Study: Methods: 8 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
Erythrocyte Glycocalyx Reports Glomerular Endothelial Glycocalyx Damage in Disease and Predicts Glomerular Albumin Permeability
This paper, published in the Journal of the American Society of Nephrology, reports that the glycocalyx layer on red blood cells reflects damage to the glycocalyx of glomerular endothelial cells in the kidney. The authors propose the erythrocyte glycocalyx as an accessible marker that also predicts glomerular permeability to albumin. Only the title and citation were available, so the methods, population, and numerical results cannot be verified here.
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Published paper
Variability of microcirculatory measurements in healthy volunteers
Two experienced operators each performed three consecutive sublingual GlycoCheck (sidestream dark-field) microcirculation measurements in 49 healthy volunteers to test reproducibility. Single measurements of perfused boundary region (PBR), red blood cell filling percentage, and microvascular vessel density had poor intraobserver reliability, but averaging three measurements raised reliability to acceptable levels. Agreement between the two observers was only fair for PBR and RBC filling and poor for vessel density, though no systematic bias was found.
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Published paper
Assessment of the sublingual microcirculation with the GlycoCheck system: Reproducibility and examination conditions
This randomized, controlled methodological study tested how reproducible sublingual glycocalyx measurements with the GlycoCheck system (perfused boundary region, PBR, and red blood cell filling) are, and how they are affected by smoking, a high-calorie meal, and coffee. Reproducibility of single measurements was poor to moderate but improved substantially when 3-5 measurements were averaged, with no meaningful differences between investigators. All three acute exposures worsened PBR and RBC filling, with effects still detectable at 180 minutes.
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Published paper
Evaluation of jejunal microvasculature of healthy anesthetized dogs with sidestream dark field video microscopy
This veterinary study tested whether sidestream dark field (SDF) video microscopy could image and quantify the small blood vessels of the jejunum (small intestine) in 30 healthy anesthetized dogs during spay surgery. Imaging was feasible and produced reference values for microvascular density, red blood cell filling, vessel width, and the perfused boundary region (PBR), an indirect index of glycocalyx thickness. The authors conclude the technique warrants further study, including in dogs with intestinal disease.
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Published paper
Variability of Microcirculatory Measurements in Critically Ill Patients
This study tested how reproducible sublingual GlycoCheck microcirculation measurements are in 60 critically ill patients, using repeated measurements by one or two experienced observers. Single measurements of glycocalyx thickness (perfused boundary region) showed poor reliability, while red blood cell filling percentage and vessel density were more consistent. Averaging three consecutive measurements substantially improved reproducibility for all parameters.
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Published paper
In vivo assessment of the human cerebral microcirculation and its glycocalyx: A technical report
This technical report describes the first in vivo measurement of the human cerebral microcirculation and its endothelial glycocalyx using sidestream dark-field (SDF) imaging with GlycoCheck software during brain surgery. Measurements were taken sublingually (as a reference), and from cortical and hippocampal surfaces in five epilepsy surgery patients, with a sterile slipcover over the camera required in the operating field. Vessel density and perfused boundary region (PBR) showed broadly similar patterns across the three sites, but the sterile slipcover itself altered the measured values.
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Published paper
Bedside analysis of the sublingual microvascular glycocalyx in the emergency room and intensive care unit – the GlycoNurse study
This single-center observational study tested whether bedside sublingual glycocalyx measurement with sidestream dark-field imaging and GlycoCheck software is practical and reproducible in routine emergency and critical care settings. A physician's repeated measurements and measurements by eight trained nurses agreed closely, and the procedure was quick and well tolerated. Perfused boundary region (PBR) values were higher in ICU than ER patients and modestly correlated with markers of acute illness.
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Published paper
Protocol for intraoperative assessment of the human cerebrovascular glycocalyx.
This is a published study protocol (no results) for a multicenter prospective case-control study in the Netherlands that plans to image the endothelial glycocalyx intraoperatively in the human brain. Using sidestream dark-field video microscopy with GlycoCheck software, investigators will measure the perfused boundary region (PBR) and perfused diameter in sublingual, cortical, and (in epilepsy patients only) hippocampal microvessels. The hypothesis is that cerebrovascular glycocalyx thickness is reduced in temporal lobe epilepsy compared with controls, potentially linking glycocalyx damage to blood-brain barrier leakage and seizure susceptibility.
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