title: Propranolol for infantile hemangioma: Effect on plasma vascular endothelial growth factor.
abstract: BACKGROUND
  Propranolol has recently been shown to be highly effective for infantile hemangioma (IH), but the mechanism of action of propranolol and the usefulness of measurement of vascular endothelial growth factor (VEGF) remain poorly understood. The aim of this study was therefore to determine the efficacy of propranolol treatment and to evaluate changes in plasma VEGF in IH patients who underwent propranolol treatment.
  
  
  METHODS
