Mycobacterium manresensis induces trained immunity in vitro

The COVID-19 pandemic posed a global health crisis, with new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants weakening vaccine-driven protection. Trained immunity could help tackle COVID-19 disease. Our objective was to analyze whether heat-killed Mycobacterium manresensis (hkMm), an environmental mycobacterium, induces trained immunity and confers protection against SARS-CoV-2 infection. To this end, THP-1 cells and primary monocytes were trained with hkMm. The increased secretion of tumor necrosis factor alpha (TNF-α), interleukin (IL)-6, IL-1β, and IL-10, metabolic activity, and changes in epigenetic marks suggested hkMm-induced trained immunity in vitro. Healthcare workers at risk of SARS-CoV-2 infection were enrolled into the MANRECOVID19 clinical trial (NCT04452773) and were administered Nyaditum resae (NR, containing hkMm) or placebo. No significant differences in monocyte inflammatory responses or the incidence of SARS-CoV-2 infection were found between the groups, although NR modified the profile of circulating immune cell populations. Our results show that M. manresensis induces trained immunity in vitro but not in vivo when orally administered as NR daily for 14 days. Biological sciences; Molecular biology; Immunology; Microbiolog

Mycobacterium manresensis induces trained immunity in vitro

The COVID-19 pandemic posed a global health crisis, with new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants weakening vaccine-driven protection. Trained immunity could help tackle COVID-19 disease. Our objective was to analyze whether heat-killed Mycobacterium manresensis (hkMm), an environmental mycobacterium, induces trained immunity and confers protection against SARS-CoV-2 infection. To this end, THP-1 cells and primary monocytes were trained with hkMm. The increased secretion of tumor necrosis factor alpha (TNF-α), interleukin (IL)-6, IL-1β, and IL-10, metabolic activity, and changes in epigenetic marks suggested hkMm-induced trained immunity in vitro. Healthcare workers at risk of SARS-CoV-2 infection were enrolled into the MANRECOVID19 clinical trial (NCT04452773) and were administered Nyaditum resae (NR, containing hkMm) or placebo. No significant differences in monocyte inflammatory responses or the incidence of SARS-CoV-2 infection were found between the groups, although NR modified the profile of circulating immune cell populations. Our results show that M. manresensis induces trained immunity in vitro but not in vivo when orally administered as NR daily for 14 days.The MANRECOVID19 clinical trial has been sponsored by the Reig Jofre Group. This research was funded by the Consorcio Centro de Investigación Biomédica en Red (CIBERES and CIBEREHD) and the European Union’s Horizon 2020 research and innovation programme under grant agreement No 847762. MDH is supported by a Margarita Salas grant from NextGenerationEU. LS-M is supported by Juan de la Cierva fellowship (FJC2019-041213-I). NI-U is supported by the Spanish Ministry of Science and Innovation (grant PID2020-117145RB-I00), EU HORIZON-HLTH-2021-CORONA-01 (grant 101046118), and institutional funding from Grifols, Pharma Mar, HIPRA, Amassence, and Palobiofarma. The Innate Immunity lab and the UTE are accredited by the Catalan Agency for Management of University and Research Grants (2017-SGR-490/2021-SGR-01186, 2021-SGR-00931, and 2017-SGR-500/2021 SGR 00920). IGTP is a member of the CERCA network of institutes supported by the Health Department of the Government of Catalonia.info:eu-repo/semantics/publishedVersio

Total and Subtypes of Dietary Fat Intake and Its Association with Components of the Metabolic Syndrome in a Mediterranean Population at High Cardiovascular Risk

