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Sun Y, Zhao J, Meng Y, Luo X, Jiang C, Deng G, Lei S. The prevalence, complications, and risk factors for infantile hemangioma: a systematic review and meta-analysis. Int J Dermatol 2024; 63:737-746. [PMID: 38329175 DOI: 10.1111/ijd.17062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/09/2024] [Accepted: 01/17/2024] [Indexed: 02/09/2024]
Abstract
The epidemiological landscape of infantile hemangioma (IH) has been extensively explored through diverse data sources; however, a scarcity of systematically pooled and quantified evidence from comprehensive global studies persists. In this meta-analysis, we systematically review available literature to elucidate the prevalence, distribution of lesions, complications, and risk factors associated with IH. A meticulous search encompassing the Cochrane Library, PubMed, Embase, and Web of Science identified 3206 records, of which 55 studies met the inclusion criteria. We found that the overall prevalence of IH is 2.8% [95% confidence interval (CI): 1.5-4.4%] (31,274,396 infants), and IH was located more frequently in the head and neck with a prevalence of 47.4% (95% CI: 39.5-55.4%). The overall prevalence of complications of IH is 24.3% (95% CI: 18.6-30.5%), ulceration is 16.0% (95% CI: 10.4-21.2%), bleeding is 5.6% (95% CI: 3.3-8.5%), visual impairment is 5.6% (95% CI: 3.0-8.9%), infection is 2.8% (95% CI: 1.5-4.8%), subglottic obstruction is 1.5% (95% CI: 0.5-3.0%), respectively. Through 27 studies, we have evaluated 35 factors encompassing perinatal factors, socioeconomic factors, maternal complications, drug factors, and antepartum procedures, and identified 18 risk factors that increase the prevalence of IH. These findings can greatly assist clinicians and family members in effectively evaluating the risk of IH, and determining whether pregnant women should undergo intensified monitoring or preventive measures.
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Affiliation(s)
- Yuming Sun
- Department of Plastic and Cosmetic Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Jinhong Zhao
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yu Meng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Xiangya Hospital, Central South University, Changsha, China
- Furong Laboratory, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Xiangyue Luo
- Department of Plastic and Cosmetic Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Chufeng Jiang
- Department of Plastic and Cosmetic Surgery, Xiangya Hospital, Central South University, Changsha, China
| | - Guangtong Deng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Xiangya Hospital, Central South University, Changsha, China
- Furong Laboratory, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, China
| | - Shaorong Lei
- Department of Plastic and Cosmetic Surgery, Xiangya Hospital, Central South University, Changsha, China
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Nifli A, Liakopoulou A, Mourelatou E, Avgoustakis K, Hatziantoniou S. Liposomal propranolol for treatment of infantile hemangioma at compounding pharmacies. J Liposome Res 2024:1-12. [PMID: 38335203 DOI: 10.1080/08982104.2024.2313452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/29/2024] [Indexed: 02/12/2024]
Abstract
Infantile hemangiomas (IH) are common benign soft tissue tumors, frequently affecting infants. While Propranolol Hydrochloride (Pro HCl) has emerged as a promising treatment for IH, its topical application remains challenging due to the need for stable and efficacious carriers. This study investigates the potential of preformulated liposomes as carriers for topical delivery of Pro HCl for the treatment of IH in compounding pharmacies. Liposomes loaded with Pro HCl were prepared using active pharmaceutical ingredient or commercially available propranolol tablets and various dilution media, including Water for Injection (WFI), Dextrose 5%, and NaCl 0.9%. The physicochemical properties of the liposomal formulations (Pro HCl content, encapsulation efficiency, loading capacity, and colloidal stability) were assessed over a 90-day storage at 4 °C. In vitro release kinetics and transdermal permeation of Pro HCl from liposomes were also evaluated. Liposome properties were influenced by the dilution medium. Pro HCl content remained stable in liposomes encapsulating API (Lipo-Pro), regardless of the dilution medium. Lipo-Pro showed sustained drug release over time, suggesting its potential for maintaining therapeutic levels. Pro HCl exhibited enhanced transdermal permeability from Lipo-Pro compared to aqueous solution, indicating its potential for topical IH treatment. Preformulated liposomes offer a stable and effective carrier for Pro HCl, potentially suitable for extemporaneous preparations in compounding pharmacies. Their enhanced transdermal permeability presents a promising alternative for topical IH treatment. This study provides valuable insights into the development of innovative and effective drug delivery strategies for managing IH, with future research focusing on in vivo applications and therapeutic potential.
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Affiliation(s)
- Antigone Nifli
- Laboratory of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
| | - Aggeliki Liakopoulou
- Laboratory of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
| | - Elena Mourelatou
- Department of Health Sciences, School of Life and Health Sciences, Pharmacy Program, University of Nicosia, Nicosia, Cyprus
- Bioactive Molecules Research Center, School of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - Konstantinos Avgoustakis
- Laboratory of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
| | - Sophia Hatziantoniou
- Laboratory of Pharmaceutical Technology, Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
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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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Ziad K, Badi J, Roaa Z, Emily AH. Laser treatment of infantile hemangioma. J Cosmet Dermatol 2023; 22 Suppl 2:1-7. [PMID: 36774645 DOI: 10.1111/jocd.15671] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/10/2023] [Accepted: 01/25/2023] [Indexed: 02/13/2023]
Abstract
BACK GROUNDS AND OBJECTIVE Infantile hemangiomas (IH) are common benign tumors of infancy. Most IH either involute spontaneously or respond to treatment with systemic Beta- blockers, but unfortunately not in all cases. In poor responses or in cases of contra indications for pharmacological treatment, laser treatment poses a very good solution. METHODS As a search strategy and study selection we searched the MEDLINE database via PubMed starting 1982 to June 2022 using a key terms related to interventions for IH (e.g., infantile hemangioma, laser, Beta blockers). RESULTS In this article, we reviewed the published data regarding the use of energy-based devices in treatment of children with IH, and noted our experience over the course of treating dozens of cases over the years. CONCLUSION There are many laser systems used for the treatment of hemangioma and vascular tumors. These laser systems are of different wavelengths and penetration depths, however, they operate by similar mechanisms and in some cases two or more lasers can be applied during the course of treating these lesions.
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Affiliation(s)
- Khamaysi Ziad
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Jiryis Badi
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
| | - Zoabi Roaa
- Clalit Medical Services, Tel Aviv-Yafo, Israel
| | - Avitan-Hersh Emily
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
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Khamaysi Z, Pam N, Zaaroura H, Avitan-Hersh E. Nd:YAG 1064-nm laser for residual infantile hemangioma after propranolol treatment. Sci Rep 2023; 13:7474. [PMID: 37156812 PMCID: PMC10167233 DOI: 10.1038/s41598-023-33870-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/20/2023] [Indexed: 05/10/2023] Open
Abstract
Infantile hemangiomas (IH) are common benign tumors of infancy. Most IH involute, either spontaneously, or secondary to pharmacological treatment with systemic propranolol. Propranolol treatment mostly leads to regression of hemangiomas with satisfactory aesthetic results, but unfortunately not in all cases. To assess the safety and efficacy of long pulsed Nd:YAG 1064 nm laser in treating patients with residual infantile hemangioma after systemic propranolol treatment. This is an open-label prospective cohort study. 30 patients with focal residual IH that had sub-optimal responses to systemic propranolol treatment were enrolled in the study. The patients were treated with 1 to 3 sessions with long pulsed Nd:YAG 1064 nm laser. The maximal response of the IH was assessed using a 4-point scale evaluation scale system. Of the 30 patients enrolled, 18 patients exhibited a great response (> 76% improvement), 10 patients had a good response (> 51-75% improvement), while only 2 patients showed a moderate response (< 50% improvement) to the treatment. No patients had an unsatisfactory response. No serious side effects were observed, and only minor side effects were reported. The treatment with long pulsed Nd:YAG 1064 nm laser for residual IH, which were resistant to systemic propranolol treatment, is safe and effective. Thus, we suggest its use as a second-line treatment for patients with sub-optimal aesthetic results following systemic propranolol.
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Affiliation(s)
- Z Khamaysi
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel.
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel.
| | - N Pam
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
| | - H Zaaroura
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
| | - E Avitan-Hersh
- Department of Dermatology, Rambam Health Care Campus, Haifa, Israel
- Bruce Rappaport Faculty of Medicine, Technion Institute of Technology, Haifa, Israel
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Esposito F, D'Auria D, Ferrara D, Esposito P, Gaglione G, Zeccolini M, Tomà P. Hepatic hemangiomas in childhood: the spectrum of radiologic findings. A pictorial essay. J Ultrasound 2023; 26:261-276. [PMID: 36071345 PMCID: PMC10063746 DOI: 10.1007/s40477-022-00714-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 07/27/2022] [Indexed: 11/26/2022] Open
Abstract
Hepatic hemangiomas (HHs) are the most common benign liver tumors in infancy, but despite their frequent occurrence, their radiologic appearance may be particularly challenging to assess, owing to unique anatomical and development features that distinguish their subtypes in the pediatric population. There are 3 main patterns of the lesions recognized in HHs: focal, multifocal and diffuse. Medical care strategies range from simple observation to surgery, and a timely diagnosis is crucial to establish the most appropriated clinical management and therapy. Ultrasound (US) is typically the first level examination of pediatric vascular anomalies, able to meet a satisfactory diagnosis and has proved very helpful to assess for involution through serial imaging. CT and MRI are second-level methods seldom performed, offering an anatomical panoramic view and clarification when US is non-conclusive. Histologic confirmation is rarely required. HHs show a variable sonographic appearance, with hypoechoic (mostly) or hyperechoic solitary\multifocal mass and wide features. Hepatic vessels assessment reveals an abnormal flow, enlarged vasa, decreased resistive index (RI) values, scarce blood supply distally to lesions and hyper vascular regions inside them. In this pictorial essay, we review HHs subtypes in further details, illustrate US, CT and MRI findings and clarify a recurrent dispute over the existing terminology.
