Ramírez Pávez, Tamara Nadira

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Ramírez Pávez, Tamara Nadira

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Ramírez Pávez, Tamara Nadira

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Bioquímica y Biología Molecular "B" e Inmunología

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Open Access
Potential of sulforaphane and broccoli membrane vesicles as regulators of M1/M2 human macrophage activity
(2022-09-22) García-Peñaranda, Andrea; García-Ibáñez, Paula; Yepes-Molina, Lucía; Carvajal, Micaela; Ruiz Alcaraz, Antonio José; Moreno, Diego A.; García Peñarrubia, María del Pilar; Martínez-Esparza Alvargonzález, María Concepción; Ramírez Pávez, Tamara Nadira; Bioquímica y Biología Molecular B e Inmunología; Facultad de Biología
Open Access
Recent insights into the characteristics and role of peritoneal macrophages from ascites of cirrhotic patients
(Baishideng Publishing Group, 2021-11-07) García Peñarrubia, María del Pilar; Ruiz Alcaraz, Antonio José; Ruiz Ballester, Miriam; Martínez-Esparza Alvargonzález, María Concepción; Ramírez Pávez, Tamara Nadira; Bioquímica y Biología Molecular B e Inmunología; Facultad de Biología
Macrophages are a diverse myeloid cell population involved in innate and adaptive immune responses, embryonic development, wound repair, and regulation of tissue homeostasis. These cells link the innate and adaptive immunities and are crucial in the development and sustainment of various inflammatory diseases. Macrophages are tissue-resident cells in steady-state conditions; however, they are also recruited from blood monocytes after local pathogen invasion or tissue injury. Peritoneal macrophages vary based on their cell complexity, phenotype, and functional capabilities. These cells regulate inflammation and control bacterial infections in the ascites of decompensated cirrhotic patients. Our recent work reported several phenotypic and functional characteristics of these cells under both healthy and pathological conditions. A direct association between cell size, CD14/CD16 expression, intracellular level of GATA-6, and expression of CD206 and HLA-DR activation/maturation markers, indicate that the large peritoneal macrophage CD14highCD16high subset constitutes the mature phenotype of human resident peritoneal macrophages during homeostasis. Moreover, elevated expression of CD14/CD16 is related to the phagocytic capacity. The novel large CD14highCD16high peritoneal subpopulation is increased in the ascites of cirrhotic patients and is highly sensitive to lipopolysaccharide (LPS)-induced activation, thereby exhibiting features of inflammatory priming. Thus, phosphorylation of ERK1/2, PKB/Akt, and c-Jun is remarkably increased in response to LPS in vitro, whereas that of p38 MAPK is reduced compared with the monocyte-derived macrophages from the blood of healthy controls. Furthermore, in vitro activated monocyte-derived macrophages from ascites of cirrhotic patients secreted significantly higher levels of IL-6, IL-10, and TNF-α and lower amounts of IL-1β and IL-12 than the corresponding cells from healthy donor’s blood. Based on these results, other authors have recently reported that the surface expression level of CD206 can be used to identify mature, resident, inflammatory peritoneal macrophages in patients with cirrhosis. Soluble CD206 is released from activated large peritoneal macrophages, and increased concentrations in patients with cirrhosis and spontaneous bacterial peritonitis (SBP) indicate reduced odds of survival for 90 d. Hence, the level of soluble CD206 in ascites might be used to identify patients with SBP at risk of death. In conclusion, peritoneal macrophages present in ascites of cirrhotic patients display multiple phenotypic modifications characterized by reduced ratio of cells expressing several membrane markers, together with an increase in the ratios of complex and intermediate subpopulations and a decrease in the classiclike subset. These modifications may lead to the identification of novel pharmaceutical targets for prevention and treatment of hepatic damage.
