Low-density lipoprotein receptor-related protein 1 (LRP1) as a modulator of the vascular inflammatory response to modified LDL

Low density lipoprotein receptor-related protein 1 (LRP1) is a ubiquitously expressed cell surface receptor that mediates the internalization of more than 40 different ligands and participates in cell signaling. LRP1 plays a key pathophysiological role in the onset, development and thrombotic resolution of the atherosclerotic process due to its role in the intracellular lipid accumulation of vascular smooth muscle cells (VSMCs). During last years, LRP1 has also been proposed as a modulator of the inflammatory phenomenon in atherosclerosis. However, the investigations have obviated the function of LRP1 as a binding receptor of modified-lipids. In addition, the studies that analysed the relation between inflammation and LRP1 are focused on immunological cells from mice models. Whether LRP1 can respond to its modified-LDL ligands developing an inflammatory response in human VSMCs is unknown. Further investigations are, thus, necessary

Methodological considerations for circulating long noncoding RNA quantification

In the past decade, significant resources have been invested in long noncoding RNA (lncRNA) research. Despite the knowledge available, we are far from incorporation of lncRNA into clinical practice. Here, we emphasize the technical challenges in the field, hoping to provoke a response leading to new consensus and guidelines

A blood microRNA classifier for the prediction of ICU mortality in COVID-19 patients: a multicenter validation study.

Background The identification of critically ill COVID-19 patients at risk of fatal outcomes remains a challenge. Here, we first validated candidate microRNAs (miRNAs) as biomarkers for clinical decision-making in critically ill patients. Second, we constructed a blood miRNA classifier for the early prediction of adverse outcomes in the ICU. Methods This was a multicenter, observational and retrospective/prospective study including 503 critically ill patients admitted to the ICU from 19 hospitals. qPCR assays were performed in plasma samples collected within the first 48 h upon admission. A 16-miRNA panel was designed based on recently published data from our group. Results Nine miRNAs were validated as biomarkers of all-cause in-ICU mortality in the independent cohort of critically ill patients (FDR < 0.05). Cox regression analysis revealed that low expression levels of eight miRNAs were associated with a higher risk of death (HR from 1.56 to 2.61). LASSO regression for variable selection was used to construct a miRNA classifier. A 4-blood miRNA signature composed of miR-16-5p, miR-192-5p, miR-323a-3p and miR-451a predicts the risk of all-cause in-ICU mortality (HR 2.5). Kaplan‒Meier analysis confirmed these findings. The miRNA signature provides a significant increase in the prognostic capacity of conventional scores, APACHE-II (C-index 0.71, DeLong test p-value 0.055) and SOFA (C-index 0.67, DeLong test p-value 0.001), and a risk model based on clinical predictors (C-index 0.74, DeLong test-p-value 0.035). For 28-day and 90-day mortality, the classifier also improved the prognostic value of APACHE-II, SOFA and the clinical model. The association between the classifier and mortality persisted even after multivariable adjustment. The functional analysis reported biological pathways involved in SARS-CoV infection and inflammatory, fibrotic and transcriptional pathways. Conclusions A blood miRNA classifier improves the early prediction of fatal outcomes in critically ill COVID-19 patients.post-print3224 K

Asymmetric organocatalytic synthesis of tertiary azomethyl alcohols: key intermediates towards azoxy compounds and α-hydroxy-β-amino esters

A series of peracylated glycosamine-derived thioureas have been synthesized and their behavior as bifunctional organocatalysts has been tested in the enantioselective nucleophilic addition of formaldehyde tert-butyl hydrazone to aliphatic α-keto esters for the synthesis of tertiary azomethyl alcohols. Using the 1,3,4,6-tetra-O-acetyl-2-amino-2-deoxy-β-d-glucosamine derived 3,5-bis-(trifluoromethyl)phenyl thiourea the reaction could be accomplished with high yields (75-98%) and moderate enantioselectivities (50-64% ee). Subsequent high-yielding and racemization-free tranformations of both aromatic- and aliphatic-substituted diazene products in a one pot fashion provide a direct entry to valuable azoxy compounds and α-hydroxy-β-amino esters.Ministerio de Economía y Competitividad CTQ2016-76908-C2-1-P, CTQ2016- 76908-C2-2-P, contract RYC-2012-10014 for G. de G.European Funds FEDERJunta de Andalucía 2012/FQM 107

