Sepsis and Major Abdominal Surgery Lead to Flaking of the Endothelial Glycocalix

Steppan, Jochen; Hofer, Stefan; Funke, Benjamin; Brenner, Thorsten; Henrich, Michael; Martin, Eike; Weitz, Jürgen; Hofmann, Udo; Weigand, Markus

doi:10.1016/j.jss.2009.04.034

Cited by 260 publications

(240 citation statements)

References 14 publications

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“…Several studies have proposed inflammation-induced shedding of glycocalyx associated with endothelial dysfunction in inflammatory cascade [5][6][7][8]. Furthermore, recent clinical studies reported the elevation of glycocalyx constitution in the blood plasma and urine of human patients with sepsis, suggesting that the circulating glycocalyx fragment might be derived from the destruction of vascular ESL [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the thickness of ESL has been suggested to be more prominent in pulmonary capillary than the systemic vessel [5,19,20]. Furthermore, the lung is the most frequently failed organ during the progression of sepsis with the elevation of glycocalyx fragment in the blood [9][10][11][12], which suggests a potential role of pulmonary endothelial glycocalyx in endothelial dysfunction, vessel integrity, and organ failure [3,21,22].…”

Section: Introductionmentioning

confidence: 99%

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Intravital imaging of a pulmonary endothelial surface layer in a murine sepsis model

Park¹,

Choe²,

Seo³

et al. 2018

Biomed. Opt. Express

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Direct intravital imaging of an endothelial surface layer (ESL) in pulmonary microcirculation could be a valuable approach to investigate the role of a vascular endothelial barrier in various pathological conditions. Despite its importance as a marker of endothelial cell damage and impairment of the vascular system, in vivo visualization of ESL has remained a challenging technical issue. In this work, we implemented a pulmonary microcirculation imaging system integrated to a custom-design video-rate laser scanning confocal microscopy platform. Using the system, a real-time cellular-level microscopic imaging of the lung was successfully performed, which facilitated a clear identification of individual flowing erythrocytes in pulmonary capillaries. Subcellular level pulmonary ESL was identified in vivo by fluorescence angiography using a dextran conjugated fluorophore to label blood plasma and the red blood cell (RBC) exclusion imaging analysis. Degradation of ESL width was directly evaluated in a murine sepsis model in vivo, suggesting an impairment of pulmonary vascular endothelium and endothelial barrier dysfunction. contribution to coronary effects of adenosine," Cardiovasc.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Intravital imaging of a pulmonary endothelial surface layer in a murine sepsis model

Park¹,

Choe²,

Seo³

et al. 2018

Biomed. Opt. Express

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“…33,34 Elevated shedding products, reflecting ESL breakdown, have been found in patients with severe sepsis, CKD, or ESRD, patients on dialysis, patients after major vascular surgery, and patients during acute or chronic hyperglycemia. 31,33,[35][36][37][38][39][40] Most of these conditions associated with a perturbed ESL are also characterized by an expanded ECV, higher BP, or both, suggesting that variability in sodium homeostasis and salt sensitivity may be related to the quality of the ESL, in which endothelial GAGs act as an intravascular buffer compartment for sodium.Considering the large ESL volume, it seems likely that, next to the skin interstitium, nonosmotic sodium storage by endothelial GAGs is a clinically relevant sodium buffer. In patients on hemodialysis, for example, increased plasma syndecan-1 levels, reflecting ESL breakdown, have been associated with an increased need for ultrafiltration, advocating that loss of ESL sodium buffer capacity is clinically relevant in patients prone to volume overload.…”

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confidence: 99%

Role of the Vascular Wall in Sodium Homeostasis and Salt Sensitivity

Engberink

Rorije

Heide

et al. 2015

Journal of the American Society of Nephrology

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Excessive sodium intake is associated with both hypertension and an increased risk of cardiovascular events, presumably because of an increase in extracellular volume. The extent to which sodium intake affects extracellular volume and BP varies considerably among individuals, discriminating subjects who are salt-sensitive from those who are salt-resistant. Recent experiments have shown that, other than regulation by the kidney, sodium homeostasis is also regulated by negatively charged glycosaminoglycans in the skin interstitium, where sodium is bound to glycosaminoglycans without commensurate effects on extracellular volume. The endothelial surface layer is a dynamic layer on the luminal side of the endothelium that is in continuous exchange with flowing blood. Because negatively charged glycosaminoglycans are abundantly present in this layer, it may act as an intravascular buffer compartment that allows sodium to be transiently stored. This review focuses on the putative role of the endothelial surface layer as a contributor to salt sensitivity, the consequences of a perturbed endothelial surface layer on sodium homeostasis, and the endothelial surface layer as a possible target for the treatment of hypertension and an expanded extracellular volume. J Am Soc Nephrol 26: 777-783, 2015. doi: 10.1681 In Western society, average daily intake of salt is 8-12 g, thereby greatly exceeding the recommended amount by the World Health Organization of 5 g daily. 1,2 This recommendation is on the basis of the observation that dietary salt intake exceeding 5 g/d, which is equivalent to 2 g or 85 mmol sodium, is associated with hypertension and increased cardiovascular risk in many cohort studies. 3,4 Other than negative effects on cardiovascular morbidity and mortality, high salt intake has also been related to intermediate end points for kidney damage, such as proteinuria, in both patients with CKD and the general population. 5,6 Dietary salt restriction is, therefore, regarded as an important target for improvement of global health. 4 For example, in the United States, it has been estimated that a reduction of dietary salt intake by 3 g/d would reduce annual health costs by $10-$24 billion. 7 Generally, detrimental effects of excessive sodium intake have been linked to expansion of extracellular volume (ECV) and hypertension, which is evidenced by various observations that low sodium reduces BP in both normotensive individuals and individuals with hypertension. 4,8 The increase in BP after dietary sodium excess is highly variable, with some individuals showing a relatively small increase, whereas large BP increases can be observed in others. 9,10 It is likely that these individual variations in salt sensitivity differentially affect cardiovascular and renal risk and may also explain the inconsistent results from population studies investigating the relation between sodium intake and cardiovascular risk. 11 According to Guyton's pressurenatriuresis curve, the kidney regulates long-term BP by altering renal sodium e...

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“…However, its role remains uncertain and a wide range of cut-off values had been used (from 12 to 2760 pg/mL). Some studies considered IL-6 an indicator for sepsis or for predicting outcome and mortality [266][267][268]. However, other studies do not support the use of IL-6 as a valid sepsis biomarker [269,270].…”

Section: Statement 44mentioning

confidence: 99%

Management of Intra-Abdominal Infections

Moore

2016

Common Problems in Acute Care Surgery

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This paper reports on the consensus conference on the management of intra-abdominal infections (IAIs) which was held on July 23, 2016, in Dublin, Ireland, as a part of the annual World Society of Emergency Surgery (WSES) meeting. This document covers all aspects of the management of IAIs. The Grading of Recommendations Assessment, Development and Evaluation recommendation is used, and this document represents the executive summary of the consensus conference findings.

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Sepsis and Major Abdominal Surgery Lead to Flaking of the Endothelial Glycocalix

Cited by 260 publications

References 14 publications

Intravital imaging of a pulmonary endothelial surface layer in a murine sepsis model

Intravital imaging of a pulmonary endothelial surface layer in a murine sepsis model

Role of the Vascular Wall in Sodium Homeostasis and Salt Sensitivity

Management of Intra-Abdominal Infections

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