Open Access
From Clinical Inflammatory Profiling to Translational Experimental Modeling of Endometriosis : Peritoneal Macrophages as a Therapeutic Target
(Universidad de Murcia, 2025-10-13) Ramírez Pávez, Tamara Nadira; Martínez-Esparza Alvargonzález, María Concepción; Machado Linde, Francisco; Sin departamento asociado; Escuelas::Escuela Internacional de Doctorado
Objetivos Esta tesis tiene como objetivo profundizar en la comprensión del entorno inmunológico y molecular de la endometriosis mediante un enfoque experimental multifacético, que integra modelos clínicos, inmunológicos y preclínicos. Los objetivos específicos incluyeron: optimizar protocolos de recogida de muestras peritoneales; caracterizar el microambiente inmunológico, en particular los macrófagos y mediadores solubles; correlacionar estos hallazgos con parámetros clínicos; e implementar un modelo murino de endometriosis para estudios in vivo. Metodología Se reclutaron 322 mujeres entre 2014 y 2025, de las cuales 197 fueron confirmadas con endometriosis mediante histología y 72 eran mujeres sanas. Se diseñó un protocolo estandarizado para la recogida de líquido y lavados peritoneales, junto con biopsias quirúrgicas. Las poblaciones de macrófagos peritoneales se caracterizaron mediante citometría de flujo y marcadores fenotípicos asociados a activación M1/M2, reparación tisular y otras subpoblaciones. Se midieron mediadores inflamatorios solubles humanos y microbianos en líquido peritoneal y plasma mediante ELISA. Por último, se desarrolló un modelo murino homólogo de endometriosis con implante de tejido endometrial GFP en ratones C57BL/6, evaluando la formación de lesiones, cambios de conducta tipo ansiedad y persistencia celular. Conclusiones Se optimizaron los protocolos de recogida de muestras, mejorando la recuperación celular en lavados peritoneales, especialmente en mujeres con obesidad. Se observó una infiltración generalizada de macrófagos, incluso en tejidos sin lesiones visibles, con una expansión significativa de subpoblaciones no-clásicas y un fenotipo complejo de marcadores proinflamatorios, reguladores y reparativos. A nivel sistémico, se detectaron alteraciones en leucocitos y citocinas, incluyendo elevación de galectina-1 y descenso de sCD163, así como un incremento moderado de β-glucanos. El índice de masa corporal se asoció con mediadores inflamatorios y mayor severidad de la enfermedad, subrayando el papel del peso en su progresión. El análisis detallado de subpoblaciones de macrófagos reveló correlaciones con la percepción de salud física y posibles vínculos con síntomas. Se identificaron asociaciones entre marcadores tumorales (CEA, HE4) y perfiles inmunológicos, lo que resalta su potencial como biomarcadores sensibles. El modelo murino homólogo aportó información útil aunque con limitaciones en la formación y detección de lesiones, destacando la necesidad de perfeccionar los sistemas preclínicos.
Open Access
The role of peritoneal macrophages in Endometriosis.
(MDPI, 2021-10-06) Marín Sánchez, Pilar; García Peñarrubia, Pilar; Martínez-Esparza Alvargonzález, María Concepción; Ramírez Pávez, Tamara Nadira; Ruiz Alcaraz, Antonio José; Machado Linde, Francisco; Bioquímica y Biología Molecular B e Inmunología
Endometriosis is an estrogen-dependent gynecological disorder, defined as the growth of endometrial stromal cells and glands at extrauterine sites. Endometriotic lesions are more frequently located into the abdominal cavity, although they can also be implanted in distant places. Among its etiological factors, the presence of immune dysregulation occupies a prominent place, pointing out the beneficial and harmful outcomes of macrophages in the pathogenesis of this disease. Macrophages are tissue-resident cells that connect innate and adaptive immunity, playing a key role in maintaining local homeostasis in healthy conditions and being critical in the development and sustainment of many inflammatory diseases. Macrophages accumulate in the peritoneal cavity of women with endometriosis, but their ability to clear migrated endometrial fragments seems to be inefficient. Hence, the characteristics of the peritoneal immune system in endometriosis must be further studied to facilitate the search for new diagnostic and therapeutic tools. In this review, we summarize recent relevant advances obtained in both mouse, as the main animal model used to study endometriosis, and human, focusing on peritoneal macrophages obtained from endometriotic patients and healthy donors, under the perspective of its future clinical translation to the role that these cells play on this pathology.