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Affiliation(s)
- Francesco Esposito
- UOSD Diagnostica per Immagini in Emergenza Urgenza, "AORN Santobono-Pausilipon", Children Hospital, 80131, Naples, Italy
| | - Divina D'Auria
- Department of Advanced Biomedical Sciences, University of Naples Federico II Unina, Via S. Pansini, 5, 80131, Naples, Italy.
| | - Dolores Ferrara
- U.O. Radiology, "A.O.R.N. Santobono-Pausilipon" Children Hospital, 80131, Naples, Italy
| | - Pasquale Esposito
- Unit of Pediatrics, "AORN Santobono-Pausillipon" Children Hospital, 80131, Naples, Italy
| | - Giovanni Gaglione
- Pediatric Surgery Unit, "AORN Santobono-Pausilipon" Children Hospital, 80131, Naples, Italy
| | - Massimo Zeccolini
- U.O. Radiology, "A.O.R.N. Santobono-Pausilipon" Children Hospital, 80131, Naples, Italy
| | - Paolo Tomà
- Imaging Department, "Bambino Gesù", Pediatric Hospital Rome, Rome, Italy
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Xie M, Liu J, Zhou P, Xu X, Liu H, Zeng L, Chen F, Zeng Y, Huang H, Peng W, Xiao H, Liu Q. Development of a digital imaging analysis system to evaluate the treatment response in superficial infantile hemangiomas. PLoS One 2023; 18:e0282274. [PMID: 36940202 PMCID: PMC10027214 DOI: 10.1371/journal.pone.0282274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 02/10/2023] [Indexed: 03/21/2023] Open
Abstract
Superficial infantile hemangiomas (IH) are benign vascular tumors common in children characterized by bright red "strawberry" lesions on the skin. In order to optimize the treatment for this disease, there is a need to develop objective tools to assess treatment response. Since a color change in the lesion is a good indicator of treatment response, we have developed a digital imaging system to quantify the values of red, green, and blue (RGB) difference and RGB ratio between the tumor and normal tissue to take into account the variations in color between different skin types. The efficacy of the proposed system in assessing treatment response in superficial IH was evaluated in relation to established visual and biochemical tools used to grade hemangiomas. As the treatment progressed, the RGB ratio was almost 1, while the RGB difference was close to 0, which indicates a good response to treatment. There was a strong correlation between the RGB score and the other visual grading systems. However, the correlation between the RGB scoring system and the biochemical method was weak. These findings suggest that the system can be used clinically to objectively and accurately evaluate disease progression and treatment response in patients diagnosed with superficial IH.
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Affiliation(s)
- Mingfeng Xie
- Jiangxi Provincial Clinical Research Center for Vascular Anomalies, The First Affiliated Hospital of GanNan Medical University, Ganzhou, Jiangxi, China
- Chinese & Western Integrative Medicine Discipline, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
- Jiangxi Key Laboratory of TCM for Prevention and Treatment on Hemangioma, Nanchang, Jiangxi, China
| | - Jianping Liu
- Jiangxi Provincial Clinical Research Center for Vascular Anomalies, The First Affiliated Hospital of GanNan Medical University, Ganzhou, Jiangxi, China
| | - Pingsheng Zhou
- Chinese & Western Integrative Medicine Discipline, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
- Jiangxi Key Laboratory of TCM for Prevention and Treatment on Hemangioma, Nanchang, Jiangxi, China
| | - Xianyun Xu
- Chinese & Western Integrative Medicine Discipline, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
- Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
| | - Haijin Liu
- Jiangxi Provincial Clinical Research Center for Vascular Anomalies, The First Affiliated Hospital of GanNan Medical University, Ganzhou, Jiangxi, China
| | - Linshan Zeng
- Jiangxi Provincial Clinical Research Center for Vascular Anomalies, The First Affiliated Hospital of GanNan Medical University, Ganzhou, Jiangxi, China
| | - Feng Chen
- Jiangxi Provincial Clinical Research Center for Vascular Anomalies, The First Affiliated Hospital of GanNan Medical University, Ganzhou, Jiangxi, China
| | - Yong Zeng
- Jiangxi Provincial Clinical Research Center for Vascular Anomalies, The First Affiliated Hospital of GanNan Medical University, Ganzhou, Jiangxi, China
| | - Haijin Huang
- Jiangxi Provincial Clinical Research Center for Vascular Anomalies, The First Affiliated Hospital of GanNan Medical University, Ganzhou, Jiangxi, China
| | - Wei Peng
- Jiangxi Provincial Clinical Research Center for Vascular Anomalies, The First Affiliated Hospital of GanNan Medical University, Ganzhou, Jiangxi, China
| | - Hui Xiao
- Chinese & Western Integrative Medicine Discipline, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
- Jiangxi Key Laboratory of TCM for Prevention and Treatment on Hemangioma, Nanchang, Jiangxi, China
| | - Qian Liu
- Chinese & Western Integrative Medicine Discipline, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
- Jiangxi Key Laboratory of TCM for Prevention and Treatment on Hemangioma, Nanchang, Jiangxi, China
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Chen H, Li Y. Circular RNA hsa_circ_0000915 promotes propranolol resistance of hemangioma stem cells in infantile haemangiomas. Hum Genomics 2022; 16:43. [PMID: 36167680 PMCID: PMC9513930 DOI: 10.1186/s40246-022-00416-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 09/20/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Propranolol is a first-line clinical drug for infantile haemangiomas (IH) therapy. Nevertheless, resistance to propranolol is observed in some patients with IH. Circular RNAs (circRNAs) has been increasingly reported to act as a pivotal regulator in tumor progression. However, the underlying mechanism of circRNAs in IH remains unclear. METHODS Quantitative real-time polymerase chain reaction was performed to detect Circ_0000915, miR-890 and RNF187 expression. Protein levels were determined using western blot. CCK-8 assay was used to measure cell proliferation. Caspase-3 activity assay and flow cytometry were conducted to determine cell apoptosis. Luciferase reporter assay was carried out to assess the interaction between miR-890 and Circ_0000915 or RNF187. Chromatin immunoprecipitation assay was performed to detect the interaction between STAT3 and Circ_0000915 promoter. Biotin pull-down assay was used to detect the direct interaction between miR-890 and Circ_0000915. In vivo experiments were performed to measure tumor formation. RESULTS Here, we discovered depletion of Circ_0000915 increased propranolol sensitivity of haemangioma derived stem cells (HemSCs) both in vitro and in vivo, whereas forced expression of Circ_0000915 exhibited opposite effects. Mechanistically, Circ_0000915, transcriptionally induced by IL-6/STAT3 pathway, competed with RNF187 for the biding site in miR-890, led to upregulation of RNF187 by acting as a miR-890 "sponge". Furthermore, silence of miR-890 reversed increased propranolol sensitivity of HemSCs due to Circ_0000915 ablation. Moreover, increased Circ_0000915 and RNF187 levels were observed in IH tissues and positively associated with propranolol resistance, miR-890 exhibited an inverse expression pattern. CONCLUSION We thereby uncover the activation of IL-6/STAT3/Circ_0000915/miR-890/RNF187 axis in propranolol resistance of IH, and provide therapeutic implications for patients of IH with propranolol resistance.
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Affiliation(s)
- Hongrang Chen
- Department of Vascular and Thyroid Surgery, Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China
| | - Yongsheng Li
- Department of Vascular and Thyroid Surgery, Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China.
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Mayer JLR, Intzes S, Oza VS, Blei F. How we approach hemangiomas in infants. Pediatr Blood Cancer 2022; 69 Suppl 3:e29077. [PMID: 34151510 DOI: 10.1002/pbc.29077] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 04/09/2021] [Indexed: 12/28/2022]
Abstract
Pediatric oncologists are increasingly involved in the management of benign vascular tumors and their associated life-threatening complications. Hemangiomas are the most common referring diagnosis to multidisciplinary vascular anomalies clinics. However, as contemporary research has revealed, hemangiomas are not a single, easily defined entity but rather a diverse set of related vascular tumors, each having a unique natural history, growth pattern, and response to therapy. This manuscript seeks to illustrate how we evaluate and manage these complex tumors, their complications, and associated syndromes, while remaining ever vigilant for malignant hemangioma mimickers such as soft tissue sarcomas and congenital leukemia.
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Affiliation(s)
- Jennifer L R Mayer
- Vascular Anomalies and Birthmarks Program, Cancer and Blood Disorders Institute, Johns Hopkins All Children's Hospital, St. Petersburg, Florida, USA
| | - Stefanos Intzes
- Pediatric Hematology/Oncology, Providence Sacred Heart Children's Hospital, Spokane, Washington, USA
| | - Vikash S Oza
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, New York, USA
| | - Francine Blei
- Hemangioma and Vascular/Lymphatic Malformations Program, New York University Langone Health, New York, New York, USA
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Peng W, Liu H, Chen J, Zheng Y, Xu X, Tang H, Liu Q. Development and validation of psychological status questionnaire for parents of infantile hemangiomas. Transl Pediatr 2021; 10:3261-3272. [PMID: 35070840 PMCID: PMC8753469 DOI: 10.21037/tp-21-554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/16/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Infantile hemangioma (IH) is the most frequent benign tumor of infancy which impacts the psychological status of parents of affected children. Parental psychological status has a significant effect on the therapeutic effect and long-term prognosis of IH children. However, no standard questionnaires had been established previously to assess the psychological status of Chinese parents of children with IH. METHODS This study prospectively developed and validated a psychological status instrument for the assessment of parents of patients with IH and to identify clinical features with effects on the psychological status. A total of 350 parents completed the 35-item Psychologic Status Questionnaire for parents of Infantile Hemangiomas (IH-PSQ) and provided demographic information. The IH-PSQ was refined via item analysis, validity analysis (including exploratory factor analysis and criterion-related validity) and reliability analysis (including internal consistency reliability, split half reliability, and test-retest reliability). RESULTS The dimensionality of the items was evaluated using factor analysis, with results suggesting 5 factors: anxiety, depression, psychological imbalance, disease shame, and disease fear. The final instrument consists of 4 scales with a total of 23 items. Construct validity was demonstrated and IH-PSQ showed good internal coherence (Cronbach's α: 0.957), good split half reliability (0.971), and good test-retest reliability (correlation coefficient: 0.967). The correlation coefficient between the Self-Rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) of children with IH was 0.874 and 0.754, respectively. Multiple linear regression analysis found that some characteristics will affect the score of IH-PSQ. CONCLUSIONS The IH-PSQ contains 5 dimensions and 23 entries, and with good reliability and validity, can objectively and effectively evaluate the psychological status of IH parents. Certain clinical characteristics of IH families, including parents' own factors (including their monthly income and cultural level) and disease-related factors of affected children (including the duration of illness, tumor size, with or without complications, single or multiple, whether being treated or not), were associated with a greater impact on IH-PSQ.