Development of circulating microRNA-based biomarkers for medical decision-making : a friendly reminder of what should NOT be done

Circulating cell-free microRNAs (miRNAs) represent a major reservoir for biomarker discovery. Unfortunately, their implementation in clinical practice is limited due to a profound lack of reproducibility. The great technical variability linked to major pre-analytical and analytical caveats makes the interpretation of circulating cell-free miRNA data challenging and leads to inconsistent findings. Additional efforts directed to standardization are fundamental. Several well-established protocols are currently used by independent groups worldwide. Nonetheless, there are some specific aspects in specimen collection and processing, sample handling, miRNA quantification, and data analysis that should be considered to ensure reproducibility of results. Here, we have addressed this challenge using an alternative approach. We have highlighted and discussed common pitfalls that negatively impact the robustness of circulating miRNA quantification and their application for clinical decision-making. Furthermore, we provide a checklist usable by investigators to facilitate and ensure the control of the whole miRNA quantification and analytical process. We expect that these recommendations improve the reproducibility of findings, and ultimately, facilitate the incorporation of circulating miRNA profiles into clinical practice as the next generation of disease biomarkers.Peer reviewe

Consensus guidelines for the validation of qRT-PCR assays in clinical research by the CardioRNA consortium

Despite promising findings, quantitative PCR (qPCR)-based tests for RNA quantification have experienced serious limitations in their clinical application. The noticeable lack of technical standardization remains a huge obstacle in the translation of qPCR-based tests. The incorporation of qPCR-based tests into the clinic will benefit from guidelines for clinical research assay validation. This will ultimately impact the clinical management of the patient, including diagnosis, prognosis, prediction, monitoring of the therapeutic response, and evaluation of toxicity. However, clear assay validation protocols for biomarker investigation in clinical trials using molecular assays are currently lacking. Here, we will focus on the necessary steps, including sample acquisition, processing and storage, RNA purification, target selection, assay design, and experimental design, that need to be taken toward the appropriate validation of qRT-PCR assays in clinical research. These recommendations can fill the gap between research use only (RUO) and in vitro diagnostics (IVD). Our contribution provides a tool for basic and clinical research for the development of validated assays in the intermediate steps of biomarker research. These guidelines are based on the current understanding and consensus within the EU-CardioRNA COST Action consortium (www. cardiorna.eu). Their applicability encompasses all clinical areas.Peer reviewe

Circulating microRNA profiles predict the severity of COVID-19 in hospitalized patients

We aimed to examine the circulating microRNA (miRNA) profile of hospitalized COVID-19 patients and evaluate its potential as a source of biomarkers for the management of the disease. This was an observational and multicenter study that included 84 patients with a positive nasopharyngeal swab Polymerase chain reaction (PCR) test for SARS-CoV-2 recruited during the first pandemic wave in Spain (March-June 2020). Patients were stratified according to disease severity: hospitalized patients admitted to the clinical wards without requiring critical care and patients admitted to the intensive care unit (ICU). An additional study was completed including ICU nonsurvivors and survivors. Plasma miRNA profiling was performed using reverse transcription polymerase quantitative chain reaction (RT-qPCR). Predictive models were constructed using least absolute shrinkage and selection operator (LASSO) regression. Ten circulating miRNAs were dysregulated in ICU patients compared to ward patients. LASSO analysis identified a signature of three miRNAs (miR-148a-3p, miR-451a and miR-486-5p) that distinguishes between ICU and ward patients [AUC (95% CI) = 0.89 (0.81-0.97)]. Among critically ill patients, six miRNAs were downregulated between nonsurvivors and survivors. A signature based on two miRNAs (miR-192-5p and miR-323a-3p) differentiated ICU nonsurvivors from survivors [AUC (95% CI) = 0.80 (0.64–0.96)]. The discriminatory potential of the signature was higher than that observed for laboratory parameters such as leukocyte counts, C-reactive protein (CRP) or D-dimer [maximum AUC (95% CI) for these variables = 0.73 (0.55–0.92)]. miRNA levels were correlated with the duration of ICU stay. Specific circulating miRNA profiles are associated with the severity of COVID-19. Plasma miRNA signatures emerge as a novel tool to assist in the early prediction of vital status deterioration among ICU patients.Supported by ISCIII (CIBERESUCICOVID, COV20/00110), co-funded by ERDF, “Una manera de hacer Europa”. DdGC acknowledges receiving financial support from Instituto de Salud Carlos III (ISCIII), Miguel Servet 2020 (CP20/00041), co-funded by the European Social Fund (ESF), “Investing in your future”. LP is the recipient of a predoctoral fellowship from the Ministry of Universities of Spain (FPU19/03526). This work partially supported by IRBLleida Biobank (B.0000682) and “Plataforma Biobancos PT17/0015/0027/”.Peer Reviewed"Article signat per 33 autors/es: David de Gonzalo-Calvo, Iván D. Benítez, Lucía Pinilla, Amara Carratalá, Anna Moncusí-Moix, Clara Gort-Paniello, Marta Molinero, Jessica González, Gerard Torres, María Bernal, Silvia Pico, Raquel Almansa, Noelia Jorge, Alicia Ortega, Elena Bustamante-Munguira, José Manuel Gómez, Milagros González-Rivera, Dariela Micheloud, Pablo Ryan, Amalia Martinez, Luis Tamayo, César Aldecoa, Ricard Ferrer, Adrián Ceccato, Laia Fernández-Barat, Ana Motos, Jordi Riera, Rosario Menéndez, Dario Garcia-Gasulla, Oscar Peñuelas, Antoni Torres, Jesús F. Bermejo-Martin, Ferran Barbé on behalf of the Ciberesucicovid Project (Cov20/00110, Isciii)"Postprint (author's final draft

