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González-Gallardo C, Martínez-Atienza J, Mataix B, Muñoz-Ávila JI, Daniel Martínez-Rodríguez J, Medialdea S, Ruiz-García A, Lizana-Moreno A, Arias-Santiago S, de la Rosa-Fraile M, Garzon I, Campos A, Cuende N, Alaminos M, González-Andrades M, Mata R. Successful restoration of corneal surface integrity with a tissue-engineered allogeneic implant in severe keratitis patients. Biomed Pharmacother 2023; 162:114612. [PMID: 36989713 DOI: 10.1016/j.biopha.2023.114612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/10/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
OBJECTIVES Corneal diseases are among the main causes of blindness, with approximately 4.6 and 23 million patients worldwide suffering from bilateral and unilateral corneal blindness, respectively. The standard treatment for severe corneal diseases is corneal transplantation. However, relevant disadvantages, particularly in high-risk conditions, have focused the attention on the search for alternatives. METHODS We report interim findings of a phase I-II clinical study evaluating the safety and preliminary efficacy of a tissue-engineered corneal substitute composed of a nanostructured fibrin-agarose biocompatible scaffold combined with allogeneic corneal epithelial and stromal cells (NANOULCOR). 5 subjects (5 eyes) suffering from trophic corneal ulcers refractory to conventional treatments, who combined stromal degradation or fibrosis and limbal stem cell deficiency, were included and treated with this allogeneic anterior corneal substitute. RESULTS The implant completely covered the corneal surface, and ocular surface inflammation decreased following surgery. Only four adverse reactions were registered, and none of them were severe. No detachment, ulcer relapse nor surgical re-interventions were registered after 2 years of follow-up. No signs of graft rejection, local infection or corneal neovascularization were observed either. Efficacy was measured as a significant postoperative improvement in terms of the eye complication grading scales. Anterior segment optical coherence tomography images revealed a more homogeneous and stable ocular surface, with complete scaffold degradation occurring within 3-12 weeks after surgery. CONCLUSIONS Our findings suggest that the surgical application of this allogeneic anterior human corneal substitute is feasible and safe, showing partial efficacy in the restoration of the corneal surface.
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Rosende-Roca M, Abdelnour C, Esteban E, Tartari JP, Alarcon E, Martínez-Atienza J, González-Pérez A, Sáez ME, Lafuente A, Buendía M, Pancho A, Aguilera N, Ibarria M, Diego S, Jofresa S, Hernández I, López R, Gurruchaga MJ, Tárraga L, Valero S, Ruiz A, Marquié M, Boada M. The role of sex and gender in the selection of Alzheimer patients for clinical trial pre-screening. Alzheimers Res Ther 2021; 13:95. [PMID: 33952308 PMCID: PMC8098013 DOI: 10.1186/s13195-021-00833-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/21/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Alzheimer disease (AD) is a progressive neurodegenerative disorder affecting the elderly with a prevalence of 7.1% in women and 3.3% in men. Sex-related patterns have been reported in prognosis, biomarker status, and risk factors. Despite this, the interaction of sex has received limited attention, with AD trials persistently recruiting lower numbers of women than the population distribution and a lack of information on the sex-disaggregated effects of anti-dementia therapies. This is the first study aiming to identify the role of sex in the selection for screening in AD clinical trials. METHODS This cross-sectional study provides a comprehensive analysis of screening eligibility according to a set of pre-selection criteria currently applied at Fundació ACE memory clinic for a more efficient trial screening process. A cohort of 6667 women and 2926 men diagnosed with AD dementia (55%) or mild cognitive impairment (45%) was analyzed. We also assessed the frequencies of men and women effectively screened for trial enrolment over a period of 10 years. Additionally, data from AddNeuroMed study was used to explore trends in eligibility based on the education criteria. RESULTS Women showed a significantly lower chance of being eligible for screening than men (OR = 1.26; p < 0.01). This imbalance was confirmed by a lower frequency of women screened for enrolment compared to the study population (63.0% vs. 69.5%). Education was revealed as the key criterion contributing to this unbalance, with men showing over twice the chance of being screened compared with women (OR = 2.25, p < 0.01). Education-based differences were greater in earlier born patients, but the gap narrowed and achieved balance with increasing year of birth. This observation was replicated using data from other European populations included in AddNeuroMed study. Comorbidity was the most limiting criterion with sex differences in frequencies and significant discrimination against the selection of men (OR = 0.86, p < 0.01). CONCLUSIONS The large number of low-educated elderly women with AD demands for a sex-focused approach in clinical research. New assessment tools insensitive to education level should be developed to enable a proportional representation of women. Although this gender education gap is mostly inexistent in developed countries, economic or cultural factors may lead to different scenarios in other regions. Overlooking the impact of sex may lead to a handicap in AD research with a direct adverse impact on women's health.
