Open access: 85 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
Deeper penetration of erythrocytes into the endothelial glycocalyx is associated with impaired microvascular perfusion
In a population-based sample of 915 middle-aged Dutch adults, researchers used sidestream dark-field imaging with automated GlycoCheck software to measure the perfused boundary region (PBR, a marker of how deeply red blood cells penetrate the endothelial glycocalyx) in sublingual microvessels. Deeper red-cell penetration (higher PBR) was strongly associated with poorer microvascular perfusion, measured as the percentage of time vessel segments contained red blood cells. The authors interpret a low PBR (thicker glycocalyx) as reflecting more efficient microvascular perfusion.
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Published paper
Microcirculatory effects of the transfusion of leukodepleted or non-leukodepleted red blood cells in patients with sepsis: a pilot study
This small randomized pilot trial compared sublingual microcirculatory and tissue oxygenation responses one hour after transfusion of leukodepleted versus non-leukodepleted red blood cells in 20 septic ICU patients. Most between-group differences were not significant, though microvascular flow index and blood flow velocity changed more favorably with leukodepleted units. Glycocalyx was assessed by sidestream dark-field perfused boundary region (GlycoCheck software) and by serum syndecan-1, hyaluronan, and heparan sulfate.
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Published paper
Damage of the endothelial glycocalyx in dialysis patients
This cross-sectional case-control study compared the sublingual microvascular glycocalyx in 40 dialysis patients (23 hemodialysis, 17 peritoneal dialysis) with 21 age- and sex-matched healthy controls using sidestream dark-field (SDF) imaging, plus blood markers of glycocalyx shedding. Dialysis patients showed a larger perfused boundary region (PBR) and perfused diameter, indicating red cells penetrating closer to the vessel wall, along with higher serum hyaluronan, syndecan-1, hyaluronidase activity, and sE-selectin. Higher inflammation (CRP >10 mg/L) and a history of cardiovascular disease were associated with greater PBR.
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Published paper
Methods for evaluating endothelial function: a position statement from the European Society of Cardiology Working Group on Peripheral Circulation
This European Society of Cardiology Working Group position statement reviews the available in-vivo and ex-vivo methods for assessing endothelial function, from invasive coronary angiography with acetylcholine to flow-mediated dilatation, pulse wave analysis, peripheral arterial tonometry, laser Doppler flowmetry, biochemical markers, endothelial microparticles, progenitor cells, and glycocalyx imaging. For each technique it outlines the physiological rationale, methodology, reproducibility, and clinical applications. The authors conclude that no single method is superior and that endothelial function testing may aid risk stratification but needs further validation before routine clinical use.
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Published paper
Effect of sulodexide on endothelial glycocalyx and vascular permeability in patients with type 2 diabetes mellitus
This small open-label study compared endothelial glycocalyx thickness in the sublingual and retinal microcirculation of 10 men with type 2 diabetes and 10 healthy age-matched men, then measured both groups again after 8 weeks of oral sulodexide (200 mg/day), a glycosaminoglycan mixture of heparan and dermatan sulfate. Men with diabetes had thinner glycocalyx in both vascular beds, higher albumin leakage from capillaries, and higher markers of hyaluronan breakdown. After sulodexide, glycocalyx dimensions increased in the diabetes group, with a non-significant trend toward normalized albumin leakage.
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