1
|
Zhang H, Yang Y, Cao Y, Guan J. Effects of chronic stress on cancer development and the therapeutic prospects of adrenergic signaling regulation. Biomed Pharmacother 2024; 175:116609. [PMID: 38678960 DOI: 10.1016/j.biopha.2024.116609] [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: 01/19/2024] [Revised: 04/14/2024] [Accepted: 04/17/2024] [Indexed: 05/01/2024] Open
Abstract
Long-term chronic stress is an important factor in the poor prognosis of cancer patients. Chronic stress reduces the tissue infiltration of immune cells in the tumor microenvironment (TME) by continuously activating the adrenergic signaling, inhibits antitumor immune response and tumor cell apoptosis while also inducing epithelial-mesenchymal transition (EMT) and tumor angiogenesis, promoting tumor invasion and metastasis. This review first summarizes how adrenergic signaling activates intracellular signaling by binding different adrenergic receptor (AR) heterodimers. Then, we focused on reviewing adrenergic signaling to regulate multiple functions of immune cells, including cell differentiation, migration, and cytokine secretion. In addition, the article discusses the mechanisms by which adrenergic signaling exerts pro-tumorigenic effects by acting directly on the tumor itself. It also highlights the use of adrenergic receptor modulators in cancer therapy, with particular emphasis on their potential role in immunotherapy. Finally, the article reviews the beneficial effects of stress intervention measures on cancer treatment. We think that enhancing the body's antitumor response by adjusting adrenergic signaling can enhance the efficacy of cancer treatment.
Collapse
Affiliation(s)
- Hao Zhang
- Department of Oncology, The Eighth Medical Center, Chinese PLA (People's Liberation Army) General Hospital, Beijing 100091, China; Department of Oncology, The Fifth Medical Center, Chinese PLA (People's Liberation Army) General Hospital, Beijing 100071, China.
| | - Yuwei Yang
- College of Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing Key Laboratory of OTIR, Beijing, 100091, China.
| | - Yan Cao
- College of Pulmonary & Critical Care Medicine, Chinese PLA General Hospital, Beijing Key Laboratory of OTIR, Beijing, 100091, China.
| | - Jingzhi Guan
- Department of Oncology, The Fifth Medical Center, Chinese PLA (People's Liberation Army) General Hospital, Beijing 100071, China.
| |
Collapse
|
2
|
Bogomolets O, Wierzbik-Strońska M, Hryshchenko R, Bogomolets C. Urgent Treatment of Complicated Ulcerated Infantile Hemangioma with β-Blockers via Telemedicine: A Case Report. Telemed J E Health 2024; 30:881-884. [PMID: 37651201 PMCID: PMC10924047 DOI: 10.1089/tmj.2023.0338] [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: 06/29/2023] [Accepted: 07/19/2023] [Indexed: 09/02/2023] Open
Abstract
Introduction: Infantile hemangiomas (IH) exacerbated by ulceration invariably necessitate hospitalization, although simple IHs are sometimes managed remotely. Furthermore, according to international regulations, β-blocker medication for such hemangiomas should be systemic and performed in a clinic, especially if there is infection and risk of bleeding. Case: War in Ukraine made it impossible to hospitalize and properly examine a patient with a complex ulcerated and infected IH, forcing us to administer β-blocker timolol therapy only through telemedicine. Conclusions: Our case demonstrates the possibility of successful distant treatment of IH with ulcer using only a topical β-blocker carried out remotely through telemedicine, which is critical in the context of the COVID-19 pandemic, war, hostilities, or natural disasters where inpatient treatment is not available.
Collapse
Affiliation(s)
- Olga Bogomolets
- Faculty of Medicine, Academy of Silesia in Katowice, Zabrze, Poland
| | | | | | | |
Collapse
|
3
|
Zhuo L, Hu Z, Chang J, Guo Q, Guo J. MicroRNA‑203a‑3p improves bleomycin and pingyangmycin sensitivity by inactivating the PI3K/AKT pathway in hemangioma. Exp Ther Med 2024; 27:80. [PMID: 38274341 PMCID: PMC10809328 DOI: 10.3892/etm.2024.12369] [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: 05/16/2023] [Accepted: 11/09/2023] [Indexed: 01/27/2024] Open
Abstract
MicroRNAs (miRs) have been found to play a fundamental role in the pathology and progression of hemangioma. Of note, miR-203a-3p prevents hemangioma progression via inactivation of the PI3K/AKT pathway. Bleomycin and pingyangmycin are drugs used in sclerotherapy, but certain hemangioma patients experience drug resistance, leading to poor clinical outcomes. The present study aimed to explore the impact of miR-203a-3p on bleomycin and pingyangmycin sensitivity in hemangioma, as well as the involvement of the PI3K/AKT pathway. miR-203a-3p or negative control mimics were transfected into human hemangioma endothelial cells, which were treated with 0-20 µM bleomycin or pingyangmycin. Subsequently, 740 Y-P, a PI3K/AKT pathway agonist, was added. Cell viability, rate of apoptosis and the expression levels of proteins involved in the PI3K/AKT pathway, including phosphorylated (p)-PI3K, PI3K, p-AKT and AKT, were detected. miR-203a-3p overexpression significantly decreased the half-maximal inhibitory concentration (IC50) values of bleomycin (5.84±0.87 vs. 14.23±2.17 µM; P<0.01) and pingyangmycin (5.13±0.55 vs. 12.04±1.86 µM; P<0.01), compared with untreated cells. In addition, under bleomycin or pingyangmycin treatment, miR-203a-3p overexpression significantly reduced the proportion of EdU positive cells (both P<0.05) and B-cell leukemia/lymphoma-2 (BCL2) protein expression levels (both P<0.05), whilst increasing cell apoptosis rate (both P<0.05) and cleaved caspase 3 protein expression levels (both P<0.05) compared with untreated controls. Furthermore, miR-203a-3p overexpression significantly inhibited the phosphorylation of PI3K and AKT (both P<0.05), an effect that was significantly diminished by 740 Y-P treatment (both P<0.01). In addition, 740 Y-P significantly increased IC50 values of bleomycin (P<0.01) and pingyangmycin (P<0.001) and also significantly increased the proportion of EdU-positive cells and BCL2 protein expression levels, while decreasing the apoptosis rate and cleaved caspase 3 protein expression levels in cells treated with bleomycin or pingyangmycin (all P<0.05). Of note, 740 Y-P weakened the effect of miR-203a-3p overexpression on the aforementioned cellular characteristics. The present study demonstrated that miR-203a-3p improved the sensitivity of cells to bleomycin and pingyangmycin treatment by inhibiting PI3K/AKT signaling in hemangioma.
