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  1. Article ; Online: Capillary rarefication as a possible cause of long-COVID syndrome.

    Osiaevi, Irina / Kümpers, Philipp / Weinmann-Menke, Julia / Pavenstädt, Hermann / Rovas, Alexandros

    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

    2024  

    Language English
    Publishing date 2024-02-02
    Publishing country England
    Document type Journal Article
    ZDB-ID 90594-x
    ISSN 1460-2385 ; 0931-0509
    ISSN (online) 1460-2385
    ISSN 0931-0509
    DOI 10.1093/ndt/gfae026
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  2. Article ; Online: Störung der Mikrozirkulation bei COVID-19.

    Rovas, Alexandros / Kümpers, Philipp

    Medizinische Klinik, Intensivmedizin und Notfallmedizin

    2021  Volume 116, Issue 6, Page(s) 530–534

    Title translation Impairment of the microculation in COVID-19.
    MeSH term(s) COVID-19 ; Endothelium, Vascular ; Glycocalyx ; Humans ; SARS-CoV-2
    Language German
    Publishing date 2021-08-10
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 2636018-4
    ISSN 2193-6226 ; 1435-1420 ; 0723-5003 ; 2193-6218 ; 0175-3851
    ISSN (online) 2193-6226 ; 1435-1420
    ISSN 0723-5003 ; 2193-6218 ; 0175-3851
    DOI 10.1007/s00063-021-00842-z
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  3. Article ; Online: Epidemiologie und Ursachen für ein akutes Nierenversagen – Übergang in eine chronische Nierenschädigung.

    Finke, Markus / Kümpers, Philipp / Rovas, Alexandros

    Deutsche medizinische Wochenschrift (1946)

    2022  Volume 147, Issue 5, Page(s) 227–235

    Abstract: Acute kidney injury (AKI) refers to an acute functional deterioration of the kidneys, which leads to retention of urinary substances, dysregulation of the electrolyte and acid-base balance, and disturbance of fluids. Although didactically helpful, the ... ...

    Title translation Epidemiology and Causes of Acute Renal Failure and Transition to Chronic Kidney Disease.
    Abstract Acute kidney injury (AKI) refers to an acute functional deterioration of the kidneys, which leads to retention of urinary substances, dysregulation of the electrolyte and acid-base balance, and disturbance of fluids. Although didactically helpful, the oversimplified AKI classification of prerenal/renal/postrenal is currently considered obsolete. Indeed, the boundaries blur quite quickly, particularly between prerenal and renal causes. Based on the AKI pathophysiology, it can be etiologically divided into decreased renal perfusion, postrenal obstruction and kidney specific injury or unspecific injury. AKI is a common event in hospitalized patients and associates strongly with mortality and chronic kidney disease (CKD). Today it is accepted that AKI and CKD are rather an individually variable continuum, than 2 distinct entities. If AKI has not regressed after 7 days, it is referred to as acute kidney disease (AKD). Persisting AKD for > 90 days is classified as CKD. The transition from AKD to CKD is the result of an incomplete and maladaptive repair process. Although follow-up of post-AKI patients is essential, optimal concepts still need to be developed.
    MeSH term(s) Acute Disease ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Causality ; Female ; Humans ; Kidney ; Male ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/etiology
    Language German
    Publishing date 2022-02-28
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 200446-x
    ISSN 1439-4413 ; 0012-0472
    ISSN (online) 1439-4413
    ISSN 0012-0472
    DOI 10.1055/a-1531-9023
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  4. Article ; Online: Interleukin-6 drives endothelial glycocalyx damage in COVID-19 and bacterial sepsis.

    Drost, Carolin Christina / Rovas, Alexandros / Osiaevi, Irina / Schughart, Klaus / Lukasz, Alexander / Linke, Wolfgang A / Pavenstädt, Hermann / Kümpers, Philipp

    Angiogenesis

    2024  

    Abstract: Damage of the endothelial glycocalyx (eGC) plays a central role in the development of vascular hyperpermeability and organ damage during systemic inflammation. However, the specific signalling pathways for eGC damage remain poorly defined. Aim of this ... ...

