Protection and rebuilding of the endothelial glycocalyx in sepsis - Science or fiction?

Carolin Christina Drost; Alexandros Rovas; Philipp Kümpers

doi:10.1016/j.mbplus.2021.100091

Protection and rebuilding of the endothelial glycocalyx in sepsis - Science or fiction?

Matrix Biol Plus. 2021 Nov 3:12:100091. doi: 10.1016/j.mbplus.2021.100091. eCollection 2021 Dec.

Authors

Carolin Christina Drost¹, Alexandros Rovas¹, Philipp Kümpers¹

Affiliation

¹ Department of Medicine D, Division of General Internal and Emergency Medicine, Nephrology, and Rheumatology, University Hospital Münster, Albert-Schweitzer-Campus 1, 48149 Münster, Germany.

Abstract

The endothelial glycocalyx (eGC), a delicate carbohydrate-rich structure lining the luminal surface of the vascular endothelium, is vital for maintenance of microvascular homeostasis. In sepsis, damage of the eGC triggers the development of vascular hyperpermeability with consecutive edema formation and organ failure. While there is evidence that protection or rebuilding of the eGC might counteract sepsis-induced vascular leakage and improve outcome, approved therapeutics are not yet available. This narrative review aims to outline possible therapeutic strategies to ameliorate organ dysfunction caused by eGC impairment.

Keywords: Glycocalyx; Glycosaminoglycan; Heparanase; Perfused boundary region; Sepsis.