TNF and Sepsis: The glycocalyx is composed of syndecan-1, heparan sulfate, hyaluronic acid, etc. In sepsis, reactive oxygen species (ROS), tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta), and other factors cause the glycocalyx to be shed, resulting in increased vascular permeability and coagulation and decreased NO production (Uchimido et al., 2019).