Dr Elba Pascual-Goñi, researcher of the Neuromuscular Diseases Group of the Research Institute of the Hospital de la Santa Creu i Sant Pau – IIB Sant Pau has described a new subgroup of patients with chronic inflammatory demyelinating polyradiculoneuropathy based on clinical and immunological characteristics. Her results have just been published in the journal Brain, the oldest journal in neurology.

Inflammatory neuropathies are a heterogeneous group of diseases characterized by the presence of an autoimmune attack on the peripheral nerves. They are rare diseases and very little is known about their pathophysiology, so there are no specific biological markers and, therefore, they are diseases that can be difficult to diagnose or go unnoticed.

In some cases, such as chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), the diagnosis is based exclusively on clinical and electrophysiological criteria, as there are no specific diagnostic biomarkers. CIDP is the most common chronic immune-mediated neuropathy, with a prevalence of around 2 per 100,000 people.

The Sant Pau neuromuscular diseases team works to find biomarkers in inflammatory neuropathies that help diagnose the disease and guide its treatment. This team has pioneered the description of antibodies against proteins of the Ranvier nodes, which are the small spaces between the myelin plates that we find throughout neurons and that are necessary for the nerve impulse to propagate correctly. “The description of these antibodies has represented a revolution in the field of immunomediated neuropathies, because it has allowed the identification of subgroups of patients that share common clinical characteristics and immunopathogenic mechanisms, highlighting the heterogeneity of this disease”, says Dr.. Luis Querol, principal investigator of the Autoimmune Neurology group of the Neuromuscular Diseases Unit in which this work was carried out.

In the recent study published in the journal Brain, researchers have described the clinical and immunological characteristics of CIDP with antibodies against the Caspr1 / CNTN1 complex, which is key to the proper functioning of the Ranvier node. “Investigating a set of specific antibodies has allowed us to identify a new subgroup of patients, who share clinical and immunological characteristics”, explains Dr Elba Pascual Goñi, neurologist and researcher at the Neuromuscular Diseases Unit of the Research Institute of the Hospital de la Santa Creu i Sant Pau – IIB Sant Pau de Barcelona and first author of the article. “Apart from identifying a unique population within the CIDP spectrum, the detection of these antibodies allows us to optimize the management of patients with this neuropathy”, concludes the researcher.

Sant Pau Biomedical Research Institute (IIB Sant Pau) is a partner in the COVIRNA project. The project aims to generate an innovative diagnostic tool to identify COVID-19 patients at risk of developing fatal cardiovascular complications in the context of the current pandemic, ultimately leading to their improved surveillance and care. The COVIRNA video outlines the project objectives and the methodology used to achieve them. It has been produced in cooperation with Science Animated.

The overall goal of the COVIRNA project is to generate a diagnostic test based on cardiovascular RNA biomarkers highly predictive of the clinical outcomes of COVID-19 patients and to enable its rapid market uptake with the aim to improve individualised surveillance, care and follow-up of these patients in the context of the current pandemic.

Watch the video to learn more about the COVIRNA Project:

International collaboration led by researchers at the Sant Pau Reseach Institute – IIB Sant Pau in Barcelona, Spain, shows effectiveness of a plasma biomarker to detect Alzheimer’s Disease in Down syndrome individuals. Their results, which have been published in Nature Communications, will enhance diagnostic capability in this particular population. In parallel, researchers have also published another study in JAMA Neurology where they analyzed the influence of the most important genetic factor for Alzheimer’s disease (APOE) on the mechanisms of this pathology in the population with Down syndrome

Scientists worldwide are immersed in the race for accurate, non-invasive and accessible biomarkers to detect and diagnose Alzheimer’s Disease. To date, major scientific advances allowed the identification of several biomarkers in cerebrospinal fluid or using positron emission tomography (PET). Yet, these methods are expensive, invasive and not accessible so they are not included in clinical routine and only restricted to a few.

Most recently, blood biomarkers have emerged as an easy and cost-effective alternative for the screening of Alzheimer’s disease. One of these new plasma biomarkers is protein p-tau 181, which was firstly described as potential biomarker by scientists at the University of Gothenburg.

Now, researchers at the Hospital de Sant Pau Research Institute – IIB Sant Pau in Barcelona in collaboration with scientists at University of Gothenburg and University of Montpellier, assessed the accuracy of p-tau 181 in plasma to detect Alzheimer’s disease in Down Syndrome individuals. As reported in Nature Communications, they have studied suitability and effectiveness of this biomarker in a cohort of 400 people, 366 of whom are adults with Down syndrome.

“In our study, we found that this biomarker actually works to detect Alzheimer’s among people with Down syndrome too. Discerning cognitive impairment in people who already have an intellectual disability or other dementias is difficult, and having biological markers available will improve our ability to diagnose”, says Dr. Albert Lleó, head of the Dementia Neurobiology Group at IIB Sant Pau and director of the Memory Unit of the Neurology Service at the Hospital de la Santa Creu i Sant Pau. “It is an important milestone to us because it will allow us to make early detection and provide appropriate care and treatment to address the progression of the disease”.

