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Chen Q, Zhang Y, Ni S, Yang L, Li J, Yuan X, Chen M, Liu J, Luo X, Xie Y, Wang H. Serum apelin as a potential biomarker for infantile hemangiomas. Pediatr Blood Cancer 2024; 71:e30989. [PMID: 38602300 DOI: 10.1002/pbc.30989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 03/16/2024] [Accepted: 03/19/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Infantile hemangiomas (IHs) are common benign vascular tumors in infants. Apelin, an endogenous cytokine, is implicated in the angiogenesis of neoplastic diseases. We aimed to explore the association between apelin and IHs, providing a foundation for clinical applications. METHODS We identified differential expression of apelin in proliferative IHs compared to healthy controls (HCs) through bioinformatics analysis of publicly available databases and verified by Immunofluorescence. Enzyme-linked immunosorbent assay was used to quantify the serum levels of apelin and vascular endothelial growth factor (VEGF) in a cohort of 116 cases of proliferative IHs, 65 cases of capillary malformations (CMs), and 70 HCs. RESULTS Apelin and APJ (APLNR, apelin receptor) were identified as the significantly upregulated differentially expressed genes (DEGs) in proliferative IHs. Immunofluorescence staining indicated high expression of apelin in proliferative IHs, while minimal expression in non-IH lesions. Apelin in IHs was reduced following 6 months of propranolol treatment. Serum apelin levels were significantly higher in the IH group compared to both the CM and HC groups. Moreover, apelin exhibited excellent discriminatory ability in distinguishing IHs from HCs, with an area under the curve (AUC) exceeding 0.90. A positive correlation was observed between the levels of apelin and the size of superficial IHs. The expression profiles of VEGF and apelin in IHs were found to be consistent. CONCLUSIONS Apelin shows promise as a potential biomarker for IHs. The association between apelin and IH size, as well as its responsiveness to propranolol treatment, indicates its possible utility as a valuable indicator for the therapeutic evaluation of IHs.
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Affiliation(s)
- Qiang Chen
- Department of Dermatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Pediatric Surgery, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Yunxuan Zhang
- Department of Dermatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Sili Ni
- Department of Dermatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Liuqing Yang
- Pediatric Research Institute, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Jiwei Li
- Department of Dermatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xingang Yuan
- Department of Dermatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Meng Chen
- Department of Pediatric Surgery, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Jing Liu
- Department of Pediatric Surgery, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Xiaoyan Luo
- Department of Dermatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Yimin Xie
- Department of Pediatric Surgery, Chongqing University Three Gorges Hospital, Chongqing, China
| | - Hua Wang
- Department of Dermatology, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Child Rare Diseases in Infection and Immunity, Children's Hospital of Chongqing Medical University, Chongqing, China
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Pascarella F, Scaramuzzo RT, Pini A, Cammalleri M, Bagnoli P, Ciantelli M, Filippi L. Propranolol: a new pharmacologic approach to counter retinopathy of prematurity progression. Front Pediatr 2024; 12:1322783. [PMID: 38292211 PMCID: PMC10824858 DOI: 10.3389/fped.2024.1322783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024] Open
Abstract
Despite the evident progress in neonatal medicine, retinopathy of prematurity (ROP) remains a serious threat to the vision of premature infants, due to a still partial understanding of the mechanisms underlying the development of this disease and the lack of drugs capable of arresting its progression. Although ROP is a multifactorial disease, retinal vascularization is strictly dependent on oxygen concentration. The exposition of the retina of a preterm newborn, still incompletely vascularized, to an atmosphere relatively hyperoxic, as the extrauterine environment, induces the downregulation of proangiogenic factors and therefore the interruption of vascularization (first ischemic phase of ROP). However, over the following weeks, the growing metabolic requirement of this ischemic retina produces a progressive hypoxia that specularly promotes the surge of proangiogenic factors, finally leading to proliferative retinopathy (second proliferative phase of ROP). The demonstration that the noradrenergic system is actively involved in the coupling between hypoxia and the induction of vasculogenesis paved the way for a pharmacologic intervention aimed at counteracting the interaction of noradrenaline with specific receptors and consequently the progression of ROP. A similar trend has been observed in infantile hemangiomas, the most common vascular lesion of childhood induced by pre-existing hypoxia, which shares similar characteristics with ROP. The fact that propranolol, an unselective antagonist of β1/2 adrenoceptors, counteracts the growth of infantile hemangiomas, suggested the idea of testing the efficacy of propranolol in infants with ROP. From preclinical studies, ongoing clinical trials demonstrated that topical administration of propranolol likely represents the optimal approach to reconcile its efficacy and maximum safety. Given the strict relationship between vessels and neurons, recovering retinal vascularization with propranolol may add further efficacy to prevent retinal dysfunction. In conclusion, the strategy of contrasting precociously the progression of the disease appears to be more advantageous than the current wait-and-see therapeutic approach, which instead is mainly focused on avoiding retinal detachment.
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Affiliation(s)
| | | | - Alessandro Pini
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Maurizio Cammalleri
- Unit of General Physiology, Department of Biology, University of Pisa, Pisa, Italy
| | - Paola Bagnoli
- Unit of General Physiology, Department of Biology, University of Pisa, Pisa, Italy
| | | | - Luca Filippi
- Neonatology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Rešić A, Benco Kordić N, Obuljen J, Bašković M. Importance of Determining Vascular Endothelial Growth Factor Serum Levels in Children with Infantile Hemangioma. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1914. [PMID: 38003963 PMCID: PMC10673278 DOI: 10.3390/medicina59111914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/10/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: A potential role of vascular endothelial growth factor (VEGF) in the pathophysiology of infantile hemangiomas (IH) is thought to be plausible. The primary objective of this study was to investigate the importance of determining VEGF serum levels at various stages of IH growth in children. Materials and Methods: A nested case-control study was conducted. For the purposes of the researched target group, samples of fifty (N = 50) children with IH without associated diseases at different stages of hemangioma growth (proliferative and involutional stages) were used. The control group consisted of one hundred (N = 100) healthy children comparable in terms of age and sex, in whom the existence of IH and vascular malformations was ruled out via clinical examination. An immunoassay (ELISA) was used to determine VEGF serum levels in hemangioma growth's proliferation and involution phases. Results: A comparison of serum levels of VEGF in the phases of proliferation and involution in the group of patients with IH did not show a statistically significant difference (p = 0.171). The control group had significantly higher serum VEGF levels than the patient group in both the proliferation phase (p = 0.009) and the involution phase (p = 0.019). In the proliferation phase, a multivariate regression model explained 15% of the variance in the dependent variable, without significant predictor variables, while in the involution phase, it explained 21% of the variance in the dependent variable, and the history of invasive prenatal procedures stood out as a significant predictor variable positively associated with serum VEGF levels (beta coefficient = 0.33; p = 0.043). Conclusions: Although IH is thought to be the result of the dysregulation of angiogenesis and vasculogenesis under the influence of angiogenic factors, especially VEGF, this study did not demonstrate that VEGF serum levels in the proliferation phase of hemangioma growth were higher than those in the involution phase, or in relation to the control group.
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Affiliation(s)
- Arnes Rešić
- Department of Pediatrics, Children’s Hospital Zagreb, Ulica Vjekoslava Klaića 16, 10 000 Zagreb, Croatia
- University Department of Health Studies, University of Split, Ruđera Boškovića 35, 21 000 Split, Croatia
| | - Nikolina Benco Kordić
- Department of Pediatrics, Children’s Hospital Zagreb, Ulica Vjekoslava Klaića 16, 10 000 Zagreb, Croatia
| | - Jasna Obuljen
- Department of Medical Biochemistry and Hematology, Children’s Hospital Zagreb, Ulica Vjekoslava Klaića 16, 10 000 Zagreb, Croatia
| | - Marko Bašković
- Department of Pediatric Surgery, Children’s Hospital Zagreb, Ulica Vjekoslava Klaića 16, 10 000 Zagreb, Croatia
- Scientific Centre of Excellence for Reproductive and Regenerative Medicine, School of Medicine, University of Zagreb, Šalata 3, 10 000 Zagreb, Croatia
- School of Medicine, University of Zagreb, Šalata 3, 10 000 Zagreb, Croatia
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Kong M, Li Y, Wang K, Zhang S, Ji Y. Infantile hemangioma models: is the needle in a haystack? J Transl Med 2023; 21:308. [PMID: 37149592 PMCID: PMC10163722 DOI: 10.1186/s12967-023-04144-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/20/2023] [Indexed: 05/08/2023] Open
Abstract
Infantile hemangioma (IH) is the most prevalent benign vascular tumor in infants, with distinct disease stages and durations. Despite the fact that the majority of IHs can regress spontaneously, a small percentage can cause disfigurement or even be fatal. The mechanisms underlying the development of IH have not been fully elucidated. Establishing stable and reliable IH models provides a standardized experimental platform for elucidating its pathogenesis, thereby facilitating the development of new drugs and the identification of effective treatments. Common IH models include the cell suspension implantation model, the viral gene transfer model, the tissue block transplantation model, and the most recent three-dimensional (3D) microtumor model. This article summarizes the research progress and clinical utility of various IH models, as well as the benefits and drawbacks of each. Researchers should select distinct IH models based on their individual research objectives to achieve their anticipated experimental objectives, thereby increasing the clinical relevance of their findings.
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Affiliation(s)
- Meng Kong
- Division of Oncology, Department of Pediatric Surgery, West China Hospital, Sichuan University, #37# Guo-Xue-Xiang, Chengdu, 610041, China
| | - Yanan Li
- Division of Oncology, Department of Pediatric Surgery, West China Hospital, Sichuan University, #37# Guo-Xue-Xiang, Chengdu, 610041, China
| | - Kai Wang
- Division of Oncology, Department of Pediatric Surgery, West China Hospital, Sichuan University, #37# Guo-Xue-Xiang, Chengdu, 610041, China
| | - Shisong Zhang
- Department of Pediatric Surgery, Children's Hospital Affiliated to Shandong University, #23976# Jingshi Road, Jinan, 250022, China.
| | - Yi Ji
- Division of Oncology, Department of Pediatric Surgery, West China Hospital, Sichuan University, #37# Guo-Xue-Xiang, Chengdu, 610041, China.
