Prevalence and clinical characteristics of patients with rheumatoid arthritis with interstitial lung disease using unstructured healthcare data and machine learning.

OBJECTIVES: Real-world data regarding rheumatoid arthritis (RA) and its association with interstitial lung disease (ILD) is still scarce. This study aimed to estimate the prevalence of RA and ILD in patients with RA (RAILD) in Spain, and to compare clinical characteristics of patients with RA with and without ILD using natural language processing (NLP) on electronic health records (EHR). METHODS: Observational case-control, retrospective and multicentre study based on the secondary use of unstructured clinical data from patients with adult RA and RAILD from nine hospitals between 2014 and 2019. NLP was used to extract unstructured clinical information from EHR and standardise it into a SNOMED-CT terminology. Prevalence of RA and RAILD were calculated, and a descriptive analysis was performed. Characteristics between patients with RAILD and RA patients without ILD (RAnonILD) were compared. RESULTS: From a source population of 3 176 165 patients and 64 241 683 EHRs, 13 958 patients with RA were identified. Of those, 5.1% patients additionally had ILD (RAILD). The overall age-adjusted prevalence of RA and RAILD were 0.53% and 0.02%, respectively. The most common ILD subtype was usual interstitial pneumonia (29.3%). When comparing RAILD versus RAnonILD patients, RAILD patients were older and had more comorbidities, notably concerning infections (33.6% vs 16.5%, p<0.001), malignancies (15.9% vs 8.5%, p<0.001) and cardiovascular disease (25.8% vs 13.9%, p<0.001) than RAnonILD. RAILD patients also had higher inflammatory burden reflected in more pharmacological prescriptions and higher inflammatory parameters and presented a higher in-hospital mortality with a higher risk of death (HR 2.32; 95% CI 1.59 to 2.81, p<0.001). CONCLUSIONS: We found an estimated age-adjusted prevalence of RA and RAILD by analysing real-world data through NLP. RAILD patients were more vulnerable at the time of inclusion with higher comorbidity and inflammatory burden than RAnonILD, which correlated with higher mortality.

Asociación del índice de masa corporal y relación cintura/estatura con la presión arterial como factor de riesgo metabólico en estudiantes universitarios / Body mass index and waist / height ratio association with blood pressure as a metabolic risk factor in college students

Los problemas relacionados con los trastornos metabólicos se han incrementado en la actualidad en población joven. Promover un estilo de vida saludable en estudiantes universitarios puede ayudar a prevenir diabetes, enfermedades cardiovasculares y diferentes tipos de cáncer. Objetivo. Calcular el Índice de Masa Corporal (IMC) de universitarios para identificar la prevalencia de obesidad e hipertensión como factores de riesgo metabólico. Materiales y método. Se utilizó muestreo probabilístico aleatorio simple (n= 282, edad 19,1 ± 1,8, 54,6% mujeres, 48,5% hombres). Se realizaron mediciones de peso y estatura para calcular el IMC, circunferencia de cintura y presión arterial. Resultados. Los resultados promedio para mujeres y hombres respectivamente fueron: IMC 24,0 ±5,5 y 25,2 ±5,2 kg/m2 (p= 0,25); cintura 76,25 ± 11,87 y 82,32 ± 15,85 cm (p= 0,001), indicando un riesgo bajo en 73,1% de mujeres y 82,5% de hombres; y presión arterial 127,73/86,03 y 142,3/94,2 mmHg (p= 0,001). La probabilidad de tener hipertensión arterial fue mayor al tener una relación cintura/estatura (RCE) alterada en mujeres y hombres (OR=3,037; IC95% 1,385-6,657 y OR=3,664; IC95% 1,249-2,179, respectivamente). Conclusiones. La población universitaria presenta factores de riesgo que pueden derivar en enfermedades crónicas no transmisibles en un futuro próximo, por lo cual es necesario modificar sus estilos de vida. La RCE es un buen predictor de riesgo de hipertensión en esta población(AU)

