Research Group on Neurological Impairment

Metabolism and Organic Damage Area

Chronic liver disease progresses in different phases, including alcoholic or nonalcoholic liver disease and nonalcoholic steatohepatitis (NASH) that can lead to fibrosis and cirrhosis.

The incidence of non-alcoholic steatohepatitis (NASH) has increased considerably in recent decades due to the lifestyle of the western population and is beginning to be a leading cause of liver cirrhosis. It is etiologically related mainly to obesity, diabetes, hyperlipidemia, and insulin resistance with features of the metabolic syndrome.

40% of patients with cirrhosis have minimal hepatic encephalopathy (MHE), with mild cognitive impairment and motor disorders that reduce their quality of life and survival. EHM progresses to clinical EH and can lead to coma and death.

Early detection and treatment and prevention of cognitive and functional impairment would improve the quality of life, survival and vitality of patients with chronic liver diseases and would reduce hospitalizations and the demand for resources on the health system, improving its sustainability.

In patients with cirrhosis, high levels of ammonia in the blood together with high levels of peripheral inflammation act synergistically to produce EHM, inducing neuroinflammation, which alters neurotransmission, leading to cognitive and motor impairment.

A better characterization of the metabolic, immunological, cerebral and neurological alterations will make it possible to identify and evaluate new, earlier and more sensitive diagnostic procedures for EHM.

The mechanisms that lead to these alterations are not well known and there are no specific treatments to reverse them. A better study of the mechanisms involved will make it possible to design and test new, more effective treatments.

Our research aims to better characterize the alterations in EHM and the mechanisms that produce them, evaluating new diagnostic and therapeutic procedures.

• Understand the biology of immunological changes associated with the appearance of EHM in cirrhotic patients
• To advance in the knowledge of the molecular mechanisms that lead to neurological alterations in EHM
• Identify new therapeutic targets
• Improve the treatment of cognitive and functional impairment in cirrhotic patients with EHM and symptoms
• Improve the early diagnosis of EHM, which will allow the treatment of patients who are not currently treated


Dra. Carmina Montoliu Félix
Coordinatora
Dra. Carmina Montoliu Félix
cmontoliu@incliva.es; carmina.montoliu@uv.es

RESEARCHERS
Leading, R4

Carmina Montoliu Félix    

Established, R3

Amparo Escudero García
José Ballester Fayos
José Luis León Guijarro
Roberto Aliaga Méndez

Recognised/Emerging, R2

Alessandra Fiorillo
Amparo Uriós Lluch
Andrea Cabrera Pastor    
Cristina Montón Rodríguez
Juan José Gallego Roig
Mª Pilar Ballester Ferré    
Nicolás Peñaranda Sarmiento
Paula Cases Bergón
Rut Victorio Muñoz
Yaiza Mª Arenas Ortiz

First Stage, R1

Adrià López Gramaje
Franc Casanova Ferrer

STAFF
Collaborating Researchers

Mika Aiko Gesler

Nurse

Mª Jesús Campa Santiago

Technicians

Laura Ávila Fernández

Administrative assistant
Publications
Improved cognition after rifaximin treatment is associated with changes in intra- and inter-brain network functional connectivity. Casanova-Ferrer F, Gallego J, Fiorillo A, Urios A, Rios M, Leon J, Ballester M, Escudero-Garcia D, Kosenko E, Belloch V, Montoliu C. Journal of Translational Medicine. 2024 Jan 12;22(1):49. doi: 10.1186/s12967-023-04844-7. PMID: 38217008

Liver disorders and celiac disease. Monton Rodriguez C, Sanchez Serrano J, Poyatos Garcia P, Abril Garcia C, Gomez Medina C, Capilla-Lozano M, Lluch Garcia P, Pascual Moreno I. Revista Espanola de Enfermedades Digestivas. 2024 Jan;116(1):41-42. doi: 10.17235/reed.2023.9516/2023. PMID: 37204091

Automatic video-oculography system for detection of minimal hepatic encephalopathy using machine learning tools. Calvo Cordoba A, Garcia Cena C, Montoliu C. Sensors. 2023 Sep 25;23(19):8073. doi: 10.3390/s23198073. PMID: 37836903

