Glycocalyx: Blood Vessel Health Indicator

Hans Vink, Ph.D

Well, good afternoon or morning. Dr Goel, very nice to meet you on your show. Well, the way I got interested in this is already a long time ago, more than 30 years ago, I started looking with big microscopes at living tissues to the sea with big magnifications how blood flows through the smallest vessels and the microcirculation that through capillaries where red cells flow through one by one. And when I entered the field and they ’98s, early 1990s people for the first time realized that these smaller festivals almost appear empty. It’s a big puzzle why only fairly few red blood cells are present in the small vessels, where the estimates were that only 5% of the volume of those small vessels were filled with red blood cells. 

And it turned out, to make a long story short that a lot of the low numbers of red cells and the dynamic changes in cell content are mediated by a transparent protective gel called the glycocalyx that’s inside these micro vessels. So when I started this, my first challenge was to identify and find evidence of this transparent elusive gel. And then after a couple of decades, having imaging technology developed to visualize the glycocalyx demonstrated it’s important for microvascular health. About that time I started developing a glycosidic medical device to measure the health microcirculation and glycocalyx in individuals. And at that time, about 2012, I met Bob, where they’re working on a therapeutic based on dietary supplements to increase the health of the glycocalyx and microcirculation. So we formed a tight team to work on both the medical device and the supplement together over the past decade already. Okay, that’s a good point for Bob to jump in.

Robert Long

Well, thanks Hans. It’s nice to be with you today. My interests came really well, my interest in the endothelial glycocalyx, I didn’t even know what it was in 2009. I had a personal healths care. I was traveling all over the world, we had a large automation and control business and then we ended up selling it to the largest electrical device company in the world in France Lagrand. So I had some time and some money on my hands, but in building that company I had been traveling around the world quite a bit and really burning the candle at both ends, and where I live is kind of up in the mountains in Utah. and when I would hike, I would fill up kind of a tightness in my chest, and that concerned me, I had been diagnosed as a type 2 diabetic probably a year before that. 

And that’s one of the early warning signs. They tell you that, that’s gonna lead to cardiovascular disease. So when I went in for my annual physical, I told my doctors actually a person a friend of mine, but you know, I was experiencing it. You said, “Well obviously that’s not good, “I want to get you into a cardiologist.” So he immediately called at cardiologists that was a friend of his, and he said, well, as luck would have it he can see it today, I want you to go down to the Utah Valley Regional Medical Center and see him. So that was like nine o’clock in the morning, so I figured out I’ll buzz down there. I’ll talk to him for a few minutes and I’ll be on my Marriott way. 

Well, that’s not what happened at all, so he came in and talked to me with his physician’s assistants, they got my medical history, checked me out, took my blood pressure, did all the normal things, and then they said, “Well, probably the reason you’re having “that tightness in your chest “is you’ve probably got a blockage in one of your arteries.” And you know, the reason I’m here at the hospital today is I’m in the cath lab and I’m doing angioplasties and we’re putting stints in patients. So explain that process to me and he said, what I really think we need to do and they came in and did some preliminary testing and they said, you know, we don’t know for sure, the only way we can know for sure is we’re going with a little camera and you’re growing back in those days, we’ll go up in and we’ll be able to see and if you have a blockage, we’ll put a stent in. And so not at all, what I was expecting to hear that day I hadn’t had a heart attack, there was no sign that I’d had a heart attack, there was nothing in my blood, he just wanted to do this as a precautionary thing. And so bottom line is they did the procedure, I was the last procedure of the day ’cause I wasn’t in an emergency, of course.

And I still remember, you know, you’re not completely out when they do that and I remember that really bright lights and I remember hearing the music really loud. But then I remember when the cardiologist came in and he told me, he said, “Hey I’ve got good news and I’ve got bad news. “What do you want to hear first?” And I said, ‘Oh, tell me the good news.” And he goes, “Well, the news is “you didn’t have any blockages, “we didn’t have to put a stent in, that’s all.” “That’s great, so what’s the bad news.” And he goes, “Well, we don’t really know what’s wrong with, “we don’t know why you get that tightness in your chest.” And so then he proceeded to write out some prescriptions, blood thinner, hypertensive meds, three or four different things. And then I said to him, ‘Well, how long have I got to take these medicines?” And he says, “Well, probably the rest of your life.” And as I drove home, that sunk in, and the more I thought about it I guess you could say in a way it made me mad. 

And it made me mad because they didn’t really know what was wrong with me, but yet they had done this, what I would term an invasive procedure. And in my previous life for 28 years, I had been in the financial services industry and I had built a very large insurance and investment agency, and I knew what impact this procedure would have on my future insureability for health insurance and life insurance, so, I wasn’t pleased that I had even done it to be honest with you. But then to find out I didn’t have anything wrong with me, made me even matter. And so we had just sold that company at the time and so as luck would have it, I had time and I had money and I was really good at looking up stuff on Google, and my radar was up really high because I wanted to find out what was wrong with me ’cause they couldn’t tell me, what was wrong with me. 

And so as luck would have it, I started researching and I was introduced by a friend, his brother was a doctor and he had introduced me to some information that was what I came to learn was had all been done by the science of Dr. Vink. And so I started reading and became I guess you could sound most obsessed with trying to find out 12 or 13 years ago, all I could about the endothelial glycocalyx. And it was one of those things where the more I studied it, I came to believe that was what was wrong with me, but yet nobody knew about this. And as I started reading some papers and stuff I also got the idea and as I understood more about the endothelial glycocalyx and that it can break down and that’s what leads to inflammation and all the things we’ll talk about on your show today. 

But basically it became clear to me that that was probably what was wrong with me. And that’s also probably what was wrong with millions of people around the world that the had the same thing happening but nobody knew what it was and nobody knew how to diagnose it, and nobody had a solution for it. And so it was kind of, for me you might say, a lightning bolt in that, oh my gosh this could be the big thing that you ought to really spend your time. And so I became an expert and I got the idea, where I live in Utah most people don’t know it, maybe they do, it’s pretty much the nutraceutical capital of the world, so there’s a lot of nutraceuticals that are developed here and I have a lot of friends that had developed nutraceutical companies. And even though that wasn’t my primary interest or what I’d done previously, I had a lot of friends that had been in that industry and had been very successful, and I personally had already always taken supplements and tried to do the best that I could for my health. 