The problems related to metabolic disorders have now increased in the young population. Promoting a healthy lifestyle in college students can help prevent diabetes, cardiovascular disease, and different types of cancer. Objective. To calculate the Body Mass Index (BMI) in college students to identify the prevalence of obesity and hypertension as metabolic risk factors. Materials and methods. Simple random probability sampling was used (n = 282, age 19,1 ± 1,8, 54,6% women, 48,5% men). BMI was calculated with weight and height, waist circumference, and blood pressure. Results. The average results for women and men respectively were: BMI 24,0 ± 5,5 and 25,2 ± 5,2 kg/m2 (p = 0,25); waist 76,25 ± 11,87 and 82,32 ± 15,85 cm (p = 0,001), indicating a low risk in 73,1% of women and 82,5% of men; and blood pressure 127,73 / 86,03 and 142,3 / 94,2 mm Hg (p = 0,001). The probability of having arterial hypertension was higher when there was an altered waist / height ratio (WHR) in women and men (OR = 3,037; 95% CI 1,385-6,657 and OR = 3,664; 95% CI 1,249-2,179, respectively). Conclusions. The university population presents risk factors that could lead to chronic diseases. It is necessary to modify their lifestyles to prevent future diseases. WHR is a good predictor of hypertension risk in this population(AU)

Abatacept in monotherapy vs combined in interstitial lung disease of rheumatoid arthritis-multicentre study of 263 Caucasian patients.

OBJECTIVE: To assess the efficacy and safety of abatacept (ABA) in monotherapy (ABAMONO) vs combined ABA [ABA plus MTX (ABAMTX) or ABA plus non-MTX conventional synthetic DMARDs (csDMARDs) (ABANON-MTX)] in RA patients with interstitial lung disease (ILD) (RA-ILD). METHODS: This was a restrospective multicentre study of RA-ILD Caucasian patients treated with ABA. We analysed in the three groups (ABAMONO, ABAMTX, ABANON-MTX) the following outcome variables: (i) dyspnoea; (ii) forced vital capacity (FVC) and diffusion capacity of the lung for the carbon monoxide (DLCO); (iii) chest high-resolution CT (HRCT); (iv) DAS28-ESR; (v) CS-sparing effect; and (vi) ABA retention and side-effects. Differences between basal and final follow-up were evaluated. Multivariable linear regression was used to assess the differences between the three groups. RESULTS: We studied 263 RA-ILD patients (mean ± s.d. age 64.6 ± 10 years) [ABAMONO (n = 111), ABAMTX (n = 46) and ABANON-MTX (n = 106)]. At baseline, ABAMONO patients were older (67 ± 10 years) and took higher prednisone dose [10 (interquartile range 5-15) mg/day]. At that time, there were no statistically significant differences in sex, seropositivity, ILD patterns, FVC and DLCO, or disease duration. Following treatment, in all groups, most patients experienced stabilization or improvement in FVC, DLCO, dyspnoea and chest HRCT as well as improvement in DAS28-ESR. A statistically significant difference between basal and final follow-up was only found in CS-sparing effect in the group on combined ABA (ABAMTX or ABANON-MTX). However, in the multivariable analysis, there were no differences in any outcome variables between the three groups. CONCLUSION: In Caucasian individuals with RA-ILD, ABA in monotherapy or combined with MTX or with other conventional-DMARDs seems to be equally effective and safe. However, a CS-sparing effect is only observed with combined ABA.

Biological agents for rheumatic diseases in the outbreak of COVID-19: friend or foe?

