Biomarkers of endothelial glycocalyx damage are associated with microvascular dysfunction in resuscitated septic shock patients

IF 2.9 4区医学 Q2 PERIPHERAL VASCULAR DISEASE Microvascular research Pub Date : 2024-03-23 DOI:10.1016/j.mvr.2024.104683

Nazir Soubihe Neto, Marcela Curci Vieira de Almeida, Helton de Oliveira Couto, Carlos Henrique Miranda

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Abstract

Background

Microvascular dysfunction plays a central role in organ dysfunction during septic shock. Endothelial glycocalyx (eGC) damage could contribute to impaired microcirculation. The aim was to assess whether several eGC-damaged biomarkers are associated with microvascular dysfunction in resuscitated septic shock patients.

Methods

This cross-sectional study included resuscitated septic shock patients (N = 31), and a group of healthy individuals (N = 20). The eGC damage biomarkers measured were syndecan-1 (SDC-1), soluble CD44 (CD44s), hyaluronic acid (HYAL) in blood sample; sulfated glycosaminoglycans (GAGs) in urine sample; and thrombomodulin (TBML) in blood sample as biomarker of endothelial cell damage. Microcirculation was assessed through sublingual videocapillaroscopy using the GlycoCheck™, which estimated the perfused vascular density (PVD); the perfused boundary region (PBR), an inverse parameter of the eGC thickness; and the microvascular health score (MVHS). We defined a low MVHS (<50th percentile in septic patients) as a surrogate for more impaired microvascular function.

Results

The SDC-1, CD44s, TBML and GAGs levels were correlated with impaired microvascular parameters (PVD of vessels with diameter < 10 μm, MVHS and flow-adjusted PBR); p < 0.05 for all comparisons, except for GAGs and flow-adjusted PBR. The SDC-1 [78 ng/mL (interquartile range (IQR) 45–336) vs. 48 ng/mL (IQR 9–85); p = 0.052], CD44s [796ρg/mL (IQR 512–1995) vs. 526ρg/mL (IQR 287–750); p = 0.036], TBML [734ρg/mL (IQR 237–2396) vs. 95ρg/mL (IQR 63–475); p = 0.012] and GAGs levels [0.42 ρg/mg (IQR 0.04–1.40) vs. 0.07 ρg/mg (IQR 0.02–0.20); p = 0.024]; were higher in septic patients with more impaired sublingual microvascular function (low MVHS vs. high MVHS).

Conclusion

SDC-1, CD44s, TBML and GAGs levels were associated with impaired microvascular function in resuscitated septic shock patients.

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内皮糖萼损伤的生物标志物与脓毒性休克复苏患者的微血管功能障碍有关。

背景：微血管功能障碍在脓毒性休克期间器官功能障碍中起着核心作用。内皮糖萼（eGC）损伤可能导致微循环受损。本研究旨在评估脓毒性休克复苏患者的几种eGC损伤生物标志物是否与微血管功能障碍有关：这项横断面研究包括脓毒性休克复苏患者（31 人）和一组健康人（20 人）。测量的eGC损伤生物标志物包括血液样本中的辛迪加-1（SDC-1）、可溶性CD44（CD44s）和透明质酸（HYAL）；尿液样本中的硫酸化糖胺聚糖（GAGs）；以及作为内皮细胞损伤生物标志物的血液样本中的血栓调节蛋白（TBML）。使用 GlycoCheck™ 舌下视频显微镜对微循环进行了评估，估算出灌注血管密度 (PVD)、灌注边界区域 (PBR)（eGC 厚度的逆参数）和微血管健康评分 (MVHS)。我们定义了低 MVHS（结果：SDC-1、CD44s、TBML 和 GAGs 水平与受损的微血管参数（直径为 PVD 的血管）相关结论：SDC-1、CD44s、TBML 和 GAGs 水平与受损的微血管参数（直径为 PVD 的血管）相关：脓毒性休克复苏患者的 SDC-1、CD44s、TBML 和 GAGs 水平与微血管功能受损有关。

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来源期刊

Microvascular research 医学-外周血管病

CiteScore

6.00

自引率

3.20%

发文量

158

审稿时长

43 days

期刊介绍： Microvascular Research is dedicated to the dissemination of fundamental information related to the microvascular field. Full-length articles presenting the results of original research and brief communications are featured. Research Areas include: • Angiogenesis • Biochemistry • Bioengineering • Biomathematics • Biophysics • Cancer • Circulatory homeostasis • Comparative physiology • Drug delivery • Neuropharmacology • Microvascular pathology • Rheology • Tissue Engineering.