RESEARCH INTEREST
Inflammation and reparative processes in lung diseases. Chronic Obstructive Pulmonary Disease (COPD). Obstructive Sleep Apnea (OSA). Asthma. Idiopathic Pulmonary Fibrosis (IPF), Chronic thromboembolic disease and pulmonary hypertension. Bronchiectasis not associated with cystic fibrosis and bronchiectasis associated with cystic fibrosis. Immunopathogenesis. Molecular diagnosis. Cellular diagnosis. New therapeutic approaches. New care models. COVID-19 and post-COVID-19. Lung diseases represent a significant health and social problem due to their high prevalence and associated morbidity and mortality. In recent years, our group has worked in various areas related to these pathologies, as reflected in our publications, which are the result of studies conducted in collaboration with other research groups. General Objectives To advance research on lung diseases. To promote quality of care in the therapeutic management of patients with chronic lung diseases. To foster the translation of research findings in the field of lung diseases. To generate new lines of research in coordination with other working groups.
Areas of Research Interest:
The Pulmonology Department at La Princesa University Hospital is part of the Biomedical R&D Program. HUP ConSEPOC-CM: Inflammation and hypoxia: mechanisms underlying the development and progression of COPD and OSA. In the coming years, various active clinical trials will be conducted on different respiratory diseases (COPD, asthma, idiopathic pulmonary fibrosis, bronchiectasis, and cystic fibrosis). Additionally, long COVID has become a new disease with a significant impact on public health in Spanish society. In Spain, it is estimated that between 400,000 and 800,000 people suffer from or will suffer from long COVID, given that between 10% and 16% of patients continue to experience symptoms one year after overcoming the acute phase of the disease. For this reason, our team has also focused its efforts on studying the long-term sequelae of long COVID. Several of our projects have received funding from the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and other funding agencies.
Action Plan 2025–2029:
The strategic action plan of Group 22 is focused on consolidating a translational, multidisciplinary and patient-centred research programme in respiratory medicine, integrating mechanistic, clinical, technological and psychosocial approaches across chronic respiratory diseases.
A major priority for the coming years will be the development of the Instituto de Salud Carlos III-funded project PI25/01682: “Obstructive Sleep Apnea and Lung Microbiota: Pathophysiological Axis in Systemic Inflammation and its Impact on Cardiometabolic Health”. This project will investigate the relationship between obstructive sleep apnea, intermittent hypoxia, lung microbiota alterations assessed through exhaled breath condensate, systemic inflammation, cardiometabolic dysfunction and subclinical atherosclerotic cardiovascular disease. The project aims to generate mechanistic evidence on the role of the respiratory microbiome as a potential mediator between sleep-disordered breathing and cardiovascular risk, with potential implications for risk stratification, biomarker discovery and precision medicine in obstructive sleep apnea.
In parallel, the group will work on the development and validation of predictive tools based on analytical, anthropometric and clinical variables to estimate the probability of moderate-to-severe obstructive sleep apnea. This line of research aims to improve diagnostic efficiency, reduce waiting times, optimise the prioritisation of patients with higher clinical risk and facilitate earlier therapeutic decision-making in a disease with high prevalence and relevant cardiovascular and metabolic consequences.
The group maintains an active research line in bronchiectasis, focused on anti-infective treatment and the microbiological impact of long-term therapeutic strategies. The group is participating in a European multicentre study evaluating the effect of inhaled antibiotics and azithromycin in patients with bronchiectasis, with particular interest in clinical outcomes, exacerbations, microbiological burden, and control of chronic bronchial infection. In parallel, the group is conducting a descriptive study on resistant microorganisms isolated from respiratory samples from patients with bronchiectasis. This project aims to characterise the frequency and profile of antimicrobial resistance, antimicrobial susceptibility patterns, and the potential relationship with previous exposure to inhaled antibiotics, macrolides, or other antibiotic treatments.
The group will also continue strengthening its established research lines in chronic respiratory diseases, particularly cystic fibrosis, bronchiectasis, pulmonary fibrosis and COPD. These lines include multicentre observational studies, registry-based research, translational studies and participation in clinical trials aimed at improving early diagnosis, phenotyping, assessment of comorbidities, prediction of disease progression and therapeutic optimisation. Special emphasis will be placed on the impact of novel therapies, including CFTR modulators in cystic fibrosis, antifibrotic and emerging therapies in pulmonary fibrosis, and innovative approaches for COPD management and exacerbation prevention.
In the specialized severe asthma unit we carry out RCTs with new treatments for severe asthma as well as new molecules for the treatment of refractory chronic cough. We are starting an RCT that compares strategies of triple inhaled fixed therapy versus double at high doses, treatment in early phases of asthma evolution to avoid structural damage and an observational, prospective multicenter medical record review to describe the post-authorization clinical experience of dupilumab in the treatment of adult severe asthma. In addition, we carried out real-world evidence studies with biologics in both severe asthma and EGPA.
