People with type 1 diabetes continue to face an elevated risk of cardiovascular disease even when they maintain good glycemic control and apparently normal cholesterol levels. This phenomenon, known as residual cardiovascular risk, calls into question the ability of routine blood tests to reflect actual risk and points to the existence of more complex alterations in the types of particles that transport cholesterol in the bloodstream. A study led by researchers from the Institut de Recerca Sant Pau (IR Sant Pau), Hospital de Sant Pau, and CIBERDEM, published in the journal Frontiers in Endocrinology, shows that these patients have increased levels of small dense low-density lipoproteins (sdLDL), a type of LDL cholesterol made up of smaller particles that accumulate more easily within arterial walls. This finding provides a mechanistic explanation for this residual cardiovascular risk and reinforces the need to go beyond standard cholesterol measurements.

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The lack of reliable biomarkers capable of anticipating corticosteroid response remains one of the major challenges in the management of alcohol-associated hepatitis. In this setting, a team from the Sant Pau Research Institute (IR Sant Pau) has identified a specific profile of circulating plasma extracellular vesicles (EVs) associated both with treatment response and with medium- and long-term mortality. The study findings, published in the International Journal of Molecular Sciences, highlight the potential of these EVs as non-invasive biomarkers to improve prognostic stratification and support clinical decision-making in a disease associated with high mortality.

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Intracerebral hemorrhage is the most severe form of stroke and one of the neurological conditions with the highest mortality. It is relatively common for decisions involving early limitation of treatment—that is, not initiating or withdrawing certain therapeutic interventions—to be made within the first hours after admission, generally when the prognosis is considered poor and these measures are not expected to provide real benefit to the patient.

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Endometriosis, a chronic inflammatory disease that affects approximately one in ten women of reproductive age—around 190 million worldwide—remains poorly understood from a biological perspective, which has historically hindered both its accurate diagnosis and the development of effective treatments. Now, an international study published in Nature Genetics provides new data to better understand the genetic basis and mechanisms involved in this condition.

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The vascular imbalance that occurs in some pregnancies may leave a lasting imprint beyond childbirth. A study led by the Sant Pau Research Institute (IR Sant Pau), published in the American Journal of Obstetrics and Gynecology, shows that this alteration, reflected by the sFlt-1/PlGF ratio, is associated with a higher risk of memory problems between three and six years after pregnancy and provides new insights into the vascular mechanism that may underlie this effect.

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Despite advances in cardiology, women continue to face significant disparities in the prevention, diagnosis, and treatment of ischemic heart disease—a condition caused by reduced blood flow to cardiac tissue and the leading cause of cardiovascular death worldwide. A study published in the European Heart Journal as a scientific position paper from the “Working Group on Coronary Pathophysiology and Microcirculation” and associations (ACVC and EAPCI) of the European Society of Cardiology (ESC) highlights how sex and gender differences play a decisive role in cardiovascular risk, pathophysiology, and prognosis in ischemic heart disease. It underscores the need to systematically integrate this perspective into clinical practice and research.

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What has long been interpreted as permanent and irreversible vascular damage may not be exclusively so. In people with Down syndrome—one of the most robust populations for studying Alzheimer’s disease due to the near-universal presence of the characteristic proteinopathies of this dementia from the age of 40—some lesions visible on magnetic resonance imaging do not follow a linear course. A longitudinal study from the Institut de Recerca Sant Pau (IR Sant Pau), published in Alzheimer’s & Dementia, shows that these alterations can fluctuate and even decrease over time in the Down syndrome population. This is especially true once the clinical symptoms of Alzheimer’s disease have begun to manifest.

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A new international methodological guideline from the GRADE group (Grading of Recommendations Assessment, Development, and Evaluation) has updated the criteria for developing and using so-called good practice statements in clinical practice and public health guidelines. The document, published as a special article in Annals of Internal Medicine, one of the most influential medical journals worldwide, seeks to avoid the inappropriate or excessive use of this type of statement and improve its justification, transparency, and credibility.

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Reducing chemotherapy toxicity without compromising efficacy remains one of the major challenges in oncology. A research team from the Institut de Recerca Sant Pau (IR Sant Pau) has shown in a study published in Materials Today Bio that a more precise design strategy in nanomedicine can maintain—and even improve—the antitumor effect while using much smaller amounts of drug.

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Preeclampsia is a pregnancy complication widely known for its immediate impact on maternal and fetal health. However, scientific evidence accumulated recently has shown that preeclampsia is also associated with an increased long-term cardiovascular risk in women who have experienced it. Despite this, the mechanisms underlying this elevated risk remain incompletely defined. Two recent studies conducted by the Perinatal and Women’s Medicine Research Group at the Institut de Recerca Sant Pau (IR Sant Pau) analyze how preeclampsia and angiogenic imbalance during pregnancy are linked to persistent changes in the female cardiovascular and renal systems several years after childbirth.

