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4.3 The dual role of imbalances in hyaluronic acid metabolism in glycocalyx damage HA has a wide variety of receptors, including cluster of differentiation 44 (CD44), HA-mediated motility receptor, lymphatic endothelial receptor-1, endocytosis-activated HA receptor, and Toll-like receptor 4, and is thus a potent signaling molecule with a range of effects that plays a crucial role in the development of sepsis (68)