Biological treatment interruption in Inflammatory Bowel Disease: motivation and predictive factors. González MRD, Ballester MP, Romero-González E, Sánchez-Pardo AM, Marti-Aguado D, Tosca J, Suria C, Ausejo RA, Moreno IP, Silvestre MDP, Pérez MM, Bosca-Watts MM. Gastroenterologia y Hepatologia. 2023 Nov;46(9):671-681. doi: 10.1016/j.gastrohep.2022.10.021. PMID: 36375696

Corrigendum to Development and validation of the AMMON-OHE model to predict risk of overt hepatic encephalopathy occurrence in outpatients with cirrhosis [J Hepatol 79(4) (2023 Oct) 967-976]. Ballester MP, Tranah TH, Balcar L, Fiorillo A, Ampuero J, Kerbert AJC, Thomsen KL, Escudero MD, Mandorfer M, Reiberger T, Shawcross DL, Romero-Gómez M, Montoliu C, Carbonell-Asins JA, Jalan R. Journal of Hepatology. 2023 Dec;79(6):1571. doi: 10.1016/j.jhep.2023.10.013. PMID: 37919110

Development and validation of an image biomarker to identify metabolic dysfunction associated steatohepatitis: MR-MASH score. Marti-Aguado D, Arnouk J, Liang J, Lara-Romero C, Behari J, Furlan A, Jimenez-Pastor A, Ten-Esteve A, Alfaro-Cervello C, Bauza M, Gallen-Peris A, Gimeno-Torres M, Merino-Murgui V, Perez-Girbes A, Benlloch S, Perez-Rojas J, Puglia V, Ferrández-Izquierdo A, Aguilera V, Giesteira B, França M, Monton C, Escudero-García D, Alberich-Bayarri A, Serra M, Bataller R, Romero-Gomez M, Marti-Bonmati L. Liver International. 2023 Oct 30. doi: 10.1111/liv.15766. PMID: 37904633

Development and validation of the AMMON-OHE model to predict risk of overt hepatic encephalopathy occurrence in outpatients with cirrhosis. Ballester M, Tranah T, Balcar L, Fiorillo A, Ampuero J, Kerbert A, Thomsen K, Escudero M, Mandorfer M, Reiberger T, Shawcross D, Romero-Gomez M, Montoliu C, Carbonell-Asins J, Jalan R. Journal of Hepatology. 2023 Oct;79(4):967-976. doi: 10.1016/j.jhep.2023.05.022. PMID: 37277075

Erythrocytes functionality in SARS-CoV-2 infection: potential link with Alzheimer’s disease. Kosenko E, Tikhonova L, Alilova G, Montoliu C. International Journal of Molecular Sciences. 2023 Mar 17;24(6):5739. doi: 10.3390/ijms24065739. PMID: 36982809

Extracellular vesicles from mesenchymal stem cells reduce neuroinflammation in hippocampus and restore cognitive function in hyperammonemic rats. Izquierdo-Altarejos P, Cabrera-Pastor A, Martinez-Garcia M, Sanchez-Huertas C, Hernandez A, Moreno-Manzano V, Felipo V. Journal of Neuroinflammation. 2023 Jan 2;20(1):1. doi: 10.1186/s12974-022-02688-4. PMID: 36593485

Extracorporeal liver support and liver transplantation for acute-on-chronic liver failure. Ballester M, Elshabrawi A, Jalan R. Liver International. 2023 Jun 14. doi: 10.1111/liv.15647. PMID: 37312660

I-CARE, a European prospective cohort study assessing safety and effectiveness of biologics in inflammatory bowel disease. Peyrin-Biroulet L, Rahier J, Kirchgesner J, Abitbol V, Shaji S, Armuzzi A, Karmiris K, Gisbert J, Bossuyt P, Helwig U, Burisch J, Yanai H, Doherty G, Magro F, Molnar T, Lowenberg M, Halfvarson J, Zagorowicz E, Rousseau H, Baumann C, Baert F, Beaugerie L, Puchades Lanza L, I-CARE Collaborator Group. Clinical Gastroenterology and Hepatology. 2023 Mar;21(3):771-788.e10. doi: 10.1016/j.cgh.2022.09.018. PMID: 36152897

