Consulta enfermera de Educación Terapéutica en asma grave / Outpatient nurse clinic on Therapeutic Education for severe asthma

La enfermera de la Unidad de Alergología del Hospital Universitario Puerta de Hierro Majadahonda (Madrid) propuso al equipo crear una consulta monográfica de educación en asma dada la alta prevalencia, consiguiendo el consenso del equipo interdisciplinar, y la acreditación de la Sociedad Española de Alergología e Inmunología Clínica. El proyecto de creación de la nueva consulta surgió al finalizar la pandemia de COVID-19, debido a la necesidad de mejorar la educación y el seguimiento de estos pacientes crónicos para reducir las recidivas. La Consulta de Educación en Asma Grave se puso en marcha en marzo de 2022. La educación terapéutica, como proceso continuo de cuidados centrado en el paciente, es una de las claves para mejorar el control de la enfermedad y la calidad de vida del paciente-familia. La enfermera es el profesional esencial que interviene en todos los procesos asistenciales, que puede conseguir promover el empoderamiento del paciente frente a su enfermedad, así como su rol activo en autocuidados. (AU)

The nurses from the Allergology Unit of the Hospital Universitario Puerta de Hierro, Majadahonda (Madrid) put forward to the team the idea of creating a specialized outpatient clinic on asthma education, given its high prevalence, and obtained consensus by the interdisciplinary team and accreditation by the Spanish Society of Allergology and Clinical Immunology. The project for creating this new outpatient clinic came up at the end of the COVID-19 pandemic, due to the need to improve the education and follow-up of these chronic patients in order to reduce relapses. The Outpatient Clinic for Education on Severe Asthma was launched in March 2022. Therapeutic education, as an ongoing process of patient-centred care, is one of the keys to improve disease control and the quality of life of patients and their families. The nurse is the key professional involved in all processes of care, who can achieve the promotion of patient empowerment regarding their disease, as well as an active role in self-care. (AU)

A TRP channel in the lysosome regulates large particle phagocytosis via focal exocytosis.

Phagocytosis of large extracellular particles such as apoptotic bodies requires delivery of the intracellular endosomal and lysosomal membranes to form plasmalemmal pseudopods. Here, we identified mucolipin TRP channel 1 (TRPML1) as the key lysosomal Ca2+ channel regulating focal exocytosis and phagosome biogenesis. Both particle ingestion and lysosomal exocytosis are inhibited by synthetic TRPML1 blockers and are defective in macrophages isolated from TRPML1 knockout mice. Furthermore, TRPML1 overexpression and TRPML1 agonists facilitate both lysosomal exocytosis and particle uptake. Using time-lapse confocal imaging and direct patch clamping of phagosomal membranes, we found that particle binding induces lysosomal PI(3,5)P2 elevation to trigger TRPML1-mediated lysosomal Ca2+ release specifically at the site of uptake, rapidly delivering TRPML1-resident lysosomal membranes to nascent phagosomes via lysosomal exocytosis. Thus phagocytic ingestion of large particles activates a phosphoinositide- and Ca2+-dependent exocytosis pathway to provide membranes necessary for pseudopod extension, leading to clearance of senescent and apoptotic cells in vivo.