Importância da galectina-3 na ação moduladora da crotoxina sobre função de monócito/macrófago

Crotoxin (CTX) has biological effects both in experimental models and in clinical trials. Our group showed that the antitumor activity of CTX is associated with the modulating actions of the toxin on the secretory activity of inflammatory mediators and on the energy metabolism of macrophages. Furthermore, we demonstrated that CTX, in vivo, interferes with the phenotypic reprogramming of resident peritoneal macrophages and the tumor microenvironment, suggesting a reprogramming or prevalence of the M1 phenotype of macrophages. Among the mechanisms involved with the phenotypic reprogramming of monocytes/macrophages, galectin-3 has been described as an immunoregulatory protein, which may favor the classic pro-inflammatory condition (macrophage-M1) or alternative (macrophage-M2, anti-inflammatory), depending on the pathophysiological condition, with involvement of the PI3K/Akt signaling pathway. Therefore, the objective of this project was to investigate whether CTX is capable of interfering with the expression and secretion of galectin-3 by monocytes and the participation of this lectin in the modulating activity of CTX on the phenotypic condition of these cells by different stimuli. For this purpose, in vitro assays were carried out using cells of the human monocytic lineage (THP-1), pre-incubated in the absence (control) or presence of CTX (0.3; 0.6 and 1.2 μg/mL), by 2 hours and maintained in culture for 72 hours under different microenvironmental stimuli: a) only in fresh RPMI 1640 culture medium (to evaluate the per se activity of CTX on the investigated proteins); b) with culture medium containing 800 μg/mL of LPS; or c) and conditioned medium (CM) from MDA-MB-231 tumor cells. The Western Blotting assay was performed to mark the proteins: PI3Kp110a, Akt (types 1 and 2) and galectin-3. Functional/phenotypic parameters, such as H2O2 release, secretion of pro-(TNF-α) and anti-inflammatory cytokines (IL-10/TGF-β1) and Gal-3, and phenotypic markers (M1- CD80/CD86 and M2-CD163/CD206) was determined in order to associate possible changes in the functional/phenotypic behavior (M1/M2) of these cells and with the expression of signaling proteins involved in the reprogramming of monocytes/macrophages, in the face of different stimuli. The results indicate that CTX modulates the Akt signaling pathway and with the expression and secretion of Gal-3, as well as with the release of H2O2 and against different signals in the microenvironment. Furthermore, a pro-inflammatory and pro-tumor role is attributed to Gal-3 in inflammatory and tumoral conditions and here, the results show the participation of this lectin in the immunomodulatory effect of CTX, both in the action per se of the toxin and in the inflammatory and tumoral microenvironments. Furthermore, particularly the concentration of CTX 0.6 and 1.2 μg/ml seems to promote a THP-1 mixed monocyte/macrophage profile or switch phenotype. This study contributes to knowledge about the immunomodulatory actions of CTX, showing for the first time the participation of Gal-3 in this process.

A Crotoxina (CTX) apresenta efeitos biológicos tanto em modelos experimentais como em estudos clínicos. Nosso grupo mostrou que a atividade antitumoral da CTX está associada às ações moduladoras da toxina sobre a atividade secretora de mediadores inflamatórios e sobre o metabolismo energético de macrófagos. Ainda, demonstramos que a CTX, in vivo, interfere com a reprogramação fenotípica de macrófagos peritoneais residentes e do microambiente tumoral, sugerindo uma reprogramação ou prevalência do fenótipo M1 de macrófagos. Dentre os mecanismos envolvidos com a reprogramação fenotípica de monócitos/macrófagos, a galectina-3 vem sendo descrita como uma proteína imunorreguladora, podendo favorecer a condição pró- inflamatória clássica (macrófago-M1) ou alternativa (macrófago-M2, anti-inflamatório), conforme a condição fisiopatológica, com envolvimento da via de sinalização PI3K/Akt. Portanto, o objetivo do presente projeto foi investigar se a CTX é capaz de interferir com a expressão e secreção de galectina-3 por monócitos e a participação desta lectina na atividade moduladora da CTX sobre a condição fenotípica dessas células, frente a diferentes estímulos. Para tanto, ensaios in vitro foram realizados utilizando células da linhagem monocítica humana (THP-1), pré-incubadas na ausência (controle) ou presença de CTX (0,3; 0,6 e 1,2 μg/mL), por 2 horas e mantidas em cultura por 72 horas em diferentes estímulos microambientais: a) apenas em meio de cultura RPMI 1640 fresco (para avaliar a atividade per se da CTX sobre as proteínas investigadas); b) com meio de cultura contendo 800 μg/mL de LPS; ou c) e meio condicionado de células tumorais MDA-MB-231. O ensaio de Western Blotting foi realizado para marcação das proteínas: PI3Kp110a, Akt (tipos 1 e 2) e galectina-3. Parâmetros funcionais/fenotípicos, como a liberação de H2O2, secreção de citocinas pró- (TNF-α) e anti-inflamatórias (IL-10/TGF-β1) e Gal-3 e marcadores fenotípicos (M1-CD80/CD86 e M2-CD163/CD206) foi determinado visando associar possíveis alterações sobre o comportamento funcional/fenotípico (M1/M2) dessas células e com a expressão das proteínas sinalizadoras envolvidas com a reprogramação dos monócitos/macrófagos, frente aos diferentes estímulos. Os resultados indicam que a CTX modula a via de sinalização Akt e com a expressão e secreção de Gal-3, bem como, com a liberação de H2O2 e frente a diferentes sinais no microambiente. Ainda, é atribuída a Gal-3 papel pró-inflamatória e pró-tumoral em condições inflamatória e tumoral e aqui, os resultados mostram a participação dessa lectina no efeito imunomodulador da CTX, tanto na ação per se da toxina quanto nos microambientes inflamatório e tumoral. Além disso, particularmente as concentrações de CTX 0,6 e 1,2 μg/mL parece promover um perfil misto de monócito/macrófago THP-1 ou fenótipo switch. Este estudo contribui com o conhecimento sobre as ações imunomoduladoras da CTX, evidenciando pela primeira vez a participação da Gal-3 nesse processo.

A new biomarker that predicts ventricular arrhythmia in patients with ischemic dilated cardiomyopathy: Galectin-3.