Letter to the Editor – Reply to ‘Ammonia – an old friend with a new area of application. Tranah TH, Ballester MP, Carbonell-Asins JA, Jalan R, Shawcross DL. Journal of Hepatology. 2023 Jan;78(1):e23-e26. doi: 10.1016/j.jhep.2022.09.023. PMID: 36216137

Long-term follow-up of HCV-infected patients with end-stage chronic kidney disease after sustained virological response with direct-acting antiviral therapy. Martinez-Camprecios J, Riveiro-Barciela M, Munoz-Gomez R, Londono MC, Roget M, Serra MA, Escudero-Garcia D, Purchades L, Rodriguez M, Losa-Garcia JE, Gutierrez ML, Carmona I, Garcia-Samaniego J, Morano L, Martin-Granizo I, Montero-Alonso M, Prieto M, Delgado M, Ramos N, Azancot MA, Rodriguez-Frias F, Buti M. Gastroenterologia y Hepatología. 2023 Oct;46(8):594-602. doi: 10.1016/j.gastrohep.2022.12.004. PMID: 36584754

Measuring and interpreting ammonia levels in cirrhosis. Ballester M, Rose C, Carbonell-Asins J, Jalan R. The American Journal of Gastroenterology. 2023 Jul 1;118(7):1297. doi: 10.14309/ajg.0000000000002245. PMID: 37377264

Mild cognitive impairment is associated with enhanced activation of Th17 lymphocytes in non-alcoholic fatty liver disease. Fiorillo A, Gallego J, Casanova-Ferrer F, Gimenez-Garzo C, Urios A, Ballester M, Durban L, Rios M, Megias J, San Miguel T, Kosenko E, Escudero-Garcia D, Benlloch S, Felipo V, Montoliu C. International Journal of Molecular Sciences. 2023 Jun 20;24(12):10407. doi: 10.3390/ijms241210407. PMID: 37373554

Neurofilament light chain protein in plasma and extracellular vesicles is associated with minimal hepatic encephalopathy and responses to rifaximin treatment in cirrhotic patients. Fiorillo A, Gallego J, Casanova-Ferrer F, Urios A, Ballester M, San Miguel T, Megias J, Kosenko E, Tosca J, Rios M, Escudero-Garcia D, Montoliu C. International Journal of Molecular Sciences. 2023 Sep 29;24(19):14727. doi: 10.3390/ijms241914727. PMID: 37834174

Pancreatic steatosis and iron overload increases cardiovascular risk in non-alcoholic fatty liver disease. Marti-Aguado D, Ten-Esteve A, Baracaldo-Silva C, Crespo A, Coello E, Merino-Murgui V, Fernandez-Paton M, Alfaro-Cervello C, Sanchez-Martin A, Bauza M, Jimenez-Pastor A, Perez-Girbes A, Benlloch S, Perez-Rojas J, Puglia V, Ferrandez A, Aguilera V, Latorre M, Monton C, Escudero-Garcia D, Bosch-Roig I, Alberich-Bayarri A, Marti-Bonmati L. Frontiers in Endocrinology. 2023 Aug 3;14:1213441. doi: 10.3389/fendo.2023.1213441. PMID: 37600695

Patients died with steatohepatitis or liver cirrhosis show neuroinflammation and neuronal loss in hippocampus. Leone P, Arenas Y, Balzano T, Mincheva G, Martinez-Garcia M, Montoliu C, Llansola M, Felipo V. European Journal of Neurology. 2023 Oct;30(10):3032-3046. doi: 10.1111/ene.15935. PMID: 37340928

Randomized, controlled clinical trial of the DIALIVE liver dialysis device versus standard of care in patients with acute-on- chronic liver failure. Agarwal B, Canizares R, Saliba F, Ballester M, Tomescu D, Martin D, Stadlbauer V, Wright G, Sheikh M, Morgan C, Alzola C, Lavin P, Green D, Kumar R, Sacleux S, Schilcher G, Koball S, Tudor A, Minten J, Domenech G, Aragones J, Oettl K, Paar M, Waterstradt K, Bode-Boger S, Ibanez-Samaniego L, Gander A, Ramos C, Chivu A, Stange J, Lamprecht G, Sanchez M, Mookerjee R, Davenport A, Davies N, Pavesi M, Andreola F, Albillos A, Cordingley J, Schmidt H, Carbonell-Asins J, Arroyo V, Fernandez J, Mitzner S, Jalan R. Journal of Hepatology. 2023 Jul;79(1):79-92. doi: 10.1016/j.jhep.2023.03.013. PMID: 37268222

