Noticias

• It is a collaborative initiative that combines data from 31 vascular risk monitoring cohorts in which 23 institutions from 12 autonomous Communities have participated. 

The Department of Health of the Government of Navarra participates in the CORDELIA Study (Collaborative cOhorts Reassembled Data to study mEchanisms and Longterm Incidence of chronic diseAses), which has received a grant in the Personalized Precision Medicine Call from the Carlos III Health Institute. The initiative is led at the national level by the Instituto Hospital del Mar de Investigaciones Médicas (IMIM) and it constitutes the representative study of the largest population of association of the human genome with risk factors for cardiovascular diseases. In addition, the research will allow progress towards the personalization of its prevention and treatment.

This collaborative project combines data from 31 vascular risk monitoring cohorts in Spain, from 23 institutions representing 12 autonomous communities, in order to carry out projects or test scientific research hypotheses with a broad statistical power to study the validity of existing cardiovascular risk functions and identify risk factors and prognostic factors. In total, this project has 163,830 participants aged 30 to 84 with an average follow-up of more than 11 years. CORDELIA is governed by a CYBER-managed agreement.

Navarra's participation in CORDELIA is focused on three research projects, cohort population studies in which participants' cardiovascular events are monitored (healthy population): the Study of cardiovascular diseases carried out in 1993 (Navarra93), which includes 1,400 people; the study EPIC-Navarra launched in 1992-1995 with a total number of 8,040 participants and the Vascular Risk in Navarra Study launched in 2004 (RIVANA), with the participation of 4,168 people. The first two (Navarra 93 and EPIC-Navarra) are managed by the Institute of Public and Occupational Health of Navarra and the study RIVANA by the Planning, Evaluation and Knowledge Management Service of the General Directorate of Health. 

From Navarre, the CORDELIA research team includes Concepción Moreno Iribas (Navarra93), Marcela Guevara Eslava (EPIC-Navarra) and María Jesús Guembe Suescun (RIVANA).
 

• Information for participants: People who have participated in these three projects in Navarra can access information about the processing of their data at the following link.

CORDELIA eta CORDELIA-GWAS

CORDELIA has obtained a grant of about 5 million euros in the call for Personalized Precision Medicine Research Projects of the Strategic Action on Health 2021-2023, from the European funds of the Recovery, Transformation and Resilience Plan with the Project “The first genome-wide association Study (GWAS) with 10-year population-based coronary heart disease in more than 100,000 participants to personalize cardiovascular prevention in Spain” (PMP22/00033). The objective of this project, CORDELIA-GWAS, is to identify genetic factors that allow refining the prediction of cardiovascular disease in the Spanish population for its practical application in the identification and prevention of risk at the individual level.

In the usual clinical practice, the individual prevention strategy is based on the estimation of the global cardiovascular risk and the implementation of preventive measures according to the estimated risk. The predictive cardiovascular risk equation developed in Framingham has been adapted to the Spanish population by the group REGICOR from the IMIM, coordinator of the CORDELIA project.

Based on the adapted equation, tables were constructed that could be easily used in clinical practice with the risks of coronary heart disease at 10 years, according to the individual characteristics of the risk factors (cholesterol, blood pressure, smoking, diabetes, age and sex). The tables have been validated in three subsequent cohort studies (the VERIFICA study, the REGICOR cohort study itself and in the FRESCO study with more than 50,000 participants from all over Spain), and are commonly used in primary care of the health systems of the autonomous communities.

One of the limitations of these functions is their low sensitivity, since approximately 60% of cases of cardiovascular disease occur in low or moderate risk groups. For this reason, in recent years an attempt has been made to improve the predictive capacity of these functions, especially in the moderate risk group, by evaluating new biomarkers. Among them, genetics are of special interest, since they need to be determined only once in a lifetime. 

The development of genetic risk scores based on the results of a GWAS study in a Spanish cohort and the evaluation of its predictive capacity should contribute to the development of personalized and precision medicine in Spain.

The aim of the study is to perform a GWAS on the more than 100,000 Spanish participants for whom DNA is available and to perform a 10-year coronary heart disease association test in Spain for the first time.
 

