including 26,587 patients with T2D from the Navarre Health System who were followed for five years was gathered from electronic clinical records. Multivariate Cox regression models were fitted to estimate the effect of PA on CVD risk and all-cause mortality, and the approach was complemented using conditional logistic regression models within a matched nested case–control design. A total of 5111 (19.2%) patients died during follow-up, which corresponds to 37.8% of the inactive group, 23.9% of the partially active group and 12.4% of the active group. CVD events occurred in 2362 (8.9%) patients, which corresponds to 11.6%, 10.1% and 7.6% of these groups. Compared with patients in the inactive group, and after matching and adjusting for confounders, the OR of having a CVD event was 0.84 (95% CI: 0.66–1.07) for the partially active group and 0.71 (95% CI: 0.56–0.91) for the active group. A slightly more pronounced gradient was obtained when focused on all-cause mortality, with ORs equal to 0.72 (95% CI: 0.61–0.85) and 0.50 (95% CI: 0.42–0.59), respectively. This study provides further evidence that physically active patients with T2D may have a reduced risk of CVD-related complications and all-cause mortality.
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Affiliation(s)
- Mónica Enguita-Germán
- Unidad de Metodología, Navarrabiomed-HUN-UPNA, 31008 Pamplona, Spain; (M.E.-G.); (I.T.); (A.G.); (J.L.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), 48902 Bilbao, Spain;
| | - Ibai Tamayo
- Unidad de Metodología, Navarrabiomed-HUN-UPNA, 31008 Pamplona, Spain; (M.E.-G.); (I.T.); (A.G.); (J.L.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), 48902 Bilbao, Spain;
| | - Arkaitz Galbete
- Unidad de Metodología, Navarrabiomed-HUN-UPNA, 31008 Pamplona, Spain; (M.E.-G.); (I.T.); (A.G.); (J.L.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), 48902 Bilbao, Spain;
- Departamento de Estadística, Universidad Pública de Navarra (UPNA), 31008 Pamplona, Spain
| | - Julián Librero
- Unidad de Metodología, Navarrabiomed-HUN-UPNA, 31008 Pamplona, Spain; (M.E.-G.); (I.T.); (A.G.); (J.L.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), 48902 Bilbao, Spain;
| | - Koldo Cambra
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), 48902 Bilbao, Spain;
- Departamento de Salud, Gobierno Vasco, 01006 Vitoria-Gasteiz, Spain
| | - Berta Ibáñez-Beroiz
- Unidad de Metodología, Navarrabiomed-HUN-UPNA, 31008 Pamplona, Spain; (M.E.-G.); (I.T.); (A.G.); (J.L.)
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas (REDISSEC), 48902 Bilbao, Spain;
- Correspondence:
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Spadaccini M, Albéniz E, Pohl H, Maselli R, Thoguluva Chandrasekar V, Correale L, Anderloni A, Carrara S, Fugazza A, Badalamenti M, Iwatate M, Antonelli G, Enguita-Germán M, Álvarez MA, Sharma P, Rex DK, Hassan C, Repici A. Prophylactic Clipping After Colorectal Endoscopic Resection Prevents Bleeding of Large, Proximal Polyps: Meta-analysis of Randomized Trials. Gastroenterology 2020; 159:148-158.e11. [PMID: 32247023 DOI: 10.1053/j.gastro.2020.03.051] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [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: 12/26/2019] [Revised: 03/23/2020] [Accepted: 03/24/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND & AIMS The benefits of prophylactic clipping to prevent bleeding after polypectomy are unclear. We conducted an updated meta-analysis of randomized trials to assess the efficacy of clipping in preventing bleeding after polypectomy, overall and according to polyp size and location. METHODS We searched the MEDLINE/PubMed, Embase, and Scopus databases for randomized trials that compared the effects of clipping vs not clipping to prevent bleeding after polypectomy. We performed a random-effects meta-analysis to generate pooled relative risks (RRs) with 95% CIs. Multilevel random-effects metaregression analysis was used to combine data on bleeding after polypectomy and estimate associations between rates of bleeding and polyp characteristics. RESULTS We analyzed data from 9 trials, comprising 71897 colorectal lesions (22.5% 20 mm or larger; 49.2% with proximal location). Clipping, compared with no clipping, did not significantly reduce the overall risk of postpolypectomy bleeding (2.2% with clipping vs 3.3% with no clipping; RR, 0.69; 95% confidence interval [CI], 0.45-1.08; P = .072). Clipping significantly reduced risk of bleeding after removal of polyps that were 20 mm or larger (4.3% had bleeding after clipping vs 7.6% had bleeding with no clipping; RR, 0.51; 95% CI, 0.33-0.78; P = .020) or that were in a proximal location (3.0% had bleeding after clipping vs 6.2% had bleeding with no clipping; RR, 0.53; 95% CI, 0.35-0.81; P < .001). In multilevel metaregression analysis that adjusted for polyp size and location, prophylactic clipping was significantly associated with reduced risk of bleeding after removal of large proximal polyps (RR, 0.37; 95% CI, 0.22-0.61; P = .021) but not small proximal lesions (RR, 0.88; 95% CI, 0.48-1.62; P = .581). CONCLUSIONS In a meta-analysis of randomized trials, we found that routine use of prophylactic clipping does not reduce risk of postpolypectomy bleeding overall. However, clipping appeared to reduce bleeding after removal of large (more than 20 mm) proximal lesions.