So I was a big believer in natural products, you could say. So I got the bright idea, What if I could go out in the world, ’cause I believe that God created it everything on the earth for man’s benefit. And I thought, what if I could go out and find the plants or the sources that you could take in your diet that could restore and rebuild your glycocalyx, surely they’ve got to be there. And so the first tip I got was I looked at well where are people in the world the most healthy from cardiovascular events? 

And you look at Japan, there’s pockets in Japan. And so I started looking in Japan and I became aware of that there was a type of seaweed that was available and that the Japanese consume. And also I became aware that this type of seaweed in an extract has some of the same characteristics or it may be like what the glycocalyx is made of. So that was my first tip that may be a type of seaweed or an extract of seaweed might be important in restoring the glycocalyx. The next area that I looked at was the Mediterranean back in 2009. The Mediterranean diet was a big hit. Everybody was talking about, you know what? The reason they live longer is because they eat a diet high in polyphenols and it’s all organic, it’s all fresh fruits and vegetables. And so I started looking at, and I was introduced to a product that had just come on the market and actually I was the first one to use it in the formula that I formulated, and it was an extract of 27 fruits and vegetables. 

And the idea was that it would be a super antioxidant and my thought with that was that it would stop the oxidative stress. And so that was the first product that I ever developed, that was back in 2011. And so at the same time, I had been reading all of Dr. Vink’s papers and I came to believe he’s the guy that proved to the world what the glycocalyx even looks like and you can probably get him to show you some pictures on the show today. But I got this bright idea because I was following him and I’ve read all of his papers and it published like 100 and something papers. 

So I got the bright idea, I could jump on a plane and I could go onto the Netherlands. And I knew he had just gotten a patent issued on this medical device. It was a camera that you could put under your tongue. And I thought rather than be in anecdotal he could tell me if I was on the right track. And so that’s what I did. And that was about this time in 2012 that we met and I went over and told him my health background. And he said, well big American you guys love your cheeseburgers, your fries in your coke, so don’t expect that you’re gonna have a good score. And so he tested himself and he got a really nice result. See, I’m just like a healthy 18 year old, and then it was my turn to get measured and he measured me. 

And then he looked at it and they pointed at the screen, and then they measured me again, and then he was talking to the other guy that was there in Dutch, and I said, “Well, what did you find, am I good or I’m bad?” And he said, “I’m really confused.” He said, “Your results are not at all what I anticipated.” He said, “Your score is actually better than mine, “and that’s not what I would have expected.” And I hadn’t told him up to our point and we’d been meeting all day. I hadn’t told him, I had been working with my team on a product and I still all part of the real reason I came here today and I didn’t tell you ’cause I wanted to see first of all, what your device was and second of all, I didn’t want you to be biased, I wanted you to test me without knowing what I was doing, and I created a all natural product that targets the glycocalyx. And that’s when he said, “Well, Bob, do you realize “up until now, I spent my whole career, “I had to prove to the world that the glycocalyx was real.” Then we had to figure out an imaging tool so we could measure it. 

We had to figure out what its physiological function was in the body, and then everybody always asks me the same thing ’cause I can measure and I can get a score and I can tell Malbec the glycocalyx is as a systemic organ but then they always asked me, so what do we do about it? And he got a little emotional and he says, “Bob, do you realize I’ve tested drugs, “I’ve tested a whole bunch of stuff, And this is the first time that “maybe you’ve discovered the so what?” And so we started talking that day clear back in 2012 and we decided that if we join forces, we can both accelerate what were we were doing and bring something totally special to the world that didn’t exist. 

And that would be an imaging device where we could noninvasively measure a person and we could get a baseline score. And not only could we tell them the systemic health of their endothelial glycocalyx, but we could also tell them how functional their micro circulation was. So we started working together, I actually became the CEO and managing partner of GlycoCheck at that time with Hans at the university. And then we joined forces and worked on a new supplement based on the things that he knew. And we put our minds together and then we were able to use the GlycoCheck to help us understand what work, and then we were able to use some scientific techniques he had used for years to evaluate things on how they would affect the glycocalyx. 

And that’s how we came up with endocalyx, the product that we offer now. And we filed a patent on it, the patent was issued in the U.S in 2018, it’s has been issued in Japan and South Korea, and soon to be interest, I think issued in Canada for example, European Union, China, all kinds of places. So that’s how we came together, kind of a long story, but I guess, your own health is a big motivator and if you want to make a difference, first of all, I wanted to fix myself, but second of all, I knew this was a big hole that nobody was focused on and this was a story that needed to come forth and be told to the world and that’s why I convinced Dr. Vink to join me in this journey, to not only bring these two products forward but to educate the world on the importance of the microcirculation and the role of the endothelial glycocalyx. So that’s how we got–

Sanjeev Goel, MD, FCFP (PC), CAFCI

This is great. I mean, I’m so glad you guys have met ’cause you’re changing everything, our whole understanding of the microvasculature. So Dr. Vink can you just tell our viewers, okay maybe in a lay person’s term, what is this glycocalyx? What does it look like, why is it there, what is it doing?

Hans Vink, Ph.D

Can I show some pictures that would help–

Robert Long

Can I show a couple of slides, can you see my screen?

Sanjeev Goel, MD, FCFP (PC), CAFCI

Yup, that’s okay.

Hans Vink, Ph.D

All right, yeah, just a few slides, just first point I want to make clear you understand is that most people if they’re thinking about the vascular system, they know the image on the left, and know the heart and the large arteries taking a blood to the organs, and an old but the large veins, collecting the blood back to the heart. What most people don’t know, if you take a microscope and look more closely, you’ll see that close to any tissue cell in your body, we have these microscopic small vessels where the blood is really thinking close to every tissue cell and where all the oxygen and nutrients are being supplied to the tissue and where the waste products collected.

