Department of Dermatology, Vanderbilt University School of Medicine, Nashville, TN, USA.
Department of Dermatology, Washington University, St. Louis, MO, USA.
Exp Dermatol. 2018 Jun;27(6):636-640. doi: 10.1111/exd.13510. Epub 2018 Apr 3.
Infantile haemangiomas (IHs) with functional or cosmetic concerns necessitate systemic treatment for which propranolol is the preferred treatment. However, the mechanism of action is unknown. Mouse models suggest the angiopoietin-2 (Ang2)/Tie-2 system is implicated. Ang2 can promote endothelial growth or induce apoptosis depending on the presence of vascular endothelial growth factor. This pilot study investigates the saliva Ang2 levels in infants with IH treated with and without systemic propranolol. Patients with clinically confirmed IHs were recruited from an academic paediatric dermatology centre. Treatment was based on clinical evaluation. Saliva samples were collected over 6 months. An enzyme-linked immunosorbent assay determined Ang2 levels. Ang2 levels were detectable in 45% of samples. However, by the late time point, only 28% had detectable levels. There were no changes of Ang2 over time, and there were no differences in Ang2 levels between groups. However, Ang2 levels were correlated with baseline size and changes in size from baseline. Ang2 is detectable in saliva of affected infants, but does not decrease with propranolol treatment. However, Ang2 levels are positively correlated with size and changes in size. Thus, Ang2 is not the primary factor in the mechanism of propranolol resulting in IH reduction.
婴儿血管瘤（IHs）如果存在功能或美容方面的问题，则需要进行全身治疗，其中普萘洛尔是首选治疗方法。然而，其作用机制尚不清楚。小鼠模型表明，血管生成素-2（Ang2）/Tie-2 系统可能与之相关。Ang2 可以根据血管内皮生长因子的存在促进内皮生长或诱导细胞凋亡。本研究旨在调查接受和未接受全身普萘洛尔治疗的 IH 婴儿的唾液 Ang2 水平。该研究从一个学术儿科皮肤科中心招募了经临床证实的 IH 患儿。治疗基于临床评估。采集了 6 个月的唾液样本。采用酶联免疫吸附试验测定 Ang2 水平。在 45%的样本中检测到 Ang2，但在晚期时间点，只有 28%的样本中检测到 Ang2。Ang2 水平随时间没有变化，且两组间的 Ang2 水平没有差异。然而，Ang2 水平与基线大小和基线大小变化呈正相关。受影响婴儿的唾液中可检测到 Ang2，但普萘洛尔治疗并不能使其降低。然而，Ang2 水平与大小和大小变化呈正相关。因此，Ang2 不是普萘洛尔导致 IH 减少的作用机制中的主要因素。
