Inmunidad innata, silenciamiento génico y defensa antiviral

En esta charla se presentarán los resultados más recientes del grupo en relación a efecto de silenciamiento génico sobre el desarrollo de las infecciones vitales en plantas. El silenciamiento génico es un mecanismo regulador de la expresión génica que actúa sobre los genomas del virus y de la planta. Más allá de su aparente función como mecanismo antiviral, el silenciamiento controla la expresión de genes que definen el signo de las interacción planta-virus. Recientemente hemos aplicado diversas estratégias transcriptómicas que nos permiten selectivamente identificar genes asociados al proceso viral cuya regulación es dependiente de silenciamiento génico. Algunos de estos genes constituyen componentes esenciales en las vías de señalización de la inmunidad innata de las plantas. Los resultados que se presentan ponen de manifiesto la interacción entre estas vías de señalización y la infección vira Nuestros datos sugieren que el efecto antiviral de la maquinaria de silenciamiento radica en gran medida en el control de elementos conservados de la inmunidad de la planta y no tanto en el autosilenciamiento de los genomas virales. En esta charla se presentan además datos relativos a las alteraciones metabólicas asociadas a la infección viral. Este es un aspecto esencial para entender la activación de respuestas de susceptibilidad y/o defensa.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Regulación de la inmunidad en las infecciones virales en plantas

En este seminario se describen los resultados recientes del grupo de Expresión génica y estrés que dirijo en el Centro de Investigaciones Biológicas de Madrid. El tema presentado ilustra el papel que desempeña el silenciamiento génico en la regulación transcripcional y post-transcripcional del gen BIR1durante las infecciones virales en plantas. BIR1 es un represor del sistema inmune basal, cuyo promotor se activa de forma dependiente de ácido salicílico en las hojas infectadas. Su función es relevante en el control de la muerte celular y las defensas de la planta por lo que su pérdida de función se asocia con un fenotipo de muerte celular y resistencia antiviral. BIR1 se regula por un mecanismo epigenético que implica metilación de DNA. El estado de metilación se ve alterado sin embargo enb respuesta a SA o a virus, lo que sugiere la contribución de factores transcripcionales asociados a la infección. BIR1 presenta un patrón característico de degradación de sus RNA mensajeros en plantas infectadas que refleja la actividad de la maquinaria de silenciamiento génico post-transcripcional. La regulación de BIR1 es fundamental para preservar la homeostasis de la planta ya que tanto la pérdida como la ganancia de función de BIR1 provoca graves fenotipos morfológicos y muerte de la planta. Este efecto es dependiente de dosis lo que sugiere que la planta utiliza el silenciamiento transcripcional y post-transcripcional para mantener sus niveles de expresión dentro de un umbral funcional óptimo, más allá del cual se produce una desregulación generalizada de las defensas de la planta.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Comunicación y Productividad en los módulos de atención al público en ESSALUD – Red Sabogal - 2014

La presente investigación tuvo como objetivo general determinar la relación entre la Comunicación y la Productividad en los Módulos de Atención al Público en EsSalud – Red Sabogal - 2014. Para ello se trabajó con toda su población. A los trabajadores se les aplicó una encuesta con 40 ítems. Los resultados de estos instrumentos fueron procesados a través del Software estadístico SPSS (versión 20); se utilizó el coeficiente de correlación de Spearman el cual determinó la correlación positiva de las variables. La población fue conformada por 166 trabajadores utilizando la escala de Likert en una encuesta, que es un tipo básico de investigación del nivel descriptivocorrelacional. La prueba de la hipótesis se realizó a través de la “r” de Spearman, que es una prueba no paramétrica cuyo valor expresa el grado y orientación de relación entre las dos variables. Los resultados de la prueba de hipótesis de Spearman indica un valor de Rs=0.693 y p-valor=0.000<0.05; por lo tanto existe correlación directa y significativa entre la Comunicación y la Productividad de los trabajadores en los Módulos de Atención al Público en EsSalud – Red Sabogal 201

Direct and Indirect Effects of Function in Associated Variables Such as Depression and Severity on Pain Intensity in Women with Carpal Tunnel Syndrome

Objective To determine the direct and indirect effects of function on clinical variables such as age, pain intensity, years of the disease, severity of symptoms, and depression in women with electrodiagnostic and clinical diagnosis of carpal tunnel syndrome (CTS). Design A cross-sectional study. Setting Patients from an urban hospital referred to a university clinic. Methods Two hundred and forty-four (n = 224) women with CTS were included. Demographic and clinical data, duration of symptoms, function, symptom's severity of the symptoms, pain intensity, and depression were self-reported collected. Correlation and path analysis with maximum likelihood estimation were conducted to assess the direct and indirect effect of hand function on pain, age, years with the disease, symptoms severity, and depression. Results Significant positive correlations between function and pain intensity, years with pain and symptoms severity were observed. The path analysis found direct effects from depression, symptoms severity, and years with pain to function (all, P < 0.01). Paths between function and depression on pain intensity (both, P < 0.01) were also observed. The amount of function explained by all predictors was 22%. The indirect effects in the path analysis revealed that function exerted an indirect effect from depression to pain intensity (B = 0.18; P < 0.01), and from symptoms severity to the intensity of pain (B = 0.10; P < 0.01). Overall, the amount of current pain intensity explained by all predictors in the model was R2 = 0.22. Conclusions Our study demonstrated that function mediates the relationship between depression and symptoms severity with pain intensity in women with CTS. Future longitudinal studies will help to determine the clinical implications of these finding

Spectral Clustering Reveals Different Profiles of Central Sensitization in Women with Carpal Tunnel Syndrome