INTRODUCTION: Ventricular arrhythmias are caused by scar tissue in patients with ischemic dilated cardiomyopathy. The gold standard imaging technique for detecting scar tissue is magnetic resonance imaging (MRI). However, MRI is not feasible for use as a screening test, and also cannot be used in patients who have received an implantable cardioverter-defibrillator (ICD). In this study, we aimed to assess the association between levels of galectin-3 (Gal-3), which is known to be secreted by scar tissue, and the history of ventricular arrhythmias in patients with ischemic dilated cardiomyopathy who received an ICD. METHODS: Nineteen healthy controls and 32 patients who had previously undergone VVI-ICD implantation due to ischemic dilated cardiomyopathy were enrolled in the study. Patients were divided into three groups: the first group including patients who had received no ICD therapies, the second including patients with arrhythmia requiring therapies with no arrhythmia storm, and the third including patients who had arrhythmia storm. We assessed the association between Gal-3 levels and the history of ventricular arrhythmias in these patients. RESULTS: Gal-3 levels were significantly higher in the patient groups than in the control group (p<0.01). Gal-3 levels of patients with arrhythmias requiring ICD therapies were significantly higher than in patients with ICD not requiring therapies (p=0.02). They were also higher in patients with a history of arrhythmia storm than in patients without shocks (p=0.05). Receiver operating curve analysis showed with 84% sensitivity and 75% specificity that Gal-3 levels over 7 ng/ml indicated ventricular arrhythmia that required therapies. CONCLUSION: Gal-3 may be used to further improve risk stratification in patients with ischemic cardiomyopathy who are more prone to developing life-threatening arrhythmias.

Serum galectin-3 and TGF-beta levels in patients with sarcoidosis / Niveles séricos de galectina-3 y TGF-beta en pacientes con sarcoidosis

Introduction: Sarcoidosis is a chronic granulomatous disease that develops with non-caseified granuloma formation. Galectin-3 is a multifunctional protein operating in biological processes such as fibrosis, angiogenesis, and immune activation. Purpose: This study evaluates the levels of serum galectin-3 and TGF-beta in sarcoidosis patients to determine a possible correlation with clinical findings. Material and method: Forty-four biopsy-proven sarcoidosis patients followed in a single centre and 41 age and sex-matched healthy volunteers were included in the study. The levels of serum galectin-3 and TGF-beta were evaluated by ELISA method. Results: Among the 44 sarcoidosis patients, 13(29.5%) were male and 31(70.5%) were female. The average patient age was 47.4 and the average disease duration was 3.2 years. The level of serum galectin-3 was found to be the same as in the control group and had no significance statistically (p=.977). No correlation was determined between the level of serum galectin-3 and clinical and laboratory findings of sarcoidosis (p>.05). The level of serum TGF-beta was found to be higher in the sarcoidosis patients when compared to that of the control group (p=.005). While a correlation was found between serum TGF-beta and enthesitis, sacroiliitis, and arthralgia (p=.006, p=.034, p=.02), no correlation was determined on the other clinical and laboratory findings (p>.05). Conclusion: While the level of serum galectin-3 was determined to be normal in sarcoidosis patients, a high level of serum TGF-beta was found. These findings show that TGF-beta may play an important role in sarcoidosis pathogenesis and the formation of granuloma.(AU)

Introducción: : La sarcoidosis es una enfermedad granulomatosa crónica que se desarrolla con una formación de granuloma no caseificado. Galectina-3 es una proteína multifuncional que opera en procesos biológicos como la fibrosis, la angiogénesis y la activación inmune. Propósito: Este estudio evalúa los niveles séricos de galectina-3 y TGF-beta en pacientes con sarcoidosis para determinar una posible correlación con los hallazgos clínicos. Material y método: Fueron seguidos en un solo centro 44 pacientes con sarcoidosis probados por biopsia y se incluyeron en el estudio 41 voluntarios sanos de la misma edad y sexo. Los niveles séricos de galectina-3 y TGF-beta fueron evaluados por el método ELISA. Resultados: Entre los 44 pacientes con sarcoidosis, 13 (29,5%) eran hombres y 31 (70,5%) eran mujeres. La edad promedio de los pacientes fue de 47,4 y la duración promedio de la enfermedad fue de 3,2 años. Se encontró que el nivel de galectina-3 en suero era el mismo que en el grupo control y no tenía significancia estadística (p = 0,977). No se determinó correlación entre el nivel sérico de galectina-3 y los hallazgos clínicos y de laboratorio de sarcoidosis (p > 0,05). El nivel de TGF-beta en suero se encontró más alto en los pacientes con sarcoidosis, en comparación con el del grupo control (p = 0,005). Si bien se encontró una correlación entre el TGF-beta sérico y la entesitis, sacroileítis y artralgia (p = 0,006, p = 0,034, p = 0,02), no se determinó correlación en los otros hallazgos clínicos y de laboratorio (p > 0,05). Conclusión: Si bien se determinó que el nivel sérico de galectina-3 era normal en pacientes con sarcoidosis, se encontró un alto nivel de TGF-beta en suero. Estos hallazgos muestran que el TGF-beta puede desempeñar un papel importante en la patogénesis de la sarcoidosis y la formación de granuloma.(AU)

Serum galectin-3 and TGF-beta levels in patients with sarcoidosis.

INTRODUCTION: Sarcoidosis is a chronic granulomatous disease that develops with non-caseified granuloma formation. Galectin-3 is a multifunctional protein operating in biological processes such as fibrosis, angiogenesis, and immune activation. PURPOSE: This study evaluates the levels of serum galectin-3 and TGF-beta in sarcoidosis patients to determine a possible correlation with clinical findings. MATERIAL AND METHOD: Forty-four biopsy-proven sarcoidosis patients followed in a single centre and 41 age and sex-matched healthy volunteers were included in the study. The levels of serum galectin-3 and TGF-beta were evaluated by ELISA method. RESULTS: Among the 44 sarcoidosis patients, 13(29.5%) were male and 31(70.5%) were female. The average patient age was 47.4 and the average disease duration was 3.2 years. The level of serum galectin-3 was found to be the same as in the control group and had no significance statistically (p=.977). No correlation was determined between the level of serum galectin-3 and clinical and laboratory findings of sarcoidosis (p>.05). The level of serum TGF-beta was found to be higher in the sarcoidosis patients when compared to that of the control group (p=.005). While a correlation was found between serum TGF-beta and enthesitis, sacroiliitis, and arthralgia (p=.006, p=.034, p=.02), no correlation was determined on the other clinical and laboratory findings (p>.05). CONCLUSION: While the level of serum galectin-3 was determined to be normal in sarcoidosis patients, a high level of serum TGF-beta was found. These findings show that TGF-beta may play an important role in sarcoidosis pathogenesis and the formation of granuloma.