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Affiliation(s)
- Wei Peng
- Department of Graduate School, China Medical University, Shenyang, China.,Department of Pediatric Surgery, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China.,Department of Clinical Research Center of Vascular Abnormalities of Jiangxi Province, Ganzhou, China
| | - Haijin Liu
- Department of Graduate School, China Medical University, Shenyang, China.,Department of Pediatric Surgery, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China.,Department of Clinical Research Center of Vascular Abnormalities of Jiangxi Province, Ganzhou, China
| | - Jincai Chen
- Department of Orthopedics, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Yanan Zheng
- Department of Medical Psychology, Gannan Medical University, Ganzhou, China
| | - Xianyun Xu
- Department of Basic Medical Science, Gannan Medical University, Ganzhou, China
| | - Hong Tang
- Department of Medical Psychology, Gannan Medical University, Ganzhou, China
| | - Qian Liu
- Department of Graduate School, China Medical University, Shenyang, China.,Department of Graduate School, Jiangxi University of Chinese Medicine, Nanchang, China.,Jiangxi Provincial Key Laboratory of Traditional Chinese Medicine Prevention and Treatment of Hemangioma, Jiangxi University of Chinese Medicine, Nanchang, China
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Shi W, He H, Jiang J, Gao Y, Quan H. Timing and Efficacy of 595-nm Pulsed-Dye Laser Combined with 0.5% Timolol Maleate Solution in the Treatment of Superficial Infantile Hemangiomas. Clin Cosmet Investig Dermatol 2021; 14:1593-1599. [PMID: 34754209 PMCID: PMC8572025 DOI: 10.2147/ccid.s337850] [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: 09/05/2021] [Accepted: 10/19/2021] [Indexed: 11/23/2022]
Abstract
Purpose Infantile hemangioma (IH) is the most common benign tumor in infancy, and superficial IH is the most common type. IH can reportedly resolve spontaneously, but this is associated with complications, such as scars, atrophy, hypopigmentation, telangiectasia, and skin sagging, in 70% of cases. This study explores the safety and feasibility of therapeutic intervention with the 595-nm pulsed-dye laser (PDL) combined with 0.5% timolol maleate solution in superficial IH and compares the difference in efficacy between the early group and the late group. Patients and Methods This retrospective study examined 167 patients with superficial IH who underwent combination therapy at the Dermatology Clinic of the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University between July 2019 and July 2020. The early and late groups were composed of children aged ≤2 and >2 months, respectively. Treatment was administered for 6 months, and patients were followed up for another 6 months. Two independent, double-blinded physicians reviewed photographs of the skin lesions before and after treatment to evaluate efficacy. Results The early group demonstrated higher treatment efficacy than the late group. The early (n = 45) and late (n = 122) groups had treatment efficacy rates of 95.5% and 86.1%, respectively; the difference was statistically significant (P< 0.05). The early and late groups underwent 3.51 ± 0.50 and 4.73 ± 0.68 months of treatment, respectively; the difference was statistically significant (P< 0.05). Seventeen (44.4%) patients in the early group had immediate adverse reactions but no permanent sequelae, whereas 25 (20.49%) and 13 (10.7%) patients in the late group had immediate and permanent sequelae, respectively. The difference was statistically significant (P<0.05). Conclusion This retrospective study demonstrated that 595-nm PDL combined with 0.5% timolol maleate solution was a safe and effective local treatment for superficial IH. Early treatment required fewer treatments, had better curative effects, and a lower probability of permanent sequelae.
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Affiliation(s)
- Weikang Shi
- Department of Dermatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang Province, People's Republic of China
| | - Huiyi He
- Department of Dermatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang Province, People's Republic of China
| | - Jicong Jiang
- Department of Dermatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang Province, People's Republic of China
| | - Yu Gao
- Department of Dermatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang Province, People's Republic of China
| | - Hehe Quan
- Department of Dermatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang Province, People's Republic of China
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USP18 promotes the growth in hemangiomas by regulating PI3K/AKT pathway. Mol Cell Toxicol 2021. [DOI: 10.1007/s13273-021-00146-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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Cuenca-Barrales C, Baselga-Torres E, del Boz-González J, Vicente A, Palencia-Pérez S, Campos-Domínguez M, Valdivieso-Ramos M, Martín-Santiago A, Montserrat-García M, Azón-Masoliver A, Feito-Rodríguez M, Domínguez-Cruz J, Roé-Crespo E, Salas-Márquez C, Giacaman A, Lorente-Lavirgen A, Quintana-Castanedo L, de Vega-Martínez M, García-Doval I, Bernabéu-Wittel J. Baseline Description of the Spanish Academy of Dermatology Infantile Haemangioma Nationwide Prospective Cohort. Comparison of Patients Treated with Propranolol in Routine Clinical Practice with Previous Pivotal Clinical Trial Data. ACTAS DERMO-SIFILIOGRAFICAS 2021. [DOI: 10.1016/j.adengl.2021.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Cuenca-Barrales C, Baselga-Torres E, Del Boz-González J, Vicente A, Palencia-Pérez SI, Campos-Domínguez M, Valdivieso-Ramos M, Martín-Santiago A, Montserrat-García MT, Azón-Masoliver A, Feito-Rodríguez M, Domínguez-Cruz JJ, Roé-Crespo E, Salas-Márquez C, Giacaman A, Lorente-Lavirgen AI, Quintana-Castanedo L, de Vega-Martínez M, García-Doval I, Bernabéu-Wittel J. Baseline description of the Spanish Academy of Dermatology infantile haemangioma nationwide prospective cohort. Comparison of patients treated with propranolol in routine clinical practice with previous pivotal clinical trial data. ACTAS DERMO-SIFILIOGRAFICAS 2021; 112:S0001-7310(21)00198-8. [PMID: 34052200 DOI: 10.1016/j.ad.2021.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/12/2021] [Accepted: 05/17/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND There are several therapeutic options for infantile haemangiomas (IH). Propranolol is used according to a pivotal trial. We aimed to describe the characteristics of IH in clinical practice, including the therapies used, and to compare the characteristics of patients treated with propranolol with those of the trial to assess its external validity. METHODS Consecutive patients attending 12 Spanish hospitals from June 2016 to October 2019 were included (n=601). RESULTS The mean age was 3.9 (SD:1.9) months, with a 2:1 female-to-male ratio. Most IHs were localized (82%, 495), superficial (64%, 383) and located in the face (25%, 157) and trunk (31%, 188). Median size was 17 (IR: 10-30) x 12 (IR: 7-20) mm. Complications were found in 16 (3%) patients. Treatment was initiated for 52% (311). Most patients received timolol (76%, 237); propranolol was reserved for complications or high-risk IHs. Aesthetic impairment was the main reason for starting therapy (64%, 199). Several characteristics of the patients and IHs treated with propranolol are similar to those of the pivotal clinical trial, but 1/3 of IHs did not reach the minimum diameter to meet the inclusion criteria, and important prognostic information was not reported. CONCLUSIONS As most patients receive treatment for aesthetic impairment, there is a need to better understand the aesthetic results of therapies and to increase evidence on the use of timolol, which is currently the most common therapy. Propranolol is being used in a population generally similar to that of the trial; however, this statement cannot be definitely confirmed.
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Affiliation(s)
- C Cuenca-Barrales
- Unidad de investigación, Fundación Piel Sana Academia Española de Dermatología y Venereología, Madrid, España; Departamento de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, España; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, España.
| | - E Baselga-Torres
- Departamento de Dermatología, Hospital Sant Joan de Déu, Barcelona, España; Clínica Dermik, Barcelona, España
| | - J Del Boz-González
- Departamento de Dermatología, Hospital Costa del Sol, Marbella, Málaga, España
| | - A Vicente
- Departamento de Dermatología, Hospital Sant Joan de Déu, Barcelona, España
| | | | | | | | - A Martín-Santiago
- Departamento de Dermatología, Hospital Son Espases, Palma de Mallorca, España
| | - M T Montserrat-García
- Departamento de Dermatología, Hospital Virgen del Rocío, Sevilla, España; Departamento de Dermatología, Hospital Viamed Santa Ángela de la Cruz, Sevilla, España
| | - A Azón-Masoliver
- Departamento de Dermatología, Hospital Sant Joan de Reus, Tarragona, España
| | | | - J J Domínguez-Cruz
- Departamento de Dermatología, Hospital Virgen del Rocío, Sevilla, España; Departamento de Dermatología, Hospital Viamed Santa Ángela de la Cruz, Sevilla, España
| | - E Roé-Crespo
- Departamento de Dermatología, Hospital Santa Creu i Sant Pau, Barcelona, España
| | - C Salas-Márquez
- Departamento de Dermatología, Hospital Costa del Sol, Marbella, Málaga, España
| | - A Giacaman
- Departamento de Dermatología, Hospital Son Espases, Palma de Mallorca, España
| | - A I Lorente-Lavirgen
- Departamento de Dermatología, Hospital Viamed Santa Ángela de la Cruz, Sevilla, España
| | | | - M de Vega-Martínez
- Unidad de investigación, Fundación Piel Sana Academia Española de Dermatología y Venereología, Madrid, España
| | - I García-Doval
- Unidad de investigación, Fundación Piel Sana Academia Española de Dermatología y Venereología, Madrid, España; Departamento de Dermatología, Complexo Hospitalario Universitario de Vigo, España
| | - J Bernabéu-Wittel
- Departamento de Dermatología, Hospital Virgen del Rocío, Sevilla, España; Departamento de Dermatología, Hospital Viamed Santa Ángela de la Cruz, Sevilla, España
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15
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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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16
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Kim JH, Lam JM. Paediatrics: how to manage infantile haemangioma. Drugs Context 2021; 10:dic-2020-12-6. [PMID: 33889196 PMCID: PMC8029639 DOI: 10.7573/dic.2020-12-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/03/2021] [Indexed: 11/21/2022] Open
Abstract
Infantile haemangiomas (IHs) are relatively common benign vascular tumours found in the paediatric population. They have varying sizes and involve different depths in the skin leading to various colours, shapes and textures. Although considered harmless in most cases, they may lead to life-threatening complications or cause permanent disfigurations and organ dysfunction. For problematic IHs, the treatment options include oral and topical beta-blockers, systemic corticosteroids, laser treatment, and surgery. In this narrative review, the treatment options for problematic IH are compared and delivered concisely to facilitate the clinical decisions from practitioners, including those in primary care settings. Oral propranolol is currently considered the first-line intervention for problematic IHs. For superficial lesions, there is robust evidence for the use of topical timolol maleate. Systemic corticosteroids are sometimes used in specific situations such as resistance or contraindications to beta-blockers. Surgical excision can be considered in cases requiring urgent intervention such as airway obstruction; this can be done alongside laser therapies for the removal of residual tissue or when reconstructing areas of deformity. The combination of multiple treatment modalities may lead to a more rapid clinical response.