So actually 99% of all the contact area between the vascular system and the tissue cells is in those small vessels. Large vessels is only 1% of the total surface area. Well, if you go into those small vessels, what we realized, and I’ll come back to this a little bit later. So if you look at one of these individual small vessels, you see the individual red blood cells going through, you realize that in healthy, small vessels, the red blood cells they never touch the inside of the vessel wall. There’s always a significant gap between the surface of the vessel wall and the center where all the blood is flowing. And so we wanted to know what’s in between that space. And then when we zoom in just a little bit more, just to give you an idea, this is even larger magnification with an electro-microscope again, a cross section, of one of those micro vessels. 

And then you see here, a large magnification on top would be where the red cells are flowing. And this is the vessel wall and on top of the vessels but the surface of the vessel wall, you see all these Bush like structures. All these boosts like fractures, all these hair sticking out. It’s a huge three-dimensional mesh of all these hairs which are polysaccharides like heparin on sole site and hyaluronic acid, that’s being produced by your endothelial cells that the line the inside of your vessels. And actually these bush, like hair-like structures they bind a lot of betterment proteins, and that sucks in a lot of fluid forming a very stable gel. 

And the gel, it’s very thick, you know, it’s 10 times thicker than the endothelium itself and protect your endothelium. And then make sure the cell don’t touch the vessel wall, they don’t stick, you don’t lose, you don’t leak a lot of your proteins and you prevent the inflammation, and you prevent quick collation disorders. So I guess that’s just to show you how it looks like. And one more slide, that summarizing all of the important functions, that we have been able to study over couple of decades with many other groups.

So on the left hand side, again you see that hair light structure forming a gel on the inside of your vessels. And now we know that any function of the endothelium that we know is important like sensing how fast the blood is flowing, and telling your endothelium to start producing nitric oxide. Well, you need those polysaccharides to tell the endothelium, you need to start producing nitric oxide. Also, the antioxidants that we know are important to balance the oxygen radical levels, like superoxide dismutase, they specifically bind to these polysaccharides structures of glycocalyx. So they need to be closed and bound to glycocalyx to capture your oxygen radicals that are produced low close to the vessel wall. And then again, leakage or plaster proteins and fluid is brief entered by glycocalyx. And the same for red cells, also blood platelets and also the inflammatory cells, the leukocytes and the monocytes, they cannot touch and stick to the wall as long as there’s a healthy glycocalyx in between. 

So a healthy glycocalyx protects your vascular system and prevents all and make sure all these functions are preserved and prevents unwanted coagulation, and prevent unwanted activation of your inflammatory system. But that’s in a nutshell. Yeah, so in atherosclerosis, that’s a very important aspect. In larger vessels, at the point a larger vessels, we know it there’s always the same spots over and over again where atherosclerosis starts. And we know exactly at those spots because of the very complex, low profiles, those branch points, there’s very little glycocalyx production. 

Those glycocalyx production is stimulated by the forward motion of the blood flowing. So those sites where ethics corrosive starts if a very thin glycocalyx compared to the rest of your vascular system. And at those sites, because of your very thin glycocalyx, you have to first size cholesterol will start leaking into your vessel wall and where platelets start sticking causing coagulation problems, where leukocyte starts sticking causing an inflammatory problem. That’s where deletion start growing ’cause that’s a very defined area with very small glycocalyx which make that part very vulnerable compared to the rest of your fastest system.

Sanjeev Goel, MD, FCFP (PC), CAFCI

And but in the microvascular small capillary’s is the same thing happening that we see in the big vessels, like, are we also seeing like blockages or it’s like, what happens when the end of the glycocalyx gets damaged?

Hans Vink, Ph.D

Yeah, so at the micro fastest system, way before you see problems in the larger vessels, when glycocalyx gets damaged and it gets damaged by exposure to all the glycocalyx factors that we know of like smoking obesity, hypertension, elevated glucose levels, elevated insulin levels or genetic predisposition. So when glycocalyx starts breaking down at the microvascular level, well a couple of things started happening. First of all he started losing many of your small capillaries. So very tiny spots of tissue will be deprived of access to capillaries and when metabolism goes up those sites that are a little bit farther away from the capillaries will get starved. 

You have micro micro spots of tissue starving, building up over the years, and at some point will cause organ dysfunction but it takes years to build up and together with losing many capillaries, when glycocalyx is damaged, you also, the lose is the dynamic of your microvascular system to changes in blood flow where you, for instance, you start exercising. So if you have a healthy microvascular system, with a healthy glycocalyx, well if you start exercising and blood flow goes up to your muscles, the same time, also glycocalyx volume goes down, allowing more blood volume to profuse through more capillaries. Now have a much more efficient delivery of nutrients induction through your muscle cells. 

So when glycocalyx breaks down that dynamic response disappears. So you have fewer capillaries and the blood flow goes up, there’s no matching increase in the blood volume at the microvascular level and no benefit for the increase in blood flow goes to the only thing that happens in a small number of capillaries is that the flow goes just faster through those few capillaries that are left. So at the very earliest stage when you’re exposed to these risk factors, you’ll lose many of the capillaries and the adaptive response to flow changes. And you’re causing all kinds of micro spots in your tissues of tissue that will be dying. And over years, no Oregon functional compromised but it doesn’t show up in organ function until a later stage when the damage is pretty damaging.

Sanjeev Goel, MD, FCFP (PC), CAFCI

How much early, like let’s say, I’ve heard about these studies where they autopsied like 18 years old and they saw already beginning of atherosclerosis happening, like from your studies of what the GlycoCheck machine, how early are we seeing changes in the glycocalyx damage?

Hans Vink, Ph.D

Very early, we just completed a study on 900 healthy individuals. This is an obesity study. Now we compared people with low risk to medium risk, to high-risk based on their framing and risk scores. So, you know, taking age into account whether they smoking their body size, the classical risk factors, but these people are still very healthy. This is years before they will develop organ problems. Already at this earliest age, if we look at individuals with an estimated risk of a cardiovascular event of 20% or higher compared to a low risk group with less than 10% already at this early stage or the high-risk individuals lost about 50% of their smallest capillaries. 

