Managing sepsis and septic shock in an endothelial glycocalyx-friendly way: from the viewpoint of surviving sepsis campaign guidelines

Annals of Intensive Care, Journal Year: 2024, Volume and Issue: 14(1)

Published: April 24, 2024

Maintaining tissue perfusion in sepsis depends on vascular integrity provided by the endothelial glycocalyx, critical layer covering luminal surface of blood vessels. The glycocalyx is composed proteoglycans, glycosaminoglycans, and functional plasma proteins that are for antithrombogenicity, regulating tone, controlling permeability, reducing interactions with leukocytes platelets. Degradation substantial due to thromboinflammation, treatments septic shock may exacerbate endotheliopathy via additional injury. As a result, therapeutic strategies aimed at preserving should be considered, including modifications fluid volume resuscitation, minimizing catecholamine use, hyperglycemia, potential use corticosteroids anticoagulants. In this review, we explore treatment aligned recommendations outlined Surviving Sepsis Campaign Guidelines 2021 special emphasis evidence regarding protection.

Language: Английский

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Sepsis-associated endothelial glycocalyx damage: a review of animal models, clinical evidence, and molecular mechanisms

International Journal of Biological Macromolecules, Journal Year: 2025, Volume and Issue: 295, P. 139548 - 139548

Published: Jan. 8, 2025

Language: Английский

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Alterations in heparan sulfate proteoglycan synthesis and sulfation and the impact on vascular endothelial function

Matrix Biology Plus, Journal Year: 2022, Volume and Issue: 16, P. 100121 - 100121

Published: Sept. 7, 2022

The glycocalyx attached to the apical surface of vascular endothelial cells is a rich network proteoglycans, glycosaminoglycans, and glycoproteins with instrumental roles in homeostasis. Given their molecular complexity ability interact intra- extracellular environment, heparan sulfate proteoglycans uniquely contribute glycocalyx's role regulating permeability, mechanosignaling, ligand recognition by cognate cell receptors. Much attention has recently been devoted enzymatic shedding from its impact on function. However, other modifications are possible may have equal or complementary clinical significance. In this narrative review, we focus putative mechanisms driving non-proteolytic changes proteoglycan expression alterations sulfation side chains within glycocalyx. We then discuss how these specific function highlight therapeutic strategies target potentially reverse pathologic changes.

Language: Английский

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Myocardial Oedema as a Consequence of Viral Infection and Persistence—A Narrative Review with Focus on COVID-19 and Post COVID Sequelae

Viruses, Journal Year: 2024, Volume and Issue: 16(1), P. 121 - 121

Published: Jan. 14, 2024

Microvascular integrity is a critical factor in myocardial fluid homeostasis. The subtle equilibrium between capillary filtration and lymphatic removal disturbed during pathological processes leading to inflammation, but also hypoxia or due alterations vascular perfusion coagulability. degradation of the glycocalyx as main component endothelial barrier well pericyte disintegration results accumulation interstitial intracellular water. Moreover, dysfunction evokes an increase metabolic waste products, cytokines inflammatory cells space contributing oedema formation. This leads stiffness impaired contractility, eventually resulting cardiomyocyte apoptosis, remodelling fibrosis. following article reviews pathophysiological including myocarditis, ischaemia-reperfusion injury viral infections with special focus on pathomechanisms evoked by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In addition, clinical implications potential long-term effects persistence (long COVID), treatment options, are discussed.

Language: Английский

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Glycocalyx–Sodium Interaction in Vascular Endothelium

Nutrients, Journal Year: 2023, Volume and Issue: 15(13), P. 2873 - 2873

Published: June 25, 2023

The glycocalyx generally covers almost all cellular surfaces, where it participates in mediating cell-surface interactions with the extracellular matrix as well intracellular signaling molecules. endothelial that luminal surface mediates of cells materials flowing circulating blood, including blood cells. Cardiovascular diseases (CVD) remain a major cause morbidity and mortality around world. cardiovascular risk factors start by causing cell dysfunction associated destruction or irregular maintenance glycocalyx, which may culminate into full-blown disease. plays crucial role shielding from excessive exposure absorption salt, can potentially damage to underlying tissues vessels. So, this mini review/commentary, we delineate provide concise summary various components their interaction subsequent involvement disease process. We also highlight could be used biomarkers drug targets management diseases.

