The Endothelial Glycocalyx as a Target of Ischemia and Reperfusion Injury in Kidney Transplantation-Where Have We Gone So Far?

The damage of the endothelial glycocalyx as a consequence of ischemia and/or reperfusion injury (IRI) following kidney transplantation has come at the spotlight of research due to potential associations with delayed graft function, acute rejection as well as long-term allograft dysfunction. The disi...

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Bibliographic Details
Published in:International journal of molecular sciences 2021-02, Vol.22 (4), p.2157
Main Authors: Duni, Anila, Liakopoulos, Vassilios, Koutlas, Vasileios, Pappas, Charalampos, Mitsis, Michalis, Dounousi, Evangelia
Format: Article
Language:English
Subjects:
Antigens
CD44 antigen
Cell adhesion & migration
Cytokines
Disintegration
Endothelial cells
endothelial glycocalyx
Endothelium
Enzymes
Extracellular matrix
Glycoproteins
Graft rejection
Heparan sulfate
Hyaluronic acid
Hypoxia
immune responses
Immune system
Inflammation
Ischemia
ischemia and/or reperfusion injury
kidney transplantation
Kidney transplants
Kinases
Medical prognosis
Oxidative stress
Pathogenesis
Permeability
Proteins
Reperfusion
Review
Shear stress
Syndecan
Toll-like receptors
Transcription factors
Tumor necrosis factor-TNF
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Summary:The damage of the endothelial glycocalyx as a consequence of ischemia and/or reperfusion injury (IRI) following kidney transplantation has come at the spotlight of research due to potential associations with delayed graft function, acute rejection as well as long-term allograft dysfunction. The disintegration of the endothelial glycocalyx induced by IRI is the crucial event which exposes the denuded endothelial cells to further inflammatory and oxidative damage. The aim of our review is to present the currently available data regarding complex links between shedding of the glycocalyx components, like syndecan-1, hyaluronan, heparan sulphate, and CD44 with the activation of intricate immune system responses, including toll-like receptors, cytokines and pro-inflammatory transcription factors. Evidence on modes of protection of the endothelial glycocalyx and subsequently maintenance of endothelial permeability as well as novel nephroprotective molecules such as sphingosine-1 phosphate (S1P), are also depicted. Although advances in technology are making the visualization and the analysis of the endothelial glycocalyx possible, currently available evidence is mostly experimental. Ongoing progress in understanding the complex impact of IRI on the endothelial glycocalyx, opens up a new era of research in the field of organ transplantation and clinical studies are of utmost importance for the future.
ISSN:1422-0067
1661-6596
1422-0067
DOI:10.3390/ijms22042157