ArticleERJ open research2022
Heparan sulfate mimetic fucoidan restores the endothelial glycocalyx and protects against dysfunction induced by serum of COVID-19 patients in the intensive care unit.
Article in ERJ open research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Endotheliopathy in Acute COVID-19 and Long COVID.International journal of molecular sciences · 2023Pooled it
- Effects of 4-month treatment with glycocalyx dietary supplement on endothelial glycocalyx and vascular function after COVID-19 infection.European journal of clinical investigation · 2025Trial
- Trial
- Effect of glycocalyx-targeted therapy on vascular function in older adults: a randomized controlled trial.Journal of applied physiology (Bethesda, Md. : 1985) · 2024Trial
- Role of dietary interventions on microvascular health in South-Asian Surinamese people with type 2 diabetes in the Netherlands: A randomized controlled trial.Nutrition & diabetes · 2024Trial
- PET-microplastics trigger endothelial glycocalyx loss via ER stress and ROS unleashing IL-1β-driven SMC switching and early aortic structural impairment.Journal of nanobiotechnology · 2026Article
- Association Between High-Density Lipoprotein Characteristics and Hemostatic Parameters in the Netherlands Epidemiology of Obesity (NEO) Study-Brief Report.Arteriosclerosis, thrombosis, and vascular biology · 2026Article
- Glycocalyx disruption mediates HP-PRRSV-induced microvascular endothelial dysfunction and underlies astragalus polysaccharide's antiviral efficacy.Open veterinary journal · 2026Article
- Fucoidan as a renal protectant: mechanistic insights and therapeutic implications of endothelial glycocalyx targeting.Frontiers in pharmacology · 2026Review
- Challenging the notion of endothelial infection by SARS-CoV-2: insights from the current scientific evidence.Frontiers in immunology · 2025Article
- Clinical Implications of COVID-19-Related Endothelial Dysfunction.JACC. Advances · 2024Review
- Protecting the endothelial glycocalyx in COVID-19.PLoS pathogens · 2024Article
- Deciphering the triad of endothelial glycocalyx, von Willebrand Factor, and P-selectin in inflammation-induced coagulation.Frontiers in cell and developmental biology · 2024Review
- Myeloperoxidase inhibition may protect against endothelial glycocalyx shedding induced by COVID-19 plasma.Communications medicine · 2023Article
- Longitudinal Assessment of Plasma Syndecan-1 Predicts 60-Day Mortality in Patients with COVID-19.Journal of clinical medicine · 2023Article
- Glycosaminoglycans and fucoidan have a protective effect on experimental glomerulonephritis.Frontiers in molecular biosciences · 2023Article
- Rationale for combined therapies in severe-to-critical COVID-19 patients.Frontiers in immunology · 2023Review
- A Dietary Supplement Containing Fucoidan Preserves Endothelial Glycocalyx through ERK/MAPK Signaling and Protects against Damage Induced by CKD Serum.International journal of molecular sciences · 2022Article
- Alterations in heparan sulfate proteoglycan synthesis and sulfation and the impact on vascular endothelial function.Matrix biology plus · 2022Review
- Endothelial glycocalyx in hepatopulmonary syndrome: An indispensable player mediating vascular changes.Frontiers in immunology · 2022Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Accumulating evidence proves that endothelial dysfunction is involved in coronavirus disease 2019 (COVID-19) progression. We previously demonstrated that the endothelial surface glycocalyx has a critical role in maintenance of vascular integrity. Here, we hypothesised that serum factors of severe COVID-19 patients affect the glycocalyx and result in endothelial dysfunction. We included blood samples of 32 COVID-19 hospitalised patients at the Leiden University Medical Center, of which 26 were hospitalised in an intensive care unit (ICU) and six on a non-ICU hospital floor; 18 of the samples were obtained from convalescent patients 6 weeks after hospital discharge, and 12 from age-matched healthy donors (control) during the first period of the outbreak. First, we determined endothelial (angiopoietin 2 (ANG2)) and glycocalyx degradation (soluble thrombomodulin (sTM) and syndecan-1 (sSDC1)) markers in plasma. In the plasma of COVID-19 patients, circulating ANG2 and sTM were elevated in patients in the ICU. Primary lung microvascular endothelial cell (HPMEC) and human glomerular microvascular endothelial cell (GEnC) cultured in the presence of these sera led to endothelial cell glycocalyx degradation, barrier disruption, inflammation and increased coagulation on the endothelial surface, significantly different compared to healthy control and non-ICU patient sera. These changes could all be restored in the presence of fucoidan. In conclusion, our data highlight the link between endothelial glycocalyx degradation, barrier failure and induction of a procoagulant surface in COVID-19 patients in ICU which could be targeted earlier in disease by the presence of heparan sulfate mimetics.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.