Collapse
Affiliation(s)
- Lei Zhuo
- Department of General Surgery IV, (Department of Plastic Surgery), Affiliated Hospital of Hebei University of Engineering, Handan, Hebei 056002, P.R. China
| | - Zhenfeng Hu
- Department of General Surgery II (Department of Plastic Surgery), Affiliated Hospital of Hebei University of Engineering, Handan, Hebei 056002, P.R. China
| | - Jin Chang
- Department of General Surgery IV, (Department of Plastic Surgery), Affiliated Hospital of Hebei University of Engineering, Handan, Hebei 056002, P.R. China
| | - Qing Guo
- The Fourth Wards of Department of Oncology, Handan Central Hospital, Handan, Hebei 056001, P.R. China
| | - Jing Guo
- The Fourth Wards of Department of Cardiovascular Medicine, Handan Central Hospital, Handan, Hebei 056001, P.R. China
| |
Collapse
|
4
|
Eroglu N, Sen HS, Kar YD, Pektas A, Eker I. Can Propranolol Affect Platelet Indices in Infantile Hemangioma? J Pediatr Hematol Oncol 2023; 45:e899-e903. [PMID: 37278557 DOI: 10.1097/mph.0000000000002683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 04/03/2023] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Propranolol, a nonselective beta-blocker used in the medical treatment of infantile Hemangioma (IH), has been shown to decrease the levels of vascular endothelial growth factor and reduce angiogenesis with its antiproliferative and antiangiogenetic effects. MATERIALS AND METHODS It has been reported that the storage, transport, and secretion of vascular endothelial growth factor (VEGF) are associated with platelet volume indices (PVI). We aimed to investigate the effect of propranolol on PVI in IH patients. Propranolol treatment was started on 22 IH patients. Platelets, mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit values in the follow-ups at months 0, 1, and 2 were compared between 22 patients who received treatment and 25 patients who did not. RESULTS While a statistically significant difference between months 0, 1, and 2 in PDW and MPV values was detected in the treated group, it was not detected in the untreated group. Taking into consideration that VEGF levels were higher at the beginning of the treatment in the pathophysiology of the disease, it was thought that the decrease in VEGF levels by propranolol may have led to a decrease in MPV and PDW levels in the treatment group. CONCLUSION Consequently, in IH cases, propranolol response follow-up can be evaluated with PVIs, especially MPV and PDW, and it may facilitate clinicians' monitoring of the disease after propranolol administration.
Collapse
Affiliation(s)
| | | | | | - Ayhan Pektas
- Pediatric Cardiology, Afyonkarahisar Health Sciences University Faculty of Medicine, Afyonkarahisar, Turkey
| | - Ibrahim Eker
- Departments of Pediatric Hematology and Oncology
| |
Collapse
|
5
|
Hong Z, Kuang J, Guo Y, Zhou G, Zhu Z, Jiang L. Effects of follicle-stimulating hormone on the proliferation and apoptosis of infantile hemangioma stem cells. Biochem Biophys Rep 2023; 35:101551. [PMID: 37823006 PMCID: PMC10562740 DOI: 10.1016/j.bbrep.2023.101551] [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: 05/20/2023] [Revised: 09/20/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023] Open
Abstract
Objective To investigate the effects of different concentrations of follicle-stimulating hormone (FSH) on the proliferation and apoptosis of human hemangioma stem cells, it will provide a basis for studying the mechanism of FSH in treating hemangioma. Methods Hemangioma specimens were collected from the Longgang District Maternity & Child Healthcare Hospital of Shenzhen City. Hemangioma stem cells were treated with different concentrations of FSH. Cell viability was detected by CCK8 method and cell apoptosis was analyzed by flow cytometry. Results Hemangioma stem cells (HemSCs) were extracted from fresh tissue of infantile hemangioma by the CD133 immunomagnetic bead method. Under the influence of FSH at different concentrations (0, 100, 1000 IU/L), the cell viability of hemangioma stem cells increased significantly in a concentration-dependent manner (P < 0.05). At the same time, the apoptosis of hemangioma stem cells decreased with increasing concentrations of follicle-stimulating hormone (P < 0.05). Specifically, 1000 IU/L FSH significantly promoted the proliferation of hemangioma stem cells and inhibited their apoptosis. Conclusion High concentration of follicle-stimulating hormone can maintain the growth of hemangioma by promoting the proliferation and inhibiting the apoptosis of hemangioma stem cells.
Collapse
Affiliation(s)
- Zhiqian Hong
- Longgang District Maternity & Child Healthcare Hospital of Shenzhen City(Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen, Guangdong, China
| | - Junxi Kuang
- Department of Cardiovascular Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yadong Guo
- Longgang District Maternity & Child Healthcare Hospital of Shenzhen City(Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen, Guangdong, China
| | - Guanglin Zhou
- Longgang District Maternity & Child Healthcare Hospital of Shenzhen City(Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen, Guangdong, China
| | - Zhengjie Zhu
- Longgang District Maternity & Child Healthcare Hospital of Shenzhen City(Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen, Guangdong, China
| | - Lewen Jiang
- Longgang District Maternity & Child Healthcare Hospital of Shenzhen City(Longgang Maternity and Child Institute of Shantou University Medical College), Shenzhen, Guangdong, China
| |
Collapse
|
6
|
Chiramel M, Katakam B, Gulati R, Gupta M, Munisamy M, S. Ranugha PS, Seetharam KA. IADVL SIG pediatric dermatology (academy) recommendations on Hemangioma of Infancy (HOI). Indian Dermatol Online J 2023; 14:172-186. [PMID: 37089858 PMCID: PMC10115319 DOI: 10.4103/idoj.idoj_52_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 12/09/2022] [Accepted: 12/13/2022] [Indexed: 03/12/2023] Open
Abstract
Hemangioma of infancy (HOI) is a benign vascular proliferation. Though resolution is the norm, potential complications make an accurate diagnosis and early management of importance. The Indian association of dermatologists, venereologists and leprologists (IADVL) special interest group (SIG) paediatric dermatology in association with IADVL academy did an extensive analysis of the literature on the clinical features, diagnosis, and management of HOI published between 2010 and 2021. Online meetings were conducted from February 2021 to March 2022 to reach a consensus on these recommendations which are made from an Indian perspective.
Collapse
|
7
|
Zheng H, Cai Y, Xu Y, Yu Q, Kang B, Chen C, Gong X, Li W. Predictors of Treatment Responses of Superficial Infantile Hemangiomas to Topical Timolol. Dermatol Ther 2022; 35:e15833. [DOI: 10.1111/dth.15833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/30/2022] [Accepted: 09/13/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Hongjie Zheng
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital Shanghai Jiao Tong University, School of Medicine Shanghai China
| | - Yizuo Cai
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital Shanghai Jiao Tong University, School of Medicine Shanghai China
| | - Yuda Xu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital Shanghai Jiao Tong University, School of Medicine Shanghai China
| | - Qian Yu
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital Shanghai Jiao Tong University, School of Medicine Shanghai China
| | - Bijun Kang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital Shanghai Jiao Tong University, School of Medicine Shanghai China
| | - Chingyu Chen
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital Shanghai Jiao Tong University, School of Medicine Shanghai China
| | - Xia Gong
- Department of Ultrasound, Shanghai Ninth People’s Hospital Shanghai Jiao Tong University, School of Medicine Shanghai China
| | - Wei Li
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People’s Hospital Shanghai Jiao Tong University, School of Medicine Shanghai China
| |
Collapse
|
8
|
Lv Z, Yang K, Wang Y. Long non-coding RNA breast cancer-associated transcript 54 sponges microRNA-1269b to suppress the proliferation of hemangioma-derived endothelial cells. Bioengineered 2022; 13:6188-6195. [PMID: 35200096 PMCID: PMC8974170 DOI: 10.1080/21655979.2022.2027064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Long non-coding RNA (lncRNA) breast cancer-associated transcript 54 (BRCAT54) and microRNA-1269b (miR-1269b) are two critical ncRNAs in cancer biology, while their roles in hemangioma are unknown. Our preliminary sequencing data revealed their altered expression in hemangioma and predicted they could interact with each other. This study was therefore carried out to investigate the roles of BRCAT54 and miR-1269b in hemangioma, with a focus on their interaction. In this study, hemangioma samples donated by 20 infantile hemangioma patients at proliferating-phase and 20 infantile hemangioma patients at involuting-phase were used. The expression of BRCAT54 and miR-1269b in hemangioma samples, as well as hemangioma-derived endothelial cells (HDECs) and human umbilical vein endothelial cells (HUVECs) were detected by RT-qPCR. IntaRNA 2.0 was applied to predict the interaction between BRCAT54 and miR-1269b, which was then confirmed by RNA-RNA pulldown assay. Accumulation of BRCAT54 in the subcellular location of HDECs was detected by subcellular fractionation assay. The role of BRCAT54 and miR-1269b in cell proliferation has been explored by the BrdU assay. Compared to proliferating-phase tissues, involuting-phase tissues exhibited decreased expression levels of BRCAT54 and increased expression levels of miR-1269b. HDECs had decreased expression levels of BRCAT54 and increased expression levels of miR-1269b compared to that of HUVECs. In HDECs, BRCAT54, which was detected in both nuclear and cytoplasm fractions, directly interacted with miR-1269b. BRCAT54 and miR-1269b did not affect the expression of each other, while BRCAT54 suppressed the role of miR-1269b in enhancing the proliferation of HDECs. BRCAT54 may sponge miR-1269b to suppress the proliferation of HDECs.