Down Syndrome and Alzheimer’s disease, a tandem to consider

Alzheimer’s disease is currently the leading medical problem for adults with Down syndrome and it is also the leading cause of death. Down syndrome is a condition in which a person has three copies of chromosome 21, which also led to have an additional copy of the amyloid precursor protein (APP) gene, making these people, therefore, much more likely to suffer Alzheimer’s disease.

IIB Sant Pau’s team, which has long experience and is an intenational benchmark in the relationship between Alzheimer’s disease and Down syndrome, includes the Alzheimer-Down unit, led by Dr. Juan Fortea. This pioneering unit, resulted from a collaboration between the Catalan Down Syndrome Foundation and the Hospital de la Santa Creu i Sant Pau.

“Understanding the pathophysiology of Alzheimer’s disease and being able to have tools for early diagnosis becomes even more relevant when we talk about people with Down syndrome”, says Juan Fortea, head of the Alzheimer-Down unit.

Deepening the mechanisms of Alzheimer’s to understand its progression

Also, researchers Florencia Iulita and Alexandre Bejanin from this unit have studied the pathophysiological processes involved in the development and progression of Alzheimer’s in Down syndrome individuals.

Researchers have focused on a particular gene encoding for the apolipoprotein APOE ɛ4, which is associated with an increased risk of Alzheimer’s. In their study, recently published in JAMA Neurology, they characterized the association of this gene with various Alzheimer’s biomarkers and segmented it by age groups of study. The main findings show that the risk of Alzheimer’s is much higher in people with Down syndrome and to what extent this risk increases with age. The study also provides information on the mechanisms by which this happens

“We believe that our work comes timely considering the large number of studies available related to the prevention and diagnosis of Alzheimer’s disease. Considering genetics and the APOE genotype may be important when designing new drugs and clinical trials”, concludes Dr. Fortea.

Advancing Alzheimer’s research from many different angles

These two works highlight the relevance of multidisciplinarity when addressing neurodegenerative diseases. IIB Sant Pau’s team approached Alzheimer’s disease from many angles and the team includes experts in neurology, neuropsychology, biology, engineering, nursing and research. They tackle several research projects aimed at improving diagnosis, at better understanding the disease and its progression, as well as at identifying therapeutic targets while improving the clinical care of patients and their caregivers.

Papers cited

• Lleó, A., Zetterberg, H., Pegueroles, J. et al.Phosphorylated tau181 in plasma as a potential biomarker for Alzheimer’s disease in adults with Down syndrome. Nat Commun 12, 4304 (2021). https://doi.org/10.1038/s41467-021-24319-x

• Bejanin A, Iulita MF, Vilaplana E, et al. Association of Apolipoprotein E ɛ4 Allele With Clinical and Multimodal Biomarker Changes of Alzheimer Disease in Adults With Down Syndrome. JAMA Neurol.Published online July 06, 2021. https://doi.org/10.1001/jamaneurol.2021.1893

An international collaboration uncovers several genetic markers associated with SARS-CoV-2 infection and COVID-19 severity. These results, which have been published in Nature, come from one of the largest genome-wide association studies ever performed. The findings could help provide targets for future therapies and illustrate the power of genetic studies in learning more about infectious disease.
IIB Sant Pau researcher, Israel Fernández Cadenas is one of the over 3,500 scientists co-authoring this paper and is the only Spanish researcher in the writing group.

Barcelona, (July 8, 2021)— In March of 2020, thousands of scientists around the world united to answer a pressing and complex question: what genetic factors influence why some COVID-19 patients develop severe, life-threatening disease requiring hospitalization, while others escape with mild symptoms or none at all?

A comprehensive summary of their findings to date, published in Nature, reveals 13 loci, or locations in the human genome, that are strongly associated with infection or severe COVID-19. The researchers also identified causal factors such as smoking and high body mass index. These results come from one of the largest genome-wide association studies ever performed, which includes nearly 50,000 COVID-19 patients and two million uninfected controls.

The findings could help provide targets for future therapies and illustrate the power of genetic studies in learning more about infectious disease.

IIB Sant Pau researcher, Israel Fernández Cadenas, is one of the scientists co-authoring this paper and the only Spanish researcher participating in the writing group.

“This is an unprecendented major collaboration including researchers, biobanks, hospitals and private companies sharing data and working in a truly transparent way,” states the researcher. “Collaboration and data sharing allowed us to quickly get the big picture of the COVID host genetics but more importantly, such effort and initiative will facilitate and foster many research projects related to other pathologies, infectious diseases, as well as to better understand COVID patients with persistent symptoms or to identify targets for drug development and treatment”, Dr. Fernández Cadenas concludes.

This global effort, called the COVID-19 Host Genomics Initiative, was founded in March 2020 by Andrea Ganna, group leader at the Institute for Molecular Medicine Finland (FIMM), University of Helsinki and Mark Daly, director of FIMM and institute member at the Broad Institute of MIT and Harvard. The initiative has grown to be one of the most extensive collaborations in human genetics and currently includes more than 3,500 authors and 61 studies from 25 countries.

Ben Neale, co-director of the Program in Medical and Population Genetics at the Broad and co-senior author of the study, said that while vaccines confer protection against infection, there is still substantial room for improvement in COVID-19 treatment, which can be informed by genetic analysis. He added that improving treatment approaches could help shift the pandemic — which has necessitated large shutdowns in much of the world — to an endemic disease that is more localized and present at low but consistent levels in the population, much like the flu.