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Affiliation(s)
- Maitee Rosende-Roca
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
| | - Carla Abdelnour
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Ester Esteban
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
| | - Juan Pablo Tartari
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
| | - Emilio Alarcon
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
| | - Juliana Martínez-Atienza
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
| | - Antonio González-Pérez
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
| | - María E Sáez
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
| | - Asunción Lafuente
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
| | - Mar Buendía
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
| | - Ana Pancho
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
| | - Nuria Aguilera
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
| | - Marta Ibarria
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
| | - Susana Diego
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
| | - Sara Jofresa
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
| | - Isabel Hernández
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Rogelio López
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
| | - Miren Jone Gurruchaga
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
| | - Lluís Tárraga
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Sergi Valero
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Agustín Ruiz
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Marquié
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Mercè Boada
- Research Center and Memory Clinic. Fundació ACE. Institut Català de Neurociències Aplicades. Universitat Internacional de Catalunya, Gran Vía de Carles III, 85 BIS, 08028, Barcelona, Spain.
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain.
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Trujillo-Rodríguez M, Viciana P, Rivas-Jeremías I, Álvarez-Ríos AI, Ruiz-García A, Espinosa-Ibáñez O, Arias-Santiago S, Martínez-Atienza J, Mata R, Fernández-López O, Ruiz-Mateos E, Gutiérrez-Valencia A, López-Cortés LF. Mesenchymal stromal cells in human immunodeficiency virus-infected patients with discordant immune response: Early results of a phase I/II clinical trial. Stem Cells Transl Med 2020; 10:534-541. [PMID: 33264515 PMCID: PMC7980217 DOI: 10.1002/sctm.20-0213] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/16/2020] [Accepted: 10/10/2020] [Indexed: 01/09/2023] Open
Abstract
Between 15% and 30% of HIV‐infected subjects fail to increase their CD4+ T‐cell counts despite continuous viral suppression (immunological nonresponders [INRs]). These subjects have a higher morbidity and mortality rate, but there are no effective treatments to reverse this situation so far. This study used data from an interrupted phase I/II clinical trial to evaluate safety and immune recovery after INRs were given four infusions, at baseline and at weeks 4, 8, and 20, with human allogeneic mesenchymal stromal cells from adipose tissue (Ad‐MSCs). Based on the study design, the first 5 out of 15 INRs recruited received unblinded Ad‐MSC infusions. They had a median CD4+ nadir count of 16/μL (range, 2‐180) and CD4+ count of 253 cells per microliter (171‐412) at baseline after 109 (54‐237) months on antiretroviral treatment and 69 (52‐91) months of continuous undetectable plasma HIV‐RNA. After a year of follow‐up, an independent committee recommended the suspension of the study because no increase of CD4+ T‐cell counts or CD4+/CD8+ ratios was observed. There were also no significant changes in the phenotype of different immunological lymphocyte subsets, percentages of natural killer cells, regulatory T cells, and dendritic cells, the inflammatory parameters analyzed, and cellular associated HIV‐DNA in peripheral blood mononuclear cells. Furthermore, three subjects suffered venous thrombosis events directly related to the Ad‐MSC infusions in the arms where the infusions were performed. Although the current study is based on a small sample of participants, the findings suggest that allogeneic Ad‐MSC infusions are not effective to improve immune recovery in INR patients or to reduce immune activation or inflammation. ClinicalTrials.gov identifier: NCT0229004. EudraCT number: 2014‐000307‐26.