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Sakata M, Kunimoto K, Kawaguchi A, Inaba Y, Kaminaka C, Yamamoto Y, Kakimoto N, Suenaga T, Tokuhara D, Jinnin M. Analysis of cytokine profiles in sera of single and multiple infantile hemangioma. J Dermatol 2023. [DOI: 10.1111/1346-8138.16781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/19/2023] [Accepted: 03/03/2023] [Indexed: 03/29/2023]
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Zhao B, Li B, Zhang J, Qi Y, Chen B, Chen L. Construction of miRNA-mRNA Regulatory Network to Identify Potential Biomarkers in Infantile Hemangioma by Integrated Bioinformatics Analysis. Crit Rev Eukaryot Gene Expr 2023; 33:61-71. [PMID: 37199314 DOI: 10.1615/critreveukaryotgeneexpr.v33.i5.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Infantile hemangioma (IH) is the most common vascular tumor among infants and children. However, the understanding of pathogenesis about IH has not been fully elucidated, and the potential diagnostic maker remains further explored. In this study, we aimed to find miRNAs as potential biomarkers of IH through bioinformatic analysis. The microarray datasets GSE69136, GSE100682 were downloaded from the GEO database. The co-expressed differential miRNAs were identified by analyzing these two datasets. The downstream common target genes were predicted by the ENCORI, Mirgene, miRWalk, and Targetscan databases. GO annotation and KEGG pathway enrichment analysis for target genes were performed. The STRING database and Cytoscape software were used to construct the protein-protein interaction network and screen hub genes. Then potential diagnostic markers for IH were further screened and identified by using Receiver operating characteristic curve analysis. A total of thirteen co-expressed up-regulated miRNAs were screened out in the above two datasets, and 778 down-regulated target genes were then predicted. GO annotation and KEGG pathway enrichment analysis indicated that the common target genes strongly correlated with IH. Through the DEM-hub gene network construction, six miRNAs associated with the hub genes were identified. Finally, has-miR-522-3p, has-miR-512-3p, has-miR-520a-5p with high diagnostic values were screened out by receiver operating characteristic analysis. In the study, the potential miRNA-mRNA regulatory network was firstly constructed in IH. And, the three miRNAs might be used as potential biomarkers for IH, which also provided novel strategies for the therapeutic intervention of IH.
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Affiliation(s)
- Boming Zhao
- Division of Joint Surgery and Sports Medicine, Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
| | - Bin Li
- Division of Joint Surgery and Sports Medicine, Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
| | - Jun Zhang
- Division of Joint Surgery and Sports Medicine, Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
| | - Yongjian Qi
- Department of Spine Surgery and Musculoskeletal Tumor, Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
| | - Biao Chen
- Division of Joint Surgery and Sports Medicine, Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
| | - Liaobin Chen
- Division of Joint Surgery and Sports Medicine, Department of Orthopedic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China
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Makkeyah SM, Elseedawy ME, Abdel-Kader HM, Mokhtar GM, Ragab IA. Vascular endothelial growth factor response with propranolol therapy in patients with infantile hemangioma. Pediatr Hematol Oncol 2022; 39:215-224. [PMID: 34477031 DOI: 10.1080/08880018.2021.1961956] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Vascular endothelial growth factor-A (VEGF-A) is a master regulator of angiogenesis, with higher levels in infantile hemangioma (IH). The effects of propranolol on IH are not fully understood and may involve vasoconstriction, angiogenesis inhibition, and apoptosis induction. Therefore, we examined the effects of propranolol therapy on levels of VEGF-A in patients with IH in the proliferative phase and compared the VEGF-A levels to those in untreated patients in the involuting or involuted phases, as well as studied the consistency between the clinical and VEGF responses in patients receiving treatment. In a prospective study, we compared 24 patients with IH in the proliferative phase to 9 patients with IH in the involuting or involuted phase, assessing clinical responses to therapy and changes in VEGF-A levels after 3 months. The median VEGF level before treatment was 275 pg/ml; however, after 3 months, the level significantly decreased to 100 pg/ml (P = 0.007). Median VEGF was significantly higher in patients in the proliferative phase after 3 months of treatment (100 pg/ml) as compared to those in the involuting phase (50 pg/ml). We found no significant correlation between VEGF level and IH size reduction. Propranolol therapy induced a significant decline in VEGF levels at the 3-month evaluation in patients in the proliferative phase; however, this did not reach the levels of IH in the involuting phase. VEGF response was not translated to a clinical response in some patients with IH. These results put in uncertainty the clinical benefit of targeting VEGF pathway in IH.
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Affiliation(s)
- S M Makkeyah
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - M E Elseedawy
- bDepartment of Pediatric Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - H M Abdel-Kader
- bDepartment of Pediatric Surgery, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - G M Mokhtar
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - I A Ragab
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Rotter A, Lima XT, Oliveira ZNP. Evaluation of plasma and urinary levels of vascular endothelial growth factor and matrix metalloproteinase-9 in patients with infantile hemangioma. Int J Dermatol 2021; 60:1263-1269. [PMID: 33959962 DOI: 10.1111/ijd.15640] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/26/2021] [Accepted: 04/08/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND The pathogenesis of infantile hemangioma (IH) is not fully understood. It has been suggested that angiogenic factors increase in the proliferative stage, decreasing subsequently in the regression phase. OBJECTIVES To evaluate vascular endothelial growth factor (VEGF) and matrix metalloproteinase 9 (MMP-9) levels, according to infantile hemangioma (IH) growth stages and size, and to compare these levels in patients with IH and control subjects. METHODS This cross-sectional study included 68 patients with IH and 25 control subjects. Plasma and urinary MMP-9 and VEGF levels were evaluated during proliferative and regression phases. These levels were correlated with tumor size measured by ultrasonography. Nonparametric tests were performed. RESULTS Among 68 patients with IH, 55 (81%) were female. Age ranged from 1 to 40 months (median 7.0 months). There was no difference in plasma and urinary levels of VEGF and MMP-9 between patients and control subjects. There were no significant differences in these levels between IH patients younger or older than 12 months of age, as a cutoff between proliferative and involution phases. No significant correlation was observed between tumor size and levels of the markers (R < 0.20 and P > 0.05 for all comparisons). CONCLUSION In our large sample, levels of VEGF and MMP-9 did not reflect the characteristic increased angiogenesis in patients with IH when compared to healthy subjects. In addition, these markers were not increased in the proliferative stage of the IH and did not correlate with tumor size.
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Affiliation(s)
- Anita Rotter
- Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil
| | - Xinaida T Lima
- Dermatology Division, Internal Medicine Department, Federal University of Ceará, Fortaleza, Brazil
| | - Zilda N P Oliveira
- Department of Dermatology, University of São Paulo Medical School, São Paulo, Brazil
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Li Z, Chai Y, Zhou Z, Li X, Bi J, Huo R. Circular RNA expression profiles in the plasma of patients with infantile hemangioma determined using microarray analysis. Exp Ther Med 2021; 21:634. [PMID: 33968165 PMCID: PMC8097215 DOI: 10.3892/etm.2021.10066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 03/03/2021] [Indexed: 11/06/2022] Open
Abstract
Circular RNAs (circRNAs) are noncoding RNAs that have important roles in tumor progression. Previous studies have examined the circRNAs involved in infantile hemangioma (IH) tumors. The present study compared the circRNA levels in plasma samples from patients with IH and control individuals. The circRNA expression profiles were determined using microarray in three pairs of plasma samples from patients with proliferative IH and healthy control subjects. Expression of the identified differentially expressed circRNAs was verified using reverse transcription-quantitative PCR (RT-qPCR) and a bioinformatics analysis was performed to predict the microRNAs targeted by the validated circRNAs. From the circRNA expression profiles in the plasma of patients with IHs, 128 differentially expressed circRNAs were identified, of which 72 were upregulated and 56 were downregulated. The downregulated expression of three circRNAs [Homo sapiens (hsa)_circRNA_101566, hsa_circRNA_103546 and hsa_circRNA_103573] was verified using RT-qPCR. Gene Ontology term and Kyoto Encyclopedia of Genes and Genomes pathway analyses indicated that all identified networks participated in angiogenesis and tumor formation and progression. It was determined that hsa_circRNA_101566, which is able to regulate the mTOR signaling pathway, may be an important regulatory molecule in IH development and that targeting of hsa_miR_520c is able to indirectly regulate the vascular endothelial growth factor signaling pathway. Further studies are required to clarify these effects and the underlying mechanisms.
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Affiliation(s)
- Zhiyu Li
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250021, P.R. China
| | - Yimeng Chai
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250021, P.R. China
| | - Zifu Zhou
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250021, P.R. China
| | - Xueqing Li
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250021, P.R. China
| | - Jianhai Bi
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China
| | - Ran Huo
- Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250021, P.R. China.,Department of Plastic and Aesthetic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong 250021, P.R. China
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Aydin Köker S, Kömüroğlu AU, Köksoy AY, Şiraz ÜG, Tekin E, Köker A. Evaluation of GLUT1, IGF-2, VEGF, FGF 1, and angiopoietin 2 in infantile hemangioma. Arch Pediatr 2021; 28:296-300. [PMID: 33715934 DOI: 10.1016/j.arcped.2021.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 09/22/2020] [Accepted: 02/13/2021] [Indexed: 01/29/2023]
Abstract
INTRODUCTION Infantile hemangioma (IH) is a common vascular tumor in children. It is reported that IHs are associated with immunochemical markers such as vascular endothelial growth factor (VEGF)-A, glucose transporter isoform 1 (GLUT1), and insulin-like growth factor-2 (IGF-2). MATERIAL AND METHODS This cross-sectional study focused on pediatric patients with IH. A total of 46 patients (mean age 14.2±21.9 months) with IH and 45 healthy controls (mean age 21.8±15.08 months) were enrolled. Demographic data, clinical findings, and laboratory parameters were recorded. Blood samples were collected. Serum GLUT1, IGF-2, VEGF-A, fibroblast growth factor 1 (FGF1), and angiopoietin 2 levels were assessed by enzyme-linked immunosorbent assay. RESULTS Serum GLUT1, IGF-2, and VEGF-A levels were significantly higher in patients with IH than in healthy controls (8.80±4.07pg/mL vs. 5.66±4.34pg/mL, 281.10±84.12pg/mL vs. 234.19±75.38pg/mL, 1196.99±389.34pg/mL vs. 996.99±349.16pg/mL, respectively, p=0.026, p=0.030, and p=0.036). Serum GLUT1, IGF-2, and VEGF-A levels in patients with complicated hemangioma were significantly higher than in healthy controls (9.69±3.94pg/mL vs. 5.66±4.34pg/mL, 289.94±83.18pg/mL vs. 234.19±75.38pg/mL, 1276.22±388.24pg/mL vs. 996.99±349.16pg/mL, respectively, p=0.017, p=0.022, and p=0.011). Serum GLUT1, IGF-2, and VEGF-A levels in patients with hemangioma receiving propranolol treatment were significantly higher than in healthy controls. Serum FGF1 levels were higher in patients with IH, complicated hemangioma, and hemangioma receiving propranolol treatment than in healthy controls but the difference was not statistically significantly. CONCLUSION Serum GLUT1, IGF-2, and VEGF-A levels were positively correlated with disease severity in patients with hemangioma, for example, in complicated hemangioma and hemangioma requiring propranolol treatment. However, further research on larger and different age subgroups is warranted to assess these markers.