“The better we get at treating COVID-19, the better equipped the medical community could be to manage the disease,” he said. “If we had a mechanism of treating infection and getting someone out of the hospital, that would radically alter our public health response.”

Harnessing diversity

To do their analysis, the consortium pooled clinical and genetic data from the nearly 50,000 patients in their study who tested positive for the virus, and 2 million controls across numerous biobanks, clinical studies, and direct-to-consumer genetic companies such as 23andMe. Because of the large amount of data pouring in from around the world, the scientists were able to produce statistically robust analyses far more quickly, and from a greater diversity of populations, than any one group could have on its own.

Of the 13 loci identified so far by the team, two had higher frequencies among patients of East Asian or South Asian ancestry than in those of European ancestry, underscoring the importance of diversity in genetic datasets. “We’ve been much more successful than past efforts in sampling genetic diversity because we’ve made a concerted effort to reach out to populations around the world,” said Daly. “I think we still have a long way to go, but we’re making very good progress.”

The team highlighted one of these two loci in particular, near the FOXP4 gene, which is linked to lung cancer. The FOXP4 variant associated with severe COVID-19 increases the gene’s expression, suggesting that inhibiting the gene could be a potential therapeutic strategy. Other loci associated with severe COVID-19 included DPP9, a gene also involved in lung cancer and pulmonary fibrosis, and TYK2, which is implicated in some autoimmune diseases.

Mari Niemi, FIMM researcher and lead analyst for the study, says the consortium prioritized communication as the scientists analyzed data, immediately releasing results on their website after they had been checked for accuracy. The team hopes their results might point the way to useful targets for repurposed drugs.

The researchers will continue to study more data as they come in and update their results through the “Matters Arising” format at Nature. They will begin to study what differentiates “long-haulers”, or patients whose COVID-19 symptoms persist for months, from others, and continue to identify additional loci associated with infection and severe disease.

“We’d like to aim to get a good handful of very concrete therapeutic hypotheses in the next year,” Daly said. “Realistically, we will most likely be addressing COVID-19 as a serious health concern for a long time. Any therapeutic that emerges this year, for example from repurposing an existing drug based on clear genetic insights, would have a great impact.”

A new space for genetics

Scientists were able to find robust genetic signals because of their collaborative efforts, a cohesive spirit of data-sharing and transparency, and the urgency that comes with knowing the entire world faces the same threat at the same time. Geneticists, who regularly work with large datasets, have known the benefits of open collaboration for a long time. “This only illustrates just how much better science is — how much faster it goes and how much more we discover — when we work together,” Ganna said.

“These discoveries have been really informative and that has made us realize that there’s a lot of untapped potential in using genetics to understand and potentially develop therapeutics for infectious disease,” Daly said. “I hope this sets an example for how we might bring population genetics approaches to a new set of problems that are especially important in developing parts of the world.”

For more information on the Host Genetics Initiative, please visit

https://www.covid19hg.org/

Paper cited

The COVID-19 Host Genetics Initiative. Mapping the human genetic architecture of COVID-19. Nature. Online July 8, 2021. https://www.nature.com/articles/s41586-021-03767-x

• Blood and vascular levels of various molecules related to oxidative stress can be good predictors of aneurysm rupture.

•  The research, developed by researchers from the Research Institute of the Hospital de la Santa Creu i Sant Pau – IIB Sant Pau and the CIBERCV together with the CSIC and the CIBEROBN at the Rey Juan Carlos University, has been published in the journal Antioxidants

Blood levels of various molecules related to oxidative stress may be useful biomarkers in predicting the risk of ruptured abdominal aortic aneurysm. This is confirmed by a study carried out by researchers from the Research Institute of the Hospital de la Santa Creu i Sant Pau – IIB Sant Pau and the CIBER for Cardiovascular Diseases (CIBERCV) in collaboration with scientists from the Barcelona Institute for Biomedical Research (IIBB-CSIC), and the CIBER of Obesity and Nutrition (CIBEROBN) of the Rey Juan Carlos University, which has been published in the journal Antioxidants.

Abdominal aortic aneurysm (AAA) is a life-threatening condition that consists of a localized and permanent dilation of the abdominal aorta, the prevalence of which can reach 4-7% of men over 65 years of age. Over time, the aortic diameter tends to expand and the risk of rupture increases, the most serious complication of this disease, which produces extensive internal bleeding. This event is responsible for between 1% and 2% of all deaths and constitutes one of the main triggers of death in men over 70 years of age.

The implementation of ultrasound detection programs has improved the early diagnosis of this pathology, but finding new indicators for the prognosis of its evolution is key in the management of the disease. In this sense, although the incidence of rupture increases with the aortic diameter, this parameter is not in all cases a good predictor of risk, since small aneurysms can also have a poor outcome. Therefore, the identification of biomarkers in the blood to assess the progression of AAA, will play a key role in improving the recognition of patients at higher risk.

This has been the objective of this new research, which focused on analysing the prognostic value of circulating (blood) levels of various molecules related to oxidative stress and inflammation. “In order to identify new circulating biomarkers, we selected a battery of immune inflammatory and oxidative stress markers that we know are involved in the pathological mechanisms of abdominal aortic aneurysm progression,” says María Galán, researcher at the Research Institute of the Hospital de the Santa Creu i Sant Pau – IIB Sant Pau, that has led the study.

