Noticias

The doctoral research was carried out at the Translational Cardiology Unit of Navarrabiomed.

Biochemist Mattie Garaikoetxea Zubillaga has explored several aspects of chronic aortic regurgitation in his doctoral thesis, defended at the Public University of Navarre (UPNA). Chronic aortic regurgitation is a degenerative cardiovascular disease characterized by the inadequate closure of the aortic valve and occurs more frequently in men. Specifically, his research examined, on the one hand, sex-related differences in valvular interstitial and endothelial cells, and on the other, the potential benefits of mineralocorticoid receptor antagonism, a type of pharmacological treatment.
The research was conducted at the Translational Cardiology Unit of Navarrabiomed under the supervision of Natalia López Andrés, principal investigator of the unit, and Eva Jover García, head of the unit’s Arrhythmias research line.

As noted, chronic aortic regurgitation is a degenerative cardiovascular disease defined by the inadequate sealing of the aortic valve, resulting in an abnormal backward flow of blood from the aorta into the left ventricle of the heart. The prevalence of its most severe form is estimated at 1.6% of the Western population over the age of 65, and it is diagnosed three times more frequently in men.

Currently, there is no effective pharmacological treatment capable of slowing, halting, let alone reversing the disease. As a result, progression toward heart failure can only be prevented through surgery. “These interventions entail significant economic and socio-healthcare costs, making it essential to identify new therapeutic targets and effective drugs that could prevent disease progression,” explains the researcher.

Against this backdrop, the doctoral thesis had a dual objective. First, to analyze sex-related differences at the molecular and cellular level, considering the marked disparity in disease prevalence between men and women. Second, to investigate the role of the mineralocorticoid receptor protein in the development of the disease and assess its pharmacological blockade as a potential therapeutic strategy.

The study included a cohort of 144 patients, who donated serum samples and aortic valve tissue following surgery. “Using this tissue, we were able to analyze both gene and protein expression in the cells that make up the aortic valve, namely valvular interstitial cells and valvular endothelial cells,” explains the author.

Differences Between Men and Women

The findings showed that valvular interstitial cells from men and women undergoing surgery for chronic aortic regurgitation differ significantly. “Cells from male patients are more prone to developing fibrotic and inflammatory processes, whereas cells from female patients appear to be healthier,” the researcher notes. “The role of valvular endothelial cells was also examined, although sex-related differences were much more limited,” he adds.

The thesis further demonstrated that the mineralocorticoid receptor is present in the aortic valves of patients with chronic aortic regurgitation, with higher expression levels observed in male patients. Moreover, receptor expression was associated with increased levels of both inflammatory and fibrotic mediators. In other cardiovascular diseases, pharmacological blockade of this receptor, using drugs already employed in routine clinical practice in Spanish hospitals, has yielded substantial clinical benefits. “In line with these findings, we demonstrated that, at both the cellular and molecular levels, blocking this receptor prevents the pro-fibrotic and pro-inflammatory effects of its activation, processes that are associated with the development of aortic regurgitation,” explains Garaikoetxea. “Furthermore, aortic valves from patients who were receiving this type of medication for other conditions showed lower expression of inflammatory and fibrotic markers.”

Overall, the research has demonstrated for the first time that, at the cellular level, men exhibit greater activation of fibrotic and inflammatory pathways, as well as higher mineralocorticoid receptor expression, in the context of chronic aortic regurgitation. By contrast, cells from women display less pronounced or comparatively healthier processes, suggesting differences in the disease’s pathophysiology and progression between sexes. “The clinical implications of the sexual dimorphism currently observed in this disease will be investigated in future studies by our research group,” says Mattie Garaikoetxea.

“Finally, molecular-level benefits of mineralocorticoid receptor antagonism have been observed, opening the door to future studies that could confirm the therapeutic value of these drugs in chronic aortic regurgitation and potentially support their repositioning for this indication,” he concludes.

Brief CV of Mattie Garaikoetxea

Mattie Garaikoetxea holds a Bachelor’s Degree in Biochemistry from the University of Navarra and a Master’s Degree in Health Sciences Research from UPNA. He received a Navarrabiomed fellowship to carry out his doctoral research. The results of his work were recently presented at the Heart Valve Society Annual Meeting 2025 in Cairo, Egypt, under the title “Sex Differences in Aortic Valve Inflammation and Remodeling in Chronic Severe Aortic Regurgitation.” During his PhD, he also completed a research stay at the Centre de Recherche des Cordeliers in Paris.

