Although no therapeutic agents to abrogate glycocalyx breakdown have yet been investigated in humans with dengue, interest is growing in the potential to translate therapeutics developed for other indications; these include strategies to inhibit heparanase activity [modified heparins, Sulodexide (24)], downregulate MMP activity to reduce proteoglycan shedding [S1P analogs (25, 26)], use intravenous fluids (IV) which may accelerate glycocalyx repair (27) [albumin (28), fresh frozen plasma (29)], or avoid bolus administration of IV fluids to prevent further damage to a fragile glycocalyx (30). The gene discussed is HPSE; the disease is dengue disease.