Open Access
Recent insights into the characteristics and role of peritoneal macrophages from ascites of cirrhotic patients
(Baishideng Publishing Group, 2021-11-07) García Peñarrubia, Pilar; Ruiz Ballester, Miriam; Martínez-Esparza Alvargonzález, María Concepción; Ramírez Pávez, Tamara Nadira; Ruiz Alcaraz, Antonio José; Bioquímica y Biología Molecular B e Inmunología
Macrophages are a diverse myeloid cell population involved in innate and adaptive immune responses, embryonic development, wound repair, and regulation of tissue homeostasis. These cells link the innate and adaptive immunities and are crucial in the development and sustainment of various inflammatory diseases. Macrophages are tissue-resident cells in steady-state conditions; however, they are also recruited from blood monocytes after local pathogen invasion or tissue injury. Peritoneal macrophages vary based on their cell complexity, phenotype, and functional capabilities. These cells regulate inflammation and control bacterial infections in the ascites of decompensated cirrhotic patients. Our recent work reported several phenotypic and functional characteristics of these cells under both healthy and pathological conditions. A direct association between cell size, CD14/CD16 expression, intracellular level of GATA-6, and expression of CD206 and HLA-DR activation/maturation markers, indicate that the large peritoneal macrophage CD14highCD16high subset constitutes the mature phenotype of human resident peritoneal macrophages during homeostasis. Moreover, elevated expression of CD14/CD16 is related to the phagocytic capacity. The novel large CD14highCD16high peritoneal subpopulation is increased in the ascites of cirrhotic patients and is highly sensitive to lipopolysaccharide (LPS)-induced activation, thereby exhibiting features of inflammatory priming. Thus, phosphorylation of ERK1/2, PKB/Akt, and c-Jun is remarkably increased in response to LPS in vitro, whereas that of p38 MAPK is reduced compared with the monocyte-derived macrophages from the blood of healthy controls. Furthermore, in vitro activated monocyte-derived macrophages from ascites of cirrhotic patients secreted significantly higher levels of IL-6, IL-10, and TNF-α and lower amounts of IL-1β and IL-12 than the corresponding cells from healthy donor’s blood. Based on these results, other authors have recently reported that the surface expression level of CD206 can be used to identifymature, resident, inflammatory peritoneal macrophages in patients with cirrhosis. Soluble CD206 is released from activated large peritoneal macrophages, and increased concentrations in patients with cirrhosis and spontaneous bacterial peritonitis (SBP) indicate reduced odds of survival for 90 d. Hence, the level of soluble CD206 in ascites might be used to identify patients with SBP at risk of death. In conclusion, peritoneal macrophages present in ascites of cirrhotic patients display multiple phenotypic modifications characterized by reduced ratio of cells expressing several membrane markers, together with an increase in the ratios of complex and intermediate subpopulations and a decrease in the classiclike subset. These modifications may lead to the identification of novel pharmaceutical targets for prevention and treatment of hepatic damage.
Open Access
The role of peritoneal macrophages in endometriosis
(MDPI, 2021-10-06) Martínez-Esparza Alvargonzález, María Concepción; Ruiz Alcaraz, Antonio José; Marín Sánchez, Pilar; Machado Linde, Francisco; García Peñarrubia, María del Pilar; Ramírez Pávez, Tamara Nadira; Bioquímica y Biología Molecular B e Inmunología; Facultad de Biología
Endometriosis is an estrogen-dependent gynecological disorder, defined as the growth of endometrial stromal cells and glands at extrauterine sites. Endometriotic lesions are more frequently located into the abdominal cavity, although they can also be implanted in distant places. Among its etiological factors, the presence of immune dysregulation occupies a prominent place, pointing out the beneficial and harmful outcomes of macrophages in the pathogenesis of this disease. Macrophages are tissue-resident cells that connect innate and adaptive immunity, playing a key role in maintaining local homeostasis in healthy conditions and being critical in the development and sustainment of many inflammatory diseases. Macrophages accumulate in the peritoneal cavity of women with endometriosis, but their ability to clear migrated endometrial fragments seems to be inefficient. Hence, the characteristics of the peritoneal immune system in endometriosis must be further studied to facilitate the search for new diagnostic and therapeutic tools. In this review, we summarize recent relevant advances obtained in both mouse, as the main animal model used to study endometriosis, and human, focusing on peritoneal macrophages obtained from endometriotic patients and healthy donors, under the perspective of its future clinical translation to the role that these cells play on this pathology.