INCIDENCE AND PREVENTION

The incidence and mortality rates of atherosclerotic cardiovascular disease (ASCVD) are decreasing in many European countries, but it remains an important cause of morbidity (~2500/100,000 inhabitants) and mortality (about 4 million deaths annually). In recent decades, the main risk factors for ASCVD have been identified. An important way to prevent ASCVD is to promote a healthy lifestyle throughout life, especially by avoiding smoking, following a healthy diet and engaging in regular physical activity. On the other hand, there are safe and effective low-cost treatments for risk factors that reduce cardiovascular risk. However, adherence to a healthy lifestyle, and control of the risk factors for ASCVD (which is often insufficient, even in patients at high risk of ASCVD), do not guarantee an absolute reduction in cardiovascular risk.

For the personalized prevention of cardiovascular diseases, it is essential to consider a holistic vision and to have a good understanding of the environmental, genetic, lifestyle (diet, obesity, exercise, alcohol and smoking mainly) and socioeconomic interactions, which need to be studied with population-based approaches at an international scale for which each country must have sufficiently large databases and biobanks. Personalized medicine, which is being developed in the present decade, will predictably evolve and be perfected, thanks to large cohorts such as IMPACT Personalized Medicine, and like the one proposed in this project, which, in themselves or together with other large international databases will allow addressing the prevention of cardiovascular diseases and other chronic diseases in a personalized and comprehensive way including individual factors and community or social factors.
 

• More information 

El Departamento de Universidad, Innovación y Transformación Digital del Gobierno de Navarra, a través de la sociedad pública Centro Europeo de Empresas e Innovación de Navarra (CEIN), ha abierto la tercera edición de la Aceleradora HEALTH. El propósito de este programa de aceleración especializado es apoyar a emprendedores y emprendedoras con ideas de negocio innovadoras en el sector salud, así como a proyectos que operen en él y lleven un máximo de un año en el mercado. Además, se premiará con 8.000 euros al mejor de los proyectos participantes.

Entre las candidaturas que se presenten, se elegirá un máximo de ocho iniciativas según criterios como su cercanía al mercado, potencial de desarrollo, contenido científico-tecnológico o características del equipo promotor.

Las personas interesadas en tomar parte en el programa pueden consultar ya las bases de participación de la convocatoria, así como presentar su candidatura a través de este formulario hasta el próximo 23 de junio.

La Aceleradora HEALTH arrancará en el mes de septiembre, y el trabajo con los proyectos elegidos se enfocará, durante 10 semanas, en la validación de la idea y en el desarrollo del modelo de negocio, gracias a un itinerario formativo adaptado a la fase en la que se encuentren. En el proceso de aceleración, las personas participantes contarán asimismo con tutorías individuales y con consultoría especializada por parte de profesionales en activo y con experiencia de mercado.
 

Premio al “Mejor proyecto del año 2023 de la Aceleradora HEALTH”

Las iniciativas que culminen la aceleradora con aprovechamiento podrán presentarse ante el jurado que fallará el premio al “Mejor proyecto del año 2023 de la Aceleradora HEALTH”, dotado con 8.000 euros, que habrán de dedicarse a su puesta en marcha.

El jurado valorará, entre otros aspectos, el carácter innovador del proyecto, su factibilidad y existencia de mercado potencial o la implicación del equipo promotor.

Además, el proyecto galardonado podrá integrarse en el programa de escalado de startups en salud de CEIN, “HEALTH ScaleUp 2023” e instalarse durante seis meses, de forma gratuita, en el Vivero de Innovación de CEIN.

La Aceleradora HEALTH forma parte del itinerario CEIN HEALTH, que facilita servicios especializados para el fomento, la aceleración y el escalado de iniciativas de innovación y emprendimiento en salud.
 

• Ver nota de prensa difundida. 

• The jury has recognized the project for promoting the autonomy, well-being, and health of the elderly population with a multicomponent approach.

The program “Promotion of Physical Exercise for the Prevention of Frailty and Falls in Older Adults: VIVIfrail,” developed by the Public University of Navarra (UPNA) and Navarrabiomed, has been awarded the XVI NAOS Strategy Awards (Nutrition, Physical Activity, and Obesity Prevention) by the Ministry of Consumer Affairs. These awards aim to promote initiatives that prevent obesity and other non-communicable diseases by promoting healthy eating habits and regular physical activity.

The jury for these awards recognized the UPNA-Navarrabiomed project, coordinated by Professor Mikel Izquierdo Redín, for its objective of “promoting autonomy, well-being, and health of older adults through a multicomponent approach that encompasses physical exercise, nutrition, and medication review by creating synergies between the sports and healthcare and social assistance sectors, working holistically to improve the health status and well-being of our seniors.” The VIVIfrail project award falls under the “healthcare” category.

