Endothelial glycocalyx as a regulator of fibrotic processes

The endothelial glycocalyx, the gel layer covering the endothelium, is composed of gly-cosaminoglycans, proteoglycans, and adsorbed plasma proteins. This structure modulates vessels’ mechanotransduction, vascular permeability, and leukocyte adhesion. Thus, it regulates several physiological and pathological events. In the present review, we described the mechanisms that disturb glycocalyx stability such as reactive oxygen species, matrix metalloproteinases, and hepara-nase. We then focused our attention on the role of glycocalyx degradation in the induction of profi-brotic events and on the possible pharmacological strategies to preserve this delicate structure.