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Investigation
Development of new diagnostic methods for invasive fungal infection
Research Lines
Content with Investigacion .
El diagnóstico de la infección fúngica invasora (IFI) es complicado y con frecuencia se retrasa ya que en muchas ocasiones a la falta de sospecha clínica se le suma la falta de herramientas diagnósticas eficaces. Esta línea de investigación se inició en el año 2003, primero liderada por el Dr. Manuel Cuenca-Estrella y posteriormente por la Dra. María José Buitrago con el objetivo general de desarrollar nuevas herramientas, basadas en la PCR en tiempo Real, para un diagnóstico rápido de IFI. Los objetivos concretos que se han ido alcanzando a lo largo de estos años han sido los siguientes:
Detección precoz de hongos causantes de infecciones fúngicas oportunistas más frecuentes en pacientes inmunodeprimidos (Aspergilosis y Candidiasis invasoras)
Se han desarrollado y validado técnicas de PCR en tiempo Real en formato multiplex para el cribado de pacientes en riesgo de padecer estas infecciones, así como para el diagnóstico en pacientes con sospecha.
Detección de IFIs causadas por hongos emergentes (Escedosporiosis, Fusariosis etc...)
El aumento de especies raras o poco frecuentes causantes de IFI hizo necesario el desarrollo de técnicas para su detección
Detección “panfúngica”
Para aquellos casos en los que no exista evidencia clara del hongo causante de la infección se han desarrollado técnicas basadas en PCR en tiempo Real.
Mejora del diagnóstico y la identificación de los hongos causantes de micosis importadas (micosis endémicas)
Debido al aumento de la inmigración y los viajes a lugares exóticos en los últimos años se ha producido un incremento de las micosis importadas en España, en concreto de aquellas causadas por hongos endémicos de determinadas regiones, los cuales son además patógenos primarios. Este objetivo es relevante en el contexto de una región no-endémica ya que existe falta de experiencia en el manejo de estas infecciones y las técnicas diagnósticas disponibles son muy escasas. A lo largo de estos años se han desarrollado y validado distintas técnicas para el diagnóstico rápido de estas micosis y se han realizado diferentes trabajos encaminados a un mejor conocimiento de los hongos que las causan.
Las técnicas desarrolladas a lo largo de estos años se han incorporado a la Cartera de Servicios del Centro Nacional de Microbiología para ofrecerlas al Sistema Nacional de Salud. Además, algunas de ellas se han patentado.
Research projects
Content with Investigacion .
1. Nombre del proyecto: Mejora del pronóstico del paciente con riesgo de enfermedad fúngica invasora: estudio de susceptibilidad del huésped y desarrollo de nuevos métodos de diagnóstico clínico. Entidad/es financiadora/s: Instituto de Salud Carlos III. Fecha de inicio-fin: 01/01/2018 - 31/12/2020. Cuantía: 72.000 €. Investigadores principales (IP, Co-IP,...): María José Buitrago Serna/Laura Alcazar Fuoli
2. Nombre del proyecto: Red española de Investigación en Patologías infecciosas REIPI
Entidad/es financiadora/s: ISCIII-FEDER Fecha de inicio-fin: 01/01/2017 - 31/12/2021
Cuantía total: 195.612 €. Coordinador: Emilia Mellado
3. Nombre del proyecto: Desarrollo y validación de un método de detección de tipo “point of care”. Entidad/es financiadora/s: Instituto de Salud Carlos III. Fecha de inicio-fin: 01/01/2015 - 31/12/2017. Cuantía total: 46.000 €. Investigador principal: María José Buitrago.
4. Nombre del proyecto: European Research Infrastructure on Highly Pathogenic Agents 2-ERINHA2(Horizon2020). Nombre del programa: FP7-Infraestructuras-2015. Programa marco. THEME (INFRA-2010-2.2.8: High Security BLS4 Laboratory). Entidad financiadora: Unión Europea. Fecha de inicio-fin: 01/01/2016 - 01/06/2017. Cuantía total: 524.848 €. Cuantía subproyecto: 141.562 €. Coordinador (IP): Raoul Hervé.