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Affiliation(s)
- Sultan Aydin Köker
- Department of Pediatric Hematology and Oncology, SBÜ Van Education and Research Hospital, Van, Turkey.
| | | | - Adem Yasin Köksoy
- Department of Pediatrics, SBÜ Van Education and Research Hospital, Van, Turkey
| | - Ülkü Gül Şiraz
- Department of Pediatrics, SBÜ Van Education and Research Hospital, Van, Turkey
| | - Emine Tekin
- Department of Pediatrics, SBÜ Van Education and Research Hospital, Van, Turkey
| | - Alper Köker
- Department of Pediatric Intensive Unit, Hatay State Hospital, Van, Turkey
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Proanthocyanidins as a Potential Novel Way for the Treatment of Hemangioma. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5695378. [PMID: 33490272 PMCID: PMC7801061 DOI: 10.1155/2021/5695378] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 12/13/2020] [Accepted: 12/24/2020] [Indexed: 02/08/2023]
Abstract
Hemangioma, the most common benign vascular tumor, not only affects the appearance and psychology but also has a life-threatening potential. It is considered that clonal vascular endothelial cell proliferation and excessive angiogenesis are responsible for hemangioma pathogenesis, in which abnormal cytokines/pathways are closely implicated, primarily including high expression of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) as well as their downstream pathways, especially phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt). These further stimulate the migration and proliferation of vascular endothelial cells and promote the formation of new vessels, ultimately leading to the occurrence and development of hemangioma. Proanthocyanidins are naturally active substance from plants and fruits. They possess multiple functions like antiproliferation, antiangiogenesis, and antitumor. It has been demonstrated that proanthocyanidins effectively work in various diseases via inhibiting the expression of various factors, e.g., HIF-1α, VEGF, PI3K, and Akt. Considering the pathogenesis of hemangioma and the effect of proanthocyanidins, we hold a hypothesis that proanthocyanidins would be applied in hemangioma via downregulating cytokine/pathway expression, suppressing vascular cell proliferation and arrest abnormal angiogenesis. Taken together, proanthocyanidins may be a potential novel way for the treatment of hemangioma.
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Park M, Jung HL, Shim YJ, Kim HS, Yoon HS, Park SK, Cheuh HW, Lee MJ, Lee JM, Park ES, Lee JH, Lim YJ, Choi YB. Serum cytokine profiles in infants with infantile hemangiomas on oral propranolol treatment: VEGF and bFGF, potential biomarkers predicting clinical outcomes. Pediatr Res 2020; 88:749-755. [PMID: 32311699 DOI: 10.1038/s41390-020-0862-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/13/2020] [Accepted: 03/04/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Oral propranolol has become first-line treatment for infantile hemangiomas (IHs). This study focused on identifying cytokines related to the biology of IH and early regression indicators of IH after propranolol treatment. METHODS For inclusion, the patients had to be aged less than 1 year and have an IH with a largest diameter ≥2 cm. Patients were scheduled to receive 1 year of propranolol treatment. Serum cytokines involved in angiogenesis, vasculogenesis, and/or chronic inflammation were analyzed at 0, 1, and/or 12 months after treatment using Multiplex Luminex assays. RESULTS Among the 49 evaluable patients, 33 completed the 1-year treatment: 16 showed excellent response and 12 had good response to propranolol. Significant decreases in serum MMP-2, bFGF, VEGF-α, and MCP-1 levels were observed after 1 year of treatment compared to pretreatment values. The maximal diameters of the lesions significantly correlated with pretreatment serum VEGF-α, bFGF, and MMP-9. Patients with higher bFGF and VEGF levels showed better response to propranolol at 1 year. CONCLUSION MMP-2, VEGF-α, bFGF, and MCP-1 may involve in the biology of IH and their downregulation may be associated with involution processes of IH. Pretreatment bFGF and VEGF could be novel biomarkers for predicting response to propranolol. IMPACT We found that decreases in the concentrations of MMP-2, bFGF, VEGF, and MCP-1 were associated with regression of the hemangioma, which indicates that one of the mechanisms of propranolol in the treatment of proliferative hemangiomas may involve downregulation of those cytokines. Patients with higher bFGF and VEGF levels showed better response to propranolol at 1 year. Importantly, serum bFGF higher than 37.07 pg/mL may predict an excellent response to propranolol. Therefore, along with the patient's age and the size and visual characteristics of the lesion, bFGF levels could help determine the viability of propranolol use in the treatment of IHs. Our study represented extensive serum profiling in IH, reporting the indicators and molecules clearly related to IH regression with propranolol treatment. The authors believe that monitoring serum cytokines, including MMP-2, bFGF, VEGF, and MCP-1, in IH patients could be important, in addition to clinical follow-up, for determining when to start and end propranolol treatment.
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Affiliation(s)
- Meerim Park
- Department of Pediatrics, Center for Pediatric Cancer, National Cancer Center, Goyang, Korea
| | - Hye Lim Jung
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Ye Jee Shim
- Department of Pediatrics, Keimyung University School of Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Heung Sik Kim
- Department of Pediatrics, Keimyung University School of Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Hoi Soo Yoon
- Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Korea
| | - Sang Kyu Park
- Department of Pediatrics, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Hee Won Cheuh
- Department of Pediatrics, Dong-A University College of Medicine, Busan, Korea
| | - Mee Jeong Lee
- Department of Pediatrics, Dankook University College of Medicine, Cheonan, Korea
| | - Jae Min Lee
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu, Korea
| | - Eun Sil Park
- Department of Pediatrics, Gyeonsang National University College of Medicine, Jinju, Korea
| | - Jae Hee Lee
- Department of Pediatrics, Chosun University School of Medicine, Gwangju, Korea
| | - Yeon-Jung Lim
- Department of Pediatrics, Chungnam National University College of Medicine, Daejeon, Korea
| | - Young Bae Choi
- Department of Pediatrics, Chungbuk National University College of Medicine, Cheongju, Korea
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Mei-Zahav M, Gendler Y, Bruckheimer E, Prais D, Birk E, Watad M, Goldschmidt N, Soudry E. Topical Propranolol Improves Epistaxis Control in Hereditary Hemorrhagic Telangiectasia (HHT): A Randomized Double-Blind Placebo-Controlled Trial. J Clin Med 2020; 9:jcm9103130. [PMID: 32998220 PMCID: PMC7601781 DOI: 10.3390/jcm9103130] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/18/2020] [Accepted: 09/26/2020] [Indexed: 02/07/2023] Open
Abstract
Epistaxis is a common debilitating manifestation in hereditary hemorrhagic telangiectasia (HHT), due to mucocutaneous telangiectases. The epistaxis can be difficult to control despite available treatments. Dysregulated angiogenesis has been shown to be associated with telangiectases formation. Topical propranolol has demonstrated antiangiogenic properties. We performed a two-phase study, i.e., a double-blind placebo-controlled phase, followed by an open-label phase. The aim of the study was assessment of safety and efficacy of nasal propranolol gel in HHT-related epistaxis. Twenty participants with moderate-severe HHT-related epistaxis were randomized to eight weeks of propranolol gel 1.5%, or placebo 0.5 cc, applied to each nostril twice daily; and continued propranolol for eight weeks in an open-label study. For the propranolol group, the epistaxis severity score (ESS) improved significantly (-2.03 ± 1.7 as compared with -0.35 ± 0.68 for the placebo group, p = 0.009); hemoglobin levels improved significantly (10.5 ± 2.6 to 11.4 ± 2.02 g/dL, p = 0.009); and intravenous iron and blood transfusion requirement decreased. The change in nasal endoscopy findings was not significant. During the open-label period, the ESS score improved significantly in the former placebo group (-1.99 ± 1.41, p = 0.005). The most common adverse event was nasal mucosa burning sensation. No cardiovascular events were reported. Our results suggest that topical propranolol gel is safe and effective in HHT-related epistaxis.
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Affiliation(s)
- Meir Mei-Zahav
- Pulmonary Institute, Schneider Children’s Medical Center of Israel, Petah Tikva 49202, Israel; (Y.G.); (D.P.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (E.B.); (E.B.); (M.W.); (E.S.)
- The National HHT Center, Pulmonary Institute, Schneider CMCI, 14 Kaplan St., Petach Tikva 49202, Israel
- Correspondence:
| | - Yulia Gendler
- Pulmonary Institute, Schneider Children’s Medical Center of Israel, Petah Tikva 49202, Israel; (Y.G.); (D.P.)
- The Department of Nursing, Ariel University, Ariel 40700, Israel
| | - Elchanan Bruckheimer
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (E.B.); (E.B.); (M.W.); (E.S.)
- Cardiology Department, Schneider Children’s Medical Center of Israel, Petah Tikva 49202, Israel
| | - Dario Prais
- Pulmonary Institute, Schneider Children’s Medical Center of Israel, Petah Tikva 49202, Israel; (Y.G.); (D.P.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (E.B.); (E.B.); (M.W.); (E.S.)
- The National HHT Center, Pulmonary Institute, Schneider CMCI, 14 Kaplan St., Petach Tikva 49202, Israel
| | - Einat Birk
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (E.B.); (E.B.); (M.W.); (E.S.)
- Cardiology Department, Schneider Children’s Medical Center of Israel, Petah Tikva 49202, Israel
| | - Muhamad Watad
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (E.B.); (E.B.); (M.W.); (E.S.)
| | - Neta Goldschmidt
- Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem 91120, Israel;
| | - Ethan Soudry
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel; (E.B.); (E.B.); (M.W.); (E.S.)
- Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center, Petah Tikva 49202, Israel
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Zeng Z, Chen H, Cai J, Huang Y, Yue J. IL-10 regulates the malignancy of hemangioma-derived endothelial cells via regulation of PCNA. Arch Biochem Biophys 2020; 688:108404. [PMID: 32416101 DOI: 10.1016/j.abb.2020.108404] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 12/13/2022]
Abstract
Hemangioma (HA) is the most common benign tumor and formed by the proliferating endothelial cells of blood vessels. Interleukins (ILs) have been reported to be critical for HA progression. Our present study found that the expression of IL-10 was decreased in HA cells and tissues as compared to their corresponding controls. Treatment with recombinant IL-10 (rIL-10) can suppress the proliferation of HA cells via suppression of proliferating cell nuclear antigen (PCNA), while over expression of PCNA can attenuate rIL-10-inhibited cell proliferation. Further, rIL-10 can decrease the promoter activity and mRNA stability of PCNA in HA cells. Mechanistically, rIL-10 can increase expression of miR-27b-3p to decrease mRNA stability of PCNA, while down regulation of YY1 is involved in rIL-10 suppressed transcription of PCNA. Collectively, IL-10 can suppress the expression of PCNA via miR-27b-3p mediated suppression of mRNA stability and YY1 mediated down regulation of transcription. It suggested that rIL-10 might be a potential therapeutic approach for HA development and progression.
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Affiliation(s)
- Zhaofan Zeng
- Department of Vascular Surgery, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, 570311, Hainan Province, PR China
| | - Hao Chen
- Department of Vascular Surgery, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, 570311, Hainan Province, PR China
| | - Junhong Cai
- Molecular Laboratory Center, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, 570311, Hainan Province, PR China
| | - Yanjing Huang
- Department of Medical Oncology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, 570311, Hainan Province, PR China
| | - Jie Yue
- Department of Cardiovascula Surgery, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, Guangdong Province, PR China.