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Affiliation(s)
- María Trujillo-Rodríguez
- Unidad Clínica Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío/Instituto Biomedicina de Sevilla/CSIC/Universidad de Sevilla, Avd. Manuel Siurto s/n, SEVILLA, España, Spain
| | - Pompeyo Viciana
- Unidad Clínica Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío/Instituto Biomedicina de Sevilla/CSIC/Universidad de Sevilla, Avd. Manuel Siurto s/n, SEVILLA, España, Spain
| | - Inmaculada Rivas-Jeremías
- Unidad Clínica Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío/Instituto Biomedicina de Sevilla/CSIC/Universidad de Sevilla, Avd. Manuel Siurto s/n, SEVILLA, España, Spain
| | - Ana I Álvarez-Ríos
- Departamento de Bioquímica Clínica, Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas (CSIC)/Servicio Andaluz de Salud (SAS)/Universidad de Sevilla, Seville, Spain
| | - Antonio Ruiz-García
- Unidad de Producción Celular e Ingeniería Tisular, Complejo Hospitalario Universitario de Granada, Granada, Spain
| | - Olga Espinosa-Ibáñez
- Unidad de Producción Celular e Ingeniería Tisular, Complejo Hospitalario Universitario de Granada, Granada, Spain
| | - Salvador Arias-Santiago
- Unidad de Producción Celular e Ingeniería Tisular, Complejo Hospitalario Universitario de Granada, Granada, Spain
| | - Juliana Martínez-Atienza
- Red Andaluza en Diseño y Traslación de Terapias Avanzadas, Fundación Pública Andaluza Progreso y Salud, Seville, Spain
| | - Rosario Mata
- Red Andaluza en Diseño y Traslación de Terapias Avanzadas, Fundación Pública Andaluza Progreso y Salud, Seville, Spain
| | - Olga Fernández-López
- Red Andaluza en Diseño y Traslación de Terapias Avanzadas, Fundación Pública Andaluza Progreso y Salud, Seville, Spain
| | - Ezequiel Ruiz-Mateos
- Unidad Clínica Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío/Instituto Biomedicina de Sevilla/CSIC/Universidad de Sevilla, Avd. Manuel Siurto s/n, SEVILLA, España, Spain
| | - Alicia Gutiérrez-Valencia
- Unidad Clínica Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío/Instituto Biomedicina de Sevilla/CSIC/Universidad de Sevilla, Avd. Manuel Siurto s/n, SEVILLA, España, Spain
| | - Luis F López-Cortés
- Unidad Clínica Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen del Rocío/Instituto Biomedicina de Sevilla/CSIC/Universidad de Sevilla, Avd. Manuel Siurto s/n, SEVILLA, España, Spain
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Rico-Sánchez L, Garzón I, González-Andrades M, Ruíz-García A, Punzano M, Lizana-Moreno A, Muñoz-Ávila JI, Sánchez-Quevedo MDC, Martínez-Atienza J, Lopez-Navas L, Sanchez-Pernaute R, Oruezabal RI, Medialdea S, Gonzalez-Gallardo MDC, Carmona G, Sanbonmatsu-Gámez S, Perez M, Jimenez P, Cuende N, Campos A, Alaminos M. Successful development and clinical translation of a novel anterior lamellar artificial cornea. J Tissue Eng Regen Med 2019; 13:2142-2154. [PMID: 31373143 PMCID: PMC6973105 DOI: 10.1002/term.2951] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [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: 04/17/2019] [Revised: 07/08/2019] [Accepted: 07/27/2019] [Indexed: 01/03/2023]
Abstract
Blindness due to corneal diseases is a common pathology affecting up to 23 million individuals worldwide. The tissue‐engineered anterior human cornea, which is currently being tested in a Phase I/II clinical trial to treat severe corneal trophic ulcers with preliminary good feasibility and safety results. This bioartificial cornea is based on a nanostructured fibrin–agarose biomaterial containing human allogeneic stromal keratocytes and cornea epithelial cells, mimicking the human native anterior cornea in terms of optical, mechanical, and biological behavior. This product is manufactured as a clinical‐grade tissue engineering product, fulfilling European requirements and regulations. The clinical translation process included several phases: an initial in vitro and in vivo preclinical research plan, including preclinical advice from the Spanish Medicines Agency followed by additional preclinical development, the adaptation of the biofabrication protocols to a good manufacturing practice manufacturing process, including all quality controls required, and the design of an advanced therapy clinical trial. The experimental development and successful translation of advanced therapy medicinal products for clinical application has to overcome many obstacles, especially when undertaken by academia or SMEs. We expect that our experience and research strategy may help future researchers to efficiently transfer their preclinical results into the clinical settings.