So this years before anything will show up in terms of a heart attack or a stroke or diabetes, or other relation disorders or inflammatory disorders, so I say a decade, maybe two decades before the organs really start dysfunctioning and you got major problems, early changes at the microvascular level already show up and it’s gonna be identified and can already be supported by the products like Bob mentioned, not like endocalyx, specifically designed. We will help the health and support the health of those capitalists at an early stage, wait years before the damage will cause organ dysfunctions.

Sanjeev Goel, MD, FCFP (PC), CAFCI

So for let’s we always hurt and learn in medical school and all that diabetes is a microvascular disease. So is there an impact of these sugars on the glycocalyx, I’m just curious what’s the connection there?

Hans Vink, Ph.D

Yeah, so, at the very early stage, at early stage of type 2 diabetes and the blood glucose levels go up and insulin levels go up, ready at that stage before there is obvious vascular issues. If we look at the microvasculature, we see that both the high glucose in combination, with the high insulin causes a lot of glycocalyx damage. And we see that you lose already know about 70 to 80% of your microvasculature. I know, and the remaining capillaries are highly permeable but also you lose again the dynamic response. So it’s okay at early stages, you lose a lot of capillaries but you keep refusing all of them all the time and keep your low based on levels at an acceptable level of number of fuse capillaries.

The as soon as there’s a meal challenge or an exercise challenge and metabolism goes up and blood flow goes up, there’s no matching increase in a number of blood through capillaries. So blood volume at the capillary level stays constant at a low level. And know when you start building up all kinds of issues, micro spots in the heart micro spots in the brain and the kidney will start being damaged. And one of the interesting fields that we have been studying for a long time is a diabetic kidney problems. And we also see that in the kidney, the very earliest stage when glycocalyx is damaged in the kidney micro vessels, to glomerular capillaries. 

You see that glycocalyx is actually the determining factor that prevents leakage of your albumin protein out of the vascular space into the urinary space, and as soon as the albumin starts leaking causes damage to the kidney capillaries and the filtration units for the glomeruli indicate they will they’ll die one after the other. And over years you’ll start losing kidney function. But as soon as you start noticing kidney function is compromised already years of damage behind you. And then you know it’s a challenge to get that up again and try to stabilize, improve your kidney function in those diabetic patients.

Sanjeev Goel, MD, FCFP (PC), CAFCI

So I want to ask Bob, the supplement endocalyx , what is it, like how successful is it with actually repairing? Like I understand maybe preventing damage, but what does the study’s looking like with actually repairing glycocalyx which has been damaged for let’s say years? What does that–

Robert Long

Oh that’s a fantastic question because that was my original target or goal was, what if we could go out and find those natural compounds and we could find them and put them in either a high enough extract rate, or make sure we have a good molecular weight that could get across the, and by the way, there’s a big glycocalyx in your gut and your gut plays a big role in your health as you know. You know that’s where 70% of your immune system takes place. And that’s also where the nutrients have to get processed but more importantly, they have to get across that barrier in the gut, which is really a pipe of glycocalyx and it’s thicker to get into the blood to get delivered in the first place. 

And so that’s what we spent a lot of time on, and we’ve actually done a lot of studies, both, maybe Han if you don’t mind, you’ve got some really good slides, some pictures, maybe you could just show the results that might be the most useful thing, to show you what we’d been actually been able to show, not only in guesses, we can show, we can immediately restore it, we can show, we restored, take diabetic mice tournament, take healthy mice them into diabetic mice and their kidneys. We can show, we can restore their kidneys back. And then we just finished a four year double-blind placebo study that the Dutch Kidney foundation paid for, and we can show you some results on that. And then we’ve also been looking at when we published a big paper on a month ago, in critical care on sepsis. And in the fall we published a big paper on COVID-19, we’re in the middle of this big sepsis patient and then we got this onslaught of all these people with COVID that were coming into the ICU. 

So we thought, well, let’s see what’s happening to these patients. And sure enough, those sickest patients with COVID-19 lost up to 95% of their capillaries. So they were worse than–

Sanjeev Goel, MD, FCFP (PC), CAFCI

When someone’s acutely ill or has an acute trauma like a insult to the glycocalyx like you said smoking perhaps a very bad high fatty meal or an infection, are these things that are transient and then the body comes back to 100% within six hours. I’m just curious, what is the science on that?

Hans Vink, Ph.D

Yeah, that’s about the time course that we see happening. If you have an acute challenge, that’s trenchant takes about six to eight hours to recover let’s say for a fatty meal, or in the early days did some acute challenges of inflammation and health insurance or smoking, let them smoke like five, five cigarettes in an hour. It’s a very acute intense challenge that you know damages a lot of your glycocalyx but you know your vessel walls repairs and rebuilds glycocalyx by itself, if that’s time enough to do that, it takes you up six, seven, eight hours to take care of that. But if you’re constantly exposed to challenges all the time and there’s not enough time, to we rebuild and you all have chronic damage.

Robert Long

Right and then infections, they attack the glycocalyx as well. So like I know, I’m fortunate I have a GlycoCheck so I can test myself every day, multiple times if I want, but, you know, I developed a sinus infection, I think it started as allergies then went into a cold but ultimately evolved into a sinus infection. And I could see it did in fact impact my glycocalyx and my microvascular health score. And I think that’s part of the reason why you started to feel that systemic, you still feel good everywhere and your brain starts to feel foggy, all that stuff. So that’s all related back to that infection was attacking your glycocalyx. In fact, Hans and I, have both noticed even just a simple thing like going to our dentist and getting our teeth cleaned aggressively. Later that day you could believe and starting to feel like you start to have flu like symptoms because they’ve released all that bacteria. That’s an insult to your glycocalyx and it takes a couple of days for that to recover from even just that simple thing of cleaning your teeth, believe it or not.

Sanjeev Goel, MD, FCFP (PC), CAFCI

Yeah, they do say that after bacteremia that occurs after a teeth cleaning–

Robert Long

Yeah, it’s like this massive release of all this bacteria, right? So Hans, did you want to show maybe some stuff, just answer the question.

