Effects from the Freezing of Either Whole or Crushed Grapes on the Volatile Compounds Contents in Muscat Wines

The transfer of aromatic compounds from the grape skins to the musts has been studied using a process involving freezing whole bunches or crushed grapes for winemaking the Muscat of Alexandria variety (white wine). Subsequently, a prefermentative maceration has been applied to some of the samples. The aromatic profiles of the final wines have been determined using gas chromatography coupled to mass spectrophotometry (GC-MS). The results revealed that, in the trials in which whole grapes were frozen, the final wines had a higher aromatic concentration compared to that of wines obtained by either freezing crushed grapes or obtained with traditional winemaking techniques. Thus, the wines produced from frozen whole grapes were found to exhibit different characteristics from the rest of the wines. The compounds affected by the freezing either of the whole bunches or the crushed grapes were terpenes, acids, and esters. Lower differences were found for wines produced applying prefermentative maceration after the freezing process

Intermediate Molecular Phenotypes to Identify Genetic Markers of Anthracycline-Induced Cardiotoxicity Risk.

Cardiotoxicity due to anthracyclines (CDA) affects cancer patients, but we cannot predict who may suffer from this complication. CDA is a complex trait with a polygenic component that is mainly unidentified. We propose that levels of intermediate molecular phenotypes (IMPs) in the myocardium associated with histopathological damage could explain CDA susceptibility, so variants of genes encoding these IMPs could identify patients susceptible to this complication. Thus, a genetically heterogeneous cohort of mice (n = 165) generated by backcrossing were treated with doxorubicin and docetaxel. We quantified heart fibrosis using an Ariol slide scanner and intramyocardial levels of IMPs using multiplex bead arrays and QPCR. We identified quantitative trait loci linked to IMPs (ipQTLs) and cdaQTLs via linkage analysis. In three cancer patient cohorts, CDA was quantified using echocardiography or Cardiac Magnetic Resonance. CDA behaves as a complex trait in the mouse cohort. IMP levels in the myocardium were associated with CDA. ipQTLs integrated into genetic models with cdaQTLs account for more CDA phenotypic variation than that explained by cda-QTLs alone. Allelic forms of genes encoding IMPs associated with CDA in mice, including AKT1, MAPK14, MAPK8, STAT3, CAS3, and TP53, are genetic determinants of CDA in patients. Two genetic risk scores for pediatric patients (n = 71) and women with breast cancer (n = 420) were generated using machine-learning Least Absolute Shrinkage and Selection Operator (LASSO) regression. Thus, IMPs associated with heart damage identify genetic markers of CDA risk, thereby allowing more personalized patient management.J.P.L.’s lab is sponsored by Grant PID2020-118527RB-I00 funded by MCIN/AEI/10.13039/ 501100011039; Grant PDC2021-121735-I00 funded by MCIN/AEI/10.13039/501100011039 and by the “European Union Next Generation EU/PRTR”, the Regional Government of Castile and León (CSI144P20). J.P.L. and P.L.S. are supported by the Carlos III Health Institute (PIE14/00066). AGN laboratory and human patients’ studies are supported by an ISCIII project grant (PI18/01242). The Human Genotyping unit is a member of CeGen, PRB3, and is supported by grant PT17/0019 of the PE I + D + i 2013–2016, funded by ISCIII and ERDF. SCLl is supported by MINECO/FEDER research grants (RTI2018-094130-B-100). CH was supported by the Department of Defense (DoD) BCRP, No. BC190820; and the National Cancer Institute (NCI) at the National Institutes of Health (NIH), No. R01CA184476. Lawrence Berkeley National Laboratory (LBNL) is a multi-program national laboratory operated by the University of California for the DOE under contract DE AC02-05CH11231. The Proteomics Unit belongs to ProteoRed, PRB3-ISCIII, supported by grant PT17/0019/0023 of the PE I + D +i, 2017–2020, funded by ISCIII and FEDER. RCC is funded by fellowships from the Spanish Regional Government of Castile and León. NGS is a recipient of an FPU fellowship (MINECO/FEDER). hiPSC-CM studies were funded in part by the “la Caixa” Banking Foundation under the project code HR18-00304 and a Severo Ochoa CNIC Intramural Project (Exp. 12-2016 IGP) to J.J.S

Effectiveness of Fosfomycin for the Treatment of Multidrug-Resistant Escherichia coli Bacteremic Urinary Tract Infections