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Dachlan I, Wahdini SI, Putri IL, Seswandhana MR, Wicaksana A, Fauzi AR. Integrated propranolol, methylprednisolone, and surgery in managing a rare case of infantile hemangioma with concurrent cleft lip and palate. Ann Med Surg (Lond) 2020; 56:91-94. [PMID: 32612824 PMCID: PMC7322350 DOI: 10.1016/j.amsu.2020.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 11/26/2022] Open
Abstract
Infantile hemangioma (IH) with concurrent cleft lip and palate is a rare case. Surgical management is often considered as the best management for infantile hemangioma with concurrent cleft lip and palate. However, considering the functionality aspect and aesthetic appearance, a plastic surgeon can also consider non-surgical management without interrupting the surgical timeline for the cleft lip and palate. This case report aimed to describe the role of oral propranolol and oral methylprednisolone for infantile hemangioma with concurrent cleft lip and palate alongside the surgical management for cleft lip and palate. A 2-month-old presented with complaints of swelling in her right upper nose and cheek along with cleft lip and palate. She was treated with oral propranolol and oral methylprednisolone. Labioplasty was performed when she was three months old. Palatoplasty and nasorraphy were done when she was one year old. A significant reduction of the hemangioma was seen and the corrective procedures showed a good result. The use of propranolol and methylprednisolone for infantile hemangioma in our patient shows a good result even when combined with labioplasty, palatoplasty, and nasorraphy for cleft lip and palate. The management of infantile hemangioma with concurrent cleft lip and palate using oral propranolol and oral methylprednisolone shows a good result with no side effects and can be elaborated with labioplasty, palatoplasty, and nasorraphy, and will not interrupt the cleft lip and palate surgical timeline.
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Affiliation(s)
- Ishandono Dachlan
- Plastic, Reconstructive, and Aesthetic Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia
| | - Siti Isya Wahdini
- Plastic, Reconstructive, and Aesthetic Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia
| | - Indri Lakhsmi Putri
- Plastic, Reconstructive, and Aesthetic Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Airlangga/Airlangga University Hospital, Surabaya, Indonesia
| | - Muhammad Rosadi Seswandhana
- Plastic, Reconstructive, and Aesthetic Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia
| | - Aditya Wicaksana
- Plastic, Reconstructive, and Aesthetic Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia
| | - Aditya Rifqi Fauzi
- Plastic, Reconstructive, and Aesthetic Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia
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Yuan X, Xu Y, Wei Z, Ding Q. CircAP2A2 acts as a ceRNA to participate in infantile hemangiomas progression by sponging miR-382-5p via regulating the expression of VEGFA. J Clin Lab Anal 2020; 34:e23258. [PMID: 32091151 PMCID: PMC7370729 DOI: 10.1002/jcla.23258] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/06/2020] [Accepted: 02/07/2020] [Indexed: 12/14/2022] Open
Abstract
Background Increasing evidences reveal that circular RNAs (circRNAs) play crucial functions in cancer development. However, the expression pattern and roles of circRNAs in infantile hemangiomas (IH) remain unclear. Methods In this study, qRT‐PCR was performed to determine the expression of circAP2A2, miR‐382‐5p, and VEGFA in IH tissues and cell lines. Moreover, MTT assay, colony formation, transwell assay, and Western blot analysis were conducted to assess the function of circAP2A2 or miR‐382‐5p on cell proliferation, and migration in vitro, respectively. Also, dual luciferase assay was used to confirm the interactions among circAP2A2, miR‐382‐5p, and VEGFA. Results CircAP2A2 was confirmed to be highly expressed in IH. CircAP2A2 knockdown or miR‐382‐5p overexpression decreased the proliferation, colony formation, migration, and invasion of HemECs and HUVEC cells. Conclusion CircAP2A2 could promote proliferation and invasion of IH by regulating miR‐382‐5p/VEGFA axis.
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Affiliation(s)
- Xiaoqi Yuan
- The Ningbo Women and Children's Hospital, Ningbo, China
| | - Yanan Xu
- The Ningbo Women and Children's Hospital, Ningbo, China
| | - Zhiqiang Wei
- The Ningbo Women and Children's Hospital, Ningbo, China
| | - Qi Ding
- Department of Diagnosis, Ningbo Diagnostic Pathology Center, Ningbo, China
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Pandey A, Singh A, Ali W, Srivastava A, Gupta A, Kureel SN, Rawat J, Wakhlu A. Evaluation of Effect of Propranolol on Serum Vascular Endothelial Growth Factor and Tissue Inhibitor of Metalloproteinase-2 Levels in Infantile Hemangioma. J Indian Assoc Pediatr Surg 2020; 25:96-102. [PMID: 32139988 PMCID: PMC7020681 DOI: 10.4103/jiaps.jiaps_22_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 05/24/2019] [Accepted: 09/05/2019] [Indexed: 02/05/2023] Open
Abstract
Background: Infantile hemangioma is the most common tumor of infancy. Currently, propranolol is a preferred drug for treating hemangioma. The exact mechanism of action of propranolol is not known. In this study, we attempted to assess whether propranolol has any effect on vascular endothelial growth factor (VEGF) and tissue inhibitor of metalloproteinase-2 (TIMP-2) over a period of time, and if it is there, how long it affects it. Materials and Methods: Propranolol was administered in the dosage of 2–3 mg/kg. The first serum sample was collected before starting the propranolol treatment. Thereafter, samples were collected at monthly intervals up to a total of six samples. The samples were assessed for TIMP-2 and VEGF using enzyme-linked immunosorbent assay kit. Results: The duration of this study was from June 2016 to November 2017. The total number of patients in this study was 15. Thirteen patients responded to treatment. The mean age of patients was 7.1 months. The mean value of baseline VEGF was 0.234 ± 0.059 and that of TIMP-2 was 1.338 ± 0.679. As compared to baseline value, the P value was statistically not significant in any of sequential values. In category-wise analysis, apart from statistically significant value in the 6th month in excellent category and good response category in the 1st month, all other values did not reveal any significant change in VEGF analysis. The analysis of TIMP-2 revealed a significant change in the levels from Sample 2 to Sample 6 in the excellent response group; however, the levels did not show a specific trend either increasing or decreasing. Conclusion: Despite its beneficial action in regression of hemangioma, the exact mechanism is yet to be identified. The exact duration of treatment needs further evaluation.
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Affiliation(s)
- Anand Pandey
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Abhishek Singh
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Wahid Ali
- Department of Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Anurag Srivastava
- Department of Community Medicine, Government Institute of Medical Sciences, Greater Noida, Uttar Pradesh, India
| | - Archika Gupta
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Shiv Narain Kureel
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Jiledar Rawat
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ashish Wakhlu
- Department of Pediatric Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
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Chelleri C, Monzani NA, Gelmetti C, Milani GP, Fossali EF, Galeone C, Cavalli R. Residual Lesions After Pharmacological and Dye-Laser Treatment of Infantile Hemangiomas: Critical Review of 432 Cases. Lasers Surg Med 2019; 52:597-603. [PMID: 31828809 DOI: 10.1002/lsm.23205] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Infantile hemangiomas (IHs) are the most common benign tumors in infanthood. Although they are often self-limiting, management of IHs is still controversial because residual lesions may persist in some cases. The aim of this study is to report our experience with patients affected with IH and investigate the frequency of residual lesions in treated versus untreated patients. STUDY DESIGN/MATERIALS AND METHODS This retrospective observational study enrolled patients with IHs evaluated over the past 10 years. Patients were managed with systemic or local pharmacotherapy, laser therapy, a combination of them, or with observation only. RESULTS A total of 432 patients were included: 71% received one or more therapies for IHs; 75.2% of untreated patients had at least one residual lesion compared with 41.4% of treated patients (P < 0.001). Patients treated with laser therapy or topical timolol had the lowest rate of residual lesions. CONCLUSIONS This rather large case series suggests that IHs management with pharmacotherapy and especially laser therapy is associated with a lower number of residual lesions than observation only. Although propranolol can be very useful to avoid life-threatening complications and severe tissue impairment, laser therapy and topical timolol are potential effective treatments to decrease the incidence of residual lesions, mostly associated with superficial IHs. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
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Affiliation(s)
- Cristina Chelleri
- Department of Pediatric Dermatology, IRCCS Ca' Granda, Ospedale Maggiore Policlinico di Milano, Milan, 20122, Italy
| | - Nicola Adriano Monzani
- Department of Pediatric Dermatology, IRCCS Ca' Granda, Ospedale Maggiore Policlinico di Milano, Milan, 20122, Italy
| | - Carlo Gelmetti
- Department of Pediatric Dermatology, IRCCS Ca' Granda, Ospedale Maggiore Policlinico di Milano, Milan, 20122, Italy
| | - Gregorio Paolo Milani
- Department of Pediatric Emergency, IRCCS Ca' Granda, Ospedale Maggiore Policlinico di Milano, Milan, 20122, Italy
| | - Emilio Filippo Fossali
- Department of Pediatric Emergency, IRCCS Ca' Granda, Ospedale Maggiore Policlinico di Milano, Milan, 20122, Italy
| | - Carlotta Galeone
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, 20122, Italy
| | - Riccardo Cavalli
- Department of Pediatric Dermatology, IRCCS Ca' Granda, Ospedale Maggiore Policlinico di Milano, Milan, 20122, Italy
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WITHDRAWN: Bisphenol S triggers the malignancy of hemangioma cells via regulation of basic fibroblast growth factor. Chem Biol Interact 2019; 315:108866. [PMID: 31669319 DOI: 10.1016/j.cbi.2019.108866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 10/15/2019] [Accepted: 10/21/2019] [Indexed: 01/21/2023]
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Rotter A, de Oliveira ZNP. Das infantile Hämangiom: Pathogenese und Wirkmechanismus von Propranolol. J Dtsch Dermatol Ges 2019; 15:1185-1191. [PMID: 29228484 DOI: 10.1111/ddg.13365_g] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 07/14/2017] [Indexed: 01/13/2023]
Affiliation(s)
- Anita Rotter
- Department of Dermatology, University of São Paulo Medical School, Brazil
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Zhu Y, Wan X, Abliz P. Effects of laser irradiation on growth factors and cell apoptosis of in vitro cultured infant hemangioma endothelial cells. Life Sci 2019; 233:116685. [PMID: 31348947 DOI: 10.1016/j.lfs.2019.116685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/15/2019] [Accepted: 07/22/2019] [Indexed: 01/13/2023]
Abstract
AIMS The present study aimed to investigate the effects of laser irradiation on the growth factors and cell apoptosis of in vitro cultured infant hemangioma endothelial cells. MAIN METHODS Endothelial cells of infant hemangioma were cultured in vitro and irradiated using a variable pulse width 1064 nm Nd:YAG laser and intense pulsed light (IPL), the expression of VEGF, VEGFR-2, bFGF and their mRNAs before and after irradiation were measured by ELISA, western blot, RT-PCR and flow cytometry, and changes in the apoptotic rate of endothelial cells in hemangioma were monitored. KEY FINDINGS The mRNA and protein expressions of VEGF, VEGFR-2, bFGF in hemangioma endothelial cells were inhibited by both Nd:YAG laser and ILP compared to the control cells. The apoptotic rates of hemangioma endothelial cells were also decreased after both laser irradiation treatments in comparison to the blank group. The differences were statistically significant. SIGNIFICANCE Laser irradiation treats hemangioma not only through a selective photothermal mechanism, but also through cytokine signaling pathways.