He is the author of 17 scientific articles published in international journals and has presented research at around 30 national and international medical conferences. In addition, he has participated in six research projects funded by IdiSNA or Navarrabiomed.

Con fecha 19 de diciembre de 2025 se ha publicado la resolución definitiva de los Programas de Ayudas de Navarrabiomed 2025.

La Unidad de Gestión de la Investigación junto con el Comité Científico Interno, la Comisión de Evaluación y Seguimiento y el Panel de Evaluación de Navarrabiomed, tras evaluar los criterios de valoración establecidos en las bases reguladoras de las ayudas postdoctoral, predoctoral, predoctoral en el área de dimensión de género y MCVM de Navarrabiomed 2025, publica la adjudicación definitiva de los Programas de Ayudas de Navarrabiomed 2025.

A continuación, se facilita la documentación relacionada:

●    Permitirá simular la atención profesional en suturas, biopsias y venopunción 

Navarrabiomed – Fundación Miguel Servet y el Hospital Universitario de Navarra han firmado un convenio de colaboración con la empresa navarra Ysium Medical que permitirá la implantación en el SNS-O de dispositivos médico-quirúrgicos innovadores. Los desarrollos permitirán a los y las profesionales formarse y ensayar técnicas sanitarias como suturas, biopsias y venopunción, entre otros, previo a la realización de dichos procedimientos a pacientes. 

La Unidad de Innovación de Navarrabiomed y del Departamento de Salud tiene como objetivo promover, apoyar y canalizar las ideas e iniciativas de innovación procedentes del sistema público navarro de Salud. En este sentido, el convenio ahora firmado pretende optimizar y mejorar los procesos del ámbito sanitario, así como promover la docencia y adiestramiento de los y las profesionales con mayor realismo y detalle antes de la realización. 
 

Validación de kits de simulación 

Los nuevos desarrollos facilitarán innovadores kits de simulación para la práctica de suturas (cara y brazo), biopsias (seno, piel y médula ósea del esternón) y venopunción. Para su validación, Navarrabiomed coordina un grupo de trabajo que cuenta con la participación activa de profesionales de diversos Servicios y Unidades del Hospital Universitario de Navarra. 
Por el momento, se han celebrado varios encuentros para certificar la calidad, usabilidad y eficacia de los desarrollos y se prevé que los dispositivos finales acordados se implanten en el HUN en el segundo semestre de 2024.  
 

• El encuentro ha dado a conocer casos de éxito en los que se han involucrado profesionales del HUN, UPNA y Navarrabiomed. 

La Unidad de Innovación de Navarrabiomed - Fundación Miguel Servet organizó la mesa redonda “Y ahora, ¿qué hago con mi investigación?” el pasado jueves, 12 de diciembre con el objetivo de abordar cómo a partir de una idea, una invención, ésta puede valorizarse, protegerse y llegar a mercado. En el encuentro intervinieron Beatriz Pérez y Marina Galilea, responsable y asesora legal de la Unidad de Innovación, respectivamente, y tres profesionales del ámbito sanitario, universitario e investigador. 

En primer lugar, Gonzalo Alonso, cardiólogo del Hospital Universitario de Navarra, intervino para dar a conocer su experiencia en protección de la innovación como inventor en una patente de asistencia ventricular para pacientes con insuficiencia cardiaca y el estado actual del proceso para licenciarla a una empresa, fase en la que está siendo asesorado por el equipo de Innovación de Navarrabiomed. 

Para dar a conocer la protección y transferencia tecnológica al mercado en el ámbito universitario participó Iñaki Casado, Jefe de la Sección de Transferencia de conocimiento de la Universidad Pública de Navarra, que expuso cuatro casos de éxito de diversa tipología y temática.   

Por último, los asistentes conocieron el caso de Leyre Ruete, co-fundadora y CEO de la empresa Eversens, una spin-off de la UPNA creada en 2015 a partir de desarrollos surgidos en el ámbito investigador, que contaron con la colaboración del Hospital Universitario de Navarra y Navarrabiomed. En la actualidad diseñan, desarrollan, fabrican y comercializan soluciones de análisis de la respiración humana para detectar, de forma no invasiva, biomarcadores exhalados útiles para el diagnóstico y monitorización de diversas enfermedades.