IMPORTANCE The consumption of broad-spectrum drugs has increased as a consequence of the spread of multidrug-resistant (MDR) Escherichia coli. Finding alternatives for these infections is critical, for which some neglected drugs may be an option. OBJECTIVE To determine whether fosfomycin is noninferior to ceftriaxone or meropenem in the targeted treatment of bacteremic urinary tract infections (bUTIs) due to MDR E coli. DESIGN, SETTING, AND PARTICIPANTS This multicenter, randomized, pragmatic, open clinical trial was conducted at 22 Spanish hospitals from June 2014 to December 2018. Eligible participants were adult patients with bacteremic urinary tract infections due to MDR E coli; 161 of 1578 screened patients were randomized and followed up for 60 days. Data were analyzed in May 2021. INTERVENTIONS Patients were randomized 1 to 1 to receive intravenous fosfomycin disodium at 4 g every 6 hours (70 participants) or a comparator (ceftriaxone or meropenem if resistant; 73 participants) with the option to switch to oral fosfomycin trometamol for the fosfomycin group or an active oral drug or pa renteral ertapenem for the comparator group after 4 days. MAIN OUTCOMES AND MEASURES The primary outcome was clinical and microbiological cure (CMC) 5 to 7 days after finalization of treatment; a noninferiority margin of 7% was considered. RESULTS Among 143 patients in the modified intention-to-treat population (median [IQR] age, 72 [62-81] years; 73 [51.0%] women), 48 of 70 patients (68.6%) treated with fosfomycin and 57 of 73 patients (78.1%) treated with comparators reached CMC (risk difference, -9.4 percentage points; 1-sided 95% CI, -21.5 to infinity percentage points; P = .10). While clinical or microbiological failure occurred among 10 patients (14.3%) treated with fosfomycin and 14 patients (19.7%) treated with comparators (risk difference, -5.4 percentage points; 1-sided 95% CI. -infinity to 4.9; percentage points; P = .19), an increased rate of adverse event-related discontinuations occurred with fosfomycin vs comparators (6 discontinuations [8.5%] vs 0 discontinuations; P = .006). In an exploratory analysis among a subset of 38 patients who underwent rectal colonization studies, patients treated with fosfomycin acquired a new ceftriaxone-resistant or meropenem-resistant gram-negative bacteria at a decreased rate compared with patients treated with comparators (0 of 21 patients vs 4 of 17 patients [23.5%]; 1-sided P = .01). CONCLUSIONS AND RELEVANCE This study found that fosfomycin did not demonstrate noninferiority to comparators as targeted treatment of bUTI from MDR E coli; this was due to an increased rate of adverse event-related discontinuations. This finding suggests that fosfomycin may be considered for selected patients with these infections

Educar para los nuevos Medios. Claves para el desarrollo de la competencia mediática en el entorno digital

Educar es una de las labores más complejas, intensas y, a la vez, más maravillosas que puede acometer una persona. Ser docente es una tarea ilusionante. En un mundo en el que la información es cada vez más importante por la rapidez con que se produce y consume, la variedad de recursos con que se difunde constituye un reto en el papel de los educadores y educadoras. La educación para la comunicación, a través de los nuevos medios, requiere de habilidades y estrategias específicas e implica prácticas innovadoras. Este texto ofrece claves para desarrollar la competencia mediática necesaria para entender, usar y comunicar en el entorno digital. Desde el concepto de competencia mediática y la escuela prosumidora se muestran experiencias y planteamientos en distintos niveles educativos y contextos curriculares que ofrecen pistas para educar a la ciudadanía. Esta alfabetización aúna la perspectiva de la experiencia de docente receptor y consumidor, atendiendo a la recepción crítica de la información, la selección y administración de la misma, el reconocimiento de valores e ideologías y la gestión emocional, junto a la elaboración y creación de contenidos

Spread of a SARS-CoV-2 variant through Europe in the summer of 2020

[EN] Following its emergence in late 2019, the spread of SARS-CoV-21,2 has been tracked by phylogenetic analysis of viral genome sequences in unprecedented detail3,4,5. Although the virus spread globally in early 2020 before borders closed, intercontinental travel has since been greatly reduced. However, travel within Europe resumed in the summer of 2020. Here we report on a SARS-CoV-2 variant, 20E (EU1), that was identified in Spain in early summer 2020 and subsequently spread across Europe. We find no evidence that this variant has increased transmissibility, but instead demonstrate how rising incidence in Spain, resumption of travel, and lack of effective screening and containment may explain the variant’s success. Despite travel restrictions, we estimate that 20E (EU1) was introduced hundreds of times to European countries by summertime travellers, which is likely to have undermined local efforts to minimize infection with SARS-CoV-2. Our results illustrate how a variant can rapidly become dominant even in the absence of a substantial transmission advantage in favourable epidemiological settings. Genomic surveillance is critical for understanding how travel can affect transmission of SARS-CoV-2, and thus for informing future containment strategies as travel resumes.S

