Albert Selva-O'Callaghan

Vall d’Hebron Institute of Oncology, Barcino, Catalonia, Spain

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Publications (76)394.68 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Epidemiological data suggest that some viruses may be linked to the development of autoimmunity.Objectives The objective of this work was to determine the presence of HHV-8 viral DNA in whole blood from patients suffering from different systemic autoimmune diseases (SAD). We also aimed at testing the prevalence of patients showing antibodies against an HHV-8 orfK8.1 peptide.Study design: Two hundred and eighty SAD patients and 50 healthy blood donor controls were included. Molecular analyses were performed by nested PCR from DNA obtained from whole blood and an enzyme immunoassay was developed in order to test for the presence of antibodies directed against a synthetic peptide derived from the HHV-8 orfK8.1 protein.ResultsOnly 2 out of the 280 samples analyzed yielded the specific HHV-8 PCR product. Antibodies against orfK8.1 were detected in 2 SLE patients, 1 patient suffering from Sjögren's syndrome and 2 patients with vasculitis.Conclusions We conclude that HHV-8 is usually not present in blood neither from autoimmune patients nor from healthy controls. Furthermore, HHV-8 antibodies against the HHV-8 orfK8.1 peptide were rarely detected. It leads us to infer that HHV-8 is not involved on the development of these disorders. It does not rule out the possibility that other environmental and microbiological triggers may account for their etiopathogenesis.
    Journal of Clinical Virology. 11/2014;
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    Journal of the American Academy of Dermatology 10/2014; 71(4):e158-9. · 4.91 Impact Factor
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    ABSTRACT: Objective To establish the clinical course of interstitial lung disease (ILD) in scleroderma related to the presence of anti-PM/Scl antibody compared with anti-Scl-70 in a Spanish cohort. Furthermore, no study has thoroughly investigated the outcome of pulmonary function test in the first group of patients. Methods Sixty-three Spanish patients with scleroderma and ILD were selected in a retrospective observational study. Fourteen were positive for anti-PM/Scl antibodies and forty-nine for anti-Scl-70. Clinical assessments, including pulmonary function test, were collected. Variations equal or greater than 10% in forced vital capacity (FVC) were considered significant. Progression-free survival of disease was defined as the period of stable illness since pulmonary fibrosis diagnosis. Results Anti-Scl-70 patients had a higher frequency of diffuse SSc subset, peripheral vasculopathy and gastrointestinal involvement. Inflammatory myopathy was associated to anti-PM/Scl antibody. Anti-PM/Scl patients presented more improvement in FVC during follow-up: 30.8%, compared to a 7.1% in Scl-70 group (P = 0.04), with less worsening of this parameter (15.4% vs. 52.4% in Scl-70 patients, P = 0.01), and secondary less frequency of severe restrictive pattern (FVC < 50%) (7.7% compared to 42.9% in the other group, P = 0.02). Regarding treatment, more anticalcineurinics were used in anti-PM/Scl patients while cyclophosphamide and mycophenolate were mainly used in anti-Scl-70. The progression-free survival of disease was higher in anti-PM/Scl patients, with 76% at 10 years from diagnosis of ILD against a 29% in Scl-70 group. Conclusions Several features and prognosis of ILD in SSc may be modified depending on the identified immunological profile.
    Seminars in Arthritis and Rheumatism 07/2014; · 3.81 Impact Factor
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    ABSTRACT: Health-related quality of life (HRQoL) and well-being are concepts that attempt to objectively capture a person’s subjective perceptions of vitality and energy. Our objectives were to determine HRQoL and well-being in adult patients diagnosed with inflammatory myopathy who attended at our outpatient clinic and to investigate clinical and biological correlations with these concepts. Sixty-two patients (52 women), with a mean age of 50.7 years, were evaluated in this cross-sectional study—47 with dermatomyositis and 15 with polymyositis. Disease damage and activity were assessed with the International Myositis Assessment and Clinical Studies-validated instruments. Manual muscle testing was used to evaluate muscle strength. Quality of life was evaluated with the WHO instrument (WHO Quality of Life Measure (WHOQOL-BREF)), adapted for use in the Spanish population, and well-being with the WHO-Five Well-Being Index (WHO-5). t tests were conducted to examine differences in HRQoL and well-being outcomes in relation to several disease- and patient-related variables. Correlation analyses were performed with the Pearson correlation coefficient. None of the clinical or biological variables analyzed was significantly associated with a poorer HRQoL or well-being. No differences in HRQoL or WHO-5 well-being score were found between the two myositis subgroups (dermatomyositis vs. polymyositis). Disease activity and muscle weakness were negatively associated with the physical and environmental domains of the HRQoL, respectively (p < 0.002), but not with well-being. Disease duration did not have a significant impact on HRQoL or well-being. In adult patients with myositis, disease activity and muscle weakness are associated with poorer HRQoL in the physical health and environmental domains, respectively.
