1
|
Martin-Cardona A, Horta D, Florez-Diez P, Vela M, Mesonero F, Ramos Belinchón C, García MJ, Masnou H, de la Peña-Negro L, Suarez Ferrer C, Casanova MJ, Durán MO, Peña E, Calvet X, Fernández-Prada SJ, González-Muñoza C, Piqueras M, Rodríguez-Lago I, Sainz E, Bas-Cutrina F, Mancediño Marcos N, Ojeda A, Orts B, Sicilia B, García AC, Domènech E, Esteve M. Safety and effectiveness of direct-acting antiviral drugs in the treatment of hepatitis C in patients with inflammatory bowel disease. Dig Liver Dis 2024; 56:468-476. [PMID: 37770282 DOI: 10.1016/j.dld.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/22/2023] [Accepted: 09/04/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND AND AIMS Hepatitis C virus (HCV) management in Inflammatory Bowel Disease (IBD) is uncertain. The ECCO guidelines 2021 recommended HCV treatment but warn about the risk of IBD reactivation. We aimed to evaluate 1) the effectiveness and safety of direct-acting antivirals (DAAs) in IBD; 2) the interaction of DAAs with IBD drugs. METHODS Multicentre study of IBD patients and HCV treated with DAAs. Variables related to liver diseases and IBD, as well as adverse events (AEs) and drug interactions, were recorded. McNemar's test was used to assess differences in the proportion of active IBD during the study period. RESULTS We included 79 patients with IBD and HCV treated with DAAs from 25,998 IBD patients of the ENEIDA registry. Thirty-one (39.2 %) received immunomodulators/biologics. There were no significant differences in the percentage of active IBD at the beginning (n = 11, 13.9 %) or at the 12-week follow-up after DAAs (n = 15, 19 %) (p = 0.424). Sustained viral response occurred in 96.2 % (n = 76). A total of 8 (10.1 %) AEs occurred and these were unrelated to activity, type of IBD, liver fibrosis, immunosuppressants/biologics, and DAAs. CONCLUSIONS We demonstrate a high efficacy and safety of DAAs in patients with IBD and HCV irrespective of activity and treatment of IBD.
Collapse
Affiliation(s)
- A Martin-Cardona
- Digestive Diseases Department, Hospital Universitari Mútua Terrassa, Terrassa, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - D Horta
- Digestive Diseases Department, Hospital Universitari Mútua Terrassa, Terrassa, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - P Florez-Diez
- Digestive Diseases Department, H.U. Central de Asturias, Oviedo, Spain
| | - M Vela
- Digestive Diseases Department, H. Nuestra Sra. de la Candelaria, Santa Cruz de Tenerife, Spain
| | - F Mesonero
- Digestive Diseases Department, H. Ramón y Cajal, Madrid, Spain
| | | | - M J García
- Gastroenterology and Hepatology Department, H. U. Marques de Valdecilla, IDIVAL, Santander, Spain
| | - H Masnou
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain; Digestive Diseases Department, H.U. Germans Trias i Pujol, Badalona, Spain
| | - L de la Peña-Negro
- Digestive Diseases Department, H.U. Bellvitge, Hospitalet de Llobregat, Spain
| | | | - M J Casanova
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain; Digestive Diseases Department, Hospital Universitario de La Princesa-Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - M Ortiz Durán
- Digestive Diseases Department, H.U. Infanta Cristina, Madrid, Spain
| | - E Peña
- Digestive Diseases Department, Hospital Royo Villanova, Zaragoza, Spain
| | - X Calvet
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain; Digestive Diseases Department, Corporació Sanitària Universitària Parc Taulí, Sabadell, Spain
| | | | - C González-Muñoza
- Digestive Diseases Department, H. de la Santa Creu i Sant Pau, Barcelona, Spain
| | - M Piqueras
- Digestive Diseases Department, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - I Rodríguez-Lago
- Digestive Diseases Department, Hospital Universitario de Galdakao and Biocruces Bizkaia Health Research Institute- Galdakao, Galdakao, Spain
| | - E Sainz
- Digestive Diseases Department, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain
| | - F Bas-Cutrina
- Digestive Diseases Department, H. General de Granollers, Granollers, Spain
| | - N Mancediño Marcos
- Digestive Diseases Department, Hospital Universitario Infanta Sofía, Madrid, Spain
| | - A Ojeda
- Digestive Diseases Department, H.G.U. Elche, Elche, Spain
| | - B Orts
- Clinical Pharmacology Department, Hospital General Universitario de Alicante, Alicante, Spain
| | - B Sicilia
- Digestive Diseases Department, Hospital Universitario de Burgos, Burgos, Spain
| | - A Castaño García
- Digestive Diseases Department, H.U. Central de Asturias, Oviedo, Spain
| | - E Domènech
- Digestive Diseases Department, H.U. Germans Trias i Pujol, Badalona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - M Esteve
- Digestive Diseases Department, Hospital Universitari Mútua Terrassa, Terrassa, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.
| |
Collapse
|
2
|
Escudero A, Takagi M, Auer F, Friedrich UA, Miyamoto S, Ogawa A, Imai K, Pascual B, Vela M, Stepensky P, Yasin L, Elitzur S, Borkhardt A, Pérez-Martínez A, Hauer J. Clinical and immunophenotypic characteristics of familial leukemia predisposition caused by PAX5 germline variants. Leukemia 2022; 36:2338-2342. [PMID: 35902733 DOI: 10.1038/s41375-022-01661-7] [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] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/14/2022] [Accepted: 07/19/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Adela Escudero
- Department of Genetics, Institute of Medical and Molecular Genetics (INGEMM), La Paz University Hospital, Madrid, Spain.,Translational Research Group in Pediatric Oncology, Hematopoietic Transplantation & Cell Therapy, Institute for Health Research (IdiPAZ), La Paz University Hospital, Madrid, Spain
| | - Masatoshi Takagi
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University (TMDU), Tokyo, Japan.
| | - Franziska Auer
- Department of Pediatrics, Children's Cancer Research Center, Kinderklinik München Schwabing, School of Medicine, Technical University of Munich, Munich, Germany
| | - Ulrike Anne Friedrich
- Pediatric Hematology and Oncology, Department of Pediatrics, University Hospital "Carl Gustav Carus", Technical University Dresden (TUD), Dresden, Germany
| | - Satoshi Miyamoto
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Atsushi Ogawa
- Department of Pediatrics, Niigata Cancer Center, Niigata, Japan
| | - Kohsuke Imai
- Department of Community Pediatrics, Perinatal and Maternal Medicine Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Barbara Pascual
- Translational Research Group in Pediatric Oncology, Hematopoietic Transplantation & Cell Therapy, Institute for Health Research (IdiPAZ), La Paz University Hospital, Madrid, Spain
| | - María Vela
- Translational Research Group in Pediatric Oncology, Hematopoietic Transplantation & Cell Therapy, Institute for Health Research (IdiPAZ), La Paz University Hospital, Madrid, Spain
| | - Polina Stepensky
- Department of Bone Marrow Transplantation and Cancer Immunotherapy, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Layal Yasin
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Heinrich-Heine University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - Sarah Elitzur
- Pediatric Hematology-Oncology, Schneider Children's Medical Center and Sackler Faculty of Medicine, Tel-Aviv university, Tel-Aviv, Israel
| | - Arndt Borkhardt
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Heinrich-Heine University Duesseldorf, Medical Faculty, Duesseldorf, Germany
| | - Antonio Pérez-Martínez
- Translational Research Group in Pediatric Oncology, Hematopoietic Transplantation & Cell Therapy, Institute for Health Research (IdiPAZ), La Paz University Hospital, Madrid, Spain.,Pediatric Hemato-Oncology Department, La Paz University Hospital, Madrid, Spain.,Pediatric Department, Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain
| | - Julia Hauer
- Department of Pediatrics, Children's Cancer Research Center, Kinderklinik München Schwabing, School of Medicine, Technical University of Munich, Munich, Germany.
| |
Collapse
|
3
|
Gómez García LM, Escudero A, Mestre C, Fuster Soler JL, Martínez AP, Vagace Valero JM, Vela M, Ruz B, Navarro A, Fernández L, Fernández A, Leivas A, Martínez-López J, Ferreras C, De Paz R, Blanquer M, Galán V, González B, Corral D, Sisinni L, Mirones I, Balas A, Vicario JL, Valle P, Borobia AM, Pérez-Martínez A. Phase 2 Clinical Trial of Infusing Haploidentical K562-mb15-41BBL-Activated and Expanded Natural Killer Cells as Consolidation Therapy for Pediatric Acute Myeloblastic Leukemia. Clin Lymphoma Myeloma Leuk 2021; 21:328-337.e1. [PMID: 33610500 DOI: 10.1016/j.clml.2021.01.013] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 01/17/2021] [Accepted: 01/19/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Acute myeloid leukemia (AML) accounts for approximately 20% of pediatric leukemia cases; 30% of these patients experience relapse. The antileukemia properties of natural killer (NK) cells and their safety profile have been reported in AML therapy. We proposed a phase 2, open, prospective, multicenter, nonrandomized clinical trial for the adoptive infusion of haploidentical K562-mb15-41BBL-activated and expanded NK (NKAE) cells as a consolidation strategy for children with favorable and intermediate risk AML in first complete remission after chemotherapy (NCT02763475). PATIENTS AND METHODS Before the NKAE cell infusion, patients underwent a lymphodepleting regimen. After the NKAE cell infusion, patients were administered low doses (1 × 106/IU/m2) of subcutaneous interleukin-2. The primary study endpoint was AML relapse-free survival. We needed to include 35 patients to demonstrate a 50% reduction in relapses. RESULTS Seven patients (median age, 7.4 years; range, 0.78-15.98 years) were administered 13 infusions of NKAE cells, with a median of 36.44 × 106 cells/kg (range, 6.92 × 106 to 193.2 × 106 cells/kg). We observed chimerism in 4 patients (median chimerism, 0.065%; range, 0.05-0.27%). After a median follow-up of 33 months, the disease of 6 patients (85.7%) remained in complete remission. The 3-year overall survival was 83.3% (95% confidence interval, 68.1-98.5), and the cumulative 3-year relapse rate was 28.6% (95% confidence interval, 11.5-45.7). The study was terminated early because of low patient recruitment. CONCLUSION This study emphasizes the difficulties in recruiting patients for cell therapy trials, though NKAE cell infusion is safe and feasible. However, we cannot draw any conclusions regarding efficacy because of the small number of included patients and insufficient biological markers.
