Lipoprotein apheresis reduces circulating galectin-3 in humans

Background: Plasma galectin‐3 (Gal‐3) is elevated in, and drives, diverse systemic inflammatory disorders, including cancer, cardiovascular diseases, and diabetes. Circulating Gal‐3 promotes tumorigenesis and metastasis, as well as fibrotic remodeling, and is a promising therapeutic target. Apheresis has proven utility in reducing circulating disease‐promoting substances, exemplified by the success of lipoprotein apheresis (LA) in abrogating cardiovascular disease progression in drug‐refractory hypercholesterolemia patients. We compared the clinical utility of two FDA‐approved LA systems in reducing plasma Gal‐3 in humans. Methods: Plasma Gal‐3 levels were assessed by ELISA in blinded samples drawn pre‐ and post‐apheresis from hypercholesterolemia patients (n = 10/group) undergoing therapeutic LA using either a heparin‐induced extracorporeal LDL precipitation (HELP) or dextran sulfate‐adsorption (DSA) system. Results: Mean baseline plasma Gal‐3 concentrations (±SD) were 14.3 ± 5.1 (range 6.6–22.8) and 14.5 ± 2.8 (range 10.6–19.8) ng/mL in the HELP and DSA groups, respectively. Post‐apheresis Gal‐3 levels were respectively reduced by 19.4% and 22.7% in the HELP (P = 0.0094) and DSA (P = 0.0027) systems (paired t‐tests); the difference between devices was insignificant (P = 0.5288; Mann–Whitney). Post‐treatment Gal‐3 levels were 11.3 ± 3.7 (HELP; range 4.5–16.3) and 11.3 ± 3.8 (DSA; range 7.5–20.7) ng/mL. Conclusions: Circulating Gal‐3 levels showed a statistically significant decrease in humans undergoing therapeutic LA. Although absolute Gal‐3 reduction was ≈19–23%, this effect, combined with reducing atherogenic LDL and other inflammation mediators (e.g., CRP, fibrinogen, Lp‐PLA2), may enhance apheresis clinical benefits. Applying new Gal‐3‐specific extraction technologies to apheresis may be advantageous in treating diverse pathologies that are promoted by elevated plasma Gal‐3. J. Clin. Apheresis 31:388–392, 2016. © 2015 Wiley Periodicals, Inc.