title: Treatment of lymphatic malformations of head and neck with OK-432 sclerotherapy induce systemic inflammatory response.
abstract: Systemic immune responses after OK-432 (Picibanil) sclerotherapy in patients with head and neck lymphatic malformations (LM) were examined to achieve a better understanding of the mechanism of OK-432 sclerotherapy and to evaluate the long-term treatment outcome. Serum samples from 17 consecutive patients with head and neck LMs were collected during a total of 26 OK-432 treatment episodes. Serum C-reactive protein (CRP), interleukins (IL) 1β, 6, 8, 10, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, RANTES, immune protein (IP)-10 and macrophage chemoattractant protein (MCP)-1 as well as blood leukocyte counts were determined. Clinical outcome of the treatment was evaluated at the last visit and from patient files. Elevated serum levels of IP-10 (means at baseline 702 ng/L, after 1 day 1180 ng/L, after 4 weeks 691 ng/L) were seen on day one after OK-432 sclerotherapy (p < 0.05). C-reactive protein and leukocyte counts 1 day after treatment differed statistically significantly (p < 0.05) from the baseline. No significant differences with other cytokines investigated were observed. Patients with macrocystic LM responded better than patients with microcystic LM (p = 0.01). The elevated levels of IP-10, C-reactive protein and leukocyte levels indicate that OK-432 sclerotherapy induces systemic immune responses in patients with LM. The mechanisms of OK-432 sclerotherapy are still not precisely understood, but the IP-10 elevation may reflect local antiangiogenetic properties of immunoactivation induced by OK-432.
authors.affiliation: Department of Otorhinolaryngology, Kuopio University Hospital and University of Kuopio, POB 1777, Kuopio, Finland. mervi.narkio-makela@kuh.fi
authors.forename: Mervi
authors.initials: M
authors.lastname: Närkiö-Mäkelä
authors.forename: Teppo
authors.initials: T
authors.lastname: Mäkelä
authors.forename: Pia
authors.initials: P
authors.lastname: Saarinen
authors.forename: Päivi
authors.initials: P
authors.lastname: Salminen
authors.forename: Ilkka
authors.initials: I
authors.lastname: Julkunen
authors.forename: Anne
authors.initials: A
authors.lastname: Pitkäranta
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood; D005260:Female; D006257:Head; D006801:Humans; D007223:Infant; D044148:Lymphatic Abnormalities / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009333:Neck; D010844:Picibanil / Q000009:adverse effects* / Q000627:therapeutic use*; D015911:Sclerotherapy / Q000379:methods*; D018746:Systemic Inflammatory Response Syndrome / Q000139:chemically induced*; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D016207:Cytokines; D010844:Picibanil