GALECTIN-3 AS A BIOMARKER OF CARDIOVASCULAR FIBROSIS IN RHEUMATOID ARTHRITIS PATIENTS WITH SUPPRESSED INFLAMMATION

Abstract

Objective: Galectin-3 has emerged as a biomarker of cardiovascular fibrosis in high cardiovascular risk individuals. Increased levels of galectin-3 have been previously reported in patients with immune-mediated inflammatory diseases. Nevertheless, it has not been elucidated whether this finding is secondary to the presence of cardiovascular comorbidities and/or the pronounced inflammatory burden of the populations most commonly included in relevant studies. We investigated whether patients with rheumatoid arthritis (RA), a disease characterized by excess cardiovascular risk, present increased levels of galectin-3 even in the absence of cardiovascular comorbidities and pronounced inflammatory load. Design and method: We recruited patients with RA who presented low levels of systemic inflammation and were free from cardiovascular comorbidities including hypertension, diabetes mellitus and established CVD, and non-RA individuals matched for age, sex and office systolic/diastolic blood pressure. Galectin-3 and high-sensitivity C-reactive protein (hsCRP) were measured with enzyme-linked immunosorbent assay using commercially available kits. Carotid-femoral pulse wave velocity (PWV) was estimated with applanation tonometry (SphygmoCor AtCor Medical, Sidney, Australia). Results: In a total of 48 individuals (mean age 53.4±8.6 years, 83.3% females), hsCRP did not significantly differ between RA patients (n = 24) and controls (n = 24) [2.0 (5.6) vs 1.7 (2.4) μg/ml), p = 0.718]. By contrast, significantly increased levels of galectin-3 were observed in the RA group compared to controls [6.9 (6.7) vs 4.6 (4.7)] ng/dl, p = 0.015]. Galectin-3 was associated with PWV (r = 0.390, p = 0.009), but this association was rendered non-significant after adjustment for age and sex. Conclusions: Patients with RA present increased levels of galectin-3. These findings were observed even in a meticulously selected population such as ours, characterized by suppressed inflammation and the absence of hypertension and cardiovascular comorbidities. Further studies are warranted to investigate the potential role of galectin-3 as a potential prognostic marker or therapeutic target in patients with immune-mediated inflammatory diseases.