Projects

RESEARCH PROJECTS

Below are all the research projects that are using data and samples from Cantabria Cohort:

Title: Impacto de la carga familiar de enfermedad de Alzheimer sobre el perfil cognitivo y funcional en adultos sin diagnóstico clínico: análisis en la Cohorte Cantabria
Aim: Caracterizar, en adultos cognitivamente intactos, con y sin antecedentes familiares de Alzheimer, las diferencias en el rendimiento cognitivo, e investigar cómo la actividad física habitual y la percepción subjetiva de salud modulan esta asociación.
Details and scientific description


Conducting entity: Universidad Antonio de Nebrija
Principal investigator: Ana Isabel Beltrán Velasco

El estudio investiga cómo los antecedentes familiares de la enfermedad de Alzheimer y los hábitos de vida pueden influir en el funcionamiento cognitivo de personas adultas que aún no presentan problemas de memoria ni deterioro cognitivo. A partir de datos ya disponibles en la cohorte, se analizará el rendimiento cognitivo, los hábitos de actividad física y la percepción de salud en más de 1.600 personas mayores de 40 años. El objetivo es comprender mejor qué señales tempranas pueden aparecer muchos años antes del diagnóstico y cómo factores del estilo de vida, como el ejercicio físico y una buena percepción de la propia salud, pueden desempeñar un papel protector. Esta información permitirá avanzar en la detección precoz del riesgo y en el diseño de estrategias preventivas accesibles para la población general.


Title: Preventing Dementia and Stroke: Analysis of Modifiable Risk Factors in the Population of Cantabria
Aim: Calculate the frequency of the main vascular and dementia risk factors in Cantabria Cohort and incorporate this information into the activities of the JADE Health initiative.
Details and scientific description


Conducting entity: IDIVAL
Principal investigator: Dra. Carmen Lage Martínez

Funding organization: EU4Health Programme, funded by the European Union

This is a descriptive study based on data collected by Cantabria Cohort to explore the main modifiable risk factors for neurodegenerative and neurovascular diseases in our community. This project is part of the European initiative JADE Health, in which IDIVAL is a participant. The initiative aims to investigate community- and country-specific risk factors, estimate the number of potentially preventable cases, and analyze the existing surveillance systems for these risk factors in each country.


Title: Impact of Circadian Disruption on Cardiometabolic Health and the Development of Chronic Diseases: Exploring the Role of Inflammation
Aim: To evaluate the impact of disruption in the sleep-wake cycle on the development of chronic systemic inflammation, a cardiometabolic risk profile, and chronic diseases such as type 2 diabetes, depression, and cardiovascular diseases.
Details and scientific description


Conducting entity: IDIVAL – Cantabria Cohort
Principal investigator: Dr. Trinidad Dierssen Sotos and Dr. Juan Irure Ventura

Funding organization: Instituto de Salud Carlos III (AES 2024)

Studies examining the relationship between circadian disruption (CD) and the development of chronic diseases have yielded inconsistent results. It has been suggested that chronic systemic inflammation (CSI) may act as a mediator in this association, although this hypothesis has not been sufficiently tested, nor has the potential modifying effect of factors such as sex or chronotype been thoroughly explored. This study aims to assess the impact of CD on CSI, cardiometabolic risk profile, and the onset of chronic diseases, within the framework of a prospective cohort study involving 25,000 participants from the Cantabria Cohort (CoCAN group). CD will be assessed using questionnaires covering work shifts, sleep patterns, chronotype, meal timing, and exposure to artificial light at night (ALAN). CSI will be measured using two indices derived from the complete blood count, while the cardiometabolic profile will be evaluated at baseline and after four years through bioimpedance analysis, lipid profile, HbA1c, and HOMA-IR. The incidence of chronic diseases will be tracked through record linkage and follow-up questionnaires. Additionally, a subgroup of 1,000 participants recruited since January 2023 (CoCIR group) will undergo a more in-depth assessment of CD and CSI. In this subgroup, inflammation indices from the blood count will be validated against circulating profiles of pro- and anti-inflammatory cytokines; the reliability of sleep questionnaires will be assessed using activity trackers, and ALAN questionnaires will be validated with luxometers. Blood pressure will also be measured at the beginning and end of the follow-up period.