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Affiliation(s)
- Marco Spadaccini
- Humanitas Research Hospital, Digestive Endoscopy Unit, Rozzano, Italy; Humanitas University, Department of Biomedical Sciences, Rozzano, Italy.
| | - Eduardo Albéniz
- Navarrabiomed Research Institute/Public University of Navarra/IdiSNA, Endoscopy Research Department, Pamplona, Spain
| | - Heiko Pohl
- Dartmouth Geisel School of Medicine, Digestive Endoscopy Unit, Hanover, New Hampshire
| | - Roberta Maselli
- Humanitas Research Hospital, Digestive Endoscopy Unit, Rozzano, Italy
| | | | - Loredana Correale
- Humanitas Research Hospital, Digestive Endoscopy Unit, Rozzano, Italy
| | - Andrea Anderloni
- Humanitas Research Hospital, Digestive Endoscopy Unit, Rozzano, Italy
| | - Silvia Carrara
- Humanitas Research Hospital, Digestive Endoscopy Unit, Rozzano, Italy
| | | | | | - Mineo Iwatate
- Sano Hospital, Gastrointestinal Center and Institute of Minimally Invasive Endoscopic Care, Kobe, Japan
| | | | - Mónica Enguita-Germán
- Navarrabiomed Research Institute/Public University of Navarra/IdiSNA, Endoscopy Research Department, Pamplona, Spain
| | - Marco Antonio Álvarez
- Indiana University School of Medicine, Digestive Endoscopy Unit, Indianapolis, Indiana
| | - Prateek Sharma
- Kansas City Veterans Affairs Medical Center, Gastroenterology and Hepatology, Kansas City, Missouri
| | - Douglas K Rex
- Nuovo Regina Margherita Hospital, Digestive Endoscopy Unit, Rome, Italy
| | - Cesare Hassan
- Hospital del Mar, Gastroenterology Department, Barcelona, Spain
| | - Alessandro Repici
- Humanitas Research Hospital, Digestive Endoscopy Unit, Rozzano, Italy; Humanitas University, Department of Biomedical Sciences, Rozzano, Italy
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Albéniz E, Álvarez MA, Espinós JC, Nogales O, Guarner C, Alonso P, Rodríguez-Téllez M, Herreros de Tejada A, Santiago J, Bustamante-Balén M, Rodríguez Sánchez J, Ramos-Zabala F, Valdivielso E, Martínez-Alcalá F, Fraile M, Elosua A, Guerra Veloz MF, Ibáñez Beroiz B, Capdevila F, Enguita-Germán M. Clip Closure After Resection of Large Colorectal Lesions With Substantial Risk of Bleeding. Gastroenterology 2019; 157:1213-1221.e4. [PMID: 31362007 DOI: 10.1053/j.gastro.2019.07.037] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [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: 04/11/2019] [Revised: 07/16/2019] [Accepted: 07/21/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS It is not clear whether closure of mucosal defects with clips after colonic endoscopic mucosal resection (EMR) prevents delayed bleeding, although it seems to have no protective effects when risk is low. We performed a randomized trial to evaluate the efficacy of complete clip closure of large (≥2 cm) nonpedunculated colorectal lesions after EMR in patients with an estimated average or high risk of delayed bleeding. METHODS We performed a single-blind trial at 11 hospitals in Spain from May 2016 through June 2018, including 235 consecutive patients who underwent EMR for large nonpedunculated colorectal lesions with an average or high risk of delayed bleeding (based on Spanish Endoscopy Society Endoscopic Resection Group score). Participants were randomly assigned to groups that received closure of the scar with 11-mm through-the-scope clips (treated, n = 119) or no clip (control, n = 116). The primary outcome was proportion of patients in each group with delayed bleeding, defined as evident hematochezia that required medical intervention within 15 days after colonoscopy. RESULTS In the clip group, complete closure was achieved in 68 (57%) cases, with partial closure in 33 (28%) cases and failure to close in 18 (15%) cases. Delayed bleeding occurred in 14 (12.1%) patients in the control group and in 6 (5%) patients in the clip group (absolute risk difference, reduction of 7% in the clip group; 95% confidence interval, -14.7% to 0.3%). After completion of the clip closure, there was only 1 (1.5%) case of delayed bleeding (absolute risk difference, reduction of 10.6%; 95% confidence interval, -4.3% to 17.9%). CONCLUSIONS In a randomized trial of patients with large nonpedunculated colorectal lesions undergoing EMR, we found that clip closure of mucosal defects in patients with a risk of bleeding can be a challenge, but also reduces delayed bleeding. Prevention of delayed bleeding required complete clip closure. ClinicalTrials.gov ID: NCT02765022.
