Alteration of the sublingual microvascular glycocalyx in critically ill patients

Donati, Abele; Damiani, Elisa; Domizi, Roberta; Romano, Rocco; Adrario, Erica; Pelaia, P; İnce, Can; Singer, Mervyn

doi:10.1016/j.mvr.2013.08.007

Cited by 103 publications

(100 citation statements)

References 14 publications

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“…Earlier clinical studies showed that increased plasma levels of HS or syndecan-1 are associated with septic shock [45][46][47] and are positively correlated with increased mortality [45]. In another clinical study, decrease in GCX thickness in critically ill patients correlated with more severe sepsis [48].…”

Section: Sepsismentioning

confidence: 94%

The glycocalyx and its significance in human medicine

2016

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Cells are covered by a surface layer of glycans that is referred to as the 'glycocalyx'. In this review, we focus on the role of the glycocalyx in vascular diseases (atherosclerosis, stroke, hypertension, kidney disease and sepsis) and cancer. The glycocalyx and its principal glycosaminoglycans [heparan sulphate (HS) and hyaluronic acid (HA)] and core proteins (syndecans and glypicans) are degraded in vascular diseases, leading to a breakdown of the vascular permeability barrier, enhanced access of leucocytes to the arterial intima that propagate inflammation and alteration of endothelial mechanotransduction mechanisms that protect against disease. By contrast, the glycocalyx on cancer cells is generally robust, promoting integrin clustering and growth factor signalling, and mechanotransduction of interstitial flow shear stress that is elevated in tumours to upregulate matrix metalloproteinase release which enhances cell motility and metastasis. HS and HA are consistently elevated on cancer cells and are associated with tumour growth and metastasis. Later, we will review the agents that might be used to enhance or protect the glycocalyx to combat vascular disease, as well as a different set of compounds that can degrade the cancer cell glycocalyx to suppress cell growth and metastasis. It is clear that what is beneficial for either vascular disease or cancer will not be so for the other. The overarching conclusions are that (i) the importance of the glycocalyx in human medicine is only beginning to be recognized, and (ii) more detailed studies of glycocalyx involvement in vascular diseases and cancer will lead to novel treatment modalities.

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Section: Sepsismentioning

confidence: 94%

The glycocalyx and its significance in human medicine

2016

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“…PBR was demonstrated to be associated with microvascular perfusion and to be increased in patients with coronary artery disease, sepsis, and renal failure (22,51,67,110). In addition, PBR was also associated with microvascular changes in the retinal vascular bed (9).…”

Section: Lea -Cd31 -Syto41mentioning

confidence: 99%

A microscopic view on the renal endothelial glycocalyx

Dane

Berg

Lee

et al. 2015

American Journal of Physiology-Renal Physiology

106

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“…the sublingual microcirculation (8,9)) or the detection of circulating glycocalyx fragments by immunoassay (6, 9 -13). These techniques offer little insight into the mechanisms underlying ESL loss across different vascular beds during critical illness.…”

mentioning

confidence: 99%

The Circulating Glycosaminoglycan Signature of Respiratory Failure in Critically Ill Adults

Schmidt

et al. 2014

Journal of Biological Chemistry

131

137

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Background: Endothelial glycocalyx degradation contributes to the pathogenesis of critical illness. Results: Mechanically ventilated subjects exhibited plasma glycocalyx breakdown signatures (glycosaminoglycan fragments) characteristic of direct versus indirect etiologies of respiratory failure. Conclusion: Circulating glycosaminoglycans provide insight into respiratory failure pathophysiology. Significance: This is the first study to characterize circulating glycosaminoglycans during critical illness, offering insight into the mechanisms underlying respiratory failure.

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Alteration of the sublingual microvascular glycocalyx in critically ill patients

Cited by 103 publications

References 14 publications

The glycocalyx and its significance in human medicine

The glycocalyx and its significance in human medicine

A microscopic view on the renal endothelial glycocalyx

The Circulating Glycosaminoglycan Signature of Respiratory Failure in Critically Ill Adults

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