Title: Validation of a precision medicine tool based on online cognitive assessment, genetic risk stratification, and blood-based biomarkers for the identification of preclinical Alzheimer's disease.
Aim: Improve the prevention and diagnosis of Alzheimer’s disease by integrating precision medicine tools that enable the development of strategies to identify cases in the early stages of the disease.
Details and scientific description


Conducting entity: Fundación CIEN
Principal investigator: Dr. Pascual Jesús Sánchez Juan

Funding organization: Instituto de Salud Carlos III, funded by the European NextGenEU funds supporting actions under the Recovery and Resilience Facility.

The SCAP-AD project (Cognitive Screening and Personalized Approach for Alzheimer’s and other Dementias) is a multicenter initiative coordinated by Fundación CIEN, involving 13 centers across 8 autonomous communities from the DEGESCO consortium. The main objective is to validate a precision medicine tool based on online cognitive assessment, genetic risk stratification, and plasma biomarker analysis for the identification of preclinical Alzheimer’s disease (PMP22/00022). To achieve this, two large cohorts will be developed in parallel. On one hand, a digital cohort will explore the use of digital biomarkers through online tools in adults over 60 years old. On the other hand, a clinical validation cohort of 2,000 individuals over 60 years of age, without a diagnosis of dementia, will undergo an in-depth assessment including clinical and neuropsychological evaluations, biomarker analysis (CSF and plasma), and magnetic resonance imaging.


Title: Cantabria in shape: A Strategic Project for the Prevention of Obesity and Overweight in the Child Population of Cantabria
Aim: Analyze the sociodemographic factors and lifestyle habits of schoolchildren and their caregivers, as well as identify the main determinants of overweight and obesity in the participants of Cantabria Cohort.
Details and scientific description


Conducting entity: General Directorate of Public Health through the Public Health Observatory of Cantabria and Cantabria Cohort, Valdecilla Research Institute Foundation (IDIVAL)
Principal investigator: Laura Rasines Pérez

Childhood obesity has serious short-term consequences and predisposes individuals to chronic diseases in adulthood, making early intervention and coordinated efforts between the healthcare, educational, and community sectors urgent. Despite previous efforts, childhood obesity rates in Cantabria have risen, reaching 8.2% in 2022. This situation highlights the need for more effective policies, grounded in scientific evidence and an integrated approach that includes both children and their families. The Directorate General of Public Health, through the Public Health Observatory of Cantabria, in collaboration with Cantabria Cohort-IDIVAL and the Ministry of Education, aims to collect real data on overweight and childhood obesity to design effective preventive strategies for the benefit of society as a whole. Through a detailed questionnaire, the goal is to gather comprehensive information on lifestyle habits and demographic characteristics of the population aged 6 to 16 years, allowing for the identification of associations. Additionally, data from Cantabria Cohort, comprising 50,000 volunteers, will be analyzed to determine the factors contributing to excess weight in the population of Cantabria.


Title: Biomonitoring of Persistent Organic Pollutants and Endocrine Disruptors in a Representative Sample of the Population of Cantabria (Cantabria Cohort)
Aim: To assess exposure to persistent organic pollutants and endocrine disruptors in participants of Cantabria Cohort and analyze their relationship with demographic factors, lifestyle, and medical history.
Details and scientific description


Conducting entity: HUMV – IDIVAL
Principal investigator: María Teresa García Unzueta, MD, PhD
Funding organization: Spanish Ministry of Health

Exposure to persistent organic pollutants (POPs) and endocrine disruptors (EDs) poses a significant public health risk. This project aims to assess the exposure of the Cantabrian population to these compounds through biomonitoring of participants in Cantabria Cohort, identifying risk factors and promoting preventive strategies. Researchers have access to a high-resolution mass spectrometry system (Orbitrap 120), enabling reliable analysis of various contaminants such as BPA, phthalates, parabens, and perfluorinated compounds. The results will provide essential information to guide public policies and reduce exposure to these harmful substances.


