Galectin-3 Promotes Vascular Remodeling and Contributes to Pulmonary Hypertension

Abstract

0.727-0.840), but mortality in women who used CPAP increased (odds ratio, 1.320; 95% confidence interval, 1.151-1.515). In men, significant interactions were found for cerebrovascular disease, diabetes mellitus, and hypertension, but patients treated with CPAP had a lower probability of death than control subjects in all scenarios (Table 1). On the other hand, CPAP treatment was associated with lower mortality in women with cerebrovascular disease but had a neutral or detrimental effect on mortality in other scenarios (Table 1). Overall, the population of patients treated with CPAP in Catalonia had lower mortality rates than age-, sex-, and regionmatched control subjects, despite a higher prevalence of most comorbidities among patients treated with CPAP. However, this finding was driven by the 74% of men in the population, because CPAP was associated with increased mortality among women. These population-based findings contrast with the less positive findings of the randomized SAVE study (3). In contrast, our results are consistent with recently published data from a Danish historical cohort (22,135 patients with OSA), which showed that CPAP treatment was associated with lower mortality rates in middle-aged and elderly men after adjustment for multiple comorbidities, but not in women (5). Although in our population sex differences in the results seem to be related to a high heart failure prevalence among women using CPAP, further research is needed on the potentially different characteristics of OSA, and associated comorbidities, among women and men. Finally, several potential limitations should be noted. First, the data used in this study lack information about CPAP adherence. Second, it was not possible to control for undiagnosed OSA in control subjects, and, finally, the observational design means that potential confounding from uncontrolled factors such as socioeconomic status, level of health literacy and self-care, or level of delivered health care cannot be avoided. In conclusion, these findings suggest that CPAP treatment is associated with reductions in mortality at the population level, although only in men. Therefore, further analyses should be planned within the frame of precision medicine (6) to clarify which patients with OSA could benefit the most from CPAP treatment and whether CPAP might be detrimental in some specific patient subgroups. n Author disclosures are available with the text of this letter at www.atsjournals.org.

Galectin-3: One Molecule for an Alphabet of Diseases, from A to Z

“…A preclinical study demonstrated that Gal-3 might be also useful as a target for the treatment of this condition. In fact, the treatment with Gal-3 inhibitors was able to counteract lung and heart remodeling and fibrosis in a rat model of PAH [ 361 ].…”

Emerging Role of Galectin-3 in Pulmonary Artery Hypertension

“…Indeed, authors reported that Gal-3 was a strong predictor of mortality after adjusting for age, sex, race, glomerular filtration rate, NT-proBNP, medications, and aetiology of PAH (Mazurek, J.A., et al, 2017). However, Gal-3 associates with severity of vascular remodeling in PAH and act as a critical regulator in the pathogenesis of PAH (Barman, S. A., 2018). Finally, Gal-3 may add prognostic value beyond traditional CV risk factors and it could be possible therapeutic target for individuals with PAH ).…”

Genome-wide association study identifies loci and candidate genes for non-idiopathic pulmonary hypertension in Eastern Chinese Han population

“…Pulmonary hypertension (PH) is a rare disease characterized by proliferation and occlusion of small pulmonary arterioles, leading to progressive elevation of pulmonary artery pressure, pulmonary vascular resistance, and right ventricular failure [ 1 ]. There are 3 subtypes of PH according to the National Organization for Rare Disorders (NORD), including heritable pulmonary hypertension (HPH), idiopathic pulmonary arterial hypertension (IPH) and associated pulmonary hypertension (APH) [ 2 ].…”

“… Galectin-3 (Gal-3) Galectin-3 (Gal-3) is a β-galactoside binding lectin that regulates multiple pathways. Our recent study has revealed the effectiveness of genetic and pharmacological strategies targeting Gal-3 in halting the progression of PH remodeling and development of experimental PH [ 1 ]. …”