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Circulating levels of galectin-3 and coronary microvascular perfusion in rheumatoid arthritis patients with suppressed inflammation

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Abstract

Objective

Cardiovascular manifestations are the leading cause of mortality in rheumatoid arthritis (RA). Galectin-3, a lectin protein with major role in cellular, inflammatory, and fibrotic processes, has been introduced as a novel cardiac biomarker. We hypothesized that patients with RA present increased levels of galectin-3, and investigated potential associations with arterial stiffness and coronary microvascular dysfunction.

Methods

This cross-sectional study enrolled RA patients and non-RA individuals without cardiovascular comorbidities. Galectin-3 and high-sensitivity C-reactive protein (hsCRP) were measured with enzyme-linked immunosorbent assay (ELISA) in serum samples. Subendocardial viability ratio (SEVR), an index of microvascular myocardial perfusion, and pulse wave velocity (PWV), the gold-standard measure of vascular stiffness, were estimated with applanation tonometry.

Results

Cardiovascular risk factors and hsCRP were comparable between patients (n = 24) and controls (n = 24). However, galectin-3 was increased [6.9 (6.7) vs 4.6 (4.7)] ng/dl, p = 0.015], and coronary microvascular perfusion was decreased (142.6 ± 22.8 vs 159.7 ± 23.2%, p = 0.028) in RA patients compared to controls, whereas PWV did not significantly differ. Galectin-3 correlated with both PWV and SEVR in univariate analysis. However, after adjustment for cardiovascular risk factors and subclinical inflammation, these associations were rendered non-significant.

Conclusion

Galectin-3 appears increased in RA, even among patients with suppressed inflammation in the absence of cardiovascular comorbidities. The observed association of galectin-3 with coronary microvascular perfusion in our study was non-significant after adjustment for cardiovascular risk factors and inflammation. The potential role of galectin-3 as a cardiac biomarker in RA warrants further investigation.

Key Points

• Galectin-3 has emerged as a novel cardiac biomarker but remains understudied in RA.

• Patients with RA present elevated levels of galectin-3 and impaired coronary microvascular perfusion compared to non-RA individuals.

• These differences were observed in patients with suppressed inflammation, even in the absence of CVD.

• The association of galectin-3 with coronary microvascular impairment in RA warrants further investigation.

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Fig. 1

Data availability

Data are available upon reasonable request from the corresponding author.

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Funding

P. Anyfanti, E. Gavriilaki, and E. Gkaliagkousi have received funding by Greece and the European Union (European Social Fund- ESF) through the Operational Programme “Human Resources Development, Education and Lifelong Learning 2014–2020” in the context of the project “Evaluation of novel markers of endothelial dysfunction and thrombotic microenvironment in patients with rheumatoid arthritis: association with markers of subclinical inflammation and cardiovascular damage (MIS 5047870).”

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Authors and Affiliations

  1. Second Medical Department, Hippokration General Hospital, Aristotle University of Thessaloniki, 49, Konstantinoupoleos Str, 54642, Thessaloniki, Greece

    Panagiota Anyfanti & Elena Angeloudi

  2. 3rd Department of Internal Medicine, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Antonia Dimitriadou, Barbara Nikolaidou, Areti Triantafyllou & Eugenia Gkaliagkousi

  3. Fourth Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Athanasia Dara & Theodoros Dimitroulas

  4. 2nd Propedeutic Department of Internal Medicine, Hippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Eleni Gavriilaki

Authors
  1. Panagiota Anyfanti
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  2. Antonia Dimitriadou
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  3. Athanasia Dara
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  4. Elena Angeloudi
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  5. Eleni Gavriilaki
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  6. Barbara Nikolaidou
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  7. Areti Triantafyllou
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  8. Theodoros Dimitroulas
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  9. Eugenia Gkaliagkousi
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Contributions

E. Gkaliagkousi designed and supervised the study and the final version of the manuscript. P. Anyfanti actively participated in subjects’ enrollment and manuscript preparation. P. Anyfanti, A. Dimitriadou, and A. Dara analyzed and interpreted the data and participated in the first draft of the manuscript and preparation of tables and figures. E. Gavriilaki and B. Nikolaidou actively participated in subject’s enrollment and measurements. A. Triantafyllou and T. Dimitroulas participated in study design and edited the manuscript. All authors read and approved the final manuscript.

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Correspondence to Panagiota Anyfanti.

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Anyfanti, P., Dimitriadou, A., Dara, A. et al. Circulating levels of galectin-3 and coronary microvascular perfusion in rheumatoid arthritis patients with suppressed inflammation. Clin Rheumatol 42, 2881–2887 (2023). https://doi.org/10.1007/s10067-023-06685-7

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  • DOI: https://doi.org/10.1007/s10067-023-06685-7

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