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An international study led by researchers from the Institut de Recerca Sant Pau (IR Sant Pau) shows that advanced use of magnetic resonance imaging (MRI) allows much more accurate identification of patients with progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). These are two rare and clearly underdiagnosed atypical parkinsonian disorders.

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A team from the Parkinson’s Disease and Movement Disorders Group at the Institut de Recerca Sant Pau (IR Sant Pau) and the Neurology Department of Hospital de Sant Pau has described in detail, for the first time, how visual perception is altered in people with Parkinson’s disease who experience hallucinations.

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The Institut de Recerca Sant Pau (IR Sant Pau) has led a multicenter study showing that incorporating the biomarker NT-proBNP, commonly used to assess cardiac function, significantly improves the ability of the angiogenic sFlt-1/PlGF ratio to predict preeclampsia in the short term. The study, published in Clinical Chemistry, demonstrates that integrating both biomarkers makes it possible to refine risk stratification in women with clinical suspicion of the disease.

Preeclampsia affects between 2% and 5% of pregnancies and is one of the leading causes of maternal–fetal morbidity worldwide. The sFlt-1/PlGF ratio allows the disease to be ruled out when values are below 38, but above 38 its interpretation becomes less conclusive and requires close follow-up and additional assessments. The main challenge lies in managing cases with an sFlt-1/PlGF ratio between 38 and 84, where diagnostic and management uncertainty is greatest. As explained by Dr. Carmen Garrido, clinical head of Obstetrics at Hospital Sant Pau and collaborating researcher in the Perinatal and Women’s Medicine group at IR Sant Pau, “It is in this intermediate diagnostic range where NT-proBNP provides an additional answer that allows us to guide both the case and follow-up much more effectively.

How the Study Was Designed and What Each Predictive Model Contributed

To assess the added value of NT-proBNP, the team developed three predictive models based on different thresholds of the angiogenic ratio. The first re-evaluated cases with values above 38 by incorporating the cardiac biomarker. The second examined its usefulness at values above 85, traditionally associated with higher clinical risk. The third focused exclusively on the 38–84 range, an interval that is particularly complex from a diagnostic standpoint. This last model showed the most robust performance, as it made it possible to better discriminate between patients who would progress to preeclampsia and those who would not, improving short-term prediction of the disease.

According to Dr. Carmen Garrido, “These models allowed us to clearly identify the situations in which NT-proBNP provides decisive information, especially when the angiogenic ratio alone does not resolve the diagnostic uncertainty.”

To determine the clinical applicability of these models, the study assessed their performance across different clinical scenarios of preeclampsia: early-onset (before 34 weeks), preterm (before 37 weeks), term (after 37 weeks), and cases with maternal or fetal complications. This approach made it possible to verify whether the benefit of combining markers was maintained across all contexts or was particularly notable in specific profiles. According to Dr. Madalina Nicoleta Nan, staff biochemist at Hospital Sant Pau and researcher in the Perinatal and Women’s Medicine group, “Stratification by clinical scenario allowed us to confirm that combining NT-proBNP with the angiogenic ratio is especially valuable in predicting early-onset preeclampsia and higher-risk forms, where disease progression can accelerate in a very short time.”

The Combination of Markers Improves Prediction and Reduces Clinical Uncertainty

The study, conducted in 316 women with clinical suspicion of preeclampsia and based on the analysis of 424 samples, shows that NT-proBNP levels are significantly elevated in those who will develop preeclampsia within the following seven days. Integrating this biomarker with the angiogenic ratio maintains a negative predictive value of 99.5%, while improving the positive predictive value. This increases from 35.4% when using the sFlt-1/PlGF ratio alone to 60.7% for predicting early-onset preeclampsia one week before the appearance of clinical manifestations. This combination provides high reliability for ruling out the disease in the short term and makes it possible to prioritize surveillance for cases that are truly likely to progress.

In addition, the combination adds a complementary pathophysiological dimension: the angiogenic ratio reflects placental dysfunction, while NT-proBNP provides information on the degree of maternal cardiovascular stress, a factor closely linked to the risk of clinical deterioration. “Combining markers that inform on different processes,” explains Dr. Garrido, “helps us more precisely identify the patients who need intensified follow-up and avoid unnecessary interventions in those who do not.”

