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  1. Article ; Online: BK polyomavirus-associated nephropathy, graft inflammation, and immunosuppression: Shedding light on the conundrum.

    Fernández-Ruiz, Mario

    Transplant infectious disease : an official journal of the Transplantation Society

    2024  Volume 26, Issue 2, Page(s) e14272

    MeSH term(s) Humans ; BK Virus ; Polyomavirus Infections ; Kidney Transplantation/adverse effects ; Immunosuppression Therapy/adverse effects ; Inflammation ; Tumor Virus Infections ; Kidney Diseases
    Language English
    Publishing date 2024-03-28
    Publishing country Denmark
    Document type Editorial
    ZDB-ID 1476094-0
    ISSN 1399-3062 ; 1398-2273
    ISSN (online) 1399-3062
    ISSN 1398-2273
    DOI 10.1111/tid.14272
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Pharmacological management of invasive mold infections in solid organ transplant recipients.

    Fernández-Ruiz, Mario

    Expert opinion on pharmacotherapy

    2024  Volume 25, Issue 3, Page(s) 239–254

    Abstract: Introduction: Solid organ transplant (SOT) recipients face an increased susceptibility to invasive fungal infection (IFI) due to filamentous fungi. Post-transplant invasive aspergillosis (IA) and mucormycosis are related to exceedingly high mortality ... ...

    Abstract Introduction: Solid organ transplant (SOT) recipients face an increased susceptibility to invasive fungal infection (IFI) due to filamentous fungi. Post-transplant invasive aspergillosis (IA) and mucormycosis are related to exceedingly high mortality rates and graft loss risk, and its management involve a unique range of clinical challenges.
    Areas covered: First, the current treatment recommendations for IA and mucormycosis among SOT recipients are critically reviewed, including the supporting evidence. Next, we discussed particular concerns in this patient population, such as drug-drug interactions (DDIs) between triazoles and post-transplant immunosuppression or treatment-related toxicity. The role for immunomodulatory and host-targeted therapies is also considered, as well as the theoretical impact of the intrinsic antifungal activity of calcineurin inhibitors. Finally, a personal opinion is made on future directions in the pharmacological approach to post-transplant IFI.
    Expert opinion: Despite relevant advances in the treatment of mold IFIs in the SOT setting, such as the incorporation of isavuconazole (with lower incidence of DDIs and better tolerability than voriconazole), there remains a large room for improvement in areas such as the position of combination therapy or the optimal strategy for the reduction of baseline immunosuppression. Importantly, future studies should define the specific contribution of newer antifungal agents and classes.
    MeSH term(s) Humans ; Antifungal Agents/therapeutic use ; Antifungal Agents/adverse effects ; Invasive Fungal Infections/drug therapy ; Organ Transplantation/adverse effects ; Drug Interactions ; Mucormycosis/drug therapy ; Aspergillosis/drug therapy ; Transplant Recipients ; Immunosuppressive Agents/adverse effects ; Immunosuppressive Agents/therapeutic use ; Animals
    Chemical Substances Antifungal Agents ; Immunosuppressive Agents
    Language English
    Publishing date 2024-03-11
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2001535-5
    ISSN 1744-7666 ; 1465-6566
    ISSN (online) 1744-7666
    ISSN 1465-6566
    DOI 10.1080/14656566.2024.2326507
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Torque Teno virus load as a surrogate marker for the net state of immunosuppression: The beneficial side of the virome.

    Fernández-Ruiz, Mario

    American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

    2020  Volume 20, Issue 8, Page(s) 1963–1964

    MeSH term(s) Biomarkers ; Graft Rejection ; Humans ; Infections ; Kidney Transplantation ; Prospective Studies ; Risk Assessment ; Torque teno virus
    Chemical Substances Biomarkers
    Language English
    Publishing date 2020-04-12
    Publishing country United States
    Document type Editorial ; Research Support, Non-U.S. Gov't ; Comment
    ZDB-ID 2060594-8
    ISSN 1600-6143 ; 1600-6135
    ISSN (online) 1600-6143
    ISSN 1600-6135
    DOI 10.1111/ajt.15872
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Reply.

    Gil Mosquera, Manuel / Fernández-Ruiz, Mario

    Medicina clinica (English ed.)

    2023  Volume 160, Issue 9, Page(s) 417–418

    Language English
    Publishing date 2023-04-20
    Publishing country Spain
    Document type Journal Article
    ISSN 2387-0206
    ISSN (online) 2387-0206
    DOI 10.1016/j.medcle.2022.12.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Reply.

    Gil Mosquera, Manuel / Fernández-Ruiz, Mario

    Medicina clinica

    2023  Volume 160, Issue 9, Page(s) 417–418

    Title translation Respuesta.
    Language Spanish
    Publishing date 2023-01-23
    Publishing country Spain
    Document type Letter ; Comment
    ZDB-ID 411607-0
    ISSN 1578-8989 ; 0025-7753
    ISSN (online) 1578-8989
    ISSN 0025-7753
    DOI 10.1016/j.medcli.2022.12.013
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  6. Article ; Online: Which trial do we need? Elective early surgical treatment of left-sided infective endocarditis.

