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Annals of Intensive Care
Fig. 1 | Annals of Intensive Care

Fig. 1

From: Managing sepsis and septic shock in an endothelial glycocalyx-friendly way: from the viewpoint of surviving sepsis campaign guidelines

Fig. 1

The structure and the degradation of the endothelial glycocalyx. The vascular endothelial glycocalyx comprises proteoglycans and glycoproteins conjugated with highly sulfated glycosaminoglycan side-chains, including heparan sulfate and chondroitin sulfate, as well as the high‐molecular‐weight polysaccharide hyaluronan (left). During sepsis, both enzymatic and non-enzymatic pathways contribute to the degradation of glycocalyx. However, the precise dynamics between proteoglycan cleavage and glycosaminoglycan degradation are only partially understood. Syndecans, glipicans, and CD44 undergo ectodomain cleavage primarily by matrix metalloproteinases (MMPs) and members of the A Disintegrin and Metalloproteinase (ADAMs) enzyme family. In addition to oxygen free radicals, enzymes like heparanases and hyaluronidases play roles in the degradation of heparan sulfate, chondroitin sulfate, and hyaluronan (right)

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