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Affiliation(s)
- Jason Hs Kim
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Joseph M Lam
- Department of Pediatrics and Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada
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17
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Putilina M, Teplova N, Dvornikov A. Cutaneomeningospinal Angiomatosis (Cobb Syndrome) in a Young Patient. CNS & NEUROLOGICAL DISORDERS-DRUG TARGETS 2021; 20:888-893. [PMID: 33602108 DOI: 10.2174/1871527320666210218083550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/28/2020] [Accepted: 11/17/2020] [Indexed: 11/22/2022]
Abstract
Cobb Syndrome (Spinal Arteriovenous Metameric Syndrome 1-31 (SAMS 1-31)) is a rare, non-hereditary disorder. Approximately 100 cases of CS have been described to date. The actual incidence may be much higher since only symptomatic patients were documented. In particular, post mortem studies suggest a possibly higher incidence of this syndrome. The main clinical manifestations of this syndrome include skin stains of vascular nature on the torso, in combination with spinal vascular malformations localized in one and the same metameric or spinal segment. A rare diagnosis of this syndrome in patients over 18 is probably related to the fact that the disease may be asymptomatic throughout a long period of time [3], while patients may tend to disregard the skin lesions [5,6]. As a result, most publications on this pathology are based on separate case reports [7-9]. Significant variability of clinical manifestations as well as prolonged progress of the disease often cause errors in diagnosis. What follows is a case report of a young patient with Cobb Syndrome, who was admitted to a regional vascular centre with a misdiagnosis of stroke. 20 patients of young age (from 20 to 35 years old), with a diagnosis of stroke, who were admitted to a University Clinic (of the Russian National Research Medical University Named After Pirogov N.I., Moscow). Among this group of patients, a patient with Cobb syndrome was identified. Patient P., of 22 years, presented with acute, intensive cervical spinal pain, predominantly on the right, numbness and weakness in the arms and legs. About 3 weeks before admission to the hospital the patient had ARVI with a fever of up to 37.5°C: two weeks before the onset of symptoms he had undergone extirpation of 2 teeth, for which reason he spent over 2 hours in a forced position with his head thrown back (prolonged overextension in the cervical spine). Multiple skin angiomas on the chest spreading to the shoulder and scapula region. Tetraparesis up to 4 points: tetraparesis in hands with low muscle tone, low reflexes, tetraparesis in legs with high muscle tone, high reflexes. Foot clonus when causing Achilles reflexes. Tremor in the extremities. No plantar reflex pathology detected. Sensitivity disorders in the hands - "the high gloves". No pelvic disorders detected. Given the presence and exacerbation of neurological symptoms and cutaneous angiomas MRI with contrast agent of the cervical spine was recommended. MRimage of an advanced arteriovenous malformation (AVM) of the cervical spinal cord with signs of gliosis and spinal cord oedema at the С2 - С7 level. Endovascular embolization of the AVM in cervical spinal cord was performed. The treatment led to complete reversal of neurological symptoms. In the presence of skin lesions the diagnosis of CS does not present particular difficulties, so in children and young patients with skin angiomatosis it is advisable to conduct a comprehensive examination using selective spinal angiography or MR angiography to exclude arteriovenous malformations in spinal cord.
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Affiliation(s)
- Marina Putilina
- Chair of Clinical Pharmacology, Chair of Dermatology and Venereology, Russian National Research Medical University Named After Pirogov N.I., Moscow. Russian Federation
| | - Nataliya Teplova
- Chair of Clinical Pharmacology, Chair of Dermatology and Venereology, Russian National Research Medical University Named After Pirogov N.I., Moscow. Russian Federation
| | - Anton Dvornikov
- Chair of Clinical Pharmacology, Chair of Dermatology and Venereology, Russian National Research Medical University Named After Pirogov N.I., Moscow. Russian Federation
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Koh SP, Leadbitter P, Smithers F, Tan ST. β-blocker therapy for infantile hemangioma. Expert Rev Clin Pharmacol 2021; 13:899-915. [PMID: 32662682 DOI: 10.1080/17512433.2020.1788938] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Fifteen percent of proliferating infantile hemangioma (IH) require intervention because of the threat to function or life, ulceration, or tissue distortion. Propranolol is the mainstay treatment for problematic proliferating IH. Other β-blockers and angiotensin-converting enzyme (ACE) inhibitors have been explored as alternative treatments. AREAS COVERED The demonstration of a hemogenic endothelium origin of IH, with a neural crest phenotype and multi-lineage differentiation capacity, regulated by the renin-angiotensin system, underscores its programmed biologic behavior and accelerated involution induced by propranolol, other β-blockers and ACE inhibitors. We review the indications, dosing regimens, duration of treatment, efficacy and adverse effects of propranolol, and therapeutic alternatives including oral atenolol, acebutolol, nadolol, intralesional propranolol injections, topical propranolol and timolol, and oral captopril. EXPERT OPINION Improved understanding of the biology of IH provides insights into the mechanism of action underscoring its accelerated involution induced by propranolol, other β-blockers and ACE inhibitors. More research is required to understand the optimal dosing and duration, efficacy and safety of these alternative therapies. Recent demonstration of propranolol's actions mediated by non-β-adrenergic isomer R-propranolol on stem cells, offers an immense opportunity to harness the efficacy of β-blockers to induce accelerated involution of IH, while mitigating their β-adrenergic receptor-mediated adverse effects.
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Affiliation(s)
- Sabrina P Koh
- Gillies McIndoe Research Institute , Wellington, New Zealand
| | - Philip Leadbitter
- Gillies McIndoe Research Institute , Wellington, New Zealand.,Centre for the Study & Treatment for Vascular Birthmarks, Wellington Regional Plastic, Maxillofacial and Burns Unit, Hutt Hospital , Wellington, New Zealand.,Department of Paediatrics, Hutt Hospital , Wellington, New Zealand
| | - Fiona Smithers
- Centre for the Study & Treatment for Vascular Birthmarks, Wellington Regional Plastic, Maxillofacial and Burns Unit, Hutt Hospital , Wellington, New Zealand
| | - Swee T Tan
- Gillies McIndoe Research Institute , Wellington, New Zealand.,Centre for the Study & Treatment for Vascular Birthmarks, Wellington Regional Plastic, Maxillofacial and Burns Unit, Hutt Hospital , Wellington, New Zealand.,Department of Surgery, The University of Melbourne , Parkville, Victoria, Australia
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19
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Qiu T, Yang K, Dai S, Chen S, Ji Y. Clinical Features of Segmental Infantile Hemangioma: A Prospective Study. Ther Clin Risk Manag 2021; 17:119-125. [PMID: 33536759 PMCID: PMC7850443 DOI: 10.2147/tcrm.s291059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 01/11/2021] [Indexed: 02/05/2023] Open
Abstract
Background Infantile hemangioma (IH) is the most common benign tumor in children. However, few studies have reported the clinical features of segmental IH. We aimed to determine the clinical characteristics of segmental IH and to identify features that may aid clinicians in managing segmental IH. Methods In the cross-sectional prospective study approved by the Ethics Committee of the hospital, children diagnosed with IH were recruited, and information including patient demographics, IH morphology and anatomical location, complications and treatments were recorded and analyzed. Results In total, 153 patients with segmental IH and 1375 patients with nonsegmental IH were enrolled in this study. The average age on the day of the first visit in patients with segmental IH was 3.63±3.23 months. In 69 patients (45.10%), segmental IH was diagnosed at birth. Most segmental IHs (49.67%) occurred in the limbs, while only 22.04% of nonsegmental IHs occurred in the extremities (P<0.001). Thirteen patients (8.50%) with segmental IH had ulceration. Compared with patients with nonsegmental IHs, patients with segmental IHs were more likely to be treated with oral drugs (P<0.001). Conclusion Segmental IHs mainly occur in the extremities and are frequently diagnosed at birth. Segmental IHs are usually accompanied by ulceration, which are more commonly seen in the neck and perineal/perianal/genital areas than nonsegmental IHs. Oral propranolol is prescribed more often in patients with segmental IH than in those with nonsegmental IH.
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Affiliation(s)
- Tong Qiu
- Division of Oncology, Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Kaiying Yang
- Division of Oncology, Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Shiyi Dai
- Division of Oncology, Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Siyuan Chen
- Pediatric Intensive Care Unit, Department of Critical Care Medicine, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
| | - Yi Ji
- Division of Oncology, Department of Pediatric Surgery, West China Hospital of Sichuan University, Chengdu 610041, People's Republic of China
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20
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Khairoun C, Barkat A. Congenital liver hemangioma revealed by cholestasis syndrome: report of a rare case. Pan Afr Med J 2021; 36:192. [PMID: 32952836 PMCID: PMC7467625 DOI: 10.11604/pamj.2020.36.192.21411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 05/02/2020] [Indexed: 11/27/2022] Open
Abstract
Our paper reports a case of hepatic angioma revealed by neonatal cholestasis, thing that has never been reported in the literature to our knowledge. A newborn boy of 25 days of life had cholestatic jaundice since his fifth day of life. During its health assessment, the angioscan detected the presence of multiple hepatic agiomas. The rest of the etiological report returned without any anomaly. Beta-blockers were started with a very good clinical and ultrasonographic evolution after 12 months of treatment.