    Abstract Damage of the endothelial glycocalyx (eGC) plays a central role in the development of vascular hyperpermeability and organ damage during systemic inflammation. However, the specific signalling pathways for eGC damage remain poorly defined. Aim of this study was to combine sublingual video-microscopy, plasma proteomics and live cell imaging to uncover further pathways of eGC damage in patients with coronavirus disease 2019 (COVID-19) or bacterial sepsis. This secondary analysis of the prospective multicenter MICROCODE study included 22 patients with COVID-19 and 43 patients with bacterial sepsis admitted to intermediate or intensive care units and 10 healthy controls. Interleukin-6 (IL-6) was strongly associated with damaged eGC and correlated both with eGC dimensions (r
    Language English
    Publishing date 2024-04-10
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1484717-6
    ISSN 1573-7209 ; 0969-6970
    ISSN (online) 1573-7209
    ISSN 0969-6970
    DOI 10.1007/s10456-024-09916-w
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  5. Article ; Online: Protection and rebuilding of the endothelial glycocalyx in sepsis - Science or fiction?

    Drost, Carolin Christina / Rovas, Alexandros / Kümpers, Philipp

    Matrix biology plus

    2021  Volume 12, Page(s) 100091

    Abstract: The endothelial glycocalyx (eGC), a delicate carbohydrate-rich structure lining the luminal surface of the vascular endothelium, is vital for maintenance of microvascular homeostasis. In sepsis, damage of the eGC triggers the development of vascular ... ...

    Abstract The endothelial glycocalyx (eGC), a delicate carbohydrate-rich structure lining the luminal surface of the vascular endothelium, is vital for maintenance of microvascular homeostasis. In sepsis, damage of the eGC triggers the development of vascular hyperpermeability with consecutive edema formation and organ failure. While there is evidence that protection or rebuilding of the eGC might counteract sepsis-induced vascular leakage and improve outcome, approved therapeutics are not yet available. This narrative review aims to outline possible therapeutic strategies to ameliorate organ dysfunction caused by eGC impairment.
    Language English
    Publishing date 2021-11-03
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2590-0285
    ISSN (online) 2590-0285
    DOI 10.1016/j.mbplus.2021.100091
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  6. Article: Epidemiologie und Ursachen für ein akutes Nierenversagen – Übergang in eine chronische Nierenschädigung

    Finke, Markus / Kümpers, Philipp / Rovas, Alexandros

    DMW - Deutsche Medizinische Wochenschrift

    2022  Volume 147, Issue 05, Page(s) 227–235

    Keywords akutes Nierenversagen ; akute Nierenschädigung ; akute Nierenerkrankung ; acute renal failure ; acute kidney injury ; acute kidney disease
    Language German
    Publishing date 2022-02-28
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 200446-x
    ISSN 1439-4413 ; 0012-0472
    ISSN (online) 1439-4413
    ISSN 0012-0472
    DOI 10.1055/a-1531-9023
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  7. Article ; Online: Identification of novel sublingual parameters to analyze and diagnose microvascular dysfunction in sepsis: the NOSTRADAMUS study.

    Rovas, Alexandros / Sackarnd, Jan / Rossaint, Jan / Kampmeier, Stefanie / Pavenstädt, Hermann / Vink, Hans / Kümpers, Philipp

    Critical care (London, England)

    2021  Volume 25, Issue 1, Page(s) 112

    Abstract: Background: The availability of handheld, noninvasive sublingual video-microscopes allows for visualization of the microcirculation in critically ill patients. Recent studies demonstrate that reduced numbers of blood-perfused microvessels and increased ... ...