Identification of subgroups of patients with chronic pain provides meaningful insights into the characteristics of a specific population, helping to identify individuals at risk of chronification and to determine appropriate therapeutic strategies. This paper proposes the use of spectral clustering (SC) to distinguish subgroups (clusters) of individuals with carpal tunnel syndrome (CTS), making use of the obtained patient profiling to argue about potential management implications. SC is a powerful algorithm that builds a similarity graph among the data points (the patients), and tries to find the subsets of points that are strongly connected among themselves, but weakly connected to others. It was chosen due to its advantages with respect to other simpler clustering techniques, such as k-means, and the fact that it has been successfully applied to similar problems. Clinical (age, duration of symptoms, pain intensity, function, and symptom severity), psycho-physical (pressure pain thresholds¿PPTs¿over the three main nerve trunks of the upper extremity, cervical spine, carpal tunnel, and tibialis anterior), psychological (depressive levels), and motor (pinch tip grip force) variables were collected in 208 women with clinical/electromyographic diagnosis of CTS, whose symptoms usually started unilaterally but eventually evolved into bilateral symmetry. SC was used to identify clusters of patients without any previous assumptions, yielding three clusters. Patients in cluster 1 exhibited worse clinical features, higher widespread pressure pain hyperalgesia, higher depressive levels, and lower pinch tip grip force than the other two. Patients in cluster 2 showed higher generalized thermal pain hyperalgesia than the other two. Cluster 0 showed less hypersensitivity to pressure and thermal pain, less severe clinical features, and more normal motor output (tip grip force). The presence of subgroups of individuals with different altered nociceptive processing (one group being more sensitive to pressure pain and another group more sensitive to thermal pain) could lead to different therapeutic programs

Multidimensional evaluation of the pain profile as prognostic factor in individuals with hip or knee osteoarthritis receiving total joint replacement:protocol of a 2-year longitudinal prognostic cohort study

INTRODUCTION: Knee and hip osteoarthritis are two highly prevalent musculoskeletal pain conditions. Unsuccessful rates after hip/knee replacement range from 10% to 20%. Subjects with sensitisation manifestations are vulnerable to worse clinical outcomes. Most studies have analysed outcomes up to 1 year after surgery. The aim of this 2-year longitudinal study will be to evaluate sensory-related, psychological and psychophysical pain sensitisation manifestations and a potential epigenetic biomarker as prognostic clinical outcomes for the development of chronic postoperative pain after knee or hip replacement.METHODS AND ANALYSIS: A prospective longitudinal study with a 2-year follow-up period will be conducted. The prognostic variables will include pain, function, related-disability, anxiety, depression, quality of life, sensitisation-associated symptoms, kinesiophobia, neuropathic pain and catastrophising, and expectative of the intervention will be assessed before surgery. We will also evaluate the presence of the Val158Met polymorphism as a possible epigenetic marker. Clinical outcomes including pain, related-disability and self-perceived satisfaction, sensitisation-associated symptoms and neuropathic pain will be assessed 3, 6, 12, 18 and 24 months after surgery. These variables will be used to construct three prediction models: (1) pain and function, (2) sensitisation-associated symptomatology and (3) neuropathic pain features classifying those patients in responders and non-responders. Data from knee or hip osteoarthritis will be analysed separately. Statistical analyses will be conducted with logistic regressions.ETHICS AND DISSEMINATION: The study has been approved by the Ethics Committee of both institutions involved (Hospital Universitario Fundación Alcorcón (HUFA) 19-141 and Universidad Rey Juan Carlos (URJC) 0312201917319). Participants will sign the written informed consent before their inclusion. Study results will be disseminated through peer-reviewed publications and presentations at scientific meetings.</p

Prognostic Factors for Postoperative Chronic Pain after Knee or Hip Replacement in Patients with Knee or Hip Osteoarthritis: An Umbrella Review

Knee and hip osteoarthritis are highly prevalent in the older population. Management of osteoarthritis-related pain includes conservative or surgical treatment. Although knee or hip joint replacement is associated with positive outcomes, up to 30% of patients report postoperative pain in the first two years. This study aimed to synthesize current evidence on prognostic factors for predicting postoperative pain after knee or hip replacement. An umbrella review of systematic reviews was conducted to summarize the magnitude and quality of the evidence for prognostic preoperative factors predictive of postoperative chronic pain (&gt;6 months after surgery) in patients who had received knee or hip replacement. Searches were conducted in MEDLINE, CINAHL, PubMed, PEDro, SCOPUS, Cochrane Library, and Web of Science databases from inception up to 5 August 2022 for reviews published in the English language. A narrative synthesis, a risk of bias assessment, and an evaluation of the evidence confidence were performed. Eighteen reviews (nine on knee surgery, four on hip replacement, and seven on both hip/knee replacement) were included. From 44 potential preoperative prognostic factors, just 20 were judged as having high or moderate confidence for robust findings. Race, opioid use, preoperative function, neuropathic pain symptoms, pain catastrophizing, anxiety, other pain sites, fear of movement, social support, preoperative pain, mental health, coping strategies, central sensitization-associated symptoms, and depression had high/moderate confidence for an association with postoperative chronic pain. Some comorbidities such as heart disease, stroke, lung disease, nervous system disorders, and poor circulation had high/moderate confidence for no association with postoperative chronic pain. This review has identified multiple preoperative factors (i.e., sociodemographic, clinical, psychological, cognitive) associated with postoperative chronic pain after knee or hip replacement. These factors may be used for identifying individuals at a risk of developing postoperative chronic pain. Further research can investigate the impact of using such prognostic data on treatment decisions and patient outcomes.</p