BACKGROUND: The recent outbreak of COVID-19 has raised concerns in the rheumatology community about the management of immunosuppressed patients diagnosed with inflammatory rheumatic diseases. It is not clear whether the use of biological agents may suppose a risk or protection against SARS-CoV-2 infection; however, it has been suggested that severe respiratory forms of COVID-19 occur as a result of exacerbated inflammation status and cytokine production. This prompted the use of interleukin 6 (IL-6) (tocilizumab and sarilumab) and IL-1 inhibitors (anakinra) in severe COVID-19 disease and more recently JAK1/2 inhibitor (baricitinib). Therefore, patients with rheumatic diseases provide a great opportunity to learn about the use of biological agents as protective drugs against SARS-CoV-2. OBJECTIVES: To estimate COVID-19 infection rate in patients treated with biological disease-modifying antirheumatic drugs (bDMARDs) for inflammatory rheumatic diseases (RMD), determine the influence of biological agents treatment as risk or protective factors and study the prognosis of patients with rheumatic diseases receiving biological agents compared to the general population in a third-level hospital setting in León, Spain. METHODS: We performed a retrospective observational study including patients seen at our rheumatology department who received bDMARDs for rheumatic diseases between December 1st 2019 and December 1st 2020, and analysed COVID-19 infection rate. All patients who attended our rheumatology outpatient clinic with diagnosis of inflammatory rheumatic disease receiving treatment with biological agents were included. Main variable was the hospital admission related to COVID-19. The covariates were age, sex, comorbidities, biological agent, duration of treatment, mean dose of glucocorticoids and need for intensive care unit . We performed an univariate and multivariate logistic regression models to assess risk factors of COVID-19 infection. RESULTS: There were a total of 4464 patients with COVID-19 requiring hospitalisation. 40 patients out of a total of 820 patients with rheumatic diseases (4.8%) receiving bDMARDs contracted COVID-19 and 4 required hospital care. Crude incidence rate of COVID-19 requiring hospital care among the general population was 3.6%, and it was 0.89% among the group with underlying rheumatic diseases. 90% of patients receiving bDMARDS with COVID-19 did not require hospitalisation. Out of the 4464 patients, 869 patients died, 2 of which received treatment with biological agents. Patients with rheumatic diseases who tested positive for COVID-19 were older (female: median age 60.8 IQR 46-74; male: median age 61.9 IQR 52-70.3) than those who were negative for COVID-19 (female: median age 58.3 IQR 48-69; male: median age 56.2 IQR 47-66), more likely to have hypertension (45% vs 26%, OR 2.25 (CI 1.18-4.27),p 0.02), cardiovascular disease (23 % vs 9.6%, OR 2.73 (1.25-5.95), p 0.02), be smokers (13% vs 4.6%, OR 2.95 (CI 1.09-7.98), p 0.04), receiving treatment with rituximab (20% vs 8%, 2.28 (CI 1.24-6.32), p 0.02) and a higher dose of glucocorticoids (OR 2.5 (1.3-10.33, p 0.02) and were less likely to be receiving treatment with IL-6 inhibitors (2.5% vs 14%, OR 0.16, (CI 0.10-0.97, p 0.03). When exploring the effect of the rest of the therapies between groups (affected patients vs unaffected), we found no significant differences in bDMARD proportions. IL-1 inhibitors, IL-6 inhibitors, JAK inhibitors and belimumab-treated patients showed the lowest incidence of COVID-19 among adult patients with rheumatic diseases. We found no differences in sex or rheumatological disease between patients who tested positive for COVID-19 and patients who tested negative. CONCLUSIONS: Overall, the use of biological disease-modifying antirheumatic drugs (bDMARDs) does not associate with severe manifestations of COVID-19. Patients with rheumatic disease diagnosed with COVID-19 were more likely to be receiving a higher dose of glucocorticoids and treatment with rituximab. IL-6 inhibitors may have a protective effect.

Encapsulation of phenolic compounds with liposomal improvement in the cosmetic industry.

Phenolic compounds are secondary metabolites present in plants which possess ideal structural characteristics for its antioxidant and anti-inflammatory activity. These compounds are usually stable and bioactive in plants but after the extraction, they are susceptible to degradation as they are very sensitive to light and heat. They are also characterized by having a low solubility, bioavailability and rapid metabolization. In order to increase the compound bioavailability and solubility, liposomes are an efficient way to encapsulate the compounds. This encapsulation prevents the rapid degradation and acts as a control to regulate the release of these compounds. In this review, factors which intervene in the efficacy of liposomes will be shown by in vitro and in vivo assays as the size of liposomes, phase transition temperature, pH, zeta potentials, fluidity of bilayer, charge, bioaccessibility and low toxicity. Also, the cosmetic application of phenolic compounds against diseases will be discussed.

Registro Español de Artritis Psoriásica de Reciente Comienzo (estudio REAPSER). Objetivos y metodología / Spanish Registry of Recent-onset Psoriatic Arthritis (REAPSER study): aims and methodology

OBJETIVOS: Describir la metodología del Registro Español de Artritis Psoriásica de reciente comienzo de la Sociedad Española de Reumatología (REAPSER), así como sus fortalezas y limitaciones. El objetivo principal del proyecto es identificar factores pronósticos de la evolución clínica y radiográfica en una cohorte de pacientes que padecen artritis psoriásica (APs) diagnosticada con menos de 2 años de evolución. MATERIAL Y MÉTODO: Estudio observacional, prospectivo (2 años de seguimiento; periodicidad anual de las visitas), multicéntrico. La intención en la visita basal fue reflejar la situación del paciente antes de que la evolución de la enfermedad se viese modificada por los tratamientos pautados en los servicios de reumatología. Los pacientes fueron invitados a participar consecutivamente en una de sus visitas habituales al reumatólogo. El tamaño muestral finalmente alcanzado fue de 211 pacientes. Se recogen datos sociodemográficos; de situación laboral; historia familiar; antecedentes personales y comorbilidad; antropométricos; estilo de vida; uso de los servicios de salud; situación clínica al diagnóstico de APs; afectación articular y dolor espinal; dolor y valoración global de la enfermedad; entesitis, dactilitis y uveítis; afectación cutánea y ungueal; situación funcional y calidad de vida; evaluación radiográfica; determinaciones analíticas; tratamiento; brotes en esqueleto axial y periférico. CONCLUSIONES: El estudio REAPSER incluye una cohorte de pacientes con APs de inicio reciente reclutados antes de que la evolución de la enfermedad se viese modificada por la prescripción de FAME en los servicios de reumatología. Se espera que la información exhaustiva recogida en las visitas suponga una amplia fuente de datos para futuros análisis