The first wave of the COVID-19 epidemic in Spain was associated with early introductions and fast spread of a dominating genetic variant

SeqCOVID-Spain consortium: Álvaro Chiner-Oms, Irving Cancino-Muñoz, Mariana G. López, Manuela Torres-Puente, Inmaculada Gómez-Navarro, Santiago Jiménez-Serrano, Jordi Pérez-Tur, Darío García de Viedma, Laura Pérez-Lago, Marta Herranz, Jon Sicilia, Pilar Catalán-Alonso, Julia Suárez González, Patricia Muñoz, Mireia Coscolla, Paula Ruiz-Rodríguez, Fernando González-Candelas, Iñaki Comas, Lidia Ruiz-Roldán, María Alma Bracho, Neris García-González, Llúcia Martínez Priego, Inmaculada Galán-Vendrell, Paula Ruiz-Hueso, Griselda De Marco, María Loreto Ferrús-Abad, Sandra Carbó-Ramírez, Giuseppe D’Auria, Galo Adrian Goig, Juan Alberola, Jose Miguel Nogueira, Juan José Camarena, David Navarro, Eliseo Albert, Ignacio Torres, Maitane Aranzamendi Zaldumbide, Óscar Martínez Expósito, Nerea Antona Urieta, María de Toro, María Pilar Bea-Escudero, Jose Antonio Boga, Cristian Castelló-Abietar, Susana Rojo-Alba, Marta Elena Álvarez-Argüelles, Santiago Melón, Elisa Martró, Antoni E. Bordoy, Anna Not, Adrián Antuori, Anabel Fernández-Navarro, Andrés Canut-Blasco, Silvia Hernáez Crespo, Maria Luz Cordón Rodríguez, Maria Concepción Lecaroz Agara, Carmen Gómez-González, Amaia Aguirre-Quiñonero, José Israel López-Mirones, Marina Fernández-Torres, Maria Rosario Almela-Ferrer, Ana Carvajal, Juan Miguel Fregeneda-Grandes, Héctor Argüello, Gustavo Cilla Eguiluz, Milagrosa Montes Ros, Luis Piñeiro Vázquez, Ane Sorarrain, José María Marimón, José J. Costa-Alcalde, Rocío Trastoy, Gema Barbeito Castiñeiras, Amparo Coira, María Luisa Pérez del Molino, Antonio Aguilera, Begoña Palop-Borrás, Inmaculada de Toro Peinado, Maria Concepción Mediavilla Gradolph, Mercedes Pérez-Ruiz, Mirian Fernández-Alonso, Jose Luis del Pozo, Oscar González-Recio, Mónica Gutiérrez-Rivas, Jovita Fernández-Pinero, Miguel Ángel Jiménez Clavero, Begoña Fuster Escrivá, Concepción Gimeno Cardona, María Dolores Ocete Mochón, Rafael Medina-Gonzalez, José Antonio Lepe, Verónica González Galán, Ángel Rodríguez-Villodres, Nieves Gonzalo Jiménez, Jordi Reina, Carla López-Causapé, Maria Dolores Gómez-Ruiz, Eva M. Gonzalez-Barbera, José Luis López-Hontangas, Vicente Martín, Antonio J. Molina, Tania Fernandez-Villa, Ana Milagro Beamonte, Nieves Felisa Martínez-Cameo, Yolanda Gracia-Grataloup, Rosario Moreno-Muñoz, Maria Dolores Tirado Balaguer, José María Navarro-Marí, Irene Pedrosa-Corral, Sara Sanbonmatsu-Gámez, Antonio Oliver, Mónica Parra Grande, Bárbara Gómez Alonso, Francisco José Arjona Zaragozí, Maria Carmen Pérez González, Francisco Javier Chamizo López, Ana Bordes-Benítez, Núria Rabella, Ferran Navarro, Elisenda Miró, Antonio Rezusta, Alexander Tristancho, Encarnación Simarro Córdoba, Julia Lozano-Serra, Lorena Robles Fonseca, Álex Soriano, Francisco Javier Roig Sena, Hermelinda Vanaclocha Luna, Isabel Sanmartín, Daniel García-Souto, Ana Pequeño-Valtierra, Jose M. C. Tubio, Javier Temes, Jorge Rodríguez-Castro, Martín Santamarina García, Manuel Rodríguez-Iglesias, Fátima Galán-Sanchez, Salud Rodríguez-Pallares, José Manuel Azcona-Gutiérrez, Miriam Blasco-Alberdi, Alfredo Mayor, Alberto L. García-Basteiro, Gemma Moncunill, Carlota Dobaño, Pau Cisteró, Oriol Mitjà, Camila González-Beiras, Martí Vall-Mayans, Marc Corbacho-Monné, Andrea Alemany, Cristina Muñoz-Cuevas, Guadalupe Rodríguez-Rodríguez, Rafael Benito, Sonia Algarate, Jessica Bueno, Andrea Vergara-Gómez, Miguel J. Martínez, Jordi Vila, Elisa Rubio, Aida Peiró-Mestres, Jessica Navero-Castillejos, David Posada, Diana Valverde, Nuria Estévez, Iria Fernández-Silva, Loretta de Chiara, Pilar Gallego-García, Nair Varela, Ulises Gómez-Pinedo, Mónica Gozalo-Margüello, Maria Eliecer Cano García, José Manuel Méndez-Legaza, Jesus Rodríguez-Lozano, María Siller, Daniel Pablo-Marcos, Maria Montserrat Ruiz-García, Antonio Galiana, Judith Sánchez-Almendro, Maria Isabel Gascón Ros, Cristina Juana Torregrosa-Hetland, Eva María Pastor Boix, Paloma Cascales Ramos, Pedro Luis Garcinuño Enríquez, Salvador Raga Borja, Julia González Cantó, Olalla Martínez