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Susceptibilidad del huésped a las infecciones fúngicas invasoras
Se estima que más de un millón y medio de personas mueren al año en el mundo debido a una enfermedad fúngica invasora (EFI). Los tratamientos con inmunosupresores, terapias con corticoides, trasplantes de células hematopoyéticas y órgano sólido así como tratamientos quimioterapéuticos contra el cáncer han favorecido el aumento de estas infecciones fúngicas. El género Aspergillus es la principal causa de EFI por hongos filamentosos, siendo A. fumigatus la especie principalmente aislada en la mayoría de los casos y más frecuentemente asociada a Aspergilosis Invasora.
Muchas de estas infecciones están infra-diagnosticadas debido, tanto a la falta de sospecha clínica como a las limitaciones diagnósticas. Esta línea de investigación tiene como principal objetivo mejorar el pronóstico de la infecciones en pacientes con riesgo de desarrollar infecciones invasoras por hongos. Para ello se estudian marcadores del individuo (denominados biomarcadores del hospedador) que puedan ser detectados de forme temprana en muestras de pacientes en riesgo y que nos permita estratificar a los mismos en función de la susceptibilidad a desarrollar una infección invasora por hongos. Además, estudios realizados en los últimos años muestran que el fondo genético del hospedador está asociado con la predisposición al desarrollo de este tipo de enfermedades. En concreto se han identificado polimorfismos genéticos de nucleótido simple (“Single Nucleotide Polymorphism”- SNP) en genes que codifican para componentes celulares que interaccionan con estructuras fúngicas y/o que están involucradas en la respuesta inmune del huésped frente a agentes infecciosos como Aspergillus. En este sentido se han estandarizado y aplicado herramientas para la detección de SNPs en humanos de genes diana asociados concretamente con la susceptibilidad a la Aspergilosis Invasora.
Estudio de los mecanismos de virulencia en Aspergillus fumigatus
En paralelo al estudio de la respuesta del hospedador se sigue una línea cuyo objetivo es caracterizar mecanismos de virulencia en A. fumigatus. Uno de los principales mecanismos por los que A. fumigatus es capaz de causar enfermedad en humanos es su capacidad de adaptarse a las condiciones ambientales del hospedador. Entre las moléculas y los genes que se han relacionado con la virulencia de este hongo se encuentran componentes de la pared celular, genes y moléculas relacionadas con la evasión de la respuesta inmune, sistemas de detoxificación de los compuestos derivados del oxígeno, la producción de toxinas, la obtención de nutrientes como hierro, fósforo, nitrógeno y la adaptación a pH y temperatura del hospedador. Estos estudios permiten profundizar en el conocimiento sobre la patogenicidad de este hongo e identificar nuevas dianas terapéuticas
Publications
Fernandez-Garcia MD, Kebe O, Fall AD, Ndiaye K. Identification and molecular characterization of non-polio enteroviruses from children with acute flaccid paralysis in West Africa, 2013-2014.
Fernandez-Garcia MD, Kebe O, Fall AD, Ndiaye K. Identification and molecular characterization of non-polio enteroviruses from children with acute flaccid paralysis in West Africa, 2013-2014. Scientific Reports. 2017 Jun 19; 7(1):3808. doi: 10.1038/s41598-017-03835-1 ISSN 2045-2322 PMID 28630462
Fernandez-Garcia MD, Manasi Majumdar, Ousmane Kebe, Kader Ndiaye, Javier Martin. Identification and whole-genome characterization of a recombinant Enterovirus B69 isolated from a patient with Acute Flaccid Paralysis in Niger, 2015
Fernandez-Garcia MD, Manasi Majumdar, Ousmane Kebe, Kader Ndiaye, Javier Martin. Identification and whole-genome characterization of a recombinant Enterovirus B69 isolated from a patient with Acute Flaccid Paralysis in Niger, 2015. Scientific Reports. 2018 Feb; 8(1):2181. doi: 10.1038/s41598-018-20346-9. ISSN 2045-2322 PMID 29391547
Fernandez-Garcia MD, Majumdar M, Kebe O, Fall AD, Kone M, Kande M, Dabo M, Sylla MS, Sompare D, Howard W, Faye O, Martin J, Ndiaye K. Emergence of Vaccine- Derived Polioviruses during Ebola Virus Disease Outbreak, Guinea, 2014-2015.