Another relevant strategic axis will be the study of patient-reported outcomes, quality of life, psychosocial burden and adherence to long-term respiratory treatments. The group will promote research focused on the psychological and behavioural dimensions of chronic respiratory disease, including interventions aimed at improving adaptation to disease, therapeutic adherence and self-management. Particular attention will be given to patients requiring non-invasive ventilatory support, such as BiPAP, or treatment with CPAP for obstructive sleep apnea, where adherence remains a key determinant of clinical effectiveness.
The group maintains an active research line in Clinical and biomarker characterization of patients with group III pulmonary hypertension secondary to diffuse interstitial lung disease (ILD) and treated with inhaled treprostinil. In collaboration with Immunology: the role of P-selectin in patients with pulmonary arterial hypertension (PAH) and in patients with ILD. Future lines of research Study of soluble factors, such as adrenomedullin or resistin-like molecule alpha (RELM-a), in patients with both PAH and pulmonary hypertension secondary to ILD.
Overall, the action plan of Group 22 seeks to reinforce its position as a competitive respiratory research group within IIS-Princesa, combining clinical excellence, translational innovation and integrated care models to improve diagnosis, prognosis, treatment adherence, comorbidity management and quality of life in patients with respiratory diseases.
Estudio multicéntrico de prevalencia y características de los pacientes con discinesia ciliar primaria en hospitales de la Comunidad de Madrid. Evaluación multidimensional. NEUMOMADRID. 2024.
Epidemiologia y caracterización clínico-microbiológica de las exacerbaciones agudas de los pacientes con bronquiectasias no debidas a fibrosis quística. SEPAR. 2014-2016.
Design and local implementation of clinical audits in different types of old (DELICATO). PI13/01993. ISCIII. 2014-2016.
CONSEPOC: Inflamación e hipoxia: mecanismos de desarrollo y progresión en EPOC y SAHS. S2010/BMD-2542. CAM. 2012-2015.
Estudio fenotipo de riesgo cardiovascular en la enfermedad pulmonar obstructiva crónica (CHAIN). SEPAR y Astra Zeneca. 2011-2016.
Elaboración de una base de datos de bronquietasias. SEPAR. 2012-2015.
Epidemiología y caracterización clínico-microbiológica de las exacerbaciones agudas de los pacientes con Bronquiectasias no debidas a fibrosis quística. SEPAR. 2014-2016.
Relación entre las alteraciones radiológicas, la calidad de vida y las exacerbaciones en pacientes adultos con fibrosis quística. SEPAR. 2015-2018.
Estudio de los factores de respuesta a hipoxia (HIF) en enfermedad pulmonar obstructiva crónica (EPOC) para la identificación de biomarcadores no invasivos diagnósticos y pronósticos. SEPAR. 2014-2017.
Estudio del papel de los glicosaminoglicanos celulares de epitelio pulmonar en el desarrollo de infecciones asociadas a fibrosis quística. SEPAR. 2015-2017.
TackSHS: Tackling secondhand smoke in Europe: assessment of SHS exposure according to policies, attributable disease and economic burden, and impact of interventions for reducing the exposure. TackSHS: 681040. Comisión Europea. 2015-2019.
Identificación y evaluación de biomarcadores relacionados con la hipoxia para el diagnóstico no invasivo de la enfermedad hepática grasa no alcohólica y del daño vascular asociado. PI17/00535. ISCIII. 2018-2020.
El objetivo del proyecto es determinar la prevalencia de enfermedad hepática grasa no alcohólica y de enfermedad cardiovascular en pacientes con síndrome de apneas/hipopneas del sueño.
Esta ayuda está financiada por el Plan Estatal de Investigación Científica y Técnica y de Innovación 2013-2016 y el ISCIII – Subdirección General de Evaluación y Fomento de la Investigación – y cofinanciadas por el Fondo Europeo de Desarrollo Regional, Programa Operativo Crecimiento Inteligente 2014-2020 de acuerdo al Reglamento (UE) Nº 1303/2013.
Papel de la hipoxia en la patogenia de las comorbilidades metabólicas y cardiovasculares asociadas a las enfermedades respiratorias crónicas más prevalentes: Utilidad diagnóstica y pronostica de nuevos biomarcadores séricos. 073/2015. SEPAR. 2016-2019.
Utilidad para valoración pronóstica de mortalidad del handgrip en pacientes con enfermedad pulmonar obstructiva crónica. 2017-2019.
Capacidad de esfuerzo, actividad física y estado nutricional en pacientes con EPOC. 2016- 2017.
DECAF score como predictor de mortalidad y su relación con el cuestionario de calidad de vida CAT en pacientes con diagnóstico de EPOC. 2017.
Efectividad de la Cirugía Maxilomandibular mediante Distracción Osteogénica Mandibular en la Apnea Obstructiva del Sueño: Un abordaje quirúrgico Innovador Mínimamente Invasivo. PI18/01891. ISCIII. 2019-2021.