Preditores de Mortalidade Total e Eventos Arrítmicos Graves em Pacientes com Insuficiência Cardíaca Não Isquêmica: O Papel da Galectina-3 / Predictors of Total Mortality and Serious Arrhythmic Events in Non-Ischemic Heart Failure Patients: The Role of Galectin-3

Resumo Fundamento: A estratificação de risco continua sendo clinicamente desafiadora em pacientes com insuficiência cardíaca (IC) de etiologia não isquêmica. A galectina-3 é um marcador sérico de fibrose que pode ajudar no prognóstico. Objetivo: Determinar o papel da galectina-3 como preditora de eventos arrítmicos graves e mortalidade total. Métodos: Este é um estudo de coorte prospectivo que incluiu 148 pacientes com IC não isquêmica. Todos os pacientes foram submetidos a uma avaliação clínica e laboratorial abrangente para coleta de dados de referência, incluindo níveis de galectina-3 sérica. O desfecho primário foi a ocorrência de síncope arrítmica, intervenções apropriadas do cardioversor desfibrilador implantável, taquicardia ventricular sustentada ou morte súbita cardíaca. O desfecho secundário foi a morte por todas as causas. Para todos os testes estatísticos, considerou-se significativo o valor p<0,05 (bicaudal). Resultados: Em seguimento mediano de 941 dias, os desfechos primário e secundário ocorreram em 26 (17,5%) e 30 (20%) pacientes, respectivamente. A galectina-3 sérica>22,5 ng/mL (quartil mais alto) não foi preditora de eventos arrítmicos graves (HR: 1,98; p=0,152). Os preditores independentes do desfecho primário foram diâmetro diastólico final do ventrículo esquerdo (DDFVE)>73 mm (HR: 3,70; p=0,001), ventilação periódica durante o exercício (VPE) no teste de esforço cardiopulmonar (HR: 2,67; p=0,01) e taquicardia ventricular não sustentada (TVNS)>8 batimentos na monitorização por Holter (HR: 3,47; p=0,027). Os preditores de morte por todas as causas foram: galectina-3>22,5 ng/mL (HR: 3,69; p=0,001), DDFVE>73 mm (HR: 3,35; p=0,003), VPE (HR: 3,06; p=0,006) e TVNS>8 batimentos (HR: 3,95; p=0,007). A ausência de todos os preditores de risco foi associada a um valor preditivo negativo de 91,1% para o desfecho primário e 96,6% para a mortalidade total. Conclusões: Em pacientes com IC não isquêmica, níveis elevados de galectina-3 não foram preditores de eventos arrítmicos graves, mas foram associados à mortalidade total. A ausência de preditores de risco revelou um subgrupo prevalente de pacientes com IC com excelente prognóstico.

Abstract Background: Risk stratification remains clinically challenging in patients with heart failure (HF) of non-ischemic etiology. Galectin-3 is a serum marker of fibrosis that might help in prognostication. Objective: To determine the role of galectin-3 as a predictor of major arrhythmic events and overall mortality. Methods: We conducted a prospective cohort study that enrolled 148 non-ischemic HF patients. All patients underwent a comprehensive baseline clinical and laboratory assessment, including levels of serum galectin-3. The primary outcome was the occurrence of arrhythmic syncope, appropriate implantable cardioverter defibrillator therapy, sustained ventricular tachycardia, or sudden cardiac death. The secondary outcome was all-cause death. For all statistical tests, a two-tailed p-value<0.05 was considered significant. Results: In a median follow-up of 941 days, the primary and secondary outcomes occurred in 26 (17.5%) and 30 (20%) patients, respectively. Serum galectin-3>22.5 ng/mL (highest quartile) did not predict serious arrhythmic events (HR: 1.98, p=0.152). Independent predictors of the primary outcome were left ventricular end-diastolic diameter (LVEDD)>73mm (HR: 3.70, p=0.001), exercise periodic breathing (EPB) on cardiopulmonary exercise testing (HR: 2.67, p=0.01), and non-sustained ventricular tachycardia (NSVT)>8 beats on Holter monitoring (HR: 3.47, p=0.027). Predictors of all-cause death were galectin-3>22.5 ng/mL (HR: 3.69, p=0.001), LVEDD>73mm (HR: 3.35, p=0.003), EPB (HR: 3.06, p=0.006), and NSVT>8 beats (HR: 3.95, p=0.007). The absence of all risk predictors was associated with a 91.1% negative predictive value for the primary outcome and 96.6% for total mortality. Conclusions: In non-ischemic HF patients, elevated galectin-3 levels did not predict major arrhythmic events but were associated with total mortality. Absence of risk predictors revealed a prevalent subgroup of HF patients with an excellent prognosis.

Galectina-3 Associada a Formas Graves e Mortalidade em Longo Prazo em Pacientes com Doença de Chagas / Galectin-3 Associated with Severe Forms and Long-term Mortality in Patients with Chagas Disease

Resumo Fundamento As características histopatológicas da doença de Chagas (DCC) são: presença de miocardite, destruição das fibras cardíacas e fibrose miocárdica. A Galectina-3 (Gal-3) é um biomarcador envolvido no mecanismo de fibrose e inflamação que pode ser útil para a estratificação de indivíduos com DCC por risco. Objetivos Nosso objetivo foi avaliar se níveis elevados de Gal-3 estão associados a formas graves de cardiomiopatia chagásica (CC) e são preditivos de mortalidade. Métodos Estudamos doadores de sangue (DS) positivos para anti-T. cruzi: não-CC-DS (187 DS sem CC com eletrocardiograma [ECG] e fração de ejeção do ventrículo esquerdo [FEVE] normais); CC-Não-Dis-DS (46 DS com CC e apresentando ECG anormal, mas FEVE normal); e 153 controles negativos correspondentes. Esta amostra foi composta por 97 pacientes com CC grave (CC-Dis). Usamos as correlações de Kruskall-Wallis e Spearman para testar a hipótese de associações, assumindo um p bicaudal <0,05 como significativo. Resultados O nível de Gal-3 foi de 12,3 ng/mL para não-CC-DS, 12,0 ng/mL para CC-Não-Dis-DS, 13,8 ng/mL para controles e 15,4 ng/mL para CC-Dis. FEVE <50 foi associada a níveis mais elevados de Gal-3 (p=0,0001). Em nosso modelo de regressão linear ajustado, encontramos associação entre os níveis de Gal-3 e os parâmetros do ecocardiograma em indivíduos positivos para T. cruzi. Nos pacientes CC-Dis, encontramos uma associação significativa de níveis mais elevados de Gal-3 (≥15,3 ng/mL) e morte ou transplante cardíaco em acompanhamento de cinco anos (Hazard ratio - HR 3,11; IC95% 1,21- 8,04; p=0,019). Conclusões Em pacientes com CC, níveis mais elevados de Gal-3 estiveram significativamente associados a formas graves da doença e maior taxa de mortalidade em longo prazo, o que significa que pode ser um meio efetivo para identificar pacientes de alto risco. (Arq Bras Cardiol. 2021; 116(2):248-256)

