{"id":23478,"date":"2023-03-31T11:44:02","date_gmt":"2023-03-31T09:44:02","guid":{"rendered":"https:\/\/idibell.cat\/?p=23478"},"modified":"2023-03-31T13:32:25","modified_gmt":"2023-03-31T11:32:25","slug":"lhospital-de-bellvitge-i-lidibell-lideren-un-assaig-clinic-estatal-per-reduir-limpacte-de-les-infeccions-en-els-pacients-trasplantats-de-cor","status":"publish","type":"post","link":"https:\/\/idibell.cat\/2023\/03\/lhospital-de-bellvitge-i-lidibell-lideren-un-assaig-clinic-estatal-per-reduir-limpacte-de-les-infeccions-en-els-pacients-trasplantats-de-cor\/","title":{"rendered":"L\u2019Hospital de Bellvitge i l\u2019IDIBELL lideren un assaig cl\u00ednic estatal per reduir l\u2019impacte de les infeccions en els pacients trasplantats de cor"},"content":{"rendered":"<p>L\u2019assaig cl\u00ednic multic\u00e8ntric ELISPOT-TC pret\u00e9n avaluar l\u2019efic\u00e0cia d\u2019una estrat\u00e8gia preventiva per fer front la infecci\u00f3 per citomegalovirus en pacients trasplantats card\u00edacs. Aquesta estrat\u00e8gia parteix de la resposta dels limf\u00f2cits T de cada persona enfront el citomegalovirus. El Servei de Cardiologia de l\u2019Hospital de Bellvitge (HUB) i el <a href=\"https:\/\/idibell.cat\/es\/investigacion\/area-de-medicina-traslacional\/programa-de-enfermedades-cardiovasculares-respiratorias-sistemicas-y-de-envejecimiento-celular\/grupo-de-investigacion-en-enfermedades-cardiovasculares-bio-heart\/\" target=\"_blank\" rel=\"noopener\">grup de recerca BIOHEART<\/a> de l\u2019IDIBELL lideren l\u2019assaig, que tindr\u00e0 els seus primers resultats a mitjans de 2024. Aquest assaig ha estat finan\u00e7at per l\u2019Instituto de Salud Carlos III mitjan\u00e7ant la convocat\u00f2ria d\u2019ajuts per projectes de R+D+i del 2019, i per una beca de la Sociedad\u00a0 Espa\u00f1ola de Cardiolog\u00eda.<\/p>\n<p>&nbsp;<\/p>\n<p>Despr\u00e9s de tancar un per\u00edode de reclutament de pacients complex, sobretot a causa de la pand\u00e8mia, l\u2019assaig ELISPOT-TC est\u00e0 en marxa amb la participaci\u00f3 de 188 pacients d\u2019un total d\u2019onze hospitals de l\u2019Estat que realitzen transplantament card\u00edac.<\/p>\n<p>&nbsp;<\/p>\n<p>En fer un trasplantament el pacient queda immunodeprimit, fet que augmenta el risc de contraure infeccions, sobretot al principi, o b\u00e9 de que es reactivin infeccions anteriors ja superades. El citomegalovirus (CMV) \u00e9s un dels microorganismes m\u00e9s habitual i alhora dels m\u00e9s perill\u00f3s en el trasplantament card\u00edac, perqu\u00e8 s\u2019associa a d\u2019altres infeccions que poden resultar greus, i a la vasculopatia de l&#8217;empelt (les art\u00e8ries del nou cor es fan malb\u00e9).<\/p>\n<p>&nbsp;<\/p>\n<p>L\u2019abordatge de la infecci\u00f3 per CMV es fa fins ara amb dues estrat\u00e8gies preventives: la profilaxi universal, es a dir, l\u2019administraci\u00f3 d\u2019un f\u00e0rmac de forma preventiva; o b\u00e9 mantenint una vigil\u00e0ncia del pacient per facilitar el tractament nom\u00e9s quan es detecta l\u2019aparici\u00f3 o reactivaci\u00f3 del virus.<\/p>\n<p>&nbsp;<\/p>\n<p>En aquest context, l\u2019assaig aplica una t\u00e8cnica de laboratori que estudia els limf\u00f2cits T de cada pacient, que s\u00f3n c\u00e8l\u00b7lules que tenen un paper clau en el control de la replicaci\u00f3 viral i al superviv\u00e8ncia del CMV. \u201cSi els limf\u00f2cits reaccionen en contacte amb el virus, vol dir que l\u2019organisme del pacient \u00e9s capa\u00e7 de respondre al CMV per si sol, mentre que sin\u00f3 s\u2019activen no ho ser\u00e0\u201d, segons explica la cardi\u00f2loga de l\u2019HUB i investigadora del grup de recerca Bioheart de l\u2019IDIBELL, Elena Garcia-Romero.