ABSTRACT
Candida albicans is an important opportunistic fungal pathogen of humans. Phenotypic plasticity is a typical biological feature of C. albicans, which is associated with pathogenicity, host adaptation, and sexual reproduction. Biofilm of C. albicans is a complex community formed by different morphological types of cells (yeast, hyphae and pseudohyphae) and secreted extracellular matrix. C. albicans biofilms are intrinsically resistant to antifungal drugs, the host immune system, and environmental stresses. Biofilm is an important virulence factor and a major clinical challenge. With the development of new technologies in global gene expression profiles and genetic manipulation, the regulatory mechanisms that govern C. albicans biofilm development and drug resistance become more and more clear. Major regulatory mechanisms involve the MAPK and cAMP signaling pathways and transcriptional regulators such as Bcr1 and Tec1. In addition, morphological transitions and sexual reproduction are also involved in the regulation of biofilm development. In this review, we focus on the genetic regulatory mechanisms of biofilm including the roles of cell-wall related proteins, transcription factors, and the MTL locus. In the last section, we also summarize the mechanisms of drug resistance of biofilm in C. albicans.
ABSTRACT
Objective To observe the efifcacy and safety of ticagrelor in patients received percutaneous coronary intervention (PCI). Methods 50 patients with non-responding platelet aggregation rate and CYPC219 gene after clopidogrel treatment were given ticagrelor and enrolled in the study. All enrolled patients received aspirin loading dosage 300 mg, followed by maintenance dosage 100 mg, once daily and ticagrelor maintenance dosage 90 mg twice daily, for 1 year. The primary endpoint for the study were the incidence of major cardiovascular events (including death, stent thrombosis, stent restenosis, nonfatal myocardial infarction, target vessel revascularization) and stroke after followed up for a month. The secondary endpoint were the incidence of general events (including minor bleeding, allergies, breathing dififculties) and platelet count changes. Results No occur major cardiovascular and stroke events record after 1 month of ticagrelor treatment. The general events rates included 2 cases of dyspnen, 1 case of epitaxis and 1 case of subcutaneous bleeding. The platelet aggregation with ticagrelor was signiifcantly lower than clopidogrel without signiifcant decrease in platelets count. Conclusions Using ticagrelor for antiplatelet in patients with coronary artery stenting in clopidogrel resistance cases is safe and effective.