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The endothelial glycocalyx and its disruption, protection and regeneration : A narrative review

Schött, Ulf LU ; Solomon, Cristina; Fries, Dietmar and Bentzer, Peter LU (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
organization
publishing date
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
publisher
BioMed Central
external identifiers
  • scopus:84962788977
  • wos:000374472200001
ISSN
1757-7241
DOI
10.1186/s13049-016-0239-y
language
English
LU publication?
yes
id
8bbb8868-dba4-49a0-bdd0-51125516b22f
date added to LUP
2016-05-12 13:48:33
date last changed
2017-10-08 04:49:10
@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>},
  articleno    = {48},
  author       = {Schött, Ulf and Solomon, Cristina and Fries, Dietmar and Bentzer, Peter},
  issn         = {1757-7241},
  keyword      = {Bleeding management,Fresh frozen plasma,Glycocalyx,Protection,Regeneration},
  language     = {eng},
  month        = {04},
  number       = {1},
  publisher    = {BioMed Central},
  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},
  volume       = {24},
  year         = {2016},
}