Effect Of PEDF/VEGF In The Evaluation Of Propranolol In The Treatment Of Infantile Hemangioma

Objective: to study the changes of serum PEDF/VEGF levels in infants with hemangioma before and after oral propranolol treatment,and to further explore the role of PEDF,VEGF and PEDF/VEGF in evaluating the clinical efficacy of propranolol in the treatment of IH.Methods: the children with IH hospitalized in the people’s Hospital of Xinjiang Uygur Autonomous region from June 2019 to December 2020 were collected.According to the different time of first diagnosis,and according to the wishes of their family members,oral propranolol was given.The follow-up period was at the beginning of treatment and 1,3,6 months after regular treatment.At the same time,normal physical examination infants less than 1 year old with matched age and sex were selected as the control group,and blood samples were taken.Results:(1)after propranolol treatment,there was no significant difference in the clinical improvement rate of HAS among different ages,genders and sites,but there was significant difference between propranolol and tumor types(P < 0.05).(2)there was no significant difference in serum PEDF,VEGF and PEDF/VEGF levels among different age,sex,location and type of IH before treatment.(3)at 1,3 and 6 months after treatment,the level of serum PEDF was not significantly different from that before treatment,but the level of VEGF decreased,and the ratio of PEDF/VEGF increased gradually,and there was significant difference after 6 months of treatment(P < 0.01).Spearman rank correlation analysis showed that the decrease of serum VEGF after treatment with propranolol was negatively correlated with the clinical improvement rate of HAS,while the increased level of PEDF/VEGF was positively correlated with the clinical improvement rate of HAS.(4)there was no significant difference in serum PEDF level between the pre-treatment group,the post-treatment group and the normal group(P > 0.05).There was significant difference in),VEGF level and PEDF/VEGF ratio between the pre-treatment group,the post-treatment group and the normal group(P < 0.01).The serum VEGF concentration in the proliferative hemangioma group before treatment was significantly higher than that in the post-treatment group and the normal group.The PEDF/VEGF ratio of proliferative hemangioma before treatment was lower than that of post-treatment group and normal group(P < 0.05).Conclusion:(1)the longer the treatment course of propranolol for IH,the lower the serum VEGF level and the higher the PEDF/VEGF ratio.(2)the decrease of serum VEGF level combined with B-ultrasound examination can be used as one of the indexes to evaluate the efficacy of propranolol in the treatment of hemangioma.(3)the mechanism of propranolol in the treatment of IH may be related to the down-regulation of VEGF expression.PEDF provides a new therapeutic strategy for propranolol in the treatment of IH,which needs further study.