ВОРОБЬЁВА Анна Павловна – врач анестезиолог-реаниматолог
г. Ставрополь
VOROBYEVA Anna Pavlovna – anesthesiologist-resuscitator of the intensive care and intensive care wards
БЫКОВ Юрий Витальевич – к.м.н., до- цент
BYKOV Yuri Vitalievich – PhD, assistant of professor of the Department of Department of Anesthesiology and Intensive care with a course of additional professorial education
БАТУРИН Владимир Александрович – д.м.н., проф., зав. кафедрой
BATURIN Vladimir Alexandrovich – MD, Professor, Head of the Department of Clinical Pharmacology, with the course of DPO
МУРАВЬЁВА Алла Анатольевна – к.м.н., доцент
MURAVYEVA Alla AnatolyevnaPhD, assistant of professor of the Department of Department of Anesthesiology and Intensive care with a course of additional professorial education
МАССОРОВ Владислав Викторович – ординатор
MASSOROV Vladislav Viktorovich – resident of the department of Anesthesiology and Intensive care with a course of additional professorial education
В предлагаемом обзоре рассмотрено участие гликокаликса (ГК) в патогенезе таких заболеваний, как сахарный диабет, сепсис, COVID-19, политравма, преэклампсия, эпилепсия и др. Описано уменьшение толщины ГК у пациентов с сахарным диабетом. Также отмечено влияние гипергликемии на структуру ГК. При сепсисе ГК повреждается свободными радикалами кислорода, которые высвобождаются циркулирующими лейкоцитами, что в свою очередь запускает каскад реакций, которые приводят к системному отеку, гиповолемии с дальнейшим развитием повреждения органов и тканей. При тяжёлой травме отмечается повреждение ГК, что сопровождается выделением синдекана, гепарансульфата, гиалуроновой кислоты в кровоток. Преэклампсия также сопряжена с повреждением ГК, что можно выявить по повышению специфических маркеров. Эпилепсия и многие другие неврологические заболевания связаны с нарушением гематоэнцефалического барьера, нарушение функции которого связано с дисфункцией ГК.
Aim: to evaluate the results of clinical studies devoted to the study of the role of endothelial glycocalyx (GC) in the pathogenesis of critical conditions.
Materials and Methods. Scientific information was searched in domestic (E-Library) and foreign databases (PubMed, Scopus, Oxford University Press, Springer, Web of Science Core Collection). 120 publications were analysed, 42 of them were selected to meet the requirements of the review.
Results. GC is a gel-like polysaccharide-protein layer covering the surface of vascular endothelial cells. GC maintains homeostasis of the vascular network, including controlling vascular permeability and microvascular tone, preventing microvascular thrombosis, and regulating leukocyte adhesion. Endothelial GC damage is a universal link of pathogenesis in various pathological processes. The proposed review considers the structure and functions of GC, its participation in the pathogenesis of such diseases as diabetes mellitus, sepsis, covid-19, poly- trauma, pre-eclampsia, epilepsy and others. A decrease in GC thickness in patients with diabe- tes mellitus has been described. The effect of hyperglycaemia on GC structure has also been noted. In sepsis, GC is damaged by free oxygen radicals, which are released by circulating leukocytes, which in turn triggers a cascade of reactions that lead to systemic oedema, hypovo- laemia with further development of organ and tissue damage. In severe trauma, damage to GC is noted, which is accompanied by the release of syndecan, heparan sulfate, hyaluronic acid into the bloodstream. Preeclampsia is also associated with GC damage, which can be detected by elevation of specific markers. Epilepsy and many other neurological diseases are associated with disruption of the blood-brain barrier, whose dysfunction is associated with GC dysfunction.
Conclusion. Timely diagnosis of GC degradation can improve life prognosis and therapeutic outcomes in critically ill patients.
The authors declare that there are no conflicts of interest present.