Macias, Adolfo de Salazar, Laura Viñuela González, Natalia Chueca, Federico García, Cristina Gómez-Camarasa, Amparo Farga Martí, Rocío Falcón, Victoria Domínguez-Márquez, Anna M. Planas, Israel Fernández-Cádenas, Maria Ángeles Marcos, Carmen Ezpeleta, Ana Navascués, Ana Miqueleiz Zapatero, Manuel Segovia, Antonio Moreno-Docón, Esther Viedma, Raúl Recio Martínez, Irene Muñoz-Gallego, Sara Gonzalez-Bodi, Maria Dolores Folgueira, Jesús Mingorance, Elias Dahdouh, Fernando Lázaro-Perona, María Rodríguez-Tejedor, María Pilar Romero-Gómez, Julio García-Rodríguez, Juan Carlos Galán, Mario Rodríguez-Dominguez, Laura Martínez-García, Melanie Abreu Di Berardino, Manuel Ponce-Alonso, Jose Maria González-Alba, Ivan Sanz-Muñoz, Diana Pérez San José, Maria Gil Fortuño, Juan B. Bellido-Blasco, Alberto Yagüe Muñoz, Noelia Hernández Pérez, Helena Buj Jordá, Óscar Pérez Olaso, Alejandro González Praetorius, Nora Mariela Martínez Ramírez, Aida Ramírez Marinero, Eduardo Padilla León, Alba Vilas Basil, Mireia Canal Aranda, Albert Bernet Sánchez, Alba Bellés Bellés, Eric López González, Iván Prats Sánchez, Mercè García-González, Miguel José Martínez-Lirola, Manuel Ángel Rodríguez Maresca, Maria Teresa Cabezas Fernández, María Eugenia Carrillo Gil, Maria Paz Ventero Martín, Carmen Molina Pardines, Nieves Orta Mira, María Navarro Cots, Inmaculada Vidal Catalá, Isabel García Nava, Soledad Illescas Fernández-Bermejo, José Martínez-Alarcón, Marta Torres-Narbona, Cristina Colmenarejo, Lidia García-Agudo, Jorge A. Pérez García, Martín Yago López, María Ángeles Goberna Bravo, Victoria Simón García, Gonzalo Llop Furquet, Agustín Iranzo Tatay, Sandra Moreno-Marro, Noelia Lozano Rodríguez, Amparo Broseta Tamarit, Juan José Badiola Díez, Amparo Martínez-Ramírez, Ana Dopazo, Sergio Callejas, Alberto Benguría, Begoña Aguado, Antonio Alcamí, Marta Bermejo Bermejo, Ricardo Ramos-Ruíz, Víctor Manuel Fernández Soria, Fernando Simón Soria & Mercedes Roig CardellsThe coronavirus disease 2019 (COVID-19) pandemic has affected the world radically since 2020. Spain was one of the European countries with the highest incidence during the first wave. As a part of a consortium to monitor and study the evolution of the epidemic, we sequenced 2,170 samples, diagnosed mostly before lockdown measures. Here, we identified at least 500 introductions from multiple international sources and documented the early rise of two dominant Spanish epidemic clades (SECs), probably amplified by superspreading events. Both SECs were related closely to the initial Asian variants of SARS-CoV-2 and spread widely across Spain. We inferred a substantial reduction in the effective reproductive number of both SECs due to public-health interventions (Re < 1), also reflected in the replacement of SECs by a new variant over the summer of 2020. In summary, we reveal a notable difference in the initial genetic makeup of SARS-CoV-2 in Spain compared with other European countries and show evidence to support the effectiveness of lockdown measures in controlling virus spread, even for the most successful genetic variants.This work was mainly funded by the Instituto de Salud Carlos III project COV20/00140, with additional funding by Spanish National Research Council project CSIC-COV19-021, Ministerio de Ciencia project PID2019-104477RB-100, ERC StG 638553 and ERC CoG 101001038 to I.C., and BFU2017-89594R to F.G.C. M.C. is supported by Ramón y Cajal program from Ministerio de Ciencia and grants RTI2018-094399-A-I00 and Generalitat Valenciana (Regional Government) project SEJI/2019/011. We gratefully acknowledge Hospital Universitari Vall d’Hebron, Instituto de Salud Carlos III, IrsiCaixa AIDS Research Lab and all the international researchers and institutions that submitted sequenced SARS-CoV-2 genomes to the GISAID’s EpiCov Database (Supplementary Table 1), as an important part of our analyses has been made possible by the sharing of their work. We also thank Unidad de Bioinformática y Estadística, Centro de Investigación Príncipe Felipe, for allowing us to use the Computer Cluster to perform some of the bioinformatic analysis.Peer reviewe

