Pediatric Skin Center, Department of Dermatology,
Department of Pediatric Surgery, Kantonsspital Aarau, Aarau, Switzerland.
Pediatrics. 2020 Mar;145(3). doi: 10.1542/peds.2019-1942. Epub 2020 Feb 12.
Since the discovery of propranolol in the treatment of infantile hemangioma (IH), there has been emergent investigation of β-adrenergic receptor (β-AR) signaling in IH and the mechanisms of action for which β-AR blockers regulate hemangioma cell proliferation. However, β-AR agonists and antagonists are known to act antithetically via the same intracellular β-AR-driven proangiogenic pathways. We present the case of a patient with involuted IH treated with propranolol that showed a full and rapid regrowth during the intravenous administration of salbutamol, a selective β2-adrenergic agonist, for an episode of severe obstructive bronchitis. This observation brings forward the clinical implication of β-signaling effects in IH and raises awareness of the potential proliferative response of IH to β-AR agonists such as salbutamol.
自普萘洛尔在治疗婴儿血管瘤（IH）中的应用被发现以来，人们对 IH 中的β-肾上腺素能受体（β-AR）信号转导以及β-AR 阻滞剂调节血管瘤细胞增殖的作用机制进行了紧急研究。然而，β-AR 激动剂和拮抗剂通过相同的细胞内β-AR 驱动的促血管生成途径发挥拮抗作用。我们报告了一例接受普萘洛尔治疗的消退期 IH 患者的病例，该患者在因严重阻塞性支气管炎静脉注射沙丁胺醇（一种选择性β2-肾上腺素能激动剂）时，血管瘤完全且迅速地重新生长。这一观察结果提出了 IH 中β 信号转导效应的临床意义，并提醒人们注意 IH 对沙丁胺醇等β-AR 激动剂的潜在增殖反应。
