• Hideshi Okada, Genzou Takemura, Kodai Suzuki, Kazumasa Oda, Chihiro Takada, Yasuaki Hotta, Nagisa Miyazaki, Akiko Tsujimoto, Isamu Muraki, Yoshiaki Ando, Ryogen Zaikokuji, Atsumu Matsumoto, Hiroki Kitagaki, Yuto Tamaoki, Takahiro Usui, Tomoaki Doi, Takahiro Yoshida, Shozo Yoshida, Hiroaki Ushikoshi, Izumi Toyoda, and Shinji Ogura.
• Department of Emergency and Disaster Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan. hideshi@gifu-u.ac.jp.
• Crit Care. 2017 Oct 23; 21 (1): 261.

BackgroundSugar-protein glycocalyx coats healthy endothelium, but its ultrastructure is not well described. Our aim was to determine the three-dimensional ultrastructure of capillary endothelial glycocalyx in the heart, kidney, and liver, where capillaries are, respectively, continuous, fenestrated, and sinusoidal.MethodsTissue samples were processed with lanthanum-containing alkaline fixative, which preserves the structure of glycocalyx.ResultsScanning and transmission electron microscopy revealed that the endothelial glycocalyx layer in continuous and fenestrated capillaries was substantially thicker than in sinusoids. In the heart, the endothelial glycocalyx presented as moss- or broccoli-like and covered the entire luminal endothelial cell surface. In the kidney, the glycocalyx appeared to nearly occlude the endothelial pores of the fenestrated capillaries and was also present on the surface of the renal podocytes. In sinusoids of the liver, glycocalyx covered not only the luminal side but also the opposite side, facing the space of Disse. In a mouse lipopolysaccharide-induced experimental endotoxemia model, the capillary endothelial glycocalyx was severely disrupted; that is, it appeared to be peeling off the cells and clumping. Serum concentrations of syndecan-1, a marker of glycocalyx damage, were significantly increased 24 h after administration of lipopolysaccharide.ConclusionsIn the present study, we visualized the three-dimensional ultrastructure of endothelial glycocalyx in healthy continuous, fenestrated, and sinusoidal capillaries, and we also showed their disruption under experimental endotoxemic conditions. The latter may provide a morphological basis for the microvascular endothelial dysfunction associated with septic injury to organs.

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