Title: Prevalence and Risk Factors of Advanced Metabolic Liver Disease in Women with Premature Ovarian Insufficiency
Aim: To determine the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and liver fibrosis in women with premature ovarian insufficiency (POI) or diminished ovarian reserve (DOR).
Details and scientific description


Conducting entity: HUMV – IDIVAL
Principal investigator: María Teresa Arias Loste, MD, PhD

There are no direct epidemiological studies linking premature ovarian insufficiency (POI) with metabolic dysfunction-associated steatotic liver disease (MASLD). However, some findings suggest a possible connection between these conditions. Women with POI exhibit metabolic alterations such as insulin resistance, dyslipidemia, and elevated liver enzymes, which could contribute to the development of MASLD. Additionally, POI has been associated with a higher risk of autoimmune diseases, some of which may impact liver function.
On the other hand, MASLD has been associated with polycystic ovary syndrome (PCOS), another endocrine condition that shares mechanisms such as insulin resistance and hyperandrogenism. Although the relationship between POI and MASLD has not been specifically studied, their common metabolic and autoimmune alterations suggest a potential link between the two. Further research is needed to determine whether women with POI have a higher risk of developing MASLD or vice versa.
The main objective of this study is to determine the prevalence of MASLD and liver fibrosis in women with POI or diminished ovarian reserve (DOR). Additionally, the study aims to evaluate the metabolic, hormonal, and autoimmune risk factors associated with MASLD in this population, as well as compare the metabolic and hepatic characteristics between women with and without POI/DOR. Finally, the study seeks to identify potential causal or correlative associations between ovarian alterations and liver fibrosis, which could contribute to a better understanding of the shared pathophysiological mechanisms.


Title: Genetic Biomarkers of the Cannabinoid System in Alcohol Use Disorder
Aim: To study the association of genetic biomarkers of the cannabinoid system in patients with alcohol use disorder.
Details and scientific description


Conducting entity: ISABIAL – Universidad Miguel Hernández (UMH)
Principal investigator: Dr. Jorge Manzanares
Funding organization: Instituto de Salud Carlos III

The development of Alcohol Use Disorder (AUD) is influenced by multiple bio-psycho-social factors. Genetic variability explains part of the individual differences in the predisposition to develop AUD. Despite the existence of various studies focusing on genetic variants in different genes encoding proteins involved in the cannabinoid system, there is no clear evidence of their implications in alcohol use disorder. Therefore, the objective of this study is to delve deeper into this topic and obtain consistent results that will help improve the management of this disorder, thereby enhancing the quality of life of these patients.
The working hypothesis suggests that the proportion of genetic variants present in the cannabinoid system in the population with Alcohol Use Disorder (AUD) is different from the proportion of these same variants in the healthy population. To test this hypothesis, an analytical cross-sectional study is proposed, where the independent variable is the presence/absence of genetic variants in the CNR1, CNR2, GPR55, and FAAH genes, and the dependent variable is the development/no development of AUD.


Title: ImpactT2D: A Genomic Strategy to Implement Precision Medicine in Type 2 Diabetes
Aim: Develop genomic tools to personalize type 2 diabetes treatment by grouping patients based on genetic profiles and treatment responses, using data from Cantabria Cohort and whole genome analyses.
Details and scientific description


Conducting entity: Centre for Genomic Regulation (CRG)
Principal investigator: Dr. Jorge Ferrer
Funding organization: Instituto de Salud Carlos III

Whole genome sequences are becoming more accessible, but further studies are needed to prove their usefulness in common diseases like type 2 diabetes (T2D). T2D affects about 14% of the Spanish adult population, is a leading cause of mortality and healthcare costs, and is highly heterogeneous but lacks markers for personalized treatment decisions.
Los scores de riesgo poligénico (PRS) tienen potencial para discriminar diferentes mecanismos de riesgo para DT2. Por otra parte, un pequeño conjunto de pacientes alberga mutaciones codificantes capaces de guiar decisiones clínicas. El estudio DecodeDiabetes ha identificado mutaciones no codificantes compartidas por pacientes con diabetes monogénicas y DT2. ImpactT2D desplegará una estrategia para demostrar la aplicabilidad clínica de la información genómica en DT2. Con este fin, obtendrá genomas completos de una cohorte singular de 1000 pacientes con un subfenotipo DT2 que maximiza la carga genética. Definirá PRS particionados y variantes raras causales, y utilizará herramientas de IA para desarrollar modelos de estratificación. Validará estos modelos en pacientes con criterios fenotípicos más amplios, y desarrollará mecanismos para implementar estos conocimientos en el sistema de salud.
ImpactT2D aligns with precision medicine and genomic initiatives for T2D in Spanish and international healthcare centers. It leverages a network of primary care providers, clinical researchers, relevant clinical and genomic cohorts, and multidisciplinary expertise in AI, clinical trials, genomics, and genetics, aiming to deliver transformative insights for precision medicine in T2D.


