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Abstract
BACKGROUND Hypoxia may play a role in the pathogenesis of infantile hemangioma. Cysteine-rich angiogenic inducer 61 (Cyr61), or CCN1, can be induced under hypoxic conditions in several types of cells. However, whether CCN1 has any impact on infantile hemangioma remains unknown. This study aims to explore the expression of CCN1 in infantile hemangioma and to investigate the effect of hypoxia on CCN1 and vascular endothelial growth factor-A (VEGF-A) production. METHODS Hemangioma-derived endothelial cells and hemangioma-derived stem cells were isolated from surgical specimens of proliferative infantile hemangioma. RNA extracted from infantile hemangioma tissue, hemangioma-derived endothelial cells, and hemangioma-derived stem cells was used to analyze gene expression by real-time polymerase chain reaction. The effects of CCN1 blockade were examined in hemangioma-derived stem cells. Immunostaining, immunoblotting, and enzyme-linked immunosorbent assays were used to assess protein expression. RESULTS By double-label immunofluorescence staining, the authors first identified that CCN1 was abundant in proliferative infantile hemangioma lesions and colocalized well with immature microvessels. The authors found that the mRNA level of CCN1 in proliferative infantile hemangioma was significantly higher than in healthy controls, as was involuting infantile hemangioma. Treatment with the hypoxia inducer cobalt chloride dramatically increased CCN1 production in hemangioma-derived endothelial cells in a time-dependent manner. Furthermore, blocking or knockdown of CCN1 expression reduced the expression of VEGF-A in hemangioma-derived stem cells. Lastly, the signaling pathway study showed that CCN1 up-regulation of VEGF-A synthesis in hemangioma-derived stem cells depends on nuclear factor-κB and JNK activation. CONCLUSIONS These findings provide new evidence that CCN1 participates in the crosstalk between hemangioma-derived endothelial cells and hemangioma-derived stem cells through promoting VEGF-A expression in the hypoxic environment of infantile hemangioma angiogenesis and vasculogenesis. Targeting of CCN1 might be a novel therapeutic strategy for infantile hemangioma.
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Khairoun C, Barkat A. Congenital liver hemangioma revealed by cholestasis syndrome: report of a rare case. Pan Afr Med J 2021; 36:192. [PMID: 32952836 PMCID: PMC7467625 DOI: 10.11604/pamj.2020.36.192.21411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 05/02/2020] [Indexed: 11/27/2022] Open
Abstract
Our paper reports a case of hepatic angioma revealed by neonatal cholestasis, thing that has never been reported in the literature to our knowledge. A newborn boy of 25 days of life had cholestatic jaundice since his fifth day of life. During its health assessment, the angioscan detected the presence of multiple hepatic agiomas. The rest of the etiological report returned without any anomaly. Beta-blockers were started with a very good clinical and ultrasonographic evolution after 12 months of treatment.
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Affiliation(s)
- Chaimae Khairoun
- Medical Department of Neonatology Reanimation, The Reference National Centre of Neonatology and Nutrition of Mother and Child, Sick Child Hospital CHU of Rabat, Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco
| | - Amina Barkat
- Medical Department of Neonatology Reanimation, The Reference National Centre of Neonatology and Nutrition of Mother and Child, Sick Child Hospital CHU of Rabat, Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco
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Bota M, Fischer-Fodor E, Bochiș OV, Cenariu M, Popa G, Blag CL, Tătaru A. Combined effect of propranolol, vincristine and bevacizumab on HUVECs and BJ cells. Exp Ther Med 2019; 17:307-315. [PMID: 30651796 PMCID: PMC6307438 DOI: 10.3892/etm.2018.6925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 09/14/2018] [Indexed: 11/05/2022] Open
Abstract