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Affiliation(s)
- Yalin Zhu
- Department of Dermatology, The first affiliated hospital of Xinjiang Medical University, Urumqi 830054, China
| | - Xuefeng Wan
- Department of Dermatology, The first affiliated hospital of Xinjiang Medical University, Urumqi 830054, China
| | - Palidae Abliz
- Department of Dermatology, The first affiliated hospital of Xinjiang Medical University, Urumqi 830054, China.
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Interleukin-6 (IL-6) triggers the malignancy of hemangioma cells via activation of HIF-1α/VEGFA signals. Eur J Pharmacol 2018; 841:82-89. [PMID: 30342949 DOI: 10.1016/j.ejphar.2018.10.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 10/12/2018] [Accepted: 10/17/2018] [Indexed: 12/14/2022]
Abstract
Hemangioma (HA) is tumor formed by hyper-proliferation of vascular endothelial cells. The roles of interleukins on the progression of HA are not well illustrated. Our present study revealed that the expression of interleukin -6 (IL-6) and IL-8 in HA cells were significantly increased as compared with that in the human umbilical vein endothelial cell (HUVEC) cells. Targeted inhibition of IL-6, while not IL-8, can significantly suppress the proliferation and migration of HA cells. IL-6 treatment can increase the expression of vascular endothelial growth factor A (VEGFA), while had no significant effect on the expression of basic fibroblast growth factor (bFGF), in HA cells. Deletion of VEGFA can abolish IL-6 induced progression of HA, suggesting the essential role of VEGFA in IL-6 induced HA development. The specific inhibitor of hypoxia-inducible factor (HIF)-1α, while not Sp1, NF-κB, or AP1, abolished IL-6 induced VEGFA expression. Over expression of HIF-1α can attenuate anti-IL-6 suppressed expression of VEGFA in HA cells. Furthermore, IL-6 triggered the expression, nuclear translocation, and transcription activities of HIF-1α in HA cells via increasing its binding with the signal transducer and activator of transcription-3 (STAT3). STAT3 inhibitor CPA7 or si-STAT3 can abolish IL-6 induced upregulation of HIF-1α in HDEC cells. Collectively, our study revealed that IL-6 can trigger the malignancy of HA cells via induction of proliferation and migration. The activation of STAT3/HIF-1α/VEGFA signal was essential for this process. It suggested that IL-6/STAT3/HIF-1α/VEGFA signal may represent a novel therapeutic target for human HA treatment.
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Laakkonen JP, Lähteenvuo J, Jauhiainen S, Heikura T, Ylä-Herttuala S. Beyond endothelial cells: Vascular endothelial growth factors in heart, vascular anomalies and placenta. Vascul Pharmacol 2018; 112:91-101. [PMID: 30342234 DOI: 10.1016/j.vph.2018.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 10/16/2018] [Accepted: 10/16/2018] [Indexed: 12/19/2022]
Abstract
Vascular endothelial growth factors regulate vascular and lymphatic growth. Dysregulation of VEGF signaling is connected to many pathological states, including hemangiomas, arteriovenous malformations and placental abnormalities. In heart, VEGF gene transfer induces myocardial angiogenesis. Besides vascular and lymphatic endothelial cells, VEGFs affect multiple other cell types. Understanding VEGF biology and its paracrine signaling properties will offer new targets for novel treatments of several diseases.
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Affiliation(s)
- Johanna P Laakkonen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland.
| | - Johanna Lähteenvuo
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Suvi Jauhiainen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Tommi Heikura
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Seppo Ylä-Herttuala
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland; Science Service Center, Kuopio University Hospital, Kuopio, Finland; Gene Therapy Unit, Kuopio University Hospital, Kuopio, Finland
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Rotter A, de Oliveira ZNP. Infantile hemangioma: pathogenesis and mechanisms of action of propranolol. J Dtsch Dermatol Ges 2017; 15:1185-1190. [PMID: 29193649 DOI: 10.1111/ddg.13365] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Accepted: 07/14/2017] [Indexed: 01/21/2023]
Abstract
Infantile hemangioma (IH) is the most common benign tumor of childhood, with a prevalence of 4 % to 10 %. It is characterized by a proliferative rapid growth phase, which starts after a few weeks of life, followed by a slow regression phase. In IH cases that are potentially disfiguring or life-threatening (10 % to 15 % of all cases), systemic therapy should be promptly initiated. Data source The present study reviews published scientific articles available in reliable electronic databases. Selected were all studies that evaluated the pathogenesis of IH and the mechanisms of action of propranolol. Conclusions The pathogenesis of IH has not been fully elucidated. Studies show that, in the proliferative phase of IH, there is an imbalance of angiogenic factors and an increase in the levels of vascular endothelial growth factor and matrix metalloproteinases 2 and 9. In the regression phase, the levels of these factors decrease, whereas those of antiangiogenic factors, including tissue inhibitors of matrix metalloproteinases, increase. Since 2008, propranolol has become the drug of choice in the treatment of IH, targeting vascular tone, angiogenesis, and apoptosis. Current insights into the pathogenesis of IH allow for the development of new therapeutic strategies.
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Affiliation(s)
- Anita Rotter
- Department of Dermatology, University of São Paulo Medical School, Brazil
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25
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Fu C, Lv R, Xu G, Zhang L, Bi J, Lin L, Liu X, Huo R. Circular RNA profile of infantile hemangioma by microarray analysis. PLoS One 2017; 12:e0187581. [PMID: 29095957 PMCID: PMC5667857 DOI: 10.1371/journal.pone.0187581] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 10/23/2017] [Indexed: 12/13/2022] Open
Abstract
Background Circular RNAs (circRNAs) are a recently identified class of noncoding RNAs that participate in several physiological processes. However, the expression of circRNAs in infantile hemangioma (IH) remains unknown. Methods The profile of circRNAs was assessed by microarray in four pairs of IH and adjacent skin tissues. The expression of circRNAs was validated by quantitative reverse transcription polymerase chain reaction (qRT-PCR). Furthermore, circRNA-microRNAs (miRNA)-mRNA networks were constructed using bioinformatics tools. Results 234 up- and 374 down- regulated circRNAs were identified in IH by microarray. Among them, the expression of two up-regulated circRNAs (hsa_circRNA_100933 and hsa_circRNA_100709) and one down-regulated circRNA (hsa_circRNA_104310) was confirmed by qRT-PCR. In addition, 3,019 miRNA response elements (MREs) of circRNAs were predicted, and two circRNA-miRNA-mRNA networks were constructed, including 100 and 94 target genes of hsa_circRNA_100933 and hsa_circRNA_104310, respectively. GO and pathway analysis showed that both networks participated in angiogenesis and vascular development-related biological processes. Conclusions This is the first study to reveal the profiling of circRNAs in IH and pave the way for further characterization of the role of circRNAs in the pathogenesis of IH.
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Affiliation(s)
- Cong Fu
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Renrong Lv
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Guangqi Xu
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Linfeng Zhang
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Jianhai Bi
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Li Lin
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Xiaowen Liu
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Ran Huo
- Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
- * E-mail:
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26
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Mei-Zahav M, Blau H, Bruckheimer E, Zur E, Goldschmidt N. Topical propranolol improves epistaxis in patients with hereditary hemorrhagic telangiectasia - a preliminary report. J Otolaryngol Head Neck Surg 2017; 46:58. [PMID: 28978360 PMCID: PMC5628419 DOI: 10.1186/s40463-017-0235-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 09/26/2017] [Indexed: 11/17/2022] Open
Abstract
Background Severe epistaxis is often difficult to control in patients with hereditary hemorrhagic telangiectasia (HHT). Propranolol has been shown to have antiangiogenic properties in vitro and in vivo and is commonly used to treat hemangiomas. We present our experience with topical nasal propranolol for the treatment of moderate to severe epistaxis in patients with HHT. Methods Retrospective case series. Six patients with HHT were treated with 0.5 cm3 of 1.5% propranolol gel, applied to each nostril twice daily for at least 12 weeks. Outcome measures were epistaxis severity score (ESS), hemoglobin level, and number of blood transfusions prior to and while on treatment. Local and systemic side effects were recorded. Results The mean duration of treatment was 30 ± 5.6 weeks. A significant improvement in the ESS was found in all patients, with a mean decrease from 6.4 ± 2.1 at treatment onset to 3.5 ± 1.7 at 12 weeks (p = 0.028). Hemoglobin level increased significantly from 8.4 ± 3.1 to 11.0 ± 1.8 g/dL at 12 weeks (p = 0.043). The mean number of blood transfusions decreased from 4.5 ± 4.9 before treatment to 2.5 ± 2.9 at 12 weeks and 0.3 ± 0.8 at 24 weeks, but the difference did not reach statistical significance (p = 0.109 for both). No significant side effects of treatment were recorded. Conclusions These preliminary results suggest that topical propranolol may be effective for the treatment of epistaxis in patients with HHT. A prospective controlled trial is required to confirm our findings.
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Affiliation(s)
- Meir Mei-Zahav
- The National HHT Center, Pulmonary Institute, Schneider Children's Medical Center of Israel, 49202, Petach Tikva, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Hannah Blau
- The National HHT Center, Pulmonary Institute, Schneider Children's Medical Center of Israel, 49202, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Elchanan Bruckheimer
- Cardiology Institutes, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eyal Zur
- Super-Pharm Professional - Central Compounding Pharmacy, Petach Tikva, Israel
| | - Neta Goldschmidt
- Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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Wang N, Chen H, Teng Y, Ding X, Wu H, Jin X. Artesunate inhibits proliferation and invasion of mouse hemangioendothelioma cells in vitro and of tumor growth in vivo. Oncol Lett 2017; 14:6170-6176. [PMID: 29113263 DOI: 10.3892/ol.2017.6986] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 06/09/2017] [Indexed: 01/01/2023] Open
Abstract
Artesunate has been demonstrated to be a novel potential antitumor agent in numerous studies. However, its efficacy in infantile hemangioma is unknown. The aim of the present study was to investigate the role of artesunate in the control of vascular tumor biological behavior and molecular mechanism using mouse hemangioendothelioma endothelial (EOMA) cells and a nude mouse model. Cell viability, apoptosis and invasion were determined by an MTT assay, flow cytometric analysis and Transwell invasion assay, respectively. Reverse transcription-quantitative polymerase chain reaction and western blotting were utilized to examine the expression of genes and proteins. Inoculated EOMA cells were injected into the subcutaneous tissues of nude mice to observe the effect of artesunate therapy on the vascular tumor, an effect that was similar to that of pingyangmycin (PYM). It was identified that artesunate treatment (0-600 µg/ml) inhibited cell growth in a time- and dose-dependent manner. Artesunate at 300 µg/ml significantly reduced the proliferation and invasion of EOMA cells, and significantly decreased the expression of vascular endothelial growth factor (VEGF)-A, VEGFR-1, VEGFR-2 and hypoxia inducible factor-1α over time; caspase-3 was simultaneously upregulated in vitro. Artesunate significantly inhibited tumor growth, and the curative effect was similar to that observed with PYM in vivo. It was concluded that artesunate could effectively inhibit the growth of vascular tumors, and thus could be a novel drug candidate for the treatment of infantile hemangioma.
