Association of Serum Galectin-3 Binding Protein with Acute Exacerbation, Inflammation, and Airway Remodeling in Pediatric Asthma

BACKGROUND: Galectin-3 binding protein (LGALS3BP) is involved in immune regulation and tissue remodeling; however, its clinical significance in pediatric asthma has not been fully elucidated. We aimed to investigate the association between serum LGALS3BP levels and acute exacerbation, airway inflammation, lung function, and airway remodeling in children with asthma. METHODS: We enrolled 93 children with asthma, including 57 in a stable state and 36 experiencing acute exacerbation, along with 100 healthy controls. Pulmonary function tests, markers of allergic and airway inflammation, pro-inflammatory cytokines, and airway remodeling-related biomarkers were assessed. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were performed to evaluate predictors and diagnostic performance for acute exacerbation. RESULTS: Serum LGALS3BP levels were significantly higher in children with asthma than in healthy controls and were further elevated during acute exacerbations (all p < 0.001). Increased LGALS3BP levels were independently associated with a higher risk of acute exacerbation (OR = 1.073, 95% CI 1.003-1.147; p = 0.040). ROC analysis showed strong discriminatory ability for exacerbations (AUC= 0.910), with 76.3% sensitivity and 91.0% specificity. Serum LGALS3BP levels were negatively correlated with lung function and positively correlated with eosinophil counts, total IgE, fractional exhaled nitric oxide, pro-inflammatory cytokines, and airway remodeling markers, including TGF-β1, MMP-2, MMP-9, and SDF-1α (all p < 0.05). CONCLUSION: Elevated serum LGALS3BP levels are closely associated with acute exacerbation, airway inflammation, impaired lung function, and airway remodeling in pediatric asthma, suggesting its potential as a noninvasive biomarker of disease activity and exacerbation risk.