Title: Technical validation by Valdecilla Biobank of the technology developed by 300K Solutions SL for the stabilization and preservation of biological samples at room temperature as an alternative to ultra-freezing.
Aim: Exploring lyophilization as an alternative to ultra-freezing (-80°C) for preserving plasma samples from 40 participants of Cantabria Cohort
Details and scientific description


Conducting entity: 300K Solutions S.L.
Principal investigator: Marta Martín Ayuso

One of the alternatives to freezing as a more sustainable method for preserving biological samples stored in biobanks is lyophilization, a dehydration methodology for biological samples that allows their maintenance at Room Temperature (RT) for long periods of time. 300K Solutions S.L. has developed proprietary technology that provides biobanks with a tool to stabilize dry samples, combining precision lyophilization technology with protective reagents for the sample and vial formats that ensure traceability in biobanks.
The present study aims to compare the quality of lyophilized plasma samples with fresh and frozen samples. The objective is to validate lyophilization as a viable storage format while maintaining the quality of biological samples at RT. To achieve this, two quantifiable circulating proteins in plasma, with significant clinical utility, will be measured: Calprotectin (CPc) and Intact Parathyroid Hormone (PTHi). The concentrations of these two molecules vary greatly depending on pre-analytical conditions, making them very useful markers for assessing the quality of samples subjected to the lyophilization process as a long-term storage method compared to cryopreservation at -80°C.


Title: Metabolomic characterization of the Spanish population through the analysis of urine and serum samples.
Aim: Refining and improving the metabolomic profile related to metabolic syndrome, as well as prospectively analyze changes in the metabolome over time.
Details and scientific description


Conducting entity: CIC bioGUNE/Precision Medicin & Metabolism Laboratory
Principal investigator: Dr. Óscar Millet
Funding organization: ELKARTEK bG21 “Plataforma de medicina de Precisión en la Comunidad Autónoma del País Vasco. Implicación y aplicaciones al estudio de las alteraciones metabólicas en COVID-19 y en Síndrome Metabólico”

Metabolic syndrome has become a global pandemic due to unhealthy lifestyle habits such as lack of exercise and high-calorie diets. Despite numerous studies to date, a clinically useful group of biomarkers has not yet been identified. The composition of the metabolome (the set of small molecules present in biological materials such as serum and urine) is also influenced by lifestyle, diseases, and diet. Therefore, studying it through techniques such as Nuclear Magnetic Resonance (NMR) can contribute to a better understanding of this disease.
This project aims to refine and improve the metabolomic profile studied in a previous project and analyze its relationship with metabolic syndrome. Additionally, a prospective study will be conducted to examine changes in the metabolome of individuals over time. Serum and urine samples will be collected through the National Biobank Network, and the metabolites and lipoproteins present in these samples will be analyzed using NMR.


Title: Standardization in flow cytometry through algorithms and prediction of CMV infection
Aim: Validating a prediction model that allows the classification of patients according to their CMV serology (detection of antibodies against cytomegalovirus)
Details and scientific description


Conducting entity: HUMV – Hospital Universitario de Regensburg (Alemania)
Principal investigator: Dr. James Hutchinson
Funding organization: Fondos europeos

The project aims to validate a new algorithm developed by Dr. Hutchinson's laboratory for patient classification using flow cytometry data. This algorithm has been shown effective in predicting CMV serology of patients using the "Duraclone T cell panel" equipment via flow cytometry. The objective is to validate this algorithm on another instrument, laboratory, and patient cohort, specifically on the Cytoflex-DH cytometer used by the requesting research group. The validation seeks to confirm the robustness and generalization of the CMV serology prediction models developed by Hutchinson's laboratory.