Open Access
Systemic immune and tumor marker profiles in ovarian and deep infiltrating endometriosis: associations with disease severity and symptom burden
(MDPI, 2025-10-01) Marín Sánchez, Pilar; Nebot, Ana; García-Izquierdo, Laura; Nieto-Meca, Lucía; Sánchez, Rocío; Machado Linde, Francisco; Martínez-Esparza Alvargonzález, María Concepción; Ramírez Pávez, Tamara Nadira; Bioquímica y Biología Molecular B e Inmunología; Facultad de Medicina
Endometriosis is a chronic, estrogen-dependent inflammatory disease with heterogeneous clinical manifestations and uncertain systemic immune involvement. This study aimed to characterize peripheral immune profiles and circulating tumor markers in women with ovarian endometrioma (OE) and deep infiltrating endometriosis (DIE), and to explore their associations with disease severity, symptom burden, and physical health perception. Peripheral blood leukocyte subsets, plasma cytokines, and tumor markers (CA125, CA19-9, CEA, HE4) were analyzed in 146 patients and 50 healthy controls. OE was associated with increased monocyte counts and reduced neutrophil proportions, while DIE showed elevated levels of IL-8 and Galectin-1. IL-33 levels correlated negatively with the revised American Society for Reproductive Medicine (rASRM) scores and positively with neutrophil proportion, suggesting a role in systemic immune regulation. Tumor marker levels varied by subtype: CA19-9 was higher in OE, and CEA in DIE. CA125 correlated with disease severity, and CEA with monocyte levels. Exploratory heatmaps revealed consistent immune-tumor associations linked to anatomical severity and symptom profiles. Although exploratory, these findings highlight the presence of distinct systemic immune patterns in endometriosis and support the potential of integrative blood-based biomarkers for future diagnostic and stratification strategies.
Open Access
Optimization of peritoneal fluid and leukocyte collection in patients with endometriosis
(ELSEVIER, 2023-10-04) García-Peñarrubia, Pilar; Nieto-Meca, Lucía; Marín-Sánchez, Pilar; Martínez-Esparza Alvargonzález, María Concepción; Ramírez Pávez, Tamara Nadira; Machado Linde, Francisco; Bioquímica y Biología Molecular B e Inmunología
Objective: To propose a standardized protocol for peritoneal free fluid and leukocyte sample collection in women with endometriosis suitable for biomedical research on the basis of the surgical procedure, the clinical and technical conditions, and the quality of the samples obtained. Design: Video showing the step-by-step collection procedure and the suitability of samples obtained for biomedical research. Subjects: This study included 103 women with confirmed endometriosis by pathology analysis, who signed informed consent and were recruited from the Hospital ‘‘Virgen de la Arrixaca’’, Murcia, Spain. The study was approved by the Ethics Committee of University of Murcia (CEI 3156/2020). Main Outcome Measures: We analyzed the presence of free fluid in the peritoneal cavity and its relationship with hormonal treatment intake. In addition, the presence of blood contamination, the number of viable leukocytes and macrophages in free peritoneal fluid and lavages as well as their relationship with the lavage volume used, the body mass index, and the age of patients were analyzed. Results: The presence of free peritoneal fluid, in which cells and molecules could be quantified, was scarce in the patients (21%), and it was not significantly related to hormonal treatment intake. The cell viability was higher than 98% in all collected samples; although 54% showed good quality and enough cellularity to be used in biomedical research, 40% were contaminated with blood and 6% had low cellularity. The number of leukocytes and macrophages recovered from the peritoneal lavages correlated positively with the lavage volume used and negatively with the body mass index and was independent of the age of the patients. Conclusion: We describe a standardized step-by-step procedure for peritoneal fluid and leukocyte collection in women with endometriosis, suitable for biomedical research, taking into account that not all women present free fluid in the peritoneal cavity. We propose to increase the lavage volume recommended by the World Endometriosis Research Foundation from 10 mL to at least 40 mL of sterile saline solution and its mobilization for at least 30 seconds within the peritoneal cavity, especially in patients with higher body mass index, to improve the efficiency of the procedure.