    Abstract Background: The availability of handheld, noninvasive sublingual video-microscopes allows for visualization of the microcirculation in critically ill patients. Recent studies demonstrate that reduced numbers of blood-perfused microvessels and increased penetration of erythrocytes into the endothelial glycocalyx are essential components of microvascular dysfunction. The aim of this study was to identify novel microvascular variables to determine the level of microvascular dysfunction in sepsis and its relationship with clinical variables.
    Methods: This observational, prospective, cross-sectional study included 51 participants, of which 34 critically ill sepsis patients were recruited from intensive care units of a university hospital. Seventeen healthy volunteers served as controls. All participants underwent sublingual videomicroscopy by sidestream darkfield imaging. A new developed version of the Glycocheck™ software was used to quantify vascular density, perfused boundary region (PBR-an inverse variable of endothelial glycocalyx dimensions), red blood cell (RBC) velocity, RBC content, and blood flow in sublingual microvessels with diameters between 4 and 25 µm.
    Results: A detailed analysis of adjacent diameter classes (1 µm each) of vessels between 4 and 25 µm revealed a severe reduction of vascular density in very small capillaries (5-7 µm), which correlated with markers of sepsis severity. Analysis of RBC velocity (V
    Conclusion: We introduce new important diameter-specific quantification and differentiated analysis of RBC kinetics, a key to understand microvascular dysfunction in sepsis. MVHS
    MeSH term(s) Adult ; Aged ; Biomarkers/analysis ; Cross-Sectional Studies ; Female ; Hemodynamics/physiology ; Humans ; Male ; Microcirculation/physiology ; Microvessels/abnormalities ; Microvessels/physiopathology ; Middle Aged ; Mouth Floor/blood supply ; Mouth Floor/physiopathology ; Prospective Studies ; Sepsis/complications ; Weights and Measures/instrumentation ; Weights and Measures/standards
    Chemical Substances Biomarkers
    Language English
    Publishing date 2021-03-19
    Publishing country England
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2041406-7
    ISSN 1466-609X ; 1364-8535
    ISSN (online) 1466-609X
    ISSN 1364-8535
    DOI 10.1186/s13054-021-03520-w
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  8. Article ; Online: Persistent capillary rarefication in long COVID syndrome.

    Osiaevi, Irina / Schulze, Arik / Evers, Georg / Harmening, Kimon / Vink, Hans / Kümpers, Philipp / Mohr, Michael / Rovas, Alexandros

    Angiogenesis

    2022  Volume 26, Issue 1, Page(s) 53–61

    Abstract: Background: Recent studies have highlighted Coronavirus disease 2019 (COVID-19) as a multisystemic vascular disease. Up to 60% of the patients suffer from long-term sequelae and persistent symptoms even 6 months after the initial infection.: Methods: ...

    Abstract Background: Recent studies have highlighted Coronavirus disease 2019 (COVID-19) as a multisystemic vascular disease. Up to 60% of the patients suffer from long-term sequelae and persistent symptoms even 6 months after the initial infection.
    Methods: This prospective, observational study included 58 participants, 27 of whom were long COVID patients with persistent symptoms > 12 weeks after recovery from PCR-confirmed SARS-CoV-2 infection. Fifteen healthy volunteers and a historical cohort of critically ill COVID-19 patients (n = 16) served as controls. All participants underwent sublingual videomicroscopy using sidestream dark field imaging. A newly developed version of Glycocheck™ software was used to quantify vascular density, perfused boundary region (PBR-an inverse variable of endothelial glycocalyx dimensions), red blood cell velocity (VRBC) and the microvascular health score (MVHS™) in sublingual microvessels with diameters 4-25 µm.
    Measurements and main results: Although dimensions of the glycocalyx were comparable to those of healthy controls, a µm-precise analysis showed a significant decrease of vascular density, that exclusively affected very small capillaries (D5: - 45.16%; D6: - 35.60%; D7: - 22.79%). Plotting VRBC of capillaries and feed vessels showed that the number of capillaries perfused in long COVID patients was comparable to that of critically ill COVID-19 patients and did not respond adequately to local variations of tissue metabolic demand. MVHS was markedly reduced in the long COVID cohort (healthy 3.87 vs. long COVID 2.72 points; p = 0.002).
    Conclusions: Our current data strongly suggest that COVID-19 leaves a persistent capillary rarefication even 18 months after infection. Whether, to what extent, and when the observed damage might be reversible remains unclear.
    MeSH term(s) Humans ; Capillaries ; Post-Acute COVID-19 Syndrome ; Prospective Studies ; Critical Illness ; COVID-19/metabolism ; SARS-CoV-2 ; Glycocalyx ; Microcirculation
    Language English
    Publishing date 2022-08-11
    Publishing country Germany
    Document type Observational Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1484717-6
    ISSN 1573-7209 ; 0969-6970
    ISSN (online) 1573-7209
    ISSN 0969-6970
    DOI 10.1007/s10456-022-09850-9
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  9. Article: Analysis of Urinary Glycosaminoglycans to Predict Outcome in COVID-19 and Community-Acquired Pneumonia-A Proof-of-Concept Study.

