Ferrer Gómez, Mercedes

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Ferrer Gómez, Mercedes

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Ferrer Gómez, Mercedes

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Universidad de Murcia. Departamento de Medicina

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Open Access
Corporal composition and gut microbiome modification through exclusion dietary intervention in adult patients with Crohn’s disease: protocol for a prospective, interventional, controlled, randomized clinical trial
(MDPI, 2025-06-05) Cano-Mármol, Rosario Paloma; Fernández Ruiz, Virginia Esperanza; Martínez-Pascual, Cristina; Ros-Madrid, Inmaculada; Martín-Pozuelo del Pozo, Gala; Oliva-Bolarín, Alba; Martínez-Sánchez, María Antonia; Egea Valenzuela, Juan; Núñez-Sánchez, María Ángeles; Ramos-Molina, Bruno; Ruiz Alcaraz, Antonio José; Ferrer Gómez, Mercedes; Bioquímica y Biología Molecular B e Inmunología; Facultad de Biología
Background: Crohn’s disease (CD) is an inflammatory bowel disease in which there is an alteration in the homeostasis and functionality of the intestinal mucosa accompanied by a dysbiosis of the commensal microbiota. The analysis of different dietary strategies to achieve CD remission and reduce gastrointestinal symptoms concludes that it is necessary to restrict the intake of ultra-processed products and to promote the consumption of those with anti-inflammatory effects that improve intestinal permeability and dysbiosis. Methods: Based on previous studies conducted in other cohorts, mainly pediatric, we propose an experimental, prospective, randomized study in patients with active CD who do not show improvement with conventional pharmacological treatment. The control group will receive standard nutritional recommendations while the intervention group will be prescribed an exclusion diet supplemented with enteral nutrition. Results: Patients in the intervention group are expected to exhibit increased lean body mass and reduced visceral fat, as measured by bioelectrical impedance analysis (BIA), alongside higher rates of clinical remission (CDAI), decreased inflammatory markers, and improved gut microbiota composition. Additionally, improvements in health-related quality of life are anticipated, as assessed by validated questionnaires. Conclusions: In the present project, we plan to conduct a detailed study to determine the potential of the exclusion diet for the treatment and remission of CD in adult patients, with the hypothesis that this nutritional intervention will be able to modify and improve intestinal dysbiosis, inflammatory status, and clinical and body composition markers in these patients.
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Lipidomic analysis reveals alterations in hepatic FA profile associated with MASLD stage in patients with obesity
(Oxford University Press, 2024-01-13) Núñez-Sánchez, María Ángeles; Martínez-Sánchez, María Antonia; Martínez-Montoro, José Ignacio; Balaguer-Román, Andrés; Murcia-García, Elena; Fernández Ruiz, Virginia Esperanza; Ferrer Gómez, Mercedes; Martínez Cáceres, Carlos Manuel; Sledzinski, Tomasz; Frutos Bernal, María Dolores; Hernández-Morante, Juan José; Fernández-García, José Carlos; Queipo-Ortuño, María Isabel; Ruiz Alcaraz, Antonio José; Mika, Adriana; Ramos-Molina, Bruno; Bioquímica y Biología Molecular B e Inmunología; Facultad de Biología
Context. Metabolic dysfunction–associated steatotic liver disease (MASLD) is characterized by the intracellular lipid accumulation in hepatocytes. Excess caloric intake and high-fat diets are considered to significantly contribute to MASLD development. Objective. To evaluate the hepatic and serum fatty acid (FA) composition in patients with different stages of MASLD, and their relationship with FA dietary intake and MASLD-related risk factors. Methods. This was a case–control study in patients with obesity undergoing bariatric surgery at a university hospital between January 2020 and December 2021. Participants were distributed in 3 groups: no MASLD (n = 26), steatotic liver disease (n = 33), and metabolic dysfunction–associated steatohepatitis (n = 32). Hepatic and serum FA levels were determined by gas chromatography-mass spectrometry. Nutritional status was evaluated using validated food frequency questionnaires. The hepatic expression of genes involved in FA metabolism was analyzed by reverse transcription quantitative polymerase chain reaction. Results. The hepatic, but not serum, FA profiles were significantly altered in patients with MASLD compared with those without MASLD. No differences were observed in FA intake between the groups. Levels of C16:0, C18:1, and the C18:1/C18:0 ratio were higher, while C18:0 levels and C18:0/C16:0 ratio were lower in patients with MASLD, being significantly different between the 3 groups. Hepatic FA levels and ratios correlated with histopathological diagnosis and other MASLD-related parameters. The expression of genes involved in the FA metabolism was upregulated in patients with MASLD. Conclusion. Alterations in hepatic FA levels in MASLD patients were due to enhancement of de novo lipogenesis in the liver.
Open Access
Gut microbiome modification through dietary intervention in patients with colorectal cancer: protocol for a prospective, interventional, controlled, randomized clinical trial in patients with scheduled surgical intervention for CRC