Hans Vink, Ph.D

Yeah, sure, I can show a few data slides on how endocalyx glycocalyx, maybe if it’s okay, I can also show a little couple of minute video to explain how we do the measurements with the GlycoCheck device? All right, alright. Here we go, hold on. So first a little bit about the GlycoCheck system, how it measures to health of microvascular system.

[Video Narrator] 

What’s your health score? The score that identifies if you’re a greater risk of the most troubling diseases and conditions the score that signals at these diseases and conditions may be silently developing inside your body. This score that will help you understand how your body is alerting you with several early warning signs. For the first time, you’re able to get an overall health score with a new, simple and non-invasive test called GlycoCheck. It’s a new patented technology and the test can be easily performed in a healthcare practitioner’s office. GlycoCheck gives you and your healthcare provider the one single number a microvascular health score that alerts you in trouble could be lurking deep inside your capillaries. The good news is that even if you have a poor score you can easily improve your health. 

While you may look healthy on the outside, inside your microvascular system a completely different situation could be unfolding. With the discovery of a transparent lining in your capillaries called the glycocalyx, your health could be declining because that lining may be breaking down and becoming leaky which can contribute to the advancement of many diseases that develop over time. Hygiene, poor diet, lack of exercise, genetics, stress and smoking can cause the glycocalyx to break down. In the past, there hasn’t been a way to peer deep inside the microvascular system to observe the breakdown of the glycocalyx. 

But now for the first time with GlycoCheck it’s possible to see live movement of red blood cells as they traveled through micro vessels. GlycoCheck was created out of the need to measure the microvascular system, by world renowned researcher, Dr. Hahns Vink. Dr. Vink began his intense study of the glycocalyx in 1989. Over the years, he has received many research grants and prestigious awards, all focused on the discovery and breakthrough understanding about the importance and clinical implications of the glycocalyx. He has authored or contribute to hundreds of scholarly papers and reviews. GlycoCheck works by simply placing a video microscope under the tongue for a few moments to video record, analyze and objectively report a single overall microvascular or health score. 

GlycoCheck counts the number of blood vessels and capillaries and measures red blood flow concentration. It also measures flow rate and defend how deeply the blood cells penetrate into the protective glycocalyx gel lining, a sign of deterioration. GlycoCheck combines all these important measurements together to generate a single systemic microvascular health score. Lower scores indicate greater risks to the health of your organs. As the test is becoming more available, it can be administered in a healthcare practitioner’s office. Each test includes a baseline score and video of the microvascular blood flow and tracks how over time the microvascular score declines with health deterioration or improves with therapy. 

Today there are more than 85 ongoing clinical studies in locations, worldwide, such as Duke University, University of Pittsburgh Medical Center, VA Hospital of Salt Lake City, Children’s Hospital in Philadelphia, the University of Oxford, Harvard, Beth Israel, Leiden University Medical Center, Steno Diabetes Center, University of Exeter and dozens more. These respected research centers are all using GlycoCheck to confirm that a damaged glycocalyx contributes to several diseases and conditions as well as the resulting complications from diabetes, stroke, septic shock obesity, cardiovascular disease, hypertension and other diseases. With GlycoCheck, now you can be tested and get the score that reveals the overall health of your microvascular system. With the results of your test, you will be in a better position to apply therapies and that can improve your microvascular health score. For more details about GlycoCheck.

Hans Vink, Ph.D

Well, I guess that was a good introduction. How we measure with the camera. Now you’ve got all these live images, and based on that, we can measure the health of your microvasculature, how decreased by being exposed to risk factors, and now the under calyx therapeutic can I help you to improve the health of your microvasculature? So just a few things about the supplement. It’s a supplement actually, if you’ve got a method on that endocalyx is actually a composition and treatment methods to improve the health of your endothelial glycocalyx. And as we discussed, it basically consists of three main compounds. 

So we have the polysaccharides that are in the CV that are almost identical to the polysaccharide in those hair-like push like structures of glycocalyx. So they will immediately fill in the holes in a damaged glycocalyx and also scavenge important enzymes that bind to the polysaccharide and you can prevent those enzymes to break down glycocalyx even further. Now we’ve also mentioned we have the antioxidants, specific antioxidants that bind to glycocalyx and scavenge oxygen radicals and prevent further damage. And then the third compound is high dosages of glucosamine. ‘Cause we now know that glucosamine is a rate limiting substrate for the endothelium to produce more glycocalyx. So with that we did several tests and studies. This is just an early study showing, if you measure the level of glycocalyx damage, before and after taking, starting taking endocalyx, you can actually monitor very closely out a level of glycocalyx diminishes in response to taking in the endocalyx. 

Another acute study was on the protective effects against acute inflammatory challenges. So if you look at the vascular system and we infuse this is a it’s more venue and we infuse every few seconds and say, line solution you flush out the block and you can see in the background those little transparent cells which are the inflammatory cells. And as long as they’re rolling, they’re good, or they’re checking whether the festival is healthy but you know, as soon as they think there is a damage and then they stop rolling, they stick to the wall and that’s causing the local inflammation. 

Now, if we count the increase in level of inflammation by counting the number of sticking inflammatory cells to the wall in response to a challenge, or you see the rep columns show in the untreated vessel if you damage the microvasculature, by breaking down the glycocalyx. Now within 30 minutes, there’s about a 300% increase in the level of inflammation. Well, if you take endocalyx or it protects your vasculature and even though there’s an initial increase in the level of inflammation upon the acute challenge it can fully protect your vascular system and your glycocalyx against fluid or inflammatory damage in an acute setting. 

Well, we have the example of a study of the re-doing in kidney patients. This is the same kidney patient before and after taking endocalyx for four months. They don’t need a lot of computing to see on the left and all your very few capillaries. And there’s very low level of blood flow, a low blood volume in the microvasculature. And after four months, there’s a very significant increase in a number of capillaries, and a level of blood flow in the microvasculature. As an example.

Robert Long

Actually new capillaries are formed. I mean, we kind of used to think this or is it just that existing capitalism opened up?