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Affiliation(s)
- Laura Rico-Sánchez
- Andalusian Initiative for Advanced Therapies, Progress and Health Andalusian Public Foundation, Sevilla, Spain
| | - Ingrid Garzón
- Tissue Engineering Group, Department of Histology, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria IBS, Granada, Spain
| | - Miguel González-Andrades
- Unidad de Oftalmología, Hospital Universitario San Cecilio, Granada, Spain.,Department of Ophthalmology, Schepens Eye Research Institute of Massachusetts, Harvard Medical School, Boston, MA.,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Department of Ophthalmology, Reina Sofia University Hospital and University of Cordoba, Cordoba, Spain
| | - Antonio Ruíz-García
- Unidad de Producción Celular e Ingeniería Tisular, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria IBS, Granada, Spain.,PhD Programme in Clinical Medicine and Public Health, Escuela de Posgrado, University of Granada, Granada, Spain
| | - Miriam Punzano
- Unidad de Producción Celular e Ingeniería Tisular, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Antonio Lizana-Moreno
- Unidad de Producción Celular e Ingeniería Tisular, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria IBS, Granada, Spain
| | - Jose Ignacio Muñoz-Ávila
- Tissue Engineering Group, Department of Histology, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria IBS, Granada, Spain
| | - Maria Del Carmen Sánchez-Quevedo
- Tissue Engineering Group, Department of Histology, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria IBS, Granada, Spain
| | - Juliana Martínez-Atienza
- Andalusian Initiative for Advanced Therapies, Progress and Health Andalusian Public Foundation, Sevilla, Spain
| | - Luis Lopez-Navas
- Andalusian Initiative for Advanced Therapies, Progress and Health Andalusian Public Foundation, Sevilla, Spain
| | - Rosario Sanchez-Pernaute
- Andalusian Initiative for Advanced Therapies, Progress and Health Andalusian Public Foundation, Sevilla, Spain
| | - Roke Iñaki Oruezabal
- Andalusian Initiative for Advanced Therapies, Progress and Health Andalusian Public Foundation, Sevilla, Spain
| | - Santiago Medialdea
- Unidad de Oftalmología, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | | | - Gloria Carmona
- Andalusian Initiative for Advanced Therapies, Progress and Health Andalusian Public Foundation, Sevilla, Spain.,PhD Programme in Biomedicine, Escuela de Posgrado, University of Granada, Granada, Spain
| | | | - Matías Perez
- Servicio de Análisis Clínicos e Inmunología, UGC de Laboratorio Clínico, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria IBS, Granada, Spain
| | - Pilar Jimenez
- Servicio de Análisis Clínicos e Inmunología, UGC de Laboratorio Clínico, Hospital Universitario Virgen de las Nieves, Granada, Spain.,Instituto de Investigación Biosanitaria IBS, Granada, Spain
| | - Natividad Cuende
- Andalusian Initiative for Advanced Therapies, Progress and Health Andalusian Public Foundation, Sevilla, Spain.,Coordinación Autonómica de Trasplantes de Andalucía, Servicio Andaluz de Salud, Sevilla, Spain
| | - Antonio Campos
- Tissue Engineering Group, Department of Histology, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria IBS, Granada, Spain
| | - Miguel Alaminos
- Tissue Engineering Group, Department of Histology, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria IBS, Granada, Spain