Circulating non-coding RNAs in biomarker-guided cardiovascular therapy : A novel tool for personalized medicine?

Current clinical guidelines emphasize the unmet need for technological innovations to guide physician decision-making and to transit from conventional care to personalized cardiovascular medicine. Biomarker-guided cardiovascular therapy represents an interesting approach to inform tailored treatment selection and monitor ongoing efficacy. However, results from previous publications cast some doubts about the clinical applicability of biomarkers to direct individualized treatment. In recent years, the non-coding human transcriptome has emerged as a new opportunity for the development of novel therapeutic strategies and biomarker discovery. Non-coding RNA (ncRNA) signatures may provide an accurate molecular fingerprint of patient phenotypes and capture levels of information that could complement traditional markers and established clinical variables. Importantly, ncRNAs have been identified in body fluids and their concentrations change with physiology and pathology, thus representing promising non-invasive biomarkers. Previous publications highlight the translational applicability of circulating ncRNAs for diagnosis and prognostic stratification within cardiology. Numerous independent studies have also evaluated the potential of the circulating non-coding transcriptome to predict and monitor response to cardiovascular treatment. However, this field has not been reviewed in detail. Here, we discuss the state-of-the-art research into circulating ncRNAs, specifically microRNAs and long non-coding RNAs, to support clinical decision-making in cardiovascular therapy. Furthermore, we summarize current methodological and conceptual limitations and propose future steps for their incorporation into personalized cardiology. Despite the lack of robust population-based studies and technical barriers, circulating ncRNAs emerge as a promising tool for biomarker-guided therapy

Macrophage Cholesterol Efflux Downregulation Is Not Associated with Abdominal Aortic Aneurysm (AAA) Progression

Recent studies have raised the possibility of a role for lipoproteins, including high-density lipoprotein cholesterol (HDLc), in abdominal aortic aneurysm (AAA). The study was conducted in plasmas from 39 large size AAA patients (aortic diameter > 50 mm), 81 small/medium size AAA patients (aortic diameter between 30 and 50 mm) and 38 control subjects (aortic diameter 5 mm per year) in patients with small/medium size AAA. Moreover, no correlation was found between MCE capacity and the aneurysm growth rate. A multivariate Cox regression analysis revealed a significant association between lower MCE capacity with the need for surgery in all AAA patients. Nevertheless, the significance was lost when only small/medium size AAA patients were included. Our results suggest that MCE, a major HDL functional activity, is not involved in AAA progression

One year overview and follow-up in a post-COVID consultation of critically ill patients

