Aldecoa Cesar, Llau Juan V, Nuvials Xavier, Artigas Antonio
Department of Anaesthesiology and Surgical Critical Care, Hospital Universitario Rio Hortega, c/Dulzaina 2, 47012, Valladolid, Spain.
Department of Anaesthesiology and Surgical Critical Care, Hospital Universitario Dr. Peset, Universitat de València, c/Gaspar Aguilar 90, 46017, Valencia, Spain.
Ann Intensive Care. 2020 Jun 22;10(1):85. doi: 10.1186/s13613-020-00697-1.
The endothelial glycocalyx comprises a complex layer of membrane-bound proteoglycans, secreted glycosaminoglycans, glycoproteins, glycolipids and bound plasma proteins such as albumin and antithrombin associated with the endothelial surface. The glycocalyx plays an important role in vascular homeostasis, regulating vascular permeability and cell adhesion, and acts as a mechanosensor for hemodynamic shear stresses; it also has antithrombotic and anti-inflammatory functions. Plasma proteins such as albumin are physiologically bound within the glycocalyx, thus contributing to stability of the layer. Albumin is the major determinant of plasma colloid osmotic pressure. In addition, albumin transports sphingosine-1-phosphate which has protective endothelial effects, acts as a free radical scavenger, and has immunomodulatory and anti-inflammatory effects. This review examines the physiological function of the endothelial glycocalyx and the role of human albumin in preserving glycocalyx integrity and the microcirculation.
内皮糖萼由一层复杂的膜结合蛋白聚糖、分泌的糖胺聚糖、糖蛋白、糖脂以及与内皮表面相关的结合血浆蛋白（如白蛋白和抗凝血酶）组成。糖萼在血管稳态中起重要作用，调节血管通透性和细胞黏附，并作为血流动力学剪切应力的机械传感器；它还具有抗血栓形成和抗炎功能。诸如白蛋白等血浆蛋白在生理状态下结合于糖萼内，从而有助于该层的稳定性。白蛋白是血浆胶体渗透压的主要决定因素。此外，白蛋白转运具有保护内皮作用的鞘氨醇 -1- 磷酸，作为自由基清除剂，具有免疫调节和抗炎作用。本综述探讨了内皮糖萼的生理功能以及人白蛋白在维持糖萼完整性和微循环中的作用。
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