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Dive into the research topics where Pilar Nos is active.

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Featured researches published by Pilar Nos.


Inflammatory Bowel Diseases | 2001

Hidradenitis suppurativa and Crohn's disease: Response to treatment with infliximab

Fernando Martinez; Pilar Nos; Salvador Benlloch; Julio Ponce

Cutaneous manifestations occur frequently in inflammatory bowel disease. The association between hidradenitis suppurativa (HS) and Crohns disease (CD) has been reported. We present a new case supporting this association. A dramatic improvement after treatment with infliximab was achieved for both refractory fistulizing CD and axillary HS.


Drugs | 2007

Crohn's disease: a review of current treatment with a focus on biologics.

Julián Panés; Fernando Gomollón; Carlos Taxonera; Joaquín Hinojosa; Juan Clofent; Pilar Nos

Crohn’s disease is a debilitating and expensive disease that is growing in incidence in both developing and developed countries. While conventional therapies, such as corticosteroids and immunosuppressants, continue to play a vital role in treating this condition, it is evident that many affected individuals do not respond to therapy or develop intolerable adverse effects. The addition of modern biological therapies to the Crohn’s disease armamentarium is providing a change in expectations for disease outcome. Infliximab and adalimumab are currently the only biological agents approved for induction and maintenance treatment in adults (infliximab and adalimumab) and children (infliximab) with Crohn’s disease. Furthermore, infliximab has a beneficial effect on perianal fistulas. Other tumour necrosis factor (TNF)-α inhibitors, such as certolizumab pegol, also demonstrate promising results in adults with moderate to severe active disease. In addition, adalimumab and certolizumab pegol have shown clinical efficacy in patients who are intolerant to or lose response to infliximab, suggesting that switching between agents may allow response to be maintained over time. The primary safety concerns with TNFα inhibitors include increased risk of serious infection (including reactivation of tuberculosis), malignancy (particularly lymphoma) and demyelinating disease. Other agents in development include recombinant human anti-inflammatory cytokines, agents that target pro-inflammatory cytokines and granulocyte-macrophage colony-stimulating factors. Further prospective studies will provide interesting insight into different mechanisms by which factors involved in the pathophysiology of Crohn’s disease can be modulated.


Inflammatory Bowel Diseases | 2010

Mitochondrial dysfunction, persistent oxidative damage, and catalase inhibition in immune cells of naïve and treated Crohn's disease

Belén Beltrán; Pilar Nos; Francisco Dasí; Marisa Iborra; Guillermo Bastida; Marcial Martínez; José-Enrique O'Connor; Guillermo T. Sáez; Ines Moret; Julio Ponce

Background: Oxidative stress is considered a potential etiological factor for Crohns disease (CD). We characterized the reactive oxygen species (ROS) generated in immune peripheral cells of CD patients, as well as their antioxidant enzyme status and the presence of oxidative damage. In addition, mitochondrial function (&Dgr;&ggr;m) was analyzed to detect the possible origin of ROS. Methods: Cells were obtained from patients at the onset of disease, prior to any treatment. Experiments were repeated when patients were in clinical remission. A set of experiments was carried out in a group of CD patients in persistent morphological remission. Controls were healthy volunteers who were not receiving any treatment at the time. The generation of superoxide, hydrogen peroxide (H2O2) and nitric oxide, &Dgr;&ggr;m, superoxide dismutase (SOD) and catalase (CAT) activities, and concentrations of malondyaldehyde (MDA) and 8‐oxo‐deoxyguanosine (8‐oxo‐dG) were measured. Results: SOD activity and H2O2 production were significantly higher during active CD but returned to control levels in remission. &Dgr;&ggr;m was inhibited during active CD and, although it returned to control levels, its recovery took longer than clinical remission. CAT activity was permanently inhibited during CD, independent of the disease activity. MDA and 8‐oxo‐dG were permanently elevated. Conclusions: Oxidative stress during active CD depends on H2O2 production. The inhibition of &Dgr;&ggr;m suggests that this organelle is a source of ROS. CAT is permanently inhibited in CD, the biological significance of which is under study. The persistent oxidative damage detected may have implications for the evolution of the disease. Inflamm Bowel Dis 2010