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Affiliation(s)
- Chaimae Khairoun
- Medical Department of Neonatology Reanimation, The Reference National Centre of Neonatology and Nutrition of Mother and Child, Sick Child Hospital CHU of Rabat, Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco
| | - Amina Barkat
- Medical Department of Neonatology Reanimation, The Reference National Centre of Neonatology and Nutrition of Mother and Child, Sick Child Hospital CHU of Rabat, Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco
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21
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Leung AKC, Lam JM, Leong KF, Hon KL. Infantile Hemangioma: An Updated Review. Curr Pediatr Rev 2021; 17:55-69. [PMID: 32384034 DOI: 10.2174/1573396316666200508100038] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/20/2020] [Accepted: 03/20/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Infantile hemangiomas are the most common vascular tumors of infancy, affecting up to 12% of infants by the first year of life. OBJECTIVE To familiarize physicians with the natural history, clinical manifestations, diagnosis, and management of infantile hemangiomas. METHODS A Pubmed search was conducted in November 2019 in Clinical Queries using the key term "infantile hemangioma". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews published within the past 20 years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article. RESULTS The majority of infantile hemangiomas are not present at birth. They often appear in the first few weeks of life as areas of pallor, followed by telangiectatic or faint red patches. Then, they grow rapidly in the first 3 to 6 months of life. Superficial lesions are bright red, protuberant, bosselated, or with a smooth surface, and sharply demarcated. Deep lesions are bluish and dome-shaped. Infantile hemangiomas continue to grow until 9 to 12 months of age, at which time the growth rate slows down to parallel the growth of the child. Involution typically begins by the time the child is a year old. Approximately 50% of infantile hemangiomas will show complete involution by the time a child reaches age 5; 70% will have disappeared by age 7; and 95% will have regressed by 10 to 12 years of age. The majority of infantile hemangiomas require no treatment. Treatment options include oral propranolol, topical timolol, and oral corticosteroids. Indications for active intervention include hemorrhage unresponsive to treatment, impending ulceration in areas where serious complications might ensue, interference with vital structures, life- or function-threatening complications, and significant disfigurement. CONCLUSION Treatment should be individualized, depending upon the size, rate of growth, morphology, number, and location of the lesion (s), existing or potential complications, benefits and adverse events associated with the treatment, age of the patient, level of parental concern, and the physician's comfort level with the various treatment options. Currently, oral propranolol is the treatment of choice for high-risk and complicated infantile hemangiomas. Topical timolol may be considered for superficial infantile hemangiomas that need to be treated and for complicated infantile hemangiomas in patients at risk for severe adverse events from oral administration of propranolol.
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Affiliation(s)
- Alexander K C Leung
- Department of Pediatrics, The University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Joseph M Lam
- Department of Pediatrics and Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kin F Leong
- Pediatric Institute, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
| | - Kam L Hon
- Department of Paediatrics, The Chinese University of Hong Kong, and Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong
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Duan P, Huang Y, Chen K, Cheng C, Wu Z, Wu Y. 15,16-dihydrotanshinone I inhibits EOMA cells proliferation by interfering in posttranscriptional processing of hypoxia-inducible factor 1. Int J Med Sci 2021; 18:3214-3223. [PMID: 34400891 PMCID: PMC8364454 DOI: 10.7150/ijms.60774] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/21/2021] [Indexed: 02/06/2023] Open
Abstract
Infantile hemangioma (IH), which threatens the physical and mental health of patients, is the most common benign tumor in infants. Previously, we found that 15,16-dihydrotanshinone I (DHTS) was significantly more effective at inhibiting hemangioma proliferation in vitro and in vivo than the first-line treatment propranolol. To investigate the underlying mechanism of DHTS, we used EOMA cells as a model to study the effect of DHTS. We compared the transcriptomes of control and DHTS-treated EOMA cells. In total, 2462 differentially expressed genes were detected between the groups. Kyoto Encyclopedia of Genes and Genomes pathway analysis revealed downregulated activity of the hypoxia-inducible factor 1 alpha (HIF-1α) signaling pathway in EOMA cells following treatment with DHTS. Thus, we investigated HIF-1α expression at protein and mRNA levels. Our results revealed that DHTS downregulated HIF-1α expression by interfering in its posttranscriptional processing, and the RNA-binding protein HuR participated in this mechanism. Our findings provide a basis for clinical transformation of DHTS and insight into pathogenic mechanisms involved in IH.
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Affiliation(s)
- Peiwen Duan
- Department of Pediatric Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,Division of Pediatric Oncology, Shanghai Institute of Pediatric Research, Shanghai, China
| | - Yingying Huang
- Department of Pediatric Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,Department of Reconstructive Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Kai Chen
- Department of Pediatric Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,Division of Pediatric Oncology, Shanghai Institute of Pediatric Research, Shanghai, China
| | - Cheng Cheng
- Department of Pediatric Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,Division of Pediatric Oncology, Shanghai Institute of Pediatric Research, Shanghai, China
| | - Zhixiang Wu
- Department of Pediatric Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,Division of Pediatric Oncology, Shanghai Institute of Pediatric Research, Shanghai, China
| | - Yeming Wu
- Department of Pediatric Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China.,Division of Pediatric Oncology, Shanghai Institute of Pediatric Research, Shanghai, China
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Hartmann F, Lockmann A, Himpel O, Kühnle I, Hensen J, Schön MP, Thoms K. Orale Propranolol‐ und Neodym:YAG‐Farbstofflaser‐Kombinationstherapie infantiler Hämangiome: eine retrospektive Analyse von 30 Kindern mit 48 Hämangiomen. J Dtsch Dermatol Ges 2020; 18:984-994. [DOI: 10.1111/ddg.14184_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 03/27/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Franziska Hartmann
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Göttingen
| | - Anike Lockmann
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Göttingen
| | - Okko Himpel
- Klinik für Kinder‐ und Jugendmedizin Universitätsmedizin Göttingen
| | - Ingrid Kühnle
- Klinik für Kinder‐ und Jugendmedizin Universitätsmedizin Göttingen
| | - Janina Hensen
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Göttingen
| | - Michael P. Schön
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Göttingen
| | - Kai‐Martin Thoms
- Klinik für Dermatologie Venerologie und Allergologie Universitätsmedizin Göttingen
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Hartmann F, Lockmann A, Himpel O, Kühnle I, Hensen J, Schön MP, Thoms KM. Combination therapy of oral propranolol and combined Nd:YAG/pulsed dye laser therapy in infantile hemangiomas: a retrospective analysis of 48 treated hemangiomas in 30 children. J Dtsch Dermatol Ges 2020; 18:984-993. [PMID: 32856787 DOI: 10.1111/ddg.14184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 03/27/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND AIMS Infantile hemangiomas can be successfully treated by both systemic propranolol and neodymium:YAG (Nd:YAG)-dye laser combination therapy. In this retrospective study, the efficacy and safety of sequential and parallel therapy of complicated hemangiomas treated with both methods were evaluated. PATIENTS AND METHODS 30 children with 48 complicated hemangiomas were treated with propranolol and Nd:YAG-dye laser combination therapy. Using photo comparison, the percentage remission rate was evaluated by three investigators on a four-step scale (I: 0-25 %, II: 26-50 %, III: 51-75 % and IV: 76-100 %). RESULTS Eleven children received propranolol and laser therapy in parallel (A), twelve children received laser therapy after propranolol (B) and seven children received propranolol after laser therapy (C). Due to emigration abroad, one child was lost to follow-up. A strong improvement (IV) was observed in 23/29 (79.3 %) of all treated children (A: 90.9 %, B 75 %, C 66.7 %). The mean duration of propranolol therapy in all children was 8.6 months (A: 8.9 months, B: 8.2 months, C: 8.9 months). On average, 2.33 laser treatments were performed per hemangioma (A: 1.95, B: 3.2, C: 1.91). Serious side effects caused by propranolol and laser therapy were not observed. CONCLUSIONS Propranolol and Nd:YAG-dye laser combination therapy can be used sequentially or in parallel safely and effectively. They complement each other in a meaningful manner.
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Affiliation(s)
- Franziska Hartmann
- Department of Dermatology, Venereology and Allergology, University Medical Center Goettingen
| | - Anike Lockmann
- Department of Dermatology, Venereology and Allergology, University Medical Center Goettingen
| | - Okko Himpel
- Department of Pediatrics and Adolescent Medicine, University Medical Center Goettingen
| | - Ingrid Kühnle
- Department of Pediatrics and Adolescent Medicine, University Medical Center Goettingen
| | - Janina Hensen
- Department of Dermatology, Venereology and Allergology, University Medical Center Goettingen
| | - Michael P Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Goettingen
| | - Kai-Martin Thoms
- Department of Dermatology, Venereology and Allergology, University Medical Center Goettingen
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Yu L, Shu H, Xing L, Lv MX, Li L, Xie YC, Zhang Z, Zhang L, Xie YY. Silencing long non‑coding RNA NEAT1 suppresses the tumorigenesis of infantile hemangioma by competitively binding miR‑33a‑5p to stimulate HIF1α/NF‑κB pathway. Mol Med Rep 2020; 22:3358-3366. [PMID: 32945470 PMCID: PMC7453642 DOI: 10.3892/mmr.2020.11409] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 05/20/2020] [Indexed: 02/07/2023] Open
Abstract
Infantile hemangioma (IH) is one of the most common vascular tumors that occurs during childhood, but its pathogenesis is currently not completely understood. Even though lncRNA nuclear paraspeckle assembly transcript 1 (NEAT1) plays vital roles in tumorigenesis of malignant tumors, its roles in IH remain unclear. Therefore, we evaluate the function of lncRNA NEAT1 in IH. Reverse transcription-quantitative PCR indicated that IH tissues exhibited high expression levels of NEAT1 and hypoxia-inducible factor 1α (HIF1α), and low expression levels of the microRNA (miR)-33a-5p. Small interfering RNA-mediated depletion of NEAT1 suppressed hemangioma endothelial cell (HemEC) proliferation, migration and invasion. The data suggested that NEAT1 positively regulated HIF1α expression by sponging miR-33a-5p in HemECs. miR-33a-5p overexpression or HIF1α silencing also acted to suppress HemEC proliferation, migration and invasion. Furthermore, the results indicated that the NEAT1/miR-33a-5p/HIF1α axis regulated the NF-κB signaling pathway. Collectively, the results revealed that depletion of lncRNA NEAT1 suppressed the tumorigenesis of IH by competitively binding miR-33a-5p and thereby stimulating the HIF1α/NF-κB signaling pathway.
