Physical Activity and the Endothelial Glycocalyx: Acute Responses, Training Adaptations, and the Impact of Exercise Intensity - A Narrative Review
DOI:
https://doi.org/10.12775/QS.2026.77.76272Keywords
physical activity, exercise, endothelial glycocalyx, endothelial function, training, vascular adaptationAbstract
Background. The endothelial glycocalyx is a dynamic layer covering the luminal surface of endothelial cells and contributes to vascular permeability, blood cell–vessel wall interactions, and shear-stress mechanotransduction. Exercise alters hemodynamic conditions, but glycocalyx responses may vary with exercise characteristics and training status.
Aim. To summarize current evidence on the effects of acute exercise and regular training on the endothelial glycocalyx, with emphasis on exercise intensity, modality, and high training load.
Material and methods. A narrative review of PubMed/MEDLINE, Scopus, and Web of Science was conducted, including human studies available up to September 1, 2026.
Results. Glycocalyx responses to exercise were heterogeneous. Acute exercise was associated with either no significant change or increased circulating shedding markers, whereas imaging-derived measures did not consistently change. Chronic training studies reported favorable changes in some markers or no significant group-level effects. High training load and ultra-endurance exercise were also associated with variable glycocalyx-related responses.
Conclusions. The endothelial glycocalyx response to exercise is context-dependent. Acute responses, long-term adaptations, and changes associated with high training load should be considered separately. Standardized studies are needed to clarify the relevance of glycocalyx-related measures for monitoring training adaptation in athletes.
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