Cardiovascular: 110 papers
Peer-reviewed work on the endothelial glycocalyx, microvascular health and the ingredients in our formulas, newest first. Abstracts are indexed here and every paper links to the journal.
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Published paper
Evaluation of Microvascular Rarefaction in Vascular Cognitive Impairment and Heart Failure (CRUCIAL): Study Protocol for an Observational Study
This is a study protocol (not results) for CRUCIAL, a consortium of four observational cohort studies investigating whether microvascular rarefaction \u2014 loss of perfused and structural microvessels \u2014 contributes to vascular cognitive impairment from cerebral small vessel disease and to heart failure with preserved ejection fraction. Investigators plan to compare advanced brain and cardiac MRI measures of microvascular density with easier surrogate measures, including sublingual capillary assessment, retinal optical coherence tomography angiography, and RNA from circulating extracellular vesicles. In the aortic stenosis surgical cohort, myocardial biopsies will provide histological validation of microvascular density.
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Published paper
Early impairment of skeletal muscle endothelial glycocalyx barrier properties in diet-induced obesity in mice.
This mouse study examined whether the endothelial glycocalyx in skeletal muscle microvessels is damaged early in the course of diet-induced obesity. Using intravital measurement of glycocalyx barrier properties (accessibility of the glycocalyx to circulating tracers/red blood cells) in mice fed a high-fat diet, the authors found loss of glycocalyx barrier function before or alongside the development of overt metabolic disease. The findings suggest the glycocalyx is an early target of obesogenic diet rather than a late consequence of established obesity.
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Published paper
Rapid insulin-mediated increase in microvascular glycocalyx accessibility in skeletal muscle may contribute to insulin-mediated glucose disposal in rats.
In rats, systemic insulin infusion rapidly increased the accessible (perfused) volume of the endothelial glycocalyx in skeletal muscle microvessels, measured as increased distribution volume of a glycocalyx-permeable tracer. Enzymatic degradation of the glycocalyx with hyaluronidase blunted both this insulin-induced increase in glycocalyx accessibility and insulin-mediated glucose disposal. The authors conclude that insulin-driven changes in glycocalyx accessibility may contribute to how insulin promotes glucose uptake by muscle.
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Published paper
Rhamnan sulfate enhances the endothelial glycocalyx and decreases the LDL permeability of human coronary artery endothelial cells in vitro
Human coronary artery endothelial cell monolayers were treated for 24 hours with two isoforms of rhamnan sulfate (a sulfated polysaccharide) and then tested for how easily LDL cholesterol crossed the cell layer. Both isoforms cut LDL permeability about 5-fold and prevented the permeability rise caused by chemically induced apoptosis, while immunostaining showed greater heparan sulfate coverage, a key glycocalyx component. The authors propose that a thicker glycocalyx adds resistance to the 'leaky junction' route that LDL uses to cross the endothelium.
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Published paper
Effects of a single aerobic exercise on perfused boundary region and microvascular perfusion: a field study
This observational field study measured sublingual microvascular glycocalyx dimensions (perfused boundary region, PBR) and red blood cell filling percentage using sidestream dark-field imaging with GlycoCheck software in 14 healthy adults immediately before and after a 10 km trail run. A single bout of aerobic exercise produced no significant change in PBR, RBC filling percentage, or capillary density. However, individual changes in PBR were inversely associated with changes in RBC filling percentage, suggesting that a thicker endothelial surface layer accompanies better microvascular perfusion.
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Published paper
Association of COVID-19 with impaired endothelial glycocalyx, vascular function and myocardial deformation four months after infection
This case-control study compared 70 people four months after COVID-19 infection with 70 age- and sex-matched untreated hypertensive patients and 70 healthy controls, measuring glycocalyx thickness (sublingual perfused boundary region), endothelial and coronary function, arterial stiffness, cardiac strain, and blood markers. Post-COVID patients showed impaired glycocalyx, reduced flow-mediated dilatation and coronary flow reserve, and stiffer arteries — similar to hypertensive patients and worse than healthy controls — plus markedly higher oxidative stress and thrombomodulin. Right ventricular function was worse in the COVID group than in either comparison group, and residual cardiovascular symptoms tracked with these abnormalities.
