3
|
Becker BF, Jacob M, Leipert S, Salmon AHJ, Chappell D. Degradation of the endothelial glycocalyx in clinical settings: searching for the sheddases. Br J Clin Pharmacol 2015; 80:389-402. [PMID: 25778676 DOI: 10.1111/bcp.12629] [Citation(s) in RCA: 276] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 02/10/2015] [Accepted: 03/11/2015] [Indexed: 12/11/2022] Open
Abstract
The endothelial glycocalyx has a profound influence at the vascular wall on the transmission of shear stress, on the maintenance of a selective permeability barrier and a low hydraulic conductivity, and on attenuating firm adhesion of blood leukocytes and platelets. Major constituents of the glycocalyx, including syndecans, heparan sulphates and hyaluronan, are shed from the endothelial surface under various acute and chronic clinical conditions, the best characterized being ischaemia and hypoxia, sepsis and inflammation, atherosclerosis, diabetes, renal disease and haemorrhagic viral infections. Damage has also been detected by in vivo microscopic techniques. Matrix metalloproteases may shed syndecans and heparanase, released from activated mast cells, cleaves heparan sulphates from core proteins. According to new data, not only hyaluronidase but also the serine proteases thrombin, elastase, proteinase 3 and plasminogen, as well as cathepsin B lead to loss of hyaluronan from the endothelial surface layer, suggesting a wide array of potentially destructive conditions. Appropriately, pharmacological agents such as inhibitors of inflammation, antithrombin and inhibitors of metalloproteases display potential to attenuate shedding of the glycocalyx in various experimental models. Also, plasma components, especially albumin, stabilize the glycocalyx and contribute to the endothelial surface layer. Though symptoms of the above listed diseases and conditions correlate with sequelae expected from disturbance of the endothelial glycocalyx (oedema, inflammation, leukocyte and platelet adhesion, low reflow), therapeutic studies to prove a causal connection have yet to be designed. With respect to studies on humans, some clinical evidence exists for benefits from application of sulodexide, a preparation delivering precursors of the glycocalyx constituent heparan sulphate. At present, the simplest option for protecting the glycocalyx seems to be to ensure an adequate level of albumin. However, also in this case, definite proof of causality needs to be delivered.
Collapse
Affiliation(s)
- Bernhard F Becker
- Walter-Brendel Centre of Experimental Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Matthias Jacob
- Department of Anaesthesiology, Hospital St Elisabeth, Straubing, Germany
| | - Stephanie Leipert
- Walter-Brendel Centre of Experimental Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Andrew H J Salmon
- Bristol Renal, School of Physiology and Pharmacology, University of Bristol, Bristol, UK
| | - Daniel Chappell
- Department of Anaesthesiology, University Hospital Munich, Munich, Germany
| |
Collapse
|
4
|
Chen W, Oberwinkler H, Werner F, Gaßner B, Nakagawa H, Feil R, Hofmann F, Schlossmann J, Dietrich A, Gudermann T, Nishida M, Del Galdo S, Wieland T, Kuhn M. Atrial Natriuretic Peptide–Mediated Inhibition of Microcirculatory Endothelial Ca
2+
and Permeability Response to Histamine Involves cGMP-Dependent Protein Kinase I and TRPC6 Channels. Arterioscler Thromb Vasc Biol 2013; 33:2121-9. [DOI: 10.1161/atvbaha.113.001974] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Wen Chen
- From the Institute of Physiology, University of Würzburg, Würzburg, Germany (W.C., H.O., F.W., B.G., H.N., M.K.); Interfakultäres Institut für Biochemie, University of Tübingen, Tübingen, Germany (R.F.); FOR 923, Technical University München, Garching, Germany (F.H.); Institute of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany (J.S.); Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University München, Munich, Germany (A.D., T.G.); Department
| | - Heike Oberwinkler
- From the Institute of Physiology, University of Würzburg, Würzburg, Germany (W.C., H.O., F.W., B.G., H.N., M.K.); Interfakultäres Institut für Biochemie, University of Tübingen, Tübingen, Germany (R.F.); FOR 923, Technical University München, Garching, Germany (F.H.); Institute of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany (J.S.); Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University München, Munich, Germany (A.D., T.G.); Department
| | - Franziska Werner
- From the Institute of Physiology, University of Würzburg, Würzburg, Germany (W.C., H.O., F.W., B.G., H.N., M.K.); Interfakultäres Institut für Biochemie, University of Tübingen, Tübingen, Germany (R.F.); FOR 923, Technical University München, Garching, Germany (F.H.); Institute of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany (J.S.); Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University München, Munich, Germany (A.D., T.G.); Department
| | - Birgit Gaßner