Language: Английский

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The Crucial Triad: Endothelial Glycocalyx, Oxidative Stress, and Inflammation in Cardiac Surgery—Exploring the Molecular Connections

International Journal of Molecular Sciences, Journal Year: 2024, Volume and Issue: 25(20), P. 10891 - 10891

Published: Oct. 10, 2024

Since its introduction, the number of heart surgeries has risen continuously. It is a high-risk procedure, usually involving cardiopulmonary bypass, which associated with an inflammatory reaction that can lead to perioperative and postoperative organ dysfunction. The extent complications following cardiac surgery been focus interest for several years because their impact on patient outcomes. Recently, numerous scientific efforts have made uncover complex mechanisms interaction between inflammation, oxidative stress, endothelial dysfunction occur after surgery. Numerous factors, such as surgical anesthetic techniques, hypervolemia hypovolemia, hypothermia, various drugs used during trigger development systemic response release species. They affect endothelium, especially glycocalyx (EG), thin surface layer responsible vascular hemostasis, permeability leukocytes endothelium. This review highlights current knowledge molecular involved in dysfunction, particularly degradation EG. In addition, major events stress responses surgery, EG, clinical implications these summarized discussed detail. A better understanding underlying leading needed improve management develop effective strategies prevent adverse outcomes complicate recovery.

Language: Английский

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Endothelial Dysfunction in Trauma: Pathogenesis, Clinical Significance, Diagnosis and Treatment

Russian Sklifosovsky Journal Emergency Medical Care, Journal Year: 2025, Volume and Issue: 13(4), P. 617 - 630

Published: Jan. 28, 2025

Severe trauma is a major medical and social problem. injures the leading cause of death in people under age 44. Many survivors become disabled. Apart from immediate victims at prehospital stage, in-hospital mortality usually due to hemorrhagic shock, coagulopathy, systemic inflammation, both infectious non-infectious nature, multiple organ failure. In last decade, significant role endothelial dysfunction development these pathological processes has been recognized. Endothelial refers excessive activation endothelium, accompanied by multisystem manifestations. This literature review presents current data on physiology normal pathogenesis trauma, its increased vascular permeability methods for diagnosis correction.

Language: Английский

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Application of Human Plasma/Serum to Cell Culture In Vitro: A Translational Research Approach to Better Define Disease Mechanisms

Clinical and Translational Science, Journal Year: 2025, Volume and Issue: 18(3)

Published: Feb. 26, 2025

ABSTRACT In vitro cell culture experiments play an important role in medical research. Various cellular mechanisms and signaling pathways have been identified with experimental techniques. Unfortunately, the clinical translational impact of these studies is often limited due to their inability closely resemble physiological or pathophysiological milieus use unrealistic conditions. Thus, further developments must be made improve translation work. The application human plasma serum as a stimulus for cells, otherwise, relatively new approach that ultimately overcomes many limitations provides more physiologically relevant model. While this technique has used investigation various diseases pharmacological mechanisms, discrepancies remain regarding appropriate methodologies. This review insight into recent findings through stimuli, well analysis methodological considerations suggestions future directions.

Language: Английский

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European Research Council–funded grant: maintenance of platelet homeostasis

European Heart Journal, Journal Year: 2025, Volume and Issue: unknown

Published: April 2, 2025

Language: Английский

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Endogenous heparin-like syndrome in obstetrics: a series of observations in obstetrics

Messenger of Anesthesiology and Resuscitation, Journal Year: 2025, Volume and Issue: 22(2), P. 108 - 116

Published: April 16, 2025

Introduction. Endogenous heparin-like syndrome (HLS) in obstetrics is a rare complication characterized by the manifestation of effect heparin absence its exogenous administration due to an increase concentration glycosaminoglycans (GAG). Obstetric patients with HLS are at risk for development hemorrhagic complications perioperative period. The heterogeneity structure and anticoagulant activity GAG complicates laboratory diagnosis therapy HLS. objective was conduct retrospective analysis clinical observations endogenous from obstetric hospital literature data on associated Materials methods . included 6 female treated basis Academician V. I. Kulakov National Medical Research Center Obstetrics, Gynecology, Perinatology, signs (HLS). Results. Laboratory were detected women after uterotomy, 5 had additional factors (thrombotic microangiopathy (TMA), placental abruption, preeclampsia, surgical correction fetal spina bifida. use thromboelastometry, namely HEPTEM, made it possible identify bleeding stopped antifibrinolytic № 2–5, however, recurred woman observation because non-specific did not fully normalize thrombin generation, which reduced under influence GAG. Conclusion. A clinically significant blood complex process. Female have high need monitoring hemostasis system Different methods, especially, tests heparinase should be used probability detecting TEM parameters allow reasonable hemostatic therapy.

Language: Английский

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