Enzymatic modulation of nanomaterials and its application to biosensing

Las páginas 156 a 173 están sujetas a confidencialidad por la autora. 182 p.La creciente demanda de dispositivos para la detección y monitorización de sustancias bio(químicas) ha llevado al estudio y desarrollo de nuevas plataformas para cubrir estas necesidades. En el ámbito de la salud, los biosensores representan la herramienta más sensible y eficaz con una amplia variedad de aplicaciones, sobre todo para su uso en el punto de medida (point-of-care). Estos dispositivos deben ser robustos, portables, sensibles y de fácil manejo. Entre las diferentes metodologías, los inmunoensayos son los más utilizados por su sensibilidad y selectividad frente a un gran número de biomarcadores de interés médico. A pesar de los ejemplos en el mercado basados en flujo lateral, todavía su integración en plataformas portables y el incremento de la sensibilidad no se han conseguido satisfactoriamente. Para abordar esta problemática, en la presente tesis doctoral se propone el estudio de la amplificación de la señal mediante el uso de reacciones enzimáticas, y su integración en una plataforma microfluídica para la fabricación de un inmunosensor fotoelectroquímico como plataforma ¿lab-on-a-chip¿. Por un lado, se estudiaron diferentes estrategias de detección y amplificación de la señal mediante la modulación enzimática de nanopartículas de sulfuro de plata y sulfuro de cadmio. Aquí, se desarrollaron tres sistemas enzimáticos para la detección de analitos de interés mediante fotoelectroquímica, fluorescencia, absorbancia y electroquimioluminiscencia. Se seleccionó la fotoelectroquímica como método de detección debido a las ventajas en cuanto a facilidad de integración en sistemas portables y alta sensibilidad. Por otro lado, se estudiaron diferentes métodos de inmovilización de anticuerpos en poliestireno para mejorar la orientación y el proceso de biorreconocimiento. Estos sustratos son transparentes y permiten su uso en dispositivos donde esté involucrada la luz. Finalmente, se diseñó una plataforma microfluídica donde se integró el poliestireno seleccionado y los electrodos serigrafiados de carbono. La validación del dispositivo se realizó mediante la ejecución del inmunoensayo acoplado al sistema de amplificación de señal enzimática para la posterior detección fotoelectroquímica.CICbiomaGUNE Tecnali

COVID-19 Severity and Survival over Time in Patients with Hematologic Malignancies: A Population-Based Registry Study

Mortality rates for COVID-19 have declined over time in the general population, but data in patients with hematologic malignancies are contradictory. We identified independent prognostic factors for COVID-19 severity and survival in unvaccinated patients with hematologic malignancies, compared mortality rates over time and versus non-cancer inpatients, and investigated post COVID-19 condition. Data were analyzed from 1166 consecutive, eligible patients with hematologic malignancies from the population-based HEMATO-MADRID registry, Spain, with COVID-19 prior to vaccination roll-out, stratified into early (February–June 2020; n = 769 (66%)) and later (July 2020–February 2021; n = 397 (34%)) cohorts. Propensity-score matched non-cancer patients were identified from the SEMI-COVID registry. A lower proportion of patients were hospitalized in the later waves (54.2%) compared to the earlier (88.6%), OR 0.15, 95%CI 0.11–0.20. The proportion of hospitalized patients admitted to the ICU was higher in the later cohort (103/215, 47.9%) compared with the early cohort (170/681, 25.0%, 2.77; 2.01–3.82). The reduced 30-day mortality between early and later cohorts of non-cancer inpatients (29.6% vs. 12.6%, OR 0.34; 0.22–0.53) was not paralleled in inpatients with hematologic malignancies (32.3% vs. 34.8%, OR 1.12; 0.81–1.5). Among evaluable patients, 27.3% had post COVID-19 condition. These findings will help inform evidence-based preventive and therapeutic strategies for patients with hematologic malignancies and COVID-19 diagnosis.Depto. de MedicinaFac. de MedicinaTRUEFundación Madrileña de Hematología y HemoterapiaFundación Leucemia y LinfomaAsociación Madrileña de Hematología y Hemoterapiapu

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Specific bioanalytical optical and photoelectrochemical assays for detection of methanol in alcoholic beverages

Methanol is a poison which is frequently discovered in alcoholic beverages. Innovative methods to detect methanol in alcoholic beverages are being constantly developed. We report for the first time a new strategy for the detection of methanol using fluorescence spectroscopy and photoelectrochemical (PEC) analysis. The analytical system is based on the oxidation of cysteine (CSH) with hydrogen peroxide (H2O2) enzymatically generated by alcohol oxidase (AOx). H2O2 oxidizes capping agent CSH, modulating the growth of CSH-stabilized cadmium sulphide quantum dots (CdS QDs). Disposable screen-printed carbon electrodes (SPCEs) modified with a conductive osmium polymer (Os-PVP) complex were employed to quantify resulting CdS QDs. This polymer facilitates the “wiring” of in situ enzymatically generated CdS QDs, which photocatalyze oxidation of 1-thioglycerol (TG), generating photocurrent as the readout signal. Likewise, we proved that our systems did not suffer from interference by ethanol. The PEC assays showed better sensitivity than conventional methods, covering a wide range of potential applications for methanol quantification.the Spanish Ministry of Economy and Competitiveness (project BIO2014-59741)