Glycocalyx and sepsis-induced alterations in vascular permeability.
Glycocalyx and sepsis-induced alterations in vascular permeability.
复制标题
DOI：
10.1186/s13054-015-0741-z
复制
发表时间：
2015-01-28
期刊：
影响因子：
--
通讯作者：
Adembri C
中科院分区：
文献类型：
--
作者：
Chelazzi C;Villa G;Mancinelli P;De Gaudio AR;Adembri C
内皮细胞排列在心脏、血管和淋巴管的内侧；细胞外基质的基底膜排列在内皮细胞的腔外一侧。内皮细胞的顶端是糖萼的位置，它是一个由大分子组成的复杂网络，包括细胞结合的蛋白多糖和唾液蛋白。脓毒症相关的这种结构改变可能损害内皮通透性，并伴随间质液体移位和全身性水肿。事实上，在脓毒症中，糖萼是炎症介质和白细胞的靶子，其无处不在的性质解释了发生在远离感染部位的组织的损害。炎症介导的糖萼损伤可导致脓毒症的一些特殊临床效果，包括急性肾损伤、呼吸衰竭和肝功能障碍。此外，一些糖萼降解的标志物，如循环中的Syndecan或选择素水平，可能被用作内皮功能障碍和脓毒症严重程度的标志物。虽然大量实验证据表明，脓毒症引起的血管内皮细胞损伤与糖基化反应的改变密切相关，但针对其完整性的治疗策略并未显著改善这些患者的预后。
Endothelial cells line the inner portion of the heart, blood vessels, and lymphatic vessels; a basal membrane of extracellular matrix lines the extraluminal side of endothelial cells. The apical side of endothelial cells is the site for the glycocalyx, which is a complex network of macromolecules, including cell-bound proteoglycans and sialoproteins. Sepsis-associated alterations of this structure may compromise endothelial permeability with associated interstitial fluid shift and generalized edema. Indeed, in sepsis, the glycocalyx acts as a target for inflammatory mediators and leukocytes, and its ubiquitous nature explains the damage of tissues that occurs distant from the original site of infection. Inflammatory-mediated injury to glycocalyx can be responsible for a number of specific clinical effects of sepsis, including acute kidney injury, respiratory failure, and hepatic dysfunction. Moreover, some markers of glycocalyx degradation, such as circulating levels of syndecan or selectins, may be used as markers of endothelial dysfunction and sepsis severity. Although a great deal of experimental evidence shows that alteration of glycocalyx is widely involved in endothelial damage caused by sepsis, therapeutic strategies aiming at preserving its integrity did not significantly improve the outcome of these patients.
登录
查看更多内容
DOI：
10.4103/0972-5229.63034
发表时间：
2010-01
期刊：
Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine
影响因子：
--
作者：
Basu S;Bhattacharya M;Chatterjee TK;Chaudhuri S;Todi SK;Majumdar A
通讯作者：
Majumdar A
影响因子：
8.8
作者：
Bark, Bjorn P.;Persson, Johan;Grande, Per-Olof
通讯作者：
Grande, Per-Olof
DOI：
10.1164/rccm.200109-016oc
发表时间：
2002-07-01
影响因子：
24.7
作者：
De Backer, D;Creteur, J;Vincent, JL
通讯作者：
Vincent, JL
影响因子：
--
作者：
BECKER, M;MENGER, MD;LEHR, HA
通讯作者：
LEHR, HA
影响因子：
5.2
作者：
De Backer D;Orbegozo Cortes D;Donadello K;Vincent JL
通讯作者：
Vincent JL