Department of Obstetrics and Gynecology, Institute of Mother and Child, Warsaw, Poland.
Department of Cardiology, Institute of Mother and Child, Warsaw, Poland.
J Physiol Pharmacol. 2020 Dec;71(6). doi: 10.26402/jpp.2020.6.08. Epub 2021 Mar 13.
Galectin-3 is β-galactoside-binding lectin, used in cardiology as a biomarker of heart failure. Available research suggest galectin-3 may play a role in the development of preeclampsia. Seventy seven women were included in the study: 39 with preeclampsia and 38 with uncomplicated pregnancy. Patients underwent blood sample analysis (galectin-3, N-terminal pro-brain natriuretic peptide (NT-proBNP), soluble fms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), cystatin C, creatinine) and echocardiographic examination. After delivery, placental tissue samples were obtained for immunohistochemistry evaluation. In patients with preeclampsia, serum galectin-3 levels (11.8 versus 9.5 ng/ml; p = 0.004) and galectin-3 expression in placental tissue (immunoreactive score (IRS) in extravillous trophoblasts: 9 versus 5; p = 0.002; in syncytiotrophoblasts: 6 versus 2, p < 0.001) were significantly higher than in the control group. Serum NT-proBNP and sFlt-1 levels, sFlt-1/PlGF ratio, serum creatinine and cystatin C levels were significantly higher, whereas serum PlGF levels and estimated glomerular filtration rate (eGFR) were significantly lower in preeclamptic patients than in uncomplicated pregnancy. On echocardiography, preeclamptic women had significantly greater thickness of interventricular septum (IVS) and left ventricle posterior wall (PW) and significantly worse left ventricle diastolic function (higher E/e' values). Serum galectin-3 level did not correlate with any other biochemical parameters, as well as the vast majority of echocardiographic parameters. Significant correlation between serum galectin-3 and its placental expression in syncytiotrophoblasts (STB) was revealed. Renal function parameters and NT-proBNP correlated with antiangiogenic state. This study demonstrated increased serum galectin-3 levels and placental galectin-3 production in preeclamptic patients, in comparison to women with uncomplicated pregnancy. Myocardial dysfunction and worse renal function parameters in patients with preeclampsia were not related to galectin-3. The main source of galectin-3 in maternal blood was its placental production. In the development of preeclampsia, galectin-3 may act as a compensatory mechanism to impaired placentation in early pregnancy.
半乳糖凝集素-3 是一种 β-半乳糖苷结合凝集素,在心脏病学中用作心力衰竭的生物标志物。现有研究表明,半乳糖凝集素-3 可能在子痫前期的发展中起作用。本研究纳入了 77 名女性:39 名子痫前期患者和 38 名正常妊娠患者。患者接受了血液样本分析(半乳糖凝集素-3、N 端脑利钠肽前体(NT-proBNP)、可溶性 fms 样酪氨酸激酶-1(sFlt-1)、胎盘生长因子(PlGF)、胱抑素 C、肌酐)和超声心动图检查。分娩后,获取胎盘组织样本进行免疫组织化学评估。与对照组相比,子痫前期患者血清半乳糖凝集素-3 水平(11.8 与 9.5ng/ml;p=0.004)和胎盘组织中半乳糖凝集素-3 表达(绒毛外滋养细胞免疫反应评分(IRS):9 与 5;p=0.002;合体滋养细胞:6 与 2,p<0.001)显著升高。子痫前期患者血清 NT-proBNP 和 sFlt-1 水平、sFlt-1/PlGF 比值、血清肌酐和胱抑素 C 水平显著升高,而血清 PlGF 水平和估算肾小球滤过率(eGFR)显著降低。与正常妊娠相比,子痫前期患者的室间隔(IVS)和左心室后壁(PW)厚度更大,左心室舒张功能更差(E/e'值更高)。血清半乳糖凝集素-3 水平与其他生化参数以及大多数超声心动图参数均无相关性。发现血清半乳糖凝集素-3 水平与合体滋养细胞(STB)中半乳糖凝集素-3 的表达呈显著相关。肾功能参数和 NT-proBNP 与抗血管生成状态相关。本研究表明,与正常妊娠妇女相比,子痫前期患者血清半乳糖凝集素-3 水平和胎盘半乳糖凝集素-3 生成增加。子痫前期患者的心肌功能障碍和肾功能参数恶化与半乳糖凝集素-3 无关。母体血液中半乳糖凝集素-3 的主要来源是胎盘产生。在子痫前期的发展中,半乳糖凝集素-3 可能作为一种代偿机制,以补偿早孕时胎盘功能不良。