Collapse
Affiliation(s)
| | - Adela Escudero
- Institute of Medical and Molecular Genetics (INGEMM), La Paz University Hospital, Madrid, Spain
| | - Carmen Mestre
- Translational Research in Pediatric Oncology, Hematopoietic Transplantation and Cell Therapy, IdiPAZ, Madrid, Spain
| | - Jose L Fuster Soler
- Pediatric Hematology-Oncology Unit, University Clinic Hospital Virgen de la Arrixaca, El Palmar, Spain
| | - Antonia Pascual Martínez
- Pediatric Hematology Unit, Maternal and Children Hospital, Regional University Hospital of Málaga, Málaga, Spain
| | - Jose M Vagace Valero
- Pediatric Hematology Department, Maternal Pediatric Hospital, University Hospital Complex of Badajoz, Badajoz, Spain
| | - María Vela
- Translational Research in Pediatric Oncology, Hematopoietic Transplantation and Cell Therapy, IdiPAZ, Madrid, Spain
| | - Beatriz Ruz
- Institute of Medical and Molecular Genetics (INGEMM), La Paz University Hospital, Madrid, Spain
| | - Alfonso Navarro
- Translational Research in Pediatric Oncology, Hematopoietic Transplantation and Cell Therapy, IdiPAZ, Madrid, Spain
| | - Lucia Fernández
- Hematological Malignancies Clinical Research Unit, National Center for Cancer Research (CNIO), Madrid, Spain
| | - Adrián Fernández
- Hematological Malignancies Clinical Research Unit, National Center for Cancer Research (CNIO), Madrid, Spain
| | - Alejandra Leivas
- Hematological Malignancies Clinical Research Unit, National Center for Cancer Research (CNIO), Madrid, Spain
| | - Joaquin Martínez-López
- Hematological Malignancies Clinical Research Unit, National Center for Cancer Research (CNIO), Madrid, Spain
| | - Cristina Ferreras
- Translational Research in Pediatric Oncology, Hematopoietic Transplantation and Cell Therapy, IdiPAZ, Madrid, Spain
| | - Raquel De Paz
- Hematology Department, La Paz University Hospital, Madrid, Spain
| | - Miguel Blanquer
- Pediatric Hematology-Oncology Unit, University Clinic Hospital Virgen de la Arrixaca, El Palmar, Spain
| | - Victor Galán
- Pediatric Onco-Hematology Department, La Paz University Hospital, Madrid, Spain
| | - Berta González
- Pediatric Onco-Hematology Department, La Paz University Hospital, Madrid, Spain
| | - Dolores Corral
- Pediatric Onco-Hematology Department, La Paz University Hospital, Madrid, Spain
| | - Luisa Sisinni
- Pediatric Onco-Hematology Department, La Paz University Hospital, Madrid, Spain
| | - Isabel Mirones
- Pediatric Onco-Hematology Department, La Paz University Hospital, Madrid, Spain
| | - Antonio Balas
- Histocompatibility and HLA Typing Laboratory, Transfusion Center of the Community of Madrid, Madrid, Spain
| | - José Luis Vicario
- Histocompatibility and HLA Typing Laboratory, Transfusion Center of the Community of Madrid, Madrid, Spain
| | - Paula Valle
- Clinical Pharmacology Department, La Paz University Hospital, Madrid, Spain
| | - Alberto M Borobia
- Clinical Pharmacology Department, La Paz University Hospital, Madrid, Spain
| | - Antonio Pérez-Martínez
- Institute of Medical and Molecular Genetics (INGEMM), La Paz University Hospital, Madrid, Spain; Translational Research in Pediatric Oncology, Hematopoietic Transplantation and Cell Therapy, IdiPAZ, Madrid, Spain; Pediatric Onco-Hematology Department, La Paz University Hospital, Madrid, Spain; Faculty of Medicine, Autonomous University of Madrid, Madrid, Spain.
| |
Collapse
|
4
|
Fernández A, Navarro-Zapata A, Escudero A, Matamala N, Ruz-Caracuel B, Mirones I, Pernas A, Cobo M, Casado G, Lanzarot D, Rodríguez-Antolín C, Vela M, Ferreras C, Mestre C, Viejo A, Leivas A, Martínez J, Fernández L, Pérez-Martínez A. Optimizing the Procedure to Manufacture Clinical-Grade NK Cells for Adoptive Immunotherapy. Cancers (Basel) 2021; 13:cancers13030577. [PMID: 33540698 PMCID: PMC7867223 DOI: 10.3390/cancers13030577] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 12/02/2020] [Revised: 01/14/2021] [Accepted: 01/26/2021] [Indexed: 01/18/2023] Open
Abstract
Simple Summary Natural Killer cells have shown promise to treat different malignancies. Several methods have been described to obtain fully activated NK cells for clinical use. Here, we use different cell culture media and different artificial antigen presenting cells to optimize a GMP compliant manufacturing method to obtain activated and expanded NK cells suitable for clinical use. Abstract Natural killer (NK) cells represent promising tools for cancer immunotherapy. We report the optimization of an NK cell activation–expansion process and its validation on clinical-scale. Methods: RPMI-1640, stem cell growth medium (SCGM), NK MACS and TexMACS were used as culture mediums. Activated and expanded NK cells (NKAE) were obtained by coculturing total peripheral blood mononuclear cells (PBMC) or CD45RA+ cells with irradiated K562mbIL15-41BBL or K562mbIL21-41BBL. Fold increase, NK cell purity, activation status, cytotoxicity and transcriptome profile were analyzed. Clinical-grade NKAE cells were manufactured in CliniMACS Prodigy. Results: NK MACS and TexMACs achieved the highest NK cell purity and lowest T cell contamination. Obtaining NKAE cells from CD45RA+ cells was feasible although PBMC yielded higher total cell numbers and NK cell purity than CD45RA+ cells. The highest fold expansion and NK purity were achieved by using PBMC and K562mbIL21-41BBL cells. However, no differences in activation and cytotoxicity were found when using either NK cell source or activating cell line. Transcriptome profile showed to be different between basal NK cells and NKAE cells expanded with K562mbIL21-41BBL or K562mbIL15-41BBL. Clinical-grade manufactured NKAE cells complied with the specifications from the Spanish Regulatory Agency. Conclusions: GMP-grade NK cells for clinical use can be obtained by using different starting cells and aAPC.
Collapse
Affiliation(s)
- Adrián Fernández
- Hematological Malignancies Lab-H12O Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; (A.F.); (A.L.); (J.M.); (L.F.)
| | - Alfonso Navarro-Zapata
- Translational Research Group in Paediatric Oncology Haematopoietic Transplantation & Cell Therapy, La Paz University Hospital Institute for Health Research-IdiPAZ, 28046 Madrid, Spain; (A.N.-Z.); (M.V.); (C.F.); (C.M.)
| | - Adela Escudero
- Institute of Medical and Molecular Genetics (INGEMM), La Paz University Hospital, 28046 Madrid, Spain;
- Translational Research in Pediatric Oncology, Hematopoietic Transplantation & Cell Therapy, La Paz University Hospital Institute for Health Research-Institute of Medical and Molecular Genetics (INGEMM-IdiPAZ), 28046 Madrid, Spain; (N.M.); (B.R.-C.)
| | - Nerea Matamala
- Translational Research in Pediatric Oncology, Hematopoietic Transplantation & Cell Therapy, La Paz University Hospital Institute for Health Research-Institute of Medical and Molecular Genetics (INGEMM-IdiPAZ), 28046 Madrid, Spain; (N.M.); (B.R.-C.)
| | - Beatriz Ruz-Caracuel
- Translational Research in Pediatric Oncology, Hematopoietic Transplantation & Cell Therapy, La Paz University Hospital Institute for Health Research-Institute of Medical and Molecular Genetics (INGEMM-IdiPAZ), 28046 Madrid, Spain; (N.M.); (B.R.-C.)
| | - Isabel Mirones
- Advanced Therapy Medicinal Products Production Unit Pediatric Hemato-Oncology Department, La Paz University Hospital, 28046 Madrid, Spain; (I.M.); (A.P.); (M.C.); (G.C.)
| | - Alicia Pernas
- Advanced Therapy Medicinal Products Production Unit Pediatric Hemato-Oncology Department, La Paz University Hospital, 28046 Madrid, Spain; (I.M.); (A.P.); (M.C.); (G.C.)
| | - Marta Cobo
- Advanced Therapy Medicinal Products Production Unit Pediatric Hemato-Oncology Department, La Paz University Hospital, 28046 Madrid, Spain; (I.M.); (A.P.); (M.C.); (G.C.)
| | - Gema Casado
- Advanced Therapy Medicinal Products Production Unit Pediatric Hemato-Oncology Department, La Paz University Hospital, 28046 Madrid, Spain; (I.M.); (A.P.); (M.C.); (G.C.)
- Advanced Therapy Medicinal Products Production Unit, Pediatric Hemato-Oncology Service and Pharmacy Service, La Paz University Hospital, 28046 Madrid, Spain
| | - Diego Lanzarot
- Applications Department Miltenyi Biotec, 28223 Madrid, Spain;
| | - Carlos Rodríguez-Antolín
- Experimental Therapies and Novel Biomarkers in Cancer, La Paz University Hospital Institute for Health Research-IdiPAZ, 28046 Madrid, Spain;
| | - María Vela
- Translational Research Group in Paediatric Oncology Haematopoietic Transplantation & Cell Therapy, La Paz University Hospital Institute for Health Research-IdiPAZ, 28046 Madrid, Spain; (A.N.-Z.); (M.V.); (C.F.); (C.M.)
| | - Cristina Ferreras
- Translational Research Group in Paediatric Oncology Haematopoietic Transplantation & Cell Therapy, La Paz University Hospital Institute for Health Research-IdiPAZ, 28046 Madrid, Spain; (A.N.-Z.); (M.V.); (C.F.); (C.M.)
| | - Carmen Mestre
- Translational Research Group in Paediatric Oncology Haematopoietic Transplantation & Cell Therapy, La Paz University Hospital Institute for Health Research-IdiPAZ, 28046 Madrid, Spain; (A.N.-Z.); (M.V.); (C.F.); (C.M.)
| | - Aurora Viejo
- Hematology and Hemotherapy Department, La Paz University Hospital, 28046 Madrid, Spain;
| | - Alejandra Leivas
- Hematological Malignancies Lab-H12O Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; (A.F.); (A.L.); (J.M.); (L.F.)
