Publications by authors named "Aguado J"

Background: Kidney transplant (KT) recipients at intermediate risk for cytomegalovirus (CMV) infection constitute a potential target for individualized prevention strategies informed by the CMV-specific cell-mediated immunity (CMV-CMI). The optimal method for the functional assessment of CMV-CMI in this group remains unclear.

Methods: We included 74 CMV-seropositive KT recipients that did not receive T-cell-depleting induction and were managed by preemptive therapy.

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Background: Multiple studies have shown good results with the use of octogenarian donors in non-HCV recipients and its use is universally accepted worldwide. There are no studies analyzing differences between hepatitis C virus (HCV) and non-HCV recipients transplanted with donors≥80 years in the direct-action antivirals (DAA) period. The rate of liver transplantation (LT) using old donors is still low, and a change in the acceptance of these grafts could increase the liver pool available for LT.

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The QuantiFERON-Monitor assay (QTF-Monitor) is intended to assess innate and adaptive immune responses by quantifying interferon (IFN)-γ release upon whole blood stimulation with a TLR7/8 agonist and an anti-CD3 antibody. We performed the QTF-Monitor in 126 kidney transplant recipients (KTRs) at different points during the first 6 post-transplant months. The primary outcome was overall infection, whereas secondary outcomes included bacterial infection, opportunistic infection and cancer.

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  • Respiratory syncytial virus-associated acute respiratory infection (RSV-ARI) is increasingly affecting adults, leading to serious health issues, as shown in a study of 275 hospitalized patients.
  • In this study, 11.2% of patients experienced poor outcomes, with certain factors increasing their risk, such as cognitive impairment, use of anticoagulants, and low oxygen saturation ratios upon hospital admission.
  • Interestingly, receiving the flu vaccine in the current season was found to reduce the risk of poor outcomes, underscoring the importance of early risk assessment for RSV-ARI in the emergency department.
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  • The study aimed to assess the likelihood of recurrent Clostridioides difficile infection (CDI) in solid-organ transplant (SOT) recipients during the year following their transplant.
  • Researchers analyzed data from 191 SOT patients who had their first CDI episode, finding a 12% recurrence rate and highlighting that severe CDI and metronidazole monotherapy significantly raised this risk.
  • The findings suggest that using metronidazole alone increases the chances of a recurrence, indicating a need for improved treatment strategies to prevent repeated infections in these patients.
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  • The study investigates the genetic factors linked to severe COVID-19, specifically focusing on hospitalized cases in admixed Americans.
  • Researchers conducted the largest genome-wide association study (GWAS) for COVID-19 hospitalization in this population, identifying four significant genetic associations, including two novel loci found in Latin Americans.
  • The findings highlight the importance of including diverse populations in genomic research, aiming to improve understanding of genetic risks associated with COVID-19 across different ethnic groups.
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Background: Preventive management of tuberculosis in liver transplantation (LT) is challenging due to difficulties in detecting and treating latent tuberculosis infection (LTBI). The aim of this study was to analyze the safety and efficacy of a screening strategy for LTBI with the inclusion of moxifloxacin as treatment.

Methods: We performed a retrospective single-center study of all LTs performed between 2016 and 2019 with a minimum 4-year follow-up and a standardized protocol for the evaluation of LTBI.

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Valproic acid (VPA) is an effective and widely used anti-seizure medication but is teratogenic when used during pregnancy, affecting brain and spinal cord development for reasons that remain largely unclear. Here we designed a genetic recombinase-based SOX10 reporter system in human pluripotent stem cells that enables tracking and lineage tracing of Neural Crest cells (NCCs) in a human organoid model of the developing neural tube. We found that VPA induces extensive cellular senescence and promotes mesenchymal differentiation of human NCCs.

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  • * A retrospective study from 2011 to 2020 documented 51 cases of leishmaniasis, revealing a significantly higher incidence in the railway-connected districts of Villaverde and Usera compared to Carabanchel.
  • * Researchers suggest that the rail connection to the outbreak area may explain the increased incidence in Villaverde and Usera, despite no demographic or risk factor differences among the districts.
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  • * A working group has developed new consensus recommendations for CMV management in SOT recipients, integrating recent advancements in cell-mediated immunity monitoring.
  • * These recommendations were rated for their evidence strength and quality using the GRADE system and were formally endorsed by a consensus meeting of experts.
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Background: Infection remains a relevant complication after kidney transplantation (KT). A well-established strategy in modern medicine is the application of bundles of evidence-based practice in clinical settings. The objective of this study is to explore the application of a personalized bundle of measures aimed to reduce the incidence of infection in the first 12 months after KT.

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Article Synopsis
  • - Pneumonia is a common and serious infectious disease, significantly impacting mortality rates and healthcare resources.
  • - The OPENIN Group, comprised of specialists in Infectious Diseases and Microbiology, focuses on improving clinical processes related to pneumonia diagnosis and treatment through a review of existing scientific research.
  • - The group's initial meeting in October 2023 addressed optimizing pneumonia diagnosis, possibly reducing antibiotic treatment duration, and exploring the use of immunomodulatory strategies like steroids, leading to expert recommendations based on their findings.
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Studying the effect of duration of treatment on prognostic outcomes using real-world data is challenging because only people who survive for a long time can receive a treatment for a long time. Specifying a target trial helps overcome such challenge. We aimed to estimate the effect of different durations of treatment with antihypertensive drugs with anticholinergic properties (AC AHT) on the risk of vascular dementia and Alzheimer's disease by emulating a target trial using the UK CPRD GOLD database (2001-2017).