    Clinical Rheumatology 06/2014; · 2.04 Impact Factor
  • Annals of the rheumatic diseases 05/2014; · 8.11 Impact Factor
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    ABSTRACT: Interstitial lung disease is a common finding in patients with the antisynthetase syndrome. High-resolution computed tomography is the reference test for diagnosis and follow-up of this condition, but it involves considerable radiation exposure. Our aim was to describe chest ultrasound features and its correlation with high-resolution computed tomography findings in a series of patients with the antisynthetase syndrome. The study included patients from our antisynthetase syndrome cohort with varying degrees of interstitial lung disease, consulting in our outpatient clinic over a 1-year period. Chest high-resolution computed tomography and chest sonography were prospectively performed within a 1-week period. High-resolution computed tomography Warrick score was calculated and chest sonography findings (B-lines) at several sonographic points along the anterior and posterior intercostal spaces were semi-quantitatively analyzed. Rho Spearman statistics were applied for possible correlations. Twenty-one consecutive patients were studied. A median of 59 thoracic points was studied per patient (IQR 6); 44.1% (95% CI 29.9-60.7) of them showed at least one B-line. A correlation coefficient of 0.135 (p=0.5) was found between the percentage of ultrasound points with B-lines and the Warrick's score. Only the number of bronchopulmonary segments showing ground glass findings was associated with the percentage of sonographic points with B-lines (Rho=0.5, p=0.02). A good correlation between the percentage of sonographic points with B-lines and high-resolution computed tomography ground glass opacities was observed in patients with the antisynthetase syndrome.
    Clinical and experimental rheumatology 04/2014; · 2.66 Impact Factor
  • J C Milisenda, A Selva-O'Callaghan, J M Grau
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    ABSTRACT: Polymyositis is classified as a separate entity among idiopathic inflammatory myopathies but it is considered as the least common since it is an exclusion diagnosis. This myopathy usually presents with subacute-chronic symmetric proximal limb weakness, although some extramuscular manifestations are common. Creatine kinase values may be increased up to 50-fold in active disease. Muscle biopsy is characterized by endomysial inflammatory infiltrate consisting predominantly of CD8+ T cells that invade healthy muscle fibres expressing the MHC-I antigen. Although serum autoantibodies, EMG and imaging techniques can help in diagnosis, muscle histopathology is a pivotal value. The clinical picture together with the pathological findings confers the also called PM pattern. A broad differential diagnosis is needed before concluding a diagnosis of pure PM. Sporadic inclusion-body myositis, toxic, endocrine and metabolic myopathies as well as muscular dystrophies are the major categories to be ruled out. Finally, a diagnostic algorithm for suspected cases of PM is also proposed.
    Journal of Autoimmunity 01/2014; · 8.15 Impact Factor
  • M Catalán, A Selva-O'Callaghan, J M Grau
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    ABSTRACT: Sporadic inclusion body myositis (sIBM) is the most common acquired muscle disease in elderly individuals, particularly men. Its prevalence varies among ethnic groups but is estimated at 35 per one million people over 50. Genetic as well as environmental factors and autoimmune processes might both have a role in its pathogenesis. Unlike other inflammatory myopathies, sIBM causes very slowly progressive muscular weakness and atrophy, having a distinctive pattern of muscle involvement and different forms of clinical presentation. In some cases a primary autoimmune disease coexists. Diagnosis is suspected on clinical grounds and is established by typical muscle pathology. As a rule sIBM is refractory to conventional forms of immunotherapy.
    Autoimmunity reviews 01/2014; · 6.37 Impact Factor
  • I Pinal-Fernandez, A Selva-O'Callaghan, J M Grau
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    ABSTRACT: Eosinophilic fasciitis (EF) is a rare scleroderma-like syndrome with an unknown etiology and pathogenesis that should be considered an immune-allergic disorder. Painful swelling with progressive induration and thickening of the skin and soft tissues of the limbs and trunk is the clinical hallmark of the disease. Peripheral blood eosinophilia, hypergammaglobulinemia, and elevated erythrocyte sedimentation rate are the main laboratory findings. Full-thickness wedge biopsy of the clinically affected skin showing inflammation and thickening of deep fascia is essential to establish the diagnosis. The differential diagnosis includes systemic sclerosis and other scleroderma subsets such as morphea, and epidemic fasciitis syndromes caused by toxic agents such as the myalgia-eosinophilia syndrome and toxic oil syndrome. Peripheral T cell lymphomas should also be ruled out. The diagnosis of EF can be established by clinical, laboratory and histological findings, but universally accepted international diagnostic criteria are lacking. Corticosteroids are efficacious and remain the standard therapy for EF, although some patients may improve spontaneously.