5. Nombre del proyecto: Iberian network of laboratories of Biological Alert Acreditation of methods for detection of highly pathogenic agents/IB-BiOALERNET Entidad/es financiadora/s: DG-Home (Unión Europea). Fecha de inicio-fin: 2013 – 2015. Cuantía total: 629.382,67 €. Coordinador (IP): Carmen Cañavate
6. Nombre del proyecto: Desarrollo de nuevos métodos de diagnóstico e identificación de especies fúngicas causantes de neumonías oportunistas. Entidad/es financiadora/s: ISCIII. Fecha de inicio-fin: 2012 – 2015. Cuantía total: 67.429,67 €. Investigador principal: María José Buitrago.
7. Nombre del proyecto: European Research Infrastructure on Highly Pathogenic Agents 2-ERINHA2 (Horizon2020). Nombre del programa: FP7-Infraestructuras-2015. Programa marco. THEME (INFRA-2010-2.2.8: High Security BLS4 Laboratory. Entidad financiadora: Unión Europea. Fecha de inicio-fin: 01/01/2010 - 31/12/2013. Cuantía total: 4.859.782,5 €. Coordinador (IP): Raoul Hervé.
8. Nombre del proyecto: RED iberoamericana de diagnóstico molecular de las infecciones endémicas y oportunistas. Entidad/es financiadora/s: CYTED-AECI. Fecha de inicio-fin: 2008 – 2009. Cuantía total: 70.000 €. Investigador principal: Luz-Elena Cano
9. Nombre del proyecto: “Desarrollo de nuevos métodos de diagnóstico en alertas biosanitarias relacionadas con la Micología”. Entidad/es financiadora/s: Instituto de Salud Carlos III. Fecha de inicio-fin: 2007 – 2009. Cuantía total: 58.500 €. Investigador Principal: María José Buitrago
Publications
Efficacy of DNA amplification in tissue biopsy samples to improve the detection of invasive fungal disease
Buitrago MJ, Aguado JM, Ballen A, Bernal-Martinez L, Prieto M, Garcia-Reyne A, Garcia-Rodriguez J, Rodriguez-Tudela JL, Cuenca-Estrella M. Efficacy of DNA amplification in tissue biopsy samples to improve the detection of invasive fungal disease. Clin Microbiol Infect. 2013 Jun;19(6):E271-7. doi: 10.1111/1469-0691.12110. Epub 2013 Mar 7. PMID: 23464751.
PUBMED DOIPotent Induction of Envelope-Specific Antibody Responses by Virus-Like Particle Immunogens Based on HIV-1 Envelopes from Patients with Early Broadly Neutralizing Responses
Beltran-Pavez C, Bontjer I, Gonzalez N, Pernas M, Merino-Mansilla A, Olvera A, Miro JM, Brander C, Alcami J, Sanders RW, Sanchez-Merino V, Yuste E. J Virol. 2022 Jan 12, 96(1): e0134321
PUBMED DOIHIV-1 envelope glycoproteins isolated from Viremic Non-Progressor individuals are fully functional and cytopathic
Cabrera-Rodríguez R, Hebmann V, Marfil S, Pernas M, Marrero-Hernández S, Cabrera C, Urrea V, Casado C, Olivares I, Márquez-Arce D, Pérez-Yanes S, Estévez-Herrera J, Clotet B, Espert L, López-Galíndez C, Biard-Piechaczyk M, Valenzuela-Fernández A, Blanco J. Sci Rep. 2019 Apr 3,9(1):5544
PUBMED DOIViral Characteristics Associated with the Clinical Nonprogressor Phenotype Are Inherited by Viruses from a Cluster of HIV-1 Elite Controllers
Casado C, Marrero-Hernández S, Márquez-Arce D, Pernas M, Marfil S, Borràs-Grañana F, Olivares I, Cabrera-Rodríguez R, Valera MS, de Armas-Rillo L, Lemey P, Blanco J, Valenzuela-Fernández A, Lopez-Galíndez C. mBio. 2018 Apr 10,9(2): e02338-17
PUBMED DOIViral and Cellular Factors Leading to the Loss of CD4 Homeostasis in HIV-1 Viremic Nonprogressors.
Colomer-Lluch M, Kilpelainen A, Pernas M, Peña R, Ouchi D, Jimenez-Moyano E, Dalmau J, Casado C, López-Galíndez C, Clotet B, Martinez-Picado J, Prado JG. J Virol. 2022 Jan 12, 96(1): e0149921. doi: 10.1128/JVI.01499-21. Epub 2021 Oct 20.