Los tres testimonios pusieron de manifiesto la importancia que tiene la protección en el proceso de transferencia tecnológica. En concreto, incidieron en cómo antes de difundir cualquier resultado de investigación se debe reflexionar y buscar asesoramiento externo para tener en cuenta el marco regulatorio y establecer la forma más adecuada de proteger y explotar los hallazgos obtenidos. 
 

• Más información y contacto Unidad de Innovación Navarrabiomed-FMS. 

• 16 entities from six European countries will participate in this initiative, which has a budget of €5.2 million.

Navarra is leading this European project, which aims to purify wastewater in hospitals and healthcare facilities. A multidisciplinary team, made up of professionals from the Microbiology Service of the University Hospital of Navarra (HUN) and the Navarrabiomed Research Centre, is working on the development of a solution that also involves 16 entities from 6 European countries: Estonia, Poland, the Netherlands, Belgium, Greece, and Spain.
This project, called THERESA PCP, receives €5,287,206 in funding from the European Commission. For its implementation, it seeks specific technology for the on-site treatment of hospital wastewater through the public procurement procedure known as Compra Pública de Innovación (public procurement of innovation). Basically, public procurement of innovation is a form of public contracting whereby private sector companies are invited to submit proposals for technological or innovative solutions to a need for which there is currently no known solution.

The multidisciplinary team from Navarra is made up of healthcare professionals from the Microbiology and Management Department, the Administration Department, General Services at the University Hospital of Navarra, and from the Department of Health’s Innovation Unit and the Management Unit at Navarrabiomed – Miguel Servet Foundation. The Public Procurement for Innovation Section of the Universities, Innovation and Digital Transformation Department is also involved.

Milagros Larráyoz, Director of Economic Management and General Services at the University Hospital of Navarra, explains why the project is so important: “THERESA PCP will enable us to study solutions that will put Navarra’s public health service at the forefront of Europe’s environmental approach. We need to implement efficient, sustainable solutions that guarantee the responsible operation of the hospital environment, from carbon footprint measurement, through waste management, materials logistics and energy efficiency, to clinical actions involving digitisation, the prescription of diagnostic tests and the use of fluorinated gases, among other aspects”.

The THERESA PCP project has been awarded the highest possible score (15/15) in a Horizon Europe pre-commercial procurement call on environmentally sustainable, climate-neutral and circular health systems, in which 12 European consortia participated.
 
Comprehensive health for a “One Health” project

THERESA PCP is part of the European Commission's “One Health” initiative, which aims to balance and optimise the health of people, animals and ecosystems. Specifically, the project promotes environmental health and biodiversity, and works to minimise and reduce the potential impact of waste from the healthcare sector through proper management and treatment.
The solution will allow to study the prioritised elimination of antibiotics, antibiotic-resistant bacteria and antimicrobial resistance genes, all of which promote antimicrobial resistance. Contrast products used in diagnostic tests and cytostatic drugs administered in cancer treatments, among others, will also be eliminated. 

The technological implementation will be part of a Pre-commercial Procurement Process (PCP) involving seven hospitals, including the University Hospital of Navarra. In the coming months, a preliminary market consultation will be carried out, in which different entities are expected to propose their technological solutions to the need published in the consultation.
Subsequently, following a tender process, the first phase of the PCP, “Solution Design”, will begin, in which five companies will design technological prototypes for the group of hospitals. After they have been assessed, a total of 3 solutions will be chosen to continue to the second phase, “Prototype Development”. As a result of this phase, 2 of the prototypes will be selected to be validated on site in hospitals from 4 different European countries (each solution in two different hospitals), as part of the third phase of the PCP. The technological solution that shows the best results will be made available for the hospitals to acquire.

• The publication, distributed by the Springer-Nature group, is aimed at R&D environments associated with the fields of neuroscience and neurology.

Cerebrospinal fluid (CSF) Proteomics: Methods and Protocols is the second edition devoted exclusively to the in-depth molecular analysis of cerebrospinal fluid (CSF). The monograph, published by Springer Nature (in print and electronic formats in English), was coordinated by Enrique Santamaría, head of the Clinical Neuroproteomics Unit, and Joaquín Fernández-Irigoyen, head of the Proteomics Scientific and Technical Department, and assembles the latest advances in CSF molecular analysis, which is so important in protecting and maintaining brain activity.

