Predictors of poor response to oral propranolol in infantile hemangiomas

Hali, F.; Moubine, Insaf; Berrami, H.; Serhier, Zineb; Othmani, Mohamed Bennani; Chiheb, Soumiya

doi:10.1016/j.arcped.2023.06.004

Archives de Pédiatrie

2023

DOI: 10.1016/j.arcped.2023.06.004

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Predictors of poor response to oral propranolol in infantile hemangiomas

F. Hali

Insaf Moubine

H. Berrami

et al.

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2024

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Cited by 2 publications

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Recent advances in understanding the molecular basis of infantile haemangioma development

Mitra,

Fitzsimons,

Hale

et al. 2024

British Journal of Dermatology

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Infantile haemangioma (IH), the most common vascular tumour of infancy, is comprised of diverse cell types including endothelial cells, pericytes, fibroblasts and immune cells. IH is characterized by rapid proliferation followed by slow involution over 1 - 10 years. Most lesions regress spontaneously, but up to 10% can be disfiguring with complications that require further medical treatment. Recent research has revealed the biological characteristics of IH, highlighting the involvement of angiogenesis and vasculogenesis during tumour formation. Gene expression profiling has provided vital insights into these underlying biological processes, with some of the key IH-related pathways identified, including VEGF, RAAS, HIF-1α, Notch, PDGF, PI3K/Akt/mTOR, JAK/STAT, FGF, PPARγ, IGF. Further evidence suggests extracellular matrix factors and hormone receptors regulate IH progression. In this review, we explore the molecular mechanisms involved in the proliferating, plateau and involuting phases of IH. This involves identifying differentially expressed genes, targeted proteins, and key signalling pathways. This knowledge will increase the broader understanding of vascular development, tissue remodelling and angiogenesis.

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Recent advances in understanding the molecular basis of infantile haemangioma development

Mitra,

Fitzsimons,

Hale

et al. 2024

British Journal of Dermatology

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Diagnosis and Treatment of Infantile Hemangioma from the Primary Care Paediatricians to the Specialist: A Narrative Review

Bellinato,

Marocchi,

Pecoraro

et al. 2024

Children

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Infantile haemangiomas (IHs) affect 3–10% of infants, 10% of whom need topical or systemic beta-blocker therapy. Propranolol is the first choice for IHs with a high risk of complications. Since more than half of IHs leave a permanent mark, to reduce outcomes, it is essential to start oral propranolol (2–3 mg/kg/day in 2 doses/day) within the 5th month of life (i.e., during the proliferative phase) and to complete the therapy cycle for at least 6 months. This review aims to summarise the epidemiology, clinical presentation, diagnosis, and treatment of IHs and to highlight the importance of proper referral to specialised hub centres. Patients with vascular anomalies, particularly those suspected of having IH, should be referred to a specialised centre for accurate diagnosis, management by a multidisciplinary team, and timely treatment. IHs may pose life-threatening, functional, and aesthetic risks or may ulcerate. Segmental infantile haemangioma of the face/neck and the lumbosacral regions can be associated with various malformations. To ensure timely specialist evaluation and treatment to reduce the potential risk of complications, it is essential to identify high-risk IHs rapidly. The Infantile Haemangioma Referral Score (IHReS) scale is an important tool to assist primary care paediatricians and general dermatologists.

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Predictors of poor response to oral propranolol in infantile hemangiomas

Cited by 2 publications

References 18 publications

Recent advances in understanding the molecular basis of infantile haemangioma development

Recent advances in understanding the molecular basis of infantile haemangioma development

Diagnosis and Treatment of Infantile Hemangioma from the Primary Care Paediatricians to the Specialist: A Narrative Review

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