AIMS: To describe the methodology of REAPSER (Spanish Registry of Recent-onset Psoriatic Arthritis), its strengths and limitations. The aim of this study is to identify prognostic factors for the clinical and radiographic course in a cohort of patients with psoriatic arthritis (PsA) diagnosed within 2 years of symptom evolution. METHODS: Multicenter, observational and prospective study (with 2-year follow-up including annual visits). Baseline visit intended to reflect patient situation before the disease course was modified by treatments prescribed in rheumatology departments. Patients were invited to participate consecutively in one of their routine visits to the rheumatologist. 211 patients were included. Following data were collected: sociodemographic variables; employment situation; family history; personal history and comorbidities; anthropometric data; lifestyle; use of healthcare services; clinical situation at the time of PsA diagnosis; joint involvement and spinal pain; pain and overall assessment; enthesitis, dactylitis and uveitis; skin and nail involvement; functional situation and quality of life; radiographic evaluation; analytical determinations; treatment; axial and peripheral flare-ups. CONCLUSIONS: The REAPSER study includes a cohort of patients with recent-onset PsA, before the disease course was modified by disease-modifying antirheumatic drugs prescribed in rheumatology departments. Exhaustive information collected in each visit is expected to be an important data source for future analysis

Spanish Registry of Recent-onset Psoriatic Arthritis (REAPSER study): Aims and methodology. / Registro Español de Artritis Psoriásica de Reciente Comienzo (estudio REAPSER). Objetivos y metodología.

AIMS: To describe the methodology of REAPSER (Spanish Registry of Recent-onset Psoriatic Arthritis), its strengths and limitations. The aim of this study is to identify prognostic factors for the clinical and radiographic course in a cohort of patients with psoriatic arthritis (PsA) diagnosed within 2years of symptom evolution. METHODS: Multicenter, observational and prospective study (with 2-year follow-up including annual visits). Baseline visit intended to reflect patient situation before the disease course was modified by treatments prescribed in rheumatology departments. Patients were invited to participate consecutively in one of their routine visits to the rheumatologist. 211 patients were included. Following data were collected: sociodemographic variables; employment situation; family history; personal history and comorbidities; anthropometric data; lifestyle; use of healthcare services; clinical situation at the time of PsA diagnosis; joint involvement and spinal pain; pain and overall assessment; enthesitis, dactylitis and uveitis; skin and nail involvement; functional situation and quality of life; radiographic evaluation; analytical determinations; treatment; axial and peripheral flare-ups. CONCLUSIONS: The REAPSER study includes a cohort of patients with recent-onset PsA, before the disease course was modified by disease-modifying antirheumatic drugs prescribed in rheumatology departments. Exhaustive information collected in each visit is expected to be an important data source for future analysis.

Anatomía Floral de Peristethium leptostachyum (Loranthaceae) / Floral anatomy of Peristethium leptostachyum (Loranthaceae)