Background: The effect of dietary fat intake on the metabolic syndrome (MetS) and in turn on cardiovascular disease (CVD) remains unclear in individuals at high CVD risk. Objective: To assess the association between fat intake and MetS components in an adult Mediterranean population at high CVD risk. Design: Baseline assessment of nutritional adequacy in participants (n = 6560, men and women, 55-75 years old, with overweight/obesity and MetS) in the PREvención con DIeta MEDiterránea (PREDIMED)-Plus randomized trial. Methods: Assessment of fat intake (total fat, monounsatured fatty acids: MUFA, polyunsaturated fatty acids: PUFA, saturated fatty acids: SFA, trans-fatty acids: trans-FA, linoleic acid, α-linolenic acid, and ω-3 FA) using a validated food frequency questionnaire, and diet quality using 17-item Mediterranean dietary questionnaire and fat quality index (FQI). Results: Participants in the highest quintile of total dietary fat intake showed lower intake of energy, carbohydrates, protein and fiber, but higher intake of PUFA, MUFA, SFA, TFA, LA, ALA and ω-3 FA. Differences in MetS components were found according to fat intake. Odds (5th vs. 1st quintile): hyperglycemia: 1.3-1.6 times higher for total fat, MUFA, SFA and ω-3 FA intake; low high-density lipoprotein cholesterol (HDL-c): 1.2 higher for LA; hypertriglyceridemia: 0.7 lower for SFA and ω-3 FA intake. Conclusions: Dietary fats played different role on MetS components of high CVD risk patients. Dietary fat intake was associated with higher risk of hyperglycemia

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Role of ZEB1 in adenoma formation, inflammation and inflammation-driven carcinoma

[eng] Multiple studies have highlighted the role of ZEB1 as critical regulator of tumor progression through the regulation of different hallmarks of cancer beyond the induction of EMT. The general aim of this dissertation is to characterize new potential mechanisms that regulate oncogenic transformation in colorectal carcinoma. The specific objectives of this dissertation are: 1. To identify new roles and targets of the transcription factor ZEB1 as a mediator of Wnt-induced intestinal adenoma formation. 2. To characterize ZEB1’s mechanism of action as a transcriptional regulator in inflammation and inflammation-induced carcinomas. To address these goals, a wide number of reagents and techniques have been used, namely, human samples of adenomas and CRC, CRC cell lines whose expression for different genes has been manipulated by overexpression or RNA interference, high throughput techniques (RNA and microbiota sequencing) and transgenic mouse models (ApcMin/+, Zeb1+/- and Mpg-/-). We found that ZEB1 expression in epithelial cells from intestinal adenomas increases adenoma formation and decreases life span in the ApcMin/+ mouse model, which is supported by decreased senescence and apoptosis in ApcMin/+/Zeb1+/+ mice when compared to ApcMin/+/Zeb1+/- counterparts. ZEB1 is both a target and a mediator of the Wnt signaling pathway. Here we provide two new mechanisms by which ZEB1 modulates the Wnt pathway through the regulation of AXIN2 and DACT2 expression. In addition, we found that ZEB1 promotes lipid accumulation in adenomas and colorectal cancer cell lines through the repression of the ATGL/PPARα/PGC-1α axis, which is critical for the degradation of lipid droplets. Besides, we show that ZEB1 is upregulated in the epithelial cells of ulcerative colitis patients and of mouse models of colitis, where its expression promotes intestinal inflammation and inflammatory tumorigenesis. ZEB1 exerts these functions, at least in part, through the increase of DNA damage and the inhibition of the MPG glycosylase, which is involved in DNA damage repair. Moreover, ZEB1 expression in CRC cells stimulates the production of ROS and IL1-β by macrophages which, in turn, reduce MPG expression in CRC cells. Altogether, from the results presented in this dissertation, it can be concluded that: 1. ZEB1 represses senescence and apoptosis during Wnt-induced intestinal adenoma formation. 