Dynamic changes in the glycocalyx and clinical outcomes in patients undergoing endovascular treatments for large vessel occlusion

Dan Liang; Xiuli Zeng; Mingzheng Yao; Fei Li; Jiaxing Lin; Liang Zhang; Jialin Liu; Li'an Huang

doi:10.3389/fneur.2023.1046915

Dynamic changes in the glycocalyx and clinical outcomes in patients undergoing endovascular treatments for large vessel occlusion

Front Neurol. 2023 Jan 26:14:1046915. doi: 10.3389/fneur.2023.1046915. eCollection 2023.

Authors

Dan Liang^{1

2}, Xiuli Zeng¹, Mingzheng Yao¹, Fei Li², Jiaxing Lin¹, Liang Zhang¹, Jialin Liu³, Li'an Huang¹

Affiliations

¹ Department of Neurology, The First Affiliated Hospital, Jinan University, Guangzhou, China.
² Department of Neurology, The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, China.
³ Department of Neurology, Meizhou People's Hospital, Meizhou, China.

Abstract

Purpose: We aimed to verify the prognostic value of the glycocalyx as a marker of blood-brain barrier damage in patients with acute ischemic stroke undergoing endovascular therapy.

Methods: We recruited patients with large vessel occlusion who were undergoing recanalization and tested their glycocalyx at multiple time points. On the basis of the 90-day follow-up data, the patients were divided into a survivor group and a nonsurvivor group. In addition, neurological function was tracked, and patients were divided into a neurological deterioration group and a group without neurological deterioration. Associations between outcomes and dynamic changes in the glycocalyx were determined using a linear mixed model, and significant factors were used as covariates.

Results: Nonsurvivors and patients with neurological deterioration had significantly higher syndecan-1 concentrations than survivors and patients without neurological deterioration, and syndecan-1 tended to decline after endovascular therapy (p < 0.05). The increased level of syndecan-1 at 36 h after endovascular treatment was positively correlated with the National Institute of Health Stroke Scale score for neurological deterioration (r = 0.702, p = 0.005). However, there was no significant difference in the level of hyaluronic acid or heparan sulfate in the plasma of patients with different clinical outcomes.

Conclusion: Pre-reperfusion syndecan-1 levels in patients with large vessel occlusion stroke are associated with 90-day mortality and the re-degradation of syndecan-1 is positively associated with neurological deterioration.

Keywords: endovascular therapy; glycocalyx; ischemia/reperfusion injury; large vessel occlusion; outcomes.

Grants and funding

This study was supported by the National Natural Science Foundation of China (81971120), the Natural Science Foundation of Guangdong Province (2022A1515012563), and the Fundamental and Applied Basic Research of Guangzhou Municipal School (College) Joint Funding Project (202201020062).