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Published paper
Long-term efficacy of liposomal nanocarriers of preassembled glycocalyx in restoring cerebral endothelial glycocalyx in sepsis
Researchers used a chronic cranial window and sidestream dark-field imaging (GlycoCheck analysis) to track cerebral microvascular density and perfused boundary region (PBR, an inverse index of glycocalyx thickness) in mice given LPS to model sepsis. LPS reduced vascular density and increased PBR within 3 hours; intravenous liposomal nanocarriers carrying preassembled glycocalyx (glycosylated syndecan-1 inserted into liposomes) blunted the PBR rise, with two doses giving longer-lasting benefit than one. Untreated animals recovered PBR spontaneously by 48 hours and vascular density by 72 hours.
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Published paper
Doxycycline protects against sepsis-induced endothelial glycocalyx shedding
In a rat model of sepsis induced by intraperitoneal E. coli lipopolysaccharide, pretreatment with oral doxycycline (an inhibitor of matrix metalloproteinases) largely preserved the endothelial glycocalyx in heart and lung capillaries, as shown by electron microscopy, lower serum syndecan-1, and lower perfused boundary region on mesenteric video capillaroscopy. Doxycycline-pretreated animals also had less vascular leakage, less perivascular edema, fewer transmigrating neutrophils, and better microvascular health scores. The authors attribute the effect to MMP inhibition, although MMP activity was not measured directly.
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Published paper
Effect of Glycocalyx-targeted Therapy on Vascular Function in Older Adults: A Randomized Controlled Trial
In this small double-blind, placebo-controlled pilot trial, 23 older adults took a glycocalyx-targeted supplement (Endocalyx Pro, 3,712 mg/day) or placebo for 12 weeks. The supplement did not significantly change overall sublingual glycocalyx thickness (perfused boundary region), brachial artery flow-mediated dilation, blood pressure, or aortic stiffness. Two secondary/exploratory signals were seen: greater capillary glycocalyx thickness among participants not on antihypertensive medication, and improved FMD normalized to shear rate.
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Published paper
Microcirculation, endothelium and glycocalyx changes associated with the use of milrinone in children with septic shock
This prospective single-center observational study used sublingual video microscopy (GlycoCheck) to compare microcirculation and glycocalyx measures in 140 children with septic shock, 81 of whom received milrinone infusions. Children given milrinone maintained functional capillary density and capillary blood volume recruitment capacity at 24 hours and showed less glycocalyx degradation (lower perfused boundary region) than those not given milrinone, with the effect most apparent in children under two years old. Higher PBR was associated with mortality in both groups.
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Published paper
The effect of 6-month treatment with coenzyme Q10 on endothelial, vascular and myocardial function in patients with nonalcoholic fatty liver disease
In this randomized placebo-controlled trial, 52 patients with non-alcoholic fatty liver disease received either 240 mg/day coenzyme Q10 or placebo for six months. The CoQ10 group showed improvements in sublingual microvascular glycocalyx thickness (perfused boundary region), arterial stiffness, brachial artery flow-mediated dilation, left ventricular global longitudinal strain, and liver steatosis on FibroScan, while the placebo group showed no significant change. The findings are reported as a conference abstract, so detailed methods and between-group statistics are not available.
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Published paper
Impact of dietary supplementation of glycocalyx precursors on vascular function in type 2 diabetes
This combined preclinical and clinical study tested whether a dietary mixture of glycocalyx precursors (glucosamine sulfate, fucoidan, superoxide dismutase, and high molecular weight hyaluronan) could restore the endothelial glycocalyx and improve vascular function in type 2 diabetes. In diabetic db/db mice, four weeks of supplementation restored glycocalyx length and improved flow-mediated dilation and arterial stiffness, and the same mixture promoted glycocalyx growth in cultured endothelial cells. However, in a pilot double-blind randomized placebo-controlled trial of 22 Veterans with type 2 diabetes, eight weeks of supplementation did not improve glycocalyx integrity or vascular function compared with placebo.
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Published paper
Sidestream dark field video microscopy demonstrates shelf-stable blood products preserve the endothelial glycocalyx in a canine hemorrhagic shock model
Six anesthetized dogs underwent induced hemorrhagic shock and were each resuscitated with five different fluid or blood-product strategies in a crossover design, with the endothelial glycocalyx assessed by sidestream dark field video microscopy (perfused boundary region, PBR). Crystalloid plus hydroxyethyl starch resuscitation was associated with increased PBR (indicating glycocalyx degradation), whereas chilled whole blood, plasma plus packed red cells, and shelf-stable products (freeze-dried plasma with a hemoglobin-based oxygen carrier, with or without lyophilized platelets) did not show significant PBR change from baseline.