    Fernández-Ruiz, Mario / Aguado, José María

    Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases

    2023  Volume 29, Issue 9, Page(s) 1103–1106

    MeSH term(s) Humans ; Endocarditis/surgery ; Endocarditis/microbiology ; Endocarditis, Bacterial/drug therapy ; Endocarditis, Bacterial/surgery ; Endocarditis, Bacterial/microbiology
    Language English
    Publishing date 2023-04-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 1328418-6
    ISSN 1469-0691 ; 1470-9465 ; 1198-743X
    ISSN (online) 1469-0691
    ISSN 1470-9465 ; 1198-743X
    DOI 10.1016/j.cmi.2023.04.010
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Is there a real risk of bacterial infection in patients receiving targeted and biological therapies?

    Noreña, Ivan / Fernández-Ruiz, Mario / Aguado, José María

    Enfermedades infecciosas y microbiologia clinica (English ed.)

    2022  Volume 40, Issue 5, Page(s) 266–272

    Abstract: Over the past decades, the advent of targeted and biological therapies has revolutionized the management of cancer and autoimmune, hematological and inflammatory conditions. Although a large amount of information is now available on the risk of ... ...

    Abstract Over the past decades, the advent of targeted and biological therapies has revolutionized the management of cancer and autoimmune, hematological and inflammatory conditions. Although a large amount of information is now available on the risk of opportunistic infections associated with some of these agents, the evidence regarding the susceptibility to bacterial infections is more limited. Biological agents have been shown to entail a variable risk of bacterial infections in pivotal randomized clinical trials and post-marketing studies. Recommendations on risk minimization strategies and therapeutic interventions are therefore scarce and often based on expert opinion, with only a few clear statements for some particular agents (i.e. meningococcal vaccination for patients receiving eculizumab). In the present review the available information regarding the incidence of and risk factors for bacterial infection associated with the use of different groups of biological agents is summarized according to their mechanisms of action, and recommendations based on this evidence are provided. Additional information coming from clinical research and real-world studies is required to address unmet questions in this emerging field.
    MeSH term(s) Bacterial Infections/drug therapy ; Bacterial Infections/epidemiology ; Bacterial Infections/etiology ; Biological Factors ; Biological Therapy/adverse effects ; Humans ; Incidence ; Opportunistic Infections/epidemiology ; Opportunistic Infections/etiology
    Chemical Substances Biological Factors
    Language English
    Publishing date 2022-05-14
    Publishing country Spain
    Document type Journal Article ; Review
    ISSN 2529-993X
    ISSN (online) 2529-993X
    DOI 10.1016/j.eimce.2020.10.014
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Severe acute respiratory syndrome coronavirus 2 infection in the stem cell transplant recipient - clinical spectrum and outcome.

    Fernández-Ruiz, Mario / Aguado, José María

    Current opinion in infectious diseases

    2021  Volume 34, Issue 6, Page(s) 654–662

    Abstract: Purpose of review: Focusing on large multicenter cohorts reported over the last months, this review aims at summarizing the available evidence by July 2021 on the impact of coronavirus disease 2019 (COVID-19) on hematopoietic stem cell transplant (HSCT) ...

    Abstract Purpose of review: Focusing on large multicenter cohorts reported over the last months, this review aims at summarizing the available evidence by July 2021 on the impact of coronavirus disease 2019 (COVID-19) on hematopoietic stem cell transplant (HSCT) recipients in terms of epidemiology, clinical features, and outcome.
    Recent findings: The incidence of COVID-19 in institutional cohorts varied according to different regions and study periods from 0.4% to 8.3%. Clinical presentation was overall comparable to other immunocompromised hosts and the general population. Microbiologically confirmed superinfection occurred in 13-25% of recipients, with most episodes due to hospital-acquired bacteria and few reported cases of COVID-19-associated aspergillosis. Prolonged nasopharyngeal severe acute respiratory syndrome coronavirus 2 shedding has been demonstrated for as long as 210 days. Mortality rates were similar across studies (14.8-28.4%) and did not markedly differ from those observed in nontransplant hematological patients during the first wave. Older age and shorter time from transplantation were associated with mortality, as well as underlying disease status and amount of immunosuppression. No outcome differences were found in most studies between allogeneic and autologous procedures.
    Summary: Considerable advances have been achieved in the characterization of COVID-19 in the HSCT population, although uncertainties remain in the optimal therapeutic management.
    MeSH term(s) Aged ; COVID-19 ; Hematopoietic Stem Cell Transplantation/adverse effects ; Humans ; Immunocompromised Host ; Multicenter Studies as Topic ; SARS-CoV-2 ; Transplant Recipients
    Language English
    Publishing date 2021-11-08
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 645085-4
    ISSN 1473-6527 ; 1535-3877 ; 0951-7375 ; 1355-834X
    ISSN (online) 1473-6527 ; 1535-3877
    ISSN 0951-7375 ; 1355-834X
    DOI 10.1097/QCO.0000000000000790
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Viruses, friends, and foes: The case of Torque Teno Virus and the net state of immunosuppression.

