» Articles » PMID: 39033135

Plasma for Prevention and Treatment of Glycocalyx Degradation in Trauma and Sepsis

Overview
Journal Crit Care
Specialty Critical Care
Date 2024 Jul 20
PMID 39033135
Authors
Affiliations
Soon will be listed here.
Abstract

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.

Citing Articles

The Resuscitation, Equilibrium and De-escalation (RED) strategy: a phased, personalized hemodynamic support in children with sepsis.

Fernandez-Sarmiento J, Ranjit S, Sanchez-Pinto L, Nadkarni V, Jabornisky R, Kissoon N Front Pediatr. 2025; 13:1530984.

PMID: 39944316 PMC: 11813869. DOI: 10.3389/fped.2025.1530984.


Navigating Hemorrhagic Shock: Biomarkers, Therapies, and Challenges in Clinical Care.

Meza Monge K, Rosa C, Sublette C, Pratap A, Kovacs E, Idrovo J Biomedicines. 2025; 12(12.

PMID: 39767770 PMC: 11673713. DOI: 10.3390/biomedicines12122864.


Plasma transfusion in the intensive care unit.

van Haeren M, Raasveld S, de Bruin S, Reuland M, van den Oord C, Schenk J Transfusion. 2024; 65(1):73-87.

PMID: 39696779 PMC: 11747124. DOI: 10.1111/trf.18071.


Immune regulation and organ damage link adiponectin to sepsis.

Zhang L, Lin Y, Zhang Z, Chen Y, Zhong J Front Immunol. 2024; 15:1444884.

PMID: 39664383 PMC: 11632310. DOI: 10.3389/fimmu.2024.1444884.


The dysfunction of complement and coagulation in diseases: the implications for the therapeutic interventions.

Jiang H, Guo Y, Wang Q, Wang Y, Peng D, Fang Y MedComm (2020). 2024; 5(11):e785.

PMID: 39445002 PMC: 11496570. DOI: 10.1002/mco2.785.


References
1.
Galvani S, Sanson M, Blaho V, Swendeman S, Obinata H, Conger H . HDL-bound sphingosine 1-phosphate acts as a biased agonist for the endothelial cell receptor S1P1 to limit vascular inflammation. Sci Signal. 2015; 8(389):ra79. PMC: 4768813. DOI: 10.1126/scisignal.aaa2581. View

2.
Barry M, Wu F, Pati S, Chipman A, Geng H, Kozar R . Lyophilized plasma resuscitation downregulates inflammatory gene expression in a mouse model of sepsis. J Trauma Acute Care Surg. 2022; 93(2S Suppl 1):S119-S127. DOI: 10.1097/TA.0000000000003658. View

3.
Pandey S, Vyas G . Adverse effects of plasma transfusion. Transfusion. 2012; 52 Suppl 1:65S-79S. PMC: 3356109. DOI: 10.1111/j.1537-2995.2012.03663.x. View

4.
Scheck M, Velten M, Klaschik S, Soehle M, Frede S, Gehlen J . Differential modulation of endothelial cell function by fresh frozen plasma. Life Sci. 2020; 254:117780. DOI: 10.1016/j.lfs.2020.117780. View

5.
Chapman C, Stainsby D, Jones H, Love E, Massey E, Win N . Ten years of hemovigilance reports of transfusion-related acute lung injury in the United Kingdom and the impact of preferential use of male donor plasma. Transfusion. 2008; 49(3):440-52. DOI: 10.1111/j.1537-2995.2008.01948.x. View