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Published paper
Diminished Microvascular Health in Heart Transplant Recipients Relative to Healthy Controls
This conference abstract reports a prospective cross-sectional comparison of sublingual microvascular health in 90 heart transplant recipients versus 23 healthy adults, measured with a sidestream dark-field camera and GlycoCheck software. Transplant recipients showed lower capillary density and capillary blood flow, a lower global microvascular HealthScore, and higher perfused boundary region (PBR) values, the latter interpreted as glycocalyx damage.
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Published paper
Six-month supplementation with high dose coenzyme Q10 improves liver steatosis, endothelial, vascular and myocardial function in patients with metabolic-dysfunction associated steatotic liver disease: A Randomized Double-blind, Placebo Controlled Trial
In this single-center, double-blind randomized trial, 60 non-diabetic patients with MASLD received either a supplement containing 240 mg/day coenzyme Q10 (plus choline, milk thistle, cynara, selenium, vitamin C and B vitamins) or placebo for 6 months, alongside Mediterranean diet and exercise advice. The CoQ10 group showed reductions in liver fat (CAP), sublingual perfused boundary region (a marker of thicker endothelial glycocalyx), arterial stiffness and blood pressure, plus improved brachial flow-mediated dilation, coronary flow reserve and left ventricular global longitudinal strain, while the placebo group showed no significant change. Reductions in liver steatosis correlated with the vascular and myocardial improvements.
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Published paper
Microvascular Responses to Donor Specific HLA Antibodies in Heart Transplantation. Sidestream Dark Field Imaging Results
This conference abstract reports a cross-sectional comparison of sublingual microvascular health in 90 heart transplant recipients, measured with sidestream dark field imaging and GlycoCheck software. Patients with donor-specific HLA antibodies (DSA) did not show worse microvascular parameters than those without; in fact, capillary density and blood flow were somewhat higher in the DSA group. The authors conclude that, in this preliminary dataset, DSA presence was not associated with impaired microvascular health.
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Published paper
Biomarkers of endothelial glycocalyx damage are associated with microvascular dysfunction in resuscitated septic shock patients
This cross-sectional study compared 31 resuscitated septic shock patients with 20 healthy individuals, measuring circulating and urinary markers of endothelial glycocalyx shedding alongside sublingual microcirculation imaging with GlycoCheck. Higher levels of syndecan-1, soluble CD44, thrombomodulin, and urinary sulfated glycosaminoglycans corresponded to worse measured microvascular function in the septic patients.
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Published paper
The association between prolonged capillary refill time and microcirculation changes in children with sepsis
This prospective single-center cohort study measured sublingual microcirculation with GlycoCheck sidestream dark-field video microscopy and blood biomarkers in 132 children with sepsis, comparing those with normal versus prolonged (>2 s) capillary refill time. Children with prolonged capillary refill had thinner glycocalyx (higher perfused boundary region) and fewer small capillaries recruited. Persistence of these abnormalities, especially with normal blood pressure ('hemodynamic incoherence'), was linked to higher mortality and longer stay.
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Published paper
Changes in the capillary plasma cell-free layer during a crystalloid or colloid fluid challenge in healthy volunteers
This work, presented as part of a doctoral thesis on perioperative hemodynamic optimization, examined how the capillary plasma cell-free layer (a marker closely tied to endothelial glycocalyx thickness) changes when healthy volunteers receive either a crystalloid or a colloid fluid bolus. The accompanying text provided is the thesis introduction, which frames questions about goal-directed therapy, fluid responsiveness, and the effect of fluid loading on glycocalyx integrity and microcirculatory perfusion. No numerical results for the volunteer fluid-challenge study are reported in the available text.
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Published paper
Capillary leak and endothelial permeability in critically ill patients: a current overview
This narrative review synthesizes current understanding of capillary leak syndrome (CLS) in critical illness, covering pathophysiology, diagnosis, and management. It describes how systemic inflammation disrupts endothelial cell junctions via the angiopoietin-2/Tie2 axis and drives enzymatic shedding of the endothelial glycocalyx, producing fluid extravasation, edema, and hypoperfusion. The authors note there are no accepted diagnostic criteria and no specific treatment, so care remains supportive with phased fluid resuscitation and de-resuscitation.