For the XVI edition of the NAOS Strategy Awards, which are presented by the Spanish Agency for Food Safety and Nutrition, a total of 78 applications were received for different categories, out of which 47 were selected.

Promotion of Exercise in Adults Over 70 Years of Age

VIVIfrail is a multicomponent physical exercise program aimed at preventing falls and frailty in adults over 70 years of age. The project has involved the participation of Nicolás Martinez-Velilla (Department of Geriatrics at the University Hospital of Navarra), researchers Fabricio Zambón Ferraresi and Mikel López Sáez de Asteasu (Navarrabiomed-UPNA), and Leocadio Rodríguez-Mañas (Biomedical Research Foundation of Getafe University Hospital and CIBER of Aging and Fragility-ISCIII). VIVIfrail is part of the Health Promotion and Quality of Life Strategy in the European Union and the World Health Organization (WHO), as well as the Ministry of Health’s strategy for frailty prevention.

To promote the program, the researchers have produced various free materials aimed at healthcare professionals and those in the field of physical activity and sports. These include an educational guide, a mobile application (for smartphones and tablets), and an e-book, all of which are available on the project’s website.

The VIVIfrail project was also selected in 2017 as a “good practice” by a panel of experts from the European Commission and recommended by the World Health Organization as an initiative to improve the functional capacity of older adults.

• Eva Jover y Amaia García de la Peña han obtenido sendos premios a mejor comunicación oral

La Unidad de investigación en Cardiología Traslacional de Navarrabiomed, integrada por profesionales del centro de investigación y del Área Clínica del Corazón del Servicio de Cardiología del Hospital Universitario de Navarra, ha sido reconocida en dos congresos internacionales celebrados recientemente en Freibourg (Alemania) y en Fuengirola, Málaga. El equipo, liderado por la Dra. Natalia López Andrés, trabaja desde el año 2013 en el estudio de los mecanismos que provocan la degeneración de las válvulas del corazón.

Nuevo tratamiento de la estenosis valvular aórtica en mujeres

La investigadora postdoctoral de Navarrabiomed, Eva Jover García, recibió el premio a mejor comunicación oral en el simposio European Section of the Aldosterone Council (ESAC), celebrado en Freibourg entre el 24 y el 25 de marzo, en el que participaron un centenar de profesionales. Su trabajo, “El antagonismo del receptor mineralocorticoide previene la calcificación de la célula intersticial valvular de mujeres vía miR19b/NR3C2 y la señalización del TFGβ”, plantea una nueva opción farmacológica para el tratamiento de la estenosis valvular aórtica en mujeres.

La estenosis valvular es una enfermedad que impide la correcta apertura de la válvula aórtica, que es muy prevalente en la tercera edad y para la que no existen fármacos para tratarla. En hombres, la válvula se deteriora adquiriendo características similares al hueso, mientras que en la mujer hay más fibrosis lo cual sugiere un desarrollo distinto de la enfermedad según el sexo. A pesar de esas diferencias, las mujeres están poco representadas en los estudios, por lo que reciben tratamientos subóptimos y tienen peor pronóstico.

El trabajo demuestra que la pequeña molécula microRNA19b se reduce durante la enfermedad sólo en las mujeres, aumentando la fibrosis y la formación de hueso, e identifica un fármaco para reestablecer los valores de esta molécula. Se trata de la espironolactona, fármaco tradicionalmente empleado en el tratamiento de las enfermedades renales y cardiovasculares.

La investigación desarrollada constata la importancia de los estudios con dimensión de género para conseguir tratamientos más eficaces al considerar la variable sexo.

Mecanismos implicados en el deterioro de la válvula mitral

Por su parte, la cardióloga e investigadora predoctoral del HUN – Navarrabiomed, Amaia García de la Peña Urtasun presentó el trabajo “Desentrañando la valvulopatía mitral primaria: patrones diferenciales histólogicos y moleculares entre los distintos subtipos etiológicos”, por el que recibió el Premio a la mejor comunicación oral durante el congreso internacional de la Heart Valve Society 2023. El encuentro se celebró entre el 29 de marzo y el 1 de abril en Fuengirola, Málaga y reunió a un total de 415 participantes.

