The endothelial glycocalyx in critical illness: A pediatric perspective.
Matrix Biol Plus
; 14: 100106, 2022 Jun.
Article
in English
| MEDLINE | ID: covidwho-1768400
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.
ACE2, angiotensin-converting enzyme 2; CD, cell differentiation marker; COVID-19, coronavirus disease 2019; CPB, cardiopulmonary bypass; CT, component therapy; Children; Critical illness; DENV NS1, dengue virus nonstructural protein 1; DM, diabetes mellitus; ECLS, extracorporeal life support; ECMO, extracorporeal membrane oxygenation; EG, endothelial glycocalyx; Endothelial glycocalyx; FFP, fresh frozen plasma; GAG, glycosaminoglycan; GPC, glypican; HPSE, heparanase; HSV, herpes simplex virus; IV, intravenous; MIS-C, multisystem inflammatory syndrome in children; MMP, matrix metalloproteinase; Pragmatic, Randomized Optimal Platelet and Plasma Ratios; RHAMM, receptor for hyaluronan-mediated motility; S protein, spike protein; SAFE, Saline versus Albumin Fluid Evaluation; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; SDC, syndecan; SDF, sidestream darkfield; SIRT1, sirtuin 1; TBI, traumatic brain injury; TBSA, total body surface area; TMPRSS2, transmembrane protease serine 2; Th2, type 2 helper T cell; VSMC, vascular smooth muscle cell; Vascular biology; WB+CT, whole blood and component therapy; eNOS, endothelial nitric oxide synthase
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Experimental Studies
/
Prognostic study
Language:
English
Journal:
Matrix Biol Plus
Year:
2022
Document Type:
Article
Affiliation country:
J.mbplus.2022.100106
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