- Hematology Department 12 de Octubre University Hospital, 28041 Madrid, Spain
| | - Joaquín Martínez
- Hematological Malignancies Lab-H12O Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; (A.F.); (A.L.); (J.M.); (L.F.)
- Hematology Department 12 de Octubre University Hospital, 28041 Madrid, Spain
| | - Lucía Fernández
- Hematological Malignancies Lab-H12O Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), 28029 Madrid, Spain; (A.F.); (A.L.); (J.M.); (L.F.)
| | - Antonio Pérez-Martínez
- Translational Research Group in Paediatric Oncology Haematopoietic Transplantation & Cell Therapy, La Paz University Hospital Institute for Health Research-IdiPAZ, 28046 Madrid, Spain; (A.N.-Z.); (M.V.); (C.F.); (C.M.)
- Pediatric Hemato-Oncology Department, La Paz University Hospital, 28046 Madrid, Spain
- Correspondence: ; Tel.: +34-912071408 (ext. 41408)
| |
Collapse
|
5
|
Zambrano A, Gaviria A, Vela M, Rodríguez-Pollit C, Guevara-Ramírez P, López-Cortés A, Armendáriz-Castillo I, García-Cárdenas J, Guerrero S, Leone P, Pérez-Villa A, Yumiceba V, Fiallos G, Gruezo C, Paz-y-Miño C. Genetic variation of high-altitude Ecuadorian population using autosomal STR markers. Forensic Science International: Genetics Supplement Series 2019. [DOI: 10.1016/j.fsigss.2019.09.025] [Citation(s) in RCA: 1] [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: 10/25/2022]
|
6
|
Fernández L, Fernández A, Mirones I, Escudero A, Cardoso L, Vela M, Lanzarot D, de Paz R, Leivas A, Gallardo M, Marcos A, Romero AB, Martínez-López J, Pérez-Martínez A. GMP-Compliant Manufacturing of NKG2D CAR Memory T Cells Using CliniMACS Prodigy. Front Immunol 2019; 10:2361. [PMID: 31649672 PMCID: PMC6795760 DOI: 10.3389/fimmu.2019.02361] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 09/19/2019] [Indexed: 12/11/2022] Open
Abstract
Natural killer group 2D (NKG2D) is a natural killer (NK) cell-activating receptor that recognizes different stress-induced ligands that are overexpressed in a variety of childhood and adult tumors. NKG2D chimeric antigen receptor (CAR) T cells have shown potent anticancer effects against different cancer types. A second-generation NKG2D CAR was generated by fusing full-length human NKG2D to 4-1BB costimulatory molecule and CD3ζ signaling domain. Patient-derived CAR T cells show limitations including inability to manufacture CAR T cells from the patients' own T cells, disease progression, and death prior to return of engineered cells. The use of allogeneic T cells for CAR therapy could be an attractive alternative, although undesirable graft vs. host reactions may occur. To avoid such adverse effects, we used CD45RA− memory T cells, a T-cell subset with less alloreactivity, as effector cells to express NKG2D CAR. In this study, we developed a protocol to obtain large-scale NKG2D CAR memory T cells for clinical use by using CliniMACS Prodigy, an automated closed system compliant with Good Manufacturing Practice (GMP) guidelines. CD45RA+ fraction was depleted from healthy donors' non-mobilized apheresis using CliniMACS CD45RA Reagent and CliniMACS Plus device. A total of 108 CD45RA− cells were cultured in TexMACS media supplemented with 100 IU/mL IL-2 and activated at day 0 with T Cell TransAct. Then, we used NKG2D-CD8TM-4-1BB-CD3ζ lentiviral vector for cell transduction (MOI = 2). NKG2D CAR T cells expanded between 10 and 13 days. Final cell products were analyzed to comply with the specifications derived from the quality and complementary controls carried out in accordance with the instructions of the Spanish Regulatory Agency of Medicines and Medical Devices (AEMPS) for the manufacture of investigational advanced therapy medicinal products (ATMPs). We performed four validations. The manufacturing protocol here described achieved large numbers of viable NKG2D CAR memory T cells with elevated levels of NKG2D CAR expression and highly cytotoxic against Jurkat and 531MII tumor target cells. CAR T cell final products met release criteria, except for one showing myc overexpression and another with viral copy number higher than five. Manufacturing of clinical-grade NKG2D CAR memory T cells using CliniMACS Prodigy is feasible and reproducible, widening clinical application of CAR T cell therapies.
Collapse
Affiliation(s)
- Lucía Fernández
- Hematological Malignancies H12O, Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Adrián Fernández
- Hematological Malignancies H12O, Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - Isabel Mirones
- Translational Research in Pediatric Oncology, Hematopoietic Transplantation and Cell Therapy, IdiPAZ, Hospital Universitario La Paz, Madrid, Spain
| | - Adela Escudero
- Pediatric Molecular Hemato-Oncology Department, Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz, Madrid, Spain
| | - Leila Cardoso
- Pediatric Molecular Hemato-Oncology Department, Instituto de Genética Médica y Molecular (INGEMM), Hospital Universitario La Paz, Madrid, Spain
| | - María Vela
- Translational Research in Pediatric Oncology, Hematopoietic Transplantation and Cell Therapy, IdiPAZ, Hospital Universitario La Paz, Madrid, Spain
| | - Diego Lanzarot
- Applications Department, Miltenyi Biotec S.L., Madrid, Spain
| | - Raquel de Paz
- Hematology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Alejandra Leivas
- Hematological Malignancies H12O, Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain.,Hematology Department, Hospital Universitario12 de Octubre, Madrid, Spain
| | - Miguel Gallardo
- Hematological Malignancies H12O, Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain.,Hematology Department, Hospital Universitario12 de Octubre, Madrid, Spain
| | - Antonio Marcos
- Hematology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Ana Belén Romero
- Hematology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Joaquín Martínez-López
- Hematological Malignancies H12O, Clinical Research Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain.,Hematology Department, Hospital Universitario12 de Octubre, Madrid, Spain
| | - Antonio Pérez-Martínez
- Translational Research in Pediatric Oncology, Hematopoietic Transplantation and Cell Therapy, IdiPAZ, Hospital Universitario La Paz, Madrid, Spain.,Pediatric Hemato-Oncology Department, Hospital Universitario La Paz, Madrid, Spain
| |
Collapse
|
7
|
Toscanini U, Gaviria A, Pardo-Seco J, Gómez-Carballa A, Moscoso F, Vela M, Cobos S, Lupero A, Zambrano AK, Martinón-Torres F, Carabajo-Marcillo A, Yunga-León R, Ugalde-Noritz N, Ordoñez-Ugalde A, Salas A. The geographic mosaic of Ecuadorian Y-chromosome ancestry. Forensic Sci Int Genet 2017; 33:59-65. [PMID: 29197245 DOI: 10.1016/j.fsigen.2017.11.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [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: 06/28/2017] [Revised: 11/16/2017] [Accepted: 11/18/2017] [Indexed: 11/29/2022]
Abstract
Ecuadorians originated from a complex mixture of Native American indigenous people with Europeans and Africans. We analyzed Y-chromosome STRs (Y-STRs) in a sample of 415 Ecuadorians (145 using the AmpFlSTR® Yfiler™ system [Life Technologies, USA] and 270 using the PowerPlex®Y23 system [Promega Corp., USA]; hereafter Yfiler and PPY23, respectively) representing three main ecological continental regions of the country, namely Amazon rainforest, Andes, and Pacific coast. Diversity values are high in the three regions, and the PPY23 exhibits higher discrimination power than the Yfiler set. While summary statistics, AMOVA, and RST distances show low to moderate levels of population stratification, inferred ancestry derived from Y-STRs reveal clear patterns of geographic variation. The major ancestry in Ecuadorian males is European (61%), followed by an important Native American component (34%); whereas the African ancestry (5%) is mainly concentrated in the Northwest corner of the country. We conclude that classical procedures for measuring population stratification do not have the desirable sensitivity. Statistical inference of ancestry from Y-STRS is a satisfactory alternative for revealing patterns of spatial variation that would pass unnoticed when using popular statistical summary indices.