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Affiliation(s)
- Li Yu
- Department of Dermatology, Kunming Children's Hospital, Kunming, Yunnan 650228, P.R. China
| | - Hong Shu
- Department of Dermatology, Kunming Children's Hospital, Kunming, Yunnan 650228, P.R. China
| | - Lu Xing
- Department of Dermatology, Kunming Children's Hospital, Kunming, Yunnan 650228, P.R. China
| | - Meng-Xing Lv
- Department of Pathology, Kunming Children's Hospital, Kunming, Yunnan 650228, P.R. China
| | - Li Li
- Department of Institute Pediatrics, Kunming Children's Hospital, Kunming, Yunnan 650228, P.R. China
| | - Yu-Cheng Xie
- Department of Pathology, Kunming Children's Hospital, Kunming, Yunnan 650228, P.R. China
| | - Zhao Zhang
- Department of Dermatology, Kunming Children's Hospital, Kunming, Yunnan 650228, P.R. China
| | - Li Zhang
- Department of Dermatology, Kunming Children's Hospital, Kunming, Yunnan 650228, P.R. China
| | - Yu-Yan Xie
- Department of Dermatology, Kunming Children's Hospital, Kunming, Yunnan 650228, P.R. China
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Influence of Cytochrome P450 2D6 Polymorphisms on the Efficacy of Oral Propranolol in Treating Infantile Hemangioma. BIOMED RESEARCH INTERNATIONAL 2020; 2020:8732871. [PMID: 32219146 PMCID: PMC7081015 DOI: 10.1155/2020/8732871] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 02/21/2020] [Accepted: 02/26/2020] [Indexed: 01/05/2023]
Abstract
Objective The aim of this study is to evaluate the association of genetic polymorphisms in Cytochrome P450 2D6(CYP2D6) and the change in VEGF levels with the response to propranolol in patients with Infantile hemangiomas (IH). Methods IH patients who underwent over six months of propranolol therapy and received oral propranolol only were enrolled. The target dose of propranolol was 1 mg kg-1day-1. Deoxyribonucleic acid was obtained from venous blood leukocytes. Genotypes of CYP2D6 (rs1065852 and rs1135840) were tested by polymerase chain reaction (PCR) and by sequencing the products. Baseline serum VEGF and serum VEGF one month after treatment were measured. The clinical responses after six months of treatment were evaluated. Genotypes of CYP2D6 (rs1065852 and rs1135840) and VEGF levels were compared between good responders and poor-to-moderate responders. Results 72 patients were enrolled in the study. Patients with CYP2D6 (rs1135840) G/G homozygote had the highest response rate to propranolol. No significant association was found between the response rates and CYP2D6 (rs1065852) polymorphism. No significant differences were found in baseline serum VEGF, serum VEGF one month after treatment, and VEGF ratio between good responders and poor-to-moderate responders. Conclusion The response to propranolol treatment in IH patients was associated with the gene polymorphism of CYP2D6 (rs1135840). A low-dose propranolol regimen was effective and safe in young infants with IH. The change of serum VEGF levels after one month's treatment could not be used to predict the response rate to propranolol.
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27
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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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28
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Mahajan R, Ashraf R, Handa S, De D. Pleuri-segmental ipsilateral nonsyndromic infantile hemangioma responding favorably to oral propranolol. Indian Dermatol Online J 2020; 11:645-647. [PMID: 32832465 PMCID: PMC7413448 DOI: 10.4103/idoj.idoj_455_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/08/2019] [Accepted: 01/06/2020] [Indexed: 11/29/2022] Open
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29
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Li MM, Dong CX, Sun B, Lei HZ, Wang YL, Gong YB, Sun LL, Sun ZW. LncRNA-MALAT1 promotes tumorogenesis of infantile hemangioma by competitively binding miR-424 to stimulate MEKK3/NF-κB pathway. Life Sci 2019; 239:116946. [DOI: 10.1016/j.lfs.2019.116946] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 09/27/2019] [Accepted: 10/07/2019] [Indexed: 12/20/2022]
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30
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Subiabre-Ferrer D, García-Rabasco A, Correa-González N, Ortiz-Salvador J, Barreda-Solana M. Role of Magnetic Resonance Image in Children with Lumbosacral and Perineal Hemangiomas: Case Reports and Review of the Literature. ACTAS DERMO-SIFILIOGRAFICAS 2019. [DOI: 10.1016/j.adengl.2018.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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31
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Papel de la resonancia magnética en niños con hemangiomas lumbosacros y perineales: informe de 3 casos clínicos y revisión de la literatura. ACTAS DERMO-SIFILIOGRAFICAS 2019; 110:728-733. [DOI: 10.1016/j.ad.2018.08.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/25/2018] [Accepted: 08/03/2018] [Indexed: 11/22/2022] Open
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Onsoi W, Chaiyarit J, Techasatian L. Common misdiagnoses and prevalence of dermatological disorders at a pediatric tertiary care center. J Int Med Res 2019; 48:300060519873490. [PMID: 31537142 PMCID: PMC7593671 DOI: 10.1177/0300060519873490] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Dermatological disorders are common in general pediatric practice. This study aimed to examine common skin problems and the manner in which they tend to be misdiagnosed. METHODS A cross-sectional study was conducted from January 2015 to December 2016 using medical record data from the Pediatric Dermatological Outpatient Unit at Khon Kaen University, Faculty of Medicine. RESULTS A total of 1551 visits by 769 patients were documented during the study period. A total of 114 presenting diseases were recorded. The most common skin disease in the study population was dermatitis (unspecified) (88/769, 11.4%), followed by atopic dermatitis (76/769, 9.8%) and infantile hemangioma (72/769, 9.3%). There was a total of 55 (48.2%) misdiagnosed diseases. Some unique cutaneous diseases were undiagnosed because of their rarity. However, the percentages of common cutaneous diseases, such as tinea capitis and molluscum contagiosum, which had been misdiagnosed, were also high (62.50% [95% confidence interval = 24.49-91.48] and 71.43% [95% confidence interval = 29.04-96.33], respectively). CONCLUSION A large percentage of misdiagnoses of common cutaneous diseases may be due to general pediatricians being undereducated in the field of dermatology. Accurate recognition and appropriate management of these conditions should be emphasized for educating general pediatricians in the future.
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Affiliation(s)
- Witchuwan Onsoi
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Jitjira Chaiyarit
- Clinical Epidemiology Unit, Faculty of Medicine, Khon Kaen University, Khon Kaen Thailand
| | - Leelawadee Techasatian
- Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Zutt M. Laser treatment of vascular dermatological diseases using a pulsed dye laser (595 nm) in combination with a Neodym:YAG-laser (1064 nm). Photochem Photobiol Sci 2019; 18:1660-1668. [PMID: 31124550 DOI: 10.1039/c9pp00079h] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
There are many vascular anomalies which are often a diagnostic and therapeutic challenge. They are classified in vascular tumors (e.g. infantile hemangioma) or vascular malformations (e.g. port-wine-stain). Moreover there are several other and rare vascular disregulations and diseases in the field of dermatology. Many laser systems focus on the therapy of vascular pathologies. We use a pulsed dye laser (595 nm) on its own or in combination with a Neodym:YAG-laser (1064 nm) to treat those vascular diseases. This paper points out the advantages and side effects of these two laser systems and describes the limitations of those.
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Affiliation(s)
- Markus Zutt
- Department of Dermatology and Allergology, Klinikum Bremen-Mitte, Bremen, Germany.
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Liu Z, Yeo YH, Jackson C, Trimble K. Treatment failure with propranolol for subglottic haemangioma. BMJ Case Rep 2019; 12:12/5/e227135. [PMID: 31088811 DOI: 10.1136/bcr-2018-227135] [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] [Indexed: 12/11/2022] Open
Abstract
The use of propranolol for the treatment of subglottic haemangioma has become hugely popular due to its effectiveness and safety profile. We report a case of 7-month-old boy who presented with stridor and histopathology suggestive of subglottic haemangioma following microlaryngoscopy and bronchoscopy (MLB). However, he did not respond to propranolol treatment. This could be due to an older age of propranolol commencement. In general, early commencement of propranolol is necessary when diagnosis of symptomatic infantile haemangioma is made to achieve maximal improvement in symptoms and prevent further proliferation. There should be a high index of suspicion for subglottic haemangioma in children presenting with chronic biphasic stridor, with early MLB and diagnosis. This will allow early treatment, giving the best chance to avoid our situation.
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Affiliation(s)
- Zhaobo Liu
- Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | - Conor Jackson
- Royal Belfast Hospital for Sick Children, Belfast, UK
| | - Keith Trimble
- Royal Belfast Hospital for Sick Children, Belfast, UK
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Wildgruber M, Sadick M, Müller-Wille R, Wohlgemuth WA. Vascular tumors in infants and adolescents. Insights Imaging 2019; 10:30. [PMID: 30868300 PMCID: PMC6419671 DOI: 10.1186/s13244-019-0718-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 02/12/2019] [Indexed: 12/16/2022] Open
Abstract
Malignant vascular tumors as part of the vascular anomalies spectrum are extremely rare in children and young adults. Instead, benign vascular neoplasias are frequently encountered in the pediatric patient population. While vascular malformations are congenital vascular lesions, originating from a mesenchymal stem cell defect, vascular tumors are neoplastic transformations of endothelial and other vascular cells. The appropriate differential diagnosis and nomenclature according to the classification of the International Society for the Study of Vascular Anomalies (ISSVA) is decisive to initiate correct therapy. While infantile hemangioma can be routinely diagnosed by clinical means and rarely require therapy, more rare vascular tumors are frequently difficult to diagnose, require dedicated cross-sectional imaging, and benefit from an interdisciplinary treatment approach. The focus of this review is to provide an overview over the spectrum of vascular tumors, typical imaging characteristics, and summarize treatment options including interventional radiology approaches.
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Affiliation(s)
- Moritz Wildgruber
- Institut für Klinische Radiologie, Universitätsklinikum Münster, Albert-Schweitzer Campus 1, 48149, Münster, Germany.
| | - Maliha Sadick
- Institut für Klinische Radiologie und Nuklearmedizin, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - René Müller-Wille
- Institut für Diagnostische und Interventionelle Radiologie, Universitätsmedizin Göttingen, Robert-Koch Strasse 40, 37075, Göttingen, Germany
| | - Walter A Wohlgemuth
- Universitätsklinik und Poliklinik für Radiologie, Ernst-Grube-Strasse 40, 06120, Halle (Saale), Germany
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Moyakine AV, Spillekom-van Koulil S, Küpers EM, van der Vleuten CJM. Influence of infantile hemangioma severity and activity on QoL of patients and their parents: A cross-sectional study. Pediatr Dermatol 2018; 35:628-634. [PMID: 30015356 DOI: 10.1111/pde.13599] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Quality of life (QoL) data are lacking in children with infantile hemangioma (IH) and their parents/caregivers. Available data are conflicting. OBJECTIVES To determine QoL of (parents of) patients with IH in the proliferative phase related to IH-severity and activity. METHODS Parents of 59 IH-patients (≤ 6 months) were asked to fill in the Dutch IH-specific QoL-questionnaire (D-IH-QoL) within 1 month after their first visit to our tertiary referral center. Hemangioma Severity Scale (HSS) score and Hemangioma Activity Score (HAS) were assessed. RESULTS D-IH-QoL-scores were low; mean: 22.6 (range 1-56; max 116). Mean HSS score and HAS score were 8.4 (range 2-28) and 4.0 (range 1.5-6), respectively. Higher HSS scores correlated with worse QoL (ρ = .358; P = .005). HAS scores did not correlate with QoL scores. CONCLUSION An IH only seems to have limited influence on QoL in young children and their parents in the first month of their first doctor's visit. QoL is more affected in more severe IH. Physicians should be alert to the impact of IH, optionally guided by the HSS score.