Infantile hemangioma is one of the most common benign tumors affecting children, with ~10-15% requiring medical treatment. These tumors consist of endothelial cells and stromal components, including fibroblasts, pericytes and mast cells. Effects of propranolol treatment in combination with bevacizumab or vincristine on cell growth were compared in the current study using human umbilical vein endothelial cells (HUVECs) and BJ human normal fibroblasts (BJs) to determine potential synergic effects in vitro. Inhibition of cell growth was investigated using MTT assays and cytotoxicity of the drugs in various combinations was expressed as half inhibitory concentration (IC50). Apoptosis was investigated using flow cytometry, with Alexa Fluor 488 and propidium iodide. Propranolol inhibited BJ and HUVEC growth in a dose-dependent manner, with increased response observed in BJs (IC50, 148,32 µg/ml; standard error logIC50, 0.07). Treatment with vincristine induced the strongest growth inhibition in HUVECs (IC50, 17,89 µg/ml; standard error log IC50, 0.07) and BJs (IC50, 24,81 µg/ml; standard error log IC50, 0.08) compared with propranolol (HUVEC IC50, 81,94 µg/ml; standard error log IC50, 0.06; BJ-IC50, 148,32 µg/ml; standard error logIC50, 0.07) or bevacizumab (HUVEC IC50 96,91 µg/ml; standard error log IC50, 0.06; BJ IC50, 182,70 µg/ml; standard error log IC50, 0.09) alone. Bevacizumab was the weakest cytotoxic agent. Combination treatment of vincristine with bevacizumab induced the highest levels of apoptosis in HUVECs compared with all other treatments and triple-drug therapy induced the levels of apoptosis in BJs. Single treatment with vincristine, propranolol or bevacizumab induced apoptosis in BJs and HUVECs. In BJs, triple treatment exhibited the greatest influence on apoptosis, compared with single and dual treatments and in HUVECs, vincristine and bevacizumab combination treatment induced apoptosis to the highest level. The present study offers novel perspectives in drug repurposing studies for the three drugs, particularly in diseases where the pathogenesis is based on healthy endothelial cell proliferation, including hemangiomas.
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Affiliation(s)
- Mădălina Bota
- Department of Pediatrics, University of Medicine and Pharmacy 'Iuliu Hațieganu', 400012 Cluj-Napoca, Romania
| | - Eva Fischer-Fodor
- Tumor Biology Department, The Oncology Institute 'I. Chiricuță', 400015 Cluj-Napoca, Romania.,Medfuture-Research Center for Advanced Medicine, University of Medicine and Pharmacy 'Iuliu Hațieganu', 400012 Cluj-Napoca, Romania
| | - Ovidiu-Vasile Bochiș
- Department of Medical Oncology, The Oncology Institute 'I. Chiricuță', 400015 Cluj-Napoca, Romania
| | - Mihai Cenariu
- Biotechnology Research Center, University of Agricultural Science and Veterinary Medicine, 400374 Cluj-Napoca, Romania
| | - Gheorghe Popa
- Department of Pediatrics, University of Medicine and Pharmacy 'Iuliu Hațieganu', 400012 Cluj-Napoca, Romania
| | - Cristina Lucia Blag
- Department of Pediatrics, University of Medicine and Pharmacy 'Iuliu Hațieganu', 400012 Cluj-Napoca, Romania
| | - Alexandru Tătaru
- Department of Dermatology, University of Medicine and Pharmacy 'Iuliu Hațieganu', 400012 Cluj-Napoca, Romania
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Bota M, Popa G, Blag CL, Leucuta DC, Tătaru A. Infantile hemangiomas: a 7-year experience of a single-center. ACTA ACUST UNITED AC 2017; 90:396-400. [PMID: 29151787 PMCID: PMC5683828 DOI: 10.15386/cjmed-781] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 05/09/2017] [Accepted: 05/23/2017] [Indexed: 11/30/2022]
Abstract
Objectives The aim of the study was to describe the historical and clinical characteristics of hemangiomas in a series of cases of our clinic. Methods This is a retrospective study of 36 patients with infantile hemangiomas consulted in our clinic. Results We had 14 multiple hemangiomas, and 1 kaposiform hemangioendothelioma. Almost two-thirds involved the cephalic extremity, and 76% of the cases were treated. Pregnancy risk factors included prematurity, low-birth weight and respiratory distress syndrome. Propranolol was used in 22 cases, followed by prednisone in 3 cases. Vincristine and interferon were used as associated therapies or as second line therapies. Two hemangiomas had complications, one ulceration and a Kasabach-Merritt syndrome. All the patients had a good evolution. Conclusions Our study results regarding the involvement of pregnancy and birth risk factors in developing infantile hemangiomas is similar to literature data. The majority of patients had at least one risk factor suggesting that at least one trigger to develop an infantile hemangioma is necessary. Our study shows that the cephalic extremity is mostly involved, and because of its potential complications they are most likely to be treated. The study shows that propranolol is the leading treatment option with few and mild side effects.
