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

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Author(s)
Meerim ParkHye Lim JungYe Jee ShimHeung Sik KimHoi Soo YoonSang Kyu ParkHee Won CheuhMee Jeong LeeJae Min LeeEun Sil ParkJae Hee LeeYeon-Jung LimYoung Bae Choi
Keimyung Author(s)
Shim, Ye Jee
Department
Dept. of Pediatrics (소아청소년학)
Journal Title
Pediatric Research
Issued Date
2020
Volume
88
Issue
5
Abstract
Background:
Oral propranolol has become first-line treatment for infantile hemangiomas (IHs). This study focused on identifying cytokines related to the biology of IH and early regression indicators of IH after propranolol treatment.

Methods:
For inclusion, the patients had to be aged less than 1 year and have an IH with a largest diameter ≥2 cm. Patients were scheduled to receive 1 year of propranolol treatment. Serum cytokines involved in angiogenesis, vasculogenesis, and/or chronic inflammation were analyzed at 0, 1, and/or 12 months after treatment using Multiplex Luminex assays.

Results:
Among the 49 evaluable patients, 33 completed the 1-year treatment: 16 showed excellent response and 12 had good response to propranolol. Significant decreases in serum MMP-2, bFGF, VEGF-α, and MCP-1 levels were observed after 1 year of treatment compared to pretreatment values. The maximal diameters of the lesions significantly correlated with pretreatment serum VEGF-α, bFGF, and MMP-9. Patients with higher bFGF and VEGF levels showed better response to propranolol at 1 year.

Conclusion:
MMP-2, VEGF-α, bFGF, and MCP-1 may involve in the biology of IH and their downregulation may be associated with involution processes of IH. Pretreatment bFGF and VEGF could be novel biomarkers for predicting response to propranolol.

Impact:
● We found that decreases in the concentrations of MMP-2, bFGF, VEGF, and MCP-1 were associated with regression of the hemangioma, which indicates that one of the mechanisms of propranolol in the treatment of proliferative hemangiomas may involve downregulation of those cytokines.
● Patients with higher bFGF and VEGF levels showed better response to propranolol at 1 year. Importantly, serum bFGF higher than 37.07 pg/mL may predict an excellent response to propranolol. Therefore, along with the patient's age and the size and visual characteristics of the lesion, bFGF levels could help determine the viability of propranolol use in the treatment of IHs.
● Our study represented extensive serum profiling in IH, reporting the indicators and molecules clearly related to IH regression with propranolol treatment. The authors believe that monitoring serum cytokines, including MMP-2, bFGF, VEGF, and MCP-1, in IH patients could be important, in addition to clinical follow-up, for determining when to start and end propranolol treatment.
Keimyung Author(s)(Kor)
심예지
Publisher
School of Medicine (의과대학)
Citation
Meerim Park et al. (2020). Serum cytokine profiles in infants with infantile hemangiomas on oral propranolol treatment: VEGF and bFGF, potential biomarkers predicting clinical outcomes. Pediatric Research, 88(5), 749–755. doi: 10.1038/s41390-020-0862-1
Type
Article
ISSN
1530-0447
Source
https://www.nature.com/articles/s41390-020-0862-1
DOI
10.1038/s41390-020-0862-1
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43269
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Pediatrics (소아청소년학)
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