Abstract Background The histopathological characteristics of Chagas disease (ChD) are: presence of myocarditis, destruction of heart fibers, and myocardial fibrosis. Galectin-3 (Gal-3) is a biomarker involved in the mechanism of fibrosis and inflammation that may be useful for risk stratification of individuals with ChD. Objectives We sought to evaluate whether high Gal-3 levels are associated with severe forms of Chagas cardiomyopathy (CC) and whether they are predictive of mortality. Methods We studied anti-T. cruzi positive blood donors (BD): Non-CC-BD (187 BD without CC with normal electrocardiogram [ECG] and left ventricular ejection fraction [LVEF]); CC-Non-Dys-BD (46 BD with CC with abnormal ECG but normal LVEF); and 153 matched serum-negative controls. This cohort was composed of 97 patients with severe CC (CC-Dys). We used Kruskall-Wallis and Spearman's correlation to test hypothesis of associations, assuming a two-tailed p<0.05 as significant. Results The Gal-3 level was 12.3 ng/mL for Non-CC-BD, 12.0 ng/mL for CC-Non-Dys-BD, 13.8 ng/mL for controls, and 15.4 ng/mL for CC-Dys. LVEF<50 was associated with higher Gal-3 levels (p=0.0001). In our linear regression adjusted model, we found association between Gal-3 levels and echocardiogram parameters in T. cruzi-seropositive subjects. In CC-Dys patients, we found a significant association of higher Gal-3 levels (≥15.3 ng/mL) and subsequent death or heart transplantation in a 5-year follow-up (Hazard ratio - HR 3.11; 95%CI 1.21-8.04; p=0.019). Conclusions In ChD patients, higher Gal-3 levels were significantly associated with severe forms of the disease and more long-term mortality, which means it may be a useful means to identify high-risk patients. (Arq Bras Cardiol. 2021; 116(2):248-256)

Evaluation of galectin-3 levels in patients with type 2 diabetes mellitus and chronic kidney disease / Avaliação dos níveis de galectina-3 em pacientes com diabetes mellitus tipo 2 e doença renal crônica

ABSTRACT INTRODUCTION: Type 2 diabetes mellitus (T2DM) is the most common manifestation of diabetes, accounting for about 90% of diagnosed cases. The causes of T2DM are not fully understood, but its pathogenesis is possibly associated with increased adiposity and a chronic low-grade inflammatory response. The glycoprotein galectin-3 (Gal-3) is known to play an important role in the modulation of blood glucose, adiposity, and inflammation. OBJECTIVES: The aim of this study was to evaluate Gal-3 levels in patients with T2DM and chronic kidney disease (CKD), in addition to relating them with complications and comorbidities present in these patients, comparing them to a control group. MATERIAL AND METHODS: Gal-3 was evaluated in 84 selected individuals, of which 42 had clinical and laboratory diagnosis of T2DM and CKD (treated at Santa Casa Hospital in Belo Horizonte, Minas Gerais, Brazil), and 42 individuals from the local community, with no history of diabetes (control group). RESULTS AND DISCURSION: Gal-3 levels were significantly higher (p = 0.012) in the T2DM group (15.17 ± 5.54 ng/ml) when compared to the control group (12.62 ± 3.2 ng/ml). There was a tendency for higher levels of Gal-3 in diabetic patients with hypertension (15.74 ± 5.61 ng/ml) when compared to patients without this complication (10.96 ± 2.49 ng/ml) (p = 0.069) CONCLUSION: The results suggest that Gal-3 may be involved in the pathophysiology of T2DM and still be a promising biomarker associated with hypertension in this group.

RESUMEN INTRODUCCIÓN: La diabetes mellitus tipo 2 (DM2) es la forma más común de la diabetes; representa alrededor del 90% de los casos diagnosticados. Todavía no se conocen por completo las causas de la DM2, pero posiblemente su etiopatogénesis se relaciona con el aumento de adiposidad y una respuesta inflamatoria crónica de bajo grado. Se sabe que la glicoproteína galectina 3 (Gal-3) juega un papel importante en la modulación de glucemia, adiposidad e inflamación. OBJETIVOS: Evaluar los niveles de Gal-3 en pacientes con DM2 y enfermedad renal crónica, además de relacionarlos con las otras complicaciones y comorbilidades presentes en eses individuos, comparándolos con un grupo control. MATERIAL Y MÉTODO: La Gal-3 fue evaluada en 84 pacientes elegidos; entre esos, 42 poseían el diagnóstico clínico y de laboratorio de DM2 y enfermedad renal crónica (atendidos en el Hospital Santa Casa de Belo Horizonte, Minas Gerais, Brasil) y 42 eran de la comunidad local, sin historial de diabetes (grupo control). RESULTADOS Y DISCUSIÓN: Los niveles de Gal-3 fueron más altos (p = 0,012) en el grupo con DM2 (15,17 ± 5,54 ng/ml) que en el grupo control (12,62 ± 3,2 ng/ml). Hubo tendencia de mayores niveles de Gal-3 en los pacientes diabéticos con hipertensión (15,74 ± 5,61 ng/ml) que en aquellos sin esa complicación (10,96 ± 2,49 ng/ml) (p = 0,069). CONCLUSIÓN: Los resultados obtenidos apuntan que la Gal-3 puede estar involucrada en la etiología de la DM2 y aún ser un biomarcador prometedor de hipertensión en ese grupo.

