Publications by authors named "Judit Garcia-Villoria"

Article Synopsis
  • In 2015, Catalonia began screening newborns for sickle cell disease (SCD) as part of its newborn screening program, introducing key treatments like penicillin and hydroxyurea.
  • A study of nearly 507,000 newborns from 2015 to 2022 found a significant decrease in age at diagnosis and earlier initiation of treatment for those screened.
  • The screened group experienced fewer SCD-related clinical issues, emergency department visits, and hospitalizations, indicating that the screening program has improved overall health outcomes for affected children.
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Glutaric aciduria type 1 (GA1) is a rare inherited metabolic disorder caused by a deficiency of glutaryl-coenzyme A dehydrogenase (GCDH), with accumulation of neurotoxic metabolites, resulting in a complex movement disorder, irreversible brain damage, and premature death in untreated individuals. While early diagnosis and a lysine restricted diet can extend survival, they do not prevent neurological damage in approximately one-third of treated patients, and more effective therapies are required. Here we report the efficacy of adeno-associated virus 9 (AAV9)-mediated systemic delivery of human GCDH at preventing a high lysine diet (HLD)-induced phenotype in mice.

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  • The use of whole exome and genome sequencing (WES and WGS) has improved the diagnosis of Mendelian disorders, but many patients remain undiagnosed due to challenges in interpreting variants and limitations of WES.
  • Integrating RNA sequencing (RNA-seq) has proven beneficial, particularly for inconclusive WES cases, as demonstrated in a study of three male patients with ATP6AP1-CDG, where RNA-seq helped identify important genetic variants.
  • The study revealed that RNA-seq and WGS can enhance genetic diagnostics and understanding of rare disorders by uncovering deep intronic variants in the ATP6AP1 gene, emphasizing the need for functional validation in routine diagnostic processes.
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Objectives: Early diagnosis of inborn errors of metabolism (IEM) is crucial to ensure early detection of conditions which are treatable. This study reports on targeted metabolomic procedures for the diagnosis of IEM of amino acids, acylcarnitines, creatine/guanidinoacetate, purines/pyrimidines and oligosaccharides, and describes its validation through external quality assessment schemes (EQA).

Methods: Analysis was performed on a Waters ACQUITY UPLC H-class system coupled to a Waters Xevo triple-quadrupole (TQD) mass spectrometer, operating in both positive and negative electrospray ionization mode.

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The gold-standard diagnostic test for peroxisomal disorders (PDs) is plasma concentration analysis of very long-chain fatty acids (VLCFAs). However, this method's time-consuming nature and limitations in cases which present normal VLCFA levels necessitates alternative approaches. The analysis of C26:0-lysophosphatydylcholine (C26:0-LPC) in dried blood spot samples by tandem-mass spectrometry (MS/MS) has successfully been implemented in certain newborn screening programs to diagnose X-linked adrenoleukodystrophy (ALD).

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  • Phenylketonuria (PKU) is a common congenital disorder leading to high levels of phenylalanine, which can cause serious neurological issues; early diagnosis and treatment have significantly improved outcomes.
  • As the first generation of treated PKU patients reaches adulthood, their unique nutritional needs—including enteral nutrition (EN)—are increasingly important, yet guidelines on EN for PKU are lacking.
  • The case study presented shows a successful method of using EN in an adult PKU patient by separately administering protein substitutes and other EN products to prevent nutritional mix-related issues and complications.
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  • Lysinuric protein intolerance (LPI) is a rare genetic metabolic disorder caused by mutations in the SLC7A7 gene, which affects the transport of cationic amino acids and can lead to serious complications during pregnancy.
  • A 28-year-old woman with LPI faced several challenges during her pregnancy, including early miscarriages, food aversion, and increased risks of growth restriction and complications such as preeclampsia.
  • Despite initial concerns about her desire for a natural childbirth without medication, the use of innovative strategies and interdisciplinary teamwork allowed for a successful delivery, highlighting the importance of considering patients' preferences in the context of their medical conditions.
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  • The study focuses on improving newborn screening (NBS) by analyzing dried blood spot (DBS) samples for metabolites through tandem mass spectrometry to reduce false positive (FP) results.
  • Researchers measured 46 metabolites in DBS from various groups, including healthy newborns and those with genetic disorders, validating that 31 metabolites exhibited strong analytical performance.
  • The method shows 100% sensitivity and 74-99% specificity for detecting diseases, enhancing NBS efficiency by decreasing FP rates and diagnosis time while accurately identifying specific organic acidurias and metabolic disorders.
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  • A study was conducted to address the challenges in identifying the effects of variants of uncertain significance (VUS) in genetic diseases, particularly inherited metabolic disorders (IMDs).
  • Researchers developed a CRISPR/Cas9-based method to create knock-in cell models that mimic the effects of specific genetic variants to better understand their functional impact.
  • The approach successfully distinguished pathogenic variants from benign ones, offering a potential alternative to more invasive diagnostic methods like biopsies, and may be applicable to other genetic conditions beyond IMDs.
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CCDC186 protein is involved in the maturation of dense-core vesicles (DCVs) in the trans-Golgi network in neurons and endocrine cells. Mutations in genes involved in DCV regulation, other than , have been described in patients with neurodevelopmental disorders. To date, only one patient, within a large sequencing study of 1000 cases, and a single case report with variants in , had previously been described.