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Ataxia Telangiectasia (AT) is a rare disorder caused by mutations in the ATM gene and results in progressive neurodegeneration for reasons that remain poorly understood. In addition to its central role in nuclear DNA repair, ATM operates outside the nucleus to regulate metabolism, redox homeostasis and mitochondrial function. However, a systematic investigation into how and when loss of ATM affects these parameters in relevant human neuronal models of AT was lacking.

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Introduction: Oxidative stress has been implicated in complications after kidney transplantation (KT), including delayed graft function (DGF) and rejection. However, its role in long-term posttransplant outcomes remains unclear.

Methods: We investigated oxidative damage and antioxidant defense dynamics, and their impact on the graft outcomes, in 41 KT recipients categorized by type of donation over 12 months.

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  • Invasive aspergillosis (IA) is a serious and often fatal condition found in liver transplant recipients, with a 37% mortality rate over 12 weeks.
  • A study involving 62 IA cases and 124 controls identified key risk factors such as systemic antibiotic use and history of pneumonia that contribute to IA occurrence.
  • Factors like Aspergillus colonization and ICU stays significantly increased the risk of mortality among IA cases, while recent use of tacrolimus was found to be protective.
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  • Isavuconazole (ISA) and voriconazole (VORI) are both recommended first-line treatments for invasive aspergillosis, but there hasn't been a direct comparison in solid organ transplant recipients.
  • A study analyzed data from two cohorts of patients treated with either ISA or VORI, focusing on clinical response, mortality rates, adverse events, and treatment discontinuation after 12 weeks.
  • Results showed no significant difference in clinical outcomes between ISA and VORI, but ISA had fewer adverse events and lower rates of treatment discontinuation, indicating better tolerability.
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Due to the severity of CMV infection in immunocompromised individuals the development of a vaccine has been declared a priority. However, despite the efforts made there is no yet a vaccine available for clinical use. We designed an approach to identify new CMV antigens able to inducing a broad immune response that could be used in future vaccine formulations.

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  • Solid organ transplant (SOT) recipients experience poorer vaccine responses and higher complications from COVID-19, but guidelines for their management are unclear.
  • A survey conducted among members of ESCMID and ESOT explored diverse approaches to handling COVID-19 in SOT recipients, covering prevention and treatment for early, late, and persistent cases.
  • The results indicated significant variability in treatment practices among participating physicians, particularly regarding early and late COVID-19 care, while prophylaxis recommendations showed more agreement.
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  • CMV-seropositive kidney transplant recipients (KTRs) with immune protection can still experience CMV infections, prompting researchers to explore potential biomarkers for identifying those at risk.
  • Whole blood miRNA sequencing was conducted, revealing that hsa-miR-125a-5p levels were significantly lower in KTRs who developed CMV viremia within 90 days.
  • hsa-miR-125a-5p may be useful as a biomarker for assessing the risk of CMV reactivation in KTRs, despite the presence of detectable CMV-specific immune responses.
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Background: Performance of active screening for multidrug-resistant Gram-negative bacteria (MDR-GNB) and administration of targeted antibiotic prophylaxis (TAP) in colonized patients undergoing liver (LT) and/or kidney transplantation (KT) are controversial issues.

Methods: Self-administered electronic cross-sectional survey disseminated from January to February 2022. Questionnaire consisted of four parts: hospital/transplant program characteristics, standard screening and antibiotic prophylaxis, clinical vignettes asking for TAP in patients undergoing LT and KT with prior infection/colonization with four different MDR-GNB (extended-spectrum cephalosporin-resistant Enterobacterales [ESCR-E], carbapenem-resistant Enterobacterales [CRE], multidrug-resistant Pseudomonas aeruginosa [MDR-Pa], and carbapenem-resistant Acinetobacter baumannii [CRAb]).

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Solid organ transplant (SOT) recipients have a higher risk of developing invasive mould diseases (IMD). Isavuconazole is a novel broad-spectrum azole active against spp. and Mucor, well tolerated, with an excellent bioavailability and predictable pharmacokinetics, that penetrates in most tissues rapidly, and has few serious adverse effects, including hepatic toxicity.

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Purpose: We investigated the role of fecal calprotectin (FC) and lactoferrin (FL) as predictive biomarkers in Clostridioides difficile infection (CDI).

Methods: We assembled a prospective cohort including all patients with a laboratory-confirmed CDI diagnosis between January and December 2017. FL and FC levels were measured at diagnosis by commercial ELISA and EIA kits.

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Aging is a major risk factor for neurodegenerative diseases, and coronavirus disease 2019 (COVID-19) is linked to severe neurological manifestations. Senescent cells contribute to brain aging, but the impact of virus-induced senescence on neuropathologies is unknown. Here we show that senescent cells accumulate in aged human brain organoids and that senolytics reduce age-related inflammation and rejuvenate transcriptomic aging clocks.

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Introduction: Solid organ transplantation (SOT) and hematopoietic stem cell transplantation (HSCT) recipients are susceptible to cytomegalovirus (CMV) infection. The incidence of refractoriness to antivirals, with or without resistance, is unclear. The purpose of this review was to describe the epidemiology of refractory CMV infection in Spain to understand the current unmet needs.

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