Reply to ‘Ammonia and prognosis of cirrhosis: a new perspective for identifying high risk patients’. Tranah T, Ballester M, Carbonell-Asins J, Jalan R, Shawcross D. Journal of Hepatology. 2023 Feb;78(2):e70-e71. doi: 10.1016/j.jhep.2022.10.025. PMID: 36334687

Reply to ‘The possible link between higher ammonia levels associated with non-alcoholic fatty liver related cirrhosis and diabetes: are we missing chronic kidney disease?’. Tranah T, Ballester M, Carbonell-Asins J, Jalan R, Shawcross D. Journal of Hepatology. 2023 Feb;78(2):e73-e74. doi: 10.1016/j.jhep.2022.10.024. PMID: 36332694

Reply to: Ammonia predicts clinical outcomes in cirrhosis – but there are caveats to consider. Ballester M, Carbonell-Asins J, Balcar L, Reiberger T, Jalan R. Journal of Hepatology. 2023 Dec;79(6):e239-e241. doi: 10.1016/j.jhep.2023.08.015. PMID: 37625482

Serological response and breakthrough infection after COVID-19 vaccination in patients with cirrhosis and post-liver transplant. Mehta G, Riva A, Ballester M, Uson E, Pujadas M, Carvalho-Gomes A, Sahuco I, Bono A, D’Amico F, Viganò R, Diago E, Lanseros B, Inglese E, Vazquez D, Sharma R, Tsou H, Harris N, Broekhoven A, Kikkert M, Morales S, Myeni S, Riveiro-Barciela M, Palom A, Zeni N, Brocca A, Cussigh A, Cmet S, Escudero-García D, Stocco M, Natola L, Ieluzzi D, Paon V, Sangiovanni A, Farina E, di Benedetto C, Sánchez-Torrijos Y, Lucena-Varela A, Román E, Sánchez E, Sánchez-Aldehuelo R, López-Cardona J, Canas-Perez I, Eastgate C, Jeyanesan D, Morocho A, Di Cola S, Lapenna L, Zaccherini G, Bongiovanni D, Zanaga P, Sayaf K, Hossain S, Crespo J, Robles-Díaz M, Madejón A, Degroote H, Fernández J, Korenjak M, Verhelst X, García-Samaniego J, Andrade R, Iruzubieta P, Wright G, Caraceni P, Merli M, Patel V, Gander A, Albillos A, Soriano G, Donato M, Sacerdoti D, Toniutto P, Buti M, Duvoux C, Grossi P, Berg T, Polak W, Puoti M, Bosch-Comas A, Belli L, Burra P, Russo F, Coenraad M, Calleja J, Perricone G, Berenguer M, Claria J, Moreau R, Arroyo V, Angeli P, Sánchez C, Ampuero J, Piano S, Chokshi S, Jalan R. Hepatology Communications. 2023 Oct 18;7(11):e0273. doi: 10.1097/HC9.0000000000000273. PMID: 37870985

Vaccination in liver diseases and liver Transplantation: Recommendations, implications and opportunities in the post-covid era. Ballester M, Jalan R, Mehta G. JHEP Reports: Innovation in Hepatology. 2023 Apr 26;5(8):100776. doi: 10.1016/j.jhepr.2023.100776. PMID: 37360567

Adherence to endoscopic surveillance for advanced lesions and colorectal cancer in inflammatory bowel disease: an AEG and GETECCU collaborative cohort study. Pilar Ballester M, Mesonero F, Florez-Diez P, Gomez C, Fuentes-Valenzuela E, Martin N, Senosiain C, Vela M, Fernandez-Clotet A, Perez P, Rubin de Celix C, Calvino-Suarez C, Hermida B, Munoz R, Gonzalez-Vivo M, Brunet E, Jimenez N, Botella B, Yebra J, Suarez-Ferrer C, Bouhmidi A, Lopez-Serrano A, Ponferrada A, Duenas C, Minguez M. Alimentary Pharmacology & Therapeutics. 2022 Jun;55(11):1402-1413. doi: 10.1111/apt.16832. PMID: 35224758