ResumenPeristethium leptostachyum es una especie hemiparásita de la familia Loranthaceae, distribuida en Colombia, Costa Rica, Ecuador, Perú, Venezuela y Panamá. Previamente tratada como Struthanthus leptostachyus, la especie fuerecientemente fue reubicada en Peristethium junto con otras que previamente estaban en los géneros Cladocolea y Struthanthus. La decisión de reconocer a Peristethium como género es controversial y fue tomada con base en caracteres de la inflorescencia y de la flor; en tanto que la monofilia de los tres géneros nombrados es incierta. En esta investigación se estudió la morfoanatomía de flores e inflorescencias de Peristethium leptostachyum, detallando la estructura del androceo y gineceo, así como los procesos de microgametogénesis y megagametogénesis; adicionalmente se realizaron comparaciones con especies afines y precisiones en relación con las diagnosis previas. Se recolectaron flores en diversas fases de desarrollo en Santa María (Boyacá-Colombia), se prepararon y analizaron bajo microscopio secciones histológicas teñidas con astrabluefucsina, además de disecciones bajo estereomicroscopio. Los resultados mostraron que P. leptostachyum comparte caracteres inflorenciales con Cladocolea (inflorescencia determinada, flor terminal ebracteada), pero también con Struthanthus (pares de tríadas a lo largo del eje, brácteas caducas y flores actinomorfas). Las flores de P. Leptostachyum de Santa María son claramente hermafroditas, con androceos y gineceos totalmente desarrollados; lo cual contradice la descripción hecha por Kuijt que reporta una condición dioica para esta especie. El androceo resultó afín al de Struthanthus vulgaris, con tapetum glandular y microsporogénesis simultánea; en contraste, Cladocolea loniceroides presenta tapetum periplasmodial y microesporogénesis sucesiva. El gineceo de P. leptostachyum, al igual que en Cladocolea, Struthanthus y Phthirusa, es unilocular con mamelón y tejido arquesporial orientado hacia el estilo, el cual es sólido y con tejido amilífero. P. leptostachyum es afín a Cladocolea loniceroides y difiere de Struthanthus vulgaris por presentar varios sacos embrionarios y pelvis (hipostasa) no lignificada. La presencia de un canal estilar sólido se propone como sinapomorfía de la tribu Psittacanthinae. Dado que P. Leptostachyum comparte caracteres anatómicos florales tanto con Cladocolea como con Strutanthus, la relación entre estos tres géneros no queda resuelta, se requieren estudios filogenéticos para establecer esta relación y poner a prueba las hipótesis de monofilia de cada uno de ellos.

AbstractPeristethium leptostachyum is a hemiparasite species of the family Loranthaceae, distributed in Colombia, Costa Rica, Ecuador, Peru, Venezuela and Panama. Previously treated as Struthanthus leptostachyus, the species was recently transferred to Peristethium together with other species of Cladocolea and Struthanthus. The present research describes the inflorescence and floral morphoanatomy of Peristethium leptostachyum, detailing the structure of the androecium and gynoecium and the processes of microgametogenesis and megagametogenesis, thus allowing comparison with Struthanthus and Cladocolea. Flowering material was collected in February and August 2012, in Santa María, Boyacá, Colombia. Histological sections were prepared and stained with astrablue-fuchsin and floral dissections were performed under a stereomicroscope. Peristethium leptostachyum shares inflorescence characters with Cladocolea (determinate inflorescence, ebracteate terminal flower), but also with Struthanthus (pairs of triads along the axis, deciduous bracts and actinomorphic flowers). The flowers of P. leptostachyum from Santa María are clearly hermaphrodites with androecium and gynoecium fully developed. This observation contradicts the description by Kuijt who reported this species to be dioecious. The androecium was observed to be similar to that of Struthanthus vulgaris, with a glandular tapetum and simultaneous microsporogenesis; in contrast, Cladocolea loniceroides has a periplasmodial tapetum and successive microsporogenesis. The gynoecium of P. leptostachyum, like that of Cladocolea, Struthanthus and Phthirusa, has a unilocular ovary with a mamelon and arquesporial tissue isoriented towards the style, which in turn is solid and amyliferous. Peristethium leptostachyum is similar to Cladocolea loniceroides and differs from Strutanthus vulgaris in presenting multiple embryo sacs and an unlignified pelvis (hipostase). The presence of a solid stylar canal is proposed as a synapomorphy of the tribe Psittacanthinae. Given that P. leptostachyum shares characters with both Cladocolea and Struthanthus generic placement cannot be clearly determined on the basis of anatomical evidence. Phylogenetic studies that include representative species of all three genera are desirable to test hypotheses of monophyly. The sexual system observed here in P. leptostachyum is different from that reported by Kuijt and more studies are needed to identify the factors (geographic, ecological, etc.) that influence this variation. Rev. Biol. Trop. 64 (1): 341-352. Epub 2016 March 01.

[Floral anatomy of Peristethium leptostachyum (Loranthaceae)]. / Anatomía Floral de Peristethium leptostachyum (Loranthaceae).