La enfermedad de la válvula mitral es la afectación valvular cardíaca más común, que afecta al 1,8% de la población en países desarrollados. Actualmente no existe tratamiento farmacológico y en casos severos el único tratamiento es una cirugía cardíaca. Una de las problemáticas de estas enfermedades es que se desconocen los mecanismos moleculares y celulares implicadas en su desarrollo.

El trabajo presentado ofrece un análisis comparativo entre las principales etiologías de las enfermedades de la válvula mitral (enfermedad de Barlow, deficiencia fibroelástica, enfermedad calcificada y enfermedad reumática), mediante el estudio del tejido obtenido en las cirugías de recambio valvular mitral de 300 pacientes. En concreto, se analizaron los principales mecanismos implicados en dichas enfermedades, observándose patrones diferenciales entre las distintas etiologías, lo que puede favorecer el desarrollo futuro de nuevas dianas terapéuticas específicas para cada patología.

ADItech Corporación Tecnológica has brought together 42 stakeholders of the Navarra R&D&I ecosystem (SINAI) for two days in the Open SINAI Fair, held at the Palacio de Congresos and Baluarte Auditorium. The event, which has had an exhibitors' area and a space for presentations, has facilitated the exchange of experiences and success stories that allow generating new synergies and business opportunities. 
 
Navarrabiomed's Stand 

Navarrabiomed has been present at the fair on both days as an exhibitor with its own corporate stand in order to bring visitors closer to the activity carried out by its 20 research units and the six scientific-technical services of the centre. The forum also served to give visibility to the Innovation Unit, which supports and channels innovation ideas and initiatives from the Navarra Health Service - Osasunbidea. 

During the second day the head of the Genomic Medicine Unit, Angel Alonso, has announced NAGEN-Mx, a project nominated for the best SciencEkaitza Award in the category of Best Strategic Project S4. 
 
More information about NAGEN-Mx

NAGEN-Mx its main objective being to contribute to the personalised screening of breast cancer in Navarra. Through the study of the human genome in different population risk groups, it is intended that those carriers of genes with a greater predisposition to develop the disease be referred to special care. 
Navarrabiomed is leading this strategic project in which professionals from the University Hospital of Navarra, the Institute of Public and Occupational Health of Navarra and the company Making Genetics are also participating. The NAGEN-Mx team analyses the genetic information and medical history of each participant to estimate their personal risk and evaluate the most appropriate screening method for each woman.

In this way, Navarra promotes a more effective and equitable personalised early detection programme for the target population. The project is part of the NAGEN Programme, a strategic commitment of the Government of Navarra to implement genome analysis in the healthcare practice of the Navarra Health Service-Osasunbidea.

• The PhD student has developed her research at Navarrabiomed thanks to an Iberus Talent grant from UPNA and the European Union.

The ability to adhere and create biofilm (a protective film that makes it more resistant) of the bacteria “staphylococcus aureus”, one of those that most often causes infections in orthopaedic prostheses, is the research object of the doctoral thesis of Liliana Andrea Morales Laverde, recently presented at the Public University of Navarra (UPNA). The research has been carried out in the Microbial Pathogenesis Unit of Navarrabiomed-IdiSNA under the direction of Iñigo Lasa Uzcudun, principal investigator of the Microbial Pathogenesis Unit, and Dr. Cristina Solano Goñi, researcher of the same unit.

As the new UPNA doctor explains, there are many elements in the staphylococcus aureus genome that may contribute to its ability to create infections, such as the presence or absence of certain genes or variations in the coding sequence or in intergenic regions. However, “the contribution of the latter has remained, in part, unexplored," she says. Precisely, during her doctoral thesis, Liliana Andrea Morales focused on analysing the role of these variations in genes important for the initial adhesion and subsequent biofilm formation of the bacteria.
For the development of the thesis, Liliana Andrea Morales has had a predoctoral fellowship under the IberusTalent 

programme of Campus Iberus, co-financed by the European Union as part of the Marie Sklodowska‐Curie Actions H2020 and the Public University of Navarra. Research has further received funding through the calls for Aid to R&D&i projects 2017 of the Ministry of Economy, Industry and Competitiveness and Aid to R&D&i projects 2020 of the Ministry of Science and Innovation, granted to the projects: 
 
