Background

 

Continuation of: Glycocalyx

 

Since then, our knowledge regarding the structure and function of the glycocalyx has greatly increased, and it has become clear that the glycocalyx plays a pivotal role in  vascular homeostasis. Supported by a network of polysaccharides that project from the surface of the endothelial cells, the glycocalyx turns out to be a hydrated gel-like compartment in which numerous blood-borne factors reside (Figure 1). 

 

Figure 1

 

Research studies from our group and others have shown that the endothelial glycocalyx is a dynamic compartment which plays an important role in protection of the vascular system against atherogenic challenges associated with cardiovascular disease.  Thus, the glycocalyx acts as a barrier against leakage of fluid, proteins and lipids across the vascular wall, it modulates adhesion of inflammatory cells and platelets to the endothelial surface, and it functions as a sensor and mechanotransducer of the fluid shear forces to which the endothelium is exposed and which is the trigger for the release of nitric oxide (Figure 2). 

 

Figure 2:

 

Glycocalyx damage is, as a result, associated with an increased vascular vulnerability: permeability increases and edema may develop, leucocytes and platelets start to adhere to the endothelium, and NO bioavailability gets compromised. Of importance, damage to the glycocalyx appears to be an early event when the body gets exposed to atherogenic risk factors, such as hyperlipidemia and hyperglycemia (see movie 2). This suggests that the glycocalyx may be the first-line of defense against cardiovascular disease and that a damaged glycocalyx in an individual may be an early marker of an increased vascular vulnerability. 

 

Movie 2:

 

More insight has also been gained in the functional role of the glycocalyx in controlling delivery of nutrients and hormones to the tissues. It has become clear that agonist-induced modulation of the glycocalyx may be central to the coordination of the increase in blood flow and blood volume during adenosine infusion in the coronary circulation (Figure 3). 

 

Figure 3: 

 

Furthermore, the glycocalyx appears to play an important role in the regulation of insulin sensitivity by controlling its delivery to the skeletal muscle fibers. Consequently, damage to the glycocalyx may contribute to the development of coronary microvascular dysfunction associated with angina in the absence of a significant lesion as well as the development of peripheral insulin resistance. 

 

 

 

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