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DOI: 10.1055/s-0036-1571946
Galectin-3 and Aldosterone as Potential Tandem Biomarkers in Pulmonary Arterial Hypertension
Objective: Several studies have identified circulating biomarkers to be associated with the presence and severity of pulmonary arterial hypertension (PAH). Recent evidence supports a role for Galectin-3 (Gal-3) and the mineralocorticoid aldosterone in left ventricular failure. However, studies on aldosterone together with Gal-3 in PAH are lacking.
Methods: A total of 57 patients, 41 with idiopathic PAH (IPAH) and 16 with PAH associated with connective tissue disease (CTD), and 8 age-matched, non-relative controls were studied. Gal-3, aldosterone and other potential protein biomarker plasma concentrations were measured by single ELISA and multi-array MSD technology.
Results: Gal-3 levels were increased in both patients with IPAH (12.2 ± 0.6ng/mL; p< 0.05) and with PAH-CTD (14.1 ± 1.6ng/mL; p< 0.05) versus control (8.5 ± 0.9ng/mL), while aldosterone was significantly elevated in IPAH only (248.5 ± 38.8pg/mL vs. control 71.9 ± 18.2pg/mL; p< 0.05). In addition, aldosterone, Gal-3, and NT-proBNP levels were all higher in patients in WHO functional class II-III versus PAH functional class I or controls. The vascular injury marker intercellular adhesion molecule 1 (ICAM-1) was increased in IPAH and CTD-PAH vs controls (559.5 ± 18.2pg/mL and 734.1 ± 59.4pg/mL vs. controls 394.8 ± 39.3pg/mL, p< 0.05, p< 0.0001, respectively), whereas vascular cell adhesion molecule 1 (VCAM-1) and proinflammatory, antiangiogenic interleukin 12 (IL-12) were elevated in CTD-PAH only (879.5 ± 110.0pg/mL and 391.2 ± 70.3pg/mL vs. controls 489.8 ± 44.6pg/mL, p< 0.01 and 102.1 ± 15.2pg/mL, p< 0.01, respectively).
Conclusion: Heightened galectin-3 and aldosterone plasma levels in PAH patients indicate a role for galectin-3 signaling in the pathobiology of IPAH and PAH-CTD, and may serve as tandem biomarkers for functional status and progression of disease.