Hans Vink, Ph.D

Well, no, it’s actually in this stage there’s a disbalance between the production of more new capillaries and the breakdown. So you have a very low number of capillaries all the time ’cause the breakdown goes faster than making new ones. And what the endocrine does and by rebuilding your glycocalyx, it protects the existing capillaries against breakdown. So there’s more time to make more new capillaries. You shift the balance, towards more capitalized being produced and surviving longer. And so the net effect is that you will have more, new capillaries that stay healthy and functional for a longer time. So the balance is more towards more production of new capillaries instead of breaking down the existing couplers too fast. So new capillaries and actually by making more new capillaries, you also will have the luxury to have a few of those scapulars not being used at all times so you can also build up a reserve capacity. 

So if you have only a few capillaries, you don’t have a reserve capacity, you use them all the time, all the capillaries you have, if you build more capillaries, well at baseline conditions you will have more capillaries and more capillary blood flow, you’ll also when you start exercising or metabolism increases for different reasons, you have a reserve number of capitals that you can actually recruit when necessary. So both are happening after the endocalyx therapeutic. 

Well, this is just showing also in the same individual, if you look at your microvascular health, that individual started with the low microvascular health score. And after three months in scores going up, then he ran out of products. We stopped taking the therapeutic, score went down again. And then the second time again, after two, three months the score went up significantly as a result of rebuilding your glycocalyx and getting higher numbers of capillaries. And at the same time, we were able to measure kidney function in the same individual and showing that this individual started out with a very low level of kidney function. So this is the filtration rate, the glomeruli filtration rate in the middle liters per minute. 

So there’s 30 mils per minute is the low end, close to complete kidney dysfunction. And again, with rebuilding your microvasculature function improved and went down again, when the patient stopped taking the therapeutic and then the second time or filtration rates went up to 70, 80 mils per minute. So it not only as stable as this is incredible, so this actually triggered a lot of support from the Kidney Foundation and the Dutch Government supporting a large clinical trial that you just completed to see also earlier stages of kidney damage. If we could stabilize and prevent the real breakdown of kidney function, but this is a patient, but then–

Sanjeev Goel, MD, FCFP (PC), CAFCI

Clinical trial completed the newest–

Hans Vink, Ph.D

The clinical trial has been completed, the data has been analyzed, the paper is being finalized. So it’ll take it a little bit longer for the paper to come out, but you know, we are very happy about the results. So I cannot share too many details yet, but you know we’re very hopeful at early stages that the therapeutic is very effective in protecting and improving the health of your microvasculature.

Sanjeev Goel, MD, FCFP (PC), CAFCI

I hope it’s just the same for everybody. Sorry, just jump in there quickly.

Hans Vink, Ph.D

Well, no, that was a good question. So the good thing about using the GlycoCheck device, oh we all start out with the same dosage, which you can actually monitor the effect, on your microvascular health and you can increase the dosage and we need a more potent therapeutic. So the baseline dosages with four capsules a day and if people are really compromised, and we advise to start with eight capsules a day and actually become monitor how effective the increase in microvascular health is depending on the dosage and the challenge you are facing this is juts another example. 

This is a person with a diabetic ulcer, showing an open skin wound in the lower limb that didn’t heal and you’d you see the tissue color changing and become a really dark and old blood profusion in the wound and the lower limbos getting very close to being amputated. I was starting thinking endocalyx already after a few weeks, I see that the color of the tissue inside a wound starts increasing, I’m showing more blood profusion, more reddish color. And after three to four months it was complete recovery and the wound started closing. Well and additional observation that is consistent, many other case studies is that this individual had an untreatable level of hypertension of 200, over 110. 

All the conventional therapeutics did not have any impact on the blood pressure. And within a couple of weeks we noticed and we were doing a lot of follow-up studies right now on the hypertensive effects, a blood pressure normalized within weeks, 226 over 70 and stayed constant consistently at the normal level. But just to follow up, we did some animal studies which I’m gonna show you some of the results, of comparing in mice, young mice to older mice. And we know with aging you lose a lot of your microvasculature, and a lot of damage to your glycocalyx, so the microvascular health score goes really down, and you only the same old mice take endocalyx for eight weeks, you already saw a very significant improvement with the microvascular health in these animals, you see also with nitric oxide, production goes down with aging and actually within eight weeks increases to an almost normal young mouse level. This is on gut inflammation–

Sanjeev Goel, MD, FCFP (PC), CAFCI

That nitrous oxide, how does the glycocalyx increase nitric oxide, can you just tell me, explain to me how–

Hans Vink, Ph.D

Yeah, one important mechanism by which your own microvasculature and your endotheium is triggered to produce more nitric oxide is by being able how blood flows over the surface of your endothelium. So if have healthy endothelium, your blood flow goes up. Endothelium sense the increase in blood flow and then glycocalyx tells your endothelium to start producing more nitric oxide, to dilate, make sure that the sheer forces do not get too high. Well, you need the healthy glycocalyx for that. If glycocalyx breaks down, both low can be really fast but your endothelium doesn’t sense. It doesn’t produce nitric outside. So by rebuilding your glycocalyx, you rebuild the sensor on your vessel wall to detect changes in blood flow and tell your endothelium to produce more of your endogenous nitric oxide levels. So that’s what up, sure sure go ahead.

Sanjeev Goel, MD, FCFP (PC), CAFCI

One question on that is about the respiratory system. Is there any connection I need to mention the gut but with the cilia of the respiratory system like this glycocalyx, is there something similar happening?

Hans Vink, Ph.D

Well, no, it’s similar. So the cilia also our sheer stress responses. And if you study us that I was part of it’s a long time ago we noticed that the cilia actually had sites of very low sheer stress and think like, okay so they are able at those sites to sense sheer stress. But the other sites where there’s higher levels of sheer stress, glycocalyx will be abundant and uncovering the cilia and acting as the main sheer stress sensors. So they team up they take care of both the low shear and the high shear regions to make sure your endothelium actually is able respond to the shear stress changes. 