Title: Validation of circulating miRNAs in the early diagnosis of breast cancer
Aim: Establish new markers (miRNAs) in the blood for the early diagnosis of breast cancer.
Details and scientific description


Principal investigator: Jéssica Alonso Molero, PhD
Funding Agency: Instituto de Investigación Marqués de Valdecilla (IDIVAL)
Funding: 5.000 €
Call resolution: NEXT-VAL 2023: NVAL23/03

The early diagnosis of tumors such as breast cancer is one of the main goals in the field of public health. Among the tools for early detection of breast cancer, the recommendation stands out for biennial mammography in women aged 50 to 74, although its effectiveness is a subject of debate. Currently, with the advent of Next Generation Sequencing (NGS) techniques, other screening methods based on genetic factors, such as circulating miRNAs, are being proposed. MiRNAs are small RNA molecules characterized mainly by being endogenous, non-coding, and highly stable. Additionally, they exhibit two key characteristics for diagnostic use: i) They are present in blood serum, making it a minimally invasive diagnostic technique; ii) miRNAs are tissue-specific, so different tumors show different expression profiles. Thus, when used as biomarkers, they could not only reveal the presence of a tumor but also identify the type of cancer it is. In a previous study by the Department of Preventive Medicine and Public Health at the University of Cantabria, 11 miRNAs with differential expression were found in cases of breast cancer compared to healthy controls. The main objective of this project is to analyze these miRNAs in a set of subjects from the Cantabria Cohort to verify their reproducibility and validity as a tool for the early diagnosis of breast cancer.


Title: Analysis of immune response in different immunizing situations during the pandemic in a prospective cohort (Cantabria Cohort). Future strategies in COVID-19.
Aim: Determine the duration of protection provided by vaccination against the SARS-CoV-2 virus, the causative agent of COVID-19, in participants of the Cantabria Cohort.
Details and scientific description


Principal investigator: Marcos López Hoyos, MD, PhD
Funding Agency: Instituto de Salud Carlos III
Funding: 147.620 €
Call resolution: AES 2022: PI22/01715

The objective of the study is to comprehensively characterize the immune response to SARS-CoV-2 infection in adults from the Cantabria Cohort project. This versatile cohort in Personalized Medicine comprises over 23,000 volunteers recruited in less than 2 years. Unlike clinical trials, this cohort involves a combination of various natural infection, vaccination, and reinfection scenarios to assess the duration of immunity concerning exposure to the SARS-CoV-2 virus. Studying the decline in immune response in different combinations will contribute to a better definition of vaccination strategies against the SARS-CoV-2 virus, with clear translational potential in the coming years for COVID-19 vaccination strategies. Additionally, exploring autoimmune features in COVID-19 patients and vaccinated individuals will enhance our understanding of potential long-term side effects and adverse effects resulting from SARS-CoV-2 infection and/or vaccination, possibly contributing to the poorly defined condition known as long COVID. The findings of this project will yield crucial insights for combating SARS-CoV-2 and characterizing key aspects of immune memory.

More information about the project here.


Title: From Reactive to Predictive Medicine in NAFLD: Identification of a New Signature for Early NAFLD Progression.
Aim: Identifying novel inflammation markers associated with non-alcoholic fatty liver disease (NAFLD) to prevent the progression of the pathology.
Details and scientific description


Principal investigator: Javier Crespo, MD, PhD
Funding Agency: Instituto de Salud Carlos III
Funding: 123.178,00 €
Call resolution: AES 2022: PI22/01853

Non-alcoholic fatty liver disease (NAFLD) is a complex and heterogeneous disorder in terms of underlying causes, presentation, progression, and prognosis. Numerous factors influence NAFLD progression, and it is considered a multisystemic condition where cardiovascular pathologies are the primary cause of disease and mortality. The advanced stage of NAFLD accentuates the scarring process in response to liver damage (fibrosis), a significant predictor of mortality in NAFLD patients. Currently, there is a need to develop new tools for predicting NAFLD progression to provide appropriate management that can reduce mortality. The ultimate goal of this project is to improve the health and quality of life of NAFLD patients. This patient-centered project aims to shift from a reactive to predictive medicine and health promotion. In this regard, the development of biomarkers capable of detecting inflammation before the fibrotic process begins will enable Precision Medicine to anticipate the development of significant liver disease.