    Autoimmunity reviews 01/2014; · 6.37 Impact Factor
  • A Selva-O'Callaghan, E Trallero, J M Grau
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    ABSTRACT: Eosinophilia-associated myopathies are clinically and pathologically heterogeneous conditions characterized by the presence of peripheral and/or muscle eosinophilia. There are at least three distinct subtypes: focal eosinophilic myositis, eosinophilic polymyositis, and eosinophilic perimyositis. Infiltrating eosinophils are not always identified in conventional muscle histologic examination, but the eosinophil major basic protein, whose extracellular diffusion is considered a hallmark of eosinophilic cytotoxicity, is usually detected by immunostaining in muscle biopsy. Whereas focal eosinophilic myositis seems to be a benign and isolated condition, and perimyositis is usually related with the inflammatory infiltrate due to fasciitis, eosinophilic polymyositis can be associated with muscular dystrophy or be a feature of multiorgan hypereosinophilic syndrome. Muscle biopsy remains the cornerstone for the diagnosis. Parasitic infections, connective tissue disorders, hematologic and non-hematologic malignancies, drugs, and toxic substances are the main etiologic agents of eosinophilia-associated myopathy. However, in some cases, no known etiologic factor is identified, and these are considered idiopathic. Glucocorticoids are the mainstay therapy in idiopathic forms. Imatinib and mepolizumab, a humanized anti-interleukin 5 monoclonal antibody, may be useful in patients with eosinophilic myositis as part of a hypereosinophilic syndrome.
    Autoimmunity reviews 01/2014; · 6.37 Impact Factor
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    ABSTRACT: Interstitial lung disease (ILD) is common in patients with myositis and is related with the presence of antisynthetase autoantibodies (aSA). Together with other manifestations, the resulting condition is known as the antisynthetase syndrome (ASS). Contact with certain environmental and occupational agents is also associated with the development of ILD. The objective of this study was to analyze occupational exposure and associated clinical manifestations in a cohort of patients with ASS. aSA had been identified by line immunoassay and confirmed by immunoprecipitation. Serial pulmonary function tests had been carried out to assess lung function. Thirty-two ASS patients and a control group of 32 myositis patients without aSA underwent a specific questionnaire interview to evaluate their cumulative exposure to biological dust, mineral dust, and gases/fumes up to disease onset. Comparisons were done with the Fisher exact test and Mann-Whitney test. Out from 32 ASS patients (median age, 42.7 yeras; IQR 32.2-52.5), twenty-six patients had anti-Jo-1, three anti-PL-12, and three anti-PL-7. Nine had polymyositis, 15 dermatomyositis, one amyopathic dermatomyositis, and seven pure ILD without myositis. Sixteen ASS patients (50 %) and seven (22 %) myositis patients without aSA had ever been highly exposed to dust, gases, or fumes (p < 0.05). A more than 10 % improvement in forced vital capacity occurred in 61 % of highly exposed patients and 23 % of those with low/no exposure (p = 0.06) over the observation period. In conclusion, a high percentage of patients with ASS had been exposed to dusts, gases, or fumes.
    Clinical Rheumatology 01/2014; · 2.04 Impact Factor
  • Albert Selva-O'Callaghan, Manel Ramos Casals, Josep M Grau Junyent
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    ABSTRACT: The aim of this article is to study the evidence-based knowledge related to the use of biological therapies in patients diagnosed with idiopathic inflammatory myopathy (dermatomyositis, polymyositis and inclusion body myositis). In this review the leading published studies related to the use of biological therapy in patients with myositis are analysed; mainly those with high methodological standards, that means randomized and controlled studies. Methodological drawbacks due to the rarity and heterogeneity of these complex diseases are also addressed. Up to now is not possible to ascertain the biologics as a recommended therapy in patients with myositis, at least based in the current evidence-based knowledge, although it can not be neglected as a therapeutic option in some clinical situations, taking into account the scarce of effective treatments in those patients, especially in refractory myositis. Future studies probably will help to better define the role of biological therapies in patients with idiopathic inflammatory myopathy.