Effects from the Freezing of Either Whole or Crushed Grapes on the Volatile Compounds Contents in Muscat Wines

The transfer of aromatic compounds from the grape skins to the musts has been studied using a process involving freezing whole bunches or crushed grapes for winemaking the Muscat of Alexandria variety (white wine). Subsequently, a prefermentative maceration has been applied to some of the samples. The aromatic profiles of the final wines have been determined using gas chromatography coupled to mass spectrophotometry (GC-MS). The results revealed that, in the trials in which whole grapes were frozen, the final wines had a higher aromatic concentration compared to that of wines obtained by either freezing crushed grapes or obtained with traditional winemaking techniques. Thus, the wines produced from frozen whole grapes were found to exhibit different characteristics from the rest of the wines. The compounds affected by the freezing either of the whole bunches or the crushed grapes were terpenes, acids, and esters. Lower differences were found for wines produced applying prefermentative maceration after the freezing process

The first wave of the Spanish COVID-19 epidemic was associated with early introductions and fast spread of a dominating genetic variant

The COVID-19 pandemic has shaken the world since the beginning of 2020. Spain is among the European countries with the highest incidence of the disease during the first pandemic wave. We established a multidisciplinar consortium to monitor and study the evolution of the epidemic, with the aim of contributing to decision making and stopping rapid spreading across the country. We present the results for 2170 sequences from the first wave of the SARS-Cov-2 epidemic in Spain and representing 12% of diagnosed cases until 14th March. This effort allows us to document at least 500 initial introductions, between early February-March from multiple international sources. Importantly, we document the early raise of two dominant genetic variants in Spain (Spanish Epidemic Clades), named SEC7 and SEC8, likely amplified by superspreading events. In sharp contrast to other non-Asian countries those two variants were closely related to the initial variants of SARS-CoV-2 described in Asia and represented 40% of the genome sequences analyzed. The two dominant SECs were widely spread across the country compared to other genetic variants with SEC8 reaching a 60% prevalence just before the lockdown. Employing Bayesian phylodynamic analysis, we inferred a reduction in the effective reproductive number of these two SECs from around 2.5 to below 0.5 after the implementation of strict public-health interventions in mid March. The effects of lockdown on the genetic variants of the virus are reflected in the general replacement of preexisting SECs by a new variant at the beginning of the summer season. Our results reveal a significant difference in the genetic makeup of the epidemic in Spain and support the effectiveness of lockdown measures in controlling virus spread even for the most successful genetic variants. Finally, earlier control of SEC7 and particularly SEC8 might have reduced the incidence and impact of COVID-19 in our country.This work was funded by the Instituto de Salud Carlos III project COV20/00140, Spanish 593 National Research Council project CSIC-COV19-021 and ERC StG 638553 to IC, and BFU2017- 594 89594R to FGC. MC is supported by Ramón y Cajal program from Ministerio de Ciencia and 595 grants RTI2018-094399-A-I00 and SEJI/2019/011. 596 We gratefully acknowledge Hospital Universitari Vall d'Hebron, Instituto de Salud Carlos 597 III, IrsiCaixa AIDS Research Lab and all the international researchers and institutions that 598 submitted sequenced SARS-CoV-2 genomes to the GISAID’s EpiCov™ Database, as an 599 important part of our analyses have been made possible by the share of their work.N

