Abstract 15235: A Pilot Study of Ac-SDKP (N-acetyl-seryl-aspartyl-lysyl-proline) and Galectin-3 Levels in Normal Pericardial Fluid and Tuberculous Pericardial Effusion: Implications for Pathogenesis and Prevention of Pericardial Constriction
Introduction Tuberculous pericarditis is associated with a high rate of progression to constrictive pericarditis. The cellular mediators and molecular mechanisms of post-inflammatory pericardial thickening and fibrosis are not known. Specifically there is no information on whether the pro-fibrotic galectin-3, or the anti-fibrotic molecule N-acetyl-Ser-Asp-Lys-Pro (AcSDKP) are involved in post tuberculous pericardial remodeling. Low levels of AcSDKP have been found to correlate closely with increased fibrosis in the myocardium, kidneys and liver. It is possible that low levels of AcSDKP or high levels of galectin-3 may correlate with pericardial fibrosis. Such information could provide novel targets for the prevention of constrictive pericarditis and its debilitating consequences in patients with tuberculous pericarditis. Hypothesis In a small pilot study we tested the hypotheses that a] AcSDKP levels in TB pericarditis are low relative to levels in normal fluid b] galectin-3 levels in TB pericarditis are high relative to levels in normal fluid.
Methods Pericardial fluid levels of AcSDKP and galectin-3 were measured in 49 and 52 (respectively) adult participants with confirmed TB pericarditis and 20 adult controls undergoing coronary bypass surgery by enzyme linked immunosorbent assay (ELISA).
Results The median level of AcSDKP in the participants with TB pericarditis (156 pg/ml [IQR 126.8-187.4]) was significantly lower than in the normal controls (412 pg/ml [IQR 146.7-717.9]), p=0.029. The median level of galectin-3 measured in the cell free pericardial fluid of patients with tuberculous pericarditis was 11ng/ml [IQR 7.55-15.6]. This was similar to the 12 ng/ml [IQR 7.49-19.62] found in the normal controls (p=0.191).
Conclusions AcSDKP in tuberculous pericarditis is significantly lower than in the pericardial fluid of normal controls, whilst the galectin-3 level is normal. These findings may have implications for the high incidence of post-tuberculous pericardial fibrosis/constriction, and could provide a potential target for anti-fibrotic therapy if confirmed
- © 2012 by American Heart Association, Inc.