Collapse
Affiliation(s)
- Zhonjun Lv
- Department of Vascular Surgery, Nanyang Central Hospital, Nanyang, Henan Province, China
| | - Ke Yang
- Department of Vascular Surgery, Nanyang Central Hospital, Nanyang, Henan Province, China
| | - Ya Wang
- Department of Vascular Surgery, Nanyang Central Hospital, Nanyang, Henan Province, China
| |
Collapse
|
9
|
Pérez-González GL, Cornejo-Bravo JM, Vera-Graciano R, Adan-López ES, Villarreal-Gómez LJ. Development, characterization, and in vitro evaluation of adhesive fibrous mat for mucosal propranolol delivery. E-POLYMERS 2021. [DOI: 10.1515/epoly-2022-0002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Abstract
This research focuses on the synthesis and adhesive properties of mucoadhesive mats, prepared with poly(vinylic alcohol) as a base polymer for the oromucosal release of propranolol (PRO) by the electrospinning technique. The nanofibers mats were evaluated by scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy, thermogravimetric analysis, and differential scanning calorimetry; in vitro drug entrapment efficiency, degradation time, and adhesion studies were performed. SEM images of the electrospun mats show the correct formation of fibers with a variable diameter and porosity. Thermal studies indicate excellent thermal stability of the scaffolds, The fibrous mats loaded with 10% of the drug exhibit the best thermal stability with decomposition after 450°C. In vitro studies indicate a drug content of 88% loaded in the mats. In the cytotoxicity test, loaded mat presents cell proliferations of 97% and 88% for drug concentrations of 10% an 15%, respectively. To conclude, the formed electrospun adhesive mats exhibited excellent thermal stability, adhesive properties, and drug entrapment efficiency, promising features for a successful drug topical release system on mucosal tissue in the oral cavity.
Collapse
Affiliation(s)
- Graciela Lizeth Pérez-González
- Facultad de Ciencias de la Ingeniería y Tecnología, Universidad Autónoma de Baja California, Blvd. Universitario 1000, Unidad Valle de las Palmas , 22260 , Tijuana , Baja California , México
- Facultad de Ciencias Químicas e Ingeniería, Universidad Autónoma de Baja California, Calzada Universidad 14418 Parque Industrial Internacional , Tijuana , Baja California 22390 , México
| | - José Manuel Cornejo-Bravo
- Facultad de Ciencias Químicas e Ingeniería, Universidad Autónoma de Baja California, Calzada Universidad 14418 Parque Industrial Internacional , Tijuana , Baja California 22390 , México
| | - Ricardo Vera-Graciano
- Instituto de Investigaciones en Materiales, Universidad Nacional Autónoma de México, Circuito Exterior S/N Circuito de la Investigación Científica, Ciudad Universitaria , 04510 , Ciudad de México , México
| | - Eduardo Sinaí Adan-López
- Facultad de Ciencias de la Ingeniería y Tecnología, Universidad Autónoma de Baja California, Blvd. Universitario 1000, Unidad Valle de las Palmas , 22260 , Tijuana , Baja California , México
| | - Luis Jesús Villarreal-Gómez
- Facultad de Ciencias de la Ingeniería y Tecnología, Universidad Autónoma de Baja California, Blvd. Universitario 1000, Unidad Valle de las Palmas , 22260 , Tijuana , Baja California , México
- Facultad de Ciencias Químicas e Ingeniería, Universidad Autónoma de Baja California, Calzada Universidad 14418 Parque Industrial Internacional , Tijuana , Baja California 22390 , México
| |
Collapse
|
10
|
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: 0] [Impact Index Per Article: 0] [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.
Collapse
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
| |
Collapse
|
11
|
Cai Y, Ge Y, Ung COL, Li F, Wang J, Xia C, Hu H. Treatment patterns and outcomes in children with infantile hemangiomas: A retrospective observational analysis. SAGE Open Med 2021; 9:20503121211056844. [PMID: 34938569 PMCID: PMC8685728 DOI: 10.1177/20503121211056844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study aimed to make use of real-world medical records to explore the clinical characteristics, treatments, and outcomes of infantile hemangiomas in southeastern China. METHODS This study applied a retrospective observational method using real-world data derived from the electronic medical records of the Foshan Women and Children Hospital, southeastern China dated between June 2014 and June 2019. RESULTS A total of 2427 patients with infantile hemangiomas were recruited in this study, including 942 (38.8%) males and 1485 (61.2%) females. Among the participants, 620 (25.5%) were high-risk infantile hemangioma, 449 (18.5%) were medium risk, and 1358 (56.0%) were low risk. A total of 14 treatment patterns in clinical practice were identified. The top 3 treatment patterns in each group of risk levels were the same: laser therapy, a combination of laser therapy and topical timolol maleate, and topical timolol maleate. The outcomes of the top 3 treatment patterns were significantly (P < 0.05) different in each risk group. CONCLUSION Among the top 3 treatment patterns, laser therapy or a combination of laser therapy and topical timolol maleate were more likely to have an "Excellent" outcome.