Datasets related to a study aimed to identify genetic markers of CDA by subphenotypes associated with cardiotoxicity

Who produced the data? The data has been created by the authors listed above. Is the title specific enough? "Datasets related to a study aimed to identify genetic markers of CDA by subphenotypes associated with cardiotoxicity." Why has the data been created? These datasets are supplementary material with which the principal and supplementary figures and tables of our indicated work were generated. What limitations do the data have (for example, sensitive data has been deleted)? All confidential patient information is not present. We have not had access to that information, following current legal regulations. How should the data be interpreted? These data sets should not be separated from the main article in which they were utilized. Thus, to better understand their context, researchers should see them in the global scenario of our work. Are there gaps in the data, or do they give a complete picture of the topic studied? As indicated above, data should be considered and interpreted in the global context of our study. What processes have generated the data? The processes that generated the data are indicated in the summary of the data above and individually for each of them. Thus, each dataset is accompanied by a legend within the document. What does the data measure in the columns of the files? As indicated, each dataset individually shows the information contained in the legend of each dataset. What software is required to be able to read the data? The datasets are in Excel format. How should the data be quoted? Researchers should cite the data in the context of the work they belong to once it is published and free of the embargo. Can the data be reused? What use licenses are assigned to you? In principle, yes. If additional clinical information is required, these data were previously published by some of us, and the references are included in our manuscript. These data are available from the principal investigators of the references listed in our work upon reasonable request. Are there more versions of the data? Where? I do not think so beyond our files and copies. Have the technical terms and acronyms referenced by the data been defined? A legend with the appropriate descriptions accompanies each dataset. Have the geographic and chronological parameters of the data been qualified? The authors of the work have generated the data. Elsewhere, we indicate the authors of the work, their contributions, and affiliations. Are keywords sufficiently data-specific? Are they based on any thesaurus? Keywords are based on our study. We include cardiotoxicity due to anthracyclines, missing heritability, subphenotype, pathophenotype, complex trait. What is the name of the research project in which the data are framed? The main research project in which the data is prepared is: Títle: "Chemotherapy cardiotoxicity in the elderly: a translational and personnel approach." Ref.: PIE14/00066 Who has financed data production and management? Each of the authors of the study has its funding. The grants are included in the acknowledgments section of our manuscript.Here we present a series of supplemental datasets that complement our study entitled "A Systems Genetics approach to identify genetic markers of cardiotoxicity due to anthracyclines in cancer patients." The datasets presented here were used to generate the main and supplementary figures and tables of the indicated study. The study consists of the identification of genetic markers of cardiotoxicity due to anthracyclines (CDA). CDA is a complex genesis disease or complex trait, and because of this, there is a component of missing heritability. Therefore, it is not possible to identify genetic markers associated with CDA risk. Here, we propose that molecular subphenotypes associated with the CDA may be a strategy for identifying some of this missing heritability and risk markers associated with it. A similar strategy could be applied to identify markers of other diseases of complex genesis. This study is done using a genetically heterogeneous cohort of mice that developed breast cancer and was treated with doxorubicin or a combined treatment of doxorubicin and docetaxel. The mouse cohort was generated by backcrossing, so each mouse is genetically unique. Post-chemotherapy heart damage was assessed by quantifying fibrosis's cardiac area and the thickness of myocardial fibers. The genetic regions associated with CDA were assessed by massive genotyping and genetic linkage analysis. Several molecular subphenotypes were quantified in the myocardium, and their association with the CDA was evaluated. Subsequently, we identified which of them were most statistically associated with CDA in multivariate models. Moreover, which complex trait loci (QTLs) associated with molecular subphenotypes best explained CDA. This strategy served to identify in the cohort of mice genes whose allelic forms could be candidates for the risk of CDA. Allelic variants of these genes were evaluated in four cohorts of cancer patients treated with anthracyclines and whose CDA was evaluated by echocardiography or cardiac magnetic resonance imaging (CMR).JPL laboratory was partially supported by the European Regional Development Fund (ERDF) and the Ministry of Science, Innovation, and Universities (SAF2014-56989-R, SAF2017-88854R), the Carlos III Health Institute (PIE14/00066), "Proyectos Integrados IBSAL 2015" (IBY15/00003), the Regional Government of Castile and Leon (CSI234P18), and "We can be heroes" Foundation. AGN laboratory and human patients' study are supported by funds from the ISCIII project grant (PI18/01242). The Human Genotyping unit is a member of CeGen, PRB3, and is supported by grant PT17/0019, of the PE I+D+i 2013-2016, funded by ISCIII and ERDF. SCLL was the recipient of a Ramón y Cajal research contract from the Spanish Ministry of Economy and Competitiveness, and the work was supported by MINECO/FEDER research grants (RTI2018-094130-B-100). The Proteomics Unit belongs to ProteoRed, PRB3-ISCIII, supported by grant PT17/0019/0023, of the PE I + D + I 2017-2020, funded by ISCIII and FEDER. RCC is funded by fellowships from the Spanish Regional Government of Castile and León. NGS is a recipient of an FPU fellowship (MINECO/FEDER). hiPSC-CM studies were funded in part by the "la Caixa" Banking Foundation under the project code HR18-00304" and Severo Ochoa CNIC Intramural Project (Expediente 12-2016 IGP) to JJ.Supplemental Dataset 1: CDA pathophenotypes after doxorubicin treatment. We treated 71 mice carrying breast cancer with doxorubicin. Each mouse was generated by backcrossing; thus, each one is genetically unique. Cardiotoxicity due to anthracyclines (CDA) was evaluated by automatically quantifying the heart fibrosis area and the average area of myocardial fibers as pathophenotypes of cardiotoxicity using the Ariol slide scanner. The histopathological damage was evaluated in the subendocardium and subepicardium from five randomly chosen regions of each sample (averages in μm2 are shown).