Brain and immune system-derived extracellular vesicles mediate regulation of complement system, extracellular matrix remodeling, brain repair and antigen tolerance in multiple sclerosis

Multiple sclerosis (MS) is an immune-mediated central nervous system disease whose course is unpredictable. Finding biomarkers that help to better comprehend the disease’s pathogenesis is crucial for supporting clinical decision-making. Blood extracellular vesicles (EVs) are membrane-bound particles secreted by all cell types that contain information on the disease’s pathological processes. Purpose: To identify the immune and nervous system-derived EV profile from blood that could have a specific role as biomarker in MS and assess its possible correlation with disease state. Results: Higher levels of T cell-derived EVs and smaller size of neuron-derived EVs were associated with clinical relapse. The smaller size of the oligodendrocyte-derived EVs was related with motor and cognitive impairment. The proteomic analysis identified mannose-binding lectin serine protease 1 and complement factor H from immune system cell-derived EVs as autoimmune disease-associated proteins. We observed hepatocyte growth factor-like protein in EVs from T cells and inter-alpha-trypsin inhibitor heavy chain 2 from neurons as white matter injury-related proteins. In patients with MS, a specific protein profile was found in the EVs, higher levels of alpha-1-microglobulin and fibrinogen β chain, lower levels of C1S and gelsolin in the immune system-released vesicles, and Talin-1 overexpression in oligodendrocyte EVs. These specific MS-associated proteins, as well as myelin basic protein in oligodendrocyte EVs, correlated with disease activity in the patients with MS. Conclusion: Neural-derived and immune-derived EVs found in blood appear to be good specific biomarkers in MSfor reflecting the disease stateWe greatly appreciate the support of Morote Traducciones S.L. for their editing assistance. This work was sponsored by a grant from Miguel Servet (CP20/00024 to Laura Otero-Ortega), Miguel Servet (CPII20/00002 to María Guti´errez-Fernández), a predoctoral fellowship (FI18/00026 to Fernando Laso-García), a Río-Hortega grant (CM22/00065 to Gabriel Torres Iglesias and CM20/00047 to Elisa Alonso-Lopez) and byResearch Project (PI21/00918) from the Instituto de Salud Carlos III and co-funded by the European Union and by a grant CA1/RSUE/2021-00753 to Dolores Piniella funded by Ministerio de Universidades, Plan de Recuperacion, ´ Transformacion ´ y Resiliencia y la Universidad Autónoma de Madri

DUbbing language-therapy CINEma-based in aphasia post-stroke (DULCINEA): study protocol for a randomized crossover pilot trial

Communication is one of the most important predictors of social reintegration after stroke. Approximately 15–42% of stroke survivors experience post-stroke aphasia. Helping people recover from aphasia is one of the research priorities after a stroke. Our aim is to develop and validate a new therapy integrating dubbing techniques to improve functional communication. Methods: The research project is structured as three work packages (WP). WP1: development of the dubbed language cinema-based therapy: Two research assistants (a speech therapist and a dubbing actor) will select the clips, mute specific words/sentences in progressive speech difficulty, and guide patients to dub them across sessions. Words to be dubbed will be those considered to be functionally meaningful by a representative sample of aphasic patients and relatives through an online survey. WP2: a randomized, crossover, interventional pilot study with the inclusion of 54 patients with post-stroke non-fluent aphasia. Patients will be treated individually in 40-min sessions twice per week for 8 weeks. Primary outcomes will be significant pre/post differences in scores in the Communicative Activity Log (CAL) questionnaire and Boston Diagnostic Aphasia Examination (BDAE) administered by a psychologist blinded to the patients’ clinical characteristics. Secondary outcomes: General Health Questionnaire (GHQ)-12, Stroke Aphasia Quality of Life Scale (SAQOL-39), Western Aphasia Battery Revised (WAB-R), and the Stroke Aphasic Depression Questionnaire (SADQ10). WP3: educational activities and dissemination of results. WP3 includes educational activities to improve public knowledge of aphasia and dissemination of the results, with the participation of the Spanish patients’ association Afasia Activa. Discussion: This pilot clinical trial will explore the efficacy of a new therapeutic tool based on dubbing techniques and computer technology to improve functional communication of patients suffering from post-stroke aphasia with the use of standardized test assessmentThis study is promoted by Blanca Fuentes and the Research Foundation of La Paz University Hospital, which hosts a research consortium joined by the Department of Neurology at La Paz University Hospital, the Department of Psychology at Comillas Pontifical University, and the patients’ association Afasia Activa. This project has received funding from “la Caixa” Banking Foundation under the project code HR18-00026. Funder is not involved in any of the following processes: design of the trial, data collection, analysis, or interpretation of data nor than in writing the manuscrip

Modelo experimental de infarto cerebral embólico en ratas: efecto de trombolisi con rt-PA i.v. y de neuroprotección por bloqueo de canales de calcio lacidipino

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Medicina, Departamento de Medicina. Fecha de lectura: 8 de Octubre de 199

Recomendações para o tratamento e a prevenção do AVC, 2004

Introducción: según la Organización Mundial de la Salud, la enfermedad cerebrovascular constituye la tercera causa de muerte y la primera de invalidez en la población adulta en el mundo. Sin embargo, la atención urgente del paciente con ictus, en un centro hospitalario bien dotado de medios materiales y personales (neurólogos expertos) y la aplicación de un programa protocolizado de cuidados, métodos diagnósticos y tratamiento específico (unidades o equipos de ictus) mejora significativamente la evolución de los pacientes afectados. Desarrollo: para difundir las evidencias científicas disponibles acerca del tratamiento y la prevención del ictus, un comité ad hoc de la Sociedad Iberoamericana de Enfermedad Cerebrovascular ha redactado esta guía, que recoge de manera esquemática todas las recomendaciones vigentes, con los niveles de evidencia que las respaldan y el grado de recomendación para cada caso. Conclusiones: este documento pretende servir de apoyo y guía para el tratamiento y la prevención en los pacientes con ictus en todos los países de Iberoamérica, y contribuir a lograr los medios necesarios para mejorar la atención al paciente con ictus en las distintas administraciones sanitarias