Autoimmune hepatitis triggered by COVID-19. Monton Rodriguez C, Navarro Cortes P, Lluch Garcia P, Minguez Perez M. Revista Espanola de Enfermedades Digestivas. 2022 Jan;114(1):64-65. doi: 10.17235/reed.2021.8045/2021. PMID: 34015933

Automated whole-liver MRI segmentation to assess steatosis and iron quantification in chronic liver disease. Marti-Aguado D, Jimenez-Pastor A, Alberich-Bayarri A, Rodriguez-Ortega A, Alfaro-Cervello C, Mestre-Alagarda C, Bauza M, Gallen-Peris A, Valero-Perez E, Ballester MP, Gimeno-Torres M, Perez-Girbes A, Benlloch S, Perez-Rojas J, Puglia V, Ferrandez A, Aguilera V, Escudero-Garcia D, Serra MA, Marti-Bonmati L. Radiology. 2022 Feb;302(2):345-354. doi: 10.1148/radiol.2021211027. PMID: 34783592

Hyperammonemia alters the function of AMPA and NMDA receptors in hippocampus: extracellular cGMP reverses some of these alterations. Sancho-Alonso M, Taoro-Gonzalez L, Cabrera-Pastor A, Felipo V, Teruel-Marti V. Neurochemical Research. 2022 Jul;47(7):2016-2031. doi: 10.1007/s11064-022-03588-y. PMID: 35386048

Is NMDA-receptor-mediated oxidative stress in mitochondria of peripheral tissues the essential factor in the pathogenesis of hepatic encephalopathy?. Kosenko E, Tikhonova L, Alilova G, Montoliu C. Journal of Clinical Medicine. 2022 Feb 4;11(3):827. doi: 10.3390/jcm11030827. PMID: 35160278

Let’s end HepC: modelling public health epidemiological policies applied to Hepatitis C in Spain. Lopes H, Baptista-Leite R, Franco D, Serra M, Escudero A, Martin-Moreno J. Frontiers in Public Health. 2022 Jan 7;9:735572. doi: 10.3389/fpubh.2021.735572. PMID: 35071151

Management of patients with Intestinal Bowel Disease and COVID-19: a review of current evidence and future perspectives. Suria C, Bosca-Watts MM, Navarro P, Tosca J, Anton R, Sanahuja A, Revaliente M, Minguez M. Gastroenterologia y Hepatología. 2022 May;45(5):383-389. doi: 10.1016/j.gastrohep.2021.06.005. PMID: 34171421

Matched paired primary and recurrent meningiomas points to cell-death program contributions to genomic and epigenomic instability along tumor progression. San-Miguel T, Megias J, Monleon D, Navarro L, Munoz-Hidalgo L, Montoliu C, Meri M, Roldan P, Cerda-Nicolas M, Lopez-Gines C. Cancers. 2022 Aug 19;14(16):4008. doi: 10.3390/cancers14164008. PMID: 36011000

Metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy. Ballester M, Gallego J, Fiorillo A, Casanova-Ferrer F, Gimenez-Garzo C, Escudero-Garcia D, Tosca J, Rios M, Monton C, Durban L, Ballester J, Benlloch S, Urios A, San-Miguel T, Kosenko E, Serra M, Felipo V, Montoliu C. Scientific Reports. 2022 Feb 14;12(1):2463. doi: 10.1038/s41598-022-06416-z. PMID: 35165326

Minimal hepatic encephalopathy is associated to alterations in eye movements. Casanova-Ferrer F, Garcia-Cena CE, Gallego JJ, Fiorillo A, Urios A, Calvo-Cordoba A, Ballester MP, Rios MP, Durban L, Hidalgo MR, Garcia F, Felipo V, Montoliu C. Scientific Reports. 2022 Oct 7;12(1):16837. doi: 10.1038/s41598-022-21230-3. PMID: 36207472

