Elaboración de blogs como herramienta virtual de aprendizaje y trabajo en equipo

Este proyecto de innovación se enmarca dentro de las actividades académicas no presenciales. Se trata de la elaboración de blogs como herramienta virtual de aprendizaje. Los blogs son un recurso de aprendizaje individual o grupal, de gran versatilidad y dinamización del aula. Además, promueve el desarrollo de competencias generales, específicas y transversales que los alumnos deben adquirir durante su formación. Creemos que su aplicación es especialmente interesante en asignaturas como “Bases Celulares de la Genética Humana” impartida en primero de Medicina, donde los alumnos se encuentran con una dificultad añadida a la complejidad de sus fundamentos: unos conceptos complejos con una terminología muy específica para asimilarlos. Los futuros médicos deberán ser capaces, de explicar con un lenguaje sencillo y comprensible a los pacientes la implicación de la genética en las patologías. Consideramos que el uso de blogs está especialmente indicado en este caso para facilitar la adquisición de esta competencia específica, además de apoyar el aprendizaje de parte de los contenidos de la asignatura y promover el trabajo en equipo. Esta herramienta aporta a los alumnos las competencias necesarias para su formación integral como profesional de la salud promoviendo el intercambio colaborativo. Es además, un recurso que puede ser utilizado tanto para la evaluación continua, por parte del profesor durante y a la finalización del diseño del blog, así como para la coevaluación entre los alumnos. Por tanto, esta propuesta facilita el aprendizaje creando espacios para ello. En definitiva, crea oportunidades de aprendizaje

Vasoactive intestinal peptide gene polymorphisms, associated with its serum levels, predict treatment requirements in early rheumatoid arthritis

We previously reported that early arthritis (EA) patients with low vasoactive intestinal peptide (VIP) serum levels demonstrate a worse clinical disease course. In this study, we analysed whether variants in the VIP gene correlated with its serum levels and clinical EA parameters. The VIP gene was sequenced in patients with extremely high/low VIP levels, measured by enzyme immunoassay. Sixteen single nucleotide polymorphisms (SNPs) were diferentially distributed between both groups, which were subsequently genotyped in two patients’ sets. We observed that patients with rs688136 CC genotype showed higher VIP levels in both discovery (n=91; p=0.033) and validation populations (n=131; p=0.007). This efect was attenuated by the presence of minor alleles rs35643203 and rs12201140, which showed a clear trend towards low VIP level association (p=0.118 and p=0.049, respectively). Functional studies with miR-205-5p, which has a target site in the 3′ UTR close to rs688136, revealed a miRNA-mediated regulatory mechanism explaining the higher VIP gene expression in homozygous patients. Moreover, patients with an rs688136 CC genotype and no minor alleles of the other polymorphisms required less treatment (p=0.009). We concluded that the identifcation of polymorphisms associated with VIP serum levels would complement the clinical assessment of the disease severity in rheumatoid arthritis patients

Santiago Ramón y Cajal: un modelo de excelencia para desarrollar competencias en el Grado en Medicina

El presente proyecto ha acercado la figura de Santiago Ramón y Cajal a los estudiantes de Medicina como estrategia para el desarrollo de competencias generales, específicas y transversales necesarias para la formación de profesionales competentes. Se han realizado una serie de actividades en torno a nuestro Premio Nobel que han involucrado a docentes, investigadores y clínicos

The anti-inflammatory mediator, vasoactive intestinal peptide, modulates the differentiation and function of Th Subsets in rheumatoid arthritis