RESUMO INTRODUÇÃO: O diabetes mellitus tipo 2 (DM2) é a manifestação mais comum do diabetes; representa cerca de 90% dos casos diagnosticados. As causas do DM2 ainda não foram completamente estabelecidas, mas sua patogênese está, possivelmente, relacionada com o aumento da adiposidade e uma resposta inflamatória crônica de baixo grau. Sabe-se que a glicoproteína galectina-3 (Gal-3) possui papel importante na modulação de glicemia, adiposidade e inflamação. OBJETIVOS: Avaliar os níveis de Gal-3 em pacientes com DM2 e doença renal crônica, além de relacioná-los com as demais complicações e comorbidades presentes nesses indivíduos, comparando-os com um grupo-controle. MATERIAL E MÉTODOS:: A Gal-3 foi avaliada em 84 pacientes selecionados; destes, 42 possuíam o diagnóstico clínico e laboratorial de DM2 e doença renal crônica (atendidos no Hospital Santa Casa de Belo Horizonte, Minas Gerais, Brasil), e 42 eram da comunidade local, sem histórico de diabetes (grupo-controle). RESULTADOS E DISCUSSÃO: Os níveis de Gal-3 foram significativamente mais elevados (p = 0,012) no grupo com DM2 (15,17 ± 5,54 ng/ml) quando comparados com os níveis do grupo-controle (12,62 ± 3,2 ng/ml). Houve tendência em maiores níveis de Gal-3 nos pacientes diabéticos com hipertensão (15,74 ± 5,61 ng/ml) em comparação com os pacientes sem essa complicação (10,96 ± 2,49 ng/ml) (p = 0,069). CONCLUSÃO: Os resultados obtidos sugerem que a Gal-3 pode estar envolvida na fisiopatologia do DM2 e ainda ser um promissor biomarcador associado à hipertensão nesse grupo.

Evaluation of galectins 1 and 3 expression in canine melanoma / Avaliação da expressão das galectinas 1 e 3 no melanoma canino

Canine melanoma is a frequently-occuring neoplasm in dogs and presents as malignant and highly metastatic in this context, studies that contribute to the understanding of the tumor microenvironment in melanoma include the role of galectins. Galectins are proteins of the family of animal lectins that display carbohydrate recognition domains. Galectin-1 and galectin-3 are associated with neoplastic transformation, neoplastic cell survival, angiogenesis, immune system evasion, and metastasis. The goal of this study was to establish a correlation between expression patterns of galectin-1 and galectin-3 and the different degrees of aggressiveness of canine melanoma, as well as to determine serum concentration of galectin-3 in dogs with melanoma. Galectin-1 and galectin-3 expression was analyzed by immunohistochemistry in 30 canine melanomas, six melanocytomas and nine metastatic lymph nodes from patients whose primary tumors were also processed and analyzed. Serum samples from 30 dogs were collected and galectin-3 concentration was determined by ELISA and compared to the samples of 10 healthy dogs. Canine melanoma samples expressed galectin-1 in the cytoplasm and presented a variable pattern of galectin-3 staining depending on melanoma aggressiveness. We observed a decrease in the percentage of cells with cytoplasmic galectin-3 immunolabeling simultaneous to the increased nuclear staining intensity, while there was also a decrease in the percent frequency of nuclear galectin-3 immunolabeled cells according to progression of melanoma, comparing the least to the most aggressive cases. Dogs with melanoma had increased serum levels of galectin-3 when compared to healthy animals, suggesting its potential biomarker of patients with melanoma.(AU)

O melanoma canino é uma neoplasia frequente em cães que apresenta um potencial maligno e metastático. Neste contexto, investigar o microambiente tumoral é fundamental para compreender os mecanismos intercelulares e intracelulares envolvidos no desenvolvimento e progressão da doença. Neste estudo, destacamos as galectinas, proteínas da família das lectinas animais que exibem domínios de reconhecimento à carboidratos; a galectina-1 e a galectina-3 estão associadas a transformação neoplásica, sobrevivência de células neoplásicas, angiogênese, evasão do sistema immune e desenvolvimento de metástases. O objetivo deste estudo foi determinar os padrões de expressão de galectina-1 e galectina-3 em diferentes graus de agressividade do melanoma canino, bem como dosar a concentração sérica de galectina-3 em cães com melanoma e comparar com cães saudáveis. A expressão de galectina-1 e galectina-3 foi analisada em 30 melanomas caninos, seis melanocitomas e nove linfonodos metastáticos. A galectina-3 sérica foi mensurada em 30 cães com melanoma e comparada a 10 cães saudáveis. No melanoma canino a expressão de galectina-1 foi citoplasmática e a expressão de galectina-3 foi variável de acordo com o grau de agressividade. Notou-se uma redução na porcentagem de células com imunomarcação de galectina-3 citoplasmática e um aumento simultâneo da intensidade de imunomarcação nuclear, enquanto houve também uma diminuição na frequência percentual de células com imunomarcação nuclear de acordo com a progressão do melanoma comparando-se os casos menos com os mais agressivos. Cães com melanoma apresentaram níveis séricos aumentados de galectina-3 quando comparados a animais saudáveis, mostrando seu uso potencial como biomarcador em pacientes com melanoma.(AU)

Serum Galectin-3 and TGF-Beta Levels in Patients With Sarcoidosis.

INTRODUCTION: Sarcoidosis is a chronic granulomatous disease that develops with non-caseified granuloma formation. Galectin-3 is a multifunctional protein operating in biological processes such as fibrosis, angiogenesis, and immune activation. PURPOSE: This study evaluates the levels of serum galectin-3 and TGF-beta in sarcoidosis patients to determine a possible correlation with clinical findings. MATERIAL AND METHOD: Forty-four biopsy-proven sarcoidosis patients followed in a single centre and 41 age and sex-matched healthy volunteers were included in the study. The levels of serum galectin-3 and TGF-beta were evaluated by ELISA method. RESULTS: Among the 44 sarcoidosis patients, 13(29.5%) were male and 31(70.5%) were female. The average patient age was 47.4 and the average disease duration was 3.2 years. The level of serum galectin-3 was found to be the same as in the control group and had no significance statistically (p=.977). No correlation was determined between the level of serum galectin-3 and clinical and laboratory findings of sarcoidosis (p>.05). The level of serum TGF-beta was found to be higher in the sarcoidosis patients when compared to that of the control group (p=.005). While a correlation was found between serum TGF-beta and enthesitis, sacroiliitis, and arthralgia (p=.006, p=.034, p=.02), no correlation was determined on the other clinical and laboratory findings (p>.05). CONCLUSION: While the level of serum galectin-3 was determined to be normal in sarcoidosis patients, a high level of serum TGF-beta was found. These findings show that TGF-beta may play an important role in sarcoidosis pathogenesis and the formation of granuloma.