This work follows on from the first edition of the manual, published in 2019, and now includes contributions from a total of 75 researchers from eight countries. It is structured into six sections, with a total of 22 chapters focusing on the different technological approaches that currently enable proteomic, metabolomic and bioinformatic analysis of CSF, facilitating both the understanding of the molecular information present in this fluid and the identification of biomarkers and therapeutic targets associated with neurodegenerative and psychiatric diseases.

“In recent years, new technologies have emerged that enable highly sensitive and specific molecular analyses, which, together with new developments in mass spectrometry, have revolutionised the way population studies associated with brain pathology are approached. We believe that this manual is a useful reference guide for students and researchers interested in -omic methodologies and precision medicine in neurology," says Enrique Santamaría.

• The conference, organised by Navarrabiomed and chaired by Vice-President Ana Ollo, included contributions from patients and professionals to move forward towards more equal and equitable research and healthcare at European level.

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Navarrabiomed held a conference today entitled “Impulsando una Europa de la Salud sin sesgo de género” (Promoting a Gender-Neutral European Health System), with the ultimate aim of contributing to the new European Equality Strategy. The Second Vice-President and Minister for Memory and Coexistence, External Action and the Basque Language of the Government of Navarra, Ana Ollo Hualde, and the Director General for External Action, Sergio Pérez García, took part in the event, which assembled 70 healthcare professionals, patient associations, institutional representatives and members of the public to consider persistent inequalities and share solutions.

The event, funded by the Directorate-General for External Action of the Government of Navarra, by means of the 2025 call for Grants for the dissemination of European Union policies and strategies, is part of the series of meetings entitled “Public health: researching and improving with Europe”, which the Navarra Joint Biomedical Research Centre has been organising for the past four years. 
Gender equality in health and biomedical research is not only a matter of social justice, but also a priority for ensuring more effective treatments, more accurate diagnoses and health policies tailored to the real needs of the entire population. With this premise in mind, Vice-President Ollo recalled the words of Hadja Lahbid, Commissioner for Equality, Preparedness and Crisis Management, spoken in the European Parliament: “Equality in health research is not optional,” she said, “it saves lives. Our biological differences affect diagnosis, response to treatment and rehabilitation... We must address the needs of all citizens, because a one-size-fits-all approach does not work in health policy.”
 
Towards a new European Equality Strategy

The conference comes at a key moment, following the presentation in March by the European Commission of its Roadmap on Women's Rights and the 2025 Report on Gender Equality. Both documents note that, although progress has been made, structural inequalities between women and men persist in the health and research fields. The European roadmap stresses the urgency of incorporating the gender dimension into the health field, calling for "higher standards in health, by supporting and complementing women's access to sexual and reproductive health and rights in full compliance with the Treaties, and promoting gender-sensitive medical research, clinical trials, diagnostics and treatments.”
To address these challenges, Lydia González Orta, senior European project officer for gender integration in R&D&I at the Spanish Foundation for Science and Technology (FECYT), shared the key elements of European policies in this area and highlighted initiatives such as GENDERACTION, GENDERNET Plus and SUPERA, which are working to reduce gender inequalities in scientific research. González pointed out that “gender equality is not irreversible, so we need to use all the tools we have at European level to ensure that health research systematically incorporates an inclusive gender analysis.”

The conference also served to highlight good practices spearheaded in Navarra in research and healthcare with a gender focus. Ernesto Martín Núñez, postdoctoral researcher at the Translational Cardiology Unit at Navarrabiomed, presented the line of research they are developing to study heart valve deterioration and the importance of taking the gender perspective into account in this field. 
Next, Elena Antoñanzas Baztán, Director of Health Strategy and Research at the Department of Health, analysed the gender assessment of Navarra's latest Health Plan and its principal conclusions. In addition, Andrea Ucar Vargas, Head of Communications at Navarrabiomed, presented proposals for social innovation, such as the use of forum theatre to raise awareness and discuss health with young people from an inclusive perspective.
 
