Abstract
Recent studies point to a dual role for galectin-3 as both a circulating damage-associated molecular pattern and a cell membrane-associated pattern recognition receptor. The aim of this study was to assess the potential of circulating galectin-3 for discriminating between infections and non-infectious inflammatory disorders on the one hand, and between fungal and bacterial infections on the other. Galectin-3 and C-reactive protein (CRP) were measured in the plasma of 127 patients with either non-infectious inflammatory disorders (gout, autoinflammatory syndrome or pancreatitis) or an infection (viral lower respiratory tract infection, bacterial sepsis or candidaemia). Circulating galectin-3 concentrations were increased in patients with infections when compared with healthy volunteers or patients with non-infectious inflammatory diseases. At cut-off values with a specificity of 95 %, the sensitivity of galectin-3 (>20.6 ng/ml) to discriminate between an infection and non-infectious inflammation was higher than that of CRP (>156 mg/l): 43 % [95 % confidence interval (CI) 33–53 %] versus 27 % (95 % CI 19–37 %), p = 0.03. After exclusion of patients with CRP <156 mg/l, galectin-3 concentration >20.6 ng/ml could identify 41 % (95 % CI 29–53 %) of the patients with an infection at the cost of one false-positive with non-infectious inflammation. Using this sequential approach, 57 % of the patients with an infection could be selected. Galectin-3 concentrations were similar in patients with bacterial and Candida sepsis, while being lower in viral respiratory infections. Although galectin-3 does not discriminate between bacterial and Candida sepsis, the sequential use of CRP and galectin-3 in distinguishing infectious diseases from non-infectious inflammation may be superior to CRP alone.
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Acknowledgements
This study was partly supported by an unrestricted research grant of Institut Mérieux. J.t.O. was supported by the European Regional Development Fund—province of Gelderland project number 2009-010034. M.G.N. was supported by a European Research Council grant (#310372).
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ten Oever, J., Giamarellos-Bourboulis, E.J., van de Veerdonk, F.L. et al. Circulating galectin-3 in infections and non-infectious inflammatory diseases. Eur J Clin Microbiol Infect Dis 32, 1605–1610 (2013). https://doi.org/10.1007/s10096-013-1919-4
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DOI: https://doi.org/10.1007/s10096-013-1919-4