Soluble vascular endothelial glycocalyx proteoglycans as potential therapeutic targets in inflammatory diseases

Immunol Cell Biol. 2024 Feb;102(2):97-116. doi: 10.1111/imcb.12712. Epub 2023 Nov 20.


Reducing the activity of cytokines and leukocyte extravasation is an emerging therapeutic strategy to limit tissue-damaging inflammatory responses and restore immune homeostasis in inflammatory diseases. Proteoglycans embedded in the vascular endothelial glycocalyx, which regulate the activity of cytokines to restrict the inflammatory response in physiological conditions, are proteolytically cleaved in inflammatory diseases. Here we critically review the potential of proteolytically shed, soluble vascular endothelial glycocalyx proteoglycans to modulate pathological inflammatory responses. Soluble forms of the proteoglycans syndecan-1, syndecan-3 and biglycan exert beneficial anti-inflammatory effects by the removal of chemokines, suppression of proinflammatory cytokine expression and leukocyte migration, and induction of autophagy of proinflammatory M1 macrophages. By contrast, soluble versikine and decorin enhance proinflammatory responses by increasing inflammatory cytokine synthesis and leukocyte migration. Endogenous syndecan-2 and mimecan exert proinflammatory effects, syndecan-4 and perlecan mediate beneficial anti-inflammatory effects and glypican regulates Hh and Wnt signaling pathways involved in systemic inflammatory responses. Taken together, targeting the vascular endothelial glycocalyx-derived, soluble syndecan-1, syndecan-2, syndecan-3, syndecan-4, biglycan, versikine, mimecan, perlecan, glypican and decorin might be a potential therapeutic strategy to suppress overstimulated cytokine and leukocyte responses in inflammatory diseases.

Keywords: Cytokines; inflammation; leukocyte extravasation; soluble proteoglycans; vascular endothelial glycocalyx.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents / metabolism
  • Biglycan / metabolism
  • Chemokines / metabolism
  • Decorin / metabolism
  • Glycocalyx* / metabolism
  • Glypicans / metabolism
  • Syndecan-1* / metabolism
  • Syndecan-2 / metabolism
  • Syndecan-3 / metabolism
  • Syndecan-4 / metabolism


  • Syndecan-1
  • Syndecan-3
  • Syndecan-4
  • Syndecan-2
  • Biglycan
  • Glypicans
  • Decorin
  • Chemokines
  • Anti-Inflammatory Agents