    Medicina Clínica 01/2014; · 1.40 Impact Factor
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    ABSTRACT: A new myositis-specific autoantibody directed against melanoma differentiation-associated gene 5 (anti-MDA5) has been described in patients with dermatomyositis (DM). We report the clinical characteristics of patients with anti-MDA5 in a large Mediterranean cohort of DM patients from a single center, and analyze the feasibility of detecting this autoantibody in patient sera using new assays with commercially available recombinant MDA5. The study included 117 white adult patients with DM, 15 (13%) of them classified as clinically amyopathic dermatomyositis (CADM). Clinical manifestations were analyzed, with special focus on interstitial lung disease and its severity. Determination of anti-MDA5 antibodies was performed by a new ELISA and immunoblot technique. In sera, from 14 (12%) DM patients (8 CADM), MDA5 was recognized by ELISA, and confirmed by immunoblot. Eight of the 14 anti-MDA5-positive patients (57.14%) presented rapidly-progressive interstitial lung disease (RP-ILD) versus 3 of 103 anti-MDA5-negative patients (2.91%) (P < 0.05; OR: 44.4, 95% CI 9.3-212). The cumulative survival rate was significantly lower in anti-MDA5-positive patients than in the remainder of the series (P < 0.05). Patients with anti-MDA5-associated ILD presented significantly lower 70-month cumulative survival than antisynthetase-associated ILD patients. Among the cutaneous manifestations, only panniculitis was significantly associated with the presence of anti-MDA5 antibodies (P < 0.05; OR: 3.85, 95% CI 1.11-13.27). These findings support the reliability of using commercially available recombinant MDA5 for detecting anti-MDA5 antibodies and confirm the association of these antibodies with RP-ILD in a large series of Mediterranean patients with DM.
    Journal of immunology research. 01/2014; 2014:290797.
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    ABSTRACT: Objective The aim of this study is to describe a novel myositis-associated autoantibody (anti-cortactin antibody) and assess related clinical and immunological manifestations and its clinical significance. Methods Adult patients with myositis (dermatomyositis, polymyositis, immune-mediated necrotizing myopathy, and inclusion body myositis), as well as patients with other autoimmune diseases and non-inflammatory myopathies were analyzed for the presence of anti-cortactin antibody using in-house developed ELISA and immunoblotting techniques with a commercial source of purified cortactin. The cut-off for positive status was determined in a group of healthy volunteers. Results Antibody against cortactin was positive in 7/34 (20%) polymyositis patients, 9/117 (7.6%) dermatomyositis, 2/7 (26%) immune-mediated necrotizing myopathy, and none of the 4 patients with inclusion body myositis. The antibody also tested positive in 3/101 patients with other autoimmune diseases (2 systemic sclerosis and 1 systemic lupus erythematosus), and in 1/29 patients with non-inflammatory myopathy. No relevant association with specific clinical features was found in patients with these antibodies. Anti-cortactin antibody was more frequently positive in patients with polymyositis and immune-mediated necrotizing myopathy than in the remaining myositis patients, and was the only myositis autoantibody found in sera of 3 patients from these groups. Conclusions Our data indicate that cortactin is a novel target antigen in patients with autoimmune diseases, especially patients with polymyositis or immune-mediated necrotizing myopathy. Anti-cortactin can be considered a new myositis-associated antibody.
    Autoimmunity Reviews. 01/2014;
  • Albert Selva-O’Callaghan, Manel Ramos Casals, Josep M. Grau Junyent
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this article is to study the evidence-based knowledge related to the use of biological therapies in patients diagnosed with idiopathic inflammatory myopathy (dermatomyositis, polymyositis and inclusion body myositis). In this review the leading published studies related to the use of biological therapy in patients with myositis are analysed; mainly those with high methodological standards, that means randomized and controlled studies. Methodological drawbacks due to the rarity and heterogeneity of these complex diseases are also addressed. Up to now is not possible to ascertain the biologics as a recommended therapy in patients with myositis, at least based in the current evidence-based knowledge, although it can not be neglected as a therapeutic option in some clinical situations, taking into account the scarce of effective treatments in those patients, especially in refractory myositis. Future studies probably will help to better define the role of biological therapies in patients with idiopathic inflammatory myopathy.
