Av Nadezhda Latysheva, overingeniør i TREC
When someone goes to the emergency room with symptoms of venous thrombosis (blood clot) such as pain, swelling of the leg or shortness of breath and chest pain, D-dimer testing is often ordered.
It is a quick, non-invasive way to help rule out abnormal or excess clotting and to determine if further testing is necessary to help diagnose venous thrombosis. However, an elevated D-dimer does not always indicate the presence of a clot because a number of other factors can also cause an increased level. Therefore there is an urgent need for the establishment of new biomarkers which can help to accurately diagnose or rule out venous thrombosis.
The recent publication in “Blood” by E. P. DeRoo, et al. from University of Michigan, USA, addresses the question whether two proteins found in blood, galectin-3 (gal3) and galectin-3 binding protein (gal3bp), promote venous thrombosis and therefore may be a potential biomarker for this disease in humans.
Gal3bp and its receptor/ligand gal3 are secreted proteins that are known to play important roles in a number of pathologies, such as cancer, atherosclerosis etc. Gal3bp and gal3 can interact with each other to promote cell-to-cell adhesion and initiate pathological, pro-inflammatory signalling cascades. Both cell-cell adhesion and inflammation are mechanisms involved in venous thrombosis.
The study of DeRoo et al has shown that gal3bp and gal3 possess pro-thrombotic and pro-inflammatory properties in mouse models of experimental venous thrombosis. In a group of human patients an elevated level of circulating blood gal3bp is correlated with acute venous thrombosis.
Based on these findings, the authors believe that gal3 and/or gal3bp may be ideal targets for therapies that seek to prevent venous thrombosis and should be rigorously investigated to determine their quality as potential biomarkers of venous thrombosis. The ability of gal3bp and gal3 to accurately diagnose or rule out venous thrombosis should then be evaluated and compared against the ability of currently used biomarkers (such as d-dimer) to do so.
DeRoo EP, Wrobleski SK, Shea EM, Al-Khalil RK, Hawley AE, Henke PK, Myers DD Jr, Wakefield TW, Diaz JA. The role of galectin-3 and galectin-3-binding protein in venous thrombosis. Blood, 2014 Nov 26. pii: blood-2014-04-569939. [Epub ahead of print]
It is very necessary and timely article!