Well, a few more on this to get back to you. So improvement of nitric oxide, in older mice with the improvement of the endocalyx. Also the gut inflammation levels. So we measured the accumulation of inflammatory cells in the gut, goes up significantly with aging, by repairing your microvascular and got glycocalyx those levels of inflammation go back to normal, low levels, as in the young mice, similar as in that one patient but the skin issues, we see that in the mice, a blood pressure drops by 25% in old compared to a mice with endocalyx. And we are doing some pilot data which we have been collecting in humans. So these are just voluntary case reports of individuals with hypertension, showing how they respond to glycocalyx. 

So now these are just averages of a few of those case reports, the solid blood pressure’s going down from 165 to 125, just in weeks. Similarly for diastolic pressures going up, going down from 100 something to close to 75, 80 millimeters of mercury. So I guess with that, while I just show you one or two more just to finish up this. This is just a proof of concept study that we did early on when we were developing the endocalyx but these are healthy individuals cross-section of the general population. 

So at baseline, we normalized their microvascular health at 100% and over time so this just have to do see four months. You see very significant improvement, of 50 or 60% improvement of their microvascular health and still increasing, it’s not plateauing yet. So we designed the study to stop after three or four months but this, you can tell now the longer you take endocalyx the better the improvement of your microvascular health will be.

Sanjeev Goel, MD, FCFP (PC), CAFCI

We think that mean COVID, the death is caused by poor oxygenation hypoxia of tissues, right? So is it not potential that endocalyx could be helpful in the acute phase of–

Hans Vink, Ph.D

Okay, oh yeah you’re you’re spot on. It’s almost like we shared my slides already with you before, huh? So we just, we just finished a very, very exciting studies on COVID patients. And as people have been reporting, we actually could confirm that COVID really hits your microvascular system. So we looked at COVID patients in the ICU, and compare it a relatively healthy COVID patients that did not need mechanical ventilation, with really sick patients that are on mechanical ventilator, we show that no, the ones on the mechanical ventilator they lose or any up to 95% of the microvasculature, and you at your levels of glycocalyx damage. 

And if you measured the level of glycocalyx damage it perfectly predicts the outcome of these individual patients in the ICU. So once with a relatively healthy microvasculature and healthy glycocalyx, we’ll do follow ups in the ICU 100% of them survive. The ones with really significant them to fly quickly to microvasculature, the longer they stay in the ICU, the smaller the chance of survival, and correlate very closely with the number of organs failing, not only the lung the kidney, the brain, the heart, very similar as another study that we did on sepsis patients. So the more damage to your microvasculature and get me the more organs will be affected and started breaking down. 

So yeah, the next step obviously would be to test endocalyx, as early as possible can help you protect against the virus, attacking your endothelium and breaking down your glycocalyx. So we are actually, as we speak designing a huge international trial as soon as people get a positive test to see if we can actually help them protect their microvasculature from breaking down, but also maybe even more important people that actually are cured from the infection. I know many of them have for many months later, all kinds of complications

Sanjeev Goel, MD, FCFP (PC), CAFCI

COVID syndrome, I had a patient tell me, two months later still feeling unwell.

Hans Vink, Ph.D

Yeah, so we see if we have a look what the lack of check system in quite a few of these people recovering from COVID and if a huge level of microvascular damage. So we can imagine if all your capitalist breakdown, oh your all your fatigue increases, kidney function goes down just a high-risk heart effects and rate issue, so very looking forward also on the longer term to see if we can help these individuals, repair and rebuilt the microvasculature, if we can help them recover much faster from that challenge.

Sanjeev Goel, MD, FCFP (PC), CAFCI

Wow, my mind is blown. But I want to come back to Bob and I asked you that question about the Omega 3 and I think I may have an answer myself, but I want to I want to hear what your thoughts about this.

Robert Long

Well, I mentioned to you that I’ve always taken lots of supplements and so I’ve been taking Omega 3 for a very long time when I had my situation. And so from what I can tell testing with the GlyoCheck and I’ve tested lots of people to get their baseline score that take Omega’s, I don’t think Omegas target specifically what we’re targeting yeah with the endocalyx supplement. So you know that there’s still, there’s lots of studies and there’s lots of things that talk about omegas, but from my view, and I’ve tested lots of people with lots of different types of omegas that they’ve taken. And I don’t see that it may say significant difference in their microvascular health score or more importantly in their microvascular density, or the thickness of their glycocalyx. 

And that’s what’s so unique about what we created, is we’re targeting specifically this function in the body. And we know what causes it to break down and so we had to go find those ingredients and make sure that they could be absorbed. And then they’re targeted to do a specific thing as Hans was explaining to you. So even he talked a little bit about the antioxidants that we put in, but the seaweed that we chose, actually you know, what happened, I says, happiness is one of the enzymes that actually attacks and breaks down the glycocalyx. Well, what we learned as part of this four year study that we just completed with endocalyx and kidney patients is doing the pharmalogical analysis and we did it in animals, in humans. 

We’ve learned that it’s 100% heparanse inhibitors. So not only are we restoring the glycocalyx, the dose level that we’ve got stays in the blood and it is 100% heparanse inhibitors which prevents the glycocalyx from breaking down. So the mechanism of action that’s why we were able to get the pattern. It’s a synergistic action of the compounds working together as a method to treat and restore the endothelial glycocalyx. Does that answer your question?

Sanjeev Goel, MD, FCFP (PC), CAFCI

Yes, that does. And I think what I, you know, people think that it looks like, like the importance of the seaweed. I’m thinking about an, a diet perspective now apart from the supplement is that we sometimes take this we think it’s one aspect of let’s say Marine food that would be healthy but it looks like there’s so much more that we don’t understand, and then–

Robert Long

Oh, there’s so much that we don’t understand. And we’ve been on this journey together since 2012. And what I tell people is, you know we really feel like we’re Lewis and Clark and we we left on a journey from the middle part, and we’re trying to find words of Pacific Ocean and you don’t know what’s in between. And so, the benefit we’ve had is we’ve been able to put the GlycoCheck and you know, well over 125 academic research hospitals and then we collaborate and we’ve gotten all of this research data on pretty much any condition or disease, you can think about in the body. And that’s what we’ve spent the last 10 years doing, is getting all of this reserve of information that clearly show when the glycocalyx breaks down then it leads to a breakdown in the density or the number of capillaries you have which then starts that spiral of organ starvation. 