<\/p>\n<p>&nbsp;<\/p>\n<p>\u201cL&#8217;objectiu final de l\u2019assaig \u00e9s comprovar si aquest procediment no \u00e9s inferior en resultats a la profilaxis universal, de forma que es puguin evitar els possibles efectes secundaris de l\u2019administraci\u00f3 preventiva del f\u00e0rmac, que pot interaccionar amb els immunosupressors\u201d, indica la Dra. Garc\u00eda-Romero. D\u2019aquesta forma es pot avan\u00e7ar en la personalitzaci\u00f3 del tractament i no administrar el f\u00e0rmac quan no \u00e9s necessari, donat que els limf\u00f2cits T ja actuen contra la infecci\u00f3 per citomegalovirus.<\/p>\n<p>&nbsp;<\/p>\n<p>Les infeccions en els pacients trasplantats de cor s\u00f3n freq\u00fcents, sobretot durant\u00a0 primer any. En la profilaxi universal, el f\u00e0rmac per prevenir la infecci\u00f3 es pren immediatament despr\u00e9s del trasplantament, de forma que coincideix amb l\u2019administraci\u00f3 dels immunosupressors per evitar el rebuig. \u201cLa combinaci\u00f3 dels dos elements poden provocar que les defenses del pacient es redueixin molt\u201d, explica la Dra. Garcia-Romero. En aquesta l\u00ednia, un dels efectes secundaris m\u00e9s importants del f\u00e0rmac \u00e9s la leucop\u00e8nia, un descens dels leuc\u00f2cits que augmenta el risc d&#8217;infeccions i pot comportar un reajustament dels\u00a0 immunosupressors. A m\u00e9s, una vegada s\u2019atura la profilaxi universal (passats entre 3 i 6 mesos) existeix risc d&#8217;infecci\u00f3 tardana, de reaparici\u00f3 del virus, tot i que s\u2019hagi superat.<\/p>\n<p>&nbsp;<\/p>\n<p>L\u2019assaig cl\u00ednic ELISPOT-TC pren com a punt de partida els treballs del grup del Dr. Oriol Bestard a l\u2019Hospital Vall d\u2019Hebron, que ha estudiat la immunitat cel\u00b7lular enfront el citomegalovirus en el trasplantament renal. En l\u2019assaig col\u00b7laboren els serveis de Microbiologia i de Malalties Infeccioses de l\u2019Hospital de Bellvitge.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Es tracta d\u2019un projecte que aprofundeix en la medicina personalitzada. Aquest assaig ha estat finan\u00e7at per l\u2019Instituto de Salud Carlos III mitjan\u00e7ant la convocat\u00f2ria d\u2019ajuts per projectes de R+D+i del 2019, i per una beca de la Sociedad\u00a0 Espa\u00f1ola de Cardiolog\u00eda.<\/p>\n","protected":false},"author":8,"featured_media":23480,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"default","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"footnotes":""},"categories":[359,334,466],"tags":[],"publishpress_future_action":{"enabled":false,"date":"2024-05-10 18:10:50","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category"},"_links":{"self":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/23478"}],"collection":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/comments?post=23478"}],"version-history":[{"count":1,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/23478\/revisions"}],"predecessor-version":[{"id":23481,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/posts\/23478\/revisions\/23481"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media\/23480"}],"wp:attachment":[{"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/media?parent=23478"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/categories?post=23478"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/idibell.cat\/wp-json\/wp\/v2\/tags?post=23478"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}