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Affiliation(s)
- Mădălina Bota
- Department of Pediatrics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Gheorghe Popa
- Department of Pediatrics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristina Lucia Blag
- Department of Pediatrics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Daniel-Corneliu Leucuta
- Department of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alexandru Tătaru
- Department of Dermatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Strumila A, Kazlauskas V, Pošiūnas G, Verkauskas G, Beiša V. Infantile hemangioma: Predicting proliferation by infrared thermography. Medicina (B Aires) 2017; 53:85-89. [DOI: 10.1016/j.medici.2017.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 03/19/2017] [Accepted: 04/06/2017] [Indexed: 01/17/2023] Open
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Alfageme Roldán F, Salgüero Fernández I, Zamanta Muñoz Garza F, Roustán Gullón G. Update on the Use of Ultrasound in Vascular Anomalies. ACTAS DERMO-SIFILIOGRAFICAS 2016. [DOI: 10.1016/j.adengl.2016.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Oral Propranolol for the Treatment of Infantile Hemangiomas in the Post-Proliferative Phase: A-Single Center Retrospective Study of 31 Cases. J Oral Maxillofac Surg 2016; 74:1623-9. [PMID: 27055227 DOI: 10.1016/j.joms.2016.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 03/08/2016] [Accepted: 03/08/2016] [Indexed: 12/24/2022]
Abstract
PURPOSE Infantile hemangiomas (IHs) are the most common benign tumors affecting infants, and most IHs are self-limiting. However, there are cases that require specific treatment. Propranolol is now widely used to treat severe IHs. Several studies have shown the efficacy and limited side effects associated with propranolol as the first-line treatment for IHs. There are a limited number of publications describing the role of propranolol in treating IHs beyond the proliferative phase (>12 months). The purpose of this study was to evaluate the effects and safety of oral high-dose (2.0 mg/kg per day) propranolol for IHs beyond the proliferative phase (>12 months). PATIENTS AND METHODS This study enrolled patients with IHs who accepted systemic propranolol treatment from the Department of Oral and Maxillofacial Surgery, Stomatological Hospital Affiliated China Medical University. This is a single-center retrospective study conducted from April 2011 to July 2015. All children who were older than 12 months were eligible for the study. Digital photographs taken before and after treatment were analyzed by a panel of 3 plastic surgeons. The esthetic results were evaluated using a 4-point scale and ranked as poor, moderate, good, or excellent. The patient follow-up visits were scheduled monthly, and changes in the size, texture, and color of the lesions were recorded. The adverse effects after medication were evaluated and managed accordingly. RESULTS We collected data on 31 eligible patients. The 31 patients had 32 hemangiomas (1 female patient had 2 lesions) and were treated with systemic propranolol at a high dose of 2 mg/kg per day. The mean age at the initiation of propranolol therapy was 18.4 months (range, 12 to 48 months), and the mean treatment duration was 10.1 months (range, 8 to 16 months). The treatment responses for the 32 hemangiomas included 17 excellent responses (53.1%), 8 good responses (25%), and 7 moderate responses (21.9%). There were no severe side effects encountered and recurrence was observed in 3 patients during the treatment and follow-up course. CONCLUSIONS Oral propranolol, 2 mg/kg per day, is a safe and effective treatment for IHs beyond the proliferative phase (>12 months of age) in the Chinese population.
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Alfageme Roldán F, Salgüero Fernández I, Zamanta Muñoz Garza F, Roustán Gullón G. Update on the Use of Ultrasound in Vascular Anomalies. ACTAS DERMO-SIFILIOGRAFICAS 2016; 107:284-93. [PMID: 26833059 DOI: 10.1016/j.ad.2015.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 11/23/2015] [Accepted: 11/29/2015] [Indexed: 12/26/2022] Open
Abstract
Advances in our understanding of the biology and therapy of vascular anomalies have made this condition a common reason for consulting a dermatologist. In addition, multidisciplinary units have been created to manage patients with complex vascular anomalies. Although most vascular anomalies are diagnosed based on clinical findings, a thorough evaluation often requires additional imaging tests to determine the nature, extension, and prognosis of these lesions. Because it is fast and noninvasive, ultrasound is usually the first imaging test ordered. In the present review, we provide a state-of-the-art synthesis of key concepts in the ultrasound examination of vascular anomalies so that they are more accessible to clinicians and medical imaging specialists involved in the management of these lesions.