The long-term clinical management and evolution of a cohort of critical COVID-19 survivors have not been described in detail. We report a prospective observational study of COVID-19 patients admitted to the ICU between March and August 2020. The follow-up in a post-COVID consultation comprised symptoms, pulmonary function tests, the 6-minute walking test (6MWT), and chest computed tomography (CT). Additionally, questionnaires to evaluate the prevalence of post-COVID-19 syndrome were administered at 1 year. A total of 181 patients were admitted to the ICU during the study period. They were middle-aged (median [IQR] of 61 [52;67]) and male (66.9%), with a median ICU stay of 9 (5–24.2) days. 20% died in the hospital, and 39 were not able to be included. A cohort of 105 patients initiated the follow-up. At 1 year, 32.2% persisted with respiratory alterations and needed to continue the follow-up. Ten percent still had moderate/severe lung diffusion (DLCO) involvement (<60%), and 53.7% had a fibrotic pattern on CT. Moreover, patients had a mean (SD) number of symptoms of 5.7 ± 4.6, and 61.3% met the criteria for post-COVID syndrome at 1 year. During the follow-up, 46 patients were discharged, and 16 were transferred to other consultations. Other conditions, such as emphysema (21.6%), COPD (8.2%), severe neurocognitive disorders (4.1%), and lung cancer (1%) were identified. A high use of health care resources is observed in the first year. In conclusion, one-third of critically ill COVID-19 patients need to continue follow-up beyond 1 year, due to abnormalities on DLCO, chest CT, or persistent symptoms.This study was supported in part by ISCIII (CIBERESUCICOVID, COV20/00110), co-funded by ERDF, “Una manera de hacer Europa,” donation program “Estar Preparados,” UNESPA, Madrid, Spain and Fundación Soria Melguizo (Madrid, Spain). DG-C had received financial support from Instituto de Salud Carlos III (Miguel Servet 2020: CP20/00041), co-funded by the European Social Fund (ESF)/“Investing in your future.” JB acknowledged receiving financial support from Instituto de Salud Carlos III (ISCIII; Miguel Servet 2019: CP19/00108), co-funded by the European Social Fund (ESF), “Investing in your future.”Peer ReviewedArticle signat per 29 autors/es: Jessica González (1,2,3,4), María Zuil (1,2,3,4), Iván D. Benítez (2,3,4), David de Gonzalo-Calvo (2,3,4), María Aguilar (1,2), Sally Santisteve (1,2,3,4), Rafaela Vaca (1,2), Olga Minguez (1,2), Faty Seck (1,2), Gerard Torres (1,2,3,4), Jordi de Batlle (2,3,4), Silvia Gómez (1,2,3,4), Silvia Barril (1,2,3,4), Anna Moncusí-Moix (2,3,4), Aida Monge (1,2,3,4), Clara Gort-Paniello (2,3,4), Ricard Ferrer (4,5), Adrián Ceccato (4), Laia Fernández (4,6), Ana Motos (4,6), Jordi Riera (4,5), Rosario Menéndez (4,7), Darío Garcia-Gasulla (8), Oscar Peñuelas (4,9), Gonzalo Labarca (10,11), Jesús Caballero (12), Carme Barberà (13), Antoni Torres (4,6) and Ferran Barbé (1,2,3,4) * on behalf of the CIBERESUCICOVID Project (COV20/00110, ISCIII) // (1) Department of Pulmonary, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, Spain, (2) Translational Research in Respiratory Medicine Group, Lleida, Spain, (3) Lleida Biomedical Research Institute, Lleida, Spain, (4) Centro de Investigación Biomédica en Red (CIBER) of Respiratory Diseases, Institute of Health Carlos III, Madrid, Spain, (5) Intensive Care Department, Vall d’Hebron Hospital Universitari, Shock, Organ Dysfunction and Resuscitation (SODIR) Research Group, Vall d’Hebron Institut de Recerca, Barcelona, Spain, (6) Department of Pulmonary, Hospital Clinic, Universitat de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain, (7) Department of Pulmonary, University and Polytechnic Hospital La Fe, Valencia, Spain, (8) Barcelona Supercomputing Center, Barcelona, Spain, (9) Hospital Universitario de Getafe, Madrid, Spain, (10) Faculty of Medicine, University of Concepción, Concepción, Chile, (11) Department of Clinical Biochemistry and Immunology, Faculty of Pharmacy, Concepción, Chile, (12) Intensive Care Department, Hospital Universitari Arnau de Vilanova de Lleida, Lleida, Spain, (13) Intensive Care Department, Hospital Universitari Santa Maria de Lleida, Lleida, SpainPostprint (published version