To achieve this, an analysis of the correlation of these markers with two risk parameters was carried out: the diameter of the aneurysm and the value of maximum arterial wall tension. The researchers had the participation of the Angiology, Vascular and Endovascular Surgery service of the Hospital de la Santa Creu i Sant Pau to study aneurysmal aortic samples and blood samples from 94 AAA patients, comparing them with abdominal aortic samples and blood from healthy people.

The results showed that the blood levels of superoxide anion, IgM, IgG, CD38, GDF15, S100A4, as well as its expression in the abdominal aorta of patients with AAA, were altered compared to healthy controls.

“The levels of IgG, CD38 and GDF15 were positively correlated with the diameter of the abdominal aorta and with the values of maximum wall tension, showing that they have the potential to help predict the risk of rupture and growth of the aneurysm in patients with AAA”, points out David Sánchez-Infantes, first author of the work.

“These findings suggest the usefulness of these biomarkers, which can be measured in a blood sample, to help the management of patients with aneurysm, along with other tools already used in prognosis such as aortic diameter and maximum wall tension”, the researchers conclude.

Reference article:

Sánchez-Infantes D, Nus M, Navas-Madroñal M, Fité J, Pérez B, Barros-Membrilla AJ, Soto B, Martínez-González J, Camacho M, Rodriguez C, Mallat Z, Galán M. Oxidative Stress and Inflammatory Markers in Abdominal Aortic Aneurysm. Antioxidants. (2021) https://doi.org/10.3390/antiox10040602

Professor Lina Badimón, head of the group of Molecular and Therapeutic Pathology of Atherothrombotic and Ischemic Diseases of the Research Institute of the Hospital de la Santa Creu i Sant Pau – IIB Sant Pau, has joined the Royal Academy of Medicine of Catalonia (RAMC) as a Numerary Academician.

Her admission ceremony was held on Sunday, May 16th , 2021, in an extraordinary public session at the headquarters of the Royal Academy of Medicine of Catalonia, in which Dr. Badimon read the speech “Precision Medicine in Cardiology”. Dr. Badimon is attached to the first section in basic, diagnostic and therapeutic sciences and entered to receive the 48 medal, that Dr. Soledat Woessner i Casas had previously held, now Emeritus Academic, who together with Dr. Miquel Vilardell i Tarrés acted as godparents. The answer to her speech on behalf of the Academy was in charge of the numerary academic, Dr. Antoni Bayés de Luna.

On precision medicine, research and cardiology

In her entrance speech, Dr. Badimon presented the so-called Precision Medicine and explained, how this new approach to medicine that relies on science – omics and data (big data) as its main support – will shape clinical practice of the future. Not only did she take a tour of this discipline and present the main benefits and challenges, but she also contextualized this type of medicine in the field of cardiovascular diseases, an area in which she is an internationally renowned expert. She showed through examples how precision medicine can contemplate many variables to the same problem, and how the integration of all these data can result in a better characterization of patients, in better defined clinical trials and in responses that allow us to offer personalized prevention tools and treatments.

As Dr. Badimon pointed out, the challenge now is to incorporate this into clinical practice.

The session and the speech of Dr. Badimon are available on the RAMC YouTube channel, at  this link.

About Dr. Lina Badimon

Lina Badimon Maestro, directs the research group of Molecular and Therapeutic Pathology of Atherothrombotic and Ischemic diseases. She is a research professor at the Higher Council for Scientific Research and Director of the Chair for Cardiovascular Research at the UAB, and the UNESCO Chair for biomedicine, Deputy Lecturer Associate Professor of Medicine – Cardiology – at the Mount Sinai School of Medicine, New York and Visiting Professor at Manchester Metropolitan University, UK and Paris-Est University, France.

Her career includes posts and positions of responsibility at the former Institute of Cardiovascular Sciences, the CSIC, the Massachusetts General Hospital in Boston, the Harvard Medical School in Boston, and the Mount Sinai School of Medicine in New York. She has been President of the Spanish Society of Arteriosclerosis, President of the European Society for Clinical Investigation, Vice President of the Spanish Society of Cardiology (SEC) and of the European Society of Cardiology (ESC), Chair of the Council on Basic Science of the ESC and of various working groups in both organizations.

Currently, she is a member of the Board of the European Society of Cardiology, Chair of the Patient Forum and Women @ ESC. She is also the President of the European Mediterranean League Against Thromboembolic Diseases Foundation (EMLTDF).

A team of researchers at the Research Institute of the Hospital de la Santa Creu i Sant Pau – IIB Sant Pau, together with scientists at École Polythecnique Fédérale de Lausanne (EPFL), describe the brain network responsible for minor hallucinations in Parkinson’s disease. Scientists developed a robotic device that allows the induction of hallucinations and the study of the brain networks that are involved. The study, which has been published in Science Translational Medicine, shows the relationship of such hallucinations in the context and progression of Parkinson’s disease, which could be relevant for early diagnostic.

Researchers at theInstitut de Receca de l’Hospital de la Santa Creu i Sant Pau – IIB Sant Pau in collaboration with scientists at the École Polythecnique Fédérale de Lausanne (EPFL) have described the brain network responsible for minor hallucinations in Parkinson’s disease and its possible relation with the progression of the disease.

