Published Online
on November 1, 2004

A more recent version of this article appeared on November 9, 2004

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Submitted on April 14, 2004
Revised on August 18, 2004
Accepted on August 23, 2004

Galectin-3 Marks Activated Macrophages in Failure-Prone Hypertrophied Hearts and Contributes to Cardiac Dysfunction

Umesh C. Sharma MB BS, MSc, Saraswati Pokharel MB BS, Thomas J. van Brakel MD, Jop H. van Berlo MD, Jack P.M. Cleutjens PhD, Blanche Schroen MSc, Sabine André PhD, Harry J.G.M. Crijns MD, PhD, Hans-J. Gabius PhD, Jos Maessen MD, PhD, and Yigal M. Pinto MD, PhD^*

From the Experimental and Molecular Cardiology Laboratory, Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM) (U.C.S., S.P., J.H.v.B., B.S., H.J.G.M.C., Y.M.P.), the Department of Cardiothoracic Surgery, University Hospital Maastricht (U.C.S., T.J.v.B., J.M.), and the Department of Pathology, CARIM, University of Maastricht (J.P.M.C.), Maastricht, the Netherlands; and the Institute of Physiological Chemistry, Faculty of Veterinary Medicine, Ludwig-Maximilians University, Munich, Germany (S.A., H.-J.G.).

^* To whom correspondence should be addressed. E-mail: y.pinto{at}carim.unimaas.nl.

Background--Inflammatory mechanisms have been proposed to be important in heart failure (HF), and cytokines have been implicated to add to the progression of HF. However, it is unclear whether such mechanisms are already activated when hypertrophied hearts still appear well-compensated and whether such early mechanisms contribute to the development of HF.

Methods and Results--In a comprehensive microarray study, galectin-3 emerged as the most robustly overexpressed gene in failing versus functionally compensated hearts from homozygous transgenic TGRmRen2-27 (Ren-2) rats. Myocardial biopsies obtained at an early stage of hypertrophy before apparent HF showed that expression of galectin-3 was increased specifically in the rats that later rapidly developed HF. Galectin-3 colocalized with activated myocardial macrophages. We found galectin-3-binding sites in rat cardiac fibroblasts and the extracellular matrix. Recombinant galectin-3 induced cardiac fibroblast proliferation, collagen production, and cyclin D1 expression. A 4-week continuous infusion of low-dose galectin-3 into the pericardial sac of healthy Sprague-Dawley rats led to left ventricular dysfunction, with a 3-fold differential increase of collagen I over collagen III. Myocardial galectin-3 expression was increased in aortic stenosis patients with depressed ejection fraction.

Conclusions--This study shows that an early increase in galectin-3 expression identifies failure-prone hypertrophied hearts. Galectin-3, a macrophage-derived mediator, induces cardiac fibroblast proliferation, collagen deposition, and ventricular dysfunction. This implies that HF therapy aimed at inflammatory responses may need to be targeted at the early stages of HF and probably needs to antagonize multiple inflammatory mediators, including galectin-3.

Key words: angiotensin • collagen • fibroblasts • heart failure

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