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Published paper
Effect of acute heparin administration on glycocalyx thickness and endothelial function in healthy younger adults
In this single-arm pilot study, 19 healthy young adults received one intravenous bolus of unfractionated heparin (5,000 U) and were reassessed 30 minutes later. Neither sublingual glycocalyx thickness (perfused boundary region by GlycoCheck), circulating syndecan-1 and heparan sulfate, nor brachial artery flow-mediated dilation changed. The authors conclude that acute heparin is not a usable way to experimentally degrade the glycocalyx in healthy humans.
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Published paper
Endothelial Damage and the Microcirculation in Critical Illness
This narrative review examines how endothelial glycocalyx damage relates to bedside-observable microcirculatory changes in critically ill patients, including sepsis, trauma, cardiogenic shock, cardiopulmonary bypass, and COVID-19. It compares biochemical markers of glycocalyx shedding (syndecan-1, heparan sulfate, hyaluronan, angiopoietin-2) with sidestream dark-field imaging measures such as perfused boundary region (PBR) and capillary density. The authors conclude that the two classes of measurement correlate in some conditions but results are highly variable, and argue that combined bedside imaging plus biomarkers could support patient phenotyping and personalized ICU care.
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Published paper
Associations Between Adipose Tissue Glycocalyx Quality, Nox Activity, and Microvascular Blood Flow
This undergraduate honors thesis reports a small within-subject human physiology experiment in which sublingual microvascular measures (GlycoCheck perfused boundary region, capillary density, red blood cell velocity) were compared under fasting conditions and during a hyperinsulinemic-euglycemic clamp, alongside adipose tissue microdialysis measures of lipolysis (glycerol), reactive oxygen species and blood flow. Insulin infusion was associated with a small but statistically significant increase in perfused boundary region (suggesting thinner/less dense glycocalyx) and decreases in red blood cell velocity and some vessel-diameter-specific densities, while microdialysis measures did not change significantly. The work is descriptive and exploratory, with only 6-8 participants analyzed per outcome.
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Published paper
Sidestream dark field imaging and biomarker evaluation reveal minimal significant changes to the microcirculation and glycocalyx in a canine hemorrhagic shock model
Eight anesthetized purpose-bred dogs underwent pressure-targeted hemorrhagic shock followed by fresh whole blood retransfusion, with sublingual sidestream dark field (GlycoCheck) imaging and plasma glycocalyx biomarkers measured at five time points. Despite marked drops in mean arterial pressure and cardiac output during shock, the perfused boundary region and microcirculatory variables did not change significantly, and only heparan sulfate showed a significant change (a decrease) over time.
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Published paper
The Microvascular Health Status Predicts Radio-Induced Acute Toxicities in Breast, Prostate and Head and Neck Cancer Patients
This conference abstract reports on 63 breast, 38 prostate, and 39 head and neck cancer patients whose sublingual microcirculation was measured with a sidestream dark-field camera and GlycoCheck software before radiotherapy. Patients with healthier baseline microvascular scores were less likely to develop clinically relevant acute radiation toxicity, and the association held across all three cancer sites.
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Published paper
The association between hypoalbuminemia and microcirculation, endothelium, and glycocalyx disorders in children with sepsis
This prospective observational PICU study measured sublingual microcirculation and glycocalyx thickness (perfused boundary region, PBR, by GlycoCheck) plus plasma endothelial biomarkers in 125 children with sepsis, comparing those with low serum albumin (<3.0 g/dL, n=48) to those with normal albumin. Children with hypoalbuminemia had thinner glycocalyx (higher flow-corrected PBR), greater small-capillary recruitment, and higher angiopoietin-2 and annexin A5, and more often required mechanical ventilation. In an observational subgroup analysis, children whose hypoalbuminemia was corrected with 20% albumin infusion had less abnormal PBR at 24 hours, shorter PICU stay, and lower mortality.
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Published paper
Differential effects of heat-not-burn, electronic, and conventional cigarettes on endothelial glycocalyx
Fifty smokers were randomized to switch for one month to either heat-not-burn cigarettes (HNBC) or electronic cigarettes (Ecig), while 50 matched smokers who continued conventional cigarettes (Tcig) served as a non-randomized control group. Sublingual glycocalyx thickness was estimated by perfused boundary region (PBR) using GlycoCheck sidestream dark-field imaging at baseline and one month. Continued conventional smoking worsened PBR across all vessel ranges, whereas switching to Ecig left PBR unchanged and HNBC improved PBR only in the largest (20-25 µm) micro-vessels.
