The endothelial glycocalyx and its disruption, protection and regeneration : A narrative review
(2016) In Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 24(1).- Abstract
The glycocalyx is a carbohydrate-rich layer that lines the luminal side of the vascular endothelium. Its soluble components exist in a dynamic equilibrium with the bloodstream and play an important role in maintaining endothelial layer integrity. However, the glycocalyx can be easily damaged and is extremely vulnerable to insults from a variety of sources, including inflammation, trauma, haemorrhagic shock, hypovolemia and ischaemia-reperfusion. Damage to the glycocalyx commonly precedes further damage to the vascular endothelium. Preclinical research has identified a number of different factors capable of protecting or regenerating the glycocalyx. Initial investigations suggest that plasma may convey protective and regenerative... (More)
The glycocalyx is a carbohydrate-rich layer that lines the luminal side of the vascular endothelium. Its soluble components exist in a dynamic equilibrium with the bloodstream and play an important role in maintaining endothelial layer integrity. However, the glycocalyx can be easily damaged and is extremely vulnerable to insults from a variety of sources, including inflammation, trauma, haemorrhagic shock, hypovolemia and ischaemia-reperfusion. Damage to the glycocalyx commonly precedes further damage to the vascular endothelium. Preclinical research has identified a number of different factors capable of protecting or regenerating the glycocalyx. Initial investigations suggest that plasma may convey protective and regenerative effects. However, it remains unclear which exact components or properties of plasma are responsible for this protective effect. Studies have reported protective effects for several plasma proteins individually, including antithrombin, orosomucoid and albumin; the latter of which may be of particular interest, due to the high levels of albumin present in plasma. A further possibility is that plasma is simply a better intravascular volume expander than other resuscitation fluids. It has also been proposed that the protective effects are mediated indirectly via plasma resuscitation-induced changes in gene expression. Further work is needed to determine the importance of specific plasma proteins or other factors for glycocalyx protection, particularly in a clinical setting.
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- author
- Schött, Ulf LU ; Solomon, Cristina ; Fries, Dietmar and Bentzer, Peter LU
- organization
- publishing date
- 2016-04-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Bleeding management, Fresh frozen plasma, Glycocalyx, Protection, Regeneration
- in
- Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
- volume
- 24
- issue
- 1
- article number
- 48
- publisher
- BioMed Central (BMC)
- external identifiers
-
- scopus:84962788977
- pmid:27068016
- wos:000374472200001
- ISSN
- 1757-7241
- DOI
- 10.1186/s13049-016-0239-y
- project
- Koagulation vid kirurgi och kritisk sjukdom
- language
- English
- LU publication?
- yes
- id
- 8bbb8868-dba4-49a0-bdd0-51125516b22f
- date added to LUP
- 2016-05-12 13:48:33
- date last changed
- 2024-09-21 13:15:54
@article{8bbb8868-dba4-49a0-bdd0-51125516b22f, abstract = {{<p>The glycocalyx is a carbohydrate-rich layer that lines the luminal side of the vascular endothelium. Its soluble components exist in a dynamic equilibrium with the bloodstream and play an important role in maintaining endothelial layer integrity. However, the glycocalyx can be easily damaged and is extremely vulnerable to insults from a variety of sources, including inflammation, trauma, haemorrhagic shock, hypovolemia and ischaemia-reperfusion. Damage to the glycocalyx commonly precedes further damage to the vascular endothelium. Preclinical research has identified a number of different factors capable of protecting or regenerating the glycocalyx. Initial investigations suggest that plasma may convey protective and regenerative effects. However, it remains unclear which exact components or properties of plasma are responsible for this protective effect. Studies have reported protective effects for several plasma proteins individually, including antithrombin, orosomucoid and albumin; the latter of which may be of particular interest, due to the high levels of albumin present in plasma. A further possibility is that plasma is simply a better intravascular volume expander than other resuscitation fluids. It has also been proposed that the protective effects are mediated indirectly via plasma resuscitation-induced changes in gene expression. Further work is needed to determine the importance of specific plasma proteins or other factors for glycocalyx protection, particularly in a clinical setting.</p>}}, author = {{Schött, Ulf and Solomon, Cristina and Fries, Dietmar and Bentzer, Peter}}, issn = {{1757-7241}}, keywords = {{Bleeding management; Fresh frozen plasma; Glycocalyx; Protection; Regeneration}}, language = {{eng}}, month = {{04}}, number = {{1}}, publisher = {{BioMed Central (BMC)}}, series = {{Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine}}, title = {{The endothelial glycocalyx and its disruption, protection and regeneration : A narrative review}}, url = {{http://dx.doi.org/10.1186/s13049-016-0239-y}}, doi = {{10.1186/s13049-016-0239-y}}, volume = {{24}}, year = {{2016}}, }