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Aiming for the end of the COVID-19 pandemic:the what,how,who,where,and when

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Chinese Medical Journal 2023年第1期136卷 1-3页

作者： Joan B.Soriano Alberto Infante Servicio de Neumología Hospital Universitario de la PrincesaMadridSpain Facultad de Medicina Universidad Autónoma de MadridMadridSpain Centro de Investigación en Red de enfermedades respiratorias(ciberes) Instituto de Salud Carlos III(ISCIII)MadridSpain National School of Public Health Institute of Health Carlos IIIMadridSpain

Severe acute respiratory syndrome coronavirus 2(SARSCoV-2)is a new virus,still full of surprises.As of September 2022,there have been over 605 million confirmed cases of coronavirus disease 2019(COVID-19),including 6.5 million deaths reported to the World Health Organization(WHO).[1]SARS-CoV-2 is a bad virus,which often produces new variants that scape natural immunity and sometimes vaccines[Figure 1].

关键词： immunity acute respiratory

Bronchiectasis and COVID-19 infection:a two-way street

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Chinese Medical Journal 2022年第20期135卷 2398-2404页

作者： Grace Oscullo Jose DanieGómez-Olivas Thais Beauperthuy AminaBekki Alberto Garcia-Ortega Maria Gabriella Matera Mario Cazzola Miguel Angel Martinez-Garcia department of Pneumology Hospital Universitario y Politécnico la Fe de ValenciaValencia 46012Spain department of Experimental Medicine University of Campania“Luigi Vanvitelli”Naples 80121Italy department of Experimental Medicine University of Rome Tor VergataRome 00185Italy CIBERES de enfermedades respiratorias Instituto de Salud Carlos IIIMadrid 41263Spain

Bronchiectasis(BE)has been linked to past viral infections such as influenza,measles,or adenovirus.Two years ago,a new pandemic viral infection severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)broke out and it still persists today,and a significant proportion of surviving patients have radiological and clinical sequelae,including BE.Our aim was to thoroughly review the information available in the literature on the bidirectional relationship between SARS-CoV-2 infection and the development of BE,as well as the impact of this infection on patients already suffering from BE.Available information indicates that only a small percentage of patients in the acute phase of coronavirus disease 2019(COVID-19)pneumonia develop BE,although the latter is recognized as one of the radiological sequelae of COVID-19 pneumonia,especially when it is caused by traction.The severity of the initial pneumonia is the main risk factor for the development of future BE,but during the COVID-19 pandemic,exacerbations in BE patients were reduced by approximately 50%.Finally,the impact of BE on the prognosis of patients with COVID-19 pneumonia is not yet known.

关键词： Bronchiectasis Coronavirus COVID-19 SARS-CoV-2

Usefulness of the CONUT index upon hospital admission as a potential prognostic indicator of COVID-19 health outcomes

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Chinese Medical Journal 2022年第2期135卷 187-193页

作者： Adrian K.Bengelloun Guillermo J.Ortega Julio Ancochea Ancor Sanz-Garcia Diego A.Rodriguez-Serrano Guillermo Fernandez-Jimenez Rosa Giron Elena Avalos Joan B.Soriano J.Ignacio de Ulibarri Facultad de Medicina Universidad Autónoma de MadridMadridSpain Unidad de Análisis de Datos Instituto de Investigación Sanitaria del Hospital de la PrincesaMadridSpain Servicios de Neumología Admisión y Documentación ClínicaCuidados Intensivos y Nutrición y DietéticaHospital Universitario de La PrincesaMadridSpain Centro de Investigación en Red de enfermedades respiratorias(ciberes) Instituto de Salud Carlos III(ISCIII)MadridEspañaSpain

Background:In-hospital mortality in patients with coronavirus disease 2019(COVID-19)is high.Simple prognostic indices are needed to identify patients at high-risk of COVID-19 health outcomes.We aimed to determine the usefulness of the CONtrolling NUTritional status(CONUT)index as a potential prognostic indicator of mortality in COVID-19 patients upon hospital admission.Methods:Our study design is of a retrospective observational study in a large cohort of COVID-19 patients.In addition to descriptive statistics,a Kaplan-Meier mortality analysis and a Cox regression were performed,as well as receiver operating curve(ROC).Results:From February 5,2020 to January 21,2021,there was a total of 2969 admissions for COVID-19 at our hospital,corresponding to 2844 patients.Overall,baseline(within 4 days of admission)CONUT index could be scored for 1627(57.2%)patients.Patients’age was 67.3±16.5 years and 44.9%were women.The CONUT severity distribution was:194(11.9%)normal(0-1);769(47.2%)light(2-4);585(35.9%)moderate(5-8);and 79(4.9%)severe(9-12).Mortality of 30 days after admission was 3.1%in patients with normal risk CONUT,9.0%light,22.7%moderate,and 40.5%in those with severe CONUT(Pdeath associated with a greater baseline CONUT stage was sustained in a multivariable Cox regression model(Pder the curve(AUC)and 95%confidence interval of 0.711(0.676-0746).Conclusion:The CONUT index upon admission is potentially a reliable and independent prognostic indicator of mortality and length of hospitalization in COVID-19 patients.

