Cardiovascular drugs in the treatment of infantile hemangioma

Abstract

Since the introduction of propranolol in the treatment of complicated infantile hemangiomas (IH) in 2008, other different beta-blockers, including timolol, acetabutolol, nadolol and atenolol, have been successfully used for the same purpose. Various hypotheses including vasoconstriction, inhibition of angiogenesis and the induction of apoptosis in proliferating endothelial cells have been advanced as the potential beta-blocker-induced effect on the accelerated IH involution, although the exact mechanism of action of beta-blockers remains unknown. This has generated an extraordinary interest in IH research and has led to the discovery of the role of the renin-angiotensin system (RAS) in the biology of IH, providing a plausible explanation for the beta-blocker induced effect on IH involution and the development of new potential indications for RAS drugs such as angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers in the treatment of IH. This review is focused on the current use of cardiovascular drugs in the treatment of IH.

The impact of propranolol on apoptosis in cutaneous squamous cell carcinomas

“…Propranolol, a beta-blocker, is a therapeutic agent used in the treatment of various types of cancer due to its anti-proliferative, anti-migratory, anti-angiogenic and cytotoxic features (3,4).…”

“…Experimental data have demonstrated possibly benefi cial effects of a combined administration of beta-adrenergic receptor antagonists (β-blockers) in cancer therapy. Despite their major side effects, including hypoglycaemia, hypotension and bradycardia, they are well tolerated (3,4).…”

Propranolol induces hemangioma endothelial cell apoptosis via a p53‑BAX mediated pathway

“…A previous study ( 24 ) demonstrated that the p53-dependent pathway is the mechanism underlying the propranolol-induced apoptotic effect on HemECs in vitro so and the clinical use of propranolol has been increased gradually ( 53 , 54 ). In the present study, propranolol was revealed to have an apoptotic effect on HemECs in vitro and, simultaneously, the expression of BAX by the mitochondrial pathway was significantly elevated.…”

Capillary hemangioma – A review

“…ACE inhibitors: In the recent reports, the RAS has been shown to play a key role the pathophysiology of CH. [6,37] Furthermore, it has been found that angiotensin I and angiotensin II play a crucial role in regulating cellular proliferation of CHs. A recent small, randomized, controlled trial, comparing captopril and propranolol establish later to be a superior therapy.…”