Galectina-3 em pacientes com pericardite constritiva crônica / Galectin-3 Levels in Patients with Chronic Constrictive Pericarditis

FUNDAMENTO: A galectina-3 (Gal-3) é uma molécula pró-inflamatória e pró-fibrótica, envolvida na patogênese da insuficiência cardíaca. O papel da Gal-3 em pacientes com pericardite constritiva crônica (PCC) não está claro. OBJETIVO: O objetivo deste estudo foi avaliar os níveis de Gal-3 em pacientes com PCC e correlacioná-los com parâmetros clínicos, funcionais e histológicos. MÉTODOS: Nós avaliamos prospectivamente 25 pacientes sintomáticos com PCC agendados à pericardiectomia e 21 controles sadios. Os pacientes foram submetidos à avaliação clínica, medidas de Gal-3 e peptídeo natriurético do tipo B (BNP), ecocardiografia, ressonância magnética cardíaca e teste cardiopulmonar de exercício (TCPE) no período basal. Seis meses após a pericardiectomia, repetiu-se o TCPE. Um erro alfa < 5% foi considerado estatisticamente significativo, com um intervalo de confiança de 95%. RESULTADOS: Foram incluídos 25 pacientes com idade mediana de 45 anos. A etiologia foi principalmente idiopática (n = 19, 76%), e 14 (56%) apresentaram classe funcional New York Heart Association (NYHA) III/IV. Os valores medianos de BNP e Gal-3 foram 143 (89-209) pg/dL e 14,8 (9,7-17,2) ng/mL, respectivamente. Os níveis de Gal-3 não foram estatisticamente maiores nos pacientes com PCC que em controles (p = 0,22). Não foram encontradas correlações significativas da Gal-3 com BNP, medidas ecocardiográficas e de ressonância magnética cardíaca, e achados histológicos. Após a pericardiectomia, encontrou-se uma correlação estatisticamente significativa entre Gal-3 e medidas do TCPE ­ duração do teste (r = ­0,79; p < 0,001) e tempo de exercício (r = ­0,79; p < 0,001). CONCLUSÕES: Pacientes com PCC apresentaram níveis normais de Gal-3, quando comparados aos indivíduos controles. A Gal-3 não se correlacionou com medidas morfológicas e funcionais antes da pericardiectomia. No entanto, associações entre Gal-3 e intolerância ao exercício após pericardiectomia pode sugerir um papel da Gal-3 na predição de prognóstico após a pericardiectomia.

Although with intact mucosa at colonoscopy, chagasic megacolons have an overexpression of Gal-3 / Embora com mucosa íntegra à colonoscopia, megacólons chagásicos apresentam superexpressão de Gal-3

ABSTRACT Objective To evaluate the density of anti-galectin-3-immunostained cells, collagen percentage, mast cell density and presence of pathological processes in intestinal muscle biopsies of patients. Methods Thirty-five patients who underwent intestinal biopsy were selected from 1997 to 2015. Patients were divided into three groups: chagasic patients with mucosal lesion (n=13), chagasic patients with intact mucosa (n=12) and non-chagasic patients with no mucosal lesion (n=10). Histological processing of the biopsied fragments and immunohistochemistry for galectin-3 were performed. Additional sections were stained with hematoxylin and eosin to evaluate the general pathological processes, picrosirius for evaluation of collagen and toluidine blue to evaluate the mast cell density. Results Patients of mucosal lesion group had a significantly higher frequency of ganglionitis and myositis when compared to the chagasic patients with intact mucosa and non-chagasic group. The density of anti-galectin-3-immunostained cells was significantly higher in the chagasic patients with intact mucosa group when compared to the non-chagasic group. The group of chagasic patients with intact mucosa presented a higher percentage of collagen in relation to the patients with mucosal lesion and to the non-chagasic group, with a significant difference. There was no significant difference in mast cell density among the three groups. Conclusion The higher density of anti-galectin-3-immunostained cells in patients in the chagasic patients with intact mucosa group suggested the need for greater attention in clinical evaluation of these patients, since this protein is associated with neoplastic transformation and progression.

RESUMO Objetivo Avaliar a densidade de células imunomarcadas por anti-galectina-3, a percentagem de colágeno, a densidade de mastócitos e a presença de processos patológicos na musculatura intestinal de pacientes biopsiados. Métodos Foram selecionados 35 pacientes submetidos à biópsia de intestino entre 1997 a 2015. Os pacientes foram divididos em três grupos: chagásicos com lesão de mucosa (n=13), chagásicos com mucosa íntegra (n=12) e não chagásicos sem lesão de mucosa (n=10). Foram realizados processamento histológico dos fragmentos biopsiados e imunohistoquímica para galectina-3. Cortes adicionais foram corados por hematoxilina e eosina, para avaliar os processos patológicos gerais, pelo picrosírius, para avaliação do colágeno, e pelo azul de toluidina, para avaliar a densidade de mastócitos. Resultados Os pacientes do grupo chagásicos com lesão de mucosa apresentaram frequência significativamente maior de ganglionite e miosite quando comparados aos dos grupos chagásico com mucosa íntegra e não chagásicos. A densidade das células imunomarcadas por anti-galectina-3 foi significativamente maior no grupo chagásicos com mucosa íntegra quando comparada ao grupo não chagásico. O grupo de chagásicos com mucosa íntegra apresentou maior percentagem de colágeno em relação aos grupos chagásicos com mucosa lesada e ao grupo de não chagásicos, com diferença significativa. Não houve diferença significativa com relação à densidade de mastócitos entre os três grupos. Conclusão A maior densidade de células imunomarcadas por anti-galectina-3 nos pacientes do grupo chagásico com mucosa íntegra sugere a necessidade de maior atenção na avaliação clínica desses pacientes, uma vez que essa proteína está associada com transformação e progressão neoplásica.