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Romero M, Suárez-de-Lezo J, Herrera C, Pan M, López-Aguilera J, Suárez-de-Lezo J, Baeza-Garzón F, Hidalgo-Lesmes FJ, Fernández-López O, Martínez-Atienza J, Cebrián E, Martín-Palanco V, Jiménez-Moreno R, Gutiérrez-Fernández R, Nogueras S, Carmona MD, Ojeda S, Cuende N, Mata R. Randomised, double-blind, placebo-controlled clinical trial for evaluating the efficacy of intracoronary injection of autologous bone marrow mononuclear cells in the improvement of the ventricular function in patients with idiopathic dilated myocardiopathy: a study protocol. BMC Cardiovasc Disord 2019; 19:203. [PMID: 31438858 PMCID: PMC6704590 DOI: 10.1186/s12872-019-1182-4] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 08/12/2019] [Indexed: 11/19/2022] Open
Abstract
Background Cellular therapies have been increasingly applied to diverse human diseases. Intracoronary infusion of bone marrow-derived mononuclear cells (BMMNC) has demonstrated to improve ventricular function after acute myocardial infarction. However, less information is available about the role of BMMNC therapy for the treatment of dilated myocardiopathies (DCs) of non-ischemic origin. This article presents the methodological description of a study aimed at investigating the efficacy of intracoronary injection of autologous BMMNCs in the improvement of the ventricular function of patients with DC. Methods This randomised, placebo-controlled, double-blinded phase IIb clinical trial compares the improvement on ventricular function (measured by the changes on the ejection fraction) of patients receiving the conventional treatment for DC in combination with a single dose of an intracoronary infusion of BMMNCs, with the functional recovery of patients receiving placebo plus conventional treatment. Patients assigned to both treatment groups are monitored for 24 months. This clinical trial is powered enough to detect a change in Left Ventricular Ejection Fraction (LVEF) equal to or greater than 9%, although an interim analysis is planned to re-calculate sample size. Discussion The study protocol was approved by the Andalusian Coordinating Ethics Committee for Biomedical Research (Comité Coordinador de Ética en Investigación Biomédica de Andalucia), the Spanish Medicines and Medical Devices Agency (Agencia Española de Medicamentos y Productos Sanitarios), and is registered at the EU Clinical Trials Register (EudraCT: 2013–002015-98). The publication of the trial results in scientific journals will be performed in accordance with the applicable regulations and guidelines to clinical trials. Trial registration ClinicalTrials.gov Identifier NCT02033278 (First Posted January 10, 2014): https://clinicaltrials.gov/ct2/show/NCT02033278; EudraCT number: 2013–002015-98, EU CT Register: https://www.clinicaltrialsregister.eu/ctr-search/search?query=2013-002015-98. Trial results will also be published according to the CONSORT statement at conferences and reported peer-reviewed journals.
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Affiliation(s)
- Miguel Romero
- Cardiology Unit, Reina Sofía University Hospital, Córdoba, Spain
| | | | - Concha Herrera
- Cell Production Unit, Reina Sofía University Hospital, Córdoba, Spain
| | - Manuel Pan
- Cardiology Unit, Reina Sofía University Hospital, Córdoba, Spain
| | | | | | | | | | - Olga Fernández-López
- Andalusian Initiative for Advanced Therapies, Andalusian Public Foundation Progress and Health - Junta de Andalucía, 41006, Esquina Avda. Hytasa, Seville, Spain
| | - Juliana Martínez-Atienza
- Andalusian Initiative for Advanced Therapies, Andalusian Public Foundation Progress and Health - Junta de Andalucía, 41006, Esquina Avda. Hytasa, Seville, Spain.
