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The projects will investigate issues such as stroke and endometrial cancer prevention.
Six research groups of Vall d'Hebron have received grants from the Strategic Plan for Research and Innovation in Health (PERIS). With this funding, several treatments and tools will be developed to treat and diagnose different pathologies.
These initiatives will make possible advances in fields such as oncology, stroke treatment and pre-eclampsia, among others, and will offer tools for professionals and treatments for patients. With these grants the projects receive funding for the period 2021-2024.
Specifically, 4 grants for the hiring of predoctoral staff (PIF-Salut) for:
Pere Canals, from the Stroke Research group who will work on the ARTERIAL project, an artificial intelligence to plan stroke operations through the automatic characterization of vascular tortuosity.
Marc Moltó, from the CIBBIM-Nanomedicine. Drug Delivery and Targeting that will work on the project Vesículas extracelulares optimizadas para mejorar el tratamiento de las enfermedades de diposición lisosomal.
Joana Ramis, from the CIBBIM-Nanomedicine. Pharmacokinetic Nanoparticles group who will work on the project Development of new antioxidant formulations for the multimodal treatment of preeclampsia.
Beatriz Villafranca, from the Biomedical Research in Gynecology group who will work on the project Development of a non-invasive machine for the early diagnosis of endometrial cancer.
A grant for the hiring of a research support technician. Miguel García, from the neurorehabilitation laboratory and the Neurovascular Diseases research group who will work on the project New strategies for neurorehabilitation after stroke: from neurorehabilitation therapies to nanomedicine.
A grant for the recruitment of nursing intensification staff. Miguel Ángel Robles, a nurse from the Multiple Sclerosis Center of Catalonia (Cemcat) who will work on the project Territorial implementation and evaluation of an expert patient program to improve the empowerment and quality of life of people with multiple sclerosis.
Extracellular vesicles to treat lysosomal diposition diseases (LDDs)
Lysosomal diposition diseases (LDDs) are a group of rare diseases caused by mutations in lysosomal proteins. Sometimes these proteins, which are in charge of digesting materials for the reconstruction of the cell, do not function correctly and cause an accumulation of diposites. This can lead to neuronal disorders, presenting symptoms that can range from progressive neurodegeneration to severe cognitive impairment. In this sense, many LDDs appear during childhood and patients die prematurely.
Currently, up to 14 subtypes of this condition can be treated by enzyme replacement therapy (ERT). This procedure consists of administering the altered protein to the patient to correct the alteration. However, the named treatment works when the disease is caused by mutations in an enzyme and eliminates the dysfunctions in the transporters. Similarly, enzymes administered intravenously are not able to reach the neck, leaving patients with neurologically affected LSD untreated.
Therefore, the proposal of the CIBBIM- Nanomedicine group. Targeting and Pharmacological Delivery at VHIR proposes to use extracellular vesicles (EVs) to deliver functional lysosomal proteins to affected cells and organs. EVs are very small particles that cells use to communicate with each other, so they occur naturally but can also be modified. The project proposes that EVs release lysosomal proteins and thus can correct the effect. The research currently seeks to produce EVs with more protein release and more targeting capacity, as well as to explore whether LDSs caused by a deficiency in the transporters can be treated with this method.
An algorithm to analyze stroke
One of the most widely used procedures to treat ischemic strokes is mechanical thrombectomy. This mechanism allows access to the occlusion that has caused the stroke by catheterization and thus allows the clot to be removed. However, up to 30% of patients with ischemic stroke in whom this intervention is performed have tortuous vascular characteristics that complicate the procedure. Thus, the intervention time is lengthened or terminated and the catheterization becomes impossible to last in time and the risk of mortality increases.
The VHIR Stroke Research group project proposes the creation of ARTERIAL, an algorithm through artificial intelligence to examine the vascular characteristics of each patient. In this way, surgeons can review the proposals before the operation and possible delays during mechanical thrombectomy are reduced. The researchers estimate that about one third of patients could benefit from this technique.
Nanoparticles to treat preeclampsia
Preeclampsia is currently untreatable and affects between 5% and 8% of women. However, a project of the CIBBIM-Nanomedicine. Pharmacokinetic Nanoparticles group at VHIR aims to establish a treatment for preeclampsia using cerium oxide nanoparticles (CeO2 NPs). These elements have obtained good results in animal models and high antioxidant and immunomodulatory anti-inflammatory activity.