    Rovas, Alexandros / Neumann, Julia Katharina / Drost, Carolin Christina / Vollenberg, Richard / Thölking, Gerold / Fobker, Manfred / Witzenrath, Martin / Kümpers, Philipp / Agamotto Study Group / Capnetz Study Group

    Journal of clinical medicine

    2023  Volume 12, Issue 16

    Abstract: Although coronavirus disease 2019 (COVID-19) is considered a systemic disease associated with vascular inflammation and eventual destruction of the protective endothelial glycocalyx (eGC), biomarkers of eGC damage are not yet available in the clinic. The ...

    Abstract Although coronavirus disease 2019 (COVID-19) is considered a systemic disease associated with vascular inflammation and eventual destruction of the protective endothelial glycocalyx (eGC), biomarkers of eGC damage are not yet available in the clinic. The most prominent components of eGC are sulphated glycosaminoglycans (sGAGs) attached to core proteoglycans. We hypothesised that the amount of sGAG fragments shed in urine (as a surrogate for systemic eGC damage) would correlate with disease severity and outcome. Total urinary sGAG concentration was measured using an in-house optimised 1,9-dimethylmethylene blue (DMMB) assay, which is highly accurate and insensitive to interferences. The median urinary sGAG concentration was significantly higher in 67 hospitalised patients with COVID-19 compared to 72 hospitalised patients with community-acquired pneumonia (CAP). In both groups, urinary sGAG concentrations predicted a combined endpoint (including intubation and death) with an area under the receiver operator characteristic curve of 0.72 (95% CI 0.55-0.88,
    Language English
    Publishing date 2023-08-13
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm12165269
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  10. Article ; Online: A Dietary Supplement Containing Fucoidan Preserves Endothelial Glycocalyx through ERK/MAPK Signaling and Protects against Damage Induced by CKD Serum.

    Regier, Manuel / Drost, Carolin Christina / Rauen, Matthias / Pavenstädt, Hermann / Rovas, Alexandros / Kümpers, Philipp / Vink, Hans / Long, Robert M / Linke, Wolfgang A / Nofer, Jerzy-Roch / Lukasz, Alexander-Henrik

    International journal of molecular sciences

    2022  Volume 23, Issue 24

    Abstract: 1) Damage to the endothelial glycocalyx (eGC), a protective layer lining the endothelial luminal surface, is associated with chronic kidney disease (CKD), which leads to a worsening of cardiovascular outcomes in these patients. Currently, there are no ... ...

    Abstract (1) Damage to the endothelial glycocalyx (eGC), a protective layer lining the endothelial luminal surface, is associated with chronic kidney disease (CKD), which leads to a worsening of cardiovascular outcomes in these patients. Currently, there are no targeted therapeutic approaches. Whether the dietary supplement Endocalyx
    Language English
    Publishing date 2022-12-08
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms232415520
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