Endothelial glycocalyx damage in kidney disease correlates with uraemic toxins and endothelial dysfunction

Liew, Hui; Roberts, Matthew A; Pope, Alun; McMahon, Lawrence P.

doi:10.1186/s12882-020-02219-4

Cited by 39 publications

(46 citation statements)

References 52 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The glycocalyx of the endothelium is also damaged in CKD, which is evidenced by the excessive shedding of its components such as syndecan-1, hyaluronan and heparan sulfate. Clinical studies have demonstrated that syndecan-1 and hyaluronan levels are elevated in the serum of patients with advanced CKD and are correlated with PCS and IS serum levels (Vlahu et al, 2012;Padberg et al, 2014;Liew et al, 2021). An increase in syndecan-1 serum levels and a reduction in the thickness of the endothelial glycocalyx have been shown in an animal model of CKD (Padberg et al, 2014).…”

Section: Uremic Toxins In Endothelial Dysfunctionmentioning

confidence: 99%

Uremic Toxins: An Alarming Danger Concerning the Cardiovascular System

et al. 2021

View full text Add to dashboard Cite

The kidneys and heart share functions with the common goal of maintaining homeostasis. When kidney injury occurs, many compounds, the so-called “uremic retention solutes” or “uremic toxins,” accumulate in the circulation targeting other tissues. The accumulation of uremic toxins such as p-cresyl sulfate, indoxyl sulfate and inorganic phosphate leads to a loss of a substantial number of body functions. Although the concept of uremic toxins is dated to the 1960s, the molecular mechanisms capable of leading to renal and cardiovascular injuries are not yet known. Besides, the greatest toxic effects appear to be induced by compounds that are difficult to remove by dialysis. Considering the close relationship between renal and cardiovascular functions, an understanding of the mechanisms involved in the production, clearance and overall impact of uremic toxins is extremely relevant for the understanding of pathologies of the cardiovascular system. Thus, the present study has as main focus to present an extensive review on the impact of uremic toxins in the cardiovascular system, bringing the state of the art on the subject as well as clinical implications related to patient’s therapy affected by chronic kidney disease, which represents high mortality of patients with cardiac comorbidities.

show abstract

Section: Uremic Toxins In Endothelial Dysfunctionmentioning

confidence: 99%

Uremic Toxins: An Alarming Danger Concerning the Cardiovascular System

et al. 2021

View full text Add to dashboard Cite

show abstract

“…As a result, leukocytes in the blood circulation can adhere more easily to vascular endothelial cells. This process promotes the development of inflammation and endothelial dysfunction ( Mulivor and Lipowsky, 2004 ; Vestweber, 2015 ; Bui et al, 2020 ; Liew et al, 2021 ). Therefore, glycocalyx shedding is an important factor in vascular endothelial dysfunction.…”

Section: The Role Of the Endothelial Glycocalyx Layer In Inflammation And Endothelial Dysfunctionmentioning

confidence: 99%

Glycocalyx Impairment in Vascular Disease: Focus on Inflammation

Cheng

et al. 2021

Front. Cell Dev. Biol.

View full text Add to dashboard Cite

The glycocalyx is a complex polysaccharide-protein layer lining the lumen of vascular endothelial cells. Changes in the structure and function of the glycocalyx promote an inflammatory response in blood vessels and play an important role in the pathogenesis of many vascular diseases (e.g., diabetes, atherosclerosis, and sepsis). Vascular endothelial dysfunction is a hallmark of inflammation-related diseases. Endothelial dysfunction can lead to tissue swelling, chronic inflammation, and thrombosis. Therefore, elimination of endothelial inflammation could be a potential target for the treatment of vascular diseases. This review summarizes the key role of the glycocalyx in the inflammatory process and the possible mechanism by which it alleviates this process by interrupting the cycle of endothelial dysfunction and inflammation. Especially, we highlight the roles of different components of the glycocalyx in modulating the inflammatory process, including components that regulate leukocyte rolling, L-selectin binding, inflammasome activation and the signaling interactions between the glycocalyx components and the vascular cells. We discuss how the glycocalyx interferes with the development of inflammation and the importance of preventing glycocalyx impairment. Finally, drawing on current understanding of the role of the glycocalyx in inflammation, we consider a potential strategy for the treatment of vascular diseases.