Collapse
Affiliation(s)
- U Toscanini
- Pricai-Fundación Favaloro, Buenos Aires, Argentina; Unidade de Xenética, Departamento de Anatomía Patolóxica e Ciencias Forenses, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, and GenPoB Research Group, Instituto de Investigaciones Sanitarias (IDIS), Hospital Clínico Universitario de Santiago, Galicia (SERGAS), Spain
| | - A Gaviria
- Laboratorio de Genética Molecular, Centros Médicos Especializados Cruz Roja Ecuatoriana-Cruz Vital, Quito, Ecuador
| | - J Pardo-Seco
- Unidade de Xenética, Departamento de Anatomía Patolóxica e Ciencias Forenses, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, and GenPoB Research Group, Instituto de Investigaciones Sanitarias (IDIS), Hospital Clínico Universitario de Santiago, Galicia (SERGAS), Spain; Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; GENVIP Research Group, Instituto de Investigación Sanitaria de Santiago, Galicia, Spain(2)
| | - A Gómez-Carballa
- Unidade de Xenética, Departamento de Anatomía Patolóxica e Ciencias Forenses, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, and GenPoB Research Group, Instituto de Investigaciones Sanitarias (IDIS), Hospital Clínico Universitario de Santiago, Galicia (SERGAS), Spain; Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; GENVIP Research Group, Instituto de Investigación Sanitaria de Santiago, Galicia, Spain(2)
| | - F Moscoso
- Unidade de Xenética, Departamento de Anatomía Patolóxica e Ciencias Forenses, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, and GenPoB Research Group, Instituto de Investigaciones Sanitarias (IDIS), Hospital Clínico Universitario de Santiago, Galicia (SERGAS), Spain; Laboratorio Biomolecular, Cuenca, Ecuador
| | - M Vela
- Laboratorio de Genética Molecular, Centros Médicos Especializados Cruz Roja Ecuatoriana-Cruz Vital, Quito, Ecuador
| | - S Cobos
- Laboratorio de Genética Molecular, Centros Médicos Especializados Cruz Roja Ecuatoriana-Cruz Vital, Quito, Ecuador
| | - A Lupero
- Laboratorio de Genética Molecular, Centros Médicos Especializados Cruz Roja Ecuatoriana-Cruz Vital, Quito, Ecuador
| | - A K Zambrano
- Centro de Investigación Genética y Genómica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnológica Equinoccial, Quito, 1701129, Ecuador
| | - F Martinón-Torres
- Translational Pediatrics and Infectious Diseases, Hospital Clínico Universitario de Santiago, Santiago de Compostela, Spain; GENVIP Research Group, Instituto de Investigación Sanitaria de Santiago, Galicia, Spain(2)
| | | | | | | | - A Ordoñez-Ugalde
- Unidade de Xenética, Departamento de Anatomía Patolóxica e Ciencias Forenses, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, and GenPoB Research Group, Instituto de Investigaciones Sanitarias (IDIS), Hospital Clínico Universitario de Santiago, Galicia (SERGAS), Spain; Laboratorio Biomolecular, Cuenca, Ecuador; Neurogenetics Group, FPGMX-IDIS, Santiago de Compostela, Spain
| | - A Salas
- Unidade de Xenética, Departamento de Anatomía Patolóxica e Ciencias Forenses, Instituto de Ciencias Forenses, Facultade de Medicina, Universidade de Santiago de Compostela, and GenPoB Research Group, Instituto de Investigaciones Sanitarias (IDIS), Hospital Clínico Universitario de Santiago, Galicia (SERGAS), Spain.
| |
Collapse
|
8
|
Roman S, Gyawali CP, Savarino E, Yadlapati R, Zerbib F, Wu J, Vela M, Tutuian R, Tatum R, Sifrim D, Keller J, Fox M, Pandolfino JE, Bredenoord AJ. Ambulatory reflux monitoring for diagnosis of gastro-esophageal reflux disease: Update of the Porto consensus and recommendations from an international consensus group. Neurogastroenterol Motil 2017; 29:1-15. [PMID: 28370768 DOI: 10.1111/nmo.13067] [Citation(s) in RCA: 202] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 02/20/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND An international group of experts evaluated and revised recommendations for ambulatory reflux monitoring for the diagnosis of gastro-esophageal reflux disease (GERD). METHODS Literature search was focused on indications and technical recommendations for GERD testing and phenotypes definitions. Statements were proposed and discussed during several structured meetings. KEY RESULTS Reflux testing should be performed after cessation of acid suppressive medication in patients with a low likelihood of GERD. In this setting, testing can be either catheter-based or wireless pH-monitoring or pH-impedance monitoring. In patients with a high probability of GERD (esophagitis grade C and D, histology proven Barrett's mucosa >1 cm, peptic stricture, previous positive pH monitoring) and persistent symptoms, pH-impedance monitoring should be performed on treatment. Recommendations are provided for data acquisition and analysis. Esophageal acid exposure is considered as pathological if acid exposure time (AET) is greater than 6% on pH testing. Number of reflux episodes and baseline impedance are exploratory metrics that may complement AET. Positive symptom reflux association is defined as symptom index (SI) >50% or symptom association probability (SAP) >95%. A positive symptom-reflux association in the absence of pathological AET defines hypersensitivity to reflux. CONCLUSIONS AND INFERENCES The consensus group determined that grade C or D esophagitis, peptic stricture, histology proven Barrett's mucosa >1 cm, and esophageal acid exposure greater >6% are sufficient to define pathological GERD. Further testing should be considered when none of these criteria are fulfilled.
Collapse
Affiliation(s)
- S Roman
- Digestive Physiology, Hospices Civils de Lyon and Lyon I University, Inserm U1032, LabTAU, Lyon, France
| | - C P Gyawali
- Division of Gastroenterology, Washington University School of Medicine, St. Louis, MO, USA
| | - E Savarino
- Division of Gastroenterology, Department of Surgical, Oncological and Gastroenterological Sciences, Padua, Italy
| | - R Yadlapati
- Division of Gastroenterology, Department of Medicine, Northwestern University, Chicago, IL, USA
| | - F Zerbib
- Department of Gastroenterology, Bordeaux University Hospital, and Université de Bordeaux, Bordeaux, France
| | - J Wu
- Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, China
| | - M Vela
- Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, AZ, USA
| | - R Tutuian
- Division of Gastroenterology, University Clinics for Visceral Surgery and Medicine, Bern University Hospital, Bern, Switzerland
| | - R Tatum
- Department of Surgery, University of Washington, Seattle, WA, USA
| | - D Sifrim
- Center for Digestive Diseases, Bart's and the London School and Dentistry, London, UK
| | - J Keller
- Department of Internal Medicine, Israelitic Hospital, University of Hamburg, Hamburg, Germany
| | - M Fox
- Department of Gastroenterology, Abdominal Center, St. Claraspital, Basel, Switzerland
| | - J E Pandolfino
- Division of Gastroenterology, Department of Medicine, Northwestern University, Chicago, IL, USA
| | - A J Bredenoord
- Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, The Netherlands
| | | |
Collapse
|
9
|
Fernández L, Metais JY, Escudero A, Vela M, Valentín J, Vallcorba I, Leivas A, Torres J, Valeri A, Patiño-García A, Martínez J, Leung W, Pérez-Martínez A. Memory T Cells Expressing an NKG2D-CAR Efficiently Target Osteosarcoma Cells. Clin Cancer Res 2017; 23:5824-5835. [DOI: 10.1158/1078-0432.ccr-17-0075] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 04/27/2017] [Accepted: 06/21/2017] [Indexed: 11/16/2022]
|
10
|
Carrasco Salas P, Fernández L, Vela M, Bueno D, González B, Valentín J, Lapunzina P, Pérez-Martínez A. The role of CDKN2A/B deletions in pediatric acute lymphoblastic leukemia. Pediatr Hematol Oncol 2016; 33:415-422. [PMID: 27960642 DOI: 10.1080/08880018.2016.1251518] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The CDKN2A/B genes in the 9p21 chromosomal region are frequently involved in human cancer, including pediatric acute lymphoblastic leukemia (ALL). These genes encode 3 proteins that belong to the RB1 and TP53 pathways and act as tumor suppressors by regulating the G1/S checkpoint of the cell cycle. The prognostic value of deletions in the CDKN2A/B locus in ALL is controversial in part due to the limitations of the methodologies used. Further studies with advanced technologies are needed for elucidation. Future studies would also highlight whether CDK4/CDK6 selective inhibitors might be useful therapies for children with these genetic aberrations.