The usefulness of NT-proBNP is particularly evident in cases where the angiogenic ratio shows intermediate values and its diagnostic capacity is more limited. As detailed by Dr. Garrido, “NT-proBNP allows us to distinguish whether we are dealing with a patient at real risk of progression or whether a less intensive monitoring approach can be considered,” information that is essential for tailoring clinical decisions more accurately.

A Tool That Helps Anticipate Severe Complications

The analysis carried out in the study reveals that combining both biomarkers also makes it possible to anticipate complications and predict short-term clinical evolution. Women with abnormal values in both markers show a mean latency to delivery of 1.3 weeks, indicating closer proximity to decompensation and the need to intensify surveillance and prepare interventions in advance.

As highlighted by Dr. Madalina Nicoleta Nan, “When both markers are elevated, progression toward the need to end the pregnancy is usually faster, and having this information allows us to plan care more effectively.” Conversely, she adds, “If the angiogenic ratio is high but NT-proBNP remains low, this usually reflects placental alteration that does not imply preeclampsia requiring imminent delivery, allowing us to avoid hasty interventions.”

A Complementary, Accessible, and Easy-to-Implement Biomarker

The research team emphasizes that NT-proBNP does not replace the angiogenic ratio but rather complements it by providing relevant clinical information in cases where sFlt-1/PlGF is inconclusive. This complementarity facilitates more precise decision-making, allows follow-up to be tailored according to risk profile, and offers a high-value tool for clinical practice. In addition, NT-proBNP is an accessible, low-cost, and widely available test, which would facilitate its incorporation into care protocols.

Although the results need to be validated in larger and more diverse cohorts, they represent a significant advance in the early prediction of preeclampsia and open the door to multimarker diagnostic strategies with greater precision and real-world applicability. IR Sant Pau thus consolidates its leadership in perinatal research and in the development of diagnostic tools aimed at safer and more personalized care.

Reference Article:

Garrido-Giménez C, Nan MN, Cruz-Lemini M, García-Manau P, Garcia-Osuna Á, Ullmo J, Mora J, Sánchez-García O, Medina-Mallén MDC, Chóliz M, Platero J, Llurba E, EuroPE Working Group. Can NT-proBNP enhance the accuracy of angiogenic factors in the short-term prediction of preeclampsia? Clin Chem 2025;72:206–16. https://doi.org/10.1093/clinchem/hvaf135

A multidisciplinary team has uncovered a key mechanism that allows the human bacterium Mycoplasma pneumoniae—responsible for atypical pneumonia and other respiratory infections—to obtain cholesterol and other essential lipids directly from the human body. The discovery has been published in Nature Communications.

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The Sant Pau Research Institute (IR Sant Pau) has led a multicenter project that redefines what is considered normal cognitive performance. The work, carried out in collaboration with Hospital Clínic de Barcelona, Hospital Universitario Marqués de Valdecilla in Santander, and the CITA-Alzheimer Foundation in San Sebastián, has resulted in two complementary scientific articles published in the journal Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring (DADM), which establish new cognitive reference standards based exclusively on individuals without amyloid pathology and demonstrate their ability to improve early diagnosis.

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A research team led by Dr. Àlex Bayés, Head of the Molecular Physiology of the Synapse Group at the Institut de Recerca Sant Pau (IR Sant Pau), has achieved what for decades had been an elusive goal: obtaining a precise, differentiated molecular portrait of individual synaptic types in the hippocampus, the brain structure that serves as the core of learning and memory.

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Researchers from the Biomarkers of Cardiovascular Disease Progression group at the Institut de Recerca Sant Pau (IR Sant Pau) have identified a new mechanism by which complement C3, a key immune system protein, can directly influence the progression of atherosclerosis. The study, published in the journal Cells, shows that activation of this molecule alters the structure and behavior of the cells that form the arterial wall, contributing to lesions becoming more unstable and more prone to rupture.

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Researchers from the Sant Pau Research Institute (IR Sant Pau) have conducted a clinical trial demonstrating that the combination of two widely available drugs, carvedilol and simvastatin, significantly improves the control of portal hypertension in patients with hepatic cirrhosis.

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The Journal of the American Medical Association (JAMA) has recently published the updated version of the Sequential Organ Failure Assessment (SOFA), the global reference system in intensive care medicine used to assess the degree of organ dysfunction in critically ill patients. The results were also presented in parallel at the Annual Congress of the European Society of Intensive Care Medicine (ESICM LIVES 2025), held in Munich, in a featured session on current topics broadcast live.

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A team from the Sant Pau Research Institute (IR Sant Pau) has discovered that basic fibroblast growth factor (bFGF) can reverse the functional impairments of adipose tissue–derived stem cells in people with type 2 diabetes. This restores their ability to proliferate, migrate, and form new blood vessels.

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