Propranolol therapy for infantile haemangiomas: review of the literature.
OBJECTIVE
Haemangiomas are the most common tumors of infancy affecting approximately 1 in 10 children. Unlike other tumors, haemangiomas enter an involution phase, during which they usually regress over the next several months to years. Sometimes intervention is required due to proliferative growth which is complicated by ulceration, bleeding, persistent aesthetic deformity or infection.


METHODS
Review of the literature.


RESULTS
Propranolol, a nonselective beta-blocker, has recently been introduced as a novel modality for the treatment of proliferating haemangiomas. The exact mechanism of action of propranolol in the treatment of haemangiomas remains unclear, but vasoconstriction, down-regulation of angiogenic factors such as VEGF and bFGF and up-regulation of apoptosis of capillary endothelial cells may be responsible for the reduction of haemangiomas. Besides, an inhibition of MMP-9 and HBMEC expression by propanolol is discussed as possible mechanism influencing the growth of haemangiomas. However, there are different case reports of successfully treated infants in the current literature.


CONCLUSIONS
There is the obtain that propranolol will detach steroids in the therapy for infantile haemangiomas.
Zimmermann
A P
AP
Department of Otolaryngology, Head and Neck Surgery, Philipps University, Marburg, Germany. anzimmer@med.uni-marburg.de
Wiegand
S
S
Werner
J A
JA
Eivazi
B
B
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D017209:Apoptosis / Q000187:drug effects; D015536:Down-Regulation; D042783:Endothelial Cells / Q000473:pathology; D005346:Fibroblast Growth Factors / Q000187:drug effects; D006258:Head and Neck Neoplasms / Q000188:drug therapy*; D006391:Hemangioma / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D020780:Matrix Metalloproteinase 9 / Q000187:drug effects; D011433:Propranolol / Q000494:pharmacology / Q000627:therapeutic use*; D015854:Up-Regulation; D042461:Vascular Endothelial Growth Factor A / Q000187:drug effects; D014661:Vasoconstriction / Q000187:drug effects
D000319:Adrenergic beta-Antagonists; D042461:Vascular Endothelial Growth Factor A; C108111:fibroblast growth factor 13; D005346:Fibroblast Growth Factors; D011433:Propranolol; D020780:Matrix Metalloproteinase 9