Fernandez-Garcia MD, Majumdar M, Kebe O, Fall AD, Kone M, Kande M, Dabo M, Sylla MS, Sompare D, Howard W, Faye O, Martin J, Ndiaye K. Emergence of Vaccine- Derived Polioviruses during Ebola Virus Disease Outbreak, Guinea, 2014-2015. Emerg Infect Dis. 2018 Jan;24(1):65-74. doi: 10.3201/eid2401.171174. PMID: 29260690; PMCID: PMC5749474.
Cabrerizo M, García-Iñiguez JP, Munell F, Amado A, Madurga-Revilla P, Rodrigo C, Pérez S, Martínez-Sapiña A, Antón A, Suárez G, Rabella N, Del Campo V, Otero A, Masa-Calles J. First Cases of Severe Flaccid Paralysis Associated With Enterovirus D68 Infection in Spain, 2015-2016.
Cabrerizo M, García-Iñiguez JP, Munell F, Amado A, Madurga-Revilla P, Rodrigo C, Pérez S, Martínez-Sapiña A, Antón A, Suárez G, Rabella N, Del Campo V, Otero A, Masa-Calles J. First Cases of Severe Flaccid Paralysis Associated With Enterovirus D68 Infection in Spain, 2015-2016. Pediatr Infect Dis J. 2017 Dec;36(12):1214-1216. doi: 10.1097/INF.0000000000001668. PMID: 28661963.
van Beek J, de Graaf M, Al-Hello H, Allen DJ, Ambert-Balay K, Botteldoorn N, Brytting M, Buesa J, Cabrerizo M, Chan M, Cloak F, Di Bartolo I, Guix S, Hewitt J, Iritani N, Jin M, Johne R, Lederer I, Mans J, Martella V, Maunula L, McAllister G, Niendorf S, Niesters HG, Podkolzin AT, Poljsak-Prijatelj M, Rasmussen LD, Reuter G, Tuite G, Kroneman A, Vennema H, Koopmans MPG; NoroNet. Molecular surveillance of norovirus, 2005-16
van Beek J, de Graaf M, Al-Hello H, Allen DJ, Ambert-Balay K, Botteldoorn N, Brytting M, Buesa J, Cabrerizo M, Chan M, Cloak F, Di Bartolo I, Guix S, Hewitt J, Iritani N, Jin M, Johne R, Lederer I, Mans J, Martella V, Maunula L, McAllister G, Niendorf S, Niesters HG, Podkolzin AT, Poljsak-Prijatelj M, Rasmussen LD, Reuter G, Tuite G, Kroneman A, Vennema H, Koopmans MPG; NoroNet. Molecular surveillance of norovirus, 2005-16: an epidemiological analysis of data collected from the NoroNet network. Lancet Infect Dis. 2018 May;18(5):545-553. doi: 10.1016/S1473-3099(18)30059-8. Epub 2018 Jan 26. PMID: 29396001.
González-Serrano L, Muñoz-Algarra M, González-Sanz R, Portero-Azorín MF, Amaro MJ, Higueras P, Cabrerizo M. Viral gastroenteritis in hospitalized patients: Evaluation of immunochromatographic methods for rapid detection in stool samples. J Clin Virol. 2020 Jul;
González-Serrano L, Muñoz-Algarra M, González-Sanz R, Portero-Azorín MF, Amaro MJ, Higueras P, Cabrerizo M. Viral gastroenteritis in hospitalized patients: Evaluation of immunochromatographic methods for rapid detection in stool samples. J Clin Virol. 2020 Jul; 128:104420. doi: 10.1016/j.jcv.2020.104420. Epub 2020 May 15. PMID: 32454428.
Bubba L, Broberg EK, Jasir A, Simmonds P, Harvala H; Enterovirus study collaborators. Circulation of non-polio enteroviruses in 24 EU and EEA countries between 2015 and 2017
Bubba L, Broberg EK, Jasir A, Simmonds P, Harvala H; Enterovirus study collaborators. Circulation of non-polio enteroviruses in 24 EU and EEA countries between 2015 and 2017: a retrospective surveillance study. Lancet Infect Dis. 2020 Mar;20(3):350-361. doi: 10.1016/S1473-3099(19)30566-3. Epub 2019 Dec 20. PMID: 31870905.