Collapse
Affiliation(s)
- Yantao Cai
- Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, China
| | - Ying Ge
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao SAR, China
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao SAR, China
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China
| | - Fuli Li
- Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, China
| | - Jiaqi Wang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao SAR, China
| | - Chenglai Xia
- Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, China
- School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, China
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao SAR, China
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China
| |
Collapse
|
12
|
Xu X, Wu Y, Li H, Xie J, Cao D, Huang X. Notch pathway inhibitor DAPT accelerates in vitro proliferation and adipogenesis in infantile hemangioma stem cells. Oncol Lett 2021; 22:854. [PMID: 34777588 PMCID: PMC8581475 DOI: 10.3892/ol.2021.13115] [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: 12/10/2020] [Accepted: 06/03/2021] [Indexed: 11/06/2022] Open
Abstract
The Notch signaling pathway is crucial in both adipogenesis and tumor development. It serves a vital role in the development and stability of blood vessels and may be involved in the proliferative phase of infantile hemangiomas, which express various related receptors. Therefore, it was hypothesized that the Notch signaling pathway inhibitor N-[N-(3,5-difluorophenacetyl)-L-alanyl]-S-phenylglycine t-butyl ester (DAPT), a γ-secretase inhibitor, might help accelerate the regression of infantile hemangiomas. The present in vitro study evaluated whether inhibition of the Notch signaling pathway using DAPT could alter adipogenesis in hemangioma stem cells (HemSCs) derived from infantile hemangioma (IH) specimens. A total of 20 infants (age, ≤6 months) with hemangiomas who had not yet received any treatment were selected, and their discarded hemangioma tissues were obtained. HemSCs were isolated from the fresh, sterile IH specimens and treated with DAPT. Reverse transcription-quantitative PCR and western blotting were used to demonstrate the inhibition of the Notch signaling pathway by DAPT. A proliferation assay (Cell Counting Kit-8), oil red O staining, flow cytometry and a transwell assay were used to detect proliferation, adipogenesis, apoptosis and migration of HemSCs. Treatment with DAPT upregulated the expression levels of CCAAT/enhancer-binding protein (C/EBP) α, C/EBPβ, peroxisome proliferator-activated receptor-γ, adiponectin and insulin-like growth factor 1, and promoted the proliferation, apoptosis, migration and lipid accumulation in HemSCs in vitro. Targeting the Notch signaling pathway using DAPT may potentially accelerate the regression of infantile hemangiomas.
Collapse
Affiliation(s)
- Xing Xu
- Department of Plastic Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230000, P.R. China
| | - Yao Wu
- Department of Plastic Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230000, P.R. China
| | - Honghong Li
- Department of Plastic Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230000, P.R. China
| | - Juan Xie
- Department of Plastic Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230000, P.R. China
| | - Dongsheng Cao
- Department of Plastic Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230000, P.R. China
| | - Xueying Huang
- Department of Anatomy, Anhui Medical University, Hefei, Anhui 230000, P.R. China
| |
Collapse
|
13
|
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.
Collapse
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
| |
Collapse
|
14
|
Rocco R, Cambindo Botto AE, Muñoz MJ, Reingruber H, Wainstok R, Cochón A, Gazzaniga S. Early redox homeostasis disruption contributes to the differential cytotoxicity of imiquimod on transformed and normal endothelial cells. Exp Dermatol 2021; 31:608-614. [PMID: 34758172 DOI: 10.1111/exd.14499] [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: 03/26/2021] [Revised: 11/01/2021] [Accepted: 11/06/2021] [Indexed: 11/28/2022]
Abstract
The off-label use of imiquimod (IQ) for hemangioma treatment has shown clinical benefits. We have previously reported a selective direct IQ-cytotoxic effect on transformed (H5V) vs. normal (1G11) endothelial cells (EC). In the present study, we investigated the mechanism underlying this selective cytotoxicity in terms of TLR7/8 receptor expression, NF-κB signalling and time-dependent modifications of oxidative stress parameters (ROS: reactive oxygen species, catalase and superoxide dismutase activities, GSH/GSSG and lipid peroxidation). TLR7/8 level was extremely low in both cell lines, and IQ did not upregulate TLR7/8 expression or activate NF-κB signalling. IQ significantly induced ROS in H5V after 2 h and strongly affected antioxidant defenses. After 12 h, enzyme activities were restored to baseline levels but a robust drop in GSH/GSSG persisted together with increased lipid peroxidation levels and a marked mitochondrial dysfunction. Although in normal IQ-treated EC some oxidative stress parameters were affected after 4 h, mitochondrial health and GSH/GSSG ratio remained notably unaffected after 12 h. Therefore, the early alterations (0-2 h) in transformed EC breached redox homeostasis as strongly as to enhance their susceptibility to IQ. This interesting facet of IQ as redox disruptor could broaden its therapeutic potential for other skin malignancies, alone or in adjuvant schemes.
Collapse
Affiliation(s)
- Rodrigo Rocco
- Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Adrián E Cambindo Botto
- Departamento de Fisiología, Biología Molecular y Celular, Facultad de Ciencias Exactas y Naturales, Instituto de Fisiología, Biología Molecular y Neurociencias (IFIBYNE-UBA-CONICET), Universidad de Buenos Aires, Ciudad Universitaria, Buenos Aires, Argentina
| | - Manuel J Muñoz
- Departamento de Fisiología, Biología Molecular y Celular, Facultad de Ciencias Exactas y Naturales, Instituto de Fisiología, Biología Molecular y Neurociencias (IFIBYNE-UBA-CONICET), Universidad de Buenos Aires, Ciudad Universitaria, Buenos Aires, Argentina.,Fondazione Istituto FIRC di Oncologia Molecolare (IFOM), Milan, Italy.,Departamento de Biodiversidad y Biología Experimental, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Hernán Reingruber
- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Rosa Wainstok
- Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), CONICET-Universidad de Buenos Aires, Buenos Aires, Argentina.,Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Adriana Cochón
- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Silvina Gazzaniga
- Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Buenos Aires, Argentina
| |
Collapse
|
15
|
Abstract
The International Society for the Study of Vascular Anomalies classifies vascular anomalies into vascular tumors and vascular malformations. Vascular tumors are neoplasms of endothelial cells, among which infantile hemangiomas (IHs) are the most common, occurring in 5%-10% of infants. Glucose transporter-1 protein expression in IHs differs from that of other vascular tumors or vascular malformations. IHs are not present at birth but are usually diagnosed at 1 week to 1 month of age, rapidly proliferate between 1 and 3 months of age, mostly complete proliferation by 5 months of age, and then slowly involute to the adipose or fibrous tissue. Approximately 10% of IH cases require early treatment. The 2019 American Academy of Pediatrics clinical practice guideline for the management of IHs recommends that primary care clinicians frequently monitor infants with IHs, educate the parents about the clinical course, and refer infants with high-risk IH to IH specialists ideally at 1 month of age. High-risk IHs include those with life-threatening complications, functional impairment, ulceration, associated structural anomalies, or disfigurement. In Korea, IHs are usually treated by pediatric hematology-oncologists with the cooperation of pediatric cardiologists, radiologists, dermatologists, and plastic surgeons. Oral propranolol, a nonselective beta-adrenergic antagonist, is the first-line treatment for IHs at a dosage of 2-3 mg/kg/day divided into 2 daily doses maintained for at least 6 months and often continuing until 12 months of age. Topical timolol maleate solution, a topical nonselective beta-blocker, may be used for small superficial type IHs at a dosage of 1-2 drops of 0.5% gel-forming ophthalmic solution applied twice daily. Pulse-dye laser therapy or surgery is useful for the treatment of residual skin changes after IH involution.
Collapse
Affiliation(s)
- Hye Lim Jung
- Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
16
|
Kowalska M, Dębek W, Matuszczak E. Infantile Hemangiomas: An Update on Pathogenesis and Treatment. J Clin Med 2021; 10:jcm10204631. [PMID: 34682753 PMCID: PMC8539430 DOI: 10.3390/jcm10204631] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 09/25/2021] [Accepted: 10/05/2021] [Indexed: 12/13/2022] Open
Abstract
Infantile hemangiomas are the most common benign vascular tumors in infancy. This review includes an update on the current knowledge on pathogenesis, a discussion on indications for treatment, and a review of the mechanisms underlying the different treatment methods. Although most infantile hemangiomas require only active observation because of their natural course, which results in involution, about 10% present with complications that require immediate treatment. The basic treatment includes systemic and topical options. In cases of insufficient response or rebound growth, other forms of treatment should be considered. In some cases, combined therapy might be initiated.
