Research Paper Advance Articles

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

Daniel R. Machin1,2, , Md. Torikul Islam3, , Alec Malouf2, , Daniel Nguyen2, , Mostafa Sabouri1, , Maryana Boulos2, , Andrew G. Horn2, , Kiana M. Schulze2, , Gwenael Layec2,4, , Lisa A. Lesniewski2,3,5,6,7, , Anthony J. Donato2,3,4,5,6,7, ,

  • 1 Department of Cell Biology and Physiology, Vascular Physiology Group, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA
  • 2 Department of Internal Medicine, University of Utah, Salt Lake City, UT 84112, USA
  • 3 Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT 84112, USA
  • 4 Department of Health and Kinesiology, University of Nebraska Omaha, Omaha, NE 68182, USA
  • 5 Department of Biochemistry, University of Utah, Salt Lake City, UT 84112, USA
  • 6 GRECC, VA Salt Lake City, Salt Lake City, UT 84112, USA
  • 7 Nora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City, UT 84112, USA

Received: April 21, 2025       Accepted: August 18, 2025       Published: August 30, 2025      

https://doi.org/10.18632/aging.206313
How to Cite

Copyright: © 2025 Machin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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.

Abbreviations

HDL: High density lipoprotein; HMW-HA: High molecular weight-hyaluronan; Has2: Hyaluronan synthase 2; LDL: Low density lipoprotein; NC: Normal chow; OEC: Old Endocalyx treatment; ONC: Old normal chow; YEC: Young Endocalyx treatment; YNC: Young normal chow.