The disease is characterized by poor placental formation in early pregnancy. This describes a series of serious medical problems that can end up being lethal for both the mother and the baby. Some of the affectations are elevated blood pressure, either in the endothelial tissue or in the cardiovascular system, and in organs such as the stomach and kidneys. Likewise, the disease is characterized by high levels of inflammatory and oxidative stress, the harmful chemicals that create the problem when subjected to a stressful and inflammatory process such as preeclampsia. In this sense, its characteristics make the pathology still suitable to be treated with CeO2NPs.
A new way of detecting endometrial cancer
Diagnosing endometrial cancer in its early stages is essential to ensure patient survival. This oncological pathology is the fourth most common and the one with the highest mortality rate among women, and although there is a diagnostic procedure for those patients who present symptoms, there is currently no procedure available for asymptomatic women.
The project of the Biomedical Research in Gynecology group of VHIR seeks to develop an innovative line that allows a non-invasive and preventive diagnosis of endometrial cancer. The procedure will be carried out from a sample of cervical fluid, which can be obtained during a regular gynecological examination. In this way, a diagnosis can be made based on the integration of molecular data - at the level of protein and pure DNA - and clinical data.
So far, detection is only done in patients with symptoms by means of a physical examination, a vaginal ultrasound and a pathological examination of an endometrial biopsy. The biopsy was obtained by accessing the endometrial cavity by minimally invasive methods, although in some cases access is not possible through cervical stenosis. Moreover, in 22% of the cases, an insufficient amount was obtained during the biopsy and it is then necessary to perform the procedure a second time and to do it through a surgical approach. With this idea, it would not be necessary to subject patients to such a procedure.
Going beyond functional stroke rehabilitation
Stroke in Europe affects more than a million people every year and leaves 30% of survivors with some kind of functional disability. However, beyond the acute phase treatments of the disease, neuro-rehabilitation therapies are only used to improve patients' recovery. The research line of the VHIR Neurovascular Diseases Group, which has received support from the PERIS programme, aims to investigate the mechanisms underlying plasticity and neurorepair activated spontaneously and by post-stroke rehabilitation treatments. It also seeks to understand its time course in order to monitor its progress and identify new therapies.
Once these molecules have been identified, the use of nanomedicine and nanomaterials could facilitate the administration of new stroke treatments in a more targeted, safer and longer-term manner, while avoiding invasive or repeated administrations. The research will include molecular studies using blood samples from stroke patients undergoing supervised rehabilitation therapy at hospital level and preclinical models of cerebral ischemia where nanotechnological platforms will be used to administer neuroreparative treatments to improve delivery to the brain with clinically relevant and minimally invasive approaches.
Implementing an Expert Patient Program for Multiple Sclerosis
Improving the quality of life of patients with Multiple Sclerosis (MS) is one of the main issues in the management of the disease. In this sense, expert patient programs facilitate that people with MS remain able to take charge of their discomfort through peer-to-peer learning. That is, some people share their experience-based knowledge about the disease with their vocabulary. Now, the Multiple Sclerosis Center of Catalonia (Cemcat) wants to implement an expert patient program in several reference units in Catalonia.
Multiple Sclerosis affects some 50,000 people in Spain and a program of this kind improves the quality of life, knowledge and autonomy related to the condition of the participants. This was carried out, after the approval of the respective Ethics Committees, with 12 groups of provincial patients from their different units. Likewise, the deployment will be carried out with 6 groups with people with relapsing MS and 6 groups with people with progressive MS. An MS patient, with the advice and support of healthcare professionals, will lead 9 educational group sessions (one session per week for 9 weeks) with 12 people to see the impact and autonomy of each patient. Subsequently, two controls are carried out for 6 and 12 months respectively.
This program seeks to transfer knowledge, reduce the impact of the disease and encourage the acquisition of healthy habits and lifestyles. Through interaction between people with MS, the aim is to share this knowledge from their own experience, based on the principle that no one knows the disease and how to deal with it better than the people who suffer from it.
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