Fernandez-Garcia MD, Simon-Loriere E, Kebe O, Sakuntabhai A, Ndiaye K. Identification and molecular characterization of the first complete genome sequence of Human Parechovirus type 15. Sci Rep. 2020 Apr 21
Fernandez-Garcia MD, Simon-Loriere E, Kebe O, Sakuntabhai A, Ndiaye K. Identification and molecular characterization of the first complete genome sequence of Human Parechovirus type 15. Sci Rep. 2020 Apr 21;10(1):6759. doi: 10.1038/s41598-020-63467-w. PMID: 32317760; PMCID: PMC7174385.
Casas-Alba D, Valero-Rello A, Muchart J, Armangué T, Jordan I, Cabrerizo M, Molero-Luís M, Artuch R, Fortuny C, Muñoz-Almagro C, Launes C. Cerebrospinal Fluid Neopterin in Children With Enterovirus-Related Brainstem Encephalitis. Pediatr Neurol. 2019 Jul
Casas-Alba D, Valero-Rello A, Muchart J, Armangué T, Jordan I, Cabrerizo M, Molero-Luís M, Artuch R, Fortuny C, Muñoz-Almagro C, Launes C. Cerebrospinal Fluid Neopterin in Children With Enterovirus-Related Brainstem Encephalitis. Pediatr Neurol. 2019 Jul; 96:70-73. doi: 10.1016/j.pediatrneurol.2019.01.024. Epub 2019 Feb 7. PMID: 30935719.
González-Sanz R, Taravillo I, Reina J, Navascués A, Moreno-Docón A, Aranzamendi M, Romero MP, Del Cuerpo M, Pérez-González C, Pérez-Castro S, Otero A, Cabrerizo M. Enterovirus D68-associated respiratory and neurological illness in Spain, 2014-2018.
González-Sanz R, Taravillo I, Reina J, Navascués A, Moreno-Docón A, Aranzamendi M, Romero MP, Del Cuerpo M, Pérez-González C, Pérez-Castro S, Otero A, Cabrerizo M. Enterovirus D68-associated respiratory and neurological illness in Spain, 2014-2018. Emerg Microbes Infect. 2019;8(1):1438-1444. doi: 10.1080/22221751.2019.1668243. PMID: 31571527; PMCID: PMC6781473.
Monocytic Myeloid-Derived Suppressor Cells Accumulate in Renal Transplant Patients and Mediate CD4(+) Foxp3(+) Treg Expansion
Luan Y, Mosheir E, Menon MC, Wilson D, Woytovich C, Ochando J, Murphy B. Monocytic Myeloid-Derived Suppressor Cells Accumulate in Renal Transplant Patients and Mediate CD4(+) Foxp3(+) Treg Expansion. 2013. Am J Transplant.13(12):3123-31.
PUBMED DOIRiquelme P, Haarer J, Kammler A, Walter L, Tomiuk S, Ahrens N, Goecze I, Wege A, Fändrich F, Schlitt H, Banas B, Lutz M, Sawitzki B, Ochando J, Geissler E and Hutchinson J. Generation of BTNL8+ TIGIT+ Tregs by Human Regulatory Macrophages Before Kidney Transplantation. Nat Commun.
Riquelme P, Haarer J, Kammler A, Walter L, Tomiuk S, Ahrens N, Goecze I, Wege A, Fändrich F, Schlitt H, Banas B, Lutz M, Sawitzki B, Ochando J, Geissler E and Hutchinson J. Generation of BTNL8+ TIGIT+ Tregs by Human Regulatory Macrophages Before Kidney Transplantation. Nat Commun. 2018; Jul 20;9(1):2858. PMID: 30030423.
Inhibiting Inflammation with Myeloid Cell-Specific Nanobiologics Promotes Organ Transplant Acceptance
Braza MS, Lameijer M, Sanchez-Gaytan B, Arts R, Pérez-Medina C, Conde P, Brahmachary M, van der Touw W, Fay F, Kluza E, Kossatz S, Stroes E, Kroon J, Dress R, Salem F, Rialdi A, Reiner T, Boros P, van Leent M, Strijkers G, Calcagno C, Ginhoux F, Marazzi I, Lutgens E, Nicolaes G, Weber C, Swirski F, Nahrendorf M, Fisher E, Fayad Z, Duivenvoorden R, Netea M, Mulder WJ, and Ochando J. Inhibiting Inflammation with Myeloid Cell-Specific Nanobiologics Promotes Organ Transplant Acceptance.Immunity. 2018; 20;49(5):819-828.e6. PMID: 30413362.