More information about the project here.


Title: Discovering chronic inflammation biomarkers that define key stages in the Healthy-to-NASH (non-alcoholic steatohepatitis) transition to inform early prevention and treatment strategies
Aim: Identifying new inflammation markers in advanced non-alcoholic steatohepatitis (NASH) to enhance the management of this pathology in participants of the Cantabria Cohort.
Details and scientific description


Funding Agency: European Commission (HORIZON Programme)
Funding: 6.348.927,28 €
Call resolution: Proyecto Halt-RONIN

Non-alcoholic fatty liver disease is a chronic multifactorial condition affecting 1 in 4 individuals, representing a significant personal, socioeconomic, and healthcare burden, particularly in the advanced and severe stages of the disease. Despite its substantial negative impact on society, this pathology remains challenging to diagnose and treat. Therefore, this project aims to uncover early triggers of the disease and its progression mechanisms to enhance existing detection methods, formulate plans to disseminate new personalized intervention strategies, and discover novel drugs. This approach will equip healthcare professionals with the tools and knowledge needed for diagnosis, prevention, and treatment guidelines. In the long term, the project seeks to reduce the number of patients with severe forms of the disease and provide strategies to improve patient outcomes. Researchers from various Spanish and European institutions collaborate on this project, with the Cantabria Cohort providing pseudo-anonymized clinical data and biological samples to the responsible investigators.

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More information about the project here.


Title: Prevalence and Characterization of ACOX2 Deficiency-Associated Hypertransaminasemia (HADA) in the Cantabria Population. ANJANA Project.
Aim: Determine the prevalence of HADA, a rare genetic disorder, among participants in the Cantabria Cohort.
Details and scientific description


Principal investigator: Marta Alonso Peña, PhD
Funding Agency: Instituto de Investigación Marqués de Valdecilla (IDIVAL)
Funding: 8.500 €
Call resolution: Proyecto Anjana (HADA-Cantabria)(NVAL 22/04)

Hypertransaminasemia is a common finding in routine laboratory tests and often indicates liver injury due to medication or the presence of metabolic liver disease. However, the cause of up to 15% of cases of persistent hypertransaminasemia in adults remains unknown. Acyl-CoA Oxidase 2 (ACOX2) Deficiency-Associated Hypertransaminasemia (HADA) is a recently discovered rare genetic disorder resulting from an inherited alteration. Currently, five affected families have been identified, with two residing in Cantabria. Therefore, this project, funded through the Next-Val call from IDIVAL, will investigate the prevalence of HADA-causing mutations in participants of the Cantabria Cohort with a history of recurrent hypertransaminasemia. This will aid in identifying new cases and enhance understanding of the progression, diagnosis, and treatment of this condition. Cantabria Cohort will provide responsible researchers with pseudo-anonymized clinical data and DNA samples to facilitate the genetic study.

More information about the project here.


Title: FOCUS Project
Aim: Detect and, if necessary, treat hepatitis virus (B and C) and human immunodeficiency virus (HIV) infections among all participants in the Cantabria Cohort.
Details and scientific description


Collaborating Company: Gilead Sciences S.L.U.
Funding: 190.000 €
Call resolution: FOCUS Project

The FOCUS Program, launched by the Gilead Group, is a collaborative public health initiative aimed at ultimately improving the prevention, diagnosis, and care of bloodborne virus infections. Gilead Sciences is a biopharmaceutical company that, in adherence to its commitment to health research, aims to contribute to the development of research activities, training, health promotion, and the humanization of spaces in healthcare facilities in Cantabria. This collaboration agreement with the Cantabrian Health Service is non-commercial in nature and focuses on prevention, diagnosis, and assistance through the implementation of screening tests for human immunodeficiency virus ("HIV"), hepatitis B virus ("HBV"), and hepatitis C virus ("HCV") in the Cantabrian population.