(MDPI, 2022-06-22) Martínez-Sánchez, María Antonia; Núñez-Sánchez, María Ángeles; Balaguer-Román, Andrés; Oliva-Bolarín, Alba; Pujante-Gilabert, Gabriel; Hernández-Agüera, Quiteria; Mesa-López, María José; Egea Valenzuela, Juan; Queipo-Ortuño, María Isabel; Ruiz Alcaraz, Antonio José; Ferrer Gómez, Mercedes; Gil-Martínez, José; Ramos-Molina, Bruno; Bioquímica y Biología Molecular B e Inmunología; Facultad de Biología
Colorectal cancer (CRC) is the third most common cancer and the second cause of cancer death worldwide. Several factors have been postulated to be involved in CRC pathophysiology, including heritable and environmental factors, which are the latest to be closely associated with nutritional habits, physical activity, obesity, and the gut microbiota. The latter may also play a key role in CRC prognosis and derived complications in patients undergoing surgery. This is a single-center, open, controlled, randomized clinical trial, in patients with scheduled surgical intervention for CRC. The primary objective is to assess whether a pre-surgical nutritional intervention, based on a high-fiber diet rich in polyunsaturated fatty acids (PUFAs), can reduce disturbances of the gut microbiota composition and, consequently, the rate of post-surgical complications in patients with CRC. Patients will be randomized in a 1:1 ratio after receiving a diagnosis of CRC. In the control arm, patients will receive standard nutritional recommendations, while patients in the intervention arm will be advised to follow a high-fiber diet rich in PUFAs before surgery. Participants will be followed up for one year to evaluate the overall rate of postsurgical complications, recurrences of CRC, response to adjuvant therapy, and overall/disease-free survival.
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Dietary modulation of gut microbiota in patients with colorectal cancer undergoing surgery: a review
(Elsevier, 2022-07-05) Martínez-Montoro, José Ignacio; Martínez-Sánchez, María Antonia; Balaguer-Román, Andrés; Gil-Martínez, José; Mesa-López, María José; Egea Valenzuela, Juan; Ruiz Alcaraz, Antonio José; Queipo-Ortuño, María Isabel; Ferrer Gómez, Mercedes; Fernández García, José Carlos; Ramos-Molina, Bruno; Bioquímica y Biología Molecular B e Inmunología; Facultad de Biología
Colorectal cancer (CRC) is the third most frequent malignancy and the second cause of cancer death worldwide. Several factors have been postulated to be involved in CRC pathophysiology, including physical inactivity, unhealthy dietary habits, obesity, and the gut microbiota. Emerging data suggest that the microbiome may play a key role in CRC prognosis and derived complications in patients undergoing colorectal surgery. On the other hand, dietary intervention has been demonstrated to be able to induce significant changes in the gut microbiota and related metabolites in different conditions; therefore, the manipulation of gut microbiota through dietary intervention may constitute a useful approach to improve perioperative dysbiosis and post-surgical outcomes in patients with CRC. In this article, we review the role of the gut microbiota in CRC surgery complications and the potential therapeutic modulation of gut microbiome through nutritional intervention in patients with CRC undergoing surgery.
Open Access
Plasma short-chain fatty acid changes after bariatric surgery in patients with severe obesity
(Elsevier, 2023-01-31) Marıa Antonia, Martínez-Sánchez; Balaguer-Roman, Andrés; Fernández Ruiz, Virginia Esperanza; Almansa-Saura, Sonia; García-Zafra, Victoria; Ferrer Gómez, Mercedes; Frutos Bernal, María Dolores; Queipo-Ortuño, María I.; Ruiz Alcaraz, Antonio José; Nuñez-Sánchez, María A.; Ramos-Molina, Bruno; Bioquímica y Biología Molecular B e Inmunología; Facultad de Biología
Background: Obesity has reached epidemic dimensions in recent decades. Bariatric surgery (BS) is one of the most effective interventions for weight loss and metabolic improvement in patients with obesity. Short-chain fatty acids (SCFA) are gut microbiota-derived metabolites with a key role in body weight control and insulin sensitivity. Although BS is known to induce significant changes in the gut microbiota composition, its impact on the circulating levels of certain metabolites produced by the gut microbiota such as SCFA remains poorly understood. Objective: To determine the impact of BS on the circulating SCFA levels in patients with severe obesity. Setting University hospital. Methods: An observational, prospective study was performed on 51 patients undergoing Roux-en-Y gastric bypass. Plasma samples were collected at baseline (1 day before surgery) and at 6 and 12 months after BS. Plasma SCFA levels were determined by liquid chromatography–mass spectrometry. Results: The results revealed significant changes in the circulating levels of SCFA after BS. A marked increase in propionate, butyrate, isobutyrate, and isovalerate levels and a decrease in acetate, valerate, hexanoate, and heptanoate levels were observed 12 months after BS. Furthermore, the changes in the levels of propionate, butyrate, and isobutyrate negatively correlated with changes in body mass index, while those of isobutyrate correlated negatively with changes in the homeostatic model assessment for insulin resistance index. Conclusion: These results suggest that propionate, butyrate, and isobutyrate levels could be related to weight loss and improved insulin sensitivity in patients with severe obesity after BS.