关键词： Admission Clinical risk CONUT COVID-19 Prognosis Score

A tumor-associated heparan sulfate-related glycosaminoglycan promotes the generation of functional regulatory T cells

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Cellular & Molecular Immunology 2023年第12期20卷 1499-1512页

作者： Leticia Martín-Cruz Marcos Viñuela Ioanna Kalograiaki Alba Angelina Paola Oquist-Phillips Irene Real-Arévalo Francisco Javier Cañada JoséIgnacio Tudela Luis Moltó Jesús Moreno-Sierra JoséLuis Subiza Oscar Palomares department of Biochemistry and Molecular Biology School of ChemistryComplutense University of MadridMadridSpain Inmunotek Alcaláde HenaresMadridSpain Fundación Investigación Hospital Clínico San Carlos Martin Lagos s/n28040MadridSpain Centro de Investigaciones Biológicas Margarita Salas CSICRamiro de Maetzu 928040MadridSpain CIBER de enfermedades respiratorias(ciberes)Avda Monforte de Lemos3-528029MadridSpain Servicio de Urología Hospital Clínico San CarlosUniversidad Complutense de MadridMartín Lagos s/n28040MadridSpain

Functional Tregs play a key role in tumor development and progression,representing a major barrier to anticancer immunity.The mechanisms by which Tregs are generated in cancer and the influence of the tumor microenvironment on these processes remain incompletely understood.Herein,by using NMR,chemoenzymatic structural assays and a plethora of in vitro and in vivo functional analyses,we demonstrate that the tumoral carbohydrate A10(Ca10),a cell-surface carbohydrate derived from Ehrlich’s tumor(ET)cells,is a heparan sulfate-related proteoglycan that enhances glycolysis and promotes the development of tolerogenic features in human DCs.Ca10-stimulated human DCs generate highly suppressive Tregs by mechanisms partially dependent on metabolic reprogramming,PD-L1,IL-10,and IDO.Ca10 also reprograms the differentiation of human monocytes into DCs with tolerogenic features.In solid ET-bearing mice,we found positive correlations between Ca10 serum levels,tumor size and splenic Treg numbers.Administration of isolated Ca10 also increases the proportion of splenic Tregs in tumor-free mice.Remarkably,we provide evidence supporting the presence of a circulating human Ca10 counterpart(Ca10H)and show,for the first time,that serum levels of Ca10H are increased in patients suffering from different cancer types compared to healthy individuals.Of note,these levels are higher in prostate cancer patients with bone metastases than in prostate cancer patients without metastases.Collectively,we reveal novel molecular mechanisms by which heparan sulfate-related structures associated with tumor cells promote the generation of functional Tregs in cancer.The discovery of this novel structural-functional relationship may open new avenues of research with important clinical implications in cancer treatment.

关键词： Tumoral carbohydrate A10 Heparan sulfate-related proteoglycan Cancer immunology dendritic cell Regulatory T cell

Latest developments in early diagnosis and specific treatment of severe influenza infection

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Journal of Intensive Medicine 2024年第2期4卷 160-174页

作者： Francisco Valenzuela-Sánchez Blanca Valenzuela-Méndez Juan Francisco Rodríguez-Gutiérrez Ángel Estella Intensive Care Unit University Hospital of JerezRonda de Circunvalación s/nJerez de la FronteraSpain Haematology department University Hospital of JerezRonda de Circunvalación s/nJerez de la FronteraSpain Centro de Investigación Biomédica en Red Enfermedades respiratoriasCIBERESInstituto de Salud Carlos IIIAv.de Monforte de LemosMadridSpain department of Oncological Surgery Institut du Cancer de Montpellier(ICM)Parc Euromédecine208 Av.des ApothicairesMontpellierFrance department of Medicine Faculty of MedicineUniversity of CádizCalle Doctor MarañónCádizSpain Instituto de Investigación e Innovación Biomédica de Cádiz(INIBiCA) Avenida Ana de Viya 21CádizSpain

