Línies de recerca
1. Nutrition, obesity, diabetes, and cardiovascular disease: from epidemiology to mechanistic studies
Dietary habits have strong effects on health. From epidemiological data, we aim to evaluate the impact of whole foods and dietary patterns on the incidence and pathophysiology of type 2 diabetes, obesity, and cardiovascular disease. From clinical studies, we aim to understand the impact of dietary interventions on the incidence of cardiovascular disease.
Our mechanistic studies in humans aim at understanding these relationships. The latter include the evaluation of the relationship between dietary patterns and hypothalamic leptin and insulin resistance in the pathophysiology of obesity, adipose tissue biology and insulin sensitivity or secretion and glucose tolerance, lipoprotein size and tissue specific circulating extracellular vesicles (exosomes) and their cargo (proteins, microRNA, and lipids) on cardiovascular disease.
2. Detection of atherosclerosis: a road to personalized medicine in dyslipidemia and diabetes
Carotid and femoral ultrasound examination and plaque detection may help tailor clinical interventions in patients (metabolic syndrome, type 1 and type 2 diabetes, central obesity, and genetic dyslipidemias) not well-represented by conventional risk evaluation scores based, mainly, on classical risk factors.
We aim to evaluate the presence of preclinical atherosclerosis and vulnerable plaques in these groups of patients, and to investigate their association with cardiometabolic risk factors and dietary biomarkers.
3. Monogenic forms of diabetes
Monogenic diabetes represents a heterogeneous group of disorders resulting from defects in single genes. The prevalence of monogenic diabetes is estimated at 2–5% of all patients with diabetes, but currently many monogenic forms are missed or misclassified as type 2 or type 1 diabetes. An accurate diagnosis is important because it may have therapeutic as well as prognostic implications.
Our research is focused in improving diagnostic algorithms and access to genetic testing in order to better identify the exact origin of diabetes in our patients.
4. Impact of bariatric surgery on health
The health burden of excess body adiposity is well documented. In the context of our extensive bariatric surgery program, we aim to better understand the interplay between obesity, type 2 diabetes and cognition. Furthermore, we aim to understand the potential caveats of bariatric surgery such as nutritional deficiencies or insufficient weight loss. To address these aims we use a multimodal approach tailored to the research question including metabolic phenotyping, neuroimaging studies, cerebrospinal fluid biomarkers, and adipose tissue biology.
5. Advanced therapies for type 1 diabetes. The artificial pancreas concept
Clinical studies have shown that automatic systems (artificial pancreas) can achieve better control of glucose levels than standard treatment in which a person makes dosing decisions continuously. In collaboration with engineering groups at the Universitat de Girona and Universitat Politècnica de València, our group is in the position to push forward the research on artificial pancreas by addressing new challenges such as alleviation of patient's burden and glycemic control improvement, while opening new areas such as "closing the loop" in patients using “smart” multiple doses of insulin.
6. Hypoglycemia and its consequences in patients with diabetes
Hypoglycemia is an important complication of glucose-lowering therapy in patients with diabetes. Attempts made at intensive glycemic control invariably increase the risk of hypoglycemia. Repeated episodes of hypoglycemia can lead to impairment of the counter-regulatory system with the potential for development of hypoglycemia unawareness. Additionally, severe hypoglycemia has been associated with an increased risk of death. Our research group is interested in the recognition of groups at risk, and the study of the consequences, prevention and best possible treatment of hypoglycemia, mainly in type 1 diabetes, including pregnancy.
7. Regenerative medicine strategies to treat beta cell deficiency in diabetes
Diabetes is characterized by an absolute (type 1 diabetes) or relative (type 2 diabetes) deficit in functional beta cell mass. Hence, regeneration and replacement of beta cells have been postulated as promising strategies to prevent and/or delay the onset or even reverse overt diabetes. One approach is to stimulate proliferation of remaining beta cells. In this line, we seek to identify extrinsic and intrinsic factors that govern beta cell proliferation during organismal postnatal life, both under physiological and pathophysiological conditions.
On the other hand, donor islet transplantation has been quite successful in providing temporary insulin independence in type 1 diabetes patients. However, donor islet scarcity makes this strategy non-viable as a broad treatment option. In this area, we seek to develop cellular reprogramming protocols to generate substitute insulin-producing cells from other somatic cell types.
8. Advancing antigen-specific nanomedicines for the treatment of type 1 diabetes
In collaboration with the group 'Patogènia i tractament de la autoimmunitat' the project involves the development of novel methodologies to identify candidate pMHC-based nanomedicines for type 1 diabetes. It also includes the testing of the pharmacodynamic and therapeutic activities of these compounds in murine models of the disease and evaluation of whether they could be suitable for human therapeutic application in the future.