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Published paper
Endothelial Glycocalyx Integrity in Treatment-Naïve People Living with HIV before and One Year after Antiretroviral Treatment Initiation
This prospective observational study measured sublingual endothelial glycocalyx thickness (via the perfused boundary region, PBR) in 66 treatment-naive people living with HIV before and at 24 and 48 weeks after starting combination antiretroviral therapy. PBR fell progressively (indicating thicker, healthier glycocalyx) over the first year, with no significant difference between integrase inhibitor- and protease inhibitor-based regimens. Final values remained above previously reported healthy-control values, suggesting only partial recovery.
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Published paper
Sex-related differences in arterial stiffness in type 2 diabetics: role of uric acid
This is a clinical trial protocol/registration document (NCT03648996) rather than a report of results. It describes a planned study testing whether a low-fructose diet (isocaloric or hypocaloric) or the xanthine oxidase inhibitor allopurinol changes arterial stiffness in people with type 2 diabetes, with attention to sex-related differences and the role of uric acid. No outcome data are presented in the provided text.
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Published paper
Glycocalyx-targeted therapy ameliorates age-related arterial dysfunction
In mice, researchers reduced glycocalyx thickness by knocking down hyaluronan synthase 2 (Has2) and found this reproduced hallmarks of arterial aging: impaired endothelium-dependent dilation and increased aortic stiffness. Conversely, feeding old mice for 10 weeks with a glycocalyx-component supplement (Endocalyx, containing high-molecular-weight hyaluronan, glucosamine sulfate, fucoidan and superoxide dismutase) or with high-molecular-weight hyaluronan alone restored glycocalyx thickness and barrier function and improved endothelial function, aortic stiffness and blood pressure. Aortic wall composition (collagen, elastin) in supplemented old mice also resembled that of young mice.
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Published paper
Evaluation of miCRovascular rarefaction in vascUlar Cognitive Impairment and heArt faiLure (CRUCIAL): Study protocol for an observational study
This is a published study protocol (no results yet) for CRUCIAL, a multicenter observational program investigating whether microvascular rarefaction - loss of perfused small vessels - is a shared mechanism in vascular cognitive impairment and heart failure with preserved ejection fraction. Participants across four cohorts (75 VCI, 60 HFpEF, 60 aortic stenosis, 200 aging controls) undergo advanced brain and cardiac MRI, cognitive testing, echocardiography, retinal OCT angiography, sublingual videomicroscopy with the GlycoCheck system, blood biomarkers, and (in the surgical cohort) myocardial biopsy. The aim is to validate cheaper non-invasive surrogate markers of microvascular density against imaging and histology.
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Published paper
Microvascular rarefaction in patients with cerebrovascular events
This prospective observational study used sublingual sidestream darkfield videomicroscopy to assess microcirculation in 21 patients within 24 hours of an acute stroke or transient ischemic attack, with repeat measurements on day 3 and after one week, compared with age- and sex-matched healthy controls. Patients showed substantially lower capillary density than controls, and the perfused boundary region (an inverse marker of glycocalyx thickness) correlated strongly with red blood cell filling of capillaries. The authors conclude that cerebrovascular events are accompanied by measurable systemic microvascular changes detectable under the tongue.
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Published paper
A Dietary Supplement Containing Fucoidan Preserves Endothelial Glycocalyx through ERK/MAPK Signaling and Protects against Damage Induced by CKD Serum
Researchers tested whether a commercial dietary supplement containing fucoidan, glucosamine sulfate, hyaluronan and antioxidants could protect the endothelial glycocalyx in laboratory models. Using atomic force microscopy on living endothelial cells, the supplement and fucoidan alone increased glycocalyx thickness, prevented heparinase-induced degradation, and reversed thinning caused by pooled serum from hemodialysis patients; effects depended on ERK/MAPK (and to a lesser extent PI3K) signaling and Golgi-dependent vesicular transport. In mice fed the supplement for two weeks, sidestream dark-field imaging of cremaster microvessels showed a reduced perfused boundary region, consistent with a thicker glycocalyx.