-- Supplemental Dataset 2: CDA pathophenotypes after the combined therapy. We treated 61 mice carrying breast cancer with the combined therapy with doxorubicin and docetaxel. Each mouse was generated by backcrossing; thus, each one is genetically unique. Cardiotoxicity due to anthracyclines (CDA) was evaluated by automatically quantifying the heart fibrosis area and the average area of myocardial fibers as pathophenotypes of cardiotoxicity using the Ariol slide scanner. The histopathological damage was evaluated in the subendocardium and subepicardium from five randomly chosen regions of each sample (averages in μm2 are shown).-- Supplemental Dataset 3: CDA subphenotypes after doxorubicin therapy. Myocardium molecular subphenotypes after doxorubicin therapy. Proteins were quantified by a multiplex bead array (Luminex). TGFβ units are shown in pg/mL. The rest of the protein levels are shown in molecular fluorescence intensity (MFI) Units. The telomeric length was quantified by QPCR (RQ units). miRNAs were quantified by QPCR (RQ units). QPCR analyses were assessed by the ΔΔCT method; we show the averages of triplicates.-- Supplemental Dataset 4: CDA subphenotypes after the combined therapy. Myocardium molecular subphenotypes after the combined therapy with doxorubicin and docetaxel. Proteins were quantified by a multiplex bead array (Luminex). TGFβ units are shown in pg/mL. The rest of the protein levels are shown in molecular fluorescence intensity (MFI) Units. The telomeric length was quantified by QPCR (RQ units). miRNAs were quantified by QPCR (RQ units). QPCR analyses were assessed by the ΔΔCT method; we show the averages of triplicates.-- Supplemental Dataset 5: Correlations identified between molecular subphenotype levels in the myocardium and pathophenotypes of cardiotoxicity due to anthracyclines (CDA) after doxorubicin therapy in all mice.-- Supplemental Dataset 6: Correlations identified between molecular subphenotype levels in the myocardium and pathophenotypes of cardiotoxicity due to anthracyclines (CDA) after doxorubicin therapy in young mice. Correlation of Spearman.-- Supplemental Dataset 7: Correlations identified between molecular subphenotype levels in the myocardium and pathophenotypes of cardiotoxicity due to anthracyclines (CDA) after doxorubicin therapy in old mice. Correlation of Spearman.-- Supplemental Dataset 8: Correlations identified between molecular subphenotype levels in the myocardium and pathophenotypes of cardiotoxicity due to anthracyclines (CDA) after the combined therapy in all mice. Correlation of Spearman.-- Supplemental Dataset 9: Correlations identified between molecular subphenotype levels in the myocardium and pathophenotypes of cardiotoxicity due to anthracyclines (CDA) after the combined therapy in young mice. Correlation of Spearman.-- Supplemental Dataset 10: Correlations identified between molecular subphenotype levels in the myocardium and pathophenotypes of cardiotoxicity due to anthracyclines (CDA) after the combined therapy in old mice. Correlation of Spearman.-- Supplemental Dataset 11: Linkage analysis of molecular subphenotype levels quantified in the myocardium. Lod scores after doxorubicin therapy in all mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 12: Linkage analysis of molecular subphenotype levels quantified in the myocardium. Lod scores after doxorubicin therapy in young mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 13: Linkage analysis of molecular subphenotype levels quantified in the myocardium. Lod scores after doxorubicin therapy in old mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 14: Linkage analysis of molecular subphenotype levels quantified in the myocardium. Lod scores after the combined therapy in all mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 15: Linkage analysis of molecular subphenotype levels quantified in the myocardium. Lod scores after the combined therapy in young mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 16: Linkage analysis of molecular subphenotype levels quantified in the myocardium. Lod scores after the combined therapy in old mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 17: Massive genotyping of mouse cohort treated with doxorubicin. The genome-wide scan was carried out at the Spanish National Centre of Genotyping (CeGEN) at the Spanish National Cancer Research Centre (CNIO, Madrid, Spain). The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution.-- Supplemental Dataset 18: Massive genotyping of mouse cohort treated with the combined therapy. The genome-wide scan was carried out at the Spanish National Centre of Genotyping (CeGEN) at the Spanish National Cancer Research Centre (CNIO, Madrid, Spain). The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution.-- Supplemental Dataset 19: Linkage analysis of CDA pathophenotypes quantified in the myocardium. Lod scores after doxorubicin therapy in all mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 20: Linkage analysis of CDA pathophenotypes quantified in the myocardium. Lod scores after doxorubicin therapy in young mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 21: Linkage analysis of CDA pathophenotypes quantified in the myocardium. Lod scores after doxorubicin therapy in old mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 22: Linkage analysis of CDA pathophenotypes quantified in the myocardium. Lod scores after the combined therapy in all mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 23: Linkage analysis of CDA pathophenotypes quantified in the myocardium. Lod scores after the combined therapy in young mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 24: Linkage analysis of CDA pathophenotypes quantified in the myocardium. Lod scores after the combined therapy in old mice. The Illumina Mouse Medium Density Linkage Panel Assay was used to genotype 130 F1BX mice at 1449 single nucleotide polymorphisms (SNPs). Genotypes were classified as FVB/FVB (F/F) or FVB/C57BL/6 (F/B). Ultimately, 806 SNPs are informative from the FVB and C57BL/6 mice; the average genomic distance between these SNPs was 9.9 Mb. The genotype proportion among the F1BX mice showed a normal distribution. Linkage analysis was carried out using interval mapping with the expectation-maximization (EM) algorithm and R/QTL software. The criteria for significant and suggestive linkages for single markers were chosen based on Lander and Kruglyak (see methods section of our manuscript).-- Supplemental Dataset 25: Human breast cancer cohort-1 genotyping. The association of genetic variants with CDA was evaluated in four patient cohorts p

