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Guazzi M, Novello G, Bursi F, Caretti A, Furlotti N, Arena R, Argiento P, Núñez J, Bayes-Genis A, Metra M. Biomarkers of lung congestion and injury in acute heart failure. ESC Heart Fail 2024. [PMID: 39118416 DOI: 10.1002/ehf2.14982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 02/05/2024] [Accepted: 07/01/2024] [Indexed: 08/10/2024] Open
Abstract
Acute heart failure (AHF) classification and management are primarily based on lung congestion and/or hypoperfusion. The quantification of the vascular and tissue lung damage is not standard practice though biomarkers of lung injury may play a relevant role in this context. Haemodynamic stress promotes alveolar and vascular derangement with loss of functional units, impaired lung capillary permeability and fluid swelling. This culminates in a remodelling process with activation of inflammatory and cytokines pathways. Four families of lung surfactant proteins (i.e., SP-A, SP-B, SP-C, and SP-D), essential for the membrane biology and integrity are released by alveolar type II pneumocites. With deregulation of fluid handling and gas exchange pathways, SPs become sensitive markers of lung injury. We report the pathobiology of lung damage; the pathophysiological and clinical implications of alveolar SPs along with the newest evidence for some classical HF biomarkers that have also shown to reflect a vascular and/or a tissue lung-related activity.
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Affiliation(s)
- Marco Guazzi
- Department of Health Science, University of Milano School of Medicine, Milan, Italy
- Division of Cardiology, San Paolo Hospital, Milan, Italy
| | - Gabriele Novello
- Department of Health Science, University of Milano School of Medicine, Milan, Italy
- Division of Cardiology, San Paolo Hospital, Milan, Italy
| | - Francesca Bursi
- Department of Health Science, University of Milano School of Medicine, Milan, Italy
- Division of Cardiology, San Paolo Hospital, Milan, Italy
| | - Anna Caretti
- Department of Health Science, University of Milano School of Medicine, Milan, Italy
- Division of Biochemistry, Milan, Italy
| | - Noemi Furlotti
- Department of Health Science, University of Milano School of Medicine, Milan, Italy
- Division of Cardiology, San Paolo Hospital, Milan, Italy
| | - Ross Arena
- Department of Physical Therapy, College of Applied Science, University of Illinois Chicago, Chicago, Illinois, USA
- Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, Illinois, USA
| | - Paola Argiento
- Department of Cardiology, University 'L Vanvitelli'-Monaldi Hospital, Naples, Italy
| | - Julio Núñez
- Hospital Clínico Universitario, Universidda de Valencia, INCLIVA, Valencia, Spain
| | | | - Marco Metra
- Spedali Civili, University of Brescia School of Medicine, Brescia, Italy
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Chen H, Chen C, Fang J, Wang R, Nie W. Circulating galectin-3 on admission and prognosis in acute heart failure patients: a meta-analysis. Heart Fail Rev 2020; 25:331-341. [PMID: 31641977 DOI: 10.1007/s10741-019-09858-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Changes of serum galectin-3 have been associated with the pathogenesis of many cardiovascular diseases. The aim of the study was to evaluate the prognostic role of serum galectin-3 in patients with acute heart failure (AHF) in a meta-analysis. Follow-up studies evaluating the association between serum galectin-3 on admission and clinical outcomes in AHF patients were identified via search of PubMed and Embase databases. A random effects or a fixed effects model was applied to pool the results depending on the heterogeneity. Subgroup analysis was used to evaluate the influences of study characteristics on the outcomes. Overall, 7057 AHF patients from eighteen follow-up studies were included. Higher serum galectin-3 was associated with higher risks of all-cause mortality (adjusted risk ratio [RR], 1.58; p < 0.001), mortality/HF rehospitalization (RR, 1.68; p < 0.001), and cardiovascular mortality (RR, 1.29; p = 0.04), but not HF rehospitalization (RR, 1.24; p = 0.25) in AHF patients. Subgroup analyses showed that study characteristics including study design, sample size, age, gender, left ventricular ejection fraction, galectin-3 variable type, follow-up duration, and adjustment of type B natriuretic peptide did not significantly impact the results. Significant heterogeneities were detected for the outcomes of all-cause mortality and mortality/HF rehospitalization. However, trim-and-fill analyses by including the imputed studies to generate symmetrical funnel plots showed similar significant meta-analysis results. These results suggested that higher serum galectin-3 may be associated with poor prognosis in AHF patients. Further studies are needed to determine the mechanisms underlying the potential prognostic role of galectin-3 in AHF.
