I. S. Fomenko*, V. A. Turkina, T. A. Alyokhina, L. P. Biletska, L. I. Kobylinska

Department of Biochemistry, DNT “Danylo Halytsky Lviv National Medical University”, Ukraine;
*e-mail: iryna.fomenko.lviv@gmail.com

Received: 21 May 2026; Revised: 16 June 2026;
Accepted: 27 July 2026; Available on-line: 04 August 2026

Background. The endothelial glycocalyx (EGX) is a dynamic carbohydrate-rich structure located at the blood-endothelium interface that regulates vascular permeability, mechanotransduction, inflammation, coagulation, and endothelial signaling. Its complex molecular architecture makes the EGX highly susceptible to enzymatic degradation, oxidative stress, and inflammatory mediators, making its disruption a key mechanism of endothelial dysfunction in diverse pathological conditions. Objective. To synthesize current evidence on the molecular architecture of the endothelial glycocalyx, the biochemical mechanisms underlying its degradation, its role in cardiovascular and stress-associated disorders, and emerging glycocalyx-targeted therapeutic strategies. Methods. This integrative review synthesizes evidence from 93 scientific studies identified through a systematic search of ten electronic databases. Results. The analysis demonstrates that glycocalyx degradation contributes to impaired endothelial nitric oxide signaling, increased vascular permeability, endothelial inflammation, and microvascular dysfunction in cardiovascular pathology. Recent evidence further suggests that chronic psychological stress and post-traumatic stress disorder may promote EGX disruption through sustained sympathetic activation, oxidative stress, and low-grade inflammation. The review also discusses therapeutic strategies aimed at preserving or restoring glycocalyx integrity, including inhibition of enzymatic degradation and glycocalyx-targeted regenerative approaches. Conclusions. These findings support a shift toward targeting the glycocalyx as an upstream regulator of vascular health rather than exclusively focusing on downstream vascular complications.

Keywords: cardiovascular disease, endothelial glycocalyx, glycocalyx shedding, post-traumatic stress disorder, vascular permeability