Measuring endothelial glycocalyx dimensions in humans: a potential novel tool to monitor vascular vulnerability
Measuring endothelial glycocalyx dimensions in humans: a potential novel tool to monitor vascular vulnerability
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DOI：
10.1152/japplphysiol.00440.2007
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发表时间：
2008-03-01
影响因子：
3.3
通讯作者：
Vink, Hans
中科院分区：
文献类型：
--
作者：
Nieuwdorp, Max;Meuwese, Marijn C.;Vink, Hans
越来越多的人认为血管内皮细胞的糖基化反应是保护血管壁免受病原性损伤的血管内隔室。这项研究的目的是将一种已建立的估计毛细血管糖唇大小的实验方法转化为临床有用的工具，并评估其在人类身上的重复性。我们首先通过活体显微镜评估了内皮和红细胞之间的距离，作为衡量糖萼厚度的指标，以及通过通过金黄地鼠提睾肌毛细血管中的白细胞而导致的红细胞柱的一过性增宽之间的关系。随后，我们使用正交偏振光谱成像技术评估了24名健康男性的舌下微血管糖肾盏厚度。同时，评估了全身性糖唇体积(使用先前发表的示踪剂稀释技术)和心血管风险概况。根据一过性红细胞增宽估计的微血管糖唇尺寸与红细胞-内皮间隙的大小有很好的相关性(r=0.63)。人体测量结果具有重复性(0.58±0.16和0.53±0.15微米，变异系数15±5%)。单因素分析显示，微血管厚度与全身血糖(r=0.45)、空腹血糖(r=0.43)、高密度脂蛋白胆固醇(r=0.40)呈显著正相关，与低密度脂蛋白胆固醇(r=-0.41)、体重指数(r=-0.45)呈显著负相关(P均<0.05)。总而言之，血管内皮细胞糖萼的大小可以在人体内重复测量，并且与心血管危险因素有关。目前尚不清楚糖萼的大小是否可以作为血管损伤的早期标志，以及以修复为目的的治疗是否能保护血管系统免受病原性挑战。
The endothelial glycocalyx is increasingly considered as an intravascular compartment that protects the vessel wall against pathogenic insults. The purpose of this study was to translate an established experimental method of estimating capillary glycocalyx dimension into a clinically useful tool and to assess its reproducibility in humans. We first evaluated by intravital microscopy the relation between the distance between the endothelium and erythrocytes, as a measure of glycocalyx thickness, and the transient widening of the erythrocyte column on glycocalyx compression by passing leukocytes in hamster cremaster muscle capillaries. We subsequently assessed sublingual microvascular glycocalyx thickness in 24 healthy men using orthogonal polarization spectral imaging. In parallel, systemic glycocalyx volume ( using a previously published tracer dilution technique) as well as cardiovascular risk profiles were assessed. Estimates of microvascular glycocalyx dimension from the transient erythrocyte widening correlated well with the size of the erythrocyte-endothelium gap (r = 0.63). Measurements in humans were reproducible (0.58 +/- 0.16 and 0.53 +/- 0.15 mu m, coefficient of variance 15 +/- 5%). In univariate analysis, microvascular glycocalyx thickness significantly correlated with systemic glycocalyx volume ( r = 0.45), fasting plasma glucose ( r = 0.43), and high- density lipoprotein-cholesterol ( r = 0.40) and correlated negatively with low-density lipoprotein-cholesterol (r = - 0.41) as well as body mass index ( r = - 0.45) ( all P < 0.05). In conclusion, the dimension of the endothelial glycocalyx can be measured reproducibly in humans and is related to cardiovascular risk factors. It remains to be tested whether glycocalyx dimension can be used as an early marker of vascular damage and whether therapies aimed at repair can protect the vasculature against pathogenic challenges.