Clinical Relevance of the Endothelial Glycocalyx in Critically Ill Patients

Astapenko, David; Beneš, Jan; Černý, V.

doi:10.1007/978-3-030-37323-8_17

Cited by 1 publication

(2 citation statements)

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“…Endothelial cell dysfunction in sepsis combines intercellular junction breakdown, increased adhesion molecule surface expression, and stimulation of complement and coagulation cascades [ 42 , 43 ]. Endothelial omics provide a rational basis for understanding sepsis pathology and computer modelling relevant therapies based on phenotypes [ 44 ].…”

Section: Omics Of Endothelial Dysfunction and Microcirculatory Altera...mentioning

confidence: 99%

“…Breakdown of the endothelial glycocalyx is an important pathophysiological step in sepsis and septic shock. The endothelium lines the vasculature and is covered by a jelly-like layer of proteoglycans and glycosaminoglycans that are intimately involved in cell signaling, propagation of inflammation, and coagulation [ 42 , 78 ]. In critical illness, inflammatory signals cause weakening of adherens and tight junctions in the endothelium causing paracellular gaps to allow molecules and fluid to escape into the interstitium as demonstrated in ( Figure 2 ) [ 79 , 80 ].…”

Section: Omics Of Endothelial Dysfunction and Microcirculatory Altera...mentioning

confidence: 99%

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Multi-Omics Endotypes in ICU Sepsis-Induced Immunosuppression

et al. 2023

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It is evident that the admission of some patients with sepsis and septic shock to hospitals is occurring late in their illness, which has contributed to the increase in poor outcomes and high fatalities worldwide across age groups. The current diagnostic and monitoring procedure relies on an inaccurate and often delayed identification by the clinician, who then decides the treatment upon interaction with the patient. Initiation of sepsis is accompanied by immune system paralysis following “cytokine storm”. The unique immunological response of each patient is important to define in terms of subtyping for therapy. The immune system becomes activated in sepsis to produce interleukins, and endothelial cells express higher levels of adhesion molecules. The proportions of circulating immune cells change, reducing regulatory cells and increasing memory cells and killer cells, having long-term effects on the phenotype of CD8 T cells, HLA-DR, and dysregulation of microRNA. The current narrative review seeks to highlight the potential application of multi-omics data integration and immunological profiling at the single-cell level to define endotypes in sepsis and septic shock. The review will consider the parallels and immunoregulatory axis between cancer and immunosuppression, sepsis-induced cardiomyopathy, and endothelial damage. Second, the added value of transcriptomic-driven endotypes will be assessed through inferring regulatory interactions in recent clinical trials and studies reporting gene modular features that inform continuous metrics measuring clinical response in ICU, which can support the use of immunomodulating agents.

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Section: Omics Of Endothelial Dysfunction and Microcirculatory Altera...mentioning

confidence: 99%