Influenza pandemics are unpredictable recurrent events with global health,economic,and social consequences.The objective of this review is to provide an update on the latest developments in early diagnosis and specific treatment of the disease and its complications,particularly with regard to respiratory organ failure.despite advances in treatment,the rate of mortality in the intensive care unit remains approximately 30%.Therefore,early identification of potentially severe viral pneumonia is extremely important to optimize treatment in these patients.The pathogenesis of influenza virus infection depends on viral virulence and host response.Thus,in some patients,it is associated with an excessive systemic response mediated by an authentic cytokine storm.This process leads to severe primary pneumonia and acute respiratory distress syndrome.Initial prognostication in the emergency department based on comorbidities,vital signs,and biomarkers(e.g.,procalcitonin,ferritin,human leukocyte antigen-DR,mid-regional proadrenomedullin,and lactate)is important.Identification of these biomarkers on admission may facilitate clinical decision-making to determine early admission to the hospital or the intensive care unit.These decisions are reached considering pathophysiological circumstances that are associated with a poor prognosis(e.g.,bacterial co-infection,hyperinflammation,immune paralysis,severe endothelial damage,organ dysfunction,and septic shock).Moreover,early implementation is important to increase treatment efficacy.Based on a limited level of evidence,all current guidelines recommend using oseltamivir in this setting.The possibility of drug resistance should also be considered.Alternative options include other antiviral drugs and combination therapies with monoclonal antibodies.Importantly,it is not recommended to use corticosteroids in the initial treatment of these patients.Furthermore,the implementation of supportive measures for respiratory failure is essential.Current recommendations are limited,heterogeneous,an

关键词： Influenza Pandemic Respiratory failure Acute respiratory distress syndr ome Intensive care unit adnission

Management of hypoxemia in SARS-CoV-2 infection:Lessons learned from one year of experience,with a special focus on silent hypoxemia

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Journal of Intensive Medicine 2021年第1期1卷 26-30页

作者： Ricardo Serrano Xavier Corbella Jordi Rello Critical Care department.Hospital de Hellín.Gerencia Atención Integrada de Hellín Albacete 02400Spain Interna Medicine department Hospital Universitari de Bellvitge-IDIBELLL’Hospitalet de LlobregatBarcelona 08907Spain School of Medicine Universitat Internacional de CatalunyaBarcelona 08017Spain Vall d’Hebron Institute of Research Barcelona 08035Spain Research in Critical Care CHU CaremeauNîmes 30900France Centro de Investigación Biomédica en Red de enfermedades respiratorias(ciberes) Instituto de Salud Carlos IIIMadrid 28029Spain

Silent hypoxemia is common in patients with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)in-fection.In this article,the possible pathophysiological mechanisms underlying respiratory symptoms have been reviewed,and the presence of hypoxemia without hypoxia is also discussed.The experience we have gained since the start of the Coronavirus disease 19(COVID-19)pandemic has changed our point of view about which patients with respiratory involvement should be admitted to the intensive care unit/high-dependency unit for mechan-ical ventilation and monitoring.In patients with clinically well-tolerated mild to moderate hypoxemia(silent hypoxemia),regardless of the extent of pulmonary opacities found in radiological studies,the administration of supplemental oxygen therapy may increase the risk of endothelial damage.The risk of sudden respiratory arrest during emergency intubation,which could expose healthcare workers to infection,should be considered along with the risks of premature intubation.Criteria for intubation need to be revisited based on updated evidence showing that many patients with severe hypoxemia do not show increased work of breathing.This has implica-tions in patient management and may explain in part reports of broad differences in outcomes among intubated patients.

关键词： COVID-19 Acute respiratory distress syndrome(ARDS) Pandemic Critical care

Analysis of tumor-draining vein secretome: A direct access to tumor-derived extracellular vesicles in surgical lung cancer patients

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BIOCELL 2023年第5期47卷 951-957页

作者： YANGYI HE DAVID SANCHEZ-LORENTE MELISSA ACOSTA-PLASENCIA MARC BOADA ANGELA GUIRAO RAMON MMARRAdeS LAUREANO MOLINS ALFONS NAVARRO Molecular Oncology and Embryology Laboratory Department of Surgery and Surgical SpecializationsHuman Anatomy UnitFaculty of Medicine and Health SciencesUniversitat de Barcelona(UB)Barcelona08036Spain School of Basic Medical Sciences Chengdu UniversityChengdu610106China department of Thoracic Surgery Hospital Clínic de BarcelonaUniversitat de Barcelona(UB)Barcelona08036Spain Thoracic Oncology Unit Hospital ClinicBarcelona08036Spain Institut d’Investigacions Biomèdiques August Pi i Sunyer(IDIBAPS) Barcelona08036Spain department of Pneumology Institut Clínic Respiratori(ICR)Hospital Clínic de BarcelonaUniversitat de Barcelona(UB)Barcelona08036Spain Centro de Investigación Biomédica en Red de enfermedades respiratorias(ciberes) Instituto de Salud Carlos IIIMadrid28029Spain

