Lipoprotein apheresis reduces circulating galectin-3 in humans

Area of Science:

• Biochemistry
• Cardiovascular Medicine
• Immunology

Background:

• Plasma galectin-3 (Gal-3) is implicated in systemic inflammatory disorders like cancer, cardiovascular diseases, and diabetes.
• Elevated Gal-3 contributes to tumorigenesis, metastasis, and fibrotic remodeling, making it a potential therapeutic target.
• Apheresis, particularly lipoprotein apheresis (LA), effectively removes circulating disease mediators.

Purpose of the Study:

• To compare the clinical utility of two FDA-approved LA systems in reducing plasma Gal-3 levels in humans.
• To evaluate the efficacy of heparin-induced extracorporeal LDL precipitation (HELP) and dextran sulfate-adsorption (DSA) in Gal-3 reduction.

Main Methods:

• Plasma Gal-3 levels were measured using ELISA in hypercholesterolemia patients (n=10 per group) before and after therapeutic LA.
• Two apheresis systems were employed: heparin-induced extracorporeal LDL precipitation (HELP) and dextran sulfate-adsorption (DSA).
• Blinded samples were analyzed to ensure objective assessment of Gal-3 concentrations.

Main Results:

• Mean baseline plasma Gal-3 concentrations were similar in both groups (HELP: 14.3 ± 5.1 ng/mL; DSA: 14.5 ± 2.8 ng/mL).
• Post-apheresis, Gal-3 levels decreased by 19.4% (P=0.0094) with HELP and 22.7% (P=0.0027) with DSA.
• The difference in Gal-3 reduction between the HELP and DSA systems was not statistically significant (P=0.5288).

Conclusions:

• Therapeutic LA significantly reduces circulating Gal-3 levels in humans.
• While the absolute reduction was modest (≈19-23%), this effect may complement LDL reduction, potentially enhancing apheresis benefits.
• Developing Gal-3-specific apheresis technologies could offer new therapeutic avenues for diseases driven by elevated Gal-3.