A team led by Jaume Kulisevsky, director of the Parkinson disease and movement disorders research group at IIB Sant Pau and of the socalled Unit at the Neurology Service of the Hospital de la Santa Creu i Sant Pau,  and by Olaf Blanke, principal investigator at EPFL in Geneva, has desenvoled a robotic device that allows the induction of hallucinations in healthy subjects and Parkinson disease patients. By combining this robot with MRI imaging, scientists have been able to study the brain networks involved in hallucinations. They identified these networks and confirmed that are the same ones related to major hallucinations in Parkinson disease, which are one of the most disturbing non-motor symptoms for these patients.

Hallucinations that were not considered but could be significant

Parkinson’s disease is the second neurode

Parkinson’s disease is the second most prevalent neurodegenerative disease worldwide after Alzheimer’s and affects primarily the elderly. It is a progressive neurodegenerative disease that has been traditionally defined as a movement disorder, characterized by tremor, rigidity and slowness of movement. But many patients also suffer from a wide array of symptoms that are not associated with movement and some may go on to suffer from mental symptoms like psychosis, depression, apathy, cognitive decline and even dementia. Hallucinations are frequent in the disease but only major hallucinations were considered real symptoms in the past.

Did you ever felt a presence behind you? Did you ever felt someone else in an empty room? Or maybe, have you ever seen animals or other things quickly passing by next to you? These kind of events are named minor hallucinations. They are very frequent in Parkinson’s disease, becoming more and more frequents as the disease progresses, even they are also present amongst the 5-10% of healthy population.

“In the past, we did not consider these hallucinations a symptom. They were attributed to medication or maybe they were not reported because many patients are hesitant to report them, and questions remain about the neurobiology at play. Our research group already identified the key role of these hallucinations in Parkinson’s disease and now, with this new paper we can conclude that the brain networks behind them are the same that will later cause major hallucinations. Thus, it can be a powerful indicator of the progression of this disease as well as of cognitive damage,” explains Jaume Kulisevsky, principal investigator at IIB Sant Pau and co-corresponding author of the paper published in Science Translational Medicine.

Practical implications

The study, which has been done with healthy individuals and with Parkinson’s disease patients at the Hospital de Sant Pau in Barcelona, and in other hospitals in Switzerland and France, confirms the funcional basis of the hallucinations phenomena and it could be a good marker to study the disease progression. The expertise of the Kulisevsky group on these kind of events and their previous work about the key role of minor hallucinations in Parkinson’s disease as a pre-motor symptom, as well as the description of the attention networks and visual connectivity in the brain, contributed the use this new device as a tool for a better understanding and diagnostic of Parkinson’s disease.

As in other neurodegenerative diseases, it is important to focus in early detection and in the identification fo new targets to develop treatments in order to stop the progression of the disease.By combining this robot with MRI imaging, scientists have been able to study the brain networks involved in hallucinations and to determine its level of severity and damage.

Reference:  Bernasconi et al., Sci. Transl. Med., 13, eabc8362 (2021) 28 April 2021. 10.1126/scitranslmed.abc8362

The partners of the European project CARDIOPATCH will present the website of the initiative the 30th of April in a virtual event. The interactive platform is a dynamic environment that aims to promote the networking and cooperation between the agents of the biomedical industry and 3D printing technologies in Southwestern Europe

CARDIOPATCH (Network of Excellence for the development of Advanced Therapies of Myocardial Infarction treatment based on regenerative medicine and 3D printing), which aims to create a new treatment through regenerative medicine and 3D printing for patients who have suffered a myocardial infarction, has developed a digital platform to connect the key actors of the biotechnology sector and the 3D printing technologies from Southwestern Europe.

This project involves the participation of Prof. Lina Badimon and Dr. Gemma Vilahur from the Institut de Recerca Hospital de la Santa Creu i Sant Pau – IIB Sant Pau. “The achievement of this project will allow us to get functionalised patches with therapeutic proteins and enriched with stem cells. As a result, we will gain the capacity to regenerate damaged tissues in heart attack patients“, stated both researchers.

The characteristics and services of this interactive platform, which is integrated in its official website, will be presented today, 30th of April, at 4:00 P.M. CEST in a virtual encounter. The event is open to the public and the inscriptions can be made following this link.

During the webinar, not only the website of CARDIOPATCH project will be presented officially, but also the main services that are included. Specifically, the members of the consortium of the project will explain the functioning of the funding opportunities search tool and the space dedicated to encourage and impulse synergies and collaborative projects.

Besides, it will be presented the map of capacities as well. This interactive environment allows the user to travel geographically through Southwestern Europe searching for research institutions and entities focused on the biomedical sector and 3D printing technologies, as well as research projects working in these fields.

CARDIOPATCH platform will allow joining the network to all the entities interested in it in order to enjoy the project’s services and be able to develop new collaborations and innovation projects.

“With this virtual network, CARDIOPATCH will foster cooperation between the different actors that work in the R&D applied to the biomedical sector in Southwest Europe. The platform is provided by tools and services that will help to create synergies and impulse the networking. It will also be an informative space where the project’s advances in cardiac regenerative medicine will be shared”, explains Felipe Prósper, director of the Navarra University Clinic Cell Therapy Department and project chief scientific officer.