PUBMED DOIContribution of the HIV-1 Envelope Glycoprotein to AIDS Pathogenesis and Clinical Progression
Valenzuela-Fernández A, Cabrera-Rodríguez R, Casado C, Pérez-Yanes S, Pernas M, García-Luis J, Marfil S, Olivares I, Estévez-Herrera J, Trujillo-González R, Blanco J, Lopez-Galindez C. Biomedicines. 2022 Sep 2,10(9):2172.
PUBMED DOIPrevalence of HIV-1 dual infection in LTNP-Elite Controllers
María Pernas, Concepción Casado, Virginia Sandonis, Carolina Arcones, Carmen Rodríguez , Ezequiel Ruiz-Mateos , Eva Ramírez de Arellano , Norma Rallón , Margarita Del Val , Eulalia Grau, Mariola López-Vazquez , Manuel Leal , Jorge del Romero , Cecilio López Galíndez . (2013). J.of AIDS. 64, 3, 225-231. IF 4.262
PUBMED DOIA Genome-to-Genome Analysis of Associations between Human Genetic Variation, HIV-1 Sequence Diversity, and Retroviral Control.
Istvan Bartha Jonathan M Carlson, Chanson J Brumme, Paul J McLaren, Zabrina L Brumme, Mina John, David W Haas, Javier Martinez-Picado, Cecilio López Galíndez, Andri Rauch, Huldrych F Günthard, Enos Bernasconi, Pietro Vernazza, Thomas Klimkait, Sabine Yerly, Jennifer Listgarten, Nico Pfeifer, Zoltan Kutalik, Todd M Allen, Viktor Müller, P Richard Harrigan, David Heckerman, Amalio Telenti, and Jacques Fellay, for the HIV Genome-to-Genome Study and the Swiss HIV Cohort Study. (2013). Elife. 2013;2:e01123
PUBMED DOIFactors Leading to the Loss of Natural Elite Control of HIV-1 Infection
Pernas M, Tarancón-Diez L, Rodríguez-Gallego E, Gómez J, Prado JG, Casado C, Dominguez-Molina B, Olivares I, Coiras M, León A, Rodriguez C, Benito JM, Rallón N, Plana M, Martinez-Madrid O, Dapena M, Iribarren JA, Del Romero J, García F, Alcamí J, Muñoz-Fernández M, Vidal F, Leal M, Lopez-Galindez C, Ruiz-Mateos E. J Virol. 2018 Feb 12,92(5): e01805-17
PUBMED DOIViruses from a cluster of HIV-1 Elite controllers inherit viral characteristics associated with the clinical non-progressor phenotype
Casado C, Marrero-Hernández S, Márquez-Arce D, Pernas M, Marfil S, Borràs-Grañana F, Olivares I, Cabrera-Rodríguez R, Valera M-S, de Armas-Rillo L, Lemey P, Blanco J, Valenzuela-Fernández A, Lopez-Galíndez C. 2018. mBio 9:e02338-17.
PUBMED DOIPermanent control of HIV-1 pathogenesis in exceptional elite controllers: a model of spontaneous cure
Casado C, Galvez C, Pernas M, Tarancon-Diez L, Rodriguez C, Sanchez-Merino V, Vera M, Olivares I, De Pablo-Bernal R, Merino-Mansilla A, Del Romero J, Lorenzo-Redondo R, Ruiz-Mateos E, Salgado M, Martinez-Picado J, Lopez-Galindez C. Sci Rep. 2020 Feb 5,10(1):1902
PUBMED DOIHigh-Risk Sexual Practices Contribute to HIV-1 Double Infection Among Men Who Have Sex with Men in Madrid
Casado C, Pernas M, Rava M, Ayerdi O, Vera M, Alenda R, Jiménez P, Docando F, Olivares I, Zaballos A, Vicario JL, Rodríguez C, Del Romero J, Lopez-Galindez C. AIDS Res Hum Retroviruses. 2020 Nov, 36(11):896-904
PUBMED DOIIdentification of a Spanish HIV-1 Long Term Non-Progressor cluster infected with a low replicating virus
Concepción Casado, Maria Pernas, Virginia Sandonis, Tamara Alvaro-Cifuentes, Isabel Olivares, Rosa Fuentes, Lorena Martínez Prats, Eulalia Grau, Lidia Ruiz, Rafael Delgado, Carmen Rodríguez, Jorge del Romero, and Cecilio López-Galíndez. (2013). PLoS One. 8 (10):e77663.
