Dr. Josep Maria Miró, Head of the IDIBAPS group on Endocarditis and Cardiovascular Infections, coordinates the ADVANZ Mistral cohort, which contains patients who started antiretroviral therapy (ART) with CD4 cell counts below 100 and offers unique insights into the gut microbiome, immune response, and antibiotic resistance. This cohort has been followed for up to 10 years.
What is relevant about your research?
What sets this study apart is the extensive biological sampling, both blood and feces, collected at multiple points during the follow-up. These samples allow researchers to analyze changes in the microbiome and correlate them with immune system recovery triggered by ART. The aim is to understand how the baseline microbiome and its evolution over time relate to immune reconstitution, and there are no previous studies on such an advanced population with this level of microbiome detail.
Are there any results so far?
Although results from the microbiome, inflammation, and bacterial translocation studies are still pending, the project has already yielded a significant discovery. In collaboration with Dr. Jordi Vila, head of Work Package 5, we have found that one antiretroviral drug demonstrated unexpected antibacterial activity, particularly against methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE), two of the most challenging pathogens in clinical settings. Moreover, in vitro studies have shown promising synergy when this drug is used alone or in combination with conventional antibiotics. Preclinical testing in animal models is now underway to evaluate its efficacy further. If successful, this could pave the way for human clinical trials and potentially offer a new weapon against drug-resistant bacterial infections.