Peristethium leptostachyum is a hemiparasite species of the family Loranthaceae, distributed in Colombia, Costa Rica, Ecuador, Peru, Venezuela and Panama. Previously treated as Struthanthus leptostachyus, the species was recently transferred to Peristethium together with other species of Cladocolea and Struthanthus. The present research describes the inflorescence and floral morphoanatomy of Peristethium leptostachyum, detailing the structure of the androecium and gynoecium and the processes of microgametogenesis and megagametogenesis, thus allowing comparison with Struthanthus and Cladocolea. Flowering material was collected in February and August 2012, in Santa María, Boyacá, Colombia. Histological sections were prepared and stained with astrablue-fuchsin and floral dissections were performed under a stereomicroscope. Peristethium leptostachyum shares inflorescence characters with Cladocolea (determinate inflorescence, ebracteate terminal flower), but also with Struthanthus (pairs of triads along the axis, deciduous bracts and actinomorphic flowers). The flowers of P. leptostachyum from Santa María are clearly hermaphrodites with androecium and gynoecium fully developed. This observation contradicts the description by Kuijt who reported this species to be dioecious. The androecium was observed to be similar to that of Struthanthus vulgaris, with a glandular tapetum and simultaneous microsporogenesis; in contrast, Cladocolea loniceroides has a periplasmodial tapetum and successive microsporogenesis. The gynoecium of P. leptostachyum, like that of Cladocolea, Struthanthus and Phthirusa, has a unilocular ovary with a mamelon and arquesporial tissue isoriented towards the style, which in turn is solid and amyliferous. Peristethium leptostachyum is similar to Cladocolea loniceroides and differs from Strutanthus vulgaris in presenting multiple embryo sacs and an unlignified pelvis (hipostase). The presence of a solid stylar canal is proposed as a synapomorphy of the tribe Psittacanthinae. Given that P. leptostachyum shares characters with both Cladocolea and Struthanthus generic placement cannot be clearly determined on the basis of anatomical evidence. Phylogenetic studies that include representative species of all three genera are desirable to test hypotheses of monophyly. The sexual system observed here in P. leptostachyum is different from that reported by Kuijt and more studies are needed to identify the factors (geographic, ecological, etc.) that influence this variation.

Psoriasis and psoriasiform lesions induced by TNFα antagonists: the experience of a tertiary care hospital from northern Spain.

The aim of this study was to investigate the cumulated incidence and clinical characteristics of the psoriasiform lesions seen in a wide cohort of rheumatic patients exposed to anti-TNFα drugs in a tertiary care hospital from northern Spain. The study population included 450 patients exposed to anti-TNFα agents from 2001 to 2007 and treated in a university hospital in northern Spain. Two hundred patients were exposed to infliximab (44%), 129 (29%) to etanercept, and 121 (27%) to adalimumab. The cumulated incidence (CI) of this skin reaction was calculated for each of the three agents studied. Psoriasis and psoriasiform lesions were documented in 7 patients diagnosed with different rheumatic inflammatory conditions (1.56%). Cases of this adverse effect were identified with all three anti-TNFα agents available at that time, but less frequently with infliximab (CI: 0.5%) compared with etanercept (CI: 2.3%) or adalimumab (CI: 2.5%). The most common lesion was palmoplantar pustulosis (71.3% of the cases), and the latency period to the development of the lesions ranged from 4 to 38 months (mean 9 months). In four of the 7 patients, treatment was suspended, while in the remaining three patients treatment was continued. The CI of this skin reaction in our setting is similar to that published by others. Infliximab was found to be less frequently associated with this adverse event. In our experience, it is not always necessary to stop anti-TNFα therapy for the skin lesions to improve.

[The stress response in the yeast Saccharomyces cerevisiae]. / La respuesta a estrés en la levadura Saccharomyces cerevisiae.

All living organisms are subject to changing environmental conditions, to which they must adapt in order to survive. Recently, there have been significant advances leading to the comprehension of the different mechanisms implicated in the responses to stressful situations in the yeast S. cerevisiae. In nature, as well as in laboratory conditions or industrial processes, this yeast is subjected to different adverse environmental situations, such as osmotic, thermal and oxidative stresses. A general stress response pathway, mediated by protein kinase A, allows S. cerevisiae to cope with these three stressful conditions. However, there are also specific response pathways that include the HOG kinase for osmotic stress, the Heat Shock Factor for thermal stress and Yap1p and Yap2p transcription factors that regulate the oxidative stress response, among other enzymatic and non-enzymatic mechanisms. In this review, we describe the perception and signal transduction pathways that regulate gene expression leading to the adaptation to most common types of stress in S. cerevisiae. We also include information regarding the interaction between the signal transduction pathways involved in the different responses that allow this organism to coordinate its various physiological processes for optimal adaptation to the changing environment.