Received: August 25, 2026
Accepted for publication: September 21, 2026
Published online: September 30, 2026
UDC: 616-092:611.018.74
DOI: 10.26212/2227-1937.2026.25.94.013
THE ROLE OF THE ENDOTHELIAL GLYCOCALYX IN THE DEVELOPMENT OF PATHOPHYSIOLOGICAL CONDITIONS (REVIEW)
Muzdubayeva B.T.1
National Scientific Center of Phthisiopulmonology of the Republic of Kazakhstan,
Almaty, Kazakhstan
Introduction: The glycocalyx is an integral part of the vascular wall endothelium and plays a fundamental role in regulating blood flow, inflammation, and coagulation. Research on the endothelial glycocalyx has made significant progress, transforming this gel‑like layer from a “passive barrier” into a key therapeutic and diagnostic marker of critical conditions. The review examines the structure, pathophysiology, and clinical significance of glycocalyx damage.
Objective: to systematize scientific data on the structure and functions of the endothelial glycocalyx, in a comprehensive assessment of the mechanisms of its degradation during the development of pathophysiological conditions.
Materials and methods: a systematic analysis of the literature published over the past 10–15 years was carried out; it covers the role of the endothelial glycocalyx in the development of pathophysiological conditions based on data from PubMed, Scopus, Web of Science, and eLibrary. The review includes original studies, meta‑analyses, and systematic reviews addressing key queries related to endothelial dysfunction of the glycocalyx, vascular pathology, and sepsis.
Results: The degradation of the endothelial glycocalyx plays a key role in triggering a cascade of vascular disorders during the development of critical conditions. An analysis of current literature data convincingly demonstrates that the endothelial glycocalyx is not merely a passive biopolymer barrier, but a dynamic sensory system that determines the functional status of the entire cardiovascular system.
Discussion: The diagnostic arsenal for verifying the state of the endothelial glycocalyx consists of a set of invasive and non‑invasive technologies. Among them, methods of dark‑field microscopy and laboratory screening of specific circulating glycocalyx‑associated biochemical markers have high diagnostic value. The correlation between glycocalyx damage markers and other prognostic markers allows us to consider glycocalyx damage as an indicator of an unfavorable course and outcome of diseases.
Conclusion: The endothelial glycocalyx is a fundamental regulator of vascular homeostasis; its degradation serves as a triggering mechanism for endothelial dysfunction, which initiates a cascade of inflammatory and coagulation responses and micro- and macrovascular disorders in the body under critical conditions. The development of glycocalyx‑protective strategies and the monitoring of markers of its degradation are promising areas for improving the prognosis in critically ill patients.
Keywords: Vascular endothelium, glycocalyx, endothelial dysfunction, glycocalyx degradation.