Plasma ammonia levels predict hospitalisation with liver-related complications and mortality in clinically stable outpatients with cirrhosis. Tranah T, Ballester M, Carbonell-Asins J, Ampuero J, Alexandrino G, Caracostea A, Sanchez-Torrijos Y, Thomsen K, Kerbert A, Capilla-Lozano M, Romero-Gomez M, Escudero-Garcia D, Montoliu C, Jalan R, Shawcross D. Journal of Hepatology. 2022 Dec;77(6):1554-1563. doi: 10.1016/j.jhep.2022.07.014. PMID: 35872326

Plasma extracellular vesicles play a role in immune system modulation in minimal hepatic encephalopathy. Gallego J, Fiorillo A, Casanova-Ferrer F, Urios A, Ballester M, Durban L, Megias J, Rubio T, Cabrera-Pastor A, Escudero-Garcia D, Felipo V, Montoliu C. International Journal of Molecular Sciences. 2022 Oct 15;23(20):12335. doi: 10.3390/ijms232012335. PMID: 36293192

Prevalence estimation of significant fibrosis because of NASH in Spain combining transient elastography and histology. Calleja J, Rivera-Esteban J, Aller R, Hernandez-Conde M, Abad J, Pericas J, Benito H, Serra M, Escudero A, Ampuero J, Lucena A, Sanchez Y, Arias-Loste M, Iruzubieta P, Romero-Gomez M, Augustin S, Crespo J. Liver International. 2022 Aug;42(8):1783-1792. doi: 10.1111/liv.15323. PMID: 35643936

Thiopurine adherence: high prevalence with low impact in UC outcomes. Gomez-Medina C, Capilla-Lozano M, Ballester Ferre M, Marti-Aguado D, Crespo A, Bosca-Watts M, Navarro Cortes P, Anton R, Pascual Moreno I, Tosca Cuquerella J, Minguez Perez M. Revista Española de Enfermedades Digestivas. 2022 Feb;114(2):76-82. doi: 10.17235/reed.2021.7630/2020. PMID: 33733802

A new score unveils a high prevalence of mild cognitive impairment in patients with nonalcoholic fatty liver disease. Gimenez-Garzo C, Fiorillo A, Ballester-Ferre M, Gallego J, Casanova-Ferrer F, Urios A, Benlloch S, Marti-Aguado D, San-Miguel T, Tosca J, Rios M, Monton C, Durban L, Escudero-Garcia D, Aparicio L, Felipo V, Montoliu C. Journal of Clinical Medicine. 2021 Jun 25;10(13):2806. doi: 10.3390/jcm10132806. PMID: 34202269

Botulinum toxin injection plus topical diltiazem for chronic anal fissure: a randomized double-blind clinical trial and long-term outcome. Herreros B, Espi A, Monton Rodriguez C, Garcia-Granero E, Sanchiz V, Ferriols FL, Almela P, Hernandez V, Mora F, Minguez M. Diseases of the Colon and Rectum. 2021 Dec 1;64(12):1521-1530. doi: 10.1097/DCR.0000000000001983. PMID: 34747917

Caustic ingestion: development and validation of a prognostic score. Tosca J, Villagrasa R, Sanahuja A, Sanchez A, Trejo G, Herreros B, Pascual I, Mas P, Pena A, Minguez M. Endoscopy. 2021 Aug;53(8):784-791. doi: 10.1055/a-1297-0333. PMID: 33096569

Definite and indeterminate nonalcoholic steatohepatitis share similar clinical features and prognosis: a longitudinal study of 1893 biopsy-proven nonalcoholic fatty liver disease subjects. Ampuero J, Aller R, Gallego-Duran R, Crespo J, Abad J, Gonzalez-Rodriguez A, Gomez-Camarero J, Caballeria J, Lo Iacono O, Ibanez L, Garcia-Samaniego J, Martin-Mateos R, Frances R, Fernandez-Rodriguez C, Diago M, Soriano G, Andrade RJ, Latorre R, Jorquera F, Morillas RM, Escudero D, Estevez P, Hernandez-Guerra M, Augustin S, Pareja-Megia MJ, Banales JM, Aspichueta P, Benlloch S, Rosales JM, Salmeron J, Turnes J, Romero-Gomez M. Liver International. 2021 Sep;41(9):2076-2086. doi: 10.1111/liv.14898. PMID: 33896100