Collapse
Affiliation(s)
- P Carrasco Salas
- a Laboratory of Molecular Pediatric Hemato-Oncology , Institute of Medical and Molecular Genetics (INGEMM), Hospital Universitario La Paz , Madrid , Spain
| | - L Fernández
- b Clinical Research Program , Cancer Research National Centre , Madrid , Spain
| | - M Vela
- c Innate Immune Research Group, IdiPAZ , Madrid , Spain
| | - D Bueno
- d Department of Pediatric Hemato-Oncology and Stem Cell Transplantation , Hospital Infantil Universitario La Paz , Madrid , Spain
| | - B González
- d Department of Pediatric Hemato-Oncology and Stem Cell Transplantation , Hospital Infantil Universitario La Paz , Madrid , Spain
| | - J Valentín
- c Innate Immune Research Group, IdiPAZ , Madrid , Spain
| | - P Lapunzina
- a Laboratory of Molecular Pediatric Hemato-Oncology , Institute of Medical and Molecular Genetics (INGEMM), Hospital Universitario La Paz , Madrid , Spain
| | - A Pérez-Martínez
- a Laboratory of Molecular Pediatric Hemato-Oncology , Institute of Medical and Molecular Genetics (INGEMM), Hospital Universitario La Paz , Madrid , Spain.,c Innate Immune Research Group, IdiPAZ , Madrid , Spain.,d Department of Pediatric Hemato-Oncology and Stem Cell Transplantation , Hospital Infantil Universitario La Paz , Madrid , Spain
| |
Collapse
|
11
|
Sánchez M, Burgos G, Gaviria A, Aguirre V, Vela M, Leone P, Paz-y-Miño C. Y STRs mutation events in father-son pairs in Ecuadorian individuals. Forensic Science International: Genetics Supplement Series 2015. [DOI: 10.1016/j.fsigss.2015.09.123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
12
|
Gaviria A, Sánchez M, Morejón G, Vela M, Aguirre V, Burgos G, Zambrano A, Leone P, Paz-y-Miño C. Characterization and Haplotype analysis of 11 Y-STR loci in Ecuadorian population. Forensic Science International: Genetics Supplement Series 2013. [DOI: 10.1016/j.fsigss.2013.10.158] [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: 10/26/2022]
|
13
|
Furia GU, Kostelijk EH, Vergouw CG, Lee H, Lee S, Park D, Kang H, Lim C, Yang K, Lee S, Lim C, Park Y, Shin M, Yang K, Lee H, Beyhan Z, Fisch JD, Sher G, Keskintepe L, VerMilyea MD, Anthony JT, Graham JR, Tucker MJ, Tucker MJ, Freour T, Lattes S, Lammers J, Mansour W, Jean M, Barriere P, El Danasouri I, Gagsteiger F, Rinaldi L, Selman H, Antonova I, Milachich T, Valkova L, Shterev A, Barcroft J, Dayoub N, Thong J, Abdel Reda H, Khalaf Y, El Touky T, Cabry R, Brzakowski R, Lourdel E, Brasseur F, Copin H, Merviel P, Yamada M, Takanashi K, Hamatani T, Akutsu H, Fukunaga T, Inoue O, Ogawa S, Sugawara K, Okumura N, Chikazawa N, Kuji N, Umezawa A, Tomita M, Yoshimura Y, Van der Jeught M, Ghimire S, O'Leary T, Lierman S, Deforce D, Chuva de Sousa Lopes S, Heindryckx B, De Sutter P, Herrero J, Tejera A, De los Santos MJ, Castello D, Romero JL, Meseguer M, Barriere P, Lammers J, Lattes S, Leperlier F, Mirallie S, Jean M, Freour T, Schats R, Al-Nofal M, Vergouw CG, Lens JW, Rooth H, Kostelijk EH, Hompes PG, Lambalk CB, Hreinsson J, Karlstrom PO, Wanggren K, Lundqvist M, Vahabi Z, Eftekhari-Yazdi P, Dalman A, Ebrahimi B, Daneshzadeh MT, Rajabpour Niknam M, Choi EG, Rho YH, Oh DS, Park LS, Cheon HS, Lee CS, Kong IK, Lee SC, Liebenthron J, Montag M, Koster M, Toth B, Reinsberg J, van der Ven H, Strowitzki T, Morita H, Hirosawa T, Watanabe S, Wada T, Kamihata M, Kuwahata A, Ochi M, Horiuchi T, Fatemeh H, Eftekhari-Yazdi P, Karimian L, Fazel M, Fouladi H, Johansson L, Ruttanajit T, Chanchamroen S, Sopaboon P, Seweewanlop S, Sawakwongpra K, Jindasri P, Jantanalapruek T, Charoonchip K, Vajta G, Quangkananurug W, Yi G, Jo JW, Jee BC, Suh CS, Kim SH, Zhang Y, Zhao HJ, Cui YG, Gao C, Gao LL, Liu JY, Sozen E, Buluc B, Vicdan K, Akarsu C, Tuncay G, Hambiliki F, Bungum M, Agapitou K, Makrakis E, Liarmakopoulou S, Anagnostopoulou C, Moustakarias T, Giannaris D, Wang J, Andonov M, Linara E, Charleson C, Ahuja KK, Ozsoy S, Morris MB, Day ML, Cobo A, Castello D, Viloria T, Campos P, Vallejo B, Remohi J, Roldan M, Perez-Cano I, Cruz M, Martinez M, Gadea B, Munoz M, Garrido N, Meseguer M, Mesut N, Ciray HN, Mesut A, Isler A, Bahceci M, Munoz M, Fortuno S, Legidos V, Muela L, Roldan M, Galindo N, Cruz M, Meseguer M, Gunasheela S, Gunasheela D, Ueno S, Uchiyama K, Kondo M, Ito M, Kato K, Takehara Y, Kato O, Edgar DH, Krapez JA, Bacer Kermavner L, Virant-Klun I, Pinter B, Tomazevic T, Vrtacnik-Bokal E, Lee SG, Kang SM, Lee SW, Jeong HJ, Lee YC, Lim JH, Bochev I, Valkova L, Kyurkchiev S, Shterev A, Wilding M, Coppola G, Di Matteo L, Dale B, Hormann-Kropfl M, Kastelic D, Montag M, Schenk M, Fourati Ben Mustapha S, Khrouf M, Braham M, Kallel L, Elloumi H, Merdassi G, Chaker A, Ben Meftah M, Zhioua F, Zhioua A, Kocent J, Neri QV, Rosenwaks Z, Palermo GD, Best L, Campbell A, Fishel S, Calimlioglu N, Sahin G, Akdogan A, Susamci T, Bilgin M, Goker ENT, Tavmergen E, Cantatore C, Ding J, Depalo R, Smith GD, Kasapi E, Panagiotidis Y, Papatheodorou A, Goudakou M, Pasadaki T, Nikolettos N, Asimakopoulos B, Prapas Y, Soydan E, Gulebenzer G, Karatekelioglu E, Budak E, Pehlivan Budak T, Alegretti J, Cuzzi J, Negrao PM, Moraes MP, Bueno MB, Serafini P, Motta ELA, Elaimi A, Harper JC, Stecher A, Baborova P, Wirleitner B, Schwerda D, Vanderzwalmen P, Zech NH, Stanic P, Hlavati V, Gelo N, Pavicic-Baldani D, Sprem-Goldstajn M, Radakovic B, Kasum M, Strelec M, Simunic V, Vrcic H, Khan I, Urich M, Abozaid T, Ullah K, Abuzeid M, Fakih M, Shamma N, Ayers J, Ashraf M, Milik S, Pirkevi C, Atayurt Z, Yazici S, Yelke H, Kahraman S, Dal Canto M, Coticchio G, Brambillasca F, Mignini Renzini M, Novara P, Maragno L, Karagouga G, De Ponti E, Fadini R, Resta S, Magli MC, Cavallini G, Muzzonigro F, Ferraretti AP, Gianaroli L, Barberi M, Orlando G, Sciajno R, Serrao L, Fava L, Preti S, Bonu MA, Borini A, Varras M, Polonifi A, Mantzourani M, Mavrogianni D, Stefanidis K, Griva T, Bletsa R, Dinopoulou V, Drakakis P, Loutradis D, Campbell A, Hickman CFL, Duffy S, Bowman N, Gardner K, Fishel S, Sati L, Zeiss C, Demir R, McGrath J, Yelke H, Atayurt Z, Yildiz S, Unal S, Kumtepe Y, Kahraman S, Atayurt Z, Yelke H, Unal S, Kumtepe Y, Kahraman S, Aljaser F, Hernandez J, Tomlinson M, Campbell B, Fosas N, Redondo Ania M, Marina F, Molfino F, Martin P, Perez N, Carrasco A, Garcia N, Gonzalez S, Marina S, Redondo Ania M, Marina F, Molfino F, Fosas N, Martin P, Perez N, Carrasco A, Garcia N, Gonzalez S, Marina S, Scaruffi P, Stigliani S, Tonini GP, Venturini PL, Anserini P, Guglielmo MC, Coticchio G, Albertini DF, Dal Canto M, Brambillasca F, Lain M, Caliari I, Mignini Renzini M, Fadini R, Oikonomou Z, Chatzimeletiou K, Sioga A, Oikonomou L, Kolibianakis E, Tarlatzis B, Nottola SA, Bianchi V, Lorenzo C, Maione M, Macchiarelli G, Borini A, Gomez E, Gil MA, Sanchez-Osorio J, Maside C, Martinez MJ, Torres I, Rodenas C, Cuello C, Parrilla I, Molina G, Garcia A, Margineda J, Navarro S, Roca J, Martinez EA, Avcil F, Ozden H, Candan ZN, Uslu H, Karaman Y, Gioacchini G, Giorgini E, Carnevali O, Bianchi V, Ferraris P, Vaccari L, Borini A, Choe S, Tae J, Kim C, Lee J, Hwang D, Kim K, Suh C, Jee B, Ozden H, Candan ZN, Avcil F, Uslu H, Karaman Y, Catt SL, Sorenson H, Vela M, Duric V, Chen P, Temple-Smith PD, Pangestu M, Yoshimura T, Fukunaga N, Nagai R, Kitasaka H, Tamura F, Hasegawa N, Kato M, Nakayama K, Takeuchi M, Aoyagi N, Yasue K, Watanabe H, Asano E, Hashiba Y, Asada Y, Iwata K, Yumoto K, Mizoguchi C, Sargent H, Kai Y, Ueda M, Tsuchie Y, Imajo A, Iba Y, Mio Y, Els-Smit CL, Botha MH, Sousa M, Windt-De Beer M, Kruger TF, Muller N, Magli C, Corani G, Giusti A, Castelletti E, Gambardella L, Gianaroli L, Seshadri S, Sunkara SK, El-Toukhy T, Kishi I, Maruyama T, Ohishi M, Akiba Y, Asada H, Konishi Y, Nakano M, Kamei K, Yoshimura Y, Lee JH, Lee KH, Park IH, Sun HG, Kim SG, Kim YY, Choi EM, Lee DH, Chavez SL, Loewke KE, Behr B, Han J, Moussavi F, Reijo Pera RA, Yokota H, Yokota Y, Yokota M, Sato S, Nakagawa M, Sato M, Anazawa I, Araki Y, Virant-Klun I, Knez K, Pozlep B, Tomazevic T, Vrtacnik-Bokal E, Lim JH, Vermilyea MD, Graham JR, Levy MJ, Tucker MJ, Carvalho M, Cordeiro I, Leal F, Aguiar A, Nunes J, Rodrigues C, Soares AP, Sousa S, Calhaz-Jorge C, Braga DPAF, Setti AS, Figueira RCS, Aoki T, Iaconelli A, Borges E, Ozkavukcu S, Sonmezer M, Atabekoglu C, Berker B, Ozmen B, Isbacar S, Ibis E, Menezes J, Lalitkumar PGL, Borg P, Ekwurtzel E, Nordqvist S, Vaegter K, Tristen C, Sjoblom P, Azevedo MC, Figueira RCS, Braga DPAF, Setti AS, Iaconelli A, Borges E, Remohi Gimenez J, Cobo A, Castello D, Gamiz P, Albert C, Ferreira RC, Braga DPAF, Figueira RCS, Setti AS, Resende S, Iaconelli A, Borges E, Colturato SS, Braga DPAF, Figueira RCS, Setti AS, Resende S, Iaconelli A, Borges E, Ferrer Buitrago M, Ferrer Robles E, Munoz Soriano P, Ruiz-Jorro M, Calatayud Lliso C, Rawe VY, Wanggren K, Hanrieder J, Hambiliki F, Gulen-Yaldir F, Bergquist J, Stavreus-Evers A, Hreinsson J, Grunskis A, Bazarova A, Dundure I, Fodina V, Brikune J, Lakutins J, Pribenszky C, Cornea M, Reichart A, Uhereczky G, Losonczy E, Ficsor L, Lang Z, Ohgi S, Nakamura C, Hagiwara C, Kawashima M, Yanaihara A, Jones GM, Biba M, Kokkali G, Vaxevanoglou T, Chronopoulou M, Petroutsou K, Sfakianoudis K, Pantos K, Perez-Cano I, Gadea B, Martinez M, Muela L, Cruz M, Galindo N, Munoz M, Garrido N, Romano S, Albricci L, Stoppa M, Cerza C, Sanges F, Fusco S, Capalbo A, Maggiulli R, Ubaldi F, Rienzi L, Ulrick J, Kilani S, Chapman M, Losada C, Ortega I, Pacheco A, Bronet F, Aguilar J, Ojeda M, Taboas E, Perez M, Munoz E, Pellicer A, Meseguer M, Boumela I, Assou S, Haouzi D, Monzo C, Dechaud H, Hamamah S, Dechaud H, Boumela I, Assou S, Haouzi D, Monzo C, Hamamah S, Nakaoka Y, Hashimoto S, Amo A, Yamagata K, Nakano T, Akamatsu Y, Mezawa T, Ohnishi Y, Himeno T, Inoue T, Ito K, Morimoto Y. EMBRYOLOGY. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.77] [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: 11/13/2022] Open
