Browsing by Author "De la Cruz, Javiera"
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Publication A Third Dose of SARS-CoV-2 mRNA Vaccine Improves Immune Response in Chronic Kidney Disease Patients(2023) Poli Harlowe, María Cecilia; Vial Cox, María Cecilia; Rey, Emma; González, Natalia; Cortés, Lina; Hormazabal, Juan; Ramírez, Carolina; De la Cruz, Javiera; Ulloa, CamiloChronic kidney disease (CKD) patients have an increased risk of morbidity and mortality following SARS-CoV-2 infection. Vaccination in these patients is prioritized, and monitoring of the immune response is paramount to define further vaccination strategies. This prospective study included a cohort of 100 adult CKD patients: 48 with kidney transplant (KT) and 52 on hemodialysis without prior COVID-19. The patients were assessed for humoral and cellular immune responses after four months of an anti-SARS-CoV-2 primary two-dose vaccination scheme (CoronaVac or BNT162b2) and one month after a booster third dose of BNT162b2 vaccine. We identified poor cellular and humoral immune responses in the CKD patients after a primary vaccination scheme, and these responses were improved by a booster. Robust polyfunctional CD4+ T cell responses were observed in the KT patients after a booster, and this could be attributed to a higher proportion of the patients having been vaccinated with homologous BNT162b2 schemes. However, even after the booster, the KT patients exhibited lower neutralizing antibodies, attributable to specific immunosuppressive treatments. Four patients suffered severe COVID-19 despite three-dose vaccination, and all had low polyfunctional T-cell responses, underscoring the importance of this functional subset in viral protection. In conclusion, a booster dose of SARS-CoV-2 mRNA vaccine in CKD patients improves the impaired humoral and cellular immune responses observed after a primary vaccination scheme.Item Evaluación de queratometrías obtenidas mediante topografía Pentacam HR, en rangos de edad y según sexo, en Las Condes, Santiago de Chile entre 2020 - 2021(2022) Araya, Javiera; De la Cruz, Javiera; Romero, PabloIntroducción: Las queratometrías entregan valores sobre la curvatura corneal. Objetivo: Determinar si existe una diferencia entre edad y sexo respecto a las queratometrías en la muestra de estudio. Metodología: Se analizaron 272 ojos de pacientes entre 20 a 80 años (promedio 50,2 + 18,14 años), los datos fueron clasificados por sexo y 4 grupos de edad (20 - 35), (36 -50), (51- 65) y (66 -80). Las variables queratometrías evaluadas fueron, queratometría más curva (K2), queratometría más plana (K1), queratometría media (Km), queratometría máxima (Kmax), eje K2, eje K1 y astigmatismo corneal. Resultados: Las mujeres presentaron queratometrías más curvas (K1, K2, Kmax y Km) respecto a los hombres en toda la muestra. El astigmatismo corneal tendió a ser menor en pacientes sobre 50 años en comparación a los grupos más jóvenes. No así, la variable K1 que obtuvo un valor más alto en los mayores de 50 años respecto al grupo más joven. Conclusión: Se pudo determinar que en la población de estudio, efectivamente existe una diferencia significativa de las variables queratométricas entre hombres y mujeres, en distintos rangos de edad.Publication Multicenter analysis of neutrophil extracellular trap dysregulation in adult and pediatric COVID-19(2022) Carmona, Carmelo; Zhang, Yu; Dobbs, Kerry; Markowitz, Tovah; Dalgard, Clifton; Oler, Andrew; Claybaugh, Dillon; Draper, Deborah; Truong, Meng; Delmonte, Ottavia; Licciardi, Francesco; Ramenghi, Ugo; Crescenzio, Nicoletta; Imberti, Luisa; Sottini, Alessandra; Quaresima, Virginia; Fiorini, Chiara; Discepolo, Valentina; Lo Vecchio, Andrea; Guarino, Alfredo; Pierri, Luca; Catzola, Andrea; Biondi, Andrea; Bonfanti, Paolo; Poli, Cecilia; Espinosa, Yasmin; Astudillo, Camila; Rey, Emma; Vial, Cecilia; De la Cruz, Javiera; González, Ricardo; Pinera, Cecilia; Mays, Jacqueline; Ng, Ashley; Platt, Andrew; NIH COVID Autopsy Consortium; COVID STORM Clinicians; Drolet, Beth; Moon, John; Cowen, Edward; Kenney, Heather; Weber, Sarah; Castagnoli, Riccardo; Magliocco, Mary; Stack, Michael; Montealegre, Gina; Barron, Karyl; Fink, Danielle; Kuhns, Douglas; Hewitt, Stephen; Arkin, Lisa; Chertow, Daniel; Su, Helen; Notarangelo, Luigi; Kaplan, MarianaDysregulation in neutrophil extracellular trap (NET) formation and degradation may play a role in the pathogenesis and severity of COVID-19; however, its role in the pediatric manifestations of this disease, including multisystem inflammatory syndrome in children (MIS-C) and chilblain-like lesions (CLLs), otherwise known as "COVID toes," remains unclear. Studying multinational cohorts, we found that, in CLLs, NETs were significantly increased in serum and skin. There was geographic variability in the prevalence of increased NETs in MIS-C, in association with disease severity. MIS-C and CLL serum samples displayed decreased NET degradation ability, in association with C1q and G-actin or anti-NET antibodies, respectively, but not with genetic variants of DNases. In adult COVID-19, persistent elevations in NETs after disease diagnosis were detected but did not occur in asymptomatic infection. COVID-19-affected adults displayed significant prevalence of impaired NET degradation, in association with anti-DNase1L3, G-actin, and specific disease manifestations, but not with genetic variants of DNases. NETs were detected in many organs of adult patients who died from COVID-19 complications. Infection with the Omicron variant was associated with decreased NET levels when compared with other SARS-CoV-2 strains. These data support a role for NETs in the pathogenesis and severity of COVID-19 in pediatric and adult patients.