**7. Conclusions**

198 Antimicrobial Agents

Fig. 7. Kaplan–Meier analysis: cumulative incidence of death by CGA and PCT quartiles.

(B), ROC curve to test the ability of CGA (black line), SAPS II (black dashed line), and PCT

ROC curves for CGA, PCT, and SAPS II are shown in Figure 7. To assess the best positive likelihood ratio, we chose the cutoff value that was associated with the best specificity. For CGA, we chose a cutoff value of 255µg/L, which produced a sensitivity of 0.63 and a specificity of 0.89 (positive likelihood ratio, 5.73; negative likelihood ratio, 0.42; AUC, 0.82). A cutoff value of 65 for SAPS II produced a sensitivity of 0.61 and a specificity of 0.85 (positive likelihood ratio, 4.07; negative likelihood ratio, 0.46; AUC, 0.87). For a PCT cutoff value of 4.82 µg/L, sensitivity and specificity were 0.60 and 0.71, respectively (positive likelihood ratio, 2.07; negative likelihood ratio, 0.56; AUC, 0.73). To conclude, in this clinical study of critically ill nonsurgical patients, we demonstrate that plasma CGA is a strong and independent prognostic in consecutive critically ill nonsurgical patients. The over expression of complete CGA suggests that for these patients the processing machinery to

**6. Insertion of synthetic antimicrobial chromogranins-derived peptides in** 

The surface of medical devices is a common site of bacterial and fungal adhesion, first step to the constitution of a resistant biofilm leading frequently to chronic infections. In order to prevent such complications, several physical and chemical modifications of the device surface have been proposed. In a previous study, we experimented a new type of topical antifungal coating using the layer-by-layer technique. The nanometric multilayer film obtained by this technique is functionalized by the insertion of a CgA-derived antifungal peptide (CGA 47-66, Chromofungin). We show that the embedded peptide keeps its

(A), Median (interquartile range) for CGA concentration data: quartile 1, 35 \_g/L (30–53 \_g/L); quartile 2, 84 \_g/L (77–94 \_g/L); quartile 3, 174 \_g/L (151–197 \_g/L);

quartile 4, 563 \_g/L (355–974 \_g/L). Each quartile includes 30 patients.

(gray dashed line) to predict outcome.

procuce antimicrobial peptides in not correct.

**biomaterials** 

CGs family emerges as prohormones able to modulate homeostatic processes in response to excessive stimulations such as microbial infections. The studies concerning the expression of CGs and their antimicrobial peptides in patients with inflammatory diseases and the correlation with the proteolytic processes occurring in these pathologies vs. controls are crucial to understand the involvement of these prohormones and their derived peptides in innate and adaptive immunities. Calcium is a universal secondary messenger involved in many cellular signal transduction pathways, regulating crucial functions such as secretion, cell motility, proliferation and cell death. The calcium-dependent immunomodulatory properties of CHR and CAT are important for the understanding of their involvement in inflammatory mechanisms. In sum, these linear peptides may represent prototypic lead molecules useful for the development of new therapeutic agents and also biomaterials.