Collapse
|
17
|
Zhou L, Jia X, Yang X. LncRNA-TUG1 promotes the progression of infantile hemangioma by regulating miR-137/IGFBP5 axis. Hum Genomics 2021; 15:50. [PMID: 34362467 PMCID: PMC8344165 DOI: 10.1186/s40246-021-00349-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 07/22/2021] [Indexed: 01/04/2023] Open
Abstract
Background Previous studies indicated that lncRNA taurine upregulated gene 1 (TUG1) played essential roles in human cancers. This study aimed to investigate its function in infantile hemangioma (IH). Methods A total of 30 pairs of clinical infantile specimens were used in this study. The expression of TUG1 in IH tissues was assessed by quantitative reverse transcriptase PCR (qRT-PCR). Two short hairpin RNA targeting TUG1 (sh-TUG1-1 and sh-TUG1-2) were transfected into hemangioma-derived endothelial cells, HemECs, to block its expression. The effects of TUG1 on HemECs were evaluated by Cell Counting Kit-8 (CCK-8), colony formation assay, wound healing assay, and Transwell assay. The underlying molecular mechanism of TUG1 was investigated by Starbase prediction and luciferase reporter assay and further determined by loss- and gain-of-function approaches. In addition, the role of TUG1 on tumorigenesis of HemECs was confirmed in an in vivo mouse model. Results TUG1 was significantly upregulated in infant hemangioma tissues compared with normal adjacent subcutaneous tissues. The loss- and gain-of-function approaches indicated that TUG1 overexpression promoted proliferation, migration, and invasion of HemECs in vitro, and TUG1 knockdown inhibited the tumorigenesis of HemECs in vivo. Specifically, TUG1 could compete with IGFBP5 for miR137 binding. Rescue experiments further confirmed the role of the TUG1/miR137/IGFBP5 axis in HemECs. Conclusion TUG1 was closely associated with the progression of IH by regulating the miR-137/IGFBP5 axis, which might be a potential target for IH treatment.
Collapse
Affiliation(s)
- Lili Zhou
- Department of Pediatrics, Beijing University of Chinese Medicine Shenzhen Hospital (Longgang), No. 1 Dayun Road, Shenzhen City, Guangdong Province, 518000, People's Republic of China.
| | - Xiao Jia
- Department of Orthopedics, Gansu Provincial Hospital of TCM, Lanzhou City, Gansu Province, 730050, People's Republic of China
| | - Xiangzheng Yang
- Department of Pediatrics, Beijing University of Chinese Medicine Shenzhen Hospital (Longgang), No. 1 Dayun Road, Shenzhen City, Guangdong Province, 518000, People's Republic of China
| |
Collapse
|
18
|
Wu ZB, Shi SL, Pan FJ, Li L, Chen HY. Propranolol inhibits infantile hemangioma by regulating the miR-424/vascular endothelial growth factor-A (VEGFA) axis. Transl Pediatr 2021; 10:1867-1876. [PMID: 34430434 PMCID: PMC8349971 DOI: 10.21037/tp-21-244] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 06/24/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Infantile hemangioma (IHA) is the most common tumor in infancy. We aimed to explore the effect of propranolol on the expression of microRNA (miR)-424 in IHA tissues and XPTS-1 cells, as well as its molecular mechanism of inhibiting XPTS-1 cell activity. METHODS Tumor tissues and peritumoral tissue were collected from 13 IHA patients in Lishui Municipal Central Hospital. The level of miR-424 were detected using real-time quantitative reverse transcription polymerase chain reaction (RT-PCR). Cell counting kit-8 (CCK-8) was used to measure XPTS-1 cell viability. Flow cytometry and transwell were used to detect the apoptosis level and invasion ability of XPTS-1 cells. Western blot was used to measure the protein level of vascular endothelial growth factor-A (VEGFA). The luciferase reporter gene assay detected the targeting relationship between miR-424 and VEGFA. RESULTS Compared with normal tissues and human umbilical vein endothelial cells, the expression level of miR-424 in IHA tissues and XPTS-1 cells was significantly reduced (P<0.05). As the concentration of propranolol increased, XPTS-1 cell viability gradually decreased (P<0.05), and the expression level of VEGFA decreased (P<0.05). The expression of miR-424 increased with the time of propranolol treatment (P<0.05). Compared with the control group, treatment with an miR-424 inhibitor resulted in a significant increase in XPTS-1 cell viability and invasion ability (P<0.05), and a decrease in apoptosis (P<0.05). However, both propranolol and miR-424 inhibitor treatment resulted in a partial decrease in XPTS-1 cell viability (P<0.05), and a partial increase in the level of apoptosis (P<0.05). MiR-424 directly targeted VEGFA; the overexpression of miR-424 resulted in a decrease in the VEGFA protein level (P<0.05), while inhibition of miR-424 resulted in an increase in the VEGFA protein level (P<0.05). Compared with the propranolol group, the XPTS-1 cell viability and invasion ability in the propranolol + VEGFA-si group were significantly decreased (P<0.05), while the level of apoptosis increased (P<0.05). Meanwhile, simultaneous miR-424 inhibitor treatment resulted in no difference in cell viability and apoptosis levels compared with the propranolol group, and the invasion ability was partially restored (P<0.05). CONCLUSIONS Propranolol affects the malignant biological behavior of IHA cells by regulating the miR-424/VEGFA axis.
Collapse
Affiliation(s)
- Zhen-Bo Wu
- College of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Sen-Lin Shi
- College of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Feng-Jun Pan
- Department of Pharmacy, Lishui Municipal Central Hospital, Lishui, China
| | - Li Li
- Department of Pharmacy, Lishui Municipal Central Hospital, Lishui, China
| | - Hong-Yu Chen
- Department of Pharmacy, Lishui Municipal Central Hospital, Lishui, China
| |
Collapse
|
19
|
Ali Akbari Ghavimi S, Gehret PM, Aronson MR, Schipani R, Smith KW, Borek RC, Germiller JA, Jacobs IN, Zur KB, Gottardi R. Drug delivery to the pediatric upper airway. Adv Drug Deliv Rev 2021; 174:168-189. [PMID: 33845038 DOI: 10.1016/j.addr.2021.04.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 03/22/2021] [Accepted: 04/06/2021] [Indexed: 11/25/2022]
Abstract
Pediatric upper airway disorders are frequently life-threatening and require precise assessment and intervention. Targeting these pathologies remains a challenge for clinicians due to the high complexity of pediatric upper airway anatomy and numerous potential etiologies; the most common treatments include systemic delivery of high dose steroids and antibiotics or complex and invasive surgeries. Furthermore, the majority of innovative airway management technologies are only designed and tested for adults, limiting their widespread implementation in the pediatric population. Here, we provide a comprehensive review of the most recent challenges of managing common pediatric upper airway disorders, describe the limitations of current clinical treatments, and elaborate on how to circumvent those limitations via local controlled drug delivery. Furthermore, we propose future advancements in the field of drug-eluting technologies to improve pediatric upper airway management outcomes.