Intermediate Molecular Phenotypes to Identify Genetic Markers of Anthracycline-Induced Cardiotoxicity Risk

Cardiotoxicity due to anthracyclines (CDA) affects cancer patients, but we cannot predict who may suffer from this complication. CDA is a complex trait with a polygenic component that is mainly unidentified. We propose that levels of intermediate molecular phenotypes (IMPs) in the myocardium associated with histopathological damage could explain CDA susceptibility, so variants of genes encoding these IMPs could identify patients susceptible to this complication. Thus, a genetically heterogeneous cohort of mice (n = 165) generated by backcrossing were treated with doxorubicin and docetaxel. We quantified heart fibrosis using an Ariol slide scanner and intramyocardial levels of IMPs using multiplex bead arrays and QPCR. We identified quantitative trait loci linked to IMPs (ipQTLs) and cdaQTLs via linkage analysis. In three cancer patient cohorts, CDA was quantified using echocardiography or Cardiac Magnetic Resonance. CDA behaves as a complex trait in the mouse cohort. IMP levels in the myocardium were associated with CDA. ipQTLs integrated into genetic models with cdaQTLs account for more CDA phenotypic variation than that explained by cda-QTLs alone. Allelic forms of genes encoding IMPs associated with CDA in mice, including AKT1, MAPK14, MAPK8, STAT3, CAS3, and TP53, are genetic determinants of CDA in patients. Two genetic risk scores for pediatric patients (n = 71) and women with breast cancer (n = 420) were generated using machine-learning Least Absolute Shrinkage and Selection Operator (LASSO) regression. Thus, IMPs associated with heart damage identify genetic markers of CDA risk, thereby allowing more personalized patient management.Ministerio de Ciencia, Innovación y Universidades (España)European ComissionJunta de Castilla y LeónInstituto de Salud Carlos IIIMinisterio de Economía, Comercio y Empresa (España)Federación Española de Enfermedades RarasDepartamento de Defensa (Estados Unidos)National Institutes of Health (Estados Unidos)Universidad de California (Estados Unidos)Instituto Nacional del Cáncer (Estados Unidos)Fundación "la Caixa"Agencia Estatal de InvestigaciónDepto. de Estadística e Investigación OperativaFac. de FarmaciaTRUEpu