The role of intergenic variations
 
As the new doctor from the UPNA explains, the results of the thesis “show that changes in intergenic regions are a source of variability between clinical isolates and contribute to different levels of expression of these elements associated with the pathogenesis of the bacterium”. Bacteria that are extracted (isolated) from an infection for further study are known as “clinical isolates”.
In her research, Liliana Morales developed a methodology to simultaneously identify and quantify different strains of staphylococcus aureus in a mouse coinfection model. “This methodology made it possible to identify significant differences in the adhesion and colonisation capacity of the isolates,” she says. “In the future, this methodology could be useful in identifying competitive advantages between closely related clinical isolates,” she concludes.
The studies were carried out in collaboration with Dr. Margarita Trobos and the Department of Biomaterials of the University of Gothenburg (Sweden), where Liliana Morales carried out a research stay.
 
Brief CV of the researcher
 
Liliana Morales studied her degree in Microbiology and Bioanalysis at the Industrial University of Santander (Colombia), where her interest in research began. Subsequently, through the Ibero-American Postgraduate University Association (AUIP) and the Early Stage Researchers programme (ESRs), IberusTalent, Liliana studied her Master's degree at the University of La Rioja and her doctoral studies with international honours at UPNA, respectively. During her training, Liliana Morales has specialised in the areas of Microbiology and Molecular Engineering focused mainly in the area of Health.

Liliana Andrea Morales Laverde, predoctoral researcher at the Microbial Pathogenesis Unit from Navarrabiomed-IdiSNA will present her doctoral thesis in Biotechnology with international distinction by the Public University of Navarra on Friday, February 17th. The event will start at 11:00 am in the assembly hall of Navarrabiomed.

The doctoral thesis, which is entitled “Analysis of the association between polymorphisms in intergenic regions of Staphylococcus aureus genes involved in biofilm formation and periprosthetic joint infections”, has been developed at Navarrabiomed under the direction of the doctors Iñigo Lasa Uzcudun, principal investigator of the Microbial Pathogenesis Unit and Cristina Solano Goñi, a researcher from the same unit.
 
Research development
 
Staphylococcus aureus it is the microorganism that is most often found causing infections associated with medical devices. Currently, the sequencing of bacterial genomes makes it possible to identify associations between genetic variations and specific phenotypes; however, changes in intergenic regions have received little attention since they are numerous and their effect is difficult to determine. During her doctoral thesis, Liliana focused on analysing the role of intergenic variations in genes that encode important elements in the pathogenesis of infections associated with medical devices, in clinical isolates of infections associated with prostheses and wounds.

The results show that variations in intergenic regions of genes encoding surface adhesins, mediating the initial adhesion to medical surfaces, are characteristic of the clonal complexes and generate significant changes in the expression levels of the adhesins. On the contrary, the intergenic regions of the operon icaADBC responsible for the synthesis of the polysaccharide PIA/PNAG, the main component of the biofilm matrix, are highly conserved and variations in these regions do not have an effect on expression levels. These results suggest that genome analysis should consider intergenic regions as an important source of phenotypic variability between clinical isolates.

On the other hand, during her thesis, Liliana developed a metagenomics methodology, based on amplicon sequencing, to simultaneously identify and quantify different strains of Staphylococcus aureus in a murine catheter coinfection model. This methodology allowed to identify significant differences in the adhesion and colonisation capacity of the isolates and, it is anticipated, will be very useful in identifying competitive advantages between closely related clinical isolates.
The research presented has been developed at Navarrabiomed and has had the collaboration of Dr. Margarita Trobos and the Department of Biomaterials of the University of Gothenburg, an institution where the doctoral student also completed a research stay from May to August 2022.
 
Financing and dissemination of results
 
For the development of the thesis, Liliana has had a predoctoral grant from the IberusTalent  programme co-financed by the European Union as part of the Marie Sklodowska ‐Curie H2020 and the Public University of Navarra. Research has further received funding through the calls for Aid to R&D&i projects 2017 of the Ministry of Economy, Industry and Competitiveness and Aid to R&D&i projects 2020 of the Ministry of Science and Innovation.
The results of this thesis are published in the following journals Microorganisms and Biofilm, and have been presented in different scientific forums: Eurobiofilms Mallorca 2022, 31st European Congress of Clinical Microbiology 2021 (online) & Infectious Diseases (ECCMID), XXVIII Congress of the Spanish Society of Microbiology (SEM) 2021 (online), Jaca Doctoral Conference 2021 and Biofilms9 (online) 2020.