World Journal of Gastroenterology | 2012

Adalimumab in prevention of postoperative recurrence of Crohn's disease in high-risk patients

Mariam Aguas; Guillermo Bastida; Elena Cerrillo; Belén Beltrán; Marisa Iborra; Cristina Sánchez-Montes; Fernando Muñoz; Jesus Barrio; Sabino Riestra; Pilar Nos

AIM To evaluate the effectiveness of adalimumab in preventing recurrence after intestinal resection for Crohns disease in high-risk patients. METHODS A multicenter, prospective, observational study was conducted from June 2009 until June 2010. We consecutively included high-risk Crohns disease patients who had undergone an ileal/ileocolonic resection. High-risk patients were defined as two or more criteria: smokers, penetrating pattern, one or more previous surgical resections or prior extensive resection. Subcutaneous adalimumab was administered 2 wk (± 5 d) after surgery at a dose of 40 mg eow, with an initial induction dose of 160/80 mg at weeks 0 and 2. Demographic data, previous and concomitant treatments (antibiotics, 5-aminosalicylates, corticosteroids, immunomodulators or biologic therapies), smoking status at the time of diagnosis and after the index operation and number of previous resections (type and reason for surgery) were all recorded. Biological status was assessed with C-reactive protein, erythrocyte sedimentation rate and fecal calprotectin. One year (± 3 mo) after surgery, an ileocolonoscopy and/or magnetic resonance enterography was performed. Endoscopic recurrence was defined as Rutgeerts score ≥ i2. Morphological recurrence was based on magnetic resonance (MR) score ≥ MR1. RESULTS Twenty-nine patients (55.2% males, 48.3% smokers at diagnosis and 13.8% after the index operation), mean age 42.3 years and mean duration of the disease 13.8 years were included in the study. A mean of 1.76 (range: 1-4) resections previous to adalimumab administration and in 37.9% was considered extensive resection. 51.7% had previously received infliximab. Immunomodulators were given concomitantly to 17.2% of patients. Four of the 29 (13.7%) developed clinical recurrence, 6/29 (20.7%) endoscopic recurrence and 7/19 (36.8%) morphological recurrence after 1-year. All patients with clinical recurrence showed endoscopic and morphological recurrence. A high degree of concordance was found between clinical-endoscopic recurrence (κ = 0.76, P < 0.001) and clinical-morphological recurrence (κ = 0.63, P = 0.003). Correlation between endoscopic and radiological findings was good (comparing the 5-point Rutgeerts score with the 4-point MR score, a score of i4 was classified as MR3, i3 as MR2, and i2-i1 as MR1) (P < 0.001, r(s) = 0.825). During follow-up, five (17.2%) patients needed adalimumab dose intensification (40 mg/wk); Mean time to intensification after the introduction of adalimumab treatment was 8 mo (range: 5 to 11 mo). In three cases (10.3%), a biological change was needed due to a worsening of the disease after the dose intensification to 40 mg/wk. One patient suffered an adverse event. CONCLUSION Adalimumab seems to be effective and safe in preventing postoperative recurrence in a selected group of patients who had undergone an intestinal resection for their CD.


Biochemical Society Transactions | 2011

Role of oxidative stress and antioxidant enzymes in Crohn's disease.

Marisa Iborra; Inés Moret; Francisco Rausell; Guillermo Bastida; Mariam Aguas; Elena Cerrillo; Pilar Nos; Belén Beltrán

There is increasing interest in oxidative stress being a potential aetiological factor and/or a triggering factor in Crohns disease, rather than a concomitant occurrence during the pathogenesis of the disease. Recent research has shown that the immune mononuclear cells of Crohns disease patients are induced to produce hydrogen peroxide (H2O2). Similarly, the regulation of antioxidant enzymes during disease in these cells has been unravelled, showing that SOD (superoxide dismutase) activity and GPx (glutathione peroxidase) activity is increased during active disease and returns to normal in remission phases. However, catalase remains constantly inhibited which supports the idea that catalase is not a redox-sensitive enzyme, but a regulator of cellular processes. ROS (reactive oxygen species) can be produced under the stimulus of different cytokines such as TNFα (tumour necrosis factor α). It has been shown in different experimental models that they are also able to regulate apoptosis and other cellular processes. The status of oxidative stress elements in Crohns disease and their possible implications in regulating cellular processes are reviewed in the present paper.


