Volume 1, Issue 2

Candida albicans (C. albicans), a conditional pathogenic fungus, is widespread in nature and can live in symbiosis with organisms in small quantities. When the normal microflora is imbalanced, the epithelial barrier is disrupted or the immune system becomes dysfunctional, C. albicans can change from commensal to pathogenic pathogen, causing both superficial and life-threatening systemic infections with no effective treatment. The morbidity and mortality of invasive Candida infections in perioperative patients are high due to underlying chronic diseases, immune deficiencies, and pathophysiological disorders. C-type lectin receptors (CLRs) are the main pattern-recognition receptors for fungal activation of innate immunity and host defense. Upon binding to ligands, CLRs induce multiple signal transduction cascades followed by activation of nuclear factor kappa B through spleen tyrosine kinase - and caspase recruitment domain containing protein 9-dependent pathways. Analyzing the effects of regulatory CLR-induced signaling cascades on host immune cells is critical for understanding the molecular mechanism in regulating antifungal immunity. As one of the core factors in host innate immune regulation, protein post-translational modifications regulate the strength of immune effects by modulating protein conformation, stability, affinity, subcellular localization, etc. This makes the post-translational modification sites promising as potential targets for modulating antifungal immunity. This review primarily described the study progress of post-translational modifications in controlling CLR-induced signaling cascades throughout the process of innate immunity against C. albicans. We aim to provide better understanding of these mechanisms and aid in the identification and development of biomarkers and drug targets for invasive candidiasis.

Objective: To assess the impact of measuring central venous pressure (CVP) on the prognosis of patients with septic shock. Methods: Septic shock patients with and without CVP measurements were identified in the Medical Information Mart for Intensive Care IV database. The primary outcome was 28-day mortality, and a multivariate logistic regression model was used to analyze the association between CVP measurement and 28-day mortality in patients with septic shock. The results were validated using logistic regression after propensity score matching. Secondary outcomes were in-hospital mortality, 1-year mortality, incidence of acute kidney injury within the first 7 days in the intensive care unit (ICU), and length of stay in the ICU. After propensity score matching, logistic regression analysis was conducted to analyze the correlation between CVP measurements and secondary outcomes in patients with septic shock. Results: A total of 2966 patients were included, including 1219 patients whose CVP was measured within 24h after admission to the ICU. CVP measurement was found to be not correlated with 28-day mortality (odds ratio=0.978, 95% Confidence Interval 0.798-1.200, P=0.835). Analyzing the cohort after propensity score matching, CVP measurement was found to be associated with prolonged ICU stay (4.9 vs. 3.2 days; P<0.001). No statistical differences were found in the primary outcome and other secondary outcomes between those with CVP measurement and those not. Conclusion: CVP measurement is associated with prolonged ICU stay in patients with septic shock but not associated with mortality and incidence of acute kidney injury within 7 days.