Participatory forum to contribute to the future European Equality Strategy 

One of the central themes of the conference was a citizen participation forum structured into five working groups, organised according to the profile of the participants: researchers, health professionals, institutional representatives, patient associations and the general public. At these round tables, participants analysed the current situation based on their own experiences and identified the main challenges and obstacles that persist in their fields in relation to gender equality in health and biomedical research.
Based on this collaborative work, specific proposals and possible measures were also put forward that can be spearheaded by Europe to move towards more equitable, inclusive and gender-sensitive public health system.
The contributions gathered in this forum will be included in a conclusions report that Navarrabiomed will draw up in the coming weeks and send to the European Commission as Navarra's contribution to the open participation process to incorporate gender-neutral health into the future European Equality Strategy.
 

•  The findings of the Protein Crystallography and Structural Immunology Unit have been published in the following international journals: Scientific Reports y Communications Biology.

The Protein Crystallography and Structural Immunology Unit at Navarrabiomed, led by Jacinto López Sagaseta, recently published a study critically analysing the current limitations of artificial intelligence, specifically AlphaFold, in protein structure prediction. In a second study, conducted in collaboration with researchers from the National Cancer Institute  in the United States, the discovery of molecular configurations previously unknown in primitive organisms is described, which suggests that key structural elements of the adaptive immune system appeared much earlier than previously thought. 

The results, which have been published in scientific articles in Scientific Reports and Communications Biology,, offer new horizons in the design and development of new therapeutic proteins.

Furthermore, the relevance of this research has transcended the local academic sphere. Jacinto López Sagaseta, the researcher who led these studies, has been invited to present these findings at the Protein & Antibody Engineering Summit 2025,conference to be held in Lisbon next November, which will assemble experts from leading centres such as MIT, Scripps, Roche and Genentech, among many others. 

1. Severe deviation in protein fold prediction by advanced AI: a case study (Scientific Reports, 2025)

This study critically evaluates the current capabilities of artificial intelligence in protein structure prediction, focusing on AlphaFold.
 Using the protein SAML, derived from the marine sponge Geodia cydonium and composed of two domains, the authors compare the structure predicted by AlphaFold with that determined experimentally by X-ray crystallography.

The researchers observed that while AlphaFold accurately predicts the individual structure of each domain (RMSD < 0.9 Å), the AI tool fails to predict the relative orientation of the two domains. This result was confirmed even when expanding the conformational folding space of the protein in AlphaFold predictions. Furthermore, the researchers achieved two forms of crystallisation of RTK, a protein similar to SAML. In both forms, the folding of the protein is identical, indicating that the crystallised conformation is robust and a faithful reflection of the native conformation. The deviation obtained in the predictions is reflected in an RMSD greater than 7.7 Å when the experimental structure and the AlphaFold prediction are overlaid, or in deviations of over 30 Å for equivalent residues when overlaying one of the domains. On a human scale, it is as if, in an anatomical reconstruction, the head were placed at the level of the navel. This analogy highlights how serious an interdomain assembly error can be in structural biology, especially when these models are used to design drugs or antibodies, where precise interaction geometry is critical. Therefore, this study reveals that AlphaFold is an accurate prediction tool for low-complexity structures, but it does not adequately model the spatial arrangement of proteins composed of more than one domain, particularly when clear evolutionary constraints are lacking or when proteins have few homologues in the databases.

These results have direct implications for health and rational drug design. Many therapeutic proteins (antibodies, receptors, enzymes) depend on precise orientation between functional domains, and errors in their prediction can compromise target selection, inhibitor design, or antibody engineering. 

In conclusion, this work reiterates that AI generates theoretical models that may deviate from the actual structure of a protein, and highlights the need to prioritise experimental data, especially in sensitive biomedical contexts such as the development of new immunotherapies.

2. Unusual traits shape the architecture of the Ig ancestor molecule (Communications Biology, 2025)

In a second article published in March this year, and in collaboration with experts from the National Institute of Health in the United States, the researchers present a rigorous study of the crystallographic structures of two ancestral Ig-like proteins (SAML and RTK) from the marine sponge Geodia cydonium, representatives of one of the oldest Metazoa lineages. Both proteins have two tandem immunoglobulin domains.

Main findings:
•    The N-terminal domain exhibits a unique architecture, distinct from known Ig types, leading to the proposal of a new category: the Early Variable (EV-set) domain.
•    The C-terminal domain adopts a C1-set configuration, which until now was considered exclusive to vertebrates. This suggests that the basic architecture of surface immune receptors may have emerged long before the appearance of the adaptive immune system.
This discovery provides a new perspective on the structural evolution of immune systems and could inspire the development of new protein scaffolds for antibody engineering or TCR receptors. Furthermore, understanding how nature has reused these modular platforms for hundreds of millions of years can guide the design of synthetic receptors with evolutionarily optimised properties, useful in immunotherapy, diagnostics and cell therapies.

