Scratching the Surface

The endothelium represents one of the largest organs in the body covering a surface area of approximately 5000 m2 [1]. Endothelial cells line the luminal surface of blood vessels and combine with a glycopeptide layer composed of glycosaminoglycans (GACs) and proteins, such as hyaluronan, heparan sulfate, syndecan-1, thrombomodulin, versican, and antithrombin III (AT III) to form the endothelial glycocalyx (EG) [2–4] (Fig. 1). This complex weblike construct on the endothelial cell surface was identified more than a half-century ago; however, recent data implicate EG disruption as an integral component in the pathophysiology of organ dysfunction and many disease processes [1,2,5,6].