PUBMED DOIContent with Investigacion .
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Leticia Bernal Martínez
Staff Scientist
ORCID code: 0000-0002-1694-5522
Dr. Bernal-Martínez obtained her degree in Biochemistry from the University of Zaragoza in 2005. She joined the Mycology Reference and Research Laboratory (LRIM) in 2006 under a trainee contract and completed her PhD within the Official Doctoral Program in Microbiology and Parasitology at the Complutense University of Madrid, defending her thesis in 2010 with highest honors (Cum Laude). In 2007, she continued her research activity at LRIM within the framework of the Spanish Network for Research in Infectious Diseases (REIPI). In 2016, she completed a Postgraduate Diploma in Promotion and Management of International Projects (Technical University of Madrid) and undertook a research stay at the Microbiology and Infection Research Domain, Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho (Braga, Portugal). She was subsequently appointed as a PhD researcher within the Biomedical Research Networking Center in Infectious Diseases (CIBERINFEC). Since 2024, she serves as Specialist Scientist at the Carlos III Health Institute (ISCIII) and is responsible for the Diagnostic and Serology Section for Endemic Fungi at the Mycology Reference and Research Laboratory.
Dr. Bernal-Martínez has authored more than 30 peer-reviewed scientific publications and two book chapters. She has actively participated in over 12 research projects and has presented her work at numerous national and international scientific conferences. Her research has focused on human fungal infections, antifungal resistance, therapeutic drug monitoring, genetic variants associated with antifungal metabolism, and the identification of predictive biomarkers of invasive fungal infections. However, her primary expertise lies in the diagnostic field, particularly in the design, optimization, and validation of real-time PCR–based methodologies.
She is currently Principal Investigator of a research project aimed at improving current diagnostic techniques for invasive fungal infections, evaluating emerging diagnostic technologies, and studying primary fungal pathogens. A substantial part of her work has been transferred to the Spanish National Health System and to research centers in Latin America. Many of the diagnostic methodologies developed have been incorporated into the official service portfolio of ISCIII. She has collaborated with multiple hospitals through research projects and clinical trials applying these technologies, as well as with the ISCIII spin-off company Micomol S.L.
Dr. Bernal-Martínez has supervised several Master’s and Undergraduate Final Degree Projects from students at the Complutense University of Madrid and the University of Alcalá. She is a member of the teaching staff of the UNED-ISCIII PhD Program in Biomedical Sciences and Public Health and serves as lecturer in the Master’s Program in Public Health and Research in Infectious Diseases at the University of Alcalá.
List of staff
Additional Information
RECENT COLLABORATIONS
1. Dr. Marco Teixeira. Visiting professor at the University of Brasilia (UnB). Affiliated researcher at Northern Arizona University (NAU)
2. Dr. Alexandre Alanio. Researcher at Hôpital St. Louis, Paris. France
3. Dr. Dunja Wilmes. Researcher at the Robert Koch Institute. Sedan. Germany.
4. Dr. Paula Sampaio. Center for Molecular and Environmental Biology (CBMA), Department of Biology, University of Minho, Braga, Portugal
