title: THE GLYCOCALYX AND TRAUMA: A REVIEW.
abstract: In the United States trauma is the leading cause of mortality among those under the age of 45, claiming approximately 192,000 lives each year. Significant personal disability, lost productivity, and long-term healthcare needs are common and contribute 580 billion dollars in economic impact each year. Improving resuscitation strategies and the early acute care of trauma patients has the potential to reduce the pathological sequelae of combined exuberant inflammation and immune suppression that can co-exist, or occur temporally, and adversely affect outcomes. The endothelial and epithelial glycocalyx has emerged as an important participant in both inflammation and immunomodulation. Constituents of the glycocalyx have been used as biomarkers of injury severity and have the potential to be target(s) for therapeutic interventions aimed at immune modulation. In this review, we provide a contemporary understanding of the physiologic structure and function of the glycocalyx and its role in traumatic injury with a particular emphasis on lung injury.
authors.affiliation: *Department of Anesthesiology, University of Illinois at Chicago, Chicago, Illinois †Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey ‡Department of Anesthesiology §Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama ||Department of Bioengineering, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Andreia Z
authors.initials: AZ
authors.lastname: Chignalia
authors.forename: Feliz
authors.initials: F
authors.lastname: Yetimakman
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Christiaans
authors.forename: Sule
authors.initials: S
authors.lastname: Unal
authors.forename: Benan
authors.initials: B
authors.lastname: Bayrakci
authors.forename: Brant M
authors.initials: BM
authors.lastname: Wagener
authors.forename: Robert T
authors.initials: RT
authors.lastname: Russell
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Kerby
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Pittet
authors.forename: Randal O
authors.initials: RO
authors.lastname: Dull
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004730:Endothelium, Vascular / Q000276:immunology*; D004848:Epithelium / Q000276:immunology*; D005260:Female; D019276:Glycocalyx / Q000276:immunology*; D006801:Humans; D056747:Immunomodulation; D007249:Inflammation / Q000191:economics / Q000276:immunology / Q000401:mortality / Q000628:therapy; D008297:Male; D012151:Resuscitation / Q000191:economics / Q000379:methods; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000191:economics / Q000276:immunology* / Q000401:mortality / Q000628:therapy