Cardiovascular and Respiratory Pathology/Other Systemic Diseases

Clinical and Molecular Epidemiology


Cód. SSPA: IBiS-D-07

Our research team is multidisciplinary and includes physicians and basic researchers with training in different areas of the biomedical field. In recent years we have focused our work on two main research areas: (a) The epidemiology and physiopathology of infection by Pneumocystis jirovecii (formerly P. carinii sp. f. hominis), and (b) the development of methods for the evaluation and improvement of clinical practice.

  • (a) Epidemiology and physiopathology of Pneumocystis jirovecii infection

  • Epidemiology of P. jirovecii. For almost a century Pneumocystis carinii was considered to be a single protozoan, able to invade and proliferate in the lung of deeply immunosuppressed human and non-human mammalian hosts. The impossibility to develop continuous in vitro cultures has limited advances in knowledge about this microorganism. Recently, molecular biology techniques have permitted it to be demonstrated that the term "P. carinii" masks a variety of ubiquitous atypical fungal parasites with strong host specificity that are actual species which are currently being described. To the present time, only one species has been identified in human hosts and has been named Pneumocystis jirovecii. Currently, many characteristics of its biology and epidemiology are unknown. Thus, identification of human-Pneumocystis reservoirs and sources of infection using molecular tools constitutes to us an important area for research.
  • Role of Pneumocystis jirovecii colonization in chronic pulmonary diseases. The development of sensitive molecular techniques has led to the recognition of a colonization or carrier state of Pneumocystis jirovecii, in which low levels of the organism are detected in persons who do not have overt Pneumocystis pneumonia. Pneumocystis colonization has been described in subjects with various chronic lung diseases, and accumulating evidence suggests that it may be an important clinical phenomenon. Unravelling the role of P. jirovecii colonization in the pathophysiology of the most frequent chronic pulmonary diseases (COPD, Cystic Fibrosis, or Idiopathic pulmonary fibrosis) is another important area of research for our group.
  • Biology of Pneumocystis jirovecii. Although still impaired by the lack of a reliable and reproducible continuous in vitro cultivation system, research into the natural history of P. jirovecii has advanced owing to the expansion of molecular-based techniques. However, little is known about the biological characteristics of P. jirovecii, since the lack of culture methods has obliged researchers to use animal models, for which most of the knowledge produced concerns rat-derived Pneumocystis. For this reason, new post-genomic approaches using transcriptomic and proteomic tools are being developed to improve our knowledge about the biology of P. jirovecii.

  • (b) Clinical practice improvement and evaluation.

  • Development of evidence-based clinical practice guidelines. Our group has developed a CPG for venous thromboembolism prevention in medical patients (PRETEMED), which has been endorsed by different scientific societies and included in the National Guideline Clearinghouse (NGC: 003602). We are currently evaluating different CPG implementation strategies and their effectiveness to change medical practices.
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