show abstract

“…They therefore suggested that estimation of endothelial glycocalyx dimension by SDF imaging might not be useful for cardiovascular risk prediction [16]. Along similar lines, a recent study was unable to detect a difference in the PBR level between healthy controls, persons with chronic kidney disease, persons on dialysis, and in kidney transplant recipients [14]. On the contrary, Mulders et al found that first degree relatives of persons with premature coronary artery disease were characterized by a higher PBR compared to healthy controls and concluded that sublingual capillary microvascular dysfunction might be useful for early risk prediction within families with premature coronary artery disease [17].…”

Section: Associations Between Endothelial Glycocalyx Dimensions and Cardio-renal Risk Factorsmentioning

confidence: 99%

“…Results have been inconsistent. Some studies could not demonstrate an association between glycocalyx size and cardiovascular or renal disease [14,15] and concluded that the technique might not contribute to cardiovascular risk stratification [16]. Whereas a higher PBR in first degree relatives of persons with premature coronary artery disease as compared to healthy controls has been described [17].…”

Section: Introductionmentioning

confidence: 99%

Endothelial glycocalyx and cardio-renal risk factors in type 1 diabetes

et al. 2021

View full text Add to dashboard Cite

Background Glycocalyx lines the inner surface of the capillary endothelium. Capillaroscopy enables visualization of the sublingual capillaries and measurement of the Perfused Boundary Region (PBR) as an estimate of the glycocalyx. Novel software enables assessment of the PBR estimated at a fixed high flow level (PBR-hf) and an overall microvascular assessment by the MicroVascular Health Score (MVHS). Damaged glycocalyx may represent microvascular damage in diabetes and assessment of its dimension might improve early cardio-renal risk stratification. Aim To assess the associations between PBR, PBR-hf and MVHS and cardio-renal risk factors in persons with type 1 diabetes (T1D); and to compare these dimensions in persons with T1D and controls. Methods Cross-sectional study including 161 persons with T1D stratified according to level of albuminuria and 50 healthy controls. The PBR, PBR-hf and MVHS were assessed by the GlycoCheck device (valid measurements were available in 136 (84.5%) with T1D and in all the controls). Higher PBR and PBR-hf indicate smaller glycocalyx width. Lower MVHS represents a worse microvascular health. Results There were no associations between PBR, PBR-hf or MVHS and the cardio-renal risk factors in persons with T1D, except for higher PBR-hf and lower MVHS in females (p = 0.01 for both). There was no difference in PBR, PBR-hf or MVHS in persons with normo-, micro- or macroalbuminuria. The PBR was higher (2.20±0.30 vs. 2.03±0.18μm; p<0.001) and MVHS lower (3.15±1.25 vs. 3.53±0.86μm; p = 0.02) in persons with T1D compared to controls (p≤0.02). After adjustment for cardio-renal risk factors the difference in PBR remained significant (p = 0.001). Conclusions The endothelial glycocalyx dimension was impaired in persons with T1D compared to controls. We found no association between the endothelial glycocalyx dimension and the level of albuminuria or cardio-renal risk factors among persons with T1D. The use of the GlycoCheck device in T1D may not contribute to cardio-renal risk stratification.

show abstract

Endothelial glycocalyx damage in kidney disease correlates with uraemic toxins and endothelial dysfunction

Cited by 39 publications

References 52 publications

Uremic Toxins: An Alarming Danger Concerning the Cardiovascular System

Uremic Toxins: An Alarming Danger Concerning the Cardiovascular System

Glycocalyx Impairment in Vascular Disease: Focus on Inflammation

Endothelial glycocalyx and cardio-renal risk factors in type 1 diabetes

Contact Info

Product

Resources

About