| | - Eva Cebrián
- Cardiology Unit, Reina Sofía University Hospital, Córdoba, Spain
| | | | | | | | - Sonia Nogueras
- Cell Production Unit, Reina Sofía University Hospital, Córdoba, Spain
| | | | - Soledad Ojeda
- Cardiology Unit, Reina Sofía University Hospital, Córdoba, Spain
| | - Natividad Cuende
- Andalusian Initiative for Advanced Therapies, Andalusian Public Foundation Progress and Health - Junta de Andalucía, 41006, Esquina Avda. Hytasa, Seville, Spain
| | - Rosario Mata
- Andalusian Initiative for Advanced Therapies, Andalusian Public Foundation Progress and Health - Junta de Andalucía, 41006, Esquina Avda. Hytasa, Seville, Spain
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6
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González-Andrades M, Mata R, González-Gallardo MDC, Medialdea S, Arias-Santiago S, Martínez-Atienza J, Ruiz-García A, Pérez-Fajardo L, Lizana-Moreno A, Garzón I, Campos A, Alaminos M, Carmona G, Cuende N. A study protocol for a multicentre randomised clinical trial evaluating the safety and feasibility of a bioengineered human allogeneic nanostructured anterior cornea in patients with advanced corneal trophic ulcers refractory to conventional treatment. BMJ Open 2017; 7:e016487. [PMID: 28947445 PMCID: PMC5623476 DOI: 10.1136/bmjopen-2017-016487] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION There is a need to find alternatives to the use of human donor corneas in transplants because of the limited availability of donor organs, the incidence of graft complications, as well as the inability to successfully perform corneal transplant in patients presenting limbal deficiency, neo-vascularized or thin corneas, etc. We have designed a clinical trial to test a nanostructured fibrin-agarose corneal substitute combining allogeneic cells that mimics the anterior human native cornea in terms of optical, mechanical and biological behaviour. METHODS AND ANALYSIS This is a phase I-II, randomised, controlled, open-label clinical trial, currently ongoing in ten Spanish hospitals, to evaluate the safety and feasibility, as well as clinical efficacy evidence, of this bioengineered human corneal substitute in adults with severe trophic corneal ulcers refractory to conventional treatment, or with sequelae of previous ulcers. In the initial phase of the trial (n=5), patients were sequentially recruited, with a safety period of 45 days, receiving the bioengineered corneal graft. In the second phase of the trial (currently ongoing), subjects are block randomised (2:1) to receive either the corneal graft (n=10), or amniotic membrane (n=5), as the control treatment. Adverse events, implant status, infection signs and induced neovascularization are evaluated as determinants of safety and feasibility of the bioengineered graft (main outcomes). Study endpoints are measured along a follow-up period of 24 months, including 27 post-implant assessment visits according to a decreasing frequency. Intention to treat, and per protocol, and safety analysis will be performed. ETHICS AND DISSEMINATION The trial protocol received written approval by the corresponding Ethics Committee and the Spanish Regulatory Authority and is currently recruiting subjects. On completion of the trial, manuscripts with the results of phases I and II of the study will be published in a peer-reviewed journal. TRIAL REGISTRATION CT.gov identifier: NCT01765244 (Jan2013). EudraCT number: 2010-024290-40 (Dec2012).
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Affiliation(s)
- Miguel González-Andrades
- Department of Ophthalmology Service, University Hospital Complex of Granada (San Cecilio and Virgen de las Nieves Hospitals), Granada, Spain
- Tissue Engineering Group, Department of Histology, University of Granada, Granada, Spain
- Department of Ophthalmology, Schepens Eye Research Institute of Massachusetts, Harvard Medical School, Boston, Massachusetts, USA
| | - Rosario Mata
- Andalusian Initiative for Advanced Therapies, Junta de Andalucía, Seville, Spain
| | - María del Carmen González-Gallardo
- Department of Ophthalmology Service, University Hospital Complex of Granada (San Cecilio and Virgen de las Nieves Hospitals), Granada, Spain
| | - Santiago Medialdea
- Department of Ophthalmology Service, University Hospital Complex of Granada (San Cecilio and Virgen de las Nieves Hospitals), Granada, Spain
| | - Salvador Arias-Santiago
- Cell Therapy and Tissue Engineering Unit, University Hospital Complex of Granada (Virgen de las Nieves Hospital), Granada, Spain
