Lung: 7 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
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
The role of the endothelial glycocalyx in fibrotic interstitial lung disease
This prospective observational study (PREDICT-ILD) assessed whether sublingual side-stream dark-field video-microscopy (GlycoCheck) is an acceptable way to measure endothelial glycocalyx health in patients with fibrotic interstitial lung disease, comparing them with age- and sex-matched healthy controls. Perfused boundary region (PBR) in 5–25 µm vessels was used as a surrogate for glycocalyx width, alongside same-day pulmonary function testing and an acceptability questionnaire. The abstract describes the rationale and methods; no numerical results are reported in the text provided.
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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
Vascular Endothelial Glycocalyx Damage in COVID-19
This narrative review, which includes a small structured literature search, argues that damage to the vascular endothelial glycocalyx is a common mechanism linking COVID-19 risk factors (hypertension, diabetes, obesity, smoking, cardiovascular disease) to severe outcomes such as ARDS, DIC, and microvascular thrombosis. The author proposes a new concept, 'systemic inflammation-reactive microvascular endotheliopathy' (SIRME), defined by inflammation, thrombogenic endothelial damage with increased permeability, and organ injury, with shed glycocalyx fragments or bilateral ground-glass lung shadows marking progression. Of six eligible clinical reports identified, all showed elevated circulating glycocalyx components in severe COVID-19.
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Published paper
May We Use Non-Invasive Indices of Aortic Stiffness and Endothelial Glycocalyx as Biomarkers for Idiopathic Pulmonary Artery Hypertension Follow-Up?
This single-patient case report tracks three annual evaluations (2018-2020) of a woman with idiopathic pulmonary arterial hypertension, comparing invasive hemodynamics and exercise capacity with two non-invasive systemic vascular measures: carotid-femoral pulse wave velocity (aortic stiffness) and sublingual perfused boundary region (endothelial glycocalyx, GlycoCheck). When her pulmonary vascular resistance worsened, glycocalyx measures worsened (higher PBR, lower red blood cell filling), and both improved after treatment was changed. The authors suggest these indices deserve further study as non-invasive follow-up markers, but a single case cannot establish this.
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Published paper
Does sublingual microscopy correlate with nailfold videocapillaroscopy in systemic sclerosis?
This single-center cross-sectional study compared automated sublingual videomicroscopy (GlycoCheck) with nailfold videocapillaroscopy (NVC), the standard test for scleroderma microvascular damage, in 39 systemic sclerosis patients on the same clinic day. Sublingual microvascular density correlated moderately with nailfold capillary number and inversely with the NVC microangiopathy evolution score. Functional measures (red blood cell fraction and glycocalyx perfused boundary region) did not correlate with NVC parameters in this mostly late-pattern cohort.
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Published paper
Microvascular dysfunction in COVID-19: the MYSTIC study
This prospective, multi-center cross-sectional study used sublingual sidestream dark-field video microscopy (GlycoCheck) plus blood biomarkers to characterize microvascular and endothelial glycocalyx changes in 23 hospitalized COVID-19 patients versus 15 healthy controls. Patients showed marked loss of small capillaries, slower red blood cell velocity, and evidence of glycocalyx damage, most pronounced in those on mechanical ventilation. Higher perfused boundary region (thinner glycocalyx) and lower ADAMTS13 were associated with 60-day in-hospital mortality.
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