Genetic background, epigenetic modifications, and environmental factors trigger autoimmune response in rheumatoid arthritis (RA). Several pathogenic infections have been related to the onset of RA and may cause an inadequate immunological tolerance towards critical self-antigens leading to chronic joint inflammation and an imbalance between different T helper (Th) subsets. Vasoactive intestinal peptide (VIP) is a mediator that modulates all the stages comprised between the arrival of pathogens and Th cell differentiation in RA through its known anti-inflammatory and immunomodulatory actions. This “neuroimmunopeptide” modulates the pathogenic activity of diverse cell subpopulations involved in RA as lymphocytes, fibroblast-like synoviocytes (FLS), or macrophages. In addition, VIP decreases the expression of pattern recognition receptor (PRR) such as toll-like receptors (TLRs) in FLS from RA patients. These receptors act as sensors of pathogen-associated molecular pattern (PAMP) and damage-associated molecular pattern (DAMP) connecting the innate and adaptive immune system. Moreover, VIP modulates the imbalance between Th subsets in RA, decreasing pathogenic Th1 and Th17 subsets and favoring Th2 or Treg profile during the differentiation/polarization of naïve or memory Th cells. Finally, VIP regulates the plasticity between theses subsets. In this review, we provide an overview of VIP effects on the aforementioned features of RA pathology

Validación del péptido intestinal vasoactivo (VIP) como biomarcador pronóstico en enfermedades reumáticas

Tesis de la Universidad Complutense de Madrid, Facultad de Ciencias Biológicas, leída el 02-02-2018La Artritis Reumatoide (AR) y la Espondiloartritis (EspA) son enfermedades reumáticasinflamatorias y crónicas con un importante componente autoinmune, cuya progresiónconduce a la destrucción de las estructuras articulares y con ello a una severa incapacidadfuncional y grave deterioro de la calidad de vida de los pacientes [1, 2].En ambas patologías, la gravedad aumenta debido al largo periodo de tiempo transcurridodesde el comienzo de la enfermedad hasta su diagnóstico e inicio del tratamiento. Sinembargo, una actuación terapéutica precoz durante la ventana de oportunidad [3-7]basada en estrategias terapéuticas personalizadas es capaz de ralentizar o inclusomodificar el curso natural de la enfermedad [8, 9].Los biomarcadores validados hasta la fecha, en AR (fundamentalmente factor reumatoidey anticuerpos contra proteínas citrulinadas, ACPA) y en EspA (HLA-B27+ y proteína Creactiva), resultan insuficientes para clasificar a los pacientes con previsión de peor cursoevolutivo y que, por tanto, se beneficiarían de un tratamiento temprano más agresivo [1, 10-13]. Así, existen aún importantes desafíos en la búsqueda de biomarcadores pronóstico.El Péptido Intestinal Vasoactivo (VIP) es ampliamente reconocido por sus propiedadesantiinflamatorias e inmunomoduladoras [14], muchas de ellas dentro del contexto de laspropias enfermedades reumáticas [15-18]. VIP ejerce sus funciones a través de 3 receptoresacoplados a proteína G (VPAC1, VPAC2, PAC1), presentes en células inmunocompetentes[19]. Se ha descrito que los perfiles de expresión del eje VIP/Receptores se encuentranalterados en diversas enfermedades autoinmunes tales como la esclerosis múltiple, el Crohno el Sjögren [20-22].Combinando su relevancia en el contexto de las enfermedades reumáticas con sudesregulación en otras patologías autoinmunes, nos preguntamos si el eje VIP/Receptorespodría servir como biomarcador pronóstico en las dos enfermedades estudiadas...Rheumatoid arthritis (RA) and Spondyloarthritis (SpA) are inflammatory and chronicrheumatic diseases with a significant autoimmune component. Its progression leads to thedestruction of joint structures and, consequently, to severe functional impairment andserious worsening of patient's quality of life [1, 2].In both diseases, severity increases due to the long period of time from onset to diagnosisand treatment establishment. Nevertheless, an early therapeutic intervention during thewindow of opportunity [3-7] based on customized therapeutic strategies is able to slowor even modify the natural course of the disease [8, 9].To date, validated biomarkers in RA (mainly rheumatoid factor and anti-citrullinatedproteins antibodies, ACPA) and in SpA (essentially HLA-B27+ and C-reactive protein), areinsufficient to classify patients who are expected to undergo worse clinical course of thedisease and, consequently, who would benefit from more aggressive early treatment [1, 10-13]. Thus, there are still major challenges in the search for prognostic biomarkers.The antiinflammatory and immunomodulatory properties of the Vasoactive IntestinalPeptide (VIP) are broadly documented [14] being many of them described within thecontext of rheumatic diseases [15-18]. VIP exerts its biological functions through three Gprotein-coupled receptors (VPAC1, VPAC2, PAC1), found in immunocompetent cells [19].The expression profile of the VIP/Receptors axis have been reported to be altered in severalautoimmune diseases such as multiple sclerosis, Crohn's disease and Sjögren's syndrome[20-22].Considering its relevance in the context of rheumatic diseases and its deregulation in otherautoimmune pathologies, we examined if the VIP/Receptors axis could serve as aprognostic biomarker in the two studied diseases...Fac. de Ciencias BiológicasTRUEunpu