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Affiliation(s)
- Ning Wang
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Medical University, Yuzhong, Chongqing 400014, P.R. China.,Key Laboratory of Pediatrics in Chongqing, Chongqing Medical University, Yuzhong, Chongqing 400014, P.R. China.,China International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing Medical University, Yuzhong, Chongqing 400014, P.R. China
| | - Hongxia Chen
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Medical University, Yuzhong, Chongqing 400014, P.R. China.,Key Laboratory of Pediatrics in Chongqing, Chongqing Medical University, Yuzhong, Chongqing 400014, P.R. China.,China International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing Medical University, Yuzhong, Chongqing 400014, P.R. China
| | - Yinping Teng
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Medical University, Yuzhong, Chongqing 400014, P.R. China.,Key Laboratory of Pediatrics in Chongqing, Chongqing Medical University, Yuzhong, Chongqing 400014, P.R. China.,China International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing Medical University, Yuzhong, Chongqing 400014, P.R. China
| | - Xionghui Ding
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Medical University, Yuzhong, Chongqing 400014, P.R. China.,China International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing Medical University, Yuzhong, Chongqing 400014, P.R. China
| | - Huan Wu
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Medical University, Yuzhong, Chongqing 400014, P.R. China.,Key Laboratory of Pediatrics in Chongqing, Chongqing Medical University, Yuzhong, Chongqing 400014, P.R. China.,China International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing Medical University, Yuzhong, Chongqing 400014, P.R. China
| | - Xianqing Jin
- Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Medical University, Yuzhong, Chongqing 400014, P.R. China.,Key Laboratory of Pediatrics in Chongqing, Chongqing Medical University, Yuzhong, Chongqing 400014, P.R. China.,China International Science and Technology Cooperation Center for Child Development and Disorders, Chongqing Medical University, Yuzhong, Chongqing 400014, P.R. China.,Department of Neonatal Gastrointestinal Surgery Children's Hospital, Chongqing Medical University, Yuzhong, Chongqing 400014, P.R. China
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28
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Wnęk A, Andrzejewska E, Kobos J, Taran K, Przewratil P. Molecular and immunohistochemical expression of apoptotic proteins Bax, Bcl-2 and Caspase 3 in infantile hemangioma tissues as an effect of propranolol treatment. Immunol Lett 2017; 185:27-31. [PMID: 28279700 DOI: 10.1016/j.imlet.2017.03.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 03/05/2017] [Accepted: 03/05/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Infantile hemangiomas (IHs) are the most common benign tumors of childhood. They are characterized by a unique clinical course with two phases, proliferation and involution, which are followed by regression. The therapy of infantile hemangiomas was revolutionized in 2008 by the introduction of propranolol, however, the mechanism of its influence on hemangiomas remains unclear. METHODS The study included 71 patients with IHs, 27 of whom were treated with propranolol while the remaining 44 were used as a comparative group. The expression of Bcl-2, Bax and Caspase3 was determined with immunohistochemistry and mRNA of Bax, Bcl-2 and Caspase3 were assessed with the use of RT-PCR. RESULTS Both methods revealed a statistically significant decrease in Bcl-2 expression and an increase in Bax in IHs tissues after propranolol treatment. CONCLUSIONS The results obtained for Bax and Bcl-2 proteins may indicate a link between the effect of propranolol and apoptosis. Higher Bax and lower Bcl-2 expression in the propranolol treated group indicates a strong pro- apoptotic action countering any anti-apoptotic activity; apoptosis was indicted in IH tissue as a potential result of propranolol treatment, with potential clinical impact in other tumors.
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Affiliation(s)
- Aneta Wnęk
- Department of Paediatric Surgery and Oncology, Medical University of Lodz, Sporna str. 36/50, 91-738 Lodz, Poland
| | - Ewa Andrzejewska
- Department of Paediatric Surgery and Oncology, Medical University of Lodz, Sporna str. 36/50, 91-738 Lodz, Poland
| | - Józef Kobos
- Department of Developmental Pathology, Medical University of Lodz, Sporna str. 36/50, 91-738 Lodz, Poland
| | - Katarzyna Taran
- Department of Pathology, Medical University of Lodz, Pomorska str. 251, 92-216 Lodz, Poland.
| | - Przemysław Przewratil
- Department of Paediatric Surgery and Oncology, Medical University of Lodz, Sporna str. 36/50, 91-738 Lodz, Poland
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Wang F, Xu R, Xu Q, Cao Y, Lin L, Dang W. Effect of laser therapy on plasma expression of VEGF and bFGF in infants with cutaneous hemangioma. Oncol Lett 2017; 13:1861-1865. [PMID: 28454335 DOI: 10.3892/ol.2017.5640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Accepted: 11/01/2016] [Indexed: 01/21/2023] Open
Abstract
The present study aimed to investigate the effect of laser therapy on the expression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) in the plasma of infants diagnosed with cutaneous hemangioma, in order to identify biomarkers for assessing the clinical efficacy of laser therapy. In total, 109 infants with superficial abdominal hemangioma received laser treatment, of which 74 were diagnosed in the proliferation phase, 20 in the regression phase and 15 in the involution phase. In addition, 10 infants without cutaneous hemangioma were recruited as normal controls. The concentrations of VEGF and bFGF in peripheral plasma samples were measured using ELISAs. Dynamic changes in the VEGF and bFGF concentrations of 23 infants diagnosed in the proliferation phase were compared before and after laser therapy. The plasma concentration of VEGF in the proliferation phase group was significantly higher compared with that in the regression phase, involution phase and normal control groups (all P<0.01), whereas it did not differ significantly among the regression phase, involution phase and normal control groups (all P>0.05). The plasma concentration of bFGF in the proliferation phase group was significantly higher compared with that in the regression phase, involution phase and normal control groups (all P<0.01), while the bFGF level did not differ significantly among the regression phase, involution phase and normal control groups (all P>0.05). Following laser therapy, the plasma concentrations of VEGF and bFGF in infants with cutaneous hemangioma were significantly decreased (both P<0.01). These results suggested that VEGF and bFGF may serve as reliable indexes to evaluate the clinical efficacy of laser therapy for treating infantile cutaneous hemangioma.
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Affiliation(s)
- Fagang Wang
- Department of Aesthetic Plastic and Burn Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Rongjian Xu
- Department of Aesthetic Plastic and Burn Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Qian Xu
- Department of Aesthetic Plastic and Burn Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Yongqian Cao
- Department of Aesthetic Plastic and Burn Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Li Lin
- Department of Aesthetic Plastic and Burn Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
| | - Wei Dang
- Department of Aesthetic Plastic and Burn Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, Shandong 250021, P.R. China
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Liu X, Lv R, Zhang L, Xu G, Bi J, Gao F, Zhang J, Xue F, Wang F, Wu Y, Fu C, Wang Q, Huo R. Long noncoding RNA expression profile of infantile hemangioma identified by microarray analysis. Tumour Biol 2016; 37:10.1007/s13277-016-5434-y. [PMID: 27709553 DOI: 10.1007/s13277-016-5434-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 09/23/2016] [Indexed: 02/05/2023] Open
Abstract
Infantile hemangioma (IH) is one of the most common vascular tumors of childhood. Long noncoding RNAs (lncRNAs) play a critical role in angiogenesis, but their involvement in hemangioma remains unknown. This study aimed to assess the expression profiles of lncRNAs in IH and adjacent normal tissue samples, exploring the biological functions of lncRNAs as well as their involvement in IH pathogenesis. The lncRNA expression profiles were determined by lncRNA microarrays. A total of 1259 and 857 lncRNAs were upregulated and downregulated in IH, respectively, at a fold change cutoff of 2.0 (p < 0.05); in addition, 1469 and 1184 messenger RNAs (mRNAs) were upregulated and downregulated, respectively (fold change cutoff of 2.0; p < 0.05). A total of 292 differentially expressed mRNAs were targeted by the lncRNAs with altered expression in hemangioma, including 228 and 64 upregulated and downregulated, respectively (cutoff of 2.0, p < 0.05). Gene ontology (GO) analyses revealed several angiogenesis-related pathways. An lncRNA-mRNA co-expression network for differentially expressed lncRNAs revealed significant associations of the lncRNAs MEG3, MEG8, FENDRR, and Linc00152 with their related mRNAs. The validation results of nine differentially expressed lncRNAs (MALAT1, MEG3, MEG8, p29066, p33867, FENDRR, Linc00152, p44557_v4, p8683) as well as two mRNAs (FOXF1, EGFL7) indicated that the microarray data correlated well with the QPCR results. Interestingly, MALAT1 knockdown induced apoptosis and S-phase cell cycle arrest in human umbilical vein endothelial cells (HUVECs). Overall, this study revealed the lncRNA expression profile of IH and that lncRNAs likely regulate several genes with important roles in angiogenesis.
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Affiliation(s)
- Xiaowen Liu
- Department of Burn & Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Renrong Lv
- Department of Burn & Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Linfeng Zhang
- Department of Burn & Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Guangqi Xu
- Department of Burn & Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Jianhai Bi
- Department of Burn & Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Feng Gao
- Department of Burn & Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Jian Zhang
- Department of Burn & Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Feng Xue
- Department of Burn & Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Fagang Wang
- Department of Burn & Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Yiliang Wu
- Department of Burn & Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Cong Fu
- Department of Burn & Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China
| | - Qiang Wang
- Department of Burn and Plastic Surgery, Tengzhou Central People's Hospital, Tengzhou, Shandong Province, China
| | - Ran Huo
- Department of Burn & Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong Province, China.
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Tanyildiz HG, Unal EC, Gokce H, Yavuz G, Tacyildiz N, Dincaslan H, Gurman C, Biyikli Z. Serum Basic Fibroblastic Growth Factor Levels in Children with Infantile Hemangioma. Indian J Pediatr 2016; 83:937-40. [PMID: 26816137 DOI: 10.1007/s12098-016-2041-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 01/13/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To determine serum levels of basic fibroblastic growth factor (b-FGF) in hemangioma patients under 2 y of age. METHODS The study group consisted of 43 children with infantile hemangioma and b-FGF levels were analyzed using ELISA. RESULTS The serum b-FGF levels were higher in hemangioma patients than in healthy control individuals (p 0.01). There were no differences between the lesion size, number of lesions, patient age and serum b-FGF levels. CONCLUSIONS Thus, b-FGF is an important growth factor that plays a central role in hemangioma, but determining b-FGF serum levels was not helpful in distinguishing between patients who require treatment and those who do not.
