Diagnostic Significance of Serum Galectin-3 in Hospitalized Patients with COVID-19—A Preliminary Study

Abstract

Severe coronavirus disease 2019 (COVID-19) is associated with hyperinflammation leading to organ injury, including respiratory failure. Galectin-3 was implicated in innate immunological response to infections and in chronic fibrosis. The aim of our preliminary study was the assessment of the diagnostic utility of serum galectin-3 in patients with COVID-19. The prospective observational study included adult patients admitted with active COVID-19 and treated in tertiary hospital between June and July 2020. The diagnosis was confirmed by the quantitative detection of nucleic acid of severe acute respiratory syndrome coronavirus 2 in nasopharyngeal swabs. Galectin-3 was measured by enzyme immunoassay in serum samples obtained during the first five days of hospital stay. We included 70 patients aged 25 to 73 years; 90% had at least one comorbidity. During the hospital stay, 32.9% were diagnosed with COVID-19 pneumonia and 12.9% required treatment in the intensive care unit (ICU). Serum galectin-3 was significantly increased in patients who developed pneumonia, particularly those who required ICU admission. Positive correlations were found between galectin-3 and inflammatory markers (interleukin-6, C-reactive protein, ferritin, pentraxin-3), a marker of endothelial injury (soluble fms-like tyrosine kinase-1), and a range of tissue injury markers. Serum galectin-3 enabled the diagnosis of pneumonia with moderate diagnostic accuracy and the need for ICU treatment with high diagnostic accuracy. Our findings strengthen the hypothesis that galectin-3 may be involved in severe COVID-19. Further studies are planned to confirm the preliminary results and to verify possible associations of galectin-3 with long-term consequences of COVID-19, including pulmonary fibrosis.

The Diagnostic and Therapeutic Potential of Galectin-3 in Cardiovascular Diseases

“…Galectin-3 is strongly involved in the modulations of inflammatory processes and disorders underlying the inflammatory condition. The proinflammatory effect of galectin-3 is associated with activation of NF-kB transcription factor, induction of tumour necrosis factor α (TNF-α) and interleukin 6, regulation of cell adhesion, promotion of cell activation and chemotaxis and regulation of cell growth or apoptosis [ 63 ].…”

“…It seems that serum galectin-3 concentration reflects the severity of COVID-19 course. In patients infected with SARS-CoV-2, in whom an unfavourable course of the disease forced administration of intensive therapy in view of respiratory failure, an almost three times higher serum galectin-3 concentrations were found, compared with patients not requiring treatment at intensive care units (ICUs) (23.46 (15.51–27.80) ng/mL vs. 8.93 (7.58–12.97) ng/mL, respectively) [ 63 ].…”

“…The study conducted by Kuśnierz-Cabala et al [ 63 ] also called attention to the use of galectin-3 in the diagnosis of pneumonia, particularly in situations of severe COVID-19 course. In patients with pneumonia, an almost twice higher serum galectin-3 concentrations were found compared with those, in whom no pneumonia developed (13.30 (8.93–17.38) ng/mL vs. 8.55 (6.73–10.98) ng/mL, respectively).…”

“…In patients with pneumonia, an almost twice higher serum galectin-3 concentrations were found compared with those, in whom no pneumonia developed (13.30 (8.93–17.38) ng/mL vs. 8.55 (6.73–10.98) ng/mL, respectively). In that group of patients also higher concentrations were revealed of other proinflammatory markers: IL-6, pentraxin-3 (PTX-3), endothelial damage marker–soluble fms-like tyrosine kinase-1 (sFlt-1) and a number of tissue damage markers [ 63 ].…”

The Complex Biological Effects of Pectin: Galectin-3 Targeting as Potential Human Health Improvement?

“…Higher serum levels of Gal-3 were related to a tendency of severe acute respiratory distress syndrome (ARDS) development, and alongside IL-6 and CRP, Gal-3 was demonstrated to be the best predictive power for mortality outcome [ 118 ]. There are also positive correlations between Gal-3 and other inflammatory markers such as PTX-3, ferritin, and the marker of endothelial dysfunction, sFlt-1 [ 119 ], which could be utilized for intensive care unit (ICU) admission biomarker. A phase 2a study, the first clinical trial using an inhalator treatment targeting Gal-3-GB0139—associated with the standard of care procedure (dexamethasone)—identified lower Gal-3 serum levels, higher mean downward of CRP levels (although higher CRP was identified at first in the treatment group) and other inflammatory agents and better fibrosis marker levels than the control group.…”