Conclusions

Both works, which focus on the structure of an ancestral protein, address key aspects of modern structural biology from different angles. The first exposes the limitations of current predictive models, warning of their risks in biomedical contexts. The second explores the evolutionary roots of Ig domains, suggesting that the basic architecture of immune recognition predates the adaptive immune system by a considerable margin.

As a whole, these studies not only enrich our understanding of the origin of immunity, but also offer conceptual and structural tools with great potential for application in modern biomedicine, from the design of therapeutic proteins to the development of diagnostic platforms.

 
Photo captions: 

• Figure 1: Overlaying of the structural model predicted by AlphaFold (yellow) and the structure determined by X-rays (blue). The turquoise spheres indicate equivalent atomic positions in both models. A discrepancy of 32 Å is observed, indicating a significant difference between the computational prediction and the actual conformation of the protein obtained by X-ray diffraction.
• Figure 2: The image shows canonical (lower panel) and non-canonical (upper panel) disulphide bridges, with alternative conformations detected by X-ray diffraction, in the SAML protein from Geodia cydonium. Early Variable and C1 immunoglobulin (Ig) domains are observed, identified for the first time in non-vertebrate organisms, with atoms coloured by type (grey: carbon, blue: nitrogen, red: oxygen, yellow: sulphur). The blue network represents the signal obtained through X-ray diffraction of SAML crystals by researchers at Navarrabiomed. 
   

• The study presented, which has led to the development of the application, was awarded second prize in the Health or Social Care category of the 2024 NAOS Awards.

This morning, the Department of Health, through the Miguel Servet-Navarrabiomed Foundation, presented a study carried out by its Physical Activity for Children and Youth Unit, which has succeeded in reducing the daily dose of insulin with no adverse effects in paediatric patients with type 1 diabetes by means of digital health and gamification techniques. Along with the Regional Minister of Health, Fernando Domínguez, the event was attended by representatives of those participating in the study: the University Hospital of Navarra (HUN)’s Paediatric Endocrinology Unit, Navarrabiomed’s Physical Activity Unit for Children and Young People, and the Navarra Diabetes Association (ANADI).

Minister of Health Domínguez underlined “the importance of collaboration between the biomedical research centre, the HUN healthcare service and the association for the development of this type of innovative initiative in the bio-health field, aimed at improving the quality of life of child and adolescent patients.” He also congratulated the entire team for winning second prize in the Health or Social Care category of the 2024 NAOS Awards organised by the Food Safety and Nutrition Agency, part of the Ministry of Social Rights, Consumer Affairs and the 2030 Agenda. 

The Navarrabiomed team has developed a comprehensive physical exercise programme using digital health techniques via a mobile app for children and young people with type 1 diabetes. The tool integrates physical activity with the monitoring of different health parameters that enable users to better control their glucose levels, improve their physical fitness, and also improves their ability to control the disease in a positive manner in their daily routine, accompanied by an improvement in their mental health. 

Type 1 diabetes is a chronic disease that often manifests itself at an early age—in Navarra, the average age of diagnosis is 7 years old—and is characterised by the attacking and destruction of the beta cells in the pancreas by the immune system. This action leads to insufficient insulin production and can trigger a dangerous increase in glucose. Every year, between 1,200 and 1,500 new cases of type 1 diabetes are diagnosed in children under the age of 15 in Spain. There are currently 175 people under the age of 15 in Navarra diagnosed with type 1 diabetes. The World Health Organisation lists Spain as one of the countries with a very high incidence of type 1 diabetes in the paediatric age group. 

The research shows that young people with type 1 diabetes have lower levels of muscle strength and a more sedentary lifestyle due to their condition and their fear of hypoglycaemia. The principal investigator of the Physical Activity in Children and Adolescents Unit and tenured professor at the UPNA, Antonio García-Hermoso, highlights the importance of working with these patients during childhood: “Overcoming this challenge involves tailoring exercise routines to each individual case to improve muscle strength and educate patients about how to manage glucose during physical activity, providing them with comprehensive support and follow-up care.”  
 