Digital pathology: accurate technique for quantitative assessment of histological features in metabolic-associated fatty liver disease. Marti-Aguado D, Rodriguez-Ortega A, Mestre-Alagarda C, Bauza M, Valero-Perez E, Alfaro-Cervello C, Benlloch S, Perez-Rojas J, Ferrandez A, Alemany-Monraval P, Escudero-Garcia D, Monton C, Aguilera V, Alberich-Bayarri A, Serra M, Marti-Bonmati L. Alimentary Pharmacology & Therapeutics. 2021 Jan;53(1):160-171. doi: 10.1111/apt.16100. PMID: 32981113

Multi-omic analysis unveils biological pathways in peripheral immune system associated to minimal hepatic encephalopathy appearance in cirrhotic patients. Rubio T, Felipo V, Tarazona S, Pastorelli R, Escudero-Garcia D, Tosca J, Urios A, Conesa A, Montoliu C. Scientific Reports. 2021 Jan 21;11(1):1907. doi: 10.1038/s41598-020-80941-7. PMID: 33479266

Patients with Minimal Hepatic Encephalopathy Show Altered Thermal Sensitivity and Autonomic Function. Rega D, Aiko M, Penaranda N, Urios A, Gallego J, Gimenez-Garzo C, Casanova F, Fiorillo A, Cabrera-Pastor A, San-Miguel T, Ipiens C, Escudero-Garcia D, Tosca J, Monton C, Ballester M, Ballester J, Aparicio L, Rios M, Durban L, Mir A, Kosenko E, Cases P, Felipo V, Montoliu C. Journal of Clinical Medicine. 2021 Jan 11;10(2):E239. doi: 10.3390/jcm10020239. PMID: 33440769

Risk factors and management strategies associated with non-response to aminosalicylates for maintenance treatment in ulcerative colitis. Marti-Aguado D, Ballester M, Minguez M. Revista Espanola de Enfermedades Digestivas. 2021 Jun;113(6):447-453. doi: 10.17235/reed.2021.7797/2021. PMID: 33569968

Surgical treatment of an intraductal papillary mucinous neoplasm of the biliary tract diagnosed by SpyGlass®. Martí Fernandez R, Garces Albir M, Ballester Ferre M, Dorcaratto D, Villagrasa Manzano R, Muñoz Forner E, Gómez Adrián J, Sanchiz Soler V, Sabater Orti L, Ortega Serrano J. Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva. 2021 Jan;113(1):45-47. doi: 10.17235/reed.2020.7122/2020. doi: 10.17235/reed.2020.7122/2020. PMID: 33054282

Transjugular intrahepatic portosystemic shunt reduces hospital care burden in patients with decompensated cirrosis. Ballester M, Lluch P, Gomez C, Capilla M, Tosca J, Marti-Aguado D, Guijarro J, Minguez M. Internal and Emergency Medicine. 2021 Sep;16(6):1519-1527. doi: 10.1007/s11739-020-02602-x. PMID: 33400160

