Galectın-3 ve Kalp Hastalıklarındaki Rolleri
Özet
Galectin-3, insan genomunda 14. kromozom üzerinde bulunan LGALS3 geni tarafından kodlanan 35 kDa ağırlığında bir β-galaktozid bağlayıcı lektin proteinidir. Vücutta bağışıklık sistemi hücreleri, fibroblastlar, epitel ve endotel hücrelerinde yüksek oranda eksprese edilen bu protein; hücresel büyüme, adhezyon, apoptoz, fibrozis, anjiyogenez ve enflamatuvar yanıtların düzenlenmesinde kritik biyolojik roller üstlenir. Kardiyovasküler hastalıklarda enflamasyon, kardiyak yeniden şekillenme ve doku fibrozisinin önemli bir belirteci olan Galectin-3; özellikle kalp yetmezliğinde kollajen üretimini, matris birikimini ve miyofibroblast aktivasyonunu artırarak sol ventrikül disfonksiyonuna yol açmaktadır. Klinik çalışmalarda yüksek Galectin-3 düzeylerinin kronik kalp yetmezliğinde kötü prognoz, mortalite ve hastaneye yeniden yatış riskinin bağımsız bir prediktörü olduğu gösterilmiş; 17,8 ng/mL kesim değeri risk sınıflandırmasında, >25,9 ng/mL değerleri ise belirgin yüksek hastaneye yatış ve mortalite riski ile ilişkili bulunmuştur. Ateroskleroz sürecinde köpük hücrelerince yüksek oranda salgılanarak ox-LDL aracılı endotel hasarını, makrofaj farklılaşmasını ve vasküler düz kas hücre proliferasyonunu indükler. Ayrıca atriyal fibrilasyon, akut miyokard enfarktüsü, iskemik inme ve anstabil angina gibi kardiyovasküler hastalıklarda tanısal ve prognostik bir biyobelirteç olarak öne çıkmaktadır. ACCF/AHA kılavuzlarınca onaylanan ve FDA kardiyovasküler biyobelirteç listesinde yer alan Galectin-3, rutin klinik kullanımda hastalıkların erken tespiti, risk değerlendirmesi ve yeni terapötik hedeflerin geliştirilmesi açısından büyük bir potansiyel sunmaktadır.
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