Collapse
|
20
|
Chottianchaiwat S, Martinez AE, Solman L, Petrof G. Infantile haemangioma presenting in combination with a cerebriform naevus sebaceous on the scalp. Clin Exp Dermatol 2021; 47:223-225. [PMID: 34173688 DOI: 10.1111/ced.14758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2021] [Indexed: 11/30/2022]
Affiliation(s)
- S Chottianchaiwat
- Department of Paediatric Dermatology, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - A E Martinez
- Department of Paediatric Dermatology, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - L Solman
- Department of Paediatric Dermatology, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | - G Petrof
- Department of Paediatric Dermatology, Great Ormond Street Hospital for Children NHS Trust, London, UK
| |
Collapse
|
21
|
Shen Z, Zhang D, Li G, Huang D, Qiu Y, Xie C, Zhang X, Wang X, Liu Y. Clinical Characteristics, Classification, and Management of Adult Nasopharyngolaryngeal Hemangioma. Laryngoscope 2021; 131:2724-2728. [PMID: 34160868 DOI: 10.1002/lary.29703] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/03/2021] [Accepted: 06/14/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVES/HYPOTHESIS To analyze the clinical features, classification, and treatment of adult nasopharyngolaryngeal hemangioma (ANPLH). STUDY DESIGN Retrospective study. METHODS From February 2009 to May 2020, 101 patients with ANPLH were reviewed and analyzed. RESULTS Symptoms of ANPLH were frequently displayed as abnormal pharyngeal sensation and functional defection. According to lesion location, ANPLH was divided into five categories including nasopharyngeal, oropharyngeal, hypopharyngeal, laryngeal, and mixed types. The mixed type constitutes the highest portion, and the nasopharyngeal type is the least in our cohort. Most lesions could resect through natural cavity under endoscopy. Patients with mixed lesions had a higher rate of postoperative recurrence and planned multiple surgeries. Acceptable but not severe intraoperative and postoperative complications occurred in our patient cohort. CONCLUSIONS Patients with ANPLH are always symptomatic and even functional defective, which can be classified into five categories based on lesion location. For these patients, endoscopic surgery through natural cavity is recommended to remove lesions with fewer complications and favorable clinical outcomes. LEVEL OF EVIDENCE 4 Laryngoscope, 2021.
Collapse
Affiliation(s)
- Zhe Shen
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Otolaryngology Major Disease Research, Key Laboratory of Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Diekuo Zhang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Otolaryngology Major Disease Research, Key Laboratory of Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Guo Li
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Otolaryngology Major Disease Research, Key Laboratory of Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Donghai Huang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Otolaryngology Major Disease Research, Key Laboratory of Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Yuanzheng Qiu
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Otolaryngology Major Disease Research, Key Laboratory of Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Changning Xie
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Otolaryngology Major Disease Research, Key Laboratory of Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Xin Zhang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Otolaryngology Major Disease Research, Key Laboratory of Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Xingwei Wang
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Otolaryngology Major Disease Research, Key Laboratory of Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China
| | - Yong Liu
- Department of Otolaryngology Head and Neck Surgery, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Otolaryngology Major Disease Research, Key Laboratory of Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Clinical Research Center for Pharyngolaryngeal Diseases and Voice Disorders in Hunan Province, Xiangya Hospital, Central South University, Changsha, People's Republic of China.,National Clinical Research Center for Geriatric Disorders (Xiangya Hospital), Xiangya Hospital, Central South University, Changsha, People's Republic of China
| |
Collapse
|
22
|
You Y, Li Y, Xiao Y, Zhang J. Propranolol vs. steroids in the treatment of infantile hemangiomas: A meta-analysis. Mol Clin Oncol 2021; 15:156. [PMID: 34178327 PMCID: PMC8220686 DOI: 10.3892/mco.2021.2318] [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: 07/05/2020] [Accepted: 03/03/2021] [Indexed: 12/02/2022] Open
Abstract
Infantile hemangioma (IH) is a common disease, and drug therapy is the most common treatment method. Clinically, steroids have long been used as first-line drugs, but in recent years, some doctors have begun to use propranolol to treat infantile hemangiomas (IHs). The present study performed a meta-analysis to evaluate the clinical effects of propranolol in comparison with steroids in the treatment of infantile hemangiomas. A detailed review of the literature on PubMed, Cochrane Library, Embase and Web of Science was performed prior to March 31, 2020. All literatures were compared with the clinical effects of propranolol and steroids in the treatment of infantile hemangiomas. A total of two researchers independently screened the literature according to the selection criteria, extracted data and assessed the risk of bias for the included studies. Review Manager 5.3 was used to meta-analyze all the included studies. According to the selection criteria, nine articles were included in the present study. The meta-analysis revealed that the effective rate of propranolol was greater than that of steroids in treating infantile hemangiomas [odds ratio (OR), 3.96, 95% confidence interval (CI), 2.47-6.37; P<0.00001]. Additionally, propranolol had fewer complications than steroids (OR, 0.21; 95% CI, 0.12-0.36; P<0.00001). The recurrence rate of the two groups was not statistically different (OR, 1.83; 95% CI, 0.59-5.70; P=0.3) and the surgical resection rate of propranolol was lower than steroids (OR, 0.19; 95% CI, 0.08-0.46; P=0.0002). The present study demonstrated that propranolol is more effective than steroids for the treatment of IHs, and provides a theoretical basis for the clinical use of propranolol as an alternative to steroids.
Collapse
Affiliation(s)
- Yiting You
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| | - Yadong Li
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| | - Yiting Xiao
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| | - Jinsong Zhang
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| |
Collapse
|
23
|
Wang Z, Wang Z, Du C, Zhang Y, Tao B, Xian H. β-elemene affects angiogenesis of infantile hemangioma by regulating angiotensin-converting enzyme 2 and hypoxia-inducible factor-1 alpha. J Nat Med 2021; 75:655-663. [PMID: 33861415 DOI: 10.1007/s11418-021-01516-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/08/2021] [Indexed: 10/21/2022]
Abstract
Infantile hemangioma (IH) is the most common benign vascular tumor resulting from the hyper-proliferation of vascular endothelial cells. In treatment of various tumors including IH, β-elemene, a compound extracted from Rhizoma zedoariae, has been reported to have anti-tumor effect. However, the underlying mechanisms of β-elemene in hemangioma have remained uninvestigated. In this presented study, functional analysis showed that low concentrations of β-elemene promoted the proliferation, migration and tube formation of human hemangioma endothelial cells (HemECs), while high concentrations of β-elemene produced inhibitory effects. Further, we also found that angiotensin-converting enzyme 2 (ACE2) expression was down-regulated at both mRNA and protein levels, while hypoxia-inducible factor-1 alpha (HIF-1-α) was up-regulated in infantile hemangiomas tissues and HemECs at both mRNA and protein levels. This result suggested that ACE2 and HIF-1-α play roles in IH. ACE2 expression was down-regulated with the treatment of β-elemene at different dosage point. Interestingly, the expression of Vascular endothelial growth factor-A (VEGFA) increased with treatment of low concentrations of β-elemene in HemECs, in contrary, the expression of VEGFA expression decreased with treatment of high concentrations of β-elemene. Moreover, if the concentration of β-elemene reached 40 μg/ml or higher, the expression of HIF-1-α decreased. Taken together, our data indicated that the different effects of β-elemene on the proliferation, migration and angiogenesis of hemangioma at different concentrations: The ACE2 signaling pathway dominates with treatment of low concentrations of β-elemene, stimulating the expression of downstream VEGFA to promote the angiogenesis of hemangioma; under the condition of high concentrations of β-elemene, the HIF-1-α signaling pathway inhibits the expression of VEGFA and further inhibits the angiogenesis of hemangioma.
