真菌血症
队列
白色念珠菌
医学
重症监护室
菌血症
血培养
白色体
回顾性队列研究
内科学
队列研究
生物标志物
免疫学
生物
真菌病
微生物学
抗生素
生物化学
作者
Jiayu Liu,Yue Li,Yuhan Liu,Renlin Yu,Yibing Yin,Xiaofei Lai,Banglao Xu,Ju Cao
标识
DOI:10.1016/j.micinf.2024.105302
摘要
Candidemia is a severe disease with high mortality in both intensive care unit (ICU) and non-ICU settings. Considering that progranulin (PGRN) is a potential therapeutic target for the candidemia caused by C. albicans, we determined the serum level of PGRN after candidemia and evaluated its association with mortality. A retrospective discovery cohort (62 patients) and a validation cohort (70 patients) were enrolled. Blood was collected on day of first blood culture positivity for C. albicans, and serum PGRN levels were then measured. In the discovery cohort, all serum PGRN studied were expressed at higher levels in candidemia patients than in bacteremia patients and healthy volunteers, non-survivors presented with significantly higher serum PGRN concentrations when compared with survivors. Serum PGRN concentration was associated with 30-day mortality and patients at a higher risk of death showed higher serum PGRN levels. These results were confirmed in the independent validation cohort. Interestingly, in vitro study demonstrated that macrophages, neutrophils and lymphocytes may be the major source of PGRN production after C. albicans infection instead of epithelial cells. Our findings highlight that serum PGRN appears as a biomarker in candidemia patients and as a promising tool for mortality risk stratification in managing candidemia.
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