{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:39:38Z","timestamp":1791848378174,"version":"4.3.4"},"reference-count":27,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["MicrobiologyOpen"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Sepsis\u2010induced endothelial dysfunction, marked by degradation of the endothelial glycocalyx and activation of endothelial cells, plays a pivotal role in the progression to organ failure and mortality. Biomarkers reflecting glycocalyx damage have demonstrated prognostic potential; however, their associations with clinical outcomes remain variable. We systematically evaluated the prognostic utility of glycocalyx\u2010associated biomarkers (syndecan\u20101, heparan sulfate, hyaluronate) and the endothelial activation marker endocan in sepsis with respect to mortality, organ dysfunction, and inter\u2010study heterogeneity. We included 23 studies through May 2025 encompassing 4529 patients with sepsis. Two independent reviewers extracted data using standardized protocols, including biomarker concentrations and clinical outcomes such as mortality, multiple organ dysfunction syndrome, and respiratory failure. Risk of bias was assessed using the NOS, with 75% of studies rated as low risk. Elevated syndecan\u20101 was significantly associated with increased mortality (nine studies,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20092167; OR 2.04, 95% CI, 1.66\u20132.51;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05;\n                    <jats:italic>I<\/jats:italic>\n                    \u00b2\u2009=\u200984%). Similarly, elevated endocan predicted mortality with a stronger effect size (six studies,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009435; OR 5.06, 95% CI, 2.52\u201310.18;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05) and low heterogeneity. In contrast, syndecan\u20101 levels were not significantly associated with multiple organ dysfunction syndrome (OR 2.35, 95% CI, 0.93\u20135.94;\n                    <jats:italic>I<\/jats:italic>\n                    \u00b2\u2009=\u200994%) or respiratory failure (OR 1.05, 95% CI, 0.27\u20134.02;\n                    <jats:italic>I<\/jats:italic>\n                    \u00b2\u2009=\u200991%). The majority of studies were ICU\u2010based (78.3%), primarily adult cohorts (91.3%), with syndecan\u20101 the most commonly assessed biomarker (65.2%). Syndecan\u20101 and endocan serve as prognostic biomarkers for mortality in sepsis, with endocan demonstrating greater inter\u2010study consistency.\n                  <\/jats:p>","DOI":"10.1002\/mbo3.70155","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T11:58:48Z","timestamp":1762430328000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Glycocalyx and Endothelial Biomarkers as Prognostic Indicators in Sepsis: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"14","author":[{"given":"Kamila R.","family":"Daniyarova","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Reanimatology West Kazakhstan Marat Ospanov Medical University Aktobe Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhanslu N.","family":"Sarkulova","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimatology West Kazakhstan Marat Ospanov Medical University Aktobe Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0222-3035","authenticated-orcid":false,"given":"Amin","family":"Tamadon","sequence":"additional","affiliation":[{"name":"Department of Natural Sciences West Kazakhstan Marat Ospanov Medical University Aktobe Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ainur B.","family":"Tokshilykova","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimatology West Kazakhstan Marat Ospanov Medical University Aktobe Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marat N.","family":"Sarkulov","sequence":"additional","affiliation":[{"name":"Department of Surgical Diseases No. 2 with a course in Urology West Kazakhstan Marat Ospanov Medical University Aktobe Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Botagoz M.","family":"Kalieva","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Reanimatology West Kazakhstan Marat Ospanov Medical University Aktobe Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadiar M.","family":"Mussin","sequence":"additional","affiliation":[{"name":"Department of Surgery No. 2 West Kazakhstan Marat Ospanov Medical University Aktobe Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9304-6945","authenticated-orcid":false,"given":"Ramazon","family":"Safarzoda Sharoffidin","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Technology Avicenna Tajik State Medical University Dushanbe 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