PUBMED DOIFernandez-Garcia MD, Volle R, Joffret ML, Sadeuh-Mba SA, Gouandjika-Vasilache I, Kebe O, Wiley MR, Majumdar M, Simon-Loriere E, Sakuntabhai A, Palacios G, Martin J, Delpeyroux F, Ndiaye K, Bessaud M. Genetic Characterization of Enterovirus A71 Circulating in Africa.
Fernandez-Garcia MD, Volle R, Joffret ML, Sadeuh-Mba SA, Gouandjika-Vasilache I, Kebe O, Wiley MR, Majumdar M, Simon-Loriere E, Sakuntabhai A, Palacios G, Martin J, Delpeyroux F, Ndiaye K, Bessaud M. Genetic Characterization of Enterovirus A71 Circulating in Africa. Emerg Infect Dis. 2018 Apr;24(4):754-757. doi: 10.3201/eid2404.171783. PMID: 29553325; PMCID: PMC5875259.
Leon KE, Schubert RD, Casas-Alba D, Hawes IA, Ramachandran PS, Ramesh A, Pak JE, Wu W, Cheung CK, Crawford ED, Khan LM, Launes C, Sample HA, Zorn KC, Cabrerizo M, Valero-Rello A, Langelier C, Muñoz-Almagro C, DeRisi JL, Wilson MR. Genomic and serologic characterization of enterovirus A71 brainstem encephalitis. Neurol Neuroimmunol Neuroinflamm. 2020
Leon KE, Schubert RD, Casas-Alba D, Hawes IA, Ramachandran PS, Ramesh A, Pak JE, Wu W, Cheung CK, Crawford ED, Khan LM, Launes C, Sample HA, Zorn KC, Cabrerizo M, Valero-Rello A, Langelier C, Muñoz-Almagro C, DeRisi JL, Wilson MR. Genomic and serologic characterization of enterovirus A71 brainstem encephalitis. Neurol Neuroimmunol Neuroinflamm. 2020 Mar 5;7(3):e703. doi: 10.1212/NXI.0000000000000703. PMID: 32139440; PMCID: PMC7136061.
González-Sanz R, Casas-Alba D, Launes C, Muñoz-Almagro C, Ruiz-García MM, Alonso M, González-Abad MJ, Megías G, Rabella N, Del Cuerpo M, Gozalo-Margüello M, González-Praetorius A, Martínez-Sapiña A, Goyanes-Galán MJ, Romero MP, Calvo C, Antón A, Imaz M, Aranzamendi M, Hernández-Rodríguez Á, Moreno-Docón A, Rey- Cao S, Navascués A, Otero A, Cabrerizo M. Molecular epidemiology of an enterovirus A71 outbreak associated with severe neurological disease, Spain, 2016. Euro Surveill. 2019
González-Sanz R, Casas-Alba D, Launes C, Muñoz-Almagro C, Ruiz-García MM, Alonso M, González-Abad MJ, Megías G, Rabella N, Del Cuerpo M, Gozalo-Margüello M, González-Praetorius A, Martínez-Sapiña A, Goyanes-Galán MJ, Romero MP, Calvo C, Antón A, Imaz M, Aranzamendi M, Hernández-Rodríguez Á, Moreno-Docón A, Rey- Cao S, Navascués A, Otero A, Cabrerizo M. Molecular epidemiology of an enterovirus A71 outbreak associated with severe neurological disease, Spain, 2016. Euro Surveill. 2019 Feb;24(7):1800089. doi: 10.2807/1560-7917.ES.2019.24.7.1800089. PMID: 30782267; PMCID: PMC6381658.
Spanish Afp Surveillance Working Group. Acute flaccid paralysis (AFP) surveillance: challenges and opportunities from 18 years' experience, Spain, 1998 to 2015. Euro Surveill.
Spanish Afp Surveillance Working Group. Acute flaccid paralysis (AFP) surveillance: challenges and opportunities from 18 years' experience, Spain, 1998 to 2015. Euro Surveill. 2018 Nov;23(47):1700423. doi: 10.2807/1560-7917.ES.2018.23.47.1700423. PMID: 30482263; PMCID: PMC6341937.