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Affiliation(s)
- Hikmet Gulsah Tanyildiz
- Division of Pediatric Hematology/Oncology, Cebeci Medical Faculty Ankara, Ankara University, Ankara, Turkey.
| | - Emel Cabi Unal
- Division of Pediatric Hematology/Oncology, Cebeci Medical Faculty Ankara, Ankara University, Ankara, Turkey
| | - Hafize Gokce
- Division of Pediatric Hematology/Oncology, Cebeci Medical Faculty Ankara, Ankara University, Ankara, Turkey
| | - Gulsan Yavuz
- Division of Pediatric Hematology/Oncology, Cebeci Medical Faculty Ankara, Ankara University, Ankara, Turkey
| | - Nurdan Tacyildiz
- Division of Pediatric Hematology/Oncology, Cebeci Medical Faculty Ankara, Ankara University, Ankara, Turkey
| | - Handan Dincaslan
- Division of Pediatric Hematology/Oncology, Cebeci Medical Faculty Ankara, Ankara University, Ankara, Turkey
| | - Ceyda Gurman
- Division of Pediatric Hematology/Oncology, Cebeci Medical Faculty Ankara, Ankara University, Ankara, Turkey
| | - Zeynep Biyikli
- Division of Biostatistics, Cebeci Medical Faculty Ankara, Ankara University, Ankara, Turkey
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Przewratil P, Kobos J, Wnęk A, Szemraj J, Wyrzykowski D, Chrzanowska B, Andrzejewska E, Taran K. Serum and tissue profile of VEGF and its receptors VGFR1/R2 in children with infantile hemangiomas on systemic propranolol treatment. Immunol Lett 2016; 175:44-9. [DOI: 10.1016/j.imlet.2016.05.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 04/17/2016] [Accepted: 05/09/2016] [Indexed: 12/15/2022]
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Fowell C, Monaghan A, Nishikawa H. Infantile haemangiomas of the head and neck: current concepts in management. Br J Oral Maxillofac Surg 2016; 54:488-95. [DOI: 10.1016/j.bjoms.2016.02.031] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 02/23/2016] [Indexed: 01/19/2023]
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Abstract
Infantile hemangiomas (IHs) are the most common tumors of childhood. Unlike other tumors, they have the unique ability to involute after proliferation, often leading primary care providers to assume they will resolve without intervention or consequence. Unfortunately, a subset of IHs rapidly develop complications, resulting in pain, functional impairment, or permanent disfigurement. As a result, the primary clinician has the task of determining which lesions require early consultation with a specialist. Although several recent reviews have been published, this clinical report is the first based on input from individuals representing the many specialties involved in the treatment of IH. Its purpose is to update the pediatric community regarding recent discoveries in IH pathogenesis, treatment, and clinical associations and to provide a basis for clinical decision-making in the management of IH.
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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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Filippi L, Dal Monte M, Casini G, Daniotti M, Sereni F, Bagnoli P. Infantile hemangiomas, retinopathy of prematurity and cancer: a common pathogenetic role of the β-adrenergic system. Med Res Rev 2014; 35:619-52. [PMID: 25523517 DOI: 10.1002/med.21336] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The serendipitous demonstration that the nonselective β-adrenergic receptor (β-AR) antagonist propranolol promotes the regression of infantile hemangiomas (IHs) aroused interest around the involvement of the β-adrenergic system in angiogenic processes. The efficacy of propranolol was related to the β2-AR blockade and the consequent inhibition of the production of vascular endothelial growth factor (VEGF), suggesting the hypothesis that propranolol could also be effective in treating retinopathy of prematurity (ROP), a retinal pathology characterized by VEGF-induced neoangiogenesis. Consequent to the encouraging animal studies, a pilot clinical trial showed that oral propranolol protects newborns from ROP progression, even though this treatment is not sufficiently safe. Further, animal studies clarified the role of β3-ARs in the development of ROP and, together with several preclinical studies demonstrating the key role of the β-adrenergic system in tumor progression, vascularization, and metastasis, prompted us to also investigate the participation of β3-ARs in tumor growth. The aim of this review is to gather the recent findings on the role of the β-adrenergic system in IHs, ROP, and cancer, highlighting the fact that these different pathologies, triggered by different pathogenic noxae, share common pathogenic mechanisms characterized by the presence of hypoxia-induced angiogenesis, which may be contrasted by targeting the β-adrenergic system. The mechanisms characterizing the pathogenesis of IHs, ROP, and cancer may also be active during the fetal-neonatal development, and a great contribution to the knowledge on the role of β-ARs in diseases characterized by chronic hypoxia may come from research focusing on the fetal and neonatal period.
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Affiliation(s)
- Luca Filippi
- Neonatal Intensive Care Unit, Medical Surgical Fetal-Neonatal Department, "A. Meyer" University Children's Hospital, Florence, Italy
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The β-adrenergic system as a possible new target for pharmacologic treatment of neovascular retinal diseases. Prog Retin Eye Res 2014; 42:103-29. [DOI: 10.1016/j.preteyeres.2014.06.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 05/30/2014] [Accepted: 06/05/2014] [Indexed: 12/31/2022]
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Belen B, Oguz A, Okur A, Dalgic B. A complication to be aware of: hyperkalaemia following propranolol therapy for an infant with intestinal haemangiomatozis. BMJ Case Rep 2014; 2014:bcr-2014-203746. [PMID: 24842358 DOI: 10.1136/bcr-2014-203746] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Infantile haemangiomas, benign vascular tumours seen in 4-10% of infants are characterised by their spontaneous remission following a 3-9 month period of dynamic growth. Propranolol has been reported to be used as a successful treatment of severe symptomatic infantile haemangiomas. Hyperkalaemia has not been recognised as a serious effect of propranolol since recently. Here, we would like to portray a 2-year-old male patient with intestinal haemangiomatosis who presented with severe hyperkalaemia and was successfully managed with hydration, loop diuretics, potassium binding granules, inhaler β-2 agonists and insulin. To date, this is the first case of intestinal haemangiomatosis complicated with severe hyperkalaemia. Our case suggested the idea of close monitorisation of potassium levels as well as haemodynamic status at the initialisation of the propranolol treatment.
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Affiliation(s)
- Burcu Belen
- Department of Pediatric Hematology and Oncology, Gaziantep Childrens' Hospital, Gaziantep, Turkey
| | - Aynur Oguz
- Department of Pediatric Oncology, Gazi University School of Medicine, Ankara, Turkey
| | - Arzu Okur
- Department of Pediatric Oncology, Gazi University School of Medicine, Ankara, Turkey
| | - Buket Dalgic
- Department of Pediatric Gastroenterology, Gazi University School of Medicine, Ankara, Turkey
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Poralla C, Specht S, Born M, Müller A, Bartmann P, Müller A. Treatment of congenital generalized lymphangiectasia with propranolol in a preterm infant. Pediatrics 2014; 133:e439-42. [PMID: 24446440 DOI: 10.1542/peds.2012-2087] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Generalized lymphangiectasia is a rare congenital disorder characterized by dilated lymphatic vessels with a fatal prognosis, especially in cases with thoracic involvement. We describe the use of propranolol in the therapy of generalized lymphangiectasia in a preterm infant with hydrops fetalis. Propranolol was well tolerated and effective within the first months. It remains to be shown whether propranolol is a treatment option for infants with generalized lymphangiectasia.
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Signaling pathways in the development of infantile hemangioma. J Hematol Oncol 2014; 7:13. [PMID: 24479731 PMCID: PMC3913963 DOI: 10.1186/1756-8722-7-13] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 01/28/2014] [Indexed: 02/05/2023] Open
Abstract
Infantile hemangioma (IH), which is the most common tumor in infants, is a benign vascular neoplasm resulting from the abnormal proliferation of endothelial cells and pericytes. For nearly a century, researchers have noted that IH exhibits diverse and often dramatic clinical behaviors. On the one hand, most lesions pose no threat or potential for complication and resolve spontaneously without concern in most children with IH. On the other hand, approximately 10% of IHs are destructive, disfiguring and even vision- or life-threatening. Recent studies have provided some insight into the pathogenesis of these vascular tumors, leading to a better understanding of the biological features of IH and, in particular, indicating that during hemangioma neovascularization, two main pathogenic mechanisms prevail, angiogenesis and vasculogenesis. Both mechanisms have been linked to alterations in several important cellular signaling pathways. These pathways are of interest from a therapeutic perspective because targeting them may help to reverse, delay or prevent hemangioma neovascularization. In this review, we explore some of the major pathways implicated in IH, including the VEGF/VEGFR, Notch, β-adrenergic, Tie2/angiopoietins, PI3K/AKT/mTOR, HIF-α-mediated and PDGF/PDGF-R-β pathways. We focus on the role of these pathways in the pathogenesis of IH, how they are altered and the consequences of these abnormalities. In addition, we review the latest preclinical and clinical data on the rationally designed targeted agents that are now being directed against some of these pathways.
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Jeltsch M, Leppänen VM, Saharinen P, Alitalo K. Receptor tyrosine kinase-mediated angiogenesis. Cold Spring Harb Perspect Biol 2013; 5:5/9/a009183. [PMID: 24003209 DOI: 10.1101/cshperspect.a009183] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The endothelial cell is the essential cell type forming the inner layer of the vasculature. Two families of receptor tyrosine kinases (RTKs) are almost completely endothelial cell specific: the vascular endothelial growth factor (VEGF) receptors (VEGFR1-3) and the Tie receptors (Tie1 and Tie2). Both are key players governing the generation of blood and lymphatic vessels during embryonic development. Because the growth of new blood and lymphatic vessels (or the lack thereof) is a central element in many diseases, the VEGF and the Tie receptors provide attractive therapeutic targets in various diseases. Indeed, several drugs directed to these RTK signaling pathways are already on the market, whereas many are in clinical trials. Here we review the VEGFR and Tie families, their involvement in developmental and pathological angiogenesis, and the different possibilities for targeting them to either block or enhance angiogenesis and lymphangiogenesis.
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Affiliation(s)
- Michael Jeltsch
- Wihuri Research Institute, Biomedicum Helsinki, University of Helsinki, FIN-00014 Helsinki, Finland
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Chen XD, Ma G, Huang JL, Chen H, Jin YB, Ye XX, Hu XJ, Lin XX. Serum-level changes of vascular endothelial growth factor in children with infantile hemangioma after oral propranolol therapy. Pediatr Dermatol 2013; 30:549-53. [PMID: 23909679 DOI: 10.1111/pde.12192] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Oral propranolol is the first-line therapy for infantile hemangioma (IH), but its mechanism of action remains unclear. The aim of this study was to evaluate the change in serum vascular endothelial growth factor (VEGF) levels in patients with IH who underwent propranolol treatment. The study included 22 patients with IH receiving propranolol treatment. At three time points-before treatment and 1 and 3 months after treatment-blood samples were examined by enzyme-linked immunosorbent assay for serum VEGF expression. The mean serum VEGF concentration in children with proliferative hemangiomas was 395.0 ± 176.7 pg/mL, approximately twice as high as in patients with venous malformations (mean 170.7 pg/mL) and in healthy controls (204.8 pg/mL, p = 0.006). After 1 month of propranolol treatment, the level had fallen 21.6% (p = 0.003), although the downward trend was less obvious after 3 months of treatment (18.0%, p = 0.63). VEGF expression correlated significantly with the lesion size (correlation coefficient [R] = 0.43, p = 0.046), whereas no correlation was observed with age (R = 0.13, p = 0.56). Serum VEGF levels were higher in patients with IH and fell after 1 month of oral propranolol treatment. Similar results, although less pronounced, were found after 3 months of treatment. Lesion volume and serum level of VEGF were significantly correlated.
