Expression Of Vascular Endothelial Growth Factor-a And Hypoxia-inducible Factor 1α,and Epidermal Growth Factor-like Domain 7 In Proliferating Hemangioma Treated With Propranolol

Objective: This study aims to investigate the expression levels of serum and urine vascular endothelial growth factor-A(VEGF-A) and epidermal growth factor-like domain 7(EGFL7) and hypoxia-inducible factor 1α(HIF-1α) in proliferating infantile hemangioma patients under propranolol treatment. Methods:Propranolol was given orally to 30 infants with proliferating haemangiomas in a dose of 0.5-2mg/kg/day. The Achauer method was used to measure the tumor radius and thus evaluate the clinical curative effects of the treatment. An ELISA was used to measure the serum and urine concentrations of VEGF-A and EGFL7 and HIF-1α at 0, 4, and 12 weeks after the treatment.Results: The treatment response was excellent in 2 patients, good in 11, moderate in 14, and poor in 3. Serum VEGF-A(335.692 pg/ml±136.146 pg/ml) was high before the treatment and then significantly decreased after 4 weeks(264.853 pg/ml±122.120 pg/ml) and 12 weeks(211.345 pg/ml±104.035 pg/ml) of treatment(P <0.05). Urine VEGF-A(76.234 pg/ml±24.169 pg/ml) was high before the treatment and then significantly decreased after four weeks(56.454 pg/ml ± 16.111 pg/ml) and twelve weeks(34.728 pg/ml±12.656 pg/ml) of treatment(P <0.05). Serum and urine HIF-1α、EGFL7 also decreased after the treatment, showing a positive relationship with VEGF-A.But the urine HIF-1α was no significantly different between before and 4 weeks after treatment(P =0.05).The serum EGFL7 was no significantly different between before and 4 weeks after treatment(P > 0.05),and was no significantly different between 4 and 12 weeks after treatment(P>0.05).Conclusions:Propranolol can be safely and effectively used to treat proliferating infantile hemangiomas. This treatment can reduce the peripheral serum and urine concentrations of VEGF-A and EGFL7 and HIF-1α in affected children.