Determinar la efectividad en el control de la sintomatología y en la corrección de parámetros clínicos de un nuevo abordaje quirúrgico mínimamente invasivo de avance de la mandíbula mediante Distracción Osteogénica en pacientes diagnosticados de síndrome de apnea hipopnea del sueño (SAHS).
Esta ayuda está financiada por el Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020 y el ISCIII – Subdirección General de Evaluación y Fomento de la Investigación – y cofinanciadas por el Fondo Europeo de Desarrollo Regional, Programa Operativo Crecimiento Inteligente 2014-2020 de acuerdo al Reglamento (UE) Nº 1303/2013.
Caracterización de los mediadores moleculares clave de la enfermedad hepática grasa metabólica asociada al síndrome de apnea obstructiva del sueño: Implicaciones diagnósticas y terapéuticas. PI20/00837. ISCIII. 2021-2023.
Evaluar el impacto de la terapia con presión positiva continua en la vía respiratoria sobre las características clínicas, metabólicas e histológicas de la enfermedad hepática grasa metabólica (EHGMet) asociada al síndrome de apnea obstructiva del sueño. Desarrollar nuevos algoritmos matemáticos para identificar pacientes con EHGMet en riesgo. Identificar los mecanismos moleculares implicados en el proceso de reversión de la EHGMet en ratones. Determinar las vías funcionalmente relevantes en el proceso de reversión de la EHGMet.
Esta ayuda está financiada por el Plan Estatal de Investigación Científica y Técnica y de Innovación 2017-2020 y el ISCIII – Subdirección General de Evaluación y Fomento de la Investigación – y cofinanciadas por el Fondo Europeo de Desarrollo Regional, Programa Operativo Crecimiento Inteligente 2014-2020 de acuerdo al Reglamento (UE) Nº 1303/2013.
Richeldi L, du Bois RM, Raghu G, Azuma A, Brown KK, Costabel U, Cottin V, Flaherty KR, Hansell DM, Inoue Y, Kim DS, Kolb M, Nicholson AG, Noble PW, Selman M, Taniguchi H, Brun M, Le Maulf F, Girard M, Stowasser S, Schlenker-Herceg R, Disse B, Collard HR, INPULSIS Trial Investigators. Efficacy and Safety of Nintedanib in Idiopathic Pulmonary Fibrosis. N Engl J Med 2014. 370: 2071-2082. FI: 55,873(Q1). PMID: 24836310. DOI: 10.1056/NEJMoa1402584.
López-Campos JL, Hartl S, Pozo-Rodriguez F, Roberts CM, European COPD Audit team. Variability of hospital resources for acute care of COPD patients: the European COPD Audit. Eur Respir J 2014. 43: 754-762. FI: 7,636(Q1). PMID: 23988775. DOI: 10.1183/09031936.00074413.
Segrelles Calvo G, Girón Moreno RM, Muñoz Vázquez A, Gago A, Ancochea J. Peripheral Polyneuropathy in a Patient With Severe Chronic Obstructive Pulmonary Disease. Arch Bronconeumol 2012. 48: 484-0. FI: 1,372(Q4). PMID: 22704528. DOI: 10.1016/j.arbres.2012.04.020.
Noble PW, Albera C, Bradford WZ, Costabel U, Glassberg MK, Kardatzke D, King TE, Lancaster L, Sahn SA, Szwarcberg J, Valeyre D, du Bois RM, CAPACITY Study Group. Pirfenidone in patients with idiopathic pulmonary fibrosis (CAPACITY): two randomised trials. LANCET 2011. 377: 1760-1769. FI: 38,278(Q1). PMID: 21571362. DOI: 10.1016/S0140-6736(11)60405-4.
Raghu, Ganesh, Collard, Harold R., Egan, Jim J., Martinez, Fernando J., Behr, Juergen, Brown, Kevin K., Colby, Thomas V., Cordier, Jean-Francois, Flaherty, Kevin R., Lasky, Joseph A., Lynch, David A., Ryu, Jay H., Swigris, Jeffrey J., Wells, Athol U., Ancochea, Julio, Bouros, Demosthenes, Carvalho, Carlos, Costabel, Ulrich, Ebina, Masahito, Hansell, David M., Johkoh, Takeshi, Kim, Dong Soon, King, Jr., Talmadge E., Kondoh, Yasuhiro, Myers, Jeffrey, Mueller, Nestor L., Nicholson, Andrew G., Richeldi, Luca, Selman, Moises, Dudden, Rosalind F., Griss, Barbara S., Protzko, Shandra L., Schuenemann, Holger J., ATS ERS JRS ALAT Comm. An Official ATS/ERSARS/ALAT Statement: Idiopathic Pulmonary Fibrosis: Evidence-based Guidelines for Diagnosis and Management. Am J Respir Crit Care Med 2011. 183: 788-824. FI: 11,080(Q1). PMID: 21471066. DOI: 10.1164/rccm.2009-040GL.