Collapse
Affiliation(s)
- Zhenyu Wang
- Department of Pediatric Surgery, Affiliated Hospital of Nantong University, Nantong University, 19 Qixiu Road, Nantong, 226001, Jiangsu, China
| | - Zhaoxiang Wang
- Department of Neurosurgery, Affiliated Hospital of Nantong University, Nantong University, Jiangsu, 226001, China
| | - Chenyu Du
- Department of Physiology, School of Medicine, Nantong University, Jiangsu, 226001, China
| | - Ye Zhang
- Laboratory of Medical Science, School of Medicine, Nantong University, Jiangsu, 226001, China
| | - Baorui Tao
- Laboratory of Medical Science, School of Medicine, Nantong University, Jiangsu, 226001, China
| | - Hua Xian
- Department of Pediatric Surgery, Affiliated Hospital of Nantong University, Nantong University, 19 Qixiu Road, Nantong, 226001, Jiangsu, China.
| |
Collapse
|
24
|
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.
Collapse
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
| |
Collapse
|
25
|
Wang L, Li S, Gao Q, Lv R, Xu G, Li X, Bi J, Huo R. Oral propranolol therapy in parotid hemangiomas: A retrospective comparison with other infantile hemangiomas. Head Neck 2021; 43:1553-1562. [PMID: 33539620 DOI: 10.1002/hed.26625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 11/24/2020] [Accepted: 01/15/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The outcomes of propranolol treatment remain controversial for parotid hemangiomas, which may be inferior to outcomes for infantile hemangiomas (IHs) at other sites. METHODS Patients with IHs treated with oral propranolol were retrospectively reviewed. Outcomes of propranolol therapy for parotid hemangiomas and other IHs were examined. Regression models were conducted to analyze the factors associated with the outcomes for parotid hemangiomas. RESULTS Longer treatment duration was needed for parotid hemangiomas (p = 0.012) at a comparable efficacy and relapse rate as those of IHs at other sites. The higher efficacy was associated with early intervention before 4 months of age (OR = 5.2, p = 0.011), while, the lower relapse rate was associated with adequate treatment duration over 6 months (OR = 9.2, p = 0.010). CONCLUSIONS With a longer propranolol treatment duration, parotid hemangiomas could achieve a comparable efficacy and relapse rate as other IHs. Early treatment initiation and adequate treatment duration benefited the outcomes.
Collapse
Affiliation(s)
- Luying Wang
- Department of Plastic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Shaohua Li
- Department of Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Qianqian Gao
- Department of Plastic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Renrong Lv
- Department of Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Guangqi Xu
- Department of Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xueqing Li
- Department of Plastic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Jianhai Bi
- Department of Plastic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Ran Huo
- Department of Plastic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| |
Collapse
|
26
|
Xu M, Ouyang T, Lv K, Ma X. Integrated WGCNA and PPI Network to Screen Hub Genes Signatures for Infantile Hemangioma. Front Genet 2021; 11:614195. [PMID: 33519918 PMCID: PMC7844399 DOI: 10.3389/fgene.2020.614195] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 11/18/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Infantile hemangioma (IH) is characterized by proliferation and regression. METHODS Based on the GSE127487 dataset, the differentially expressed genes (DEGs) between 6, 12, or 24 months and normal samples were screened, respectively. STEM software was used to screen the continued up-regulated or down-regulated in common genes. The modules were assessed by weighted gene co-expression network analysis (WGCNA). The enrichment analysis was performed to identified the biological function of important module genes. The area under curve (AUC) value and protein-protein interaction (PPI) network were used to identify hub genes. The differential expression of hub genes in IH and normal tissues was detected by qPCR. RESULTS There were 5,785, 4,712, and 2,149 DEGs between 6, 12, and 24 months and normal tissues. We found 1,218 DEGs were up-regulated or down-regulated expression simultaneously in common genes. They were identified as 10 co-expression modules. Module 3 and module 4 were positively or negatively correlated with the development of IH, respectively. These two module genes were significantly involved in immunity, cell cycle arrest and mTOR signaling pathway. The two module genes with AUC greater than 0.8 at different stages of IH were put into PPI network, and five genes with the highest degree were identified as hub genes. The differential expression of these genes was also verified by qRTPCR. CONCLUSION Five hub genes may distinguish for proliferative and regressive IH lesions. The WGCNA and PPI network analyses may help to clarify the molecular mechanism of IH at different stages.
Collapse
Affiliation(s)
| | | | - Kaiyang Lv
- Department of Plastic and Reconstructive Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaorong Ma
- Department of Plastic and Reconstructive Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
27
|
Qiao J, Lin J, Zhang D, Li J, Chen C, Yu H, Li X, Fang B. Efficacy of Combined Topical Timolol and Oral Propranolol for Treating Infantile Hemangioma: A Meta-Analysis of Randomized Controlled Trials. Front Pharmacol 2020; 11:554847. [PMID: 33132908 PMCID: PMC7578425 DOI: 10.3389/fphar.2020.554847] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/31/2020] [Indexed: 11/21/2022] Open
Abstract
Background Oral propranolol has become the first-line treatment for infantile hemangioma (IH). However, combined therapy with topical timolol and oral propranolol has been proposed as a more effective IH treatment strategy. We aimed to compare the safety and efficacy of topical timolol, oral propranolol, and their combination for treating IH in a meta-analysis. Methods Relevant randomized controlled trials (RCTs) were obtained after searching the PubMed, Embase, Cochrane’s Library, China National Knowledge Infrastructure, and WanFang databases. A random-effect model was used to pool the results. Results Eight RCTs with 759 patients with IH were included in this meta-analysis. Treatment with topical timolol alone showed a similar response rate compared to oral propranolol (risk ratio [RR] = 0.97, p = 0.63), but resulted in fewer adverse events (RR = 0.36, p = 0.002). Combined treatment with topical timolol and oral propranolol showed a favorable response rate compared to treatment with oral propranolol (RR = 1.14, p = 0.03) or topical timolol (RR = 1.36, p = 0.01) alone. Moreover, combined treatment showed similar risks of adverse events compared to oral propranolol (RR = 0.80, p = 0.24) or topical timolol (RR = 1.31, p = 0.25) alone. Conclusions Combined treatment with topical timolol and oral propranolol may be more effective than either single treatment strategy in patients with IH. Topical timolol alone conferred similar efficacy for IH compared to oral propranolol, but with less incidence of adverse events.