Co-funded by the EU Interreg Sudoe Programme, via the European Regional Development Fund (ERDF), CARDIOPATCH is led by Clínica Universidad de Navarra. The project’s consortium is also made up by CIMA University of Navarra, via the Foundation for Applied Medical Research, the Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau, LEARTIKER technology centre, communication agency GUK, Centre Hospitalier Universitaire de Toulouse, the University of Montpellier (UM) – Institut des Biomolécules Max Mousseron (IBMM), GenIbet Biopharmaceuticals and the Instituto de Biologia Experimental e Tecnológica.

The project also has the support of associate partners Viscofan, Sodena and the Nouvelle-Aquitaine, Euskadi, Navarre Euroregion (NAEN), among others.

An international team with participation of the Cerebrovascular Diseases group at IIB Sant Pau and led by ICFO researchers, has carried out a pooled analysis, combining the results of three studies about the cerebral blood flow in cerebrovascular disease patients. The analysis concludes that the response of their cerebral blood flow to changes of the head-of-bed position can indicate failures in the brain’s autoregulation.

Ischemic stroke and brain self-regulation

Approximately 80% of the strokes that occur are of the ischemic type. An ischemic stroke is a cerebrovascular disease condition, caused by damage in the arteries (a narrowing or blockage of the vessels) that carry blood to the brain. The damage can cause a severe reduction in the blood flow, called ischemia, which can lead to the death of the brain tissue.

Cerebral autoregulation is a biological process working as a neural protection tool, carried out by our bodies to maintain the blood supply to the brain despite blood pressure changes, as occurs during the drug administration after injuries. Although many processes are involved in the cerebral autoregulation, the exact control mechanism is still unknown.

For patients who have suffered cerebrovascular accidents such as stroke, clinicians use different inclinations of the head-of-bed during the early stages of stroke, in order to improve the perfusion of blood flow to the brain. It is a non-invasive technique that does not require patient cooperation and the study of the cerebral response to this procedure may help to estimate  the functioning of the mechanisms of cerebral autoregulation

Previous studies have indicated that approximately 25% of ischemic stroke patients respond to posture changes in an unexpected way. After changing the head-of-bed between lying flat and a degree of inclination, the blood flow of the brain does not return to the initial levels.

Researchers Clara Gregori, Igor Blanco, Peyman Zirak, Lisa Kobayashi, Stella Avtzi, Federica Maruccia and Giacomo Giacalone, led by ICREA Prof. at ICFO Turgut Durduran, have collaborated with researchers of the Cerebrovascular Diseases Group at IIB Sant Pau, consisted in the following neurologists from the Cerebrovascular Diseases Unit in the Hospital de Sant Pau, Pol Camps-Renom, Joan Martí-Fàbregas, Luís Prats-Sánchez and Alejandro Martínez-Domeño, led by Raquel Delgado-Mederos. The analysis, published recently in BMC Neurology, also includes researchers from the University of Pennsylvania, the Massachusetts General Hospital, the University of Campinas, and the Washington University of St. Louis. It investigates the relationship between these changes in blood flow and blood pressure, one of its main drivers.

Meta-analysis of seventy-two patients

To do a proper analysis on the matter, the team gathered data from three different studies, carried out between 2005 and 2017 in the United States and Spain, that included seventy-two patients with cerebrovascular disease. With this data, they performed a systematic analysis of the cerebral blood flow measurements.

All the data was obtained using diffuse correlation spectroscopy (DCS) techniques. The team measured the changes in cerebral blood flow, in response to a specific protocol for handling patients in bed, from three study subgroups: healthy individuals, patients with carotid stenosis (a narrowing of the carotid artery) and patients with ischemic stroke.

The head-of-bed protocol consisted of placing the patients in a supine position – lying on their backs -, then raising the head of the bed to an angle of 30º, and finally returning them to the initial position, maintaining each position for five minutes. During this process, researchers monitored the cerebral blood flow and blood pressure to see if there were any changes in the parameter.

Mobilizing patients could backfire

They analysed the data from all the patients of the subgroups and showed that, in healthy individuals, cerebral blood flow increases when they pass from a supine position to an elevated posture and then decreases to initial levels when they are lying down again. In contrast, in ischemic stroke and carotid stenosis patients, the cerebral blood flow and the blood pressure values do not return to baseline after postural changes.

Researchers observed that, during the first 48 hours after the stroke, the cerebral blood flow of these patients is correlated with the mean arterial pressure, only in the injured hemisphere of the brain.

These two observations suggest that these posture changes in stroke patients may be used to identify deficits or errors in the brain’s autoregulation response.

Helping to improve the management of stroke patients

Early mobilization of patients with ischemic stroke promotes the motor recovery. But the data provided by this analysis could suggest that moving patients during the first hours after the stroke may have an effect on the cerebral blood flow perfusion of the ischemic damage.

To study this issue in-depth, the team of ICFO researchers in collaboration with clinicians from the Hospital de Sant Pau and IIB-Sant Pau will carry out a clinical trial on 200 individuals who have suffered an ischemic stroke. They aim to clarify the role of cerebral autoregulation and provide more information to improve their clinical management.