    Redondo, Natalia / Navarro, David / Aguado, José María / Fernández-Ruiz, Mario

    Transplant infectious disease : an official journal of the Transplantation Society

    2022  Volume 24, Issue 2, Page(s) e13778

    Abstract: New reliable biomarkers are needed to improve individual risk assessment for post-transplant infection, acute graft rejection and other immune-related complications after solid organ transplantation (SOT) and allogeneic hematopoietic stem cell ... ...

    Abstract New reliable biomarkers are needed to improve individual risk assessment for post-transplant infection, acute graft rejection and other immune-related complications after solid organ transplantation (SOT) and allogeneic hematopoietic stem cell transplantation (allo-HSCT). One promising strategy relies on the monitoring of replication kinetics of virome components as functional surrogate for the net state of immunosuppression. Torque Teno Virus (TTV) is a small, non-enveloped, circular, single-stranded DNA anellovirus with no attributable pathological effects. A major component of the human blood virome, TTV exhibits various features that facilitate its application as immune biomarker: high prevalence rates, nearly ubiquitous distribution, stable viral loads with little intra-individual variability, insensitivity to antiviral drugs, and availability of commercial PCR assays for DNA quantification. The present review summarizes the available studies supporting the use of post-transplant TTV viremia to predict patient and graft outcomes after SOT and allo-HSCT. Taken together, this evidence suggests that high or increasing TTV DNA levels precede the occurrence of infectious complications in the SOT setting, whereas low or decreasing viral loads are associated with the development of acute rejection. The interpretation in allo-HSCT recipients is further complicated by complex interplay with the underlying disease, conditioning regimen, and timing of recovery of lymphocyte counts, although TTV kinetics may act as a marker of immunological reconstitution at the early post-transplant period. The standardization of PCR methods and reporting units for TTV DNAemia and the results from ongoing interventional trials evaluating a TTV load-guided strategy to adjust immunosuppressive therapy are achievements expected in the coming years.
    MeSH term(s) DNA, Viral ; Friends ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Immunosuppression Therapy/adverse effects ; Torque teno virus/genetics ; Viral Load
    Chemical Substances DNA, Viral
    Language English
    Publishing date 2022-01-31
    Publishing country Denmark
    Document type Journal Article ; Review
    ZDB-ID 1476094-0
    ISSN 1399-3062 ; 1398-2273
    ISSN (online) 1399-3062
    ISSN 1398-2273
    DOI 10.1111/tid.13778
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  10. Article ; Online: Risk of infection in patients with hematological malignancies receiving CAR T-cell therapy: systematic review and meta-analysis.

    Telli Dizman, Gülçin / Aguado, José María / Fernández-Ruiz, Mario

    Expert review of anti-infective therapy

    2022  Volume 20, Issue 11, Page(s) 1455–1476

    Abstract: Background: Chimeric antigen receptor (CAR) T-cell therapy has emerged as a promising treatment option for relapsed or refractory B-cell malignancies and multiple myeloma. Underlying and treatment-related variables may contribute to the development of ... ...

    Abstract Background: Chimeric antigen receptor (CAR) T-cell therapy has emerged as a promising treatment option for relapsed or refractory B-cell malignancies and multiple myeloma. Underlying and treatment-related variables may contribute to the development of infectious complications.
    Research design and methods: We conducted a systematic review and meta-analysis on the incidence of overall and severe (grade ≥3) infection in patients with hematological malignancies receiving CAR T-cells. Secondary outcomes included the specific rates of bacterial, viral and invasive fungal infection (IFI), and infection-related mortality. PubMed, Embase and Web of Science databases were searched from inception to 27 May 2022. Sensitivity analysis were performed according to the type of malignancy and study design (randomized clinical trials [RCTs] or observational studies).
    Results: Forty-five studies (34 RCTs) comprising 3,591 patients were included. The pooled incidence rates of overall and severe infection were 33.8% (I
    Conclusions: Infection is a frequent adverse event in patients receiving CAR T-cell therapy. Further research should address specific risk factors in this population.
    MeSH term(s) Humans ; Immunotherapy, Adoptive/adverse effects ; Receptors, Chimeric Antigen ; Antigens, CD19 ; Hematologic Neoplasms/therapy ; Neoplasms/drug therapy
    Chemical Substances Receptors, Chimeric Antigen ; Antigens, CD19
    Language English
    Publishing date 2022-09-28
    Publishing country England
    Document type Meta-Analysis ; Systematic Review ; Journal Article
    ZDB-ID 2181279-2
    ISSN 1744-8336 ; 1478-7210
    ISSN (online) 1744-8336
    ISSN 1478-7210
    DOI 10.1080/14787210.2022.2128762
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