Collapse
Affiliation(s)
- Junbo Qiao
- Department of Hemangioma Surgery, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junjie Lin
- Department of Hemangioma Surgery, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Dexin Zhang
- Department of Hemangioma Surgery, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junhua Li
- Department of Hemangioma Surgery, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Changkuan Chen
- Department of Hemangioma Surgery, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongye Yu
- Department of Hemangioma Surgery, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaodi Li
- Department of Hemangioma Surgery, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Bin Fang
- Department of Hemangioma Surgery, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
28
|
Ma J, Tao X, Huang Y. Silencing microRNA-210 in Hypoxia-Induced HUVEC-Derived Extracellular Vesicles Inhibits Hemangioma. Cerebrovasc Dis 2020; 49:462-473. [PMID: 32877893 DOI: 10.1159/000508302] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 04/28/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Hemangioma (Hem) is a benign tumor commonly seen in infancy with a relative high morbidity. Human umbilical vein endothelial cell (HUVEC)-derived extracellular vesicles (EVs) are actively participated in Hem. Therefore, this study is designed to figure out the underlying mechanism of HUVEC-derived EVs in Hem. METHODS Initially, EVs were separated from HUVECs and identified. HUVEC-derived EVs in normoxia or hypoxia were then cultivated with Hem endothelial cells (HemECs) to test the proliferation, apoptosis, and migration of HemECs. Microarray analysis was performed to select microRNAs (miRs) with differential expression. miR-210 in hypoxia-induced HUVECs was silenced, and the relevant EVs were extracted and then co-cultured with HemECs to perform biological effect experiments. Then, the target relation between miR-210 and homeobox A9 (HOXA9) was identified by the dual luciferase reporter gene assay and RNA immunoprecipitation assay. Moreover, xenograft transplantation was also applied to confirm the in vitro experiments. RESULTS Hypoxia-induced HUVECs promoted release of EVs, which were absorbed by HemECs. Hypoxia-induced HUVEC-EVs promoted HemEC proliferation and migration and inhibited apoptosis. miR-210 from the hypoxia-induced HUVEC-EVs was highly expressed and promoted HemEC growth. Silencing miR-210 expression in the hypoxia-induced HUVEC-EVs suppresses Hem development in vivo. In addition, miR-210 targeted HOXA9. CONCLUSION Silencing miR-210 in HUVEC-derived EVs could suppress Hem by targeting HOXA9. This investigation may provide novel insights for Hem treatment.
Collapse
Affiliation(s)
- Jingwen Ma
- Department of Dermatology, Zhejiang Provincial People's Hospital, Hangzhou, China
| | - Xiaohua Tao
- Department of Dermatology, Zhejiang Provincial People's Hospital, Hangzhou, China,
| | - Youming Huang
- Department of Dermatology, Zhejiang Provincial People's Hospital, Hangzhou, China
| |
Collapse
|
29
|
Fei Q, Lin Y, Chen X. Treatments for infantile Hemangioma: A systematic review and network meta-analysis. EClinicalMedicine 2020; 26:100506. [PMID: 33089121 PMCID: PMC7565185 DOI: 10.1016/j.eclinm.2020.100506] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 07/23/2020] [Accepted: 07/28/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Infantile hemangioma (IH) is common in children, which may bring about cosmetically disfiguring, functional impairment, and exhibiting complications. There had been various therapies and we aimed to assess the efficacy and adverse effects of different therapies through network meta-analysis. METHODS We searched PubMed, Embase, Cochrane Library and Web of Science (from database inception to April 11, 2020) for studies assessing the efficacy, success rate and adverse effects. Direct pairwise comparison and a network meta-analysis under random effects were performed. We also assessed the ranking probability. FINDINGS A total of 30 randomized clinical trials with more than 20 different therapeutic regimens were identified. Treatment combined propranolol orally with laser could improve the curative effect than monotherapy. Laser with topical β blockers showed more efficiency than others whether in children under 6 months or not. The long-pulsed dye laser might be the best laser therapy. A higher dose and a longer treatment duration of propranolol orally achieved a higher success rate and increased side effects. Plus pulse dye laser with propranolol had the lowest incidence of adverse reactions, such as ulcer, color sink and color reduction. INTERPRETATION A combination of β blockers and laser might be the first-line treatment of IHs and a longer pulsed dye laser is preferred. FUNDING No funding was received.
Collapse
Key Words
- ATL, atenolol
- CAP, captopril
- CI, confidence intervals
- H, a higher dose
- Hemangioma
- IH, infantile hemangioma
- IMQ, imiquimod
- L, a longer treatment duration
- LPDL, PDL at a long pulse duration
- Laser, PDL and Nd:YAG laser
- NMA, network meta-analysis
- Nd, Nd:YAG laser
- Network meta-analysis
- OR, odds ratios
- PDL, pulsed dye laser
- PED, prednisone
- PRO, propranolol
- RCT, randomized clinical trials
- S, a shorter treatment duration
- SUCRA, surface under the cumulative ranking curve
- TA, triamcinolone
- Therapeutics
- β, topical β-blockers treatment
Collapse
|
30
|
Chen J, Wu D, Dong Z, Chen A, Liu S. The expression and role of glycolysis-associated molecules in infantile hemangioma. Life Sci 2020; 259:118215. [PMID: 32768579 DOI: 10.1016/j.lfs.2020.118215] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/30/2020] [Accepted: 08/03/2020] [Indexed: 01/10/2023]
Abstract
AIMS Infantile hemangioma (IH) is one of the most common tumors in infancy, which etiology and pathogenesis has not been fully elucidated, hypoxia and abnormal glucose metabolism is regarded as critical pathogenic factors. This study investigated the expression and function of glycolysis-associated molecules (GLUT1, HK2, PFKFB3, PKM2, and LDHA) under normoxic and hypoxic conditions to further understand the pathogenesis of IH. MAIN METHODS Hemangioma-derived endothelial cells (HemECs) were isolated from proliferating phase infantile hemangiomas and identified by immunofluorescence. HemECs and human umbilical vein endothelial cells (HUVECs) were cultured under normoxic and hypoxic conditions. RNA and protein expression of glycolysis-associated molecules were analyzed by quantitative real-time RT-PCR, western blotting, and immunohistochemistry. Glucose consumption, ATP production and lactate production were measured. Glycolysis-associated molecules were inhibited by WZB117, 3BP, 3PO, SKN, and GSK 2837808A and the resulting effects on HemECs proliferation, migration, and tube formation were quantified. KEY FINDINGS Glycolysis-associated molecules were highly expressed at both mRNA and protein levels in HemECs compared with HUVECs (P < 0.05). Glucose consumption and ATP production were higher in HemECs than in HUVECs, while lactate production in HemECs was lower than in HUVECs (P < 0.05). Inhibition of some glycolysis-associated molecules reduced the proliferation, migration, and tube formation capacity of HemECs (P < 0.05). SIGNIFICANCE Our study revealed that glycolysis-associated molecules were highly expressed in IH. Glucose metabolismin HemECs differed from normal endothelial cells. Altering the expression of glycolysis-associated molecules may influence the phenotype of HemECs and provide new therapeutic approaches to the successful treatment of IH.
Collapse
Affiliation(s)
- Jian Chen
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Department of Oral and Maxillofacial Surgery, Qilu Hospital, Cheeloo College of Medicine, Institute of Stomatology, Shandong University, Jinan, Shandong 250012, China
| | - Dan Wu
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Department of Oral and Maxillofacial Surgery, Qilu Hospital, Cheeloo College of Medicine, Institute of Stomatology, Shandong University, Jinan, Shandong 250012, China
| | - Zuoqing Dong
- Department of Oral and Maxillofacial Surgery, Qilu Hospital, Cheeloo College of Medicine, Institute of Stomatology, Shandong University, Jinan, Shandong 250012, China
| | - Anwei Chen
- Department of Oral and Maxillofacial Surgery, Qilu Hospital, Cheeloo College of Medicine, Institute of Stomatology, Shandong University, Jinan, Shandong 250012, China
| | - Shaohua Liu
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, China; Department of Oral and Maxillofacial Surgery, Qilu Hospital, Cheeloo College of Medicine, Institute of Stomatology, Shandong University, Jinan, Shandong 250012, China.
| |
Collapse
|