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Affiliation(s)
| | | | | | | | | | | | | | | | - José Santiago
- Hospital Universitario Puerta de Hierro, Madrid, Spain
| | | | | | | | | | | | | | | | | | - Berta Ibáñez Beroiz
- Navarrabiomed, Universidad Pública de Navarra, Instituto de Investigación Sanitaria de Navarra, Red de Investigación en Servicios Sanitarios y Enfermedades Crónicas, Pamplona, Spain
| | - Ferrán Capdevila
- Navarrabiomed, Universidad Pública de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Mónica Enguita-Germán
- Navarrabiomed, Universidad Pública de Navarra, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
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Castresana, Enguita-Germán M, Balbuena J, Rey JA, Lázcoz P, Castresana JS. Analysis of stemness gene expression and CD133 abnormal methylation in neuroblastoma cell lines. Oncol Rep 2010; 24:1355-62. [DOI: 10.3892/or_00000993] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Enguita-Germán M, Gurrea M, Schiapparelli P, Zhu TS, Crowley JG, Hamm LL, Costello MA, He X, Talsma CE, Flack CG, Hervey-Jumper SL, Heth JA, Muraszko KM, Rey JA, Fan X, Castresana JS. KIT expression and methylation in medulloblastoma and PNET cell lines and tumors. J Neurooncol 2010; 103:247-53. [PMID: 20853134 DOI: 10.1007/s11060-010-0391-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2010] [Accepted: 08/26/2010] [Indexed: 02/02/2023]
Abstract
The stem cell factor/kit tyrosine kinase receptor pathway is related to tumor growth and progression in several cancers including Ewing sarcoma, a peripheral PNET (pPNET). Identifying additional groups of tumors that may use the pathway is important as they might be responsive to imatinib mesylate treatment. MB and central PNET (cPNET) are embryonal tumors of the CNS that share similar undifferentiated morphology with Ewing sarcomas and display aggressive clinical behavior. cPNET outcome is significantly lower than MB outcome, even for localized tumors treated with high-risk MB therapy. The elucidation of signaling pathways involved in MB and cPNET pathogenesis, and the discovery of new therapeutic targets is necessary to improve the treatment of these neoplasms. We analyzed KIT expression in 2 MB, one pPNET, one cPNET and 2 rhabdomyosarcoma (RMS) cell lines. Also, in 13 tumor samples (12 MB and one cPNET), we found KIT overexpression in the most aggressive cell lines (metastatic MB and pPNET). Hypermethylation of KIT was clear in the RMS non-expressing cell lines. Among MB tumors, we could see variable levels of KIT expression; a subset of them (25%) might be related in its growth pattern to KIT up-regulation. No methylated KIT was detected in the tumors expressing the lowest levels of KIT. Our results point to methylation as an epigenetic regulatory mechanism for KIT inhibition only in the KIT non-expressing RMS cell lines, and neither in the rest of the cell lines nor in the tumor samples.
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Affiliation(s)
- Mónica Enguita-Germán
- Brain Tumor Biology Unit-CIFA, University of Navarra School of Sciences, Irunlarrea 1, 31008, Pamplona, Spain
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Enguita-Germán M, Schiapparelli P, Rey JA, Castresana JS. CD133+ cells from medulloblastoma and PNET cell lines are more resistant to cyclopamine inhibition of the sonic hedgehog signaling pathway than CD133- cells. Tumour Biol 2010; 31:381-90. [PMID: 20480407 DOI: 10.1007/s13277-010-0046-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Accepted: 04/26/2010] [Indexed: 10/19/2022] Open
Abstract
CD133 has recently been used as a reliable marker for brain tumor stem cells isolation. Sonic hedgehog (SHH) is implicated in medulloblastoma and central primitive neuroectodermal tumor (cPNET) formation. It has recently been suggested a role for the EWS/FLI1 fusion protein--typical of pPNET--in the upregulation of GLI1 and PTCH1 genes. Cyclopamine inhibits the SHH pathway in medulloblastoma cell lines, but its effect on cPNET and pPNET cell lines has not been well established yet. Our purpose was to study the effect of cyclopamine on medulloblastoma and PNET cell lines and to analyze whether CD133 expression might be able to modify this effect. We analyzed gene expression, cell viability, apoptosis, and tumorigenic capability before and after cyclopamine treatment in CD133 high-expressing and CD133 low-expressing cell lines. All medulloblastoma and PNET cell lines displayed an inhibitory effect on the expression of SHH pathway genes, on viability, and on tumorigenic potential after treatment. Nevertheless, CD133 expression made the cells more resistant to cyclopamine inhibition. These results open new doors to the understanding of CD133+ cancer stem cells as residual cells that might be responsible for treatment resistance.
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