Figure 1.

Schematic representation of the glycocalyx and its component, syndecan-1, on the surface of endothelial cells. The luminal surface of endothelial cells is normally coated with a glycocalyx that acts as a barrier against the adhesion of circulating cells or leakage of plasma components. Syndecan-1 is one of the major core proteins to which glycosaminoglycans, such as heparan sulfate (HS) and chondroitin sulfate (CS), become covalently attached. During sepsis, the glycocalyx becomes thinner and sparser, partly through the enzymatic degradation of proteoglycans and glycosaminoglycans. This results in augmented leukocyte adhesion to the vascular wall, enhanced vascular permeability, and intravascular coagulation.