Shedding of the Endothelial Glycocalyx in Patients Undergoing Major Vascular Surgery With Global and Regional Ischemia
Top Cited Papers
- 23 October 2007
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 116 (17), 1896-1906
- https://doi.org/10.1161/circulationaha.106.684852
Abstract
Background— The astonishing thickness of the endothelial glycocalyx, which rivals that of endothelial cells in the microvasculature, was disclosed in the last 15 years. As already demonstrated, this structure plays a key role in the regulation of inflammation and vascular permeability. Methods and Results— Two components of the glycocalyx, syndecan-1 and heparan sulfate, were measured in arterial blood of 18 patients undergoing surgery of the ascending aorta with cardiopulmonary bypass (n=12 with and n=6 without deep hypothermic circulatory arrest) and of 14 patients undergoing surgery for infrarenal aortic aneurysm. Basal values of syndecan-1 (1.2 μg/dL) and heparan sulfate (590 μg/dL) of patients were similar to those of control subjects. Anesthesia and initiation of surgery caused no changes. Global ischemia with circulatory arrest (n=12) was followed by transient 42- and 10-fold increases in syndecan-1 and heparan sulfate, respectively, during early reperfusion (0 to 15 minutes). After regional ischemia of heart and lungs (cardiopulmonary bypass; n=6), syndecan-1 increased 65-fold, and heparan sulfate increased 19-fold. Infrarenal ischemia was followed by 15- and 3-fold increases, respectively (n=14). The early postischemic rises were positively correlated ( r =0.76, P Conclusions— This study provides the first evidence in humans for shedding of the endothelial glycocalyx during ischemia/reperfusion procedures.Keywords
This publication has 37 references indexed in Scilit:
- Syndecans in wound healing, inflammation and vascular biologyThe International Journal of Biochemistry & Cell Biology, 2007
- Technical and physiological background of plasma volume measurement with indocyanine green: a clarification of misunderstandingsJournal of Applied Physiology, 2007
- The endothelial glycocalyx affords compatibility of Starling's principle and high cardiac interstitial albumin levelsCardiovascular Research, 2007
- Heparan sulfate and inflammationNature Immunology, 2005
- Size and Charge Characteristics of the Protein Leak in Dengue Shock SyndromeThe Journal of Infectious Diseases, 2004
- Pretreatment serum syndecan-1 levels and outcome in small cell lung cancer patients treated with platinum-based chemotherapyLung Cancer, 2003
- Influence of the Endothelial Glycocalyx on Cerebral Blood Flow in MiceJournal of Cerebral Blood Flow & Metabolism, 2000
- The Effect of the Endothelial-Cell Glycocalyx on the Motion of Red Blood Cells through CapillariesMicrovascular Research, 1998
- Role of heparan sulfate in immune system-blood vessel interactionsImmunology Today, 1993
- Effects of perfusate composition on binding of ruthenium red and gold colloid to glycocalyx of rabbit aortic endothelium.Journal of Histochemistry & Cytochemistry, 1984