Journal of Crohns & Colitis | 2011

Infliximab and adalimumab-induced psoriasis in Crohn's disease: a paradoxical side effect.

Marisa Iborra; Belén Beltrán; Guillermo Bastida; Mariam Aguas; Pilar Nos

Treatment with antitumor necrosis factor-alpha (anti-TNF-α) offers a significant improvement in several immune-based diseases, including Crohns disease (CD) and psoriasis. Different cutaneous side effects have been described for anti-TNF-α therapy such as psoriasis. Previous reports showed that inhibition of TNF-α can induce over expression of cutaneous IFN-α, which in turn caused a predisposition to psoriasis. We report a 31-year-old woman with extensive CD and perianal lesions, without response to conventional treatment. She paradoxically developed a cutaneous eruption with psoriasiform morphology and distribution during treatment with both anti-TNF-α approved in Europe for CD, infliximab and adalimumab. These lesions cleared after topical application of corticosteroids and cessation of the anti-TNF-α treatment. Due to uneffectiveness of pharmacological treatment on disease, the patient had to undergo surgery. TNF-induced psoriasis in patients with CD is rare and has been previously documented with infliximab or adalimumab. The reason for this apparently paradoxical effect of the therapy is still unclear. This is the first case of psoriasis induced first by infliximab and later by adalimumab in the same CD patient. We would like to review and to draw attention about psoriasis as a cutaneous side effect with anti-TNF-α treatments.


PLOS ONE | 2013

Assessing an Improved Protocol for Plasma microRNA Extraction

Inés Moret; Dolors Sánchez-Izquierdo; Marisa Iborra; Luis Tortosa; Ana Navarro-Puche; Pilar Nos; José Cervera; Belén Beltrán

The first step in biomarkers discovery is to identify the best protocols for their purification and analysis. This issue is critical when considering peripheral blood samples (plasma and serum) that are clinically interesting but meet several methodological problems, mainly complexity and low biomarker concentration. Analysis of small molecules, such as circulating microRNAs, should overcome these disadvantages. The present study describes an optimal RNA extraction method of microRNAs from human plasma samples. Different reagents and commercially available kits have been analyzed, identifying also the best pre-analytical conditions for plasma isolation. Between all of them, the column-based approaches were shown to be the most effective. In this context, miRNeasy Serum/Plasma Kit (from Qiagen) rendered more concentrated RNA, that was better suited for microarrays studies and did not require extra purification steps for sample concentration and purification than phenol based extraction methods. We also present evidences that the addition of low doses of an RNA carrier before starting the extraction process improves microRNA purification while an already published carrier dose can result in significant bias over microRNA profiles. Quality controls for best protocol selection were developed by spectrophotometry measurement of contaminants and microfluidics electrophoresis (Agilent 2100 Bioanalyzer) for RNA integrity. Selected donor and patient plasma samples and matched biopsies were tested by Affymetrix microarray technology to compare differentially expressed microRNAs. In summary, this study defines an optimized protocol for microRNA purification from human blood samples, increasing the performance of assays and shedding light over the best way to discover and use these biomarkers in clinical practice.


Digestive Diseases and Sciences | 2003

Manifestations of Gastroesophageal Reflux and Response to Omeprazole Therapy in Patients with Chronic Posterior Laryngitis: An Evaluation Based on Clinical Practice

Vicente Garrigues; Lirios Gisbert; Guillermo Bastida; Vicente Ortiz; Inmaculada Bau; Pilar Nos; Julio Ponce

Our aims were to describe clinical characteristics of patients with chronic posterior laryngitis and to predict the response to omeprazole therapy. Ninety-one patients with posterior laryngitis were evaluated by a questionnaire, esophageal manometry and pH recording, and endoscopy. Patients were treated with omeprazole, 20 mg twice daily for 3 months. Therapy was continued another 3 months if necessary. Clinical manifestations of reflux occurred in 84 (92%) patients, abnormal acid reflux in 53 (65%) cases, and esophagitis in 6 of 50 (12%). After 3 months of therapy significant improvement occurred in 30 of 70 patients (41%). Continuing therapy for 3 more months increased the response to 65% (45 of 69 cases). Response to therapy was associated with lower age and lower duration of laryngeal symptoms, but a consistent prediction of the response could not be made. In conclusion, patients with posterior laryngitis frequently present with manifestations of gastroesophageal reflux. Response to therapy can not be predicted with certainty.


