Relationship of between galectin-3 levels and response of antifibroti̇c therapy in pati̇ents with idiopathic pulmonary fi̇brosis

Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease of unknown cause, poor prognosis, characterized by progressive fibrosis. In this disease, which is known to have a survival rate of 3-5 years after diagnosis, early diagnosis is important, but the diagnosis is usually made late since there is no biomarker that can be used in the diagnosis. Galectin 3 is a B-galactoside binding lectin that plays a central role in inflammation and fibrosis, expressed in various cells. We aimed to define the levels of serum galectin-3 protein in patients by grouping them according to the antifibrotic treatment they use and comparing them with healthy subjects. In addition, we aimed to show that galectin-3 concentrations can be used as diagnostic and prognostic biomarker in the serum of IPF patients and that the use of galectin-3 inhibitors in combination with antifibrotic treatments can be beneficial in the therapeutic management of fibrosis. In our study, 44 patients and 35 control patients who were followed up with the diagnosis of IPF in our outpatient clinic between 2016 and 2022 were evaluated, and their detailed anamnesis, spirometric measurements and galectin-3 results were recorded. While the mean galectin-3 level of the patient group was 8.4 ng/ml, the mean galectin-3 level of the control group was 8.2 ng/ml. The serum gal-3 level was 8.9 ng/ml in those receiving pirfenidone treatment, while it was 8.2 ng/ml in those receiving nintedanib. Again, gal-3 was found to be higher in patients using pirfenidone compared to nintedanib. However, no statistically significant difference was observed between the groups. No correlation was found between galectin-3 levels and other parameters measured simultaneously. While our patients were using antifibrotic treatment, some loss of FVC and DLCO was observed in their spirometric follow-up compared to baseline. In addition, gal-3 levels were found to decrease as the follow-up period increased in IPF patients in our study. These patients were using pirfenidone or nintedanib treatment during their follow-up, and perhaps as the exposure to these drugs increased, a decrease in the galectin-3 levels of the patients may have been observed. Further studies are needed to clarify these mechanisms. Keywords: Idiopathic Pulmonary Fibrosis, Galectin-3, Biomarker