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Affiliation(s)
- Andre V Moyakine
- Department of Dermatology, Radboudumc Expertise Center for Hemangioma and Vascular Malformations Hecovan, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Elselien M Küpers
- Department of Pediatrics, Gelderse Vallei Hospital, Ede, The Netherlands
| | - Catharina J M van der Vleuten
- Department of Dermatology, Radboudumc Expertise Center for Hemangioma and Vascular Malformations Hecovan, Radboud University Medical Center, Nijmegen, The Netherlands
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Abstract
BACKGROUND Circular RNAs (circRNAs) have emerged as a novel class of widespread non-coding RNAs, and they play crucial roles in various biological processes. However, the characterization and function of circRNAs in infantile hemangioma (IH) remain elusive. METHODS In this study, we used RNA-Seq and circRNA prediction to study and characterize the circRNAs in IH tissue and a matched normal skin control. Specific circRNAs were verified using real-time polymerase chain reaction. RESULTS AND CONCLUSION We found that of the 9811 identified circRNAs, 249 candidates were differentially expressed, including 124 upregulated and 125 downregulated circRNAs in the IH group compared with the matched normal skin control group. A set of differentially expressed circRNAs (in particular, hsa_circRNA001885 and hsa_circRNA006612 expression) were confirmed using qRT-PCR. Gene ontology and pathway analysis revealed that compared to matched normal skin tissues, many processes that were over-represented in IH group were related to the binding, protein binding, gap junction, and focal adhesion. Specific circRNAs were associated with several micro-RNAs (miRNAs) predicted using miRanda. Altogether, our findings highlight the potential importance of circRNAs in the biology of IH and its response to treatment.
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Li J, Li Q, Chen L, Gao Y, Zhou B, Li J. Competitive endogenous RNA networks: integrated analysis of non-coding RNA and mRNA expression profiles in infantile hemangioma. Oncotarget 2018; 9:11948-11963. [PMID: 29552284 PMCID: PMC5844720 DOI: 10.18632/oncotarget.23946] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 12/30/2017] [Indexed: 01/04/2023] Open
Abstract
Infantile hemangioma (IH) is the most common vascular tumour in infants. The pathogenesis of IH is complex and poorly understood. Therefore, achieving a deeper understanding of IH pathogenesis is of great importance. Here, we used the Ribo-Zero RNA-Seq and HiSeq methods to examine the global expression profiles of protein-coding transcripts and non-coding RNAs, including miRNAs and lncRNAs, in IH and matched normal skin controls. Bioinformatics assessments including gene ontology (GO) and kyoto encyclopedia of genes and genomes (KEGG) pathway analyses were performed. Of the 16370 identified coding transcripts, only 144 were differentially expressed (fold change ≥ 2, P ≤ 0.05), including 84 up-regulated and 60 down-regulated transcripts in the IH samples compared with the matched normal skin controls. Gene ontology analysis of these differentially expressed transcripts revealed 60 genes involved in immune system processes, 62 genes involved in extracellular region regulation, and 35 genes involved in carbohydrate derivative binding. In addition, 256 lncRNAs and 142 miRNAs were found to be differentially expressed. Of these, 177 lncRNAs and 42 miRNAs were up-regulated in IH, whereas 79 lncRNAs and 100 miRNAs were down-regulated. By analysing the Ribo-Zero RNA-Seq data in combination with the matched miRNA profiles, we identified 1256 sponge modulators that participate in 87 miRNA-mediated, 70 lncRNA-mediated and 58 mRNA-mediated interactions. In conclusion, our study uncovered a competitive endogenous RNA (ceRNA) network that could further the understanding of the mechanisms underlying IH development and supply new targets for investigation.
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Affiliation(s)
- Jun Li
- Department of Plastic and Cosmetic Surgery, Maternal and Child Health Medical Institute, The Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - Qian Li
- Department of Plastic and Cosmetic Surgery, Maternal and Child Health Medical Institute, The Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - Ling Chen
- Department of Plastic and Cosmetic Surgery, Maternal and Child Health Medical Institute, The Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - Yanli Gao
- Department of Plastic and Cosmetic Surgery, Maternal and Child Health Medical Institute, The Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - Bei Zhou
- Department of Plastic and Cosmetic Surgery, Maternal and Child Health Medical Institute, The Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
| | - Jingyun Li
- Department of Plastic and Cosmetic Surgery, Maternal and Child Health Medical Institute, The Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing 210004, China
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Strumila A, Dagilytė RV, Beiša V. Recommendations and a guideline for referral of infantile haemangioma to tertiary centres. Acta Med Litu 2018; 25:38-44. [PMID: 29928156 PMCID: PMC6008002 DOI: 10.6001/actamedica.v25i1.3702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 02/15/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Infantile haemangioma is the most common childhood vascular tumour, which causes great anxiety to parents and treating first-line physicians due to its proliferative nature. It accounts for a large percentage of a tertiary centre consultations, thus delaying consultation time for patients in need of immediate care. MATERIALS AND METHODS Review of literature and experience of treatment and observation of infantile haemangiomas in a tertiary centre of paediatric surgery. RESULTS Based on the gathered information, we established an observation guideline of infantile haemangiomas for first-line physicians. CONCLUSIONS First-line physicians must recognise the infantile haemangioma that requires immediate referral to a tertiary centre in order to prevent the appearance of associated complications. The remaining population of the patients of infantile haemangioma can be actively monitored once a month for at least a year by the treating pediatrician or family doctor. New and easy to use protocoled diagnostic tests such as thermography would greatly benefit first-line and tertiary-centre physicians in the follow-up of infantile haemangiomas.
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Affiliation(s)
- Arūnas Strumila
- Children’s Hospital, Affiliate of Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | | | - Virgilijus Beiša
- Children’s Hospital, Affiliate of Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Abstract
With a prevalence of 4·5%, infantile haemangiomas are the most common benign tumours of infancy, arising in the first few weeks of life and exhibiting a characteristic sequence of growth and spontaneous involution. Most infantile haemangiomas do not require therapy. However, to identify at-risk haemangiomas, close follow-up is crucial in the first weeks of life; 80% of all haemangiomas reach their final size by 3 months of age. The main indications for treatment are life-threatening infantile haemangioma (causing heart failure or respiratory distress), tumours posing functional risks (eg, visual obstruction, amblyopia, or feeding difficulties), ulceration, and severe anatomic distortion, especially on the face. Oral propranolol is now the first-line treatment, which should be administered as early as possible to avoid potential complications. Haemangioma shrinkage is rapidly observed with oral propranolol, but a minimum of 6 months of therapy is recommended.
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Affiliation(s)
| | - John I Harper
- Department of Paediatric Dermatology, Institute of Child Health and Great Ormond Street Hospital, London, UK
| | - Peter H Hoeger
- Departments of Paediatrics and Paediatric Dermatology, Catholic Children's Hospital Wilhelmstift, Hamburg, Germany
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41
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Hémangiomes infantiles cutanés. Arch Pediatr 2017; 24:592-596. [DOI: 10.1016/j.arcped.2017.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Revised: 03/06/2017] [Accepted: 03/23/2017] [Indexed: 11/22/2022]
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Cazeau C, Blei F, Gonzáles Hermosa MDRF, Cavalli R, Boccara O, Fölster-Holst R, Berdeaux G, Delarue A, Voisard JJ. Burden of Infantile Hemangioma on Family: An International Observational Cross-Sectional Study. Pediatr Dermatol 2017; 34:295-302. [PMID: 28382698 DOI: 10.1111/pde.13133] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND/OBJECTIVES Infantile hemangioma (IH) is the most frequent benign tumor of infancy resulting from vascular proliferation. Data regarding the burden on families of children with IHs are limited. This study aimed to characterize IHs and provide a comprehensive evaluation of the burden of IHs on parents of children requiring systemic treatment in the United States and Europe. METHODS This noninterventional cross-sectional study included infants with newly diagnosed IH requiring systemic treatment. A parent or family member completed two questionnaires (Family Member questionnaire; Hemangioma Family Burden [HFB] questionnaire). RESULTS A total of 693 individuals were evaluable in five countries. IHs were observed in more girls than boys (66%-83% female) and the mean age at inclusion was 0.44 to 1.4 years. Approximately half of patients had superficial IHs, approximately 70% of cases affected the head, and approximately 80% of cases were moderate or severe. Most patients received propranolol treatment. Their child's IH affected more than 70% of parents in each country, but fewer than 10% were offered psychological support. Approximately half of all parents reported that their child's IH affected their professional life. The global HFB score was significantly (p < 0.001) greater with greater IH severity. More than 90% of parents in each country were satisfied with the care of their child's disease. CONCLUSIONS This international study using the validated HFB questionnaire provides further insight into the burden of IH and highlights potential areas for future focus in assisting families with affected children.
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Affiliation(s)
| | - Francine Blei
- North Shore LIJ Healthcare System, New York, New York
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Patrizi A, Neri I, Ricci G, Cipriani F, Ravaioli GM. Advances in pharmacotherapeutic management of common skin diseases in neonates and infants. Expert Opin Pharmacother 2017; 18:717-725. [PMID: 28429969 DOI: 10.1080/14656566.2017.1316371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION neonatal and infantile skin diseases are frequently encountered in the clinical practice and represent worldwide a socioeconomic issue. They encompass a wide range of acquired or congenital conditions, including infections, vascular lesions and inflammatory diseases and can present with different degrees of severity, leading in some cases to dramatic complications. Areas covered: In this paper we report the most recent evidences on the management of some common skin diseases in neonates and infants. Hemangiomas, viral, fungal and bacterial infections, omphalitis, atopic and seborrhoeic dermatitis, napkin disease will be treated and discussed. Expert opinion: The majority of the dermatologic alterations in neonates are physiological, transient and do not require any treatment, thus the parents can be reassured about the good prognosis. However, in some cases, serious conditions must be excluded. In particular neonatal and infantile infections should be promptly recognized and properly managed, to avoid severe complications. The therapeutic options include traditional and, although few, innovative medical treatments, which will be carefully taken into consideration by the expert Dermatologists and Paediatricians.