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Affiliation(s)
- Hongsen Chen
- Department of Intensive Care Unit, The First People's Hospital of Xiangshan, No. 291 Donggu Road, Xiangshan County, Ningbo, 315700, China.
| | - Chensong Chen
- Department of Intensive Care Unit, The First People's Hospital of Xiangshan, No. 291 Donggu Road, Xiangshan County, Ningbo, 315700, China
| | - Junjie Fang
- Department of Intensive Care Unit, The First People's Hospital of Xiangshan, No. 291 Donggu Road, Xiangshan County, Ningbo, 315700, China
| | - Ren Wang
- Department of Intensive Care Unit, The First People's Hospital of Xiangshan, No. 291 Donggu Road, Xiangshan County, Ningbo, 315700, China
| | - Wanshui Nie
- Department of Intensive Care Unit, The First People's Hospital of Xiangshan, No. 291 Donggu Road, Xiangshan County, Ningbo, 315700, China
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Alam ML, Katz R, Bellovich KA, Bhat ZY, Brosius FC, de Boer IH, Gadegbeku CA, Gipson DS, Hawkins JJ, Himmelfarb J, Kestenbaum BR, Kretzler M, Robinson-Cohen C, Steigerwalt SP, Tuegel C, Bansal N. Soluble ST2 and Galectin-3 and Progression of CKD. Kidney Int Rep 2018; 4:103-111. [PMID: 30596173 PMCID: PMC6308819 DOI: 10.1016/j.ekir.2018.09.013] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 09/03/2018] [Accepted: 09/17/2018] [Indexed: 01/20/2023] Open
Abstract
Introduction Cardiac biomarkers soluble ST2 (sST2) and galectin-3 may reflect cardiac inflammation and fibrosis. It is plausible that these mechanisms may also contribute to the progression of kidney disease. We examined associations of sST2 and galectin-3 with kidney function decline in participants with chronic kidney disease (CKD). Methods This was a pooled analysis of 2 longitudinal cohorts of participants with CKD: the Clinical Phenotyping and Resource Biobank (C-PROBE) study and the Seattle Kidney Study (SKS). We measured circulating concentrations of sST2 and galectin-3 at baseline. Our primary outcome was progression to estimated glomerular filtration rate (eGFR) <15 ml/min per 1.73 m2 or end-stage renal disease (ESRD). We used competing risk Cox regression models to study the association of sST2 and galectin-3 with CKD progression, adjusting for demographics, kidney function, and comorbidity. Results Among the 841 participants in the pooled cohort, baseline eGFR was 51 ± 27 ml/min per 1.73 m2 and median urine albumin-to-creatinine ratio (UACR) was 141 (interquartile range = 15−736) mg/g. Participants with higher sST2 and galectin-3 were more likely to be older, to have heart failure and diabetes, and to have lower eGFR. Adjusting for demographics, kidney function, and comorbidity, every doubling of sST2 was not associated with progression to eGFR <15 ml/min per 1.73 m2 or ESRD (adjusted hazard ratio 1.02, 95% confidence interval = 0.76−1.38). Every doubling of galectin-3 was significantly associated with a 38% (adjusted hazard ratio = 1.35, 95% confidence interval = 1.01−1.80) increased risk of progression to eGFR <15 ml/min per 1.73 m2 or ESRD. Conclusion Higher concentrations of the cardiac biomarker galectin-3 may be associated with progression of CKD, highlighting potential novel mechanisms that may contribute to the progression of kidney disease.
