Serum cytokine profiles in infants with infantile hemangiomas on oral propranolol treatment: VEGF and bFGF, potential biomarkers predicting clinical outcomes

Park, Meerim; Jung, Hye Lim; Shim, Ye Jee; Kim, Heung Sik; Yoon, Hoi Soo; Park, Soo Young; Cheuh, Hee Won; Lee, Mee Jeong; Lee, Jae Min; Park, Eun Sil; Lee, Jae Hee; Lim, Yeon Jung; Choi, Young Bae

doi:10.1038/s41390-020-0862-1

Cited by 16 publications

(25 citation statements)

References 29 publications

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“…9,[11][12][13] In Korea, IHs are usually treated by pediatric hematology-oncologists with the cooperation of pediatric cardiologists, radiologists, dermatologists, and plastic surgeons. [19][20][21][22] The AAP CPG for the management of IHs recommends oral propranolol, an oral nonselective beta-adrenergic antagonist, as the present gold standard treatment for high-risk IHs at a dosage of 2-3 mg/kg/day divided into two daily doses maintained for at least 6 months. 11) This AAP CPG also approves topical timolol maleate, a topical non-selective beta-blocker, for the treatment of some small, thin, superficial IHs at a dose of 1-2 drops of 0.5% gelforming ophthalmic solution applied twice daily.…”

Section: A C C E P T E Dmentioning

confidence: 99%

“…13,[28][29][30] Tissue hypoxia induces neovascularization and angiogenesis by stimulating the expression of angiogenic factors such as VEGF and basic fibroblast growth factor (bFGF), on EPCs. 5,7,11,21,27) VEGF may be the most potent angiogenic factor involved in the pathogenesis of IH, stimulating endothelial cell proliferation and mobilization through matrix metalloproteinases. 27) The…”

Section: Pathogenesis Of Ihmentioning

confidence: 99%

“…At the first clinic visit, the documented history should include birth history (gestation age, delivery type, birth weight, parity, single or twin pregnancy, maternal age), date (age) of onset or detection of hemangioma, period of proliferative growth, age at when the hemangioma stopped growing and started to regress, and the occurrence of complications such as ulceration or bleeding or infection (oozing). 11,16,[19][20][21][22] A physical examination should be performed initially and at every outpatient clinic visit at 1-3-month intervals and include vital signs, body weight and height, systemic physical examinations, and the details of the hemangiomas such as location, number, color, long diameter, thickness, consistency, and signs of involution to the adipose and fibrous tissue. 12,[19][20][21][22]51) Hemangiomas should be photographed serially at the first visit, at every follow-up visit, and at 3 and 6 months after the discontinuation of treatment for comparison.…”

Section: Diagnosis Of Ihmentioning

confidence: 99%

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Update on infantile hemangioma

Jung

2021

Clin Exp Pediatr

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The International Society for the Study of Vascular Anomalies classifies vascular anomalies into vascular tumors and vascular malformations. Vascular tumors are neoplasms of endothelial cells, among which infantile hemangiomas (IHs) are the most common, occurring in 5-10% of infants. Glucose transporter-1 protein expression in IHs differs from that of other vascular tumors or vascular malformations. IHs are not present at birth but are usually diagnosed at 1 week to 1 month of age, rapidly proliferate between 1 and 3 months of age, mostly complete proliferation by 5 months of age, and then slowly involute to the adipose or fibrous tissue. Approximately 10% of IH cases require early treatment. The 2019 American Academy of Pediatrics clinical practice guideline for the management of IHs recommends that primary care clinicians frequently monitor infants with IHs, educate the parents about the clinical course, and refer infants with high-risk IH to IH specialists ideally at 1 month of age.High-risk IHs include those with life-threatening complications, functional impairment, ulceration, associated structural anomalies, or disfigurement. In Korea, IHs are usually treated by pediatric hematology-oncologists with the cooperation of pediatric cardiologists, radiologists, dermatologists, and plastic surgeons. Oral propranolol, a non-selective betaadrenergic antagonist, is the first-line treatment for IHs at a dosage of 2-3 mg/kg/day divided into two daily doses maintained for at least 6 months and often continuing until 12 months of age. Topical timolol maleate solution, a topical non-selective beta-blocker, may be used for small superficial type IHs at a dosage of 1-2 drops of 0.5% gel-forming ophthalmic solution applied twice daily. Pulse-dye laser therapy or surgery is useful for the treatment of residual skin changes after IH involution.

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Section: A C C E P T E Dmentioning

confidence: 99%

Section: Pathogenesis Of Ihmentioning

confidence: 99%

Section: Diagnosis Of Ihmentioning

confidence: 99%

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Update on infantile hemangioma

Jung

2021

Clin Exp Pediatr

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“…In these situations, prediction of treatment responses to oral propranolol may be helpful in managing infantile hemangioma. However, there have been few reports regarding prediction of responses to propranolol in patients with infantile hemangioma [27]. A recent multicenter study found that patients with higher serum bFGF and VEGF levels showed better response to propranolol at 1-year follow-up.…”

Section: Plos Onementioning

confidence: 99%

Ultrasound and MRI findings as predictors of propranolol therapy response in patients with infantile hemangioma

et al. 2021

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Objectives To evaluate the prognostic value of ultrasound and MRI findings in patients with infantile hemangioma undergoing propranolol therapy. Methods This study was based on retrospective interpretation of prospectively acquired data. Thirty-eight consecutive patients (28 females and 10 males; mean age ± standard deviation, 3.2 ± 2.2 months) who underwent propranolol treatment for infantile hemangioma were included. Pre-treatment ultrasound images were assessed in terms of echogenicity, lesion height and vascularity. Presence of prominent intratumoral fat, non-fat septa, and enhancement pattern on MRI were retrospectively evaluated. Mann-Whitney test, chi-square, and Fisher’s exact tests were used to compare imaging parameters between patients with treatment success and failure. Results All patients underwent ultrasound and 15 patients underwent MRI. A total of 24 patients showed successful treatment. Between patients with treatment success and failure, there were significant differences in increased vascularity on pre-treatment ultrasound (19/24 vs. 6/14, p = 0.025), decreased vascularity on post-treatment ultrasound (21/24 vs. 5/14, p = 0.001), and prominent intratumoral fat on MRI (1/8 vs. 5/7 p = 0.033). There were no significant differences in echogenicity, lesion height on ultrasound, non-fat septa and MR enhancement pattern. Conclusions Increased vascularity on pre-treatment ultrasound was significantly associated with successful treatment for propranolol therapy in patients with infantile hemangioma, whereas prominent fat component on MRI was significantly associated with treatment failure.

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“…Angiogenesis, the formation of blood vessels from a pre-existing microvessels, is mediated by numerous factors which either stimulate or inhibit the process, otherwise referred to as positive and negative regulators of angiogenesis respectively (Weis and Cheresh, 2011). In hemangioma, positive regulators of angiogenesis predominate and constitutive vascular endothelial growth factor-A (VEGF-A) signalling plays a role in the development of hemangiomas (Chim et al, 2012;Mabeta, 2018;Park et al, 2020).…”

Section: Introductionmentioning

confidence: 99%