| | | | - Antonio Ruiz-García
- Cell Therapy and Tissue Engineering Unit, University Hospital Complex of Granada (Virgen de las Nieves Hospital), Granada, Spain
- PhD program Clinical Medicine and Public Health, University of Granada, Granada, Spain
| | - Lorena Pérez-Fajardo
- Andalusian Initiative for Advanced Therapies, Junta de Andalucía, Seville, Spain
| | - Antonio Lizana-Moreno
- Cell Therapy and Tissue Engineering Unit, University Hospital Complex of Granada (Virgen de las Nieves Hospital), Granada, Spain
| | - Ingrid Garzón
- Tissue Engineering Group, Department of Histology, University of Granada, Granada, Spain
| | - Antonio Campos
- Tissue Engineering Group, Department of Histology, University of Granada, Granada, Spain
| | - Miguel Alaminos
- Tissue Engineering Group, Department of Histology, University of Granada, Granada, Spain
| | - Gloria Carmona
- Andalusian Initiative for Advanced Therapies, Junta de Andalucía, Seville, Spain
- PhD program Clinical Medicine and Public Health, University of Granada, Granada, Spain
| | - Natividad Cuende
- Andalusian Initiative for Advanced Therapies, Junta de Andalucía, Seville, Spain
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Pérez-Romero P, Bulnes-Ramos A, Torre-Cisneros J, Gavaldá J, Aydillo T, Moreno A, Montejo M, Fariñas M, Carratalá J, Muñoz P, Blanes M, Fortún J, Suárez-Benjumea A, López-Medrano F, Barranco J, Peghin M, Roca C, Lara R, Cordero E, Alamo J, Gasch A, Gentil-Govantes M, Molina-Ortega F, Lage E, Martínez-Atienza J, Sánchez M, Rosso C, Arizón J, Aguera M, Cantisán S, Montero J, Páez A, Rodríguez A, Santos S, Vidal E, Berasategui C, Campins M, López-Meseguer M, Saez B, Marcos M, Sanclemente G, Diez N, Goikoetxea J, Casafont F, Cobo-Beláustegy M, Durán R, Fábrega-García E, Fernández-Rozas S, González-Rico C, Zurbano-Goñi F, Bodro M, Niubó J, Oriol S, Sabé N, Anaya F, Bouza E, Catalán P, Diez P, Eworo A, Kestler M, Lopez-Roa P, Rincón D, Rodríguez M, Salcedo M, Sousa Y, Valerio M, Morales-Barroso I, Aguado J, Origuen J. Influenza vaccination during the first 6 months after solid organ transplantation is efficacious and safe. Clin Microbiol Infect 2015; 21:1040.e11-8. [DOI: 10.1016/j.cmi.2015.07.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 07/01/2015] [Accepted: 07/17/2015] [Indexed: 10/23/2022]
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Martínez-Atienza J, Jiang X, Garciadeblas B, Mendoza I, Zhu JK, Pardo JM, Quintero FJ. Conservation of the salt overly sensitive pathway in rice. Plant Physiol 2007; 143:1001-12. [PMID: 17142477 PMCID: PMC1803719 DOI: 10.1104/pp.106.092635] [Citation(s) in RCA: 318] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2006] [Accepted: 11/20/2006] [Indexed: 05/12/2023]
Abstract
The salt tolerance of rice (Oryza sativa) correlates with the ability to exclude Na+ from the shoot and to maintain a low cellular Na+/K+ ratio. We have identified a rice plasma membrane Na+/H+ exchanger that, on the basis of genetic and biochemical criteria, is the functional homolog of the Arabidopsis (Arabidopsis thaliana) salt overly sensitive 1 (SOS1) protein. The rice transporter, denoted by OsSOS1, demonstrated a capacity for Na+/H+ exchange in plasma membrane vesicles of yeast (Saccharomyces cerevisiae) cells and reduced their net cellular Na+ content. The Arabidopsis protein kinase complex SOS2/SOS3, which positively controls the activity of AtSOS1, phosphorylated OsSOS1 and stimulated its activity in vivo and in vitro. Moreover, OsSOS1 suppressed the salt sensitivity of a sos1-1 mutant of Arabidopsis. These results represent the first molecular and biochemical characterization of a Na+ efflux protein from monocots. Putative rice homologs of the Arabidopsis protein kinase SOS2 and its Ca2+-dependent activator SOS3 were identified also. OsCIPK24 and OsCBL4 acted coordinately to activate OsSOS1 in yeast cells and they could be exchanged with their Arabidopsis counterpart to form heterologous protein kinase modules that activated both OsSOS1 and AtSOS1 and suppressed the salt sensitivity of sos2 and sos3 mutants of Arabidopsis. These results demonstrate that the SOS salt tolerance pathway operates in cereals and evidences a high degree of structural conservation among the SOS proteins from dicots and monocots.
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Affiliation(s)
- Juliana Martínez-Atienza
- Instituto de Recursos Naturales y Agrobiología, Consejo Superior de Investigaciones Científicas, Sevilla 41012, Spain
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