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Impact on the Sustainable Development Goals (SDGs)

Analysis of institutional authors

Peces-Barba G.AuthorGarcía-Río F.Author

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January 5, 2026
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Article

Immune Checkpoint Biomarkers Galectin-9 and TIM-3 Predict Melanoma and Lung Cancer Mortality in Obstructive Sleep Apnoea

Publicated to: Archivos De Bronconeumologia. 61 (12): 735-748 - 2025-12-01 61(12), DOI: 10.1016/j.arbres.2025.03.018

Authors:

Díaz-García, E; Alfaro, E; Pérez-Moreno, P; Lopez-Fernández, C; García-Sánchez, A; Martínez-Garcia, MA; Mañas, E; Cano-Pumarega, I; Casitas, R; Campos-Rodríguez, F; Sánchez-de-la-Torre, M; Nagore, E; Martorell-Calatayud, A; Blasco, LH; Pastor, E; Abad-Capa, J; Montserrat, JM; Cabriada-Nuño, V; Corral-Peñafiel, J; Arias, E; Mediano, O; Somoza-González, M; Dalmau-Arias, J; Almendros, I; Troncoso-Acevedo, F; Gotera-Rivera, C; Pérez-Warnisher, T; Peces-Barba, G; Seijo, LM; Gozal, D; García-Rio, F; Cubillos-Zapata, C
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Affiliations

Autonomous Univ Madrid, Fac Med - Author
Clin Univ Navarra - Author
Hosp 12 Octubre, Resp Dept - Author
Hosp Clin Barcelona, Resp Dept, IDIBAPS - Author
Hosp Consorcio Terrassa, Pneumol Dept - Author
Hosp Germans Trias i Pujol, Ctr Invest Biomed, Resp Dept - Author
Hosp La Paz Inst Hlth Res IdiPAZ, Resp Dis Dept, Resp Dis Grp - Author
Hosp Manises, Dermatol Dept - Author
Hosp San Juan Alicante, Resp Dept - Author
Hosp Santa Creu & Sant Pau, Dermatol Dept - Author
Hosp Univ & Politecn La Fe, Resp Dept - Author
Hosp Univ Cruces, Resp Dept - Author
Hosp Univ Guadalajara, Resp Dept - Author
Hosp Univ Ramon & Cajal, Serv Neumol - Author
Hosp Univ S Pedro Alcantara, Resp Dept - Author
Hosp Univ Valme, Resp Dept, IBIS - Author
IIS Fdn Jimenez Diaz, Serv Neumol - Author
Inst Invest Biomed August Pi I Sunyer IDIBAPS - Author
Inst Valenciano Oncol, Dermatol Dept - Author
Marshall Univ, Joan C Edwards Sch Med, Off Dean - Author
Univ Castilla La Mancha, Hosp Nacl Paraplej, Dept Nursing Physiotherapy & Occupat Therapy, Fac Physiotherapy & Nursing,IDISCAM,Grp Precis Med - Author
Univ Miguel Hernandez, Dept Med Clin - Author
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Abstract

Objectives: Obstructive sleep apnoea (OSA) has been associated with increased cancer risk and mortality, yet specific biomarkers for patient stratification remain lacking. This study explores the role of immune checkpoint biomarkers, soluble Galectin-9 (sGalectin-9) and TIM-3 (sTIM-3), in identifying OSA patients at higher risk of cancer-related mortality. Methods: We conducted a multicohort, prospective observational study including 684 patients, with and without cancer, who underwent sleep studies. Plasma levels of sGalectin-9 and sTIM-3 were assessed using bead-based multiplexed assays. In vitro and ex vivo models were employed to investigate the pathogenic mechanisms underlying biomarker upregulation and their immunological impact. Results: In severe OSA patients with melanoma or lung cancer, sGalectin-9 and sTIM-3 were associated with tumour aggressiveness and with an increased mortality risk. In the three study cohorts, biomarker levels were higher in severe OSA patients than in the other groups. In non-cancer OSA patients' monocyte intracellular Galectin-9 and T-lymphocyte membrane-bound TIM-3 were upregulated. Experimental data revealed that intermittent hypoxia drove the expression of these biomarkers, which were positively associated with inflammatory mediators and inversely related to T-cell proliferation and infiltration. These findings underscore a mechanistic link between hypoxemia and immune suppression. Interpretation: sGalectin-9 and sTIM-3 are promising prognostic biomarkers for medium- to long-term survival in OSA patients with melanoma or lung cancer. Their upregulation highlights a potential pathophysiological pathway connecting OSA-induced hypoxemia to cancer aggressiveness through immune modulation. Further validation could inform risk stratification and personalised therapeutic strategies. (c) 2025 The Authors. Published by Elsevier Espana, S.L.U. on behalf of SEPAR. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Archivos De Bronconeumologia due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2025, it was in position 6/108, thus managing to position itself as a Q1 (Primer Cuartil), in the category Respiratory System. Notably, the journal is positioned above the 90th percentile.

Independientemente del impacto esperado determinado por el canal de difusión, es importante destacar el impacto real observado de la propia aportación.

Según las diferentes agencias de indexación, el número de citas acumuladas por esta publicación hasta la fecha 2026-04-04:

  • WoS: 1
  • Scopus: 2
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Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2026-04-04:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 14.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 14 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 16.
  • The number of mentions in news outlets: 2 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
Continuing with the social impact of the work, it is important to emphasize that, due to its content, it can be assigned to the area of interest of ODS 3 - Ensure healthy lives and promote well-being for all at all ages, with a probability of 78% according to the mBERT algorithm developed by Aurora University.
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Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: United States of America.

the author responsible for correspondence tasks has been Garcia-Rio, F.

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Project objectives

Los objetivos perseguidos en esta aportación se centran en profundizar en la relación entre la apnea obstructiva del sueño (OSA) y la mortalidad por cáncer mediante biomarcadores inmunológicos. Se pretende analizar el papel de los biomarcadores de puntos de control inmunitarios solubles Galectina-9 (sGalectin-9) y TIM-3 (sTIM-3) en la estratificación de riesgo de pacientes con OSA. Evaluar los niveles plasmáticos de sGalectin-9 y sTIM-3 en pacientes con y sin cáncer. Determinar la asociación entre estos biomarcadores y la agresividad tumoral, así como el riesgo de mortalidad en melanoma y cáncer de pulmón. Caracterizar los mecanismos patogénicos subyacentes a la regulación de estos biomarcadores y su impacto inmunológico, especialmente en relación con la hipoxia intermitente.
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