- From the Institute of Physiology, University of Würzburg, Würzburg, Germany (W.C., H.O., F.W., B.G., H.N., M.K.); Interfakultäres Institut für Biochemie, University of Tübingen, Tübingen, Germany (R.F.); FOR 923, Technical University München, Garching, Germany (F.H.); Institute of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany (J.S.); Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University München, Munich, Germany (A.D., T.G.); Department
| | - Hitoshi Nakagawa
- From the Institute of Physiology, University of Würzburg, Würzburg, Germany (W.C., H.O., F.W., B.G., H.N., M.K.); Interfakultäres Institut für Biochemie, University of Tübingen, Tübingen, Germany (R.F.); FOR 923, Technical University München, Garching, Germany (F.H.); Institute of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany (J.S.); Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University München, Munich, Germany (A.D., T.G.); Department
| | - Robert Feil
- From the Institute of Physiology, University of Würzburg, Würzburg, Germany (W.C., H.O., F.W., B.G., H.N., M.K.); Interfakultäres Institut für Biochemie, University of Tübingen, Tübingen, Germany (R.F.); FOR 923, Technical University München, Garching, Germany (F.H.); Institute of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany (J.S.); Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University München, Munich, Germany (A.D., T.G.); Department
| | - Franz Hofmann
- From the Institute of Physiology, University of Würzburg, Würzburg, Germany (W.C., H.O., F.W., B.G., H.N., M.K.); Interfakultäres Institut für Biochemie, University of Tübingen, Tübingen, Germany (R.F.); FOR 923, Technical University München, Garching, Germany (F.H.); Institute of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany (J.S.); Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University München, Munich, Germany (A.D., T.G.); Department
| | - Jens Schlossmann
- From the Institute of Physiology, University of Würzburg, Würzburg, Germany (W.C., H.O., F.W., B.G., H.N., M.K.); Interfakultäres Institut für Biochemie, University of Tübingen, Tübingen, Germany (R.F.); FOR 923, Technical University München, Garching, Germany (F.H.); Institute of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany (J.S.); Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University München, Munich, Germany (A.D., T.G.); Department
| | - Alexander Dietrich
- From the Institute of Physiology, University of Würzburg, Würzburg, Germany (W.C., H.O., F.W., B.G., H.N., M.K.); Interfakultäres Institut für Biochemie, University of Tübingen, Tübingen, Germany (R.F.); FOR 923, Technical University München, Garching, Germany (F.H.); Institute of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany (J.S.); Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University München, Munich, Germany (A.D., T.G.); Department
| | - Thomas Gudermann
- From the Institute of Physiology, University of Würzburg, Würzburg, Germany (W.C., H.O., F.W., B.G., H.N., M.K.); Interfakultäres Institut für Biochemie, University of Tübingen, Tübingen, Germany (R.F.); FOR 923, Technical University München, Garching, Germany (F.H.); Institute of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany (J.S.); Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University München, Munich, Germany (A.D., T.G.); Department
| | - Motohiro Nishida
- From the Institute of Physiology, University of Würzburg, Würzburg, Germany (W.C., H.O., F.W., B.G., H.N., M.K.); Interfakultäres Institut für Biochemie, University of Tübingen, Tübingen, Germany (R.F.); FOR 923, Technical University München, Garching, Germany (F.H.); Institute of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany (J.S.); Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University München, Munich, Germany (A.D., T.G.); Department
| | - Sabrina Del Galdo
- From the Institute of Physiology, University of Würzburg, Würzburg, Germany (W.C., H.O., F.W., B.G., H.N., M.K.); Interfakultäres Institut für Biochemie, University of Tübingen, Tübingen, Germany (R.F.); FOR 923, Technical University München, Garching, Germany (F.H.); Institute of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany (J.S.); Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University München, Munich, Germany (A.D., T.G.); Department
| | - Thomas Wieland
- From the Institute of Physiology, University of Würzburg, Würzburg, Germany (W.C., H.O., F.W., B.G., H.N., M.K.); Interfakultäres Institut für Biochemie, University of Tübingen, Tübingen, Germany (R.F.); FOR 923, Technical University München, Garching, Germany (F.H.); Institute of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany (J.S.); Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University München, Munich, Germany (A.D., T.G.); Department
| | - Michaela Kuhn
- From the Institute of Physiology, University of Würzburg, Würzburg, Germany (W.C., H.O., F.W., B.G., H.N., M.K.); Interfakultäres Institut für Biochemie, University of Tübingen, Tübingen, Germany (R.F.); FOR 923, Technical University München, Garching, Germany (F.H.); Institute of Pharmacology and Toxicology, University of Regensburg, Regensburg, Germany (J.S.); Walther-Straub-Institute for Pharmacology and Toxicology, Ludwig-Maximilians-University München, Munich, Germany (A.D., T.G.); Department
| |
Collapse
|