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Affiliation(s)
- Annalisa Patrizi
- a Dermatology, Department of Experimental, Diagnostic and Specialty Medicine , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - Iria Neri
- a Dermatology, Department of Experimental, Diagnostic and Specialty Medicine , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - Giampaolo Ricci
- b Division of Pediatrics, Department of Medical and Surgical Sciences , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - Francesca Cipriani
- b Division of Pediatrics, Department of Medical and Surgical Sciences , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
| | - Giulia Maria Ravaioli
- a Dermatology, Department of Experimental, Diagnostic and Specialty Medicine , Sant'Orsola-Malpighi Hospital, University of Bologna , Bologna , Italy
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El Hachem M, Gesualdo F, Diociaiuti A, Berti I, Vercellino N, Boccaletti V, Neri I, Porcedda G, Greco A, Carnevale C, Oranges T, Cutrone M, Dalmonte P. Safety and effectiveness of oral propranolol for infantile hemangiomas started before 5 weeks and after 5 months of age: an Italian multicenter experience. Ital J Pediatr 2017; 43:40. [PMID: 28424095 PMCID: PMC5395924 DOI: 10.1186/s13052-017-0357-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 04/08/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Despite not being licensed for the treatment of infantile hemangiomas (IH) in infants younger than 5 weeks or older than 5 months, propranolol is often used in these age groups to prevent or to treat potentially severe complications. The objective of the present study was to review the experience of 8 Italian pediatric and dermatologic centers regarding propranolol treatment for IH started before 5 weeks or after 5 months of age. METHODS We retrospectively reviewed the records of patients followed up for IH, on propranolol treatment started before 5 weeks or after 5 months of age, and collected information on sociodemographic data, treatment indications, IH involution, IH relapse, and treatment side effects. RESULTS A total of 343 patients were enrolled; 15 were started on propranolol before 5 weeks (group 1), 328 were started after 5 months of age (group 2). The most frequent indications were permanent aesthetical disfigurement (91.8%) and function threatening complications (42.6%). In most cases, the treatment was effective. The involution was partial in 67.7% of patients. In 11.8% of cases a relapse was observed. No relapse was observed in group 1. Treatment complications were reported in 15.8% of children, most frequently sleep disorders (6.6%), followed by irritability (5.1%) and diarrhea (2.2%). Only a case of mild constipation was observed in group 1. CONCLUSION The safety and effectiveness profile of propranolol in infants younger than 5 weeks or older than 5 months may be acceptable. Taking in account propranolol's potential in preventing severe complications, further studies should assess the acceptability of propranolol treatment, especially in the <5-week age group .
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Affiliation(s)
- Maya El Hachem
- Pediatric Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Francesco Gesualdo
- Multifactorial and Complex Disease Research Area, Bambino Gesù Children's Hospital IRCCS, Viale Baldelli 41, 00146, Rome, Italy.
| | - Andrea Diociaiuti
- Pediatric Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Irene Berti
- Institute for Maternal and Child Health - IRCCS Burlo Garofolo, Trieste, Italy
| | - Nadia Vercellino
- Angioma Center, Cardiovascular Department, Gaslini Children's Research Institute, Genoa, Italy
| | | | - Iria Neri
- Division of Dermatology, Department of of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Giulio Porcedda
- Pediatric Cardiology Unit, Anna Meyer Children's Hospital, Florence, Italy
| | - Antonella Greco
- Pediatric Cardiology Unit, Anna Meyer Children's Hospital, Florence, Italy
| | - Claudia Carnevale
- Pediatric Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Teresa Oranges
- Pediatric Dermatology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Mario Cutrone
- Pediatric Emergency Department, Ospedale dell'Angelo Ulss12, Venice, Italy
| | - Pietro Dalmonte
- Angioma Center, Cardiovascular Department, Gaslini Children's Research Institute, Genoa, Italy
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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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Piccolo V, Moscarella E, Ametrano O, Picciocchi R, Russo T. Image Gallery: PELVIS syndrome. Br J Dermatol 2017; 176:e14. [PMID: 28244079 DOI: 10.1111/bjd.15283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- V Piccolo
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - E Moscarella
- Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - O Ametrano
- Unit of Pediatric Dermatology, A.O.R.N. Santobono-Pausillipon, Naples, Italy
| | - R Picciocchi
- Unit of Pediatric Dermatology, A.O.R.N. Santobono-Pausillipon, Naples, Italy
| | - T Russo
- Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
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Hartmann F, Lockmann A, Grönemeyer LL, Haenssle HA, Zutt M, von Fintel H, Kühnle I, Schön MP, Thoms KM. Nd:YAG and pulsed dye laser therapy in infantile haemangiomas: a retrospective analysis of 271 treated haemangiomas in 149 children. J Eur Acad Dermatol Venereol 2017; 31:1372-1379. [PMID: 27911476 DOI: 10.1111/jdv.14074] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 11/15/2016] [Indexed: 12/18/2022]
Abstract
BACKGROUND Infantile haemangiomas (IH) are common benign tumours in infancy. Most IH resolve spontaneously, but some require treatment due to ulceration, functional impairment or cosmetic disfiguration. While systemic propranolol is effective in many cases, laser therapy may be a safe topical alternative. OBJECTIVE To assess the efficacy of combined Nd:YAG/pulsed dye laser (PDL) or PDL alone for therapy of IH. PATIENTS AND METHODS A total of 271 IH in 149 infants were treated with combined Nd:YAG/PDL or PDL alone. Based on photographs before and 4-6 weeks after the last treatment, the results were evaluated independently by three physicians. Remissions were categorized as 0-25% (I), 26-50% (II), 51-75% (III) and 76-100% (IV). RESULTS In total, 472 laser treatments were performed. In 137 of 149 infants (91.9%) laser therapy was performed during a short sevoflurane mask anaesthesia, while 12 of 149 infants (8.1%) received topical anaesthetic gel. Combined Nd:YAG/PDL was applied in 187 of 271 IH (69.0%), while PDL alone in 84 of 271 IH (31.0%). On average, 1.74 treatments per IH were necessary (Nd:YAG/PDL: 1.95, PDL: 1.26). Moderate or strong (III/IV) improvement was observed in 92.4% of all IH treated. No serious adverse effects were observed. CONCLUSION Combined Nd:YAG/PDL therapy is an effective and well-tolerated local treatment option for IH of any classification, in any phase of development and at any age. With regard to the systemic use of propranolol, combined Nd:YAG/PDL therapy seems a safe and promising alternative in many cases.
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Affiliation(s)
- F Hartmann
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - A Lockmann
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - L-L Grönemeyer
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - H A Haenssle
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany.,Department of Dermatology, University Hospital Heidelberg, Heidelberg, Germany
| | - M Zutt
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany.,Department of Dermatology and Allergology, Klinikum Bremen Mitte, Bremen, Germany
| | - H von Fintel
- Department of Pediatrics I, University Medical Center, Göttingen, Germany
| | - I Kühnle
- Department of Pediatrics I, University Medical Center, Göttingen, Germany
| | - M P Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
| | - K-M Thoms
- Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany
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Ozeki M, Nozawa A, Hori T, Kanda K, Kimura T, Kawamoto N, Fukao T. Propranolol for infantile hemangioma: Effect on plasma vascular endothelial growth factor. Pediatr Int 2016; 58:1130-1135. [PMID: 26991797 DOI: 10.1111/ped.12981] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 02/03/2016] [Accepted: 03/04/2016] [Indexed: 01/16/2023]
Abstract
BACKGROUND Propranolol has recently been shown to be highly effective for infantile hemangioma (IH), but the mechanism of action of propranolol and the usefulness of measurement of vascular endothelial growth factor (VEGF) remain poorly understood. The aim of this study was therefore to determine the efficacy of propranolol treatment and to evaluate changes in plasma VEGF in IH patients who underwent propranolol treatment. METHODS The study group consisted of 35 children with IH. Oral propranolol was give at a dose of 2.0 mg/kg/day and was divided in three doses. Outcome was assessed using the visual analog scale (VAS) of size and color. Plasma VEGF concentration was analyzed on enzyme-linked immunoabsorbent assay, and compared between the groups. RESULTS Improvement in VAS in patients who started propranolol before 6 months of age was superior to that in those who started propranolol after 6 months of age. VEGF concentration was significantly correlated with lesion size (P = 0.002), whereas no correlation was observed with age. VEGF concentration 4 weeks after treatment was significantly lower than that before treatment (P < 0.01). CONCLUSIONS Measurement of VEGF may be a useful tool for predicting the course of IH and monitoring the effectiveness of treatment.
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Affiliation(s)
- Michio Ozeki
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Akifumi Nozawa
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Tomohiro Hori
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Kaori Kanda
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Takeshi Kimura
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Norio Kawamoto
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Toshiyuki Fukao
- Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan
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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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Torres E, Rosa J, Leaute-Labreze C, Soares-de-Almeida L. Multifocal infantile haemangioma: a diagnostic challenge. BMJ Case Rep 2016; 2016:bcr-2016-214827. [PMID: 27317759 DOI: 10.1136/bcr-2016-214827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We describe a case of a newborn who presented with multiple dark red macules that developed into red-to-purple papules associated with thrombocytopaenia. Abdominal ultrasound showed multiple hyperechoic papules and nodules. Endothelial cells from a skin biopsy stained positively for endothelial cell glucose transporter 1, which was consistent with a diagnosis of multifocal infantile haemangioma. At the age of 2 months, the child developed intestinal bleeding and anaemia. Upper and lower endoscopies showed no intestinal haemangiomas. Oral treatment with propranolol (3 mg/kg/day) resulted in complete involution of the skin and hepatic haemangiomas over the period of treatment, which lasted until the child was aged 15 months. This is a rare case of multifocal cutaneous haemangioma with hepatic and probable intestinal involvement, successfully treated with propranolol.
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Affiliation(s)
- Erica Torres
- Serviço de Pediatria, Hospital Faro, Centro Hospitalar Algarve, Faro, Portugal
| | - João Rosa
- Serviço de Pediatria, Hospital Faro, Centro Hospitalar Algarve, Faro, Portugal
| | | | - Luis Soares-de-Almeida
- Department of Dermatology, Hospital de Santa Maria-Centro Hospitalar de Lisboa Norte, Lisbon, Portugal
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