ISSN (print) 1726-9806     ISSN (online) 1818-474X
No. 2 (2019), INTENSIVE CARE OF SEPSIS AND NOSOCOMIAL INFECTIONS
No. 2 (2019)
INTENSIVE CARE OF SEPSIS AND NOSOCOMIAL INFECTIONS

Sepsis-induced damage to endothelial glycocalyx (literature review)

Published 26.03.2019
Yana Y. Ilyina
Department of Anesthesiology, City Hospital No 1, Arkhangelsk; Department of Anesthesiology and Intensive Care, Northern State Medical University, Arkhangelsk
https://orcid.org/0000-0002-5942-1243
E.V. Fot
Department of Anesthesiology, City Hospital No 1, Arkhangelsk; Department of Anesthesiology and Intensive Care, Northern State Medical University, Arkhangelsk
https://orcid.org/0000-0003-0052-8086
V.V. Kuzkov
Department of Anesthesiology, City Hospital No 1, Arkhangelsk; Department of Anesthesiology and Intensive Care, Northern State Medical University, Arkhangelsk
https://orcid.org/0000-0002-8191-1185
M.Y. Kirov
Department of Anesthesiology, City Hospital No 1, Arkhangelsk; Department of Anesthesiology and Intensive Care, Northern State Medical University, Arkhangelsk
https://orcid.org/0000-0002-4375-3374
#2019-2
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Keywords

endothelial glycocalyx
endothelium
sepsis
septic shock
glycocalyx shedding
vascular permeability

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1.
Ilyina Y.Y., Fot E.V., Kuzkov V.V., Kirov M.Y. Sepsis-induced damage to endothelial glycocalyx (literature review). Annals of Critical Care. 2019;(2):32-39. doi:10.21320/1818-474X-2019-2-32-39
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Abstract

Glycocalyx is a gel-like layer covering the surface of vascular endothelial cells. It consists of membrane-attached proteoglycans, glycosaminoglycan chains, glycoproteins, and plasma adhesive proteins. Glycocalyx plays a key role in maintaining vascular homeostasis, controls vascular permeability and the tone of the microvasculature, prevents microvascular thrombosis and regulates leukocyte adhesion. In sepsis and septic shock, damage and shedding of glycocalyx occurs. The degradation of glycocalyx is activated by reactive oxygen species and pro-inflammatory cytokines, such as tumor necrosis factor (TNF) and interleukin-1β (IL-1β). The inflammation-mediated degradation of glycocalyx leads to vascular hyperpermeability, unregulated vasodilation, microvascular thrombosis, and enhanced leukocyte adhesion. The inflammation-mediated degradation of glycocalyx leads to vascular hyperpermeability, unregulated vasodilation, microvascular thrombosis, and enhanced leukocyte adhesion. Clinical studies have demonstrated a correlation between the levels of glycocalyx components in the blood and organ dysfunction and mortality in sepsis and septic shock. Inflammation-induced damage to glycocalyx can cause a number of specific clinical effects of sepsis, including acute kidney damage, respiratory failure and liver dysfunction. Infusion therapy is an integral part of the treatment of sepsis, but super-aggressive infusion load methods (leading to hypervolemia) may increase the degradation of glycocalyx. Moreover, some markers of glycocalyx degradation, such as circulating levels of syndecan 1 or heparan sulfate, can be used as markers of endothelial dysfunction and sepsis severity.
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