Caracterización de la expresión de galectina-3 mediante inmunohistoquímica enlesiones intraepiteliales de glándula mamaria de perras sin evidencia de tumor / Characterization of galectin-3 expression by immunohistochemistry in mammary intraepithelial lesions in bitches without evidence of tumor

RESUMEN Las lesiones intraepiteliales (LIEs) son anormalidades morfológicas locales de los ductos y los lobulillos de la glándula mamaria que incrementan el riesgo de cáncer. Los programas de detección temprana de cáncer de seno han incrementado la identificación de LIEs. En este sentido, en perras se ha propuesto las LIEs como modelo comparativo con humanos. La galectina-3 está involucrada con la progresión del cáncer en mujeres y hembras caninas pero su papel en el comportamiento biológico de las neoplasias es contradictorio según la célula de origen. El objetivo de este trabajo fue caracterizar la expresión de la galectina-3 por medio de inmunohistoquímica en 19 glándulas mamarias (GM) de seis perras sin evidencia de tumor que contenían 50 tipos de LIEs y 7 carcinomas invasivos, teniendo en cuenta el porcentaje de células positivas y la intensidad del color de la inmunoreacción. No hubo inmunomarcación para galectina-3 en las adenosis, las hiperplasias ductales usuales, la hiperplasia lobular atípica, las lesiones de células columnares, los carcinomas complejos o las hiperplasias complejas. Un papiloma/ adenoma con hiperplasia de acinos tuvo inmunomarcación multifocal en 11-50% de las células con moderada intensidad. Dos carcinomas in situ del subtipo lobular (uno de grado histológico nuclear intermedio y el otro de alto grado) tuvieron marcación en 10% de las células, pero uno tuvo intensidad baja y el otro, intensidad moderada. Los hallazgos sugieren que el papel de la galectina-3 es poco importante en la iniciación de las LIEs, pero sugieren que es una proteína de interés en la progresión de estas lesiones que posiblemente interactua en el comportamiento biológico de esta enfermedad.

ABSTRACT Intraepithelial lesions (IELs) are local morphological abnormalities of the ducts and lobules of the mammary gland that increase the risk of cancer. Programs of early detection of breast cancer have improved the identification of IELs. In canines they have been proposed as a comparative model with human IELs. Galectin-3 is involved with cancer progression in women and bitches but its role in the biological behavior of neoplasias is contradictory depending on the source cell. The aim of this study was to characterize by immunohistochemistry the expression of galectin-3 in 19 mammary glands (MG) from 6 canines without clinical signs of tumor, containing 50 types of IELs and seven invasive carcinomas, taking into account the percentage of positive cells and the intensity of color immunoreaction. There wasn't any immunostaining for galectin-3 in the adenosis, in the usual ductal hyperplasias, in the atypical lobular hyperplasia, in the columnar cell lesions, in the complex carcinomas or in the complex hyperplasias. A papilloma/adenoma with acinar hyperplasia had multifocal staining in 11-50% of the cells with moderate intensity. Two in situ lobular carcinomas (ISLC) (one of nuclear intermediate grade and the other of high nuclear grade) had 10% staining cells, but the intensity was moderate in one of them and low in the other. Findings suggest that the role of galectin-3 is unimportant in the initiation of IELs, but also that it is a protein of interest in the progression of the lesions and that it possibly acts in the biological behavior of the disease.

Galectina-3 as a biomarker of acute kidney injury risk in patients with decompensated heart failure. / Galectina-3 como biomarcador de riesgo de daño renal agudo en pacientes con insuficiencia cardiaca descompensada.

INTRODUCTION: In decompensated heart failure (HF), both acute kidney injury (AKI) and high Galectina-3 (Gal-3) levels have been associated with poorer outcomes. Plasma Gal-3 levels are affected by renal function; however, the potential role of Gal-3 as a predictor of AKI has not been established. METHODS: We measured Gal-3 concentrations at admission for 175 patients hospitalised for HF and recorded the onset of AKI according to the Risk, Injury, Failure, Loss and End-stage kidney disease (RIFLE) analytical criteria. RESULTS: During hospitalisation, 44 patients (25.1%) developed AKI, although only 14 (8%) corresponded to more advanced stages. These 14 patients had significantly higher Gal-3 levels at admission, which remained a predictor of AKI after the multivariate adjustment by other predictors and by baseline renal function. CONCLUSIONS: High Gal-3 levels at admission are associated with a higher risk of AKI during hospitalisation for decompensated HF.

A Global Assessment of Circulating Prolysyl Oxidase in Nonischemic Patients With Garden-variety Heart Failure With Preserved Ejection Fraction.

INTRODUCTION AND OBJECTIVES: Lysyl oxidase is overexpressed in the myocardium of patients with hypertensive cardiomyopathy. We aimed to explore whether patients with hypertensive-metabolic heart failure with preserved ejection fraction (HM-HFpEF) also have increased concentrations of circulating prolysyl oxidase (cpLOX) and its possible consequences. METHODS: We quantified cpLOX concentrations in 85 nonischemic patients with stage C, HM-HFpEF, and compared them with those of 51 healthy controls. We also assessed the correlations of cpLOX with myocardial stiffness parameters, collagen turnover products and fibrogenic cytokines, as well as the predictive value of plasma proenzyme levels at 1-year of follow-up. RESULTS: We detected raised cpLOX values and found that they correlated with calculated E/E' ratios and stiffness constants. The subgroup of patients with type I diastolic dysfunction showed a single negative correlation between cpLOX and B-type natriuretic peptide whereas patients with a restrictive diastolic pattern showed a strong correlation between cpLOX and galectin-3. Kaplan-Meier analysis revealed that cpLOX > 52.20 ng/mL slightly increased the risk of a fatal outcome (log-rank = 4.45; P = .034). When Cox regression was used, cpLOX was found to be a significant independent predictor of cardiovascular death or hospitalization due to the decompensation of HM-HFpEF (HR, 1.360; 95%CI, 1.126-1.638; P = .046). CONCLUSIONS: Patients with symptomatic HM-HFpEF show high cpLOX serum levels associated with restrictive diastolic filling indices. These levels represent a moderate risk factor for poor clinical outcome. Throughout the natural history of HM-HFpEF, we observed that cpLOX concentrations were initially negatively correlated with B-type natriuretic peptide but positively correlated with galectin-3 as advanced diastolic dysfunction developed.

Circulating Galectin-3 Following Heart Transplant: Long-term Dynamics and Prognostic Value.

INTRODUCTION AND OBJECTIVES: Circulating galectin-3 (Gal-3) is elevated and significantly correlates with all-cause and cardiovascular mortality in patients with heart failure. However, the relationship between serum Gal-3 and heart transplant (HT) outcomes is unclear. The aim of this study was to describe the longitudinal trend and prognostic value of Gal-3 levels after HT. METHODS: Banked serum samples were available from 122 HT recipients, collected before transplant and at 1, 3, 6, and 12 months posttransplant. Gal-3 levels in these serum samples were measured by enzyme immune assay. Multivariable Cox regression was performed to determine the prognostic value of 12-month posttransplant Gal-3 serum levels. The primary endpoint was the composite variable all-cause death or graft failure over long-term posttransplant follow-up. RESULTS: Circulating Gal-3 concentration steadily decreased during the first year after HT (median values: pretransplant, 19.1 ng/mL; 1-year posttransplant, 14.6 ng/mL; P<.001). Circulating Gal-3 levels 1-year posttransplant were associated with an increased risk of all-cause death or graft failure (adjusted HR per 1 ng/mL, 1.04; 95%CI, 1.01-1.08; P=.008). The predictive accuracy of this biomarker was moderate: area under the ROC curve, 0.72 (95%CI, 0.60-0.82; P<.001). CONCLUSIONS: Circulating Gal-3 steadily decreased during the first year after HT. However, 1-year posttransplant Gal-3 serum levels that remained elevated were associated with increased long-term risk of death and graft failure.

