title: Galectin-3 and aldosterone as potential tandem biomarkers in pulmonary arterial hypertension.
abstract: BACKGROUND
  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 mineralcorticoid aldosterone in left ventricular failure. However, studies on aldosterone together with Gal-3 in PAH are lacking.
  
  
  OBJECTIVE
  We investigated a novel Aldosterone-galectin-3 (Gal-3) tandem and several other potential PAH biomarkers and their association with the disease severity.
  
  
  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 plasma concentrations were measured by single ELISA and multi-array MSD (Meso Scale Discovery) technology.
  
  
  RESULTS
  Gal-3 values were increased in both patients with IPAH (12.2±0.6 ng/mL; p<0.05) and with PAH-CTD (14.1±1.6 ng/mL; p<0.05) versus control (8.5±0.9 ng/mL), while aldosterone was significantly elevated in IPAH only (248.5±38.8 pg/mL vs control 71.9±18.2 pg/mL; p<0.05). In addition, aldosterone, Gal-3, and N-terminal pro-brain natriuretic peptide (NT-proBNP) values 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 PAH-CTD versus controls (559.5±18.2 pg/mL and 734.1±59.4 pg/mL vs controls 394.8±39.3 pg/mL, p<0.05, p<0.0001, respectively), whereas vascular cell adhesion molecule 1 (VCAM-1) and proinflammatory, anti-angiogenic interleukin-12 (IL-12) were elevated in PAH-CTD only (879.5±110.0 pg/mL and 391.2±70.3 pg/mL vs controls 489.8±44.6 pg/mL, p<0.01, and 102.1±15.2 pg/mL, p<0.01, respectively).
  
  
  CONCLUSIONS
  Heightened Gal-3 and aldosterone plasma concentrations in PAH patients indicate a role for Gal-3 signalling in the pathobiology of IPAH and PAH-CTD, and may serve as biomarkers for functional status and progression of disease.
authors: Department of Pediatric Cardiology and Critical Care, Hannover Medical School, Hannover, Germany.
authors: Laurent
authors: L
authors: Calvier
authors: Department of Pediatric Cardiology and Critical Care, Hannover Medical School, Hannover, Germany.
authors: Ekaterina
authors: E
authors: Legchenko
authors: Department of Pediatric Cardiology and Critical Care, Hannover Medical School, Hannover, Germany.
authors: Lena
authors: L
authors: Grimm
authors: Department of Neonatology, Charité University Medical Center, Berlin, Germany.
authors: Hannes
authors: H
authors: Sallmon
authors: Department of Chemical Engineering, Northeastern University, Boston, Massachusetts, USA.
authors: Adam
authors: A
authors: Hatch
authors: Department of Chemical Engineering, Northeastern University, Boston, Massachusetts, USA.
authors: Brian D
authors: BD
authors: Plouffe
authors: Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany.
authors: Christoph
authors: C
authors: Schroeder
authors: Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
authors: Johann
authors: J
authors: Bauersachs
authors: Department of Chemical Engineering, Northeastern University, Boston, Massachusetts, USA Barnett Institute of Chemical and Biological Analysis, Northeastern University, Boston, Massachusetts, USA.
authors: Shashi K
authors: SK
authors: Murthy
authors: Department of Pediatric Cardiology and Critical Care, Hannover Medical School, Hannover, Germany.
authors: Georg
authors: G
authors: Hansmann
mesh_terms: D000328:Adult; D000368:Aged; D000450:Aldosterone / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins; D016022:Case-Control Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D037502:Galectin 3 / Q000097:blood*; D037161:Galectins; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D018836:Inflammation Mediators / Q000097:blood; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; D037502:Galectin 3; D037161:Galectins; D018836:Inflammation Mediators; C428445:LGALS3 protein, human; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D000450:Aldosterone