Chignalia Andreia Z, Yetimakman Feliz, Christiaans Sarah C, Unal Sule, Bayrakci Benan, Wagener Brant M, Russell Robert T, Kerby Jeffrey D, Pittet Jean-Francois, Dull Randal O
*Department of Anesthesiology, University of Illinois at Chicago, Chicago, Illinois †Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey ‡Department of Anesthesiology §Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama ||Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois.
Shock. 2016 Apr;45(4):338-48. doi: 10.1097/SHK.0000000000000513.
In the United States trauma is the leading cause of mortality among those under the age of 45, claiming approximately 192,000 lives each year. Significant personal disability, lost productivity, and long-term healthcare needs are common and contribute 580 billion dollars in economic impact each year. Improving resuscitation strategies and the early acute care of trauma patients has the potential to reduce the pathological sequelae of combined exuberant inflammation and immune suppression that can co-exist, or occur temporally, and adversely affect outcomes. The endothelial and epithelial glycocalyx has emerged as an important participant in both inflammation and immunomodulation. Constituents of the glycocalyx have been used as biomarkers of injury severity and have the potential to be target(s) for therapeutic interventions aimed at immune modulation. In this review, we provide a contemporary understanding of the physiologic structure and function of the glycocalyx and its role in traumatic injury with a particular emphasis on lung injury.
在美国，创伤是45岁以下人群死亡的主要原因，每年约有19.2万人丧生。严重的个人残疾、生产力丧失和长期医疗需求很常见，每年造成5800亿美元的经济影响。改善复苏策略和创伤患者的早期急性护理有可能减少可能同时存在或在不同时间发生的过度炎症和免疫抑制联合作用所导致的病理后遗症，而这些病理后遗症会对治疗结果产生不利影响。内皮和上皮糖萼已成为炎症和免疫调节的重要参与者。糖萼的成分已被用作损伤严重程度的生物标志物，并且有可能成为旨在免疫调节的治疗干预的靶点。在本综述中，我们对糖萼的生理结构和功能及其在创伤性损伤中的作用提供了当代的理解，特别强调了肺损伤。