BMC Gastroenterology | 2007

Septic thrombophlebitis of the superior mesenteric vein and multiple liver abscesses in a patient with Crohn's disease at onset

Mariam Aguas; Guillermo Bastida; Pilar Nos; Belén Beltrán; Jose Luis Grueso; Julio Grueso

BackgroundPortal-mesenteric vein thrombosis, pylephlebitis and liver abscesses are rare complications of inflammatory bowel disease (IBD). The purpose of this case report is to relate an unusual presentation of CD in order to show how conservative treatment could be an appropriate option as a bridge to the surgery, in patients with septic thrombophlebitis and multiple liver abscesses with CD.Case presentationWe report a case of a 25-year-old man with Crohns disease (CD) who developed a superior mesenteric venous thrombosis, multiple liver abscesses and pylephlebitis, diagnosed through abdominal ultrasound and an abdominal computed tomography (CT) scan. The patient was successfully treated with conservative treatment consisting of intravenous antibiotics, subcutaneous anticoagulation and percutaneous catheter drainage of liver abscesses.ConclusionWe reported an unnusual case of pylephlebitis in CD. Until now this association has not been reported in adult patients at onset. We hypothesise that the infection developed as a result of mucosal disease and predisposed by corticoid therapy. Adequated management was discussed.


Inflammatory Bowel Diseases | 2015

Fecal Calprotectin in Ileal Crohn's Disease: Relationship with Magnetic Resonance Enterography and a Pathology Score.

Elena Cerrillo; Belén Beltrán; Salvador Pous; Ana Echarri; José C. Gallego; Marisa Iborra; Jose Pamies; Pilar Nos

Background:Magnetic resonance enterography (MRE) is an effective method of assessing small bowel Crohns disease (CD). Fecal calprotectin (FC) correlates well with endoscopic disease activity. We aimed to evaluate the correlation between FC and disease activity according to MRE and surgical pathology in small bowel CD. Methods:One hundred twenty consecutive patients with ileal CD who underwent MRE assessment were included. Clinical data, C-reactive protein and FC, radiological and histological variables were obtained. Clinical activity was evaluated by the Harvey–Bradshaw Index and FC by enzyme-linked immunosorbent assay. MRE activity was assessed by means of the Magnetic Resonance Index of Activity score. Chioreans score was used to grade pathological inflammation in surgical specimens. Results:Seventy-five patients (62.5%) were in clinical remission (Harvey–Bradshaw Index < 5) and 45 (37.5%) had active disease (Harvey–Bradshaw Index ≥ 5). The Magnetic Resonance Index of Activity score was significantly associated with FC levels (P < 0.01), with a moderate overall correlation (Spearmans r = 0.56, P < 0.001). FC reflected MRE inflammatory activity with an area under the receiver operating characteristic curve of 0.914 (confidence interval, 0.849–0.958; P < 0.001). A cutoff value of 166.50 &mgr;g/g had 90% sensitivity, 74% specificity, 89% positive predictive value, and 76% negative predictive value for diagnosis of inflammation. Twenty-eight of 120 patients were operated. Surgical pathology showed a good agreement with FC for moderate (P = 0.03) and severe (P = 0.01) Chioreans index. No relationship was detected for C-reactive protein. Conclusions:FC correlates with the degree of MRE inflammatory activity and with surgical pathology damage in ileal CD. Thus, FC could be a surrogate marker of disease control used to select patients for MRE assessment and therapeutic adjustment.

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Julio Ponce

Instituto de Salud Carlos III

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Ines Moret

University of Valencia

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Javier P. Gisbert

Autonomous University of Madrid

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Eugeni Domènech

Autonomous University of Barcelona

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