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Galectina-3 e a resposta à terapêutica na insuficiência cardíaca : revisão sistemática
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A Galectina-3 (Gal-3) é um biomarcador de fibrose. Níveis elevados de Gal-3 têm sido associados a doenças como a Insuficiência Cardíaca (IC), doença renal crónica, fibrose pulmonar, cancro (sobretudo na presença de metástases), entre outros. Na IC, os estudos focam-se sobretudo no papel prognóstico deste marcador, mas também no diag-nóstico e resposta terapêutica. Esta revisão sistemática incidiu sobre a relação da Gal-3 com a resposta à terapêutica. Recorreu-se a bases de dados online: selecionaram-se 8 artigos sobre a Gal-3 como marcador de resposta à terapêutica e 12 artigos sobre o papel da Gal-3 na predição da resposta à terapêutica para efeitos de estratificação de risco. Com os estudos disponíveis, a Gal-3 não parece ser um biomarcador fidedigno como marcador de resposta à terapêutica. Sendo um marcador de fibrose e, portanto, da pro-gressão da doença, não reduz significativamente os seus níveis após terapêutica. No entanto, a determinação clínica de cutoffs poderá ser útil na seleção de doentes para te-rapêuticas específicas, gerindo os recursos terapêuticos de forma mais eficaz. A hetero-geneidade dos estudos e a reduzida dimensão das amostras não permitem conclusões significativas e a sua aplicação clínica na área da resposta terapêutica.
Galectin-3 (Gal-3) is a fibrosis biomarker. High levels have been associated with diseases such as heart failure (HF), chronic kidney disease, pulmonary fibrosis, cancer (especially in the presence of metastasis), among others. In HF, studies focus mostly on its role as a prognostic biomarker, but also as a diagnosis and therapeutic response bi-omarker. This systematic review focuses on the latter. A screening of online databases was performed, with a selection of 8 articles on Gal-3 as a biomarker to therapeutic re-sponse and 13 articles on Gal-3 as a predictor of therapeutic response, to serve as a risk stratifier for patients. With the available articles, Gal-3 did not appear to be a reliable biomarker for therapeutic response, as it marks fibrosis and, therefore, disease progres-sion, which explains the non-significant reduction of its levels after proper treatment. However, the clinical determination of cutoffs might be useful for the selection of pa-tients suitable for specific therapies, making it possible for a more efficient management of therapeutic resources. The heterogeneity of studies and the reduced patient popula-tion make it difficult to assess significant conclusions that are applicable to the thera-peutic response area.
Galectin-3 (Gal-3) is a fibrosis biomarker. High levels have been associated with diseases such as heart failure (HF), chronic kidney disease, pulmonary fibrosis, cancer (especially in the presence of metastasis), among others. In HF, studies focus mostly on its role as a prognostic biomarker, but also as a diagnosis and therapeutic response bi-omarker. This systematic review focuses on the latter. A screening of online databases was performed, with a selection of 8 articles on Gal-3 as a biomarker to therapeutic re-sponse and 13 articles on Gal-3 as a predictor of therapeutic response, to serve as a risk stratifier for patients. With the available articles, Gal-3 did not appear to be a reliable biomarker for therapeutic response, as it marks fibrosis and, therefore, disease progres-sion, which explains the non-significant reduction of its levels after proper treatment. However, the clinical determination of cutoffs might be useful for the selection of pa-tients suitable for specific therapies, making it possible for a more efficient management of therapeutic resources. The heterogeneity of studies and the reduced patient popula-tion make it difficult to assess significant conclusions that are applicable to the thera-peutic response area.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2016
Palavras-chave
Galectina 3 Insuficiência cardíaca Fibrose