D1.167 - Galectin-3 and Airway Remodelling: Diagnostic and Prognostic Implications in Children

Recurrent wheezing (RW) in early childhood is a heterogeneous syndrome which, in a subset of children, marks the onset of a persistent asthmatic phenotype and early airway remodelling. Given the limitations of invasive diagnostic methods, reliable non-invasive biomarkers that reflect structural changes in the airways are needed. The aim of this study was to evaluate the diagnostic and prognostic value of galectin-3 (Gal-3) in children with RW and cystic fibrosis (CF), focusing on airway remodelling.

A total of 48 children were enrolled: 26 with recurrent wheezing under the age of 4 years and 22 with cystic fibrosis. Serum Gal-3 levels were measured. Children with RW were stratified by age and by wheezing frequency (≤3 vs ≥6 episodes per month during the autumn–winter period). In the CF group, the association between Gal-3 levels, genotype (ΔF508), and CT-verified bronchiectasis was analysed.

Elevated Gal-3 levels were detected as early as infancy in children with RW, with episode frequency correlating with markedly increased values (>17.8 ng/mL). In CF patients homozygous for ΔF508, the presence of bronchiectasis was associated with an approximately four-fold increase in Gal-3 levels, whereas patients without significant structural lung changes showed values within the normal range. Among heterozygous patients, Gal-3 levels were comparable across subgroups.

Gal-3 shows potential as an early non-invasive biomarker for identifying children at high risk of airway remodelling associated with a severe broncho-obstructive phenotype. Timely identification of this subset is crucial for appropriate therapy and long-term prognosis.