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The Predictive Value of Plasma Galectin-3 for Ards Severity and Clinical Outcome

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Background:

Galectin-3 is a β-galactoside-binding lectin implicated as a mediator in a variety of inflammatory and fibrotic diseases. However, information about galectin-3 release in patients with acute respiratory distress syndrome (ARDS) is very limited. We sought to determine whether plasma galectin-3 levels were increased in ARDS patients and were associated with disease severity.
Methods:

Patients admitted to intensive care unit (ICU) within 48 h and diagnosed with ARDS were identified. In addition, healthy subjects were assigned to a control group. Plasma samples were collected from patients within 48 h after ICU admission as well as healthy subjects. Plasma galectin-3 levels were measured by enzyme-linked immunosorbent assay. The primary outcome was mortality at 28 days.
Results:

Sixty-three ARDS patients were identified. Among these, 27 patients died within 28 days of admission. The plasma galectin-3 levels of the patients were significantly higher than those of control subjects (median [IQR]: 12.37 [7.94–18.79] vs. 5.01 [4.15–5.69] ng/mL, respectively, P <0.0001). Furthermore, galectin-3 levels were significantly higher in non-surviving patients than in those who survived (15.38 [11.59–22.98] vs. 10.07 [7.39–15.54] ng/mL, respectively, P = 0.0136). Plasma galectin-3 levels were significantly correlated with acute physiology and chronic health evaluation II scores and arterial oxygen tension/inspiratory oxygen fraction ratios (Spearman rho = 0.44, P <0.0001 and −0.616, P <0.0001, respectively). At an optimal cutoff of 10.59 ng/mL, the sensitivity and specificity of galectin-3 for prediction of 28-day mortality were 81.48% (95% CI 0.62–0.94) and 55.56% (95% CI 0.38–0.72), respectively.
Conclusions:

Higher levels of galectin-3 were significantly associated with disease severity and worse outcomes in ARDS patients.
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Keywords: APACHE; ARDS; AUC; Acute respiratory distress syndrome; BALF; CI; ELISA; FiO2; GFR; HR; ICU; IPF; IQR; NA; PCT; PEEP; PaO2; ROC; acute physiology and chronic health evaluation; acute respiratory distress syndrome; area under the curve; arterial oxygen tension; bronchoalveolar fluid; confidence interval; critical illness; enzyme-linked immunosorbent assay; galectin-3; glomerular filtration rate; hazard ratio; idiopathic pulmonary fibrosis; inspiratory oxygen fraction; intensive care; intensive care unit; interquartile range; not applicable; outcome; positive end expiratory pressure; procalcitonin; receiver operating characteristic

Document Type: Research Article

Affiliations: 1: State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Department of Critical Care Medicine, Guangzhou, China 2: State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Department of Critical Care Medicine, Guangzhou, China, Department of Infection Control, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China 3: State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Department of Critical Care Medicine, Guangzhou, China

Publication date: March 1, 2017

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