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Published paper
Differences in coronary flow reserve and flow-mediated dilation between plaque psoriasis and psoriatic arthritis
This cross-sectional study compared vascular and cardiac function in 311 patients with psoriatic disease (185 plaque psoriasis, 126 psoriatic arthritis) and 150 risk-factor-matched controls. Patients with psoriatic disease had thicker perfused boundary region (indicating a thinner, more damaged endothelial glycocalyx), lower coronary flow reserve, lower brachial flow-mediated dilation, and reduced left ventricular longitudinal strain. Glycocalyx impairment was similar in both psoriatic subgroups, whereas coronary microvascular and brachial endothelial function were worse in psoriatic arthritis.
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Published paper
Endothelial glycocalyx improvement after six months and one-year of antiretroviral therapy in treatment naive patients with human immunodeficiency virus
This conference abstract reports on 54-58 newly diagnosed, treatment-naive HIV patients whose sublingual microvascular glycocalyx was measured with sidestream dark-field imaging (GlycoCheck) before and after starting antiretroviral therapy. Perfusion boundary region (PBR), an inverse marker of glycocalyx thickness, fell at 6 months and further at 12 months, indicating improved glycocalyx integrity, even though body weight and blood pressure rose over the same period.
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Published paper
Perfused boundary region as biomarker for endothelial integrity in former preterms in adolescence
In the Belgian PREMATCH cohort, researchers measured sublingual perfused boundary region (PBR, an inverse index of glycocalyx thickness) by sidestream dark-field imaging in 93 adolescents born at extremely low birth weight (ELBW) and 87 healthy controls, alongside blood pressure, cystatin-C-based eGFR, and retinal vessel imaging. PBR did not differ between the groups even though ELBW survivors had higher blood pressure, lower eGFR, and altered retinal vessel width and tortuosity. The authors provide reference PBR values for adolescents but conclude that PBR correlates too weakly with other microvascular markers to serve as a stand-alone marker of endothelial integrity in this group.
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Published paper
Persistent capillary rarefication in long COVID syndrome
This prospective observational study used sublingual sidestream dark-field videomicroscopy with GlycoCheck software to compare microvascular structure and function in 27 long COVID patients, 15 healthy controls, and 16 historical critically ill COVID-19 patients. Long COVID patients showed a marked loss of the smallest capillaries and impaired capillary recruitment a median of ~18 months after infection, while glycocalyx thickness (PBR) was similar to healthy controls. The authors conclude that COVID-19 may leave persistent capillary rarefication, though the design cannot establish causality with symptoms.
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Published paper
Endothelial glycocalyx integrity in oncological patients
This study compared sublingual microvascular glycocalyx thickness (measured as perfused boundary region, PBR) in 64 cancer patients versus 32 controls with similar cardiovascular risk profiles. Cancer patients had significantly higher PBR values, indicating a thinner/damaged glycocalyx, even though arterial stiffness and standard echocardiographic measures were largely comparable. The impairment tracked with cancer stage rather than with traditional risk factors or anticancer treatment.
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Published paper
Ways and Means of Cellular Reconditioning for Kidney Regeneration
This narrative review proposes 'cellular reconditioning' — repairing individual damaged cell components to trigger broader recovery — as an addition to regenerative nephrology. It catalogs mitochondrial, lysosomal/autophagy, and peroxisomal dysfunction alongside loss of endothelial glycocalyx integrity as interconnected contributors to acute and chronic kidney disease, and reviews the enzymes (metalloproteinases, heparanase-1, hyaluronidases) that shed the glycocalyx. It also summarizes clinical glycocalyx biomarkers and imaging methods, plus reported preventive and restorative interventions.
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Published paper
Mutations in the heparan sulfate backbone elongating enzymes EXT1 and EXT2 have no major effect on endothelial glycocalyx and the glomerular filtration barrier
Researchers tested whether people carrying a single defective copy of the heparan sulfate chain-elongating genes EXT1 or EXT2 (causing multiple osteochondromas) have a damaged endothelial glycocalyx or leaky glomerular filtration barrier. Using sublingual GlycoCheck measurements and urine albumin testing in 19 patients versus 19 matched controls, plus review of archived kidney biopsies from 24 osteochondroma cases, they found no meaningful differences. Only one archival case showed the rare fibrillar glomerular deposits previously described as 'glomerulopathy of hereditary multiple exostoses'.
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