|
14
|
Cicarelli R, De Castro M, Vela M, Aguirre V, Morejon G, Burgos G, Valenzuela G, Builes J, Gaviria A. Latin-American Society Of Forensic Genetics (SLAGF) results of the Interlaboratory Quality Control Exercise 2010–2011. Forensic Science International: Genetics Supplement Series 2011. [DOI: 10.1016/j.fsigss.2011.08.120] [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: 11/27/2022]
|
15
|
Abstract
Twenty-four-hour multichannel intraluminal impedance and pH (MII-pH) esophageal monitoring detects both acid and nonacid gastroesophageal reflux episodes. The MII-pH catheter contains six impedance segments placed 3, 5, 7, 9, 15, and 17 cm above the lower esophageal sphincter (LES). A pH electrode at 5 cm above the LES identifies the type of reflux, i.e. acid or nonacid. Patients with acid and nonacid reflux exhibit typical and atypical symptoms often within 5 min following a reflux episode. The aim of this study is to compare the timing of symptoms after reflux episodes in patients with acid and nonacid reflux. Methods include a review of 70 MII-pH tracings (42 females, mean age 40, range 18-85 years) either on (50 points) or off (20 points) acid suppression therapy. Typical (heartburn, regurgitation) and atypical (cough) symptoms with acid or nonacid reflux episodes detected by impedance were analyzed. Symptoms were considered positive with acid reflux if there was a pH drop to <4, plus an MII detected a reflux episode and with nonacid reflux if pH remained >4 and MII detected a reflux episode. The timing of the symptom after each reflux episode was recorded. Symptom perception occurred significantly sooner after acid versus nonacid reflux (P < 0.05). Acid reflux episodes are more likely to be perceived in the first 2 min following the reflux episode. Patients with acid reflux are likely to perceive symptoms earlier, and symptoms with acid and nonacid reflux may be produced by different mechanisms.
Collapse
Affiliation(s)
- A Agrawal
- Digestive Diseases Center, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
| | | | | | | | | | | |
Collapse
|
16
|
Baudet JS, Salata H, Soler M, Castro V, Díaz-Bethencourt D, Vela M, Morales S, Avilés J. Hyperplastic gastric polyps after argon plasma coagulation treatment of gastric antral vascular ectasia (GAVE). Endoscopy 2007; 39 Suppl 1:E320. [PMID: 18273773 DOI: 10.1055/s-2007-966802] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- J S Baudet
- Department of Gastroenterology, Ntra. Sra. de Candelaria University Hospital, Santa Cruz de Tenerife, Spain.
| | | | | | | | | | | | | | | |
Collapse
|
17
|
Mainie I, Tutuian R, Shay S, Vela M, Zhang X, Sifrim D, Castell DO. Acid and non-acid reflux in patients with persistent symptoms despite acid suppressive therapy: a multicentre study using combined ambulatory impedance-pH monitoring. Gut 2006; 55:1398-402. [PMID: 16556669 PMCID: PMC1856433 DOI: 10.1136/gut.2005.087668] [Citation(s) in RCA: 441] [Impact Index Per Article: 24.5] [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] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Empiric proton pump inhibitor (PPI) trials have become increasingly popular leading to gastroenterologists frequently evaluating gastro-oesophageal reflux disease (GORD) patients only after they have "failed" PPI therapy. Combined multichannel intraluminal impedance and pH (MII-pH) monitoring has the ability to detect gastro-oesophageal reflux (GOR) episodes independent of their pH and evaluate the relationship between symptoms and all types of GOR. Using this technique, we aimed to characterise the frequency of acid and non-acid reflux (NAR) and their relationship to typical and atypical GOR symptoms in patients on PPI therapy. METHODS Patients with persistent GORD symptoms referred to three centres underwent 24 hour combined MII-pH monitoring while taking PPIs at least twice daily. Reflux episodes were detected by impedance channels located 3, 5, 7, 9, 15, and 17 cm above the lower oesophageal sphincter (LOS) and classified into acid or non-acid based on pH data from 5 cm above the LOS. A positive symptom index (SI) was declared if at least half of each specific symptom events were preceded by reflux episodes within five minutes. RESULTS A total of 168 patients (103 (61%) females and 65 (39%) males; mean age 53 (range 18-85) years) underwent combined MII-pH monitoring while taking PPIs at least twice daily. One hundred and forty four (86%) patients recorded symptoms during the study day and 24 (15%) patients had no symptoms during testing. Sixty nine (48%) symptomatic patients had a positive SI for at least one symptom (16 (11%) with acid reflux and 53 (37%) with NAR) and 75 (52%) had a negative SI. A total of 171 (57%) typical GORD symptoms were recorded, 19 (11%) had a positive SI for acid reflux, 52 (31%) for NAR, and 100 (58%) had a negative SI. One hundred and thirty one (43%) atypical symptoms were recorded, four (3%) had a positive SI for acid reflux, 25 (19%) had a positive SI for NAR, and 102 (78%) had a negative SI. CONCLUSION Combined MII-pH identifies the relation of reflux of all types to persistent symptoms and the importance of NAR in patients taking PPIs.
Collapse
Affiliation(s)
- I Mainie
- Division of Gastroenterology and Hepatology, Medical University South Carolina, 96 Jonathan Lucas St, 210 Clinical Science Building, PO Box 250327 Charleston, SC 29425, USA.
| | | | | | | | | | | | | |
Collapse
|
18
|
Junyent M, Gilabert R, Núñez I, Corbella E, Vela M, Zambón D, Ros E. [Carotid ultrasound in the assessment of preclinical atherosclerosis. Distribution of intima-media thickness values and plaque frequency in a Spanish community cohort]. Med Clin (Barc) 2006; 125:770-4. [PMID: 16373026 DOI: 10.1016/s0025-7753(05)72186-2] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE High-resolution B-mode ultrasound measurements of carotid intima-media thickness (IMT) and determination of plaque presence are useful to assess preclinical atherosclerosis. Normal IMT values have not been reported in Spanish subjects. Our aim was to define normality data of carotid ultrasound by sex and age. SUBJECTS AND METHODS We studied 250 healthy, normolipidemic subjects, 125 men and 125 women, with mean age 49 years (range, 20-81). We assessed cardiovascular risk factors and performed ultrasound determination of mean and maximum IMT in the far wall of the common carotid artery, plaque occurrence, and maximum plaque height. RESULTS Reference values for carotid IMT, expressed as 25th, 50th, and 75th percentiles by sex and 5 age groups, have been obtained. The 50th percentiles of mean IMT ranged from 0.50 to 0.74 mm in men in the age groups 35 years or younger and 65 years or older, respectively. For women, corresponding IMT values ranged from 0.40 to 0.65 mm. IMT was strongly related (p < 0.001) to age, both in men (r = 0.57) and women (r = 0.61). From the regression equations, the estimated yearly increase in IMT was 0.005 mm in men and 0.007 mm in women. More than 50% of men aged 55 years and older, and of women aged 65 years and older, had carotid plaques. CONCLUSIONS Both IMT and plaque frequency were associated with age in men and women. Carotid IMT values in a Spanish community cohort were lower than those reported for countries with higher cardiovascular risk, such as Northern European countries and the US.
Collapse
Affiliation(s)
- Mireia Junyent
- Unidad de Lípidos, Servicio de Endocrinología y Nutrición, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Barcelona, España
| | | | | | | | | | | | | |
Collapse
|
19
|
Junyent M, Gilabert R, Zambón D, Núñez I, Vela M, Civeira F, Pocoví M, Ros E. The use of Achilles tendon sonography to distinguish familial hypercholesterolemia from other genetic dyslipidemias. Arterioscler Thromb Vasc Biol 2005; 25:2203-8. [PMID: 16123315 DOI: 10.1161/01.atv.0000183888.48105.d1] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Achilles tendon (AT) xanthomas, specific for familial hypercholesterolemia (FH), may be clinically undetectable. We assessed the usefulness of AT sonography in the diagnosis of FH. METHODS AND RESULTS Sonographic AT characteristics were evaluated in 127 subjects with FH (81 genetically ascertained), 84 familial combined hyperlipidemia, 79 polygenic hypercholesterolemia, and 88 normolipidemic controls. Abnormal echostructure (sonographic xanthoma) was noted only in FH. AT thickness was higher (P<0.001) in FH men and women compared with all of the other groups and, in FH mutation carriers but not in others, correlated positively with low-density lipoprotein cholesterol (r=0.345; P<0.001) and negatively with high-density lipoprotein cholesterol (r=-0.265, P=0.015). Thickness thresholds for the diagnosis of FH with specificity >80%, as were derived from receiver operating curves, were 5.3 and 5.7 mm in men < and >45 years, and 4.8 and 4.9 mm in women < and >50 years, respectively. In FH mutation carriers, sonographic findings increased the clinical diagnosis of xanthomas from 35 (43%) to 55 (68%). Using thresholds in validation sets of 70 genetically identified FH and 54 dyslipidemic non-FH correctly classified 80% and 88%, respectively. CONCLUSIONS Sonographic AT characteristics are normal in non-FH dyslipidemias. Identification of suspected FH by ultrasound using sex- and age-specific AT thickness thresholds is recommended.