Tumor-secreted extracellular vesicles(EVs)participate in the metastasis process through different mechanisms,including the preparation of the pre-metastatic niche to grant circulating tumor cells(CTCs)implantation and growth.The study of the metastasis process through the analysis of CTCs and tumor-derived EVs is difficult because of the dilution grade of these elements in peripheral blood.In early-stage lung cancer patients,the tumor-secreted products are even more diluted.An attractive strategy in surgical lung cancer patients is to purify them from a pulmonary tumor-draining vein where they are enriched.The information obtained from the analysis of EVs and CTCs purified from this source could give more accurate information about tumor biology and could be an important source of biomarkers to identify patients at high risk of relapse after curative surgery.

关键词： Lung cancer Liquid biopsy Tumor-draining vein Extracellular vesicles Exosomes

Tools for the diagnosis of hepatitis C virus infection and hepatic fibrosis staging

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World Journal of Gastroenterology 2014年第13期20卷 3431-3442页

作者： Verónica Saludes Victoria González Ramon Planas Lurdes Matas Vicente Ausina Elisa Martró Institut d’ Investigació en Ciències de la Salut Germans Trias i Pujol Hospital Universitari Germans Trias i Pujol (Universitat Autònoma de Barcelona)08916 BadalonaSpain CIBER Epidemiología y Salud Pública (ciberesP) 08003 BarcelonaSpain Centre for Epidemiological Studies on HIV/STI in Catalonia (CEEISCAT)-ICO 08916 BadalonaSpain Liver Unit Hospital Universitari Germans Trias i Pujol08916 BadalonaSpain Ramon Planas CIBER Enfermedades Hepáticas y Digestivas (CIBEREHD)08036 BarcelonaSpain CIBER enfermedades respiratorias (ciberes) 07110 BunyolaSpain

Hepatitis C virus(HCV)infection represents a major public health issue.Hepatitis C can be cured bytherapy,but many infected individuals are unaware of their status.Effective HCV screening,fast diagnosis and characterization,and hepatic fibrosis staging are highly relevant for controlling transmission,treating infected patients and,consequently,avoiding end-stage liver disease.Exposure to HCV can be determined with high sensitivity and specificity with currently available third generation serology assays.Additionally,the use of point-of-care tests can increase HCV screening opportunities.However,active HCV infection must be confirmed by direct diagnosis methods.Additionally,HCV genotyping is required prior to starting any treatment.Increasingly,high-volume clinical laboratories use different types of automated platforms,which have simplified sample processing,reduced hands-on-time,minimized contamination risks and human error and ensured full traceability of results.Significant advances have also been made in the field of fibrosis stage assessment with the development of non-invasive methods,such as imaging techniques and serum-based tests.However,no single test is currently available that is able to completely replace liver biopsy.This review focuses on approved commercial tools used to diagnose HCV infection and the recommended hepatic fibrosis staging tests.

关键词： Hepatitis C virus Diagnosis Real-time poly-merase

实时经支气管超声引导针吸活检在肺癌分期中的应用

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中国肺癌杂志 2010年第5期13卷 406-409页

作者： Ignasi GARCIA-OLIVé José SANZ-SANTOS Felipe ANDREO Eduard MONSó 南娟丁燕 Respiratory Service Hospital Universitari Germans Trias i Pujol Badalona Catalunya Spain departament de Medicina. Universitat Autònoma de Barcelona Ciber de enfermedades respiratorias-ciberes Bunyola Spain 天津医科大学总医院天津市肺癌研究所天津市肺癌转移与肿瘤微环境重点实验室

线性经支气管超声引导针吸活检(endobronchial ultrasound-guided transbronchial needle aspiration,EBUS-TBNA)是新引进的技术,它是实时超声下可视淋巴结的针吸活检。尽管有研究显示,其为肺癌纵隔分期的有效方法,但全世界多数机构并... 详细信息

线性经支气管超声引导针吸活检(endobronchial ultrasound-guided transbronchial needle aspiration,EBUS-TBNA)是新引进的技术,它是实时超声下可视淋巴结的针吸活检。尽管有研究显示,其为肺癌纵隔分期的有效方法,但全世界多数机构并未应用该技术。本报道旨在分享我们应用EBUS-TBNA的经验,并对相关文献做一简要概述。我们对有关该技术的已有文献进行综述,并特别介绍了我们应用该技术方面的经验。EBUS-TBNA用以探查肺癌患者的转移性纵隔淋巴结和/或肺门淋巴结是有效且安全的。在其它病理状态下,其亦为有效的诊断方法。

关键词： EBUS 线性经支气管超声引导针吸活检肺癌分期实时经支气管超声引导针吸活检