Serum concentrations of VEGF and bFGF in the course of propranolol therapy of infantile hemangioma in children: Are we closer to understand the mechanism of action of propranolol on hemangiomas?

Autor: Lidia Puchalska-Niedbał, Maciej Bagłaj, Justyna Rajewska-Majchrzak, Katarzyna Fischer, Elzbieta Gawrych, Lidia Babiak-Choroszczak, Anna Walecka, Kaja Giżewska-Kacprzak
Rok vydání: 2018
Předmět:
Vascular Endothelial Growth Factor A
0301 basic medicine
medicine.medical_specialty
Angiogenesis
Vasodilator Agents
Basic fibroblast growth factor
Medicine (miscellaneous)
Propranolol
Gastroenterology
General Biochemistry
Genetics and Molecular Biology

Hemangioma
Lesion
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Internal medicine
Internal Medicine
medicine
Humans
Pharmacology (medical)
Child
Genetics (clinical)
Neovascularization
Pathologic

business.industry
Infant
Ultrasonography
Doppler

medicine.disease
Vascular endothelial growth factor
Vascular endothelial growth factor A
Treatment Outcome
030104 developmental biology
chemistry
Reviews and References (medical)
Fibroblast Growth Factor 2
medicine.symptom
business
030217 neurology & neurosurgery
Vasoconstriction
medicine.drug
Zdroj: Advances in Clinical and Experimental Medicine. 27:703-710
ISSN: 1899-5276
DOI: 10.17219/acem/84800
Popis: Background Propranolol has become the treatment of choice for infantile hemangiomas (IH). Neither the pathogenesis of IH nor the mechanism of action of propranolol on them are well understood. Possible explanations include the inhibition of angiogenesis by decreasing vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF), induction of vascular endothelial cell apoptosis and vasoconstriction. Objectives The aim of the study was to assess serum concentrations of VEGF and bFGF in the course of propranolol therapy of IH in children, and to assess their clinical implications. Material and methods The study included 51 children with IH treated with propranolol. The participants were assessed before, during and after the therapy with Hemangioma Activity Score (HAS), Doppler ultrasound (US) of the lesions, as well as VEGF and bFGF serum concentrations. Results All children showed clinical improvement measured in the HAS. A complete involution of the IH was reported in 32 (63%) children at the time of decision of the gradual withdrawing of propranolol, and in 28 (61%) patients at the end of the treatment (out of 46 patients present at the follow up after 1.5 months). Doppler US at the follow-up showed a complete disappearance of the blood flow in the lesion in 24 (52%) children and its reduction in 12 (26%) children. There was a significant decrease in VEGF and bFGF during and after treatment compared to pretreatment values. There was a correlation between the outcome of the Doppler US and changes in bFGF during and after treatment. Changes in VEGF during treatment did not correlate with changes in the Doppler US. Conclusions Serum concentrations of VEGF and bFGF decreased during the propranolol treatment of IH, which may indicate the effect of propranolol on both. However, the statistical analysis showed their low prognostic value as biochemical markers of propranolol treatment. Clinical evaluation combined with Doppler US is the most valuable method of monitoring the therapy.
Databáze: OpenAIRE