PDF(Pubmed)
Abstract：
The glycocalyx is a ubiquitous structure found on endothelial cells that extends into the vascular lumen. It is enriched in proteoglycans, which are proteins attached to the glycosaminoglycans heparan sulfate, chondroitin sulfate, dermatan sulfate, keratan sulfate, and hyaluronic acid. In health and disease, the endothelial glycocalyx is a central regulator of vascular permeability, inflammation, coagulation, and circulatory tonicity. During sepsis, a life-threatening syndrome seen commonly in hospitalized patients, the endothelial glycocalyx is degraded, significantly contributing to its many clinical manifestations. In this review we discuss the intrinsically linked mechanisms responsible for septic endothelial glycocalyx destruction: glycosaminoglycan degradation and proteoglycan cleavage. We then examine the consequences of local endothelial glycocalyx loss to several organ systems and the systemic consequences of shed glycocalyx constituents. Last, we explore clinically relevant non-modifiable and modifiable factors that exacerbate or protect against endothelial glycocalyx shedding during sepsis.
摘要：
糖萼是在延伸到血管腔中的内皮细胞上发现的普遍存在的结构。它富含蛋白聚糖，是附着在糖胺聚糖硫酸乙酰肝素上的蛋白质，硫酸软骨素，硫酸皮肤素,硫酸角质素,和透明质酸。在健康和疾病中，内皮糖萼是血管通透性的中枢调节因子,炎症,凝血,和循环张力。在脓毒症期间，一种常见于住院患者的危及生命的综合征，内皮糖萼被降解，显着促成其许多临床表现。在这篇综述中，我们讨论了导致败血症内皮糖萼破坏的内在联系的机制：糖胺聚糖降解和蛋白聚糖裂解。然后，我们研究了局部内皮糖萼对几个器官系统的损失的后果以及脱落的糖萼成分的全身性后果。最后,我们探讨了临床相关的不可改变和可改变的因素,这些因素加剧或保护脓毒症期间的内皮糖萼脱落.