Differential Prognostic Value of Galectin-3 According to Carbohydrate Antigen 125 Levels in Transcatheter Aortic Valve Implantation.

INTRODUCTION AND OBJECTIVES: Galectin-3 (Gal-3) and carbohydrate antigen 125 (CA125) have been associated with adverse outcomes after transcatheter aortic valve implantation (TAVI). Experimental data have suggested a potential molecular interaction. Therefore, we assessed the association of Gal-3 and CA125 with prognosis after TAVI. METHODS: A total of 439 patients were enrolled. The primary endpoint was a composite of all-cause mortality or readmission for worsening heart failure after TAVI. RESULTS: The primary endpoint occurred in 16.4%. Gal-3 was dichotomized at ≥ 8.71 ng/mL into elevated and not elevated. Gal-3 was elevated in 31.9% and was associated with a higher risk of the primary endpoint (25% vs 12.4%, HR, 2.26; P<.001). After multivariable adjustment, the association of elevated Gal-3 with the primary endpoint was borderline significant (HR, 1.59; P=.068). CA125 was dichotomized at ≥ 18.4 U/mL, accordingly. CA125 was elevated in 51.9% and was also associated with a higher risk of the primary endpoint (25.4% vs 6.6%, HR, 4.20; P<.001). After multivariable adjustment, elevated CA125 (HR, 2.83; P=.001) remained independently associated with the primary endpoint. A differential prognostic effect of Gal-3 was found across CA125 status (P for interaction=.048). Elevated Gal-3 was associated with a higher risk of the primary endpoint when CA125 was elevated (38.8% vs 18.2%, HR, 2.02; P=.015) but lacked significance when CA125 was not elevated (6.6% vs 6.7%, HR, 1.16; P=.981). CONCLUSIONS: In patients undergoing TAVI, Gal-3 predicted adverse clinical outcomes only when CA125 was elevated.

Global longitudinal strain as a biomarker in diabetic cardiomyopathy. A comparative study with Gal-3 in patients with preserved ejection fraction / Deformación longitudinal global como un biomarcador en miocardiopatía diabética. Estudio comparativo con galectina-3 en pacientes con fracción de eyección preservada

Abstract: Objectives: To establish a relationship between global longitudinal strain (GLS) and Galectin-3 in pre-clinical heart failure in diabetic patients. Galectin-3 is a biomarker in heart failure with depressed ejection fraction (HFdEF). The hypothesis is presented that Galectin-3 is related to GLS and can detect left ventricular dysfunction in heart failure with preserved ejection fraction. Methods: Galectin-3 and GLS were measured in 121 asymptomatic individuals: 14 diabetics with mild depressed ejection fraction (mdEF) (LVEF 47.0 ± 6.9); 76 diabetics with preserved ejection fraction (LVEF 61 ± 5.5), and 31 controls (61.7 ± 5.1). Results: Galectin-3 was elevated in all diabetics vs controls (3.46 ± 1.36 ng/ml vs 2.78 ± 0.91 ng/ml; p = .003). It was also elevated in mdEF (3.76 ± 1.12 ng/ml vs 2.78 ± 0.9 ng/ml; p = .009) and pEF subjects (3.41 ± 1.40 ng/ml vs 2.78 ± 0.9 ng/ml; p = .058), respectively, vs controls. No difference in Gal-3 was found between diabetic groups (p = .603). Diabetics had lower GLS than controls (-18.5 ± 3.9 vs -20 ± 2.6; p = .022). Diabetics with mdEF had lower GLS than those with pEF (-13.3 ± 3.41 vs -19 ± 3.2; P<.001). There was no difference in GLS with pEF compared to controls (-19.4 ± 3.2 vs -20 ± 2.6; p = .70). Conclusions: Galectin-3 is elevated in diabetic patients with mdEF, and is associated with a diminished GLS. GLS could be an early marker of left ventricular dysfunction as well as evidence of diabetic cardiomyopathy.

Resumen: Objetivos: Establecer una asociación entre deformación longitudinal global (DLG) y galectina-3 en insuficiencia cardiaca preclínica en pacientes diabéticos. Galectina-3 es un biomarcador en insuficiencia cardiaca con fracción de eyección deprimida. Nuestra hipótesis es que la DLG y galectina-3 correlacionan y pueden detectar disfunción ventricular en insuficiencia cardiaca con FEVI preservada. Métodos: Se midieron galectina-3 y DLG en 121 individuos asintomáticos: 14 diabéticos con FEVI deprimida leve (FEdl) (FEVI 47 ± 6.9); 76 diabéticos con FEVI preservada (FEp) (FEVI 61 ± 5.5) y 31 sujetos controles (FEVI 61.7 ± 5.1). Resultados: Galectina-3 se encontró elevada en todos los diabéticos vs controles (3.46 ± 1.36 ng/ml vs 2.78 ± 0.91 ng/ml; p = 0.003). Está elevada en sujetos con FEdl (3.76 ± 1.12 vs 2.78 ± 0.9 vs ng/ml p = 0.009) y FEp (3.41 ± 1.40 vs 2.78 ± 0.9 ng/ml p = 0.058), respectivamente vs controles; no encontramos diferencia en galectina-3 en ambos grupos de diabéticos (p = 0.603). Los diabéticos tienen menor DLG que los controles (-18.5 ± 3.9 vs -20 ± 2.6; p = 0.022). Los diabéticos con FEdl tienen DLG más disminuida que aquellos con FEp (-13.3 ± 3.41 vs -19 ± 3.2; p < 0.001). No existe diferencia en DLG con FEp y controles (-19.4 ± 3.2 vs -20 ± 2.6; p = 0.70). Conclusiones: Galectina-3 está elevada en diabéticos con FEdl y correlaciona DLG disminuida. DLG podría ser un marcador temprano de disfunción ventricular y evidencia en miocardiopatía diabética.