Glycocalyx-targeted therapy prevents age-related muscle loss and declines in maximal exercise capacity

Aging (Albany NY). 2025 Aug 30;17(9):2335-2350. doi: 10.18632/aging.206313. Epub 2025 Aug 30.

Abstract

Age-related declines in cardiovascular function contribute to reduced physical capacity, both of which are independent predictors of mortality. We have previously demonstrated that glycocalyx-targeted therapy with Endocalyx™ that contains high-molecular-weight hyaluronan (HMW-HA) improves cardiovascular health in old age, raising the possibility that HMW-HA also plays a role in age-related physical dysfunction. Here, we first demonstrate that tamoxifen-inducible deletion of Has2, which produces HMW-HA, leads to glycocalyx depletion, decreases exercise capacity, and impairs skeletal muscle respiratory capacity. We then sought to determine the effects of Endocalyx™ on physical function in old mice. Young (7 months) and old (29 months) mice underwent standard diet or Endocalyx-supplemented diet for 10 weeks. Glycocalyx thickness was higher in young and Endocalyx-treated old mice compared to standard diet-fed old mice. While standard diet-fed old mice demonstrated a reduction in running exercise capacity over the intervention, Endocalyx-supplemented diet prevented this age-related decline. Gastrocnemius citrate synthase activity, a marker of mitochondrial content in skeletal muscle, was lower in standard diet-fed old mice compared to young and Endocalyx-treated old mice. Collectively, these findings suggest that glycocalyx integrity is a critical determinant of physical function and that glycocalyx-targeted interventions may be a viable therapeutic strategy to treat age-related physical dysfunction.

Keywords: aging; glycocalyx; hyaluronan.

MeSH terms

  • Aging* / physiology
  • Animals
  • Exercise Tolerance* / drug effects
  • Glycocalyx* / drug effects
  • Glycocalyx* / metabolism
  • Hyaluronan Synthases
  • Hyaluronic Acid* / pharmacology
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Muscle, Skeletal* / drug effects
  • Muscle, Skeletal* / metabolism
  • Muscle, Skeletal* / pathology
  • Physical Conditioning, Animal* / physiology

Substances

  • Hyaluronic Acid
  • Has2 protein, mouse
  • Hyaluronan Synthases