Plasma glycocalyx pattern: a mirror of endothelial damage in chronic kidney disease

Area of Science:

• Nephrology
• Cardiovascular Medicine
• Immunology

Background:

• Chronic kidney disease (CKD) is associated with endothelial damage and increased cardiovascular disease risk.
• Microinflammation and endothelial damage contribute to the heightened atherogenicity observed in CKD patients.
• Elevated levels of endothelial glycocalyx degradation products, including perlecan and decorin, are noted in CKD.

Purpose of the Study:

• To investigate the association between plasma perlecan and decorin levels and the pro-inflammatory and atherogenic state in CKD.
• To explore the relationship between these markers and monocyte subpopulations and intracellular adhesion molecule (ICAM)-1 expression in CKD patients.

Main Methods:

• Study included 17 healthy controls and 109 CKD patients (advanced CKD, hemodialysis, peritoneal dialysis, kidney transplantation).
• Plasma perlecan and decorin levels were quantified using enzyme-linked immunosorbent assays.
• Monocyte phenotype, including ICAM-1 expression, was analyzed via direct immunofluorescence and flow cytometry.

Main Results:

• Plasma perlecan levels were significantly higher in CKD patients compared to controls.
• Higher perlecan levels correlated with an increased prevalence of ICAM-1 positive monocytes.
• Advanced CKD patients exhibited higher decorin levels, associated with reduced ICAM-1 expression on monocytes.

Conclusions:

• Elevated perlecan in CKD may indicate a pro-inflammatory state linked to increased ICAM-1 positive monocytes.
• Elevated decorin might function as a negative regulator of ICAM-1 expression on monocytes.
• Perlecan and decorin show potential as biomarkers for inflammation, monocyte activation, and endothelial damage in CKD.