Cerebral microvascular endothelial glycocalyx damage, its implications on the blood–brain barrier and a possible contributor to cognitive impairment

Patrice Stoddart*, Simon C Satchell, Raina D Ramnath

*Corresponding author for this work

Research output: Contribution to journalReview article (Academic Journal)peer-review

13 Citations (Scopus)
192 Downloads (Pure)


The socio-economic impact of diseases associated with cognitive impairment is increasing. According to the Alzheimer’s Society there are over 850,000 people with dementia in the UK, costing the UK £26 billion in 2013. Therefore, research into treatment of those conditions is vital. Research into the cerebral endothelial glycocalyx (CeGC) could offer effective treatments.

The CeGC, consisting of proteoglycans, glycoproteins and glycolipids, is a dynamic structure covering the luminal side of the endothelial cells of capillaries throughout the body. The CeGC is thicker in cerebral micro vessels, suggesting specialisation for its function as part of the blood–brain barrier (BBB). Recent research evidences that the CeGC is vital in protecting fragile parenchymal tissue and effective functioning of the BBB, as one particularly important CeGC function is to act as a protective barrier and permeability regulator.

CeGC degradation is one of the factors which can lead to an increase in BBB permeability. It occurs naturally in aging, nevertheless, premature degradation has been evidenced in multiple conditions linked to cognitive impairment, such as inflammation, brain edema, cerebral malaria, Alzheimer’s and recently Covid-19. Increasing knowledge of the mechanisms of CeGC damage has led to research into preventative techniques showing that CeGC is a possible diagnostic marker and a therapeutic target. However, the evidence is relatively new, inconsistent and demonstrated mainly in experimental models.

This review evaluates the current knowledge of the CeGC, its structure, functions, damage and repair mechanisms and the impact of its degeneration on cognitive impairment in multiple conditions, highlighting the CeGC as a possible diagnostic marker and a potential target for therapeutic treatment.
Original languageEnglish
Article number147804
Number of pages12
JournalBrain Research
Early online date29 Jan 2022
Publication statusPublished - 1 Apr 2022

Bibliographical note

Funding Information:
I wish to show my appreciation and am indebted to Jana and Michael Stoddart for all their proof reading and language help.

Publisher Copyright:
© 2022 Elsevier B.V.

Structured keywords

  • Bristol Heart Institute


  • Cerebral endothelial glycocalyx
  • Cognitive impairment
  • Diagnostic marker


Dive into the research topics of 'Cerebral microvascular endothelial glycocalyx damage, its implications on the blood–brain barrier and a possible contributor to cognitive impairment'. Together they form a unique fingerprint.

Cite this