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Affiliation(s)
- F Alfageme Roldán
- Servicio de Dermatología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España.
| | - I Salgüero Fernández
- Servicio de Dermatología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
| | | | - G Roustán Gullón
- Servicio de Dermatología, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, España
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Léauté-Labrèze C. [Propranolol in infantile hemangiomas]. Arch Pediatr 2015; 22:452-5. [PMID: 25753275 DOI: 10.1016/j.arcped.2015.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 01/07/2015] [Indexed: 10/23/2022]
Abstract
Propranolol has been recently approved by health authorities to treat infantile haemangiomas (IH). Propranolol is indicated in infants less than 5months of age with an IH requiring systemic therapy: IH at life-threatening and/or functional risk, painful ulcerated IH and IH that may cause permanent disfigurement. Propranolol should be initiated by physicians who have expertise in the diagnosis, treatment and management of IH. In addition, the first intake and every escalation should be administrated in a controlled clinical setting where adequate facilities for handling of adverse reactions, including those requiring urgent measures, are available. Then a monthly monitoring with dose adjustment weight is mandatory by the family doctor. Parents should be informed of the risk of hypoglycaemia and bronchoconstriction, especially during respiratory infectious outbreaks. The recommended duration of treatment is 6months without tapering. Relapses are possible necessitating a second course of 3 to 6months of treatment.
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Affiliation(s)
- C Léauté-Labrèze
- Unité de dermatologie pédiatrique et centre de référence des maladies rares de la peau, hôpital Pellegrin-Enfants, CHU de Bordeaux, 33076 Bordeaux cedex, France.
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Gey A, Ezzedine K, Diallo A, Prey S, Dreyfus I, Maza A, Mazereeuw-Hautier J, Taïeb A, Léauté-Labrèze C. Stay in NICU and infantile haemangioma development. J Eur Acad Dermatol Venereol 2015; 29:566-73. [DOI: 10.1111/jdv.12639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A. Gey
- Department of Dermatology and Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin and University of Bordeaux; Inserm U1035; Bordeaux France
| | - K. Ezzedine
- Department of Dermatology and Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin and University of Bordeaux; Inserm U1035; Bordeaux France
| | - A. Diallo
- Department of Dermatology and Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin and University of Bordeaux; Inserm U1035; Bordeaux France
| | - S. Prey
- Department of Dermatology and Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin and University of Bordeaux; Inserm U1035; Bordeaux France
| | - I. Dreyfus
- Dermatology Department; Larrey Hospital; Toulouse France
| | - A. Maza
- Dermatology Department; Larrey Hospital; Toulouse France
| | | | - A. Taïeb
- Department of Dermatology and Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin and University of Bordeaux; Inserm U1035; Bordeaux France
| | - C. Léauté-Labrèze
- Department of Dermatology and Pediatric Dermatology; National Centre for Rare Skin Disorders; Hôpital Pellegrin and University of Bordeaux; Inserm U1035; Bordeaux France
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Bota M, Popa G, Blag C, Tataru A. Infantile Hemangioma: A Brief Review. ACTA ACUST UNITED AC 2015; 88:23-7. [PMID: 26528043 PMCID: PMC4508608 DOI: 10.15386/cjmed-381] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 12/29/2014] [Indexed: 12/13/2022]
Abstract
Infantile hemangiomas as frequent infancy tumors have been a controversial issue of medical scientists worldwide. Their clinical aspects are various and their physiopathology is yet to be fully understood. Numerous publications outline the characteristics, causes, evolution possibilities and therapeutic approaches. Deciding whether to treat or not is the main question of this kind of pathology. Hemangiomas that have complications or can cause irreversible damage need therapy. This is a brief review of up-to-date information regarding the presentation of infantile hemangiomas and target-therapies.
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Affiliation(s)
- Madalina Bota
- Department of Pediatrics II, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Gheorghe Popa
- Department of Pediatrics II, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristina Blag
- Department of Pediatrics II, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alexandru Tataru
- Department of Dermatology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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À propos des ivacaftor, bédaquiline, florbétapir F18 et propranolol. ANNALES PHARMACEUTIQUES FRANÇAISES 2014; 72:229-37. [DOI: 10.1016/j.pharma.2014.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 03/12/2014] [Accepted: 03/13/2014] [Indexed: 11/23/2022]
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