Collapse
Affiliation(s)
- Mireia Junyent
- Unitat de Lípids, Servei d'Endocrinologia i Nutrició, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Barcelona, Spain
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Junyent M, Gilabert R, Núnez I, Vela M, Zambón D, Ros E. T07-P-005 Achilles tendon sonography in control subjects, familial hypercholesterolemia with and without molecular diagnosis and other genetic hyperlipidemias. ATHEROSCLEROSIS SUPP 2005. [DOI: 10.1016/s1567-5688(05)80671-3] [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: 10/25/2022]
|
21
|
Castell DO, Vela M. Combined multichannel intraluminal impedance and pH-metry: an evolving technique to measure type and proximal extent of gastroesophageal reflux. Am J Med 2001; 111 Suppl 8A:157S-159S. [PMID: 11749943 DOI: 10.1016/s0002-9343(01)00826-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.9] [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: 12/26/2022]
Abstract
The accepted "gold standard" for measuring gastroesophageal reflux (GER), distal esophageal pH recording, has limited ability to measure nonacid GER, a potentially important cause of symptoms, in an era of potent acid-suppressing medications. A combination of multichannel intraluminal impedance (MII) and pH- metry offers an advantage over pH measurement alone. MII can detect GER at multiple levels of the esophagus independent of pH. In addition, use of MII enables refined characterization of intraluminal events, including presence, type (air, liquid, or mixed), and spaciotemporal characterization of a bolus. MII has the potential to become a useful clinical tool to assess ongoing reflux in patients on acid-suppression therapy.
Collapse
Affiliation(s)
- D O Castell
- Department of Medicine, Graduate Hospital, Suite 501, Pepper Pavilion, 1800 Lombard Street, Philadelphia, PA 19146, USA
| | | |
Collapse
|
22
|
Abstract
UNLABELLED Vigorous achalasia was described in 1957 as a subset of achalasia with a higher contraction amplitude (>37 mm Hg), minimal esophageal dilatation, prominent tertiary contractions, and higher incidence of chest pain. GOALS Ascertain the existence of a distinct achalasia group based on manometric, radiographic, and clinical grounds. STUDY The records of 209 idiopathic achalasia patients seen over a 9-year interval were reviewed for duration and frequency of dysphagia, chest pain, heartburn, weight loss, and nocturnal symptoms, as well as for treatment outcome. Manometric tracings were reanalyzed for lower esophageal sphincter pressure (LESP), LES residual pressure, distal esophageal contraction amplitude, and presence of repetitive waves. Patients were subsequently divided into classic (amplitude < or =37 mm Hg) and vigorous (amplitude >37 mm Hg) achalasia groups. Esophagrams were reassessed blindly for esophageal diameter both in the upright and recumbent positions and presence of lumen-occlusive tertiary contractions. RESULTS One hundred forty-four classic and 65 vigorous achalasia patients were identified. These groups were similar in age and gender, as well as duration of symptoms. Chest pain was equally prevalent in both groups. Lower esophageal sphincter pressure was higher ( p < 0.01) and repetitive waves more common ( p < 0.0001) in the vigorous achalasia group. Upright esophageal diameter was smaller ( p = 0.0003) and tertiary contractions more frequent ( p = 0.0004) in this group. CONCLUSION The original manometric and radiographic description of vigorous achalasia is accurate. The incidence of chest pain is similar to that of patients with classic achalasia.
Collapse
Affiliation(s)
- L Camacho-Lobato
- Department of Medicine, Graduate Hospital, Philadelphia, Pennsylvania 19146, USA
| | | | | | | | | |
Collapse
|
23
|
Rodríguez Santiago J, Targarona EM, Ros E, Martínez J, Poca E, Vela M, Massó J, Nadal A, Marco C, Trias M. [Increased bile lithogenicity after simultaneous total parenteral nutrition and octrotide. A model of calcium palmitate Gallstones]. Gastroenterol Hepatol 2001; 24:321-6. [PMID: 11481065 DOI: 10.1016/s0210-5705(01)70186-0] [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: 11/20/2022]
Abstract
Gallbladder stasis and gallstone formation are well-known complications of both fasting-associated total parenteral nutrition (TPN) and long-term treatment with octreotide. Additive noxious effects to hepatobiliary function may develop when both therapies are given together as treatment of enteric fistulae. The aim of this study was to assess the risk of gallstone formation during treatment with TPN and octreotide separately and in combination. We studied four groups of New Zealand rabbits (n = 32) during a 2-week intervention period: 14 chow-fed controls; 6 fasted and TPN-fed; 6 chow-fed and administered octreotide, and 6 fasted and treated with both TPN and octreotide. After treatment, the bile duct was cannulated and the gallbladder and liver tissue were obtained for histological analysis. Hepatic and gallbladder bile were retrieved for microscopic examination and measurement of biliary lipids, bilirubin, calcium, total protein, and cholesterol nucleation time. The chemical composition of gallstones was also analyzed. The results of the study suggest that simultaneous administration of these two therapies in rabbits has additive effects on gallbladder stasis and bile lithogenicity. The administration of both treatments can play an important role in the formation of calcium palmitate gallstones in these animals.
Collapse
Affiliation(s)
- J Rodríguez Santiago
- Servicio de Cirugía General, Hospital Mutua de Terrassa, Universidad de Barcelona, Spain
| | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Sahuquillo A, Rubio R, Ribó JM, Ros E, Vela M. Application of focused-microwave wet digestion to the determination of trace metals in human gallstones by ICP/AES. J Trace Elem Med Biol 2000; 14:96-9. [PMID: 10941721 DOI: 10.1016/s0946-672x(00)80038-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [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: 10/25/2022]
Abstract
We propose an analytical digestion method for trace metal determination (Co, Cr, Cu, Fe, Mn, Ni and Zn) in gallstones, in an attempt to facilitate detection of their origin. The method consists of sample digestion with HNO3 and H2O2 by means of focused microwave. Metals are quantified by inductively coupled plasma atomic emission spectroscopy. The effect of calcium concentration in the analytical solutions was studied. Cu, Fe, Mn and Zn were detected in all the samples analysed and the highest concentrations were obtained for Cu and Fe, especially in black-pigmented gallstones. The reproducibility in terms of %RSD, determined in the gallstones with the lowest metal content, was below 5% for Cu, between 10% and 15% for Mn and Zn and up to 25% for Fe.
Collapse
Affiliation(s)
- A Sahuquillo
- Departament de Química Analítica, Universitat de Barcelona, Spain
| | | | | | | | | |
Collapse
|
25
|
Vela M, Heredia NL, Feng P, Santos García-Alvarado J. DNA probe analysis for the carriage of enterotoxigenic Clostridium perfringens in feces of a Mexican subpopulation. Diagn Microbiol Infect Dis 1999; 35:101-4. [PMID: 10579088 DOI: 10.1016/s0732-8893(99)00058-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [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: 11/22/2022]
Abstract
Clostridium perfringens has been implicated as a causative agent of foodborne poisoning, infectious diarrhea (not associated with foods), gas gangrene, and several veterinary diseases. Fecal carriage of enterotoxigenic strains of this bacterium appears to be important in the development of infectious diarrhea and as a source of C. perfringens contamination of foods. In this work, carriage of this bacterium in feces of a Mexican population was analyzed. C. perfringens was found in 126 of the 200 fecal samples obtained from healthy individuals from northern Mexico. The samples had an average of 7.4 x 10(3) spores per gram, with the elderly population showing the highest levels. Dot blot analyses using a dig-labeled probe specific for the enterotoxin gene showed that 7% of the samples had isolates with toxigenic potential.
Collapse
Affiliation(s)
- M Vela
- Departamento de Microbiología e Inmunología, Universidad A. de Nuevo León, San Nicolás, México
| | | | | | | |
Collapse
|
26
|
Vela M, Gamboa S, Loera-Luna A, Aguirre BE, Pérez-Palacios G, Velázquez A. Neonatal screening for congenital hypothyroidism in Mexico: experience, obstacles, and strategies. J Med Screen 1999; 6:77-9. [PMID: 10444724 DOI: 10.1136/jms.6.2.77] [Citation(s) in RCA: 10] [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: 11/03/2022]
Abstract
OBJECTIVE To report the experience, obstacles, and strategies of screening for congenital hypothyroidism. SETTING Newborns in Mexico. METHODS Thyroid stimulating hormone (TSH) was measured by enzyme immunoassay using commercial kits in 1,140,364 newborns. RESULTS There were 464 positive cases, of whom 299 (64.4%) were girls. 236 (50.9% showed ectopic nodules, 202 (43.5%) thyroid agenesis, 21 (4.5%) dyshormonogenesis, and 5 (1.1%) an unclassified goitre. The false positive rate was 0.024% and there were 11 false negative results. Currently, 600,000 (26%) of the 2,300,000 newborns are screened. This percentage has been increased in recent years by taking samples from cord blood and will be increased further by starting congenital hypothyroidism screening at social security units and by midwives screening infants born at home. CONCLUSIONS Mental retardation in infants in developing countries can be reduced by neonatal screening, and carefully planned strategies can steadily extend the benefits of screening.