Blogs: una herramienta de autoaprendizaje en la docencia de la genética humana

La implantación del Espacio Europeo de Educación Superior implica un cambio en el modelo de aprendizaje. Se pretende estimular el aprendizaje autónomo y que el alumno sea el centro del proceso. En este sentido, los blogs son una herramienta en exploración en el área de la educación. El objetivo general fue estimular el aprendizaje autónomo en los estudiantes de Genética Humana mediante la elaboración, en equipos, de Blogs de enfermedades de origen genético. Además, se pretendió facilitar el estudio de los contenidos de la asignatura, así como implicar a los alumnos en la evaluación del proceso

La co-evaluación de blogs: Un motor del aprendizaje

En la evaluación orientada al aprendizaje (Boud y Falchikov, 2007; Carless, 2003), la coevaluación se contempla como una interesante alternativa metodológica complementaria (Gessa, 2011). Involucra activamente a los estudiantes en su propio aprendizaje (Falchikov, 2005) y les permite identificar sus propias fortalezas y debilidades, así como desarrollar determinadas competencias transferibles a otras áreas (Topping, 2003)

Biomarkers Predicting a Need for Intensive Treatment in Patients with Early Arthritis

The heterogeneous nature of rheumatoid arthritis (RA) complicates early recognition and treatment. In recent years, a growing body of evidence has demonstrated that intervention during the window of opportunity can improve the response to treatment and slow— or even stop—irreversible structural changes. Advances in therapy, such as biologic agents, and changing approaches to the disease, such as the treat to target and tight control strategies, have led to better outcomes resulting from personalized treatment to patients with different prognostic markers. The various biomarkers identified either facilitate early diagnosis or make it possible to adjust management to disease activity or poor outcomes. However, no single biomarker can bridge the gap between disease onset and prescription of the first DMARD, and traditional biomarkers do not identify all patients requiring early aggressive treatment. Furthermore, the outcomes of early arthritis cohorts are largely biased by the treatment prescribed to patients; therefore, new challenges arise in the search for prognostic biomarkers. Herein, we discuss the value of traditional and new biomarkers and suggest the need for intensive treatment as a new surrogate marker of poor prognosis that can guide therapeutic decisions in the early stages of RA

Vasoactive intestinal peptide in early spondyloarthritis: low serum levels as a potential biomarker for disease severity

Spondyloarthritis (SpA) is a family of inflammatory diseases sharing clinical, genetic, and radiological features. While crucial for tailoring early interventions, validated prognostic biomarkers are scarce in SpA. We analyze the correlation between serum levels of vasoactive intestinal peptide (VIP) and disease activity/severity in patients with early chronic inflammatory back pain. The study population comprised 54 patients enrolled in our early chronic inflammatory back pain register. We collected demographic information, clinical data, laboratory data, and imaging findings. VIP levels were measured by enzyme immunoassay in serum samples from 162 visits. The association between independent variables and VIP levels was analyzed using longitudinal multivariate analysis nested by patient and visit. No significant differences were observed in VIP levels between these two groups. Lower levels of VIP were significantly associated with a higher Bath Ankylosing Spondylitis Disease Activity Index (BASFI) score, presence of bone edema in magnetic resonance imaging (MRI) scan, and lower hemoglobin levels. Coexistence of cutaneous psoriasis was independently associated with lower VIP levels, and similar trend was observed for enthesitis.We conclude that SpA patients with low serum VIP levels had worse 2-year disease outcome, suggesting tha