The endothelial glycocalyx, a gel-like layer that lines the luminal surface of blood vessels, is composed of proteoglycans, glycoproteins, and glycosaminoglycans. The endothelial glycocalyx plays an essential role in vascular homeostasis, and its degradation in trauma and sepsis can lead to microvascular dysfunction and organ injury. While there are no proven therapies for preventing or treating endothelial glycocalyx degradation, some initial literature suggests that plasma may have a therapeutic role in trauma and sepsis patients. Overall, the literature suggesting the use of plasma as a therapy for endothelial glycocalyx degradation is non-clinical basic science or exploratory. Plasma is an established therapy in the resuscitation of patients with hemorrhage for restoration of coagulation factors. However, plasma also contains other bioactive components, including sphingosine-1 phosphate, antithrombin, and adiponectin, which may protect and restore the endothelial glycocalyx, thereby helping to maintain or restore vascular homeostasis. This narrative review begins by describing the endothelial glycocalyx in health and disease: we discuss the overlapping disease mechanisms in trauma and sepsis that lead to its damage and introduce plasma transfusion as a potential therapy for prevention and treatment of endothelial glycocalyx degradation. Second, we review the literature on plasma as an exploratory therapy for endothelial glycocalyx degradation in trauma and sepsis. Third, we discuss the safety of plasma transfusion by reviewing the adverse events associated with plasma and other blood product transfusions, and we examine modern transfusion precautions that have enhanced the safety of plasma transfusion. We conclude that the literature proposes that plasma may have the potential to prevent and treat endothelial glycocalyx degradation in trauma and sepsis, indicating the need for further research.

中文翻译：

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用于预防和治疗创伤和脓毒症中糖萼降解的血浆


内皮糖萼是排列在血管管腔表面的凝胶状层，由蛋白聚糖、糖蛋白和糖胺聚糖组成。内皮糖萼在血管稳态中起着至关重要的作用，它在创伤和败血症中的降解可导致微血管功能障碍和器官损伤。虽然没有经过验证的预防或治疗内皮糖萼降解的疗法，但一些初步文献表明血浆可能对创伤和败血症患者具有治疗作用。总体而言，表明使用血浆作为内皮糖萼降解疗法的文献是非临床基础科学或探索性的。血浆是出血患者复苏以恢复凝血因子的成熟疗法。然而，血浆还含有其他生物活性成分，包括磷酸鞘氨醇-1、抗凝血酶和脂联素，它们可以保护和恢复内皮糖萼，从而有助于维持或恢复血管稳态。本叙述性综述首先描述了健康和疾病中的内皮糖萼：我们讨论了创伤和败血症中导致其损伤的重叠疾病机制，并介绍了血浆输注作为预防和治疗内皮糖萼降解的潜在疗法。其次，我们回顾了关于血浆作为创伤和败血症中内皮糖萼降解的探索性疗法的文献。第三，我们通过回顾与血浆和其他血液制品输注相关的不良事件来讨论血浆输注的安全性，并研究提高血浆输注安全性的现代输血预防措施。 我们得出结论，文献提出血浆可能具有预防和治疗创伤和败血症中内皮糖萼降解的潜力，表明需要进一步研究。