Collapse
Affiliation(s)
- M Vela
- Dirección General de Salud Reproductiva, Secretaría de Salud, Mexico
| | | | | | | | | | | |
Collapse
|
27
|
Meco JF, Pintó X, Escribà JM, Vela M, Jara F, Pallarés C, Castiñeiras MJ, Pujol R. Cardiovascular risk factors associated with clinically isolated and diffuse atherosclerosis in Spanish patients with coronary artery disease. Eur J Clin Invest 1998; 28:643-50. [PMID: 9767359 DOI: 10.1046/j.1365-2362.1998.00350.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [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: 11/20/2022]
Abstract
BACKGROUND Patients with coronary artery disease (CAD) associated with peripheral (PAD) or cerebrovascular disease (CVD), a condition called diffuse atherosclerosis, have a higher risk of death than patients with isolated CAD. The prevalence of diffuse atherosclerosis and the atherogenic risk factors associated with this condition in our geographic area have not been described previously. METHODS A cohort of 2597 patients (62 +/- 10.8 years, 665 women) consecutively admitted at Bellvitge Hospital because of acute coronary syndromes were studied. CAD patients were divided in two groups with diffuse and located atherosclerosis according to whether they had or they had not an associated PAD or CVD. Baseline history, physical data and lipid profile were recorded in each patient according to a standardized questionnaire. RESULTS A total of 370 patients (14.2%) had diffuse atherosclerosis. Among them, there were more men and women older than 55 years than among those with isolated CAD. Patients with diffuse atherosclerosis were more frequently hypertensive, diabetic and former smokers than those with isolated CAD (60.5% vs. 49.4%, P < 0.01; 37.4% vs. 24.5%, P < 0.01; and 47% vs. 35.7%, P < 0.01, respectively). There were no significant differences in the mean values of total cholesterol (TC), low-density cholesterol (LDL-C), high-density cholesterol (HDL-C) and triglycerides between both groups of patients, but patients with diffuse atherosclerosis had a lower HDL-C/TC ratio, with borderline statistical significance (0.18 +/- 0.06 vs. 0.19 +/- 0.06, P = 0.06). Using multiple logistic regression analysis, the variables associated with diffuse atherosclerosis in men were age greater than 55 years (OR 1.97, CI 1.33-2.93), hypertension (OR 1.50, CI 1.14-2.20), diabetes (OR 1.78, CI 1.20-2.70), smoking (former smokers) (OR 2.09, CI 1.36-3.24) and HDL-C/TC < 0.20 (OR 1.60, CI 1.18-2.17); and in women hypertension (OR 3.43, CI 1.48-7.94) and diabetes (OR 2.58, CI 1.55-4.80). CONCLUSIONS Clinically overt diffuse atherosclerosis is a relatively common disease. Older patients and those with hypertension, diabetes or low HDL-C/TC ratio are more likely to have diffuse atherosclerosis than those without these conditions.
Collapse
Affiliation(s)
- J F Meco
- Bellvitge Hospital, Barcelona, Spain
| | | | | | | | | | | | | | | |
Collapse
|
28
|
Vela M, Saurina J, Hernández-Cassou S. Flow-Injection Spectrophotometric Determination of Amino Acids by Using 1,2-Naphthoquinone-4-sulfonate Immobilized on an Ion Exchange Resin. ANAL LETT 1998. [DOI: 10.1080/00032719808002048] [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: 10/17/2022]
|
29
|
Pintó X, Escribà J, Villa R, Barjau E, Vela M, Meco F, Castiñeiras M, Capdevila J, Pujol R. 2.P.237 Cardiovascular risk factors in peripheral arterial disease patients with and without previous history of coronary artery disease. Atherosclerosis 1997. [DOI: 10.1016/s0021-9150(97)88872-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
30
|
Abstract
BACKGROUND & AIMS Apolipoprotein (apo) E is a genetically polymorphic protein influencing lipoprotein metabolism and the risk of both atherosclerosis and Alzheimer's disease. As opposed to common apo E3, apo E2 decreases and apo E4 increases hepatic lipoprotein uptake; hence, apo E4 could promote gallstone formation by increasing hepatic and biliary cholesterol concentrations. This study was designed to evaluate whether apo E polymorphism is related to gallstone risk. METHODS apo E phenotype was determined in subjects older than 40 years of age (160 with and 125 without gallstones) and in 61 patients with cholesterol gallstones who underwent cholecystectomy. Bile composition, nucleation time, and gallstone features were analyzed in surgical patients. RESULTS The E4/3 phenotype was enriched in both patients with gallstones and those who underwent cholecystectomy, with significantly (P < 0.006) higher epsilon 4 allele frequencies than in gallstone-free subjects (odds ratio, 2.67 [95% confidence limits, 1.23-5.93] and 3.62 [95% confidence limits, 1.49-8.91], respectively); women, but not men, accounted for these differences. The prevalence of the epsilon 4 allele increased with age in patients with gallstones, whereas the opposite occurred in gallstone-free subjects. Biliary lipid and gallstone cholesterol content tended to increase in the sequence E4 > E3 > E2 in patients who underwent cholecystectomy. CONCLUSIONS Carrying the apo E4 isoform is a genetic risk factor for cholelithiasis in humans, thus adding another adverse effect of apo E polymorphism on health.
Collapse
Affiliation(s)
- A Bertomeu
- Lipid Clinic, Hospital Clínic i Provincial, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | |
Collapse
|
31
|
Velázquez A, Bilbao G, González-Trujillo JL, Hernández D, Pérez-Andrade ME, Vela M, Cicerón I, Loera-Luna A, Cederbaum S, Phoenix B. Apparent higher frequency of phenylketonuria in the Mexican state of Jalisco. Hum Genet 1996; 97:99-102. [PMID: 8557271 DOI: 10.1007/bf00218842] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The geographic origin of Mexican patients with phenylketonuria (PKU) in Mexico City and in southern California was studied. Compared to patients with other metabolic disorders, patients with PKU were significantly more likely to have originated from the Los Altos region of the state of Jalisco and its environs. The incidence of PKU among mentally retarded students attending special education schools was found to be significantly higher in Jalisco (particularly the Los Altos region) than in the neighboring state of Guanajuato (1.09% vs 0.3%). These results strongly suggest a "population of origin" effect, the mutant allele(s) having been introduced by the Spanish ancestors of the current population. Our findings also support the addition of PKU to the neonatal screening program for this region of Mexico.
Collapse
Affiliation(s)
- A Velázquez
- Nutritional Genetics Unit, Instituto de Investigaciones Biomédicas UNAM, Mexico City, Mexico
| | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
|
33
|
Di Mario U, Crisa L, Anastasi E, Contreas G, Andreani D, Raponi MP, Napoleone E, Candela A, Vela M, Campea L. Anti-goat immunoglobulin antibodies in diabetic children at diagnosis and follow-up: comparison with islet cell antibodies and other autoantibodies. Acta Endocrinol (Copenh) 1989; 120:326-30. [PMID: 2648725 DOI: 10.1530/acta.0.1200326] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The presence of antibodies reacting with human as well as animal immunoglobulins in sera from recent onset Type I diabetic patients has been recently demonstrated by some of our group. In the present study, the occurrence of these antibodies has been evaluated in sera from 19 Type I diabetic patients, at diagnosis and at follow-up within three years, and from 26 normal subjects, and has also been compared with the presence of islet cell antibodies and other organ-specific autoantibodies. A solid-phase radioimmunoassay has been used: serum was incubated in goat immunoglobulin-coated wells and the binding of 125-I-anti-human immunoglobulin antibodies was evaluated. Anti-goat immunoglobulin antibodies were above the 90th percentile of normal values in all diabetic patients at diagnosis (median, interquartile range, in micrograms 125I-antibody bound/1 serum: 83, 77.5-88, versus 51.5, 44.5-62 in normal subjects, P less than 0.001) and significantly declined with time after diagnosis (P less than 0.001). Islet cell antibodies were present in 79% of patients at diagnosis, whereas at least one other auto-antibody was found in 21% of patients. In the follow-up study the decline in anti-goat immunoglobulin antibody levels was different from that of islet cell antibody positivity. A circulating immunoglobulin reacting with other immunoglobulins is thus present in the early stages of Type I diabetes and may well play a part in the complex immunopathogenetic interactions.
Collapse
Affiliation(s)
- U Di Mario
- Clinica Medica 2 (Endocrinologia), University La Sapienza, Rome, Italy
| | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Vela M, Adorno D, Longo A, Papola F, Maccarone D, Centis D, Raponi MP, Candela A, Campea L, Orsini M. HLA typing data on 100 type 1 (insulin-dependent) diabetic patients from central Italy show a negative association with DR5 rather than with DR2. Clin Immunol Immunopathol 1987; 45:143-6. [PMID: 3497749 DOI: 10.1016/0090-1229(87)90121-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
HLA typing of 100 Type 1 diabetic patients from the Rome area confirmed the strong association with DR3 and DR4 and the prevalence of DR3/4 heterozygotes. However, DR5 rather than DR2 showed a significantly negative association.
Collapse
|
35
|
Hernández R, Vela M, Andriollo A, Monasterios W, Arcos B, Delgado A, Pérez Machado L. [Pancreatic ducts change in alcoholics]. G E N 1986; 40:120-5. [PMID: 3135228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
36
|
de Silva SB, Hamana N, Arcos B, Delgadoo A, Vela M, Quirós E, de Pasos LL, Alemán C. [Ultrasonic diagnosis of diffuse liver disease]. G E N 1986; 40:126-32. [PMID: 3135229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
37
|
Tosi R, Vela M, Adorno D, Longo A, Papola F, Maccarone D, Centis D, Tanigaki N, Raponi MP, Candela A. Radioimmunoassay typing gives a more precise definition of the HLA association of type 1 (insulin-dependent) diabetes. Diabetologia 1986; 29:430-3. [PMID: 3462067 DOI: 10.1007/bf00506534] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The problem of the HLA association of Type 1 (insulin-dependent) diabetes was re-examined by testing Class II antigenic specificities detectable by radioimmunoassay. Established (DRw53, DQw1, DQw2, DQw3) as well as newly described (DC5, DCalpha3) specificities were typed. The data obtained suggest that the association with DR3 and DR4 is secondary to that with DQ specificities in linkage disequilibrium with DR3 and DR4.
Collapse
|
38
|
Campea L, Vela M, Candela A, Raponi MP, Napoleone E, Strappini P, Betterle C, Orsini M. [Organ-specific autoantibodies in type I diabetic patients and their relatives]. Recenti Prog Med 1986; 77:226-32. [PMID: 3526459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|