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Affiliation(s)
- Mariam L Alam
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Ronit Katz
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Keith A Bellovich
- Department of Medicine, St. John Hospital Medical Center, Detroit, Michigan, USA
| | - Zeenat Y Bhat
- Department of Medicine, Wayne State University, Detroit, Michigan, USA
| | - Frank C Brosius
- Department of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Ian H de Boer
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | | | - Debbie S Gipson
- Department of Pediatrics, University of Michigan, Ann Arbor, Michigan, USA
| | - Jennifer J Hawkins
- Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Bryan R Kestenbaum
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Matthias Kretzler
- Department of Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | | | | | - Courtney Tuegel
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Nisha Bansal
- Department of Medicine, University of Washington, Seattle, Washington, USA
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Dong R, Zhang M, Hu Q, Zheng S, Soh A, Zheng Y, Yuan H. Galectin-3 as a novel biomarker for disease diagnosis and a target for therapy (Review). Int J Mol Med 2017; 41:599-614. [PMID: 29207027 PMCID: PMC5752178 DOI: 10.3892/ijmm.2017.3311] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 11/29/2017] [Indexed: 01/03/2023] Open
Abstract
Galectin-3 is a member of the galectin family, which are β‑galactoside‑binding lectins with ≥1 evolutionary conserved carbohydrate‑recognition domain. It binds proteins in a carbohydrate‑dependent and ‑independent manner. Galectin‑3 is predominantly located in the cytoplasm; however, it shuttles into the nucleus and is secreted onto the cell surface and into biological fluids including serum and urine. It serves important functions in numerous biological activities including cell growth, apoptosis, pre‑mRNA splicing, differentiation, transformation, angiogenesis, inflammation, fibrosis and host defense. Numerous previous studies have indicated that galectin‑3 may be used as a diagnostic or prognostic biomarker for certain types of heart disease, kidney disease and cancer. With emerging evidence to support the function and application of galectin‑3, the current review aims to summarize the latest literature regarding the biomarker characteristics and potential therapeutic application of galectin‑3 in associated diseases.
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Affiliation(s)
- Rui Dong
- Department of Pediatric Hepatobiliary Surgery, Children's Hospital of Fudan University and Key Laboratory of Neonatal Disease, Ministry of Health, Shanghai 200433, P.R. China
| | - Min Zhang
- Medical College, Xizang Minzu University, Xianyang, Shaanxi 712000, P.R. China
| | - Qunying Hu
- Medical College, Xizang Minzu University, Xianyang, Shaanxi 712000, P.R. China
| | - Shan Zheng
- Department of Pediatric Hepatobiliary Surgery, Children's Hospital of Fudan University and Key Laboratory of Neonatal Disease, Ministry of Health, Shanghai 200433, P.R. China
| | - Andrew Soh
- Medical Scientific Affairs, Abbott Diagnostics Division, Abbott Laboratories, Shanghai 200032, P.R. China
| | - Yijie Zheng
- Medical Scientific Affairs, Abbott Diagnostics Division, Abbott Laboratories, Shanghai 200032, P.R. China
| | - Hui Yuan
- Department of Clinical Laboratory, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P.R. China
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Beneficial Effects of Galectin-3 Blockade in Vascular and Aortic Valve Alterations in an Experimental Pressure Overload Model. Int J Mol Sci 2017; 18:ijms18081664. [PMID: 28758988 PMCID: PMC5578054 DOI: 10.3390/ijms18081664] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 07/28/2017] [Accepted: 07/28/2017] [Indexed: 12/19/2022] Open
Abstract
Galectin-3 (Gal-3) is involved in cardiovascular fibrosis and aortic valve (AV) calcification. We hypothesized that Gal-3 pharmacological inhibition with modified citrus pectin (MCP) could reduce aortic and AV remodeling in normotensive rats with pressure overload (PO). Six weeks after aortic constriction, vascular Gal-3 expression was up-regulated in male Wistar rats. Gal-3 overexpression was accompanied by an increase in the aortic media layer thickness, enhanced total collagen, and augmented expression of fibrotic mediators. Further, vascular inflammatory markers as well as inflammatory cells content were greater in aorta from PO rats. MCP treatment (100 mg/kg/day) prevented the increase in Gal-3, media thickness, fibrosis, and inflammation in the aorta of PO rats. Gal-3 levels were higher in AVs from PO rats. This paralleled enhanced AV fibrosis, inflammation, as well as greater expression of calcification markers. MCP treatment prevented the increase in Gal-3 as well as fibrosis, inflammation, and calcification in AVs. Overall, Gal-3 is overexpressed in aorta and AVs from PO rats. Gal-3 pharmacological inhibition blocks aortic and AV remodeling in experimental PO. Gal-3 could be a new therapeutic approach to delay the progression and the development of aortic remodeling and AV calcification in PO.
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