Projects
Reference: CIGE/2021/083
Title: Estudio de las vesículas extracelulares en plasma de pacientes con obesidad mórbida antes y tras cirugía bariátrica. Subvenciones concedidas a grupos de investigación emergentes
Funding body: Conselleria de Educación
Principal Investigator: Andrea Cabrera Pastor
Duration: 2022 – 2023
Total budget: 20.000 €
Reference: CP20/00009
Title: Role of extracellular vesicles, metabolome and altered intercellular communication in the induction of minimal hepatic encephalopathy: mechanisms, therapeutic and diagnostic implications
Funding body: Instituto de Salud Carlos III – Cofinanciado FEDER
Principal Investigator: Andrea Cabrera Pastor
Duration: 2021 – 2024
Total budget: 40.000 €
Reference: AP-2021-001
Title: LIGAM1: Efecto de la activación de TLR por medio de sus ligandos sobre la polarización de macrófagos hacia M1 y su función citocida frente a las células madre de glioblastoma
Funding body: Universidad de Valencia – INCLIVA
Principal Investigator: Javier Megías Vericat, Andrea Cabrera Pastor
Duration: 2021 – 2022
Total budget: 4.608 €
Reference: PI18/00150
Title: Caracterización de las alteraciones neurológicas y cerebrales en pacientes con encefalopatía hepática mínima. Contribucu¡ión de la Inflamación. Implicaciones diagnósticas y terapéuticas
Funding body: Instituto de Salud Carlos III – Cofinanciado FEDER
Principal Investigator: Carmina Montoliu Félix
Duration: 2019 – 2021
Total budget: 171.820 €
Reference: GV/2019/049
Title: Papel de los exosomas en el inicio y progresión de la neuroinflamación, alteraciones en la neurotransmisión y deterioro cognitivo y motor en encefalopatía hepática mínima. Posible utilidad como biomarcadores tempranos
Funding body: Conselleria de Educación
Principal Investigator: Andrea Cabrera Pastor
Duration: 2019 – 2020
Total budget: 16.000 €
Reference: PROMETEO/2018/051
Title: Mecanismos moleculares y cerebrales de las alteraciones cognitivas y motoras en hiperamonemia y encefalopatía hepática. lmplicaciones terapéuticas y diagnósticas
Funding body: Conselleria de Educación, Cultura y Deporte
Principal Investigator: Vicente Felipo Orts
Duration: 2018 – 2021
Total budget: 289.194,57
+ Info
Title: Caracterización de los cambios en el inmunofenotipo asociados a la aparición del deterioro cognitivo leve en pacientes con enfermedad de hígado graso no alcohólico
Doctoral candidate: Fiorillo, Alesandra
Director(s): Montoliu Felix, Carmina; San Miguel Díaz, Teresa
Date of the defense: 01/11/2023
University: University de Valencia

Title: Caracterización de las alteraciones en el inmunofenotipo asociadas a la aparición de la encefalopatía hepática mínima en pacientes cirróticos. Implicación de las vesículas extracelulares
Doctoral candidate: Gallego Roig, Juan José
Director(s): Montoliu Felix, Carmina; Megías Vericat, Javier
Date of the defense: 01/11/2023
University: University de Valencia

Title: Characterization and evaluation of alterations in sensitivity and autonomic function in patients with minimal hepatic encephalopathy
Doctoral candidate: Rega Caballero, Dalia
Director(s): Montoliu Felix, Carmina; Uriós Lluch, Amparo; Cases Bergón, Paula
Date of the defense: 05/12/2022
University: Universitat Politècnica de València

Title: Papel de las vesículas extracelulares en el deterioro cognitivo y motor en hiperamonemia y encefalopatía hepática. Mecanismos moleculares e implicaciones terapéuticas
Doctoral candidate: Izquierdo Altarejos, Paula
Director(s): Felipo Orts, Vicente; Cabrera Pastor, Andrea
Date of the defense: 20/05/2022
University: Universitat de València

Title: Mecanismos moleculares por los que la hiperamonemia crónica induce neuroinflamación y alteraciones en la neurotransmisión en cerebelo de ratas hiperamonémicas
Doctoral candidate: Arenas Ortiz, Yaiza María
Director(s): Cabrera Pastor, Andrea; Balzano, Tiziano; Felipo Orts, Vicente
Date of the defense: 12/04/2022
University: Universitat de València

Title: Impacto de la inmunosuppresión y otros factores de riesgo en el desarrollo de infecciones en pacientes con enfermedad inflamatoria intestinal: estudio caso-control
Doctoral candidate: García Gimeno, Natalia
Director(s): Mínguez Pérez, Miguel; Tosca Cuquerella, Joan; Mora Miguel, Francisco
Date of the defense: 05/11/2021
University: Universitat de València

Title: Estudio epidemiológico retrospectivo de 10 años de los enfermos con virus C diagnosticados en el servicio de Medicina Digestiva del Hospital Clínico Universitario de Valencia
Doctoral candidate: Puchades Lanza, Laura
Director(s): Serra Desfilis, Miguel Ángel; Escudero García, Desamparados
Date of the defense: 28/06/2021
University: Universitat de València

Title: Caracterización del deterioro neurológico y la respuesta al tratamiento con rifaximina en pacientes con encefalopatía hepática mínima
Doctoral candidate: Ballester Ferré, Maria Pilar
Director(s): Montoliu Félix, Carmina; Escudero García, Desamparados; Serra Desfílis Miguel Ángel
Date of the defense: 08/01/2021
University: Universitat de València