Research

Area 1

Infectious diseases and AIDS

Team leader

More information

AIDS Research Group, Retrovirology and Viral Immunopathology Laboratory

Strategic objectives

1. In the AIDS field:

  • Immunotherapy of the disease and natural and acquired defense mechanisms, including the development of therapeutic and preventive vaccines.
  • Efficacy and resistance and tolerance mechanisms of new antiretrovirals.
  • Immunopathogenesis, treatment response and resistance mechanisms of certain opportunistic infections, including tuberculosis, pneumocystis carinii pneumonia (PCP) and toxoplasmosis.

2. In the general infections field:

  • Prevention and treatment support in endocarditis due to multiresistant germs, including animal models.
  • Infection in solid-organ transplant recipients.
  • Interactions between nosocomial infections and antibiotic use.
Main lines of research


1. In the AIDS field:

  • The most important line focuses on the peripheral (blood) and central response (lymphatic tissue and cerebrospinal fluid) to different antiretroviral therapies when administered in very early evolutive stages (CD4 > 500 mm3). We have developed ultrasensitive techniques for the determination of viral load in plasma and tissues, as well as techniques for the determination of genotypic resistance and for immunophenotyping and the evaluation of CD4+ lymphocyte proliferation in response to antigens of the HIV virus. Techniques for the determination of drug levels have also been developed in collaboration with the clinical pharmacology group. Having ruled out the possibility of eradicating the HIV virus, the working hypothesis is to see whether it is possible to almost completely suppress HIV replication over the long term, recover the host immune system and quantify the degree of such recovery. The interruption of treatment leads to a rapid disease rebound effect.
  • The mechanism by which the virus is able to escape the cytotoxic immune response is subject to study, and could correspond to the selection of quasispecies different from the reservoirs (immunological resistance). For this reason we have started a research line aimed at developing techniques for stimulating the immune system, with a view to associating them with antiretroviral therapy. Cyclic interruption of the treatment can induce recovery of the specific immune response to HIV antigens, associated with a spontaneous decrease in viral load, which is correlated to the degree of proliferative and specific cytotoxic response against HIV-1 in a small percentage of patients.
  • We have also developed an immunotherapeutic technique based on the administration of autologous dendritic cells stimulated ex vivo with the virus of the patient. The first phase I study in patients has already been completed and published. The second study, using higher viral concentrations to induce the ex vivo stimulation of the autologous dendritic cells, has now practically been completed.
  • We are developing different immunogens which may be potential candidates for therapeutic or preventive vaccines.

2. In the general infections field:

  • Clinical and experimental endocarditis, including endocarditis in illegal drug abusers (Dr. J.M. Miró).
  • Infections in transplant recipients. Microbiological diagnosis and prognostic markers (Dr. A. Moreno).
  • Predictive factors and markers of treatment response in nosocomial infections (Dr. J. Mensa).
  • Response to treatment, resistance and transmission of tuberculosis.
  • Prognostic factors of community-acquired and nosocomial respiratory infections in both immunocompetent and immune depressed individuals.
  • The genetic fundaments of host susceptibility and the biochemical, molecular and replicative capacity bases of the resistant strains.

Grups

Endocarditis. Cardiovascular infections. Experimental model (Associated)

MIRO, JOSEP MARIA

(ICMiD)

This group studies the epidemiological, clinical, diagnostic, preventive and therapeutic aspects of infectious endocarditis. This is done based on studies of local, national or international cohorts (ICE) that have revealed an increase in endocarditis produced by methicillin-sensitive and -resistant Staphylococcus aureus (MSSA and MRSA, respectively). Studies using the experimental model of endocarditis due to MRSA and glycopeptide intermediate-resistant Staphylococcus aureus (GISA) have evaluated the activity of new antibiotic combinations (phosphomycin and imipenem), or new antibiotics such as daptomycin and telavancin.

Infections in solid-organ transplant recipients (Associated)

MORENO, ASUNCION

(ICMiD)

In the last year, this group has studied the clinical and evolutive characteristics of bacteremias in patients subjected to different solid organ transplants (kidney, liver, heart and renal-pancreatic). We have shown that mannose binding to lectin polymorphisms (MBL) condition an increase in the prevalence of cytomegalovirus (CMV) disease, and have analyzed the mortality risk factors of pneumonia in transplant patients. Studies have been made of the prevalence of other viruses of the herpes group (HHV-6 and -7) in the transplant population, as well as their pathogenic role in the post-transplantation period. These studies have been made jointly with investigators specialized in Microbiology and Immunology, and with the different Transplantation Units (Institutes of Digestive, Renal and Thoracic Diseases).

AIDS and HIV infection (Associated)

GATELL, JOSEP MARIA

(ICMiD)

This group studies the clinical, diagnostic, therapeutic and preventive aspects of HIV infection. The scientific contribution of this line of research is very competitive and is internationally renowned. This group of investigators focuses on exploration of the potential for eradicating HIV infection and on reconstruction of the immune system, including the development of preventive and therapeutic vaccines. Since its start in 2002, Dr. Gatell has coordinated the Spanish network of research groups in AIDS (RIS), funded by the FIS, and since 2007 has coordinated the HIVACAT project on research into vaccines against HIV infection.

Nosocomial infection study group (Emergent)

SORIANO, ALEX

(ICMiD)

This group studies the clinical, diagnostic, therapeutic and preventive aspects of nosocomial (in-hospital) infections. The scientific contribution is particularly notorious in the treatment and management of bacteremia, infections in Intensive Care Units, and infections related to orthopedic implants. Its components are members of the REIPI (Spanish Research Network in Infectious Disease), and participate actively in multicenter projects financed by the FIS.