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Peroxisomal biogenesis disorders (PBDs) are a heterogeneous group of genetic diseases. Multiple peroxisomal pathways are impaired, and very long chain fatty acids (VLCFA) are the first line biomarkers for the diagnosis. The clinical presentation of PBDs may range from severe, lethal multisystemic disorders to milder, late-onset disease.

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Article Synopsis
  • - The laboratory conducted a review of the new-born screening (NBS) process to identify subjective steps that could compromise patient outcomes, focusing particularly on classifying dried blood spots (DBS) and assigning haemoglobin patterns.
  • - Inter-rater studies were implemented using dried blood spots to evaluate the reliability of these subjective activities, utilizing Krippendorff's alpha test for assessment, and addressing inconsistencies in criteria used for classification and reporting.
  • - Results showed initial inadequacy in reliability, which improved after enhanced training and reaching a consensus on classification criteria, demonstrating the importance of inter-rater reliability in maintaining NBS quality.
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The biochemical measurement of the CoQ status in different tissues can be performed using HPLC with electrochemical detection (ED). Because the production of the electrochemical cells used with the Coulochem series detectors was discontinued, we aimed to standardize a new HPLC-ED method with new equipment. We report all technical aspects, troubleshooting and its performance in different biological samples, including plasma, skeletal muscle homogenates, urine and cultured skin fibroblasts.

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Purine nucleoside phosphorylase (PNP) deficiency is a rare inherited disorder, resulting in severe combined immunodeficiency. To date, PNP deficiency has been detected in newborn screening only through the use of liquid chromatography tandem mass spectrometry. We report the first case in which PNP deficiency was detected by TREC analysis.

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In the field of laboratory medicine, proficiency testing is a vehicle used to improve the reliability of reported results. When proficiency tests are unavailable for a given analyte, an alternative approach is required to ensure adherence to the International Organization for Standardization (ISO) 15189:2012 standard. In this study, we report the results of a split-sample testing program performed as an alternative to a formal PT.

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Newborn screening (NBS) for severe combined immunodeficiency (SCID) started in Catalonia in January-2017, being the first Spanish and European region to universally include this testing. In Spain, a pilot study with 5000 samples was carried out in Seville in 2014; also, a research project with about 35,000 newborns will be carried out in 2021-2022 in the NBS laboratory of Eastern Andalusia. At present, the inclusion of SCID is being evaluated in Spain.

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Background: Alteration of vitamin B metabolism can be genetic or acquired, and can result in anemia, failure to thrive, developmental regression and even irreversible neurologic damage. Therefore, early diagnosis and intervention is critical. Most of the neonatal cases with acquired vitamin B deficiency have been detected by clinical symptoms and only few of them trough NBS programs.

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  • Acute intermittent porphyria (AIP) is a rare metabolic disorder caused by specific gene mutations, leading to elevated total homocysteine (tHcy) levels in many patients.
  • In a study with 37 AIP patients, 68% exhibited hyperhomocysteinemia (HHcy), particularly those with recurrent symptoms on heme arginate treatment, showing significant variations in tHcy levels over time.
  • The study found that along with high tHcy, patients had low levels of key nutrients like pyridoxal-5'-phosphate and folate, and notable increases in other amino acids after starting givosiran treatment, suggesting a complex link between AIP treatment and metabolic changes.
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Article Synopsis
  • Severe combined immunodeficiency (SCID) is a critical T-cell immunodeficiency that can be detected at birth through T-cell receptor excision circles (TREC) in blood samples, allowing for faster intervention and improved life expectancy.
  • Catalonia became the first region in Spain and Europe to implement universal newborn screening for SCID in January 2017, using the EnLite Neonatal TREC kit for identification.
  • Out of 222,857 newborns screened by June 2020, three were diagnosed with SCID, while others presented various T-cell issues, demonstrating the importance of including SCID in newborn screening programs.
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The Catalonian Newborn Screening Program (CNSP) began in 1969, in Barcelona. It was promoted by Dr. Juan Sabater Tobella and supported by Barcelona Provincial Council and Juan March Foundation.

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Objective: Newborn screening programmes (NBSP) have experienced a qualitative breakthrough due to the implementation of tandem mass spectrometry. However, the tests used give rise to false positives (FP) generating an excessive request for second samples with the consequent anxiety of the families. In order to avoid this problem several programmes have developed second-tier tests (2TT).

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  • * Protocols were modified, leading to a 36% faster arrival of second samples at the laboratory and a complete elimination of second sample requests for cystic fibrosis detection.
  • * The NSP demonstrated strong leadership during the crisis, achieving greater efficiency and successfully consolidating new processes that improved overall program outcomes.
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Isolated complex I (CI) deficiency is the most common cause of oxidative phosphorylation (OXPHOS) dysfunction. Whole-exome sequencing identified biallelic mutations in NDUFA8 (c.[293G > T]; [293G > T], encoding for an accessory subunit of CI, in two siblings with a favorable clinical evolution.

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