Reference: Gregori-Pla et al. Blood flow response to orthostatic challenge identifies signatures of the failure of static cerebral autoregulation in patients with cerebrovascular disease. BMC Neurology (2021) 21:154. https://doi.org/10.1186/s12883-021-02179-8

Exheus, a spin-off of the Sant Pau Research Institute – IIB Sant Pau and CREB UPC that analyzes gene expression using artificial intelligence, has received a grant worth 75,000 euros within the framework of ACCIÓ’s ‘Startup Capital’. Startup Capital is a direct grant for emerging technological startups that require financing to set about the initial phases of the business, to develop their product or service and to validate the business model for accessing the market.

Exheus develops a solution that is able to sequence RNA, from a small blood sample, and match gene expression to more than 320 metabolic pathways that act as biomarkers of the parameters of the body. This solution, analyzes all those variations to improve and prevent health problems.

According to Teresa Tarragó, CEO and co-founder of Exheus, “we offer the most advanced health report including all the genes that are expressed in a blood sample. It’s a real time picture that shows what is actually happening inside your body in a particular moment”.

“Our report provides specific recommendations to improve Health, according to the indicators shown in the gene expression analysis”, explains the entrepreneur.

One of Exheus primary goals is to reduce the high-performance sports injuries and improve the associated recovery. Validated in different sports, its technology is being developed and tested with some of the main European clubs and sports centers as well as with runners of the Barcelona Marathon. Apart from their solution oriented to high-performance athletes, they are also providing solutions to improve health amongs general people, through nutrition and wellness. A second solution offers a personalised report including healthy living guidelines.

“Projects such as Exheus highlight the importance of artificial intelligence in the health ecosystem,” said Alexandre Perera, director of the Center for Research in Biomedical Engineering (CREB) at the UPC.

Dr. Jordi Surrallés, director of the Sant Pau Research Institute – IIB Sant Pau, highlighted “the importance of health research to boost not only scientific knowledge and health solutions for citizens and patients but to create business and economic value.” He also stated: “A country’s commitment to research and innovation will also determine its economic development.”

Exheus was born in June 2020, during the COVID-19 pandemics, as a spin-off of the Institut de Recerca de l’Hospital de la Santa Creu i Sant Pau – IIB Sant Pau and CREB at UPC. The company is currently located at Pier01 in Barcelona and at the Tecnocampus  premises in Mataró.

The first CAR-T immunotherapy drug produced entirely in Sant Pau and administered to the first patient, is part of a clinical trial of the centre itself, pioneer in Europe, of phase I CAR-T immunotherapy / II for the autologous treatment of relapsed / refractory CD30 + classic Hodgkin lymphoma and non-Hodgkin T lymphoma, funded by the Carlos III Health Institute and the Josep Carreras Leukaemia Foundation and the Josep Carreras Leukaemia Research Institute.

The research project is led by Dr. Javier Briones, head of the Cellular Immunotherapy and Gene Therapy Research Group of the Research Institute of the Hospital de la Santa Creu i Sant Pau – IIB-Sant Pau. Briones and his team have designed the CAR-T 30 and performed its pre-clinical development. They are also responsible for the production and quality control of the HSP-CAR-T 30 cells under GMP conditions to be infused into the pacients.

Sant Pau’s CAR-T cells are manufactured from the patient’s own T lymphocytes and by gene therapy they express a receptor to enhance the destruction of the tumour, the “chimeric antigen receptor” for which they are called CAR-T. The CAR-T of Sant Pau is enriched in a type of T lymphocytes called memory T; these cells in the human body are few in number, but extremely efficient and are generated after a primary infection. Memory T lymphocytes are the cells in charge of intervening in the body’s defence in successive infections with the same pathogen.

These cells have a powerful cytotoxic effect, quality of being toxic compared to others that are altered, and they live for many years in our body. “We will select these memory T lymphocytes from the patient himself and equip them with a “weapon” designed to eliminate CD30 antigens in their every detection, which are expressed by lymphoma tumour cells. Thus, in perpetuity, a «detector and eliminator» in the patient’s body would remain for any lymphoma cell that reappeared. Ultimately, it is the genetic modification of the patient’s own T lymphocytes so that they attack cancer cells “, explains Dr. Javier Briones, clinical responsible of the project.

The treatment has been carried out in the Haematology Service of the Hospital de la Santa Creu i Sant Pau, directed by Prof. Jordi Sierra and with the collaboration of the rest of the doctors, nurses, other staff and with the help of a multidisciplinary support team.

In the coming months a second academic CAR-T entirely produced in Sant Pau CD19 will be administered for patients with lymphomas and line B leukaemias, thanks to a 2 million euros grant by the “la Caixa” Foundation.

This scientific and clinical milestone has been possible thanks to the recent accreditation of the clean room to develop advanced therapies at IIB Sant Pau. The Research Institute of the Hospital de la Santa Creu i Sant Pau – IIB Sant Pau, in collaboration with the Banc de Sang i Teixitis de Catalunya, recently obtained the certificate of compliance with the Standards of Correct Manufacture of Advanced Therapy Medicines from the Spanish Agency of Medicines and Medical Devices (AEMPS) from the Ministry of Health, certificate that allows the production and quality control of cellular medicines type CAR-T. The accreditation and equipment at the new clean room will allow the IIB Sant Pau research groups to develop new therapies. In short, it will reinforce and boost translational research in Sant Pau this offering innovative treatments and advanced therapies to the patients.