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Affiliation(s)
- Xiao Dong Chen
- Department of Plastic and Reconstructive Surgery, Jiangsu Province Hospital of Traditional Chinese Medicine, Nanjing, China
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Blanke K, Dähnert I, Salameh A. Role of connexins in infantile hemangiomas. Front Pharmacol 2013; 4:41. [PMID: 23596415 PMCID: PMC3627141 DOI: 10.3389/fphar.2013.00041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Accepted: 03/25/2013] [Indexed: 12/12/2022] Open
Abstract
The circulatory system is one of the first systems that develops during embryogenesis. Angiogenesis describes the formation of blood vessels as a part of the circulatory system and is essential for organ growth in embryogenesis as well as repair in adulthood. A dysregulation of vessel growth contributes to the pathogenesis of many disorders. Thus, an imbalance between pro- and antiangiogenic factors could be observed in infantile hemangioma (IH). IH is the most common benign tumor during infancy, which appears during the first month of life. These vascular tumors are characterized by rapid proliferation and subsequently slower involution. Most IHs regress spontaneously, but in some cases they cause disfigurement and systemic complications, which requires immediate treatment. Recently, a therapeutic effect of propranolol on IH has been demonstrated. Hence, this non-selective β-blocker became the first-line therapy for IH. Over the last years, our understanding of the underlying mechanisms of IH has been improved and possible mechanisms of action of propranolol in IH have postulated. Previous studies revealed that gap junction proteins, the connexins (Cx), might also play a role in the pathogenesis of IH. Therefore, affecting gap junctional intercellular communication is suggested as a novel therapeutic target of propranolol in IH. In this review we summarize the current knowledge of the molecular processes, leading to IH and provide new insights of how Cxs might be involved in the development of these vascular tumors.
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Affiliation(s)
- Katja Blanke
- Department of Pediatric Cardiology, Heart Center Leipzig, University of Leipzig Germany
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45
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Filippi L, Cavallaro G, Fiorini P, Malvagia S, Della Bona M, Giocaliere E, Bagnoli P, Dal Monte M, Mosca F, Donzelli G, la Marca G. Propranolol concentrations after oral administration in term and preterm neonates. J Matern Fetal Neonatal Med 2013. [DOI: 10.3109/14767058.2012.755169] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Cho JH, Han I, Lee MR, Cho HS, Oh JH, Kim HS. Isolation and characterization of endothelial cells from intramuscular hemangioma. J Orthop Sci 2013; 18:137-44. [PMID: 22996814 DOI: 10.1007/s00776-012-0303-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Accepted: 08/16/2012] [Indexed: 01/18/2023]
Abstract
BACKGROUND Intramuscular hemangiomas (IMHs) are benign vascular tumors of deep soft tissue characterized by endothelial cell (EC) proliferation. The purpose of this study was to isolate ECs from IMH, characterize their angiogenic phenotype and functional characteristics, and search for a possible signaling pathway related to IMH development. METHODS EC Isolation from IMH was performed by digestion, filtration, washing, incubation, and purification in sequence. Tie2 expression was compared between ECs from IMH and controls using reverse transcriptase polymerase chain reaction (RT-PCR). Cell invasion and proliferation assays were used to analyze functional responses of ECs to angiopoietin 1 (Ang1) and vascular endothelial growth factor (VEGF). Expression of downstream targets was analyzed using Western blot analysis. RESULTS Isolated ECs showed typical cobblestone appearance under light microscopy and formed capillary-like tubular structures using Matrigel tube-forming assay. RT-PCR of isolated ECs from six patients showed increased expression of Tie2 and VEGF receptor 1 (VEGFR1) compared with control ECs. Tie2 activation by Ang1 compared with VEGFR1 by VEGF resulted in increased EC migration and proliferation. Western blot analysis showed increased Tie2 expression in hemangioma samples compared with normal ECs. Phosphorylated Akt and phosphorylated forkhead box O1 (FOXO1) expression was observed in hemangioma samples only. CONCLUSION EC isolation from IMH could be a useful tool for further research. These results suggest that increased Tie2 expression, via Akt-FOXO1 pathway activation, may play an important role in IMH pathogenesis.
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MESH Headings
- Adolescent
- Adult
- Blotting, Western
- Cell Movement
- Cell Proliferation
- Child
- DNA, Neoplasm/genetics
- Endothelium, Vascular/metabolism
- Endothelium, Vascular/pathology
- Female
- Gene Expression Regulation, Neoplastic
- Hemangioma/genetics
- Hemangioma/metabolism
- Hemangioma/pathology
- Humans
- Immunohistochemistry
- Male
- Muscle Neoplasms/genetics
- Muscle Neoplasms/metabolism
- Muscle Neoplasms/pathology
- Neovascularization, Pathologic/genetics
- Neovascularization, Pathologic/metabolism
- Neovascularization, Pathologic/pathology
- Receptor, TIE-2/biosynthesis
- Receptor, TIE-2/genetics
- Reverse Transcriptase Polymerase Chain Reaction
- Signal Transduction
- Tumor Cells, Cultured
- Young Adult
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Affiliation(s)
- Jae Hwan Cho
- Department of Orthopaedic Surgery, Seoul National University Hospital, 101 Daehangno, Jongno Gu, Seoul 110-744, Republic of Korea
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Abstract
1.Review the key features of the life cycle of infantile hemangiomas.2.Highlight cellular and molecular pathways involved in hemangioma-genesis.3.Discuss theories that may account for hemangioma-genesis.In the past, it was believed that a mother's visual impressions or behavior during pregnancy caused the growth of infantile hemangioma in her unborn child. She might have had an excessive craving for strawberries, witnessed the slaughter of an animal, directly contacted human or animal blood, or mocked a child with a similar birthmark.1 This folklore began to slowly fade once hemangiomas were examined through the light microscope. In 1863, Virchow2 suggested that hemangiomas are composed of proliferating new blood vessels resulting from progressive irritation of tissue. In 1933, Laidlow and Murray3 proposed a phylogenetic origin for hemangiomas and hypothesized that hemangiomas are remnants of vascular tufts functioning as accessory lungs for primitive amphibia. Pack and Miller4 (1950) hypothesized that hemangiomas develop from embryonic islands of angioblastic cells that were isolated from the systemic vasculature during fetal development.
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Masoumi Moghaddam S, Amini A, Morris DL, Pourgholami MH. Significance of vascular endothelial growth factor in growth and peritoneal dissemination of ovarian cancer. Cancer Metastasis Rev 2012; 31:143-62. [PMID: 22101807 PMCID: PMC3350632 DOI: 10.1007/s10555-011-9337-5] [Citation(s) in RCA: 151] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Vascular endothelial growth factor (VEGF) is a key regulator of angiogenesis which drives endothelial cell survival, proliferation, and migration while increasing vascular permeability. Playing an important role in the physiology of normal ovaries, VEGF has also been implicated in the pathogenesis of ovarian cancer. Essentially by promoting tumor angiogenesis and enhancing vascular permeability, VEGF contributes to the development of peritoneal carcinomatosis associated with malignant ascites formation, the characteristic feature of advanced ovarian cancer at diagnosis. In both experimental and clinical studies, VEGF levels have been inversely correlated with survival. Moreover, VEGF inhibition has been shown to inhibit tumor growth and ascites production and to suppress tumor invasion and metastasis. These findings have laid the basis for the clinical evaluation of agents targeting VEGF signaling pathway in patients with ovarian cancer. In this review, we will focus on VEGF involvement in the pathophysiology of ovarian cancer and its contribution to the disease progression and dissemination.
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Affiliation(s)
- Samar Masoumi Moghaddam
- Cancer Research Laboratories, Department of Surgery, St George Hospital, University of New South Wales, Sydney, NSW 2217 Australia
| | - Afshin Amini
- Cancer Research Laboratories, Department of Surgery, St George Hospital, University of New South Wales, Sydney, NSW 2217 Australia
| | - David L. Morris
- Department of Surgery, St George Hospital, University of New South Wales, Sydney, NSW 2217 Australia
| | - Mohammad H. Pourgholami
- Cancer Research Laboratories, Department of Surgery, St George Hospital, University of New South Wales, Sydney, NSW 2217 Australia
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Talaat AA, Elbasiouny MS, Elgendy DS, Elwakil TF. Propranolol treatment of infantile hemangioma: clinical and radiologic evaluations. J Pediatr Surg 2012; 47:707-14. [PMID: 22498385 DOI: 10.1016/j.jpedsurg.2011.10.058] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Revised: 10/21/2011] [Accepted: 10/22/2011] [Indexed: 12/01/2022]
Abstract
BACKGROUND There is no way to predict the size that proliferative infantile hemangiomas (IHs) can reach and to expect the occurrence of complications. Moreover, there are no well-known characteristics that can affect the rate of involution of IHs and to predict its completion. Accordingly, intervention is frequently indicated. Different modalities have been reported for treatment of IHs. The possible mechanisms of action of propranolol on IHs are complex. METHODS Fifty infants presented with 80 IHs treated by oral propranolol at a dose of 2 mg/kg body weight per day. Treatment outcomes were clinically and radiologically evaluated. RESULTS The first noticeable effects on propranolol treatment were the changes in color and softening of IHs, followed by regression of their sizes. The clinically elicited color changes of superficial IHs and superficial components of compound IHs have been objectively proven by statistically significant color clearance (P ≤ .001) and resisting index (P ≤ .01) (∼50% increase) as a good indicator of lower vascular activity within IHs. Moreover, the softening of lesions followed by the clinically elicited regression of sizes of deep IHs and deep components of compound IHs has been objectively proven by statistically significant changes at lesions' thickness (P ≤ .01) (∼50% regression) and resisting index (P ≤ .01) (∼50% increase). CONCLUSIONS Collectively, high efficacy and tolerance of propranolol treatment have been elicited. However, propranolol treatment of IHs is still an issue suitable for more studies to confirm the safety and efficacy of the drug and to investigate whether there are some hemangiomas that are, perhaps, nonresponsive to propranolol treatment.
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Affiliation(s)
- Ahmed A Talaat
- Unit of Clinical Research, Department of Pediatrics, National Research Centre, Cairo, Egypt
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