Molecular Epidemiology of Human Parechoviruses in Children With Acute Respiratory Infection in Spain
M Cabrerizo*, C Calvo, G Trallero, ML García-García, M Arroyas, V Sánchez, F Pozo, I Casas. Molecular epidemiology of human parechoviruses children with acute respiratory infection in Spain. Pediatric Infect Dis J 32:802-3 (2013).
PUBMED DOIIdentification of novel Betaherpesviruses in iberian bats reveals parallel evolution
Pozo F, Juste J, Vázquez-Morón S., Aznar-López C, Ibáñez C, Garin I, Aihartza J, Casa I, Tenorio A, Echevarría JE. Identification of novel Betaherpesviruses in iberian bats reveals parallel evolution. PLoS ONE. 2016. 11(12): e0169153. doi:10.1371/journal.pone.0169153
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. -
Laura Alcázar Fuoli
Research Scientist
Graduated in Biochemistry from the Autonomous University of Madrid and PhD in Biology from the Complutense University of Madrid in 2006. She completed her doctoral thesis at the National Center of Microbiology (CNM) under the direction of Dr. Emilia Mellado, in the study of the synthesis of Ergosterol in Aspergillus fumigatus. In 2012 Laura joined the reference laboratory in mycology with a researcher contract for the “Miguel Servet” program after having worked for three years as an associate researcher at Imperial College London. During that period his research focused on host adaptation mechanisms and virulence factors of A. fumigatus. In 2014 he obtained the position of Senior Scientist of Public Research Organizations carrying out his research work at the CNM.
List of staff
Additional Information
The Pneumococcus Unit is in charge of two very important aspects related to pneumococcus infections, such as epidemiological surveillance and basic and translational research of diseases caused by this pathogen. Our unit contributes to the epidemiological surveillance of invasive pneumococcal disease (IPD), characterizing the serotypes and genotypes of invasive pneumococci circulating in Spain, as well as the evolution of antibiotic resistance in this pathogen.
Identification of culture-negative samples (CSF and pleural fluids) is performed using real-time PCR. Serotyping is performed using the Dot-blot and PCR-sequencing technique. Genotyping for the study of outbreaks and characterization of clones associated with hypervirulent and/or multiresistant strains is performed using the MLST technique and the analysis of complete genomes by massive sequencing. In addition, antibiotic susceptibility is determined following the EUCAST criteria.
Our unit belongs to the IBD-labnet network of the ECDC and annually notifies all cases of IPD to the ECDC and also to the IRIS (Invasive Respiratory Infection Surveillance) network. At the level of basic and translational research, our unit is responsible for studying and characterizing different molecular mechanisms of pathogenicity and protection related to pneumococcal infection. Among the main objectives are the molecular characterization of virulence factors, the study of different vaccine candidate proteins and determining the possible impact that tobacco smoke and the formation of biofilms have on the colonization of the respiratory tract.
The Pneumococcus Unit is in charge of two very important aspects related to pneumococcus infections, such as epidemiological surveillance and basic and translational research of diseases caused by this pathogen. Our unit contributes to the epidemiological surveillance of invasive pneumococcal disease (IPD), characterizing the serotypes and genotypes of invasive pneumococci circulating in Spain, as well as the evolution of antibiotic resistance in this pathogen.
Identification of culture-negative samples (CSF and pleural fluids) is performed using real-time PCR. Serotyping is performed using the Dot-blot and PCR-sequencing technique. Genotyping for the study of outbreaks and characterization of clones associated with hypervirulent and/or multiresistant strains is performed using the MLST technique and the analysis of complete genomes by massive sequencing. In addition, antibiotic susceptibility is determined following the EUCAST criteria.
Our unit belongs to the IBD-labnet network of the ECDC and annually notifies all cases of IPD to the ECDC and also to the IRIS (Invasive Respiratory Infection Surveillance) network. At the level of basic and translational research, our unit is responsible for studying and characterizing different molecular mechanisms of pathogenicity and protection related to pneumococcal infection. Among the main objectives are the molecular characterization of virulence factors, the study of different vaccine candidate proteins and determining the possible impact that tobacco smoke and the formation of biofilms have on the colonization of the respiratory tract.