Participation of 61 minors with type 1 diabetes

The research was conducted between 2022 and 2024 and was funded by the Carlos III Health Institute, and was managed and coordinated by the Miguel Servet-Navarrabiomed Foundation. In the initial phase, Navarrabiomed conducted an epidemiological surveillance study in children and adolescents with type 1 diabetes, examining various health indicators and healthy habits, including physical activity levels and dietary patterns over a three-year period. 

Every year, patients and their families have received an exhaustive report that includes various parameters evaluated in order to raise their awareness of the need to improve or maintain these parameters. After evaluating 83 young people with type 1 diabetes, it was found that only 18% carried out the recommended three muscle-strengthening sessions per week. 

A total of 61 children with type 1 diabetes participated in the randomised controlled trial. Participants were randomly assigned to one of two groups: one group carried out an individualised strength training programme at least three times a week (following WHO and ADA guidelines) for 24 weeks using the Diactive-1 app, and a control group on a waiting list, which received the necessary materials and the app for use at the end of the trial period. The app has over 350 exercises, all guided by a 3D avatar that gives patients detailed instructions during each exercise, specifying the weights, sets, and reps to do.

The study found a significant reduction of 0.17 U/kg in daily insulin doses and a downward trend in glycated haemoglobin in patients compared to the control group that did not use the app. This improvement in glycemic control helps prevent adverse glucose-related events, such as hypoglycaemia, offering greater stability for patients and a reduction in the medication associated with the disease.

In terms of body composition, significant improvements have been achieved in total lean mass and bone mineral content, indicators directly linked to healthy development in children and adolescents with type 1 diabetes. An improvement in muscle strength and power is observed, evidenced by an increase in handgrip strength and a rise of more than 14 percentiles compared to European references according to age and sex.
It is important to note that several participants in the intervention and control groups continue to use the app today, demonstrating a good adherence to the app among children and adolescents. These results indicate that Diactive-1 not only contributes to improving clinical parameters, but also promotes treatment adherence and motivates the study population, establishing itself as an innovative tool with a positive impact on overall health and quality of life, which promotes the empowerment of these patients. 

The results of the study have been published in the scientific journal Diabetes Care under the title Effect of Diactive-1 mHealth-Supported Progressive Resistance Training on Insulin Requirements, Glycemic Stability, and Muscular Strength in Children and Adolescents With Type 1 Diabetes: A Parallel-Group Randomized Controlled Trial. 

The tool has also enabled a detailed record of more than 2,000 physical exercise sessions to be compiled, including data on pre- and post-exercise blood glucose levels, trends, training times, exercises performed and heart rate during the session. This volume of information, combined with machine learning techniques, will allow interventions to be personalised even further, maximising the app’s impact on health and the management of type 1 diabetes.
 
Continuity and sustainability of the project 

During 2024, the research team once again obtained funding from the Carlos III Health Institute to implement the app developed in 11 hospitals: the University Hospital of Navarra (Pamplona / Iruña), University Hospital of Cruces (Barakaldo), Barbastro Hospital (Huesca), San Jorge General Hospital (Huesca), Araba University Hospital (Vitoria-Gasteiz), Marqués de Valdecilla University Hospital (Santander), Cabueñes University Hospital (Gijón), San Millán-San Pedro Hospital (Logroño), Lozano Blesa University Clinical Hospital (Zaragoza), Central University Hospital of Asturias (Oviedo) and Miguel Servet University Hospital (Zaragoza), all of which are members of the Northern Paediatric Endocrinology Group.
This new project, which will be managed by the Healthcare Research Institute of Navarra (IdiSNA), aims to reach more than 200 patients from different geographical contexts, in order to extrapolate and evaluate the data obtained in Navarra and position the Diactive-1 app as a nationwide clinical benchmark tool for the management of type 1 diabetes in children and adolescents. 
 
18th NAOS Strategy Awards, 2024 edition

This project was recently awarded second prize in the Health or Social Care category of the Awards organised by the Spanish Agency for Food Safety and Nutrition, part of the Ministry of Social Rights, Consumer Affairs and the 2030 Agenda. This acknowledgement highlights digital innovation serving children’s health and supports the work of Navarrabiomed's Physical Activity in Children and Adolescents Unit in improving the non-pharmacological management of type 1 diabetes through personalised technological solutions.

