PDF(Pubmed)
Abstract：
The vascular endothelium is the interface between circulating blood and end organs and thus has a critical role in preserving organ function. The endothelium is lined by a glycan-rich glycocalyx that uniquely contributes to endothelial function through its regulation of leukocyte and platelet interactions with the vessel wall, vascular permeability, coagulation, and vasoreactivity. Degradation of the endothelial glycocalyx can thus promote vascular dysfunction, inflammation propagation, and organ injury. The endothelial glycocalyx and its role in vascular pathophysiology has gained increasing attention over the last decade. While studies characterizing vascular glycocalyx injury and its downstream consequences in a host of adult human diseases and in animal models has burgeoned, studies evaluating glycocalyx damage in pediatric diseases are relatively few. As children have unique physiology that differs from adults, significant knowledge gaps remain in our understanding of the causes and effects of endothelial glycocalyx disintegrity in pediatric critical illness. In this narrative literature overview, we offer a unique perspective on the role of the endothelial glycocalyx in pediatric critical illness, drawing from adult and preclinical data in addition to pediatric clinical experience to elucidate how marked derangement of the endothelial surface layer may contribute to aberrant vascular biology in children. By calling attention to this nascent field, we hope to increase research efforts to address important knowledge gaps in pediatric vascular biology that may inform the development of novel therapeutic strategies.
摘要：
血管内皮是循环血液和末端器官之间的界面，因此在保持器官功能方面具有关键作用。内皮由富含聚糖的糖萼衬里，其通过调节白细胞和血小板与血管壁的相互作用而独特地促进内皮功能。血管通透性,凝血,和血管反应性。因此，内皮糖萼的降解可以促进血管功能障碍，炎症传播，器官损伤。在过去的十年中，内皮糖萼及其在血管病理生理学中的作用已引起越来越多的关注。虽然在许多成年人疾病和动物模型中描述血管糖萼损伤及其下游后果的研究已经蓬勃发展，评估小儿疾病中糖萼损伤的研究相对较少。由于儿童有不同于成人的独特生理机能，我们对儿科危重病中内皮糖萼不完整的原因和影响的理解仍然存在显著的知识差距。在这篇叙事文献综述中，我们提供了一个独特的观点，在小儿危重病的内皮糖萼的作用，除儿科临床经验外，还从成人和临床前数据中得出，以阐明内皮表面层的明显紊乱如何导致儿童血管生物学异常。通过引起人们对这个新兴领域的关注，我们希望加大研究力度,以弥补儿科血管生物学方面的重要知识空白,这可能为开发新的治疗策略提供信息.