    Medicina Clínica. 01/2014;
  • Annals of the rheumatic diseases 03/2013; · 8.11 Impact Factor
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    ABSTRACT: OBJECTIVES: The aim of this paper is to assess the effect of calcineurin inhibitors (tacrolimus or cyclosporine) for treating patients with interstitial lung disease (ILD) associated with antisynthetase autoantibodies. METHODS: Sixty patients with antisynthetase autoantibodies were identified in our myositis cohort of 179 patients. The medical records of 15 patients with antisynthetase autoantibody-associated ILD treated with tacrolimus/cyclosporine (11 for refractory disease and 4 as first-line therapy) between 1980 and 2011 were retrospectively reviewed. Serial pulmonary function tests were used to assess the clinical response. Qualitative data are presented as a number and percentage, and quantitative data as the median and interquartile range (IQR). RESULTS: Patients were classified as having probable or definite idiopathic inflammatory myopathy (8 dermatomyositis and 4 polymyositis), and pure interstitial lung disease (3 cases). The 15 patients had received tacrolimus/cyclosporine for an average of 19 (IQR 14-30) months. Median age at onset of ILD was 42.3 (IQR 32.4-56.8) years and median duration of lung disease before administration of calcineurin inhibitors was 11 (IQR: 5-49) months. Median duration of follow-up was 24 (IQR 12-32) months. Thirteen patients had anti-histidyl-transfer RNA synthetase autoantibody (anti-Jo-1) and two had anti-alanyl-transfer RNA synthetase autoantibody (anti-PL-12). A more than 10% increase in FVC or stabilisation was observed in 13 (87%; 95%CI 56-98) patients who received calcineurin inhibitors (9 [81%] refractory cases and 4 [100%] as first-line therapy). CONCLUSIONS: Calcineurin inhibitors seem to be a good therapeutic option for managing ILD associated with antisynthetase autoantibodies, not only in refractory cases, but also as first-line treatment.
    Clinical and experimental rheumatology 03/2013; · 2.66 Impact Factor
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    ABSTRACT: Background and objectiveErdheim-Chester disease (EC) is a rare form of non-Langerhans’ cell histiocytosis. It is characterized by the xanthomatous infiltration of tissues with foamy CD68+/CD1a- histiocytes. We report a series of 12 patients diagnosed with EC.Patients and methodsWe reviewed the clinical, pathological and therapeutic aspects of 12 cases diagnosed with EC at 7 tertiary teaching hospitals in Spain. Patients were included if tissue infiltration by histiocytes CD68+/CD1a- could be demonstrated in an appropriate clinical setting.ResultsTwelve patients (7 male) were included. Median follow-up was 36 months (IQR: 20-84). The median age at the time of clinical onset and pathological diagnosis was 49 (IQR: 28-61) and 56 years (IQR: 37-62), respectively. In 6 cases multiples biopsies were performed (skin, muscle, testicular) previous to diagnosis, which was confirmed in 3 cases after a carefully review of pathological tissues. Neurological involvement was independently associated with mortality (P < .05). Characteristic long bone osteosclerosis was detected in 9 patients.ConclusionEC is a multisystemic and heterogeneous clinicopathological condition. A high index of suspicion and fluent communication between clinicians and pathologists is necessary to achieve a correct diagnosis.
    Medicina Clínica. 10/2012; 139(9):398–403.
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    ABSTRACT: Erdheim-Chester disease (EC) is a rare form of non-Langerhans' cell histiocytosis. It is characterized by the xanthomatous infiltration of tissues with foamy CD68+/CD1a- histiocytes. We report a series of 12 patients diagnosed with EC. We reviewed the clinical, pathological and therapeutic aspects of 12 cases diagnosed with EC at 7 tertiary teaching hospitals in Spain. Patients were included if tissue infiltration by histiocytes CD68+/CD1a- could be demonstrated in an appropriate clinical setting. Twelve patients (7 male) were included. Median follow-up was 36 months (IQR: 20-84). The median age at the time of clinical onset and pathological diagnosis was 49 (IQR: 28-61) and 56 years (IQR: 37-62), respectively. In 6 cases multiples biopsies were performed (skin, muscle, testicular) previous to diagnosis, which was confirmed in 3 cases after a carefully review of pathological tissues. Neurological involvement was independently associated with mortality (P<.05). Characteristic long bone osteosclerosis was detected in 9 patients. EC is a multisystemic and heterogeneous clinicopathological condition. A high index of suspicion and fluent communication between clinicians and pathologists is necessary to achieve a correct diagnosis.
    Medicina Clínica 07/2012; 139(9):398-403. · 1.40 Impact Factor
  • Mar Riveiro-Barciela, Ane Labirua-Iturburu, Albert Selva-O'Callaghan
    Chest 07/2012; 142(1):252-5. · 7.13 Impact Factor

Publication Stats

621 Citations
394.68 Total Impact Points

Institutions

  • 2011–2014
    • Vall d’Hebron Institute of Oncology
      Barcino, Catalonia, Spain
  • 2001–2014
    • Autonomous University of Barcelona
      • Department of Medicine
      Cerdanyola del Vallès, Catalonia, Spain
  • 1994–2014
    • University Hospital Vall d'Hebron
      • Department of Internal Medicine
      Barcino, Catalonia, Spain