Study: Controlled Trial: 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
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
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
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
Effects of high-intensity interval training on microvascular glycocalyx and associated microRNAs
Fifty healthy young adults completed a 4-week high-intensity interval training (HIIT) program consisting of 4 x 30-s all-out runs, with sublingual microvascular imaging (sidestream dark-field, perfused boundary region) before and after. Exercise capacity correlated with glycocalyx measures, and several circulating microRNAs were upregulated by HIIT, with baseline miR-143 predicting later glycocalyx changes. The authors conclude HIIT alters the endothelial glycocalyx of the microvasculature and that miRNAs may serve as markers of early vascular adaptation.
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Published paper
The impact of periodontal disease treatment on endothelium of sublingual microvessels
Thirty-five patients with severe chronic periodontitis had their sublingual microvessels assessed by sidestream/darkfield microscopy with GlycoCheck RI software before and after treatment. One group received only local anti-inflammatory therapy, the other also underwent periodontal surgery. Glycocalyx measures changed little early on, but six months after surgery the surgical group showed a reduced permeable glycocalyx thickness and increased red blood cell filling of the capillaries.
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Published paper
Effects of ultrapure hemodialysis and low molecular weight heparin on the endothelial surface layer
In 20 hemodialysis patients, researchers measured the endothelial surface layer during dialysis sessions using sidestream dark-field imaging (perfused boundary region, PBR) and plasma markers of glycocalyx shedding, varying whether low molecular weight heparin was given at the start of dialysis or 120 minutes in. Plasma syndecan-1 rose significantly during hemodialysis, with the increase appearing to follow heparin administration, while PBR did not change measurably.
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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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