AVAILABLE VIDEO  HERE (in Spanish).

Thanks to this agreement, a mobile vascular disease assessment service will be promoted. Also, companies will be able to collaborate and help fund research into the fight against vascular diseases.

Sant Pau welcomed the signing of the collaboration agreement between the association Activa’tt per la Salut, linked to the Research Institute of the Hospital de la Santa Creu i Sant Pau, and Foment. The aim of the agreement is to promote knowledge and prevention of diseases such as deep vein thrombosis, pulmonary embolism, chronic venous insufficiency and aortic aneurysms, among others, as well as fundraising for research.

These diseases are the leading cause of death in developed countries. The latest data show that only in Europe there are around 1.5 million thrombosis every year (causing more than 543 thousand deaths) with an estimated direct expenditure of three billion euros a year. Therefore, as stated in the agreement, this pathology is a public health problem that requires a large amount of economic resources.

Thanks to this agreement, a mobile vascular disease assessment service will be promoted, made up of professionals from the Angiology, Vascular and Endovascular Surgery Service of the Hospital de la Santa Creu i Sant Pau, which will visit companies to diagnose and assess the thrombotic risk of their workers and relatives. At the same time, companies will be able to collaborate and help fund research into the fight against vascular diseases carried out at the Research Institute of the Hospital de la Santa Creu i Sant Pau.

Dr. José Manuel Soria, president of Activa’tt per la Salut and director of Genomics of Complex Diseases at the Sant Pau Research Institute, emphasized that “the countries with the most developed research are the ones with the greatest interaction between industry and research institutes. Research is the most efficient investment a society can make”. Dr. Soria added that “this alliance between business and research must allow us to move forward from reactive to predictive medicine. This is our commitment. Every minute a person dies in Europe from thrombosis, research is the best prevention for this scourge.”

For his part, the President of Public Works, Josep Sánchez Llibre, remarked that “this agreement shows how companies together with civil society organizations can be a key active part in the prevention and management of these diseases”. He also encouraged companies to “implement healthy habits programs, to promote and develop knowledge of vascular diseases and to carry out actions for early detection of the disease in the workplace, such as through the mobile vascular disease assessment service”.

The signing ceremony, which took place at the Sant Pau Art Nouveau Site, was also attended by the the manager of the hospital, Dr. Gemma Cray winckel, and the director of the Sant Pau Research Institute, Dr. Jordi Surrallés.

This new unit makes it possible to coordinate and carry out complex clinical trials with drugs in the early development phase, thus studying and offering new treatment opportunities for cancer patients .

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The Sant Pau Art Nouveau Site hosts the “Solidarity Art” Exhibition, from February 26th to March 26th, to benefit the research on Covid-19. We will find works by Silvio Alino, Art is Trash, Carles Azcón, Balu, Lluís Cadafalch, Patricia Cancelo, Luisa Chaves, Josep M. Forcada, Mª José Hernández, Mercedes Roglà and Valiente Creations.

Monday to Saturday from 11 am to 7 pm. Sundays from 11 a.m. to 2 p.m.

Free admission www.santpau.barcelona

A multidisciplinary team of researchers from the University of Calgary, the Sant Pau Research Institute (IIB Sant Pau) and the Institute of Biomedical Research of Barcelona (IIBB-CSIC), and the Polytechnic University of Catalonia – BarcelonaTech (UPC) has identified one of the molecular mechanisms responsible for cardiac alternans, an alteration of the heart rhythm that facilitates the induction of ventricular fibrillation, a potentially lethal type of arrhythmia. This discovery, published today, February 19, in the journal Circulation Research (AHA Journals), opens the door to the development of new pharmacological treatments. 

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An article published in the journal Cancer Research describes a new molecular mechanism that counteracts the immunosuppressive action of macrophages in promoting tumour growth, and provides knowledge of potential interest for designing future therapeutic options against cancer. The new preclinical study, in which researchers from the Sant Pau Research Institute (IIB Sant Pau) have participated, is led by Professor Annabel Valledor, from the Faculty of Biology (UB) and the Institute of Biomedicine of the UB (IBUB).

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The Sant Pau Thoracic Surgery Service is organising the 2nd Refresher Course on the Diagnosis and Treatment of Thymic Tumours. This course offers an update on the theoretical and practical knowledge of the diagnosis and treatment of thymic tumours, with and without diagnosis, of Myasthenia Gravis (MG). Free of charge and in virtual format, it will take place on 4 March.

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The Sant Pau Medical Oncology Service, in collaboration with the Immunology and Inflammatory Diseases Research Group of the Sant Pau Research Institute-IIB, led by Dr. Silvia Vidal, has published an article in the journal Cancer Immunology and Immunotherapy. The article, “Circulating Leukocyte-platelet complex as a Predictive Biomarker for the development of immune-related Adverse events in advanced non-small cell lung cancer patients receiving anti-PD- (L) 1 blocking agents”, is the result of collaboration between the two teams over more than two years, which has led to the identification of a predictive profile of increased risk of adverse effects of immunotherapy treatment in a group of lung cancer patients receiving immunotherapy treatment.

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