5. Dr. Rosely Zancope-Oliveira. Professor at the Oswaldo Cruz Foundation. Rio de Janeiro, Brazil.
6. Dr. Ana Cecilia Mesa Arango. Professor at the University of Antioquia. Medellin. Colombia
7. Dr. Néstor Pakasa. Professor, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
8. Dr. David aka. Researcher at the Félix Houphouët-Boigny University, Abidjan, Ivory Coast
PATENTS
a) Registered industrial property title: “Development of a rapid method for the diagnosis of histoplasmosis and/or paracoccidioidomycosis by multiplex Real-Time PCR with Molecular Beacon type probe initiators.” Inventors: María José Buitrago Serna; Manuel Cuenca Estrella; Juan Luis RodriguezTudela; Alicia Gómez López. Rights holder entity: Carlos III Health Institute. Application number: P200802665. Country of registration: Spain. Registration date: 09/19/2008. Grant date: 09/14/2011
b) Registered industrial property title: Riboflavin-synthese in Ashbya gossypii. Inventors/authors/breeders: Jose Luis Revuelta Doval; María José Buitrago Serna; Maria de los Angeles Santos García. Rights holder entity: BASF Aktiengesellschaft. Application number: CA 2186403. Registration date: 03/25/1994. Grant date: 01/24/2006
c) Registered industrial property title: Riboflavin-Synthese in Hefen. Inventors/authors/breeders: Jose Luis Revuelta Doval; Jose Javier García Ramírez; Maria de Los Angeles Santos García; Gloria Angélica González; María José Buitrago Serna. Rights holder entity: BASF Aktiengesellschaft. Application number: EP19940901793. Registration date: 11/19/199. Grant date: 05/07/1997
DIRECTION OF DOCTORAL THESES
1. Title: Development of new methods for diagnosis and identification of fungal species that cause opportunistic pneumonia. Implementation entity: Complutense University-ISCIII. Student: Clara Valero Fernández. Qualification obtained: Excellent Cum Laude. Defense date: 05/19/2017
2. Title: Development and Validation of diagnostic techniques for invasive fungal infection. Implementation entity: Complutense University of Madrid-ISCIII. Student: Sara Gago Prieto. Grade obtained: Excellent cum laude. Defense date: 07/18/2014
3. Title: Development of techniques based on real-time PCR for the diagnosis of invasive fungal infections. Implementation entity: Complutense University of
Madrid-ISCIII. Student: Leticia Bernal Martinez. Grade obtained: Excellent cum laude. Defense date: 2010
RECENT COLLABORATIONS
1. Dr. Marco Teixeira. Visiting professor at the University of Brasilia (UnB). Affiliated researcher at Northern Arizona University (NAU)
2. Dr. Alexandre Alanio. Researcher at Hôpital St. Louis, Paris. France
3. Dr. Dunja Wilmes. Researcher at the Robert Koch Institute. Sedan. Germany.
4. Dr. Paula Sampaio. Center for Molecular and Environmental Biology (CBMA), Department of Biology, University of Minho, Braga, Portugal
5. Dr. Rosely Zancope-Oliveira. Professor at the Oswaldo Cruz Foundation. Rio de Janeiro, Brazil.
6. Dr. Ana Cecilia Mesa Arango. Professor at the University of Antioquia. Medellin. Colombia
7. Dr. Néstor Pakasa. Professor, Kinshasa University Hospital, Kinshasa, Democratic Republic of the Congo
8. Dr. David aka. Researcher at the Félix Houphouët-Boigny University, Abidjan, Ivory Coast
PATENTS
a) Registered industrial property title: “Development of a rapid method for the diagnosis of histoplasmosis and/or paracoccidioidomycosis by multiplex Real-Time PCR with Molecular Beacon type probe initiators.” Inventors: María José Buitrago Serna; Manuel Cuenca Estrella; Juan Luis RodriguezTudela; Alicia Gómez López. Rights holder entity: Carlos III Health Institute. Application number: P200802665. Country of registration: Spain. Registration date: 09/19/2008. Grant date: 09/14/2011
b) Registered industrial property title: Riboflavin-synthese in Ashbya gossypii. Inventors/authors/breeders: Jose Luis Revuelta Doval; María José Buitrago Serna; Maria de los Angeles Santos García. Rights holder entity: BASF Aktiengesellschaft. Application number: CA 2186403. Registration date: 03/25/1994. Grant date: 01/24/2006
c) Registered industrial property title: Riboflavin-Synthese in Hefen. Inventors/authors/breeders: Jose Luis Revuelta Doval; Jose Javier García Ramírez; Maria de Los Angeles Santos García; Gloria Angélica González; María José Buitrago Serna. Rights holder entity: BASF Aktiengesellschaft. Application number: EP19940901793. Registration date: 11/19/199. Grant date: 05/07/1997
DIRECTION OF DOCTORAL THESES
1. Title: Development of new methods for diagnosis and identification of fungal species that cause opportunistic pneumonia. Implementation entity: Complutense University-ISCIII. Student: Clara Valero Fernández. Qualification obtained: Excellent Cum Laude. Defense date: 05/19/2017
2. Title: Development and Validation of diagnostic techniques for invasive fungal infection. Implementation entity: Complutense University of Madrid-ISCIII. Student: Sara Gago Prieto. Grade obtained: Excellent cum laude. Defense date: 07/18/2014
3. Title: Development of techniques based on real-time PCR for the diagnosis of invasive fungal infections. Implementation entity: Complutense University of
Madrid-ISCIII. Student: Leticia Bernal Martinez. Grade obtained: Excellent cum laude. Defense date: 2010