Research

Area 1

Infectious diseases and AIDS

Team leader

  • José M. Miró
    (Hospital Clínic)

Related Websites

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.
  • Non-AIDS defining complications related with age and residual viral replication, inflammation and immuneactivation.

2. In the general infections field:

  • Prevention and treatment of endocarditis due to multiresistant microrganisms, 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, which could be avoided partially or totally (functional recovery).
  • The mechanism by which the virus is able to escape the cytotoxic immune response subject to study 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 them treatment and therapeutic vaccines 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 dministration of autologous dendritic cells stimulated ex vivo with the virus of the patient. The first three Phase I clinical trials have already been finished and published. We are also developing different immunogens which may be potential candidates for therapeutic or preventive vaccines in the setting of an FP7 program.

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. A. Soriano).
  • Response to treatment, resistance and transmission of tuberculosis.
  • Prognostic factors of communityacquired 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.

Research Group

Endocarditis. Cardiovascular infections. Experimental model

Josep Maria Miro

(HCB)

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 methicillinsensitive 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.

Research Group

Infections in solid-organ transplant recipients

Asuncion Moreno

(HCB)

In the last years, 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 I investigators specialized in Microbiology and Immunology, and with the different Transplantation Units (Institutes of Digestive, Renal and Thoracic Diseases). Its components are members of the REIPI (Spanish Research Network in Infectious Disease), and participate actively in multicenter projects financed by the FIS

Research Group

AIDS and HIV infection

Josep Mallolas

(Hospital Clínic)

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 therapeutic and preventive vaccines against HIV infection.

Emergent Group

Nosocomial infection study group

Alex Soriano

(HCB)

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.