Endothelial Glycocalyx Damage and Restoration Following Vascular Stent Implantation.

The endothelial glycocalyx layer forms interface between the luminal surface and circulating blood, and consists of cell surface membrane-bound glycosaminoglycan chains and transmembrane embedded glycoproteins and proteoglycans, such as glypicans and syndecans. This dynamic layer contributes to various endothelial functions, including maintenance of vascular permeability, mechanosensation, shear-stress-mediated nitric oxide generation, modulation of interactions with constituents of blood, and regulation of vascular tone. Following vascular device placement, the transmembrane-linked glycosaminoglycan side chains are damaged and released into the circulation as soluble heparan sulfate, hyaluronan, and chondroitin sulfate. Damage to the glycocalyx causes an increase in vascular permeability, adhesion of leukocytes and platelets to the endothelium, extravasation of proinflammatory cells, dysregulation of vascular tone, imbalance of coagulation, and loss of antioxidant defense mechanisms. This review highlights the function of the endothelial glycocalyx as a vasoprotective layer and discusses targeted therapeutic approaches to promoting the restoration of glycocalyx disrupted by vascular stent implantation.