And so, you know, if I had a dollar for every doctor that had told me, man if I could have had this the last, I’ve been wishing I had a device like this because it would be so nice to see what’s happening to a patient before they show up in the ICU with a heart attack or a stroke. But, you know, there was no way to know. And so this is really the canary in the coal mine that’s gonna give a health practitioner a much better idea about what’s happening. And as you say it’s very complex, it’s not the diet that has an impact. One of the early studies that we did, we did a study just because we wanted to see the impact of food. 

So we had the group of people all eat the same diet, and then we fed them a high-fat highest sugar mill, we gave them a quarter pounder, a large fry and a large coke. And that’s what Hans, and then we tracked the people in different people. They recovered different timeframes from that high fat, high sugar challenge. But that’s where we learned that the average recovery time is five to maybe some people took longer than eight hours. And that was an indication as we were validating that their microvascular health was poor, but then it was validated even by how the food they ate was processed. So things like, you know, Hans talked about exercise, all the things that you’ve talked to your patients about, everything has an impact on the even the altitude, the air we breathe, we’ve even had people take a GlycoCheckup the very high altitudes and to see what effect how the dude house on glycocalyx. 

I mean, everything you can think about has an impact on this internal regular. It is the largest organ in your body, if you stop and think about it. And it’s it regulates all kinds of stuff. You see another thing you think about how the body communicates its negative and positive charges. Well, the glycocalyx as a negative charge, it’s the grounding mechanism for the body, for example. And so that’s why you got to have a really strong glycocalyx is that you know what happens in a house if it’s not grounded, you get sign waves and all kinds of miscommunication, and burn up motors and all kinds of stuff.

Sanjeev Goel, MD, FCFP (PC), CAFCI

So this is amazing, again, I think this will open up a whole new world for me and the viewers. Where in the go to learn more about the GlycoCheck, I mean, this is obviously something that’s in doctor’s offices or research institutes and the supplement endocalyx.

Robert Long

Well, so GlycoCheck until just recently, we only offered it to research hospitals, but we’re just now coming out with a version that will be offered to medical clinics like yours and you’re fortunate I put you on the list. So you’ll be one of the first ones to receive one, but they can go to GlycoCheck.com. So I was just like, it sounds G-L-Y-C-O-C-H-E-C-K.com, GlycoCheck.com and there’s videos and we explain, and if they want to do a deep dive, if you’ve got doctors listening in there’s I think over 70, I don’t know what we’re up to 75 or six peer reviewed published papers, across the wide range of diseases, all showing you the impact of a decreased microvascular system and that microvascular health score. 

The other place they can go to to learn about endocalyx would be to go to microvascular.com and that’s the website there and we offer endocalyx there. And then I know you’re located in Canada and we just now are getting the supplement, you have to get it approved so we can import it into Canada. And I think by the end of the month, I’m hopeful, will be approved in Canada. And then it will be available from a physicians like you and then we have an auto fulfillment program, they combine it when they come into your office, you can put it on your website and they can sign up for auto-ship and move fulfill it from our warehouse in Canada.

Sanjeev Goel, MD, FCFP (PC), CAFCI

I know that’s amazing. When’s a consumer device coming for GlycoCheck, is that coming ’cause I can just imagine that one would want to be able to check this all the time and see the impact ’cause they, why wait for the doctor once a year, I would, that’d be quite difficult?

Robert Long

No, so you read my mind. So the first thing we had to do is we had to get all the validation in the clinical studies and then we needed to bring it to the doctors. So it’s falling a lot in the same path that blood pressure cuffs or glucose meters are a lot of the things that were originally done in the doctor’s office, now, consumers don’t want to know and there’s a lot of them can do it in their home. So what we’re doing right now is we’re taking our software and we’re putting it up into the cloud, so it would become software as a service. And then all of that data will be stored up there on a HIPAA compliant way to protect the privacy. And then, we have a brand new camera, that you’ll be one of the first recipients of, and then we’re working on a consumer version of that camera and an app and then people will be able to use their smartphone as the screen to see that what you saw on the screen, you’ll be able to see that on your phone. 

And then you’ll be able to send it up to the cloud. And in a few minutes, we’ll send you back the report and then we’ll have an app and it can mesh well we’ll have to work to mesh with all the other health apps that you have on your phone. But you’re absolutely right, this is gonna have an impact on consumers because there’s a lot of people that track their blood pressure, they track their glucose levels, they track their cardio, variable heart rate, I track all these things myself with my smartwatch, and then I’ve got a couple other little things I do. I want to know what’s happening to me. And so this is one of the key elements. And so you’re very intuitive, I think this will become a part of every person’s annual physical. It’s just as important, maybe more important to know this than even your glucose level and your blood pressure ’cause this was what’s implicated in what’s happening in those two areas, right? But then, the other thing is that’s a huge opportunities is when it comes to peak performance and health performance in individuals. 

So we have actually tested a professional endurance athletes, and there’s a huge difference that we can measure even in the function of their endothelial glycocalyx and that’s gonna impact how well they can, the oxygen level what’s gonna affect what’s happening to the muscles when they get under stress. And it also has a big impact on their recovery time, how stiff they get and how quick they can get back to action, because not only are we delivering all the nutrients, the oxygen and hormones, you think about it, we’re moving all the waste in the CO2. So it’s that whole cycle needs to be at optimum levels. So yeah, there’s going to be a, there will be a consumer version.

Sanjeev Goel, MD, FCFP (PC), CAFCI

Yeah, this is very exciting. Thank you so much, I really appreciate your time guys. Thank you, Dr. Vink.

Robert Long​

Our pleasure, thank you.

Sanjeev Goel, MD, FCFP (PC), CAFCI

Thank you, Dr. Bob Long. Thank you, okay.