Successful treatment of gastrointestinal infection-induced septic shock using the oXiris■ hemofilter: A case report

BACKGROUND Septic shock leads to multiple organ failure,and bacterial endotoxins and endogenous cytokines play essential roles in the pathogenesis.The oXiris■hemofilter can efficiently adsorb endotoxins and cytokines.CASE SUMMARY We admitted a critically ill 59 year-old male patient with gastrointestinal septic shock due to infection by a Gram-negative bacterium and septic acute kidney injury(AKI).Prior to intensive care unit admission,the patient reported intermittent diarrhea and decreased urine output.His blood pressure was 70/40 mmHg,necessitating fluid resuscitation and large doses of noradrenaline.Based on the results of a blood culture and the presence of hypotension,oliguria,and hypoxemia,we diagnosed septic shock,AKI,and multiple organ dysfunction.We administered continuous renal replacement therapy(CRRT)with an oXiris■hemofilter for 72 h with intermittent continuous veno-venous hemodiafiltration(CVVHDF),and changed the filter every 12 h.After his hemodynamic parameters were stable,we used a traditional filter(AN69 hemofilter)with intermittent CVVHDF.The 72 h CRRT with the oXiris■hemofilter led to stabilization of his vital signs,marked reductions in disease severity scores,and decreased levels of procalcitonin,endotoxin,and inflammatory factors.After 8 d of CRRT,his kidney function had completely recovered.CONCLUSION We conclude that the oXiris■hemofilter combined with appropriate antibacterial therapy was an effective treatment for this patient with gastrointestinal septic shock.

Advances in metabolic engineering of yeasts for the production of fatty acid-derived hydrocarbon fuels

The reliance of the transport sector on fossil fuels has led to increasing concerns related to sustainability and environmental impact.Growing petroleum shortages and global climate change caused by greenhouse gas emissions have given an impetus to the development of renewable and low-carbon energy sources.Fatty acidderived hydrocarbons are an attractive drop-in biofuel to substitute fossil fuels consumed by the transport sector,especially heavy vehicles.Compared to traditional biofuels such as ethanol and biodiesel,fatty acidderived hydrocarbons have higher energy density and better compatibility with existing storage and transport systems.As a common microbial platform for biofuel production,yeasts have been engineered to produce fatty acid-derived hydrocarbons.Here,we attempted to comprehensively review the latest advances in metabolic engineering strategies for the production of fatty acid-derived hydrocarbons in the yeasts Saccharomyces cerevisiae and Yarrowia lipolytica.The heterologous hydrocarbon synthesis pathways and combinational metabolic engineering strategies have been summarized,followed by a discussion of future research directions for the development of yeasts as industrial hydrocarbon producers.

Engineering Yarrowia lipolytica to produce nutritional fatty acids:Current status and future perspectives

Due to their vital physiological functions,nutritional fatty acids have great potential as nutraceutical food supplements for preventing an array of diseases such as inflammation,depression,arthritis,osteoporosis,diabetes and cancer.Microbial biosynthesis of fatty acids follows the trend of sustainable development,as it enables green,environmentally friendly and efficient production.As a natural oleaginous yeast,Yarrowia lipolytica is especially well-suited for the production of fatty acids.Moreover,it has a variety of genetic engineering tools and novel metabolic engineering strategies that make it a robust workhorse for the production of an array of value-added products.In this review,we summarize recent advances in metabolic engineering strategies for accumulating nutritional fatty acids in Y.lipolytica,including conjugated fatty acids and polyunsaturated fatty acids.In addition,the future prospects of nutritional fatty acid production using the Y.lipolytica platform are discussed in light of the current progress,challenges,and trends in this field.Finally,guidelines for future studies are also emphasized.