• Con el eslogan “¡Si te llaman, ven!”, Salud recalca la importancia de que la ciudadanía seleccionada participe en el estudio
   

El estudio nacional Cohorte IMPaCT celebra su primer año de andadura en Navarra alcanzando los 200 participantes seleccionados de forma aleatorizada para participar en este proyecto de investigación epidemiológica del Programa de Medicina Predictiva de la Infraestructura IMPaCT (Infraestructura de Medicina de Precisión asociada a la Ciencia y la Tecnología), para comprender y mejorar la salud de la población española. A nivel nacional el estudio ya cuenta con un total de 10.000 personas implicadas. El Departamento de Salud anima a toda la ciudadanía contactada a sumarse a este estudio difundiendo el eslogan “¡Si te llaman, ven! / Deitzen badizute, etorri!”, que permitirá ofrecer un diagnóstico de la salud de la población española durante 20 años. 

La iniciativa, que cuenta con una financiación global de 35 millones de euros, está impulsada por el Instituto de Salud Carlos III, y está coordinada por el Centro de Investigación Biomédica en Red (CIBER). En ella participan 21 instituciones y los servicios de Atención Primaria de todas las comunidades autónomas. Este proyecto permitirá conocer el origen de las principales enfermedades con el fin de ayudar a prevenirlas y tratarlas, y avanzar hacia una medicina personalizada y de precisión. 

En Navarra, Cohorte IMPaCT se gestiona desde el centro de investigación biomédica Navarrabiomed – Fundación Miguel Servet y Atención Primaria del Servicio Navarro de Salud – Osasunbidea es quien coordina y ejecuta el estudio con el centro de salud de Lezkairu como nodo del proyecto. Los doctores Patricia Palacio y Óscar Lecea, investigadora principal y colaborador del estudio, respectivamente, lideran el equipo de trabajo formado por tres técnicos. Además, el proyecto cuenta con la colaboración de una enfermera del CS de Lezkairu y varios médicos del Centro de Salud de Mutilva / Mutiloa, así como con el apoyo de la Gerencia de Atención Primaria.
 

Estudio pionero

El Departamento de Salud insiste en la importancia de participar en el estudio, ya que los datos que se obtendrán en Cohorte IMPaCT permitirán a la comunidad científica conocer mejor cómo prevenir las principales enfermedades y el deterioro asociado a la edad, las lesiones y la discapacidad. Disponer en España de un registro dinámico de datos individuales y poblacionales, clínicos, genéticos, epidemiológicos y de hábitos de vida, facilitará desarrollar modelos predictivos de enfermedad, identificar las desigualdades en salud, monitorizar indicadores clave y evaluar el impacto de políticas sanitarias.

Las personas seleccionadas por el SNS-O recibirán un mensaje de texto indicándoles que les contactarán desde el centro de salud de Lezkairu invitándoles a participar en el estudio y un enlace a la web informativa donde podrán encontrar todos los detalles. El mensaje tendrá como destinatario “Salud Comunicaciones” y tendrá el siguiente texto, tanto en su versión en castellano como en euskera:

[Nombre +iniciales apellidos]: Estamos realizando un estudio sobre salud de la población navarra Cohorte IMPaCT. Te llamaremos del Centro de Salud de Lezkairu para invitarte a participar. + información:  portalsalud.navarra.es/es/cohorte
[Izena + hasierako abizenak]: Nafarroako biztanleriaren osasunari buruzko azterlan bat egiten ari gara IMPaCT Kohortea. Lezkairuko Osasun Zentroak parte hartzera gonbidatzeko deituko dizu. Informazio +:  portalsalud.navarra.es/eu/kohortea
Implicación de 4.000 personas

Hasta el año 2029 se prevé la incorporación de otras 3.800 personas residentes en Navarra, de entre 16 y 79 años, de las cuatro zonas básicas de salud seleccionadas: Lezkairu, Segundo Ensanche, Milagrosa y Valle de Aranguren. Para garantizar una fiel representación de la población española, los y las participantes son elegidos al azar, bajo los mismos criterios en todas las comunidades autónomas. 

Al comienzo de su participación y una vez cada cinco años, se les realizará en el centro de salud de Lezkairu un completo examen físico, responderán a un detallado cuestionario de salud y se les realizará una toma de muestras biológicas. Además, se realizarán contactos de seguimiento más frecuentes por teléfono o mediante aplicaciones móviles. Toda esta información se completará con la que hay disponible en las bases de datos clínicas o estadísticas del SNS-O.