2. ZEB1 potentiates Wnt signaling in intestinal adenomas through the activation of AXIN2 and the repression of DACT2. 3. ZEB1 induces accumulation of lipids in intestinal cells through Wnt-dependent repression of ATGL, PPARα and PGC-1α. 4. ZEB1 is upregulated in the epithelial cells of UC patients and of mouse models of colitis, where its expression promotes intestinal inflammation and inflammation-driven tumorigenesis. 5. ZEB1 promotes colitis and inflammation-driven CRC through the induction of DNA damage and the inhibition of the DNA repair glycosylase MPG. 6. ZEB1 expression in epithelial cells stimulates the production of ROS and IL1-β by macrophages that, in turn, reduce MPG expression in CRC cells. These results establish ZEB1 as an important regulator of intestinal adenoma formation, and describe ZEB1 as a mediator of inflammation and inflammation-driven carcinogenesis, setting ZEB1 as a potential therapeutic target in colorectal carcinoma.[cat] Múltiples estudis han destacat el paper de ZEB1 com a regulador essencial de la progressió tumoral a través de la regulació de varis dels trets distintius del càncer més enllà de la inducció de la transició epiteli-mesènquima (EMT). Els resultats presentats en aquesta tesi indiquen que ZEB1 regula la formació de tumors intestinals des de les fases més inicials, i descriuen ZEB1 com un important inductor de colitis i de càncer de colon induït per inflamació. Hem trobat que l’expressió de ZEB1 en cèl·lules epitelials d’adenomes intestinals augmenta la formació d’adenomes i redueix la supervivència en el model de ratolí ApcMin/+. A més, en comparació amb els ratolins ApcMin/+/Zeb1+/+, els ratolins ApcMin/+/Zeb1+/- presenten més senescència i apoptosi. ZEB1 és tant una diana com un mediador de la via de senyalització Wnt. Els nostres resultats proporcionen dos nous mecanismes pels quals ZEB1 interacciona amb la via Wnt a través de la regulació de l’expressió d’AXIN2 i DACT2. Addicionalment, hem observat que ZEB1 promou l’acumulació de lípids a través de la repressió de l’eix ATGL/PPARα/PGC-1α, el qual té un paper crític en la degradació de les vesícules lipídiques. En paral·lel, hem demostrat que ZEB1 es troba sobreexpressat en cèl·lules epitelials de pacients de colitis ulcerativa i en models murins de colitis, on la seva expressió promou la inflamació intestinal i la tumorogènesi derivada de la inflamació. ZEB1 exerceix aquestes funcions, al menys en part, a través de l’augment de les lesions en l’ADN i la inhibició de MPG, una glicosilasa implicada en la reparació de les lesions en l’ADN. A més, l’expressió de ZEB1 en les cèl·lules de càncer de colon estimula la producció d’espècies reactives d’oxigen (ROS) i IL-1β per part dels macròfags que, a la vegada, redueix els nivells de MPG en les cèl·lules de càncer de colon. En conjunt, aquests resultats estableixen ZEB1 com un element regulador de la formació d’adenomes intestinals, així com un mediador de la inflamació i la carcinogènesi derivada de la inflamació, confirmant ZEB1 com a potencial diana terapèutica en càncer colorectal

Role of ZEB1 in adenoma formation, inflammation and inflammation-driven carcinoma

Multiple studies have highlighted the role of ZEB1 as critical regulator of tumor progression through the regulation of different hallmarks of cancer beyond the induction of EMT. The general aim of this dissertation is to characterize new potential mechanisms that regulate oncogenic transformation in colorectal carcinoma. The specific objectives of this dissertation are: 1. To identify new roles and targets of the transcription factor ZEB1 as a mediator of Wnt-induced intestinal adenoma formation. 2. To characterize ZEB1’s mechanism of action as a transcriptional regulator in inflammation and inflammation-induced carcinomas. To address these goals, a wide number of reagents and techniques have been used, namely, human samples of adenomas and CRC, CRC cell lines whose expression for different genes has been manipulated by overexpression or RNA interference, high throughput techniques (RNA and microbiota sequencing) and transgenic mouse models (ApcMin/+, Zeb1+/- and Mpg-/-). We found that ZEB1 expression in epithelial cells from intestinal adenomas increases adenoma formation and decreases life span in the ApcMin/+ mouse model, which is supported by decreased senescence and apoptosis in ApcMin/+/Zeb1+/+ mice when compared to ApcMin/+/Zeb1+/- counterparts. ZEB1 is both a target and a mediator of the Wnt signaling pathway. Here we provide two new mechanisms by which ZEB1 modulates the Wnt pathway through the regulation of AXIN2 and DACT2 expression. In addition, we found that ZEB1 promotes lipid accumulation in adenomas and colorectal cancer cell lines through the repression of the ATGL/PPARα/PGC-1α axis, which is critical for the degradation of lipid droplets. Besides, we show that ZEB1 is upregulated in the epithelial cells of ulcerative colitis patients and of mouse models of colitis, where its expression promotes intestinal inflammation and inflammatory tumorigenesis. ZEB1 exerts these functions, at least in part, through the increase of DNA damage and the inhibition of the MPG glycosylase, which is involved in DNA damage repair. Moreover, ZEB1 expression in CRC cells stimulates the production of ROS and IL1-β by macrophages which, in turn, reduce MPG expression in CRC cells. Altogether, from the results presented in this dissertation, it can be concluded that: 1. ZEB1 represses senescence and apoptosis during Wnt-induced intestinal adenoma formation. 2. ZEB1 potentiates Wnt signaling in intestinal adenomas through the activation of AXIN2 and the repression of DACT2. 3. ZEB1 induces accumulation of lipids in intestinal cells through Wnt-dependent repression of ATGL, PPARα and PGC-1α. 4. ZEB1 is upregulated in the epithelial cells of UC patients and of mouse models of colitis, where its expression promotes intestinal inflammation and inflammation-driven tumorigenesis. 5. ZEB1 promotes colitis and inflammation-driven CRC through the induction of DNA damage and the inhibition of the DNA repair glycosylase MPG. 6. ZEB1 expression in epithelial cells stimulates the production of ROS and IL1-β by macrophages that, in turn, reduce MPG expression in CRC cells. These results establish ZEB1 as an important regulator of intestinal adenoma formation, and describe ZEB1 as a mediator of inflammation and inflammation-driven carcinogenesis, setting ZEB1 as a potential therapeutic target in colorectal carcinoma.Múltiples estudis han destacat el paper de ZEB1 com a regulador essencial de la progressió tumoral a través de la regulació de varis dels trets distintius del càncer més enllà de la inducció de la transició epiteli-mesènquima (EMT). Els resultats presentats en aquesta tesi indiquen que ZEB1 regula la formació de tumors intestinals des de les fases més inicials, i descriuen ZEB1 com un important inductor de colitis i de càncer de colon induït per inflamació. Hem trobat que l’expressió de ZEB1 en cèl·lules epitelials d’adenomes intestinals augmenta la formació d’adenomes i redueix la supervivència en el model de ratolí ApcMin/+. A més, en comparació amb els ratolins ApcMin/+/Zeb1+/+, els ratolins ApcMin/+/Zeb1+/- presenten més senescència i apoptosi. ZEB1 és tant una diana com un mediador de la via de senyalització Wnt. Els nostres resultats proporcionen dos nous mecanismes pels quals ZEB1 interacciona amb la via Wnt a través de la regulació de l’expressió d’AXIN2 i DACT2. Addicionalment, hem observat que ZEB1 promou l’acumulació de lípids a través de la repressió de l’eix ATGL/PPARα/PGC-1α, el qual té un paper crític en la degradació de les vesícules lipídiques. En paral·lel, hem demostrat que ZEB1 es troba sobreexpressat en cèl·lules epitelials de pacients de colitis ulcerativa i en models murins de colitis, on la seva expressió promou la inflamació intestinal i la tumorogènesi derivada de la inflamació. ZEB1 exerceix aquestes funcions, al menys en part, a través de l’augment de les lesions en l’ADN i la inhibició de MPG, una glicosilasa implicada en la reparació de les lesions en l’ADN. A més, l’expressió de ZEB1 en les cèl·lules de càncer de colon estimula la producció d’espècies reactives d’oxigen (ROS) i IL-1β per part dels macròfags que, a la vegada, redueix els nivells de MPG en les cèl·lules de càncer de colon. En conjunt, aquests resultats estableixen ZEB1 com un element regulador de la formació d’adenomes intestinals, així com un mediador de la inflamació i la carcinogènesi derivada de la inflamació, confirmant ZEB1 com a potencial diana terapèutica en càncer colorectal

Role of ZEB1 in adenoma formation, inflammation and inflammation-driven carcinoma

Multiple studies have highlighted the role of ZEB1 as critical regulator of tumor progression through the regulation of different hallmarks of cancer beyond the induction of EMT. The general aim of this dissertation is to characterize new potential mechanisms that regulate oncogenic transformation in colorectal carcinoma. The specific objectives of this dissertation are: 1. To identify new roles and targets of the transcription factor ZEB1 as a mediator of Wnt-induced intestinal adenoma formation. 2. To characterize ZEB1’s mechanism of action as a transcriptional regulator in inflammation and inflammation-induced carcinomas. To address these goals, a wide number of reagents and techniques have been used, namely, human samples of adenomas and CRC, CRC cell lines whose expression for different genes has been manipulated by overexpression or RNA interference, high throughput techniques (RNA and microbiota sequencing) and transgenic mouse models (ApcMin/+, Zeb1+/- and Mpg-/-). We found that ZEB1 expression in epithelial cells from intestinal adenomas increases adenoma formation and decreases life span in the ApcMin/+ mouse model, which is supported by decreased senescence and apoptosis in ApcMin/+/Zeb1+/+ mice when compared to ApcMin/+/Zeb1+/- counterparts. ZEB1 is both a target and a mediator of the Wnt signaling pathway. Here we provide two new mechanisms by which ZEB1 modulates the Wnt pathway through the regulation of AXIN2 and DACT2 expression. In addition, we found that ZEB1 promotes lipid accumulation in adenomas and colorectal cancer cell lines through the repression of the ATGL/PPARα/PGC-1α axis, which is critical for the degradation of lipid droplets. Besides, we show that ZEB1 is upregulated in the epithelial cells of ulcerative colitis patients and of mouse models of colitis, where its expression promotes intestinal inflammation and inflammatory tumorigenesis. ZEB1 exerts these functions, at least in part, through the increase of DNA damage and the inhibition of the MPG glycosylase, which is involved in DNA damage repair. Moreover, ZEB1 expression in CRC cells stimulates the production of ROS and IL1-β by macrophages which, in turn, reduce MPG expression in CRC cells. Altogether, from the results presented in this dissertation, it can be concluded that: 1. ZEB1 represses senescence and apoptosis during Wnt-induced intestinal adenoma formation. 2. ZEB1 potentiates Wnt signaling in intestinal adenomas through the activation of AXIN2 and the repression of DACT2. 3. ZEB1 induces accumulation of lipids in intestinal cells through Wnt-dependent repression of ATGL, PPARα and PGC-1α. 4. ZEB1 is upregulated in the epithelial cells of UC patients and of mouse models of colitis, where its expression promotes intestinal inflammation and inflammation-driven tumorigenesis. 5. ZEB1 promotes colitis and inflammation-driven CRC through the induction of DNA damage and the inhibition of the DNA repair glycosylase MPG. 6. ZEB1 expression in epithelial cells stimulates the production of ROS and IL1-β by macrophages that, in turn, reduce MPG expression in CRC cells. These results establish ZEB1 as an important regulator of intestinal adenoma formation, and describe ZEB1 as a mediator of inflammation and inflammation-driven carcinogenesis, setting ZEB1 as a potential therapeutic target in colorectal carcinoma.Múltiples estudis han destacat el paper de ZEB1 com a regulador essencial de la progressió tumoral a través de la regulació de varis dels trets distintius del càncer més enllà de la inducció de la transició epiteli-mesènquima (EMT). Els resultats presentats en aquesta tesi indiquen que ZEB1 regula la formació de tumors intestinals des de les fases més inicials, i descriuen ZEB1 com un important inductor de colitis i de càncer de colon induït per inflamació. Hem trobat que l’expressió de ZEB1 en cèl·lules epitelials d’adenomes intestinals augmenta la formació d’adenomes i redueix la supervivència en el model de ratolí ApcMin/+. A més, en comparació amb els ratolins ApcMin/+/Zeb1+/+, els ratolins ApcMin/+/Zeb1+/- presenten més senescència i apoptosi. ZEB1 és tant una diana com un mediador de la via de senyalització Wnt. Els nostres resultats proporcionen dos nous mecanismes pels quals ZEB1 interacciona amb la via Wnt a través de la regulació de l’expressió d’AXIN2 i DACT2. Addicionalment, hem observat que ZEB1 promou l’acumulació de lípids a través de la repressió de l’eix ATGL/PPARα/PGC-1α, el qual té un paper crític en la degradació de les vesícules lipídiques. En paral·lel, hem demostrat que ZEB1 es troba sobreexpressat en cèl·lules epitelials de pacients de colitis ulcerativa i en models murins de colitis, on la seva expressió promou la inflamació intestinal i la tumorogènesi derivada de la inflamació. ZEB1 exerceix aquestes funcions, al menys en part, a través de l’augment de les lesions en l’ADN i la inhibició de MPG, una glicosilasa implicada en la reparació de les lesions en l’ADN. A més, l’expressió de ZEB1 en les cèl·lules de càncer de colon estimula la producció d’espècies reactives d’oxigen (ROS) i IL-1β per part dels macròfags que, a la vegada, redueix els nivells de MPG en les cèl·lules de càncer de colon. En conjunt, aquests resultats estableixen ZEB1 com un element regulador de la formació d’adenomes intestinals, així com un mediador de la inflamació i la carcinogènesi derivada de la inflamació, confirmant ZEB1 com a potencial diana terapèutica en càncer colorectal