Regeneration and Assessment of the Endothelial Glycocalyx To Address Cardiovascular Disease

Endothelial cell (EC) glycocalyx (GCX) loss permits blood circulating particle infiltration of the vessel walls and leads to vascular dysfunction, atherosclerosis, and serious downstream cardiovascular events, motivating EC GCX regeneration to treat cardiovascular disease. This review discusses the benefits and drawbacks of current options for EC GCX regeneration and assessment. Existing pharmaceutical therapies are being explored for their applicability to EC GCX regeneration, while nutraceuticals are under development as primary EC GCX regeneration approaches, and novel therapies continue to emerge. Promotion of increased efficacy of these therapies by using novel targeted drug delivery approaches is proposed. In addition, development of intravital (and intravascular, if possible) detection tools for assessment of GCX health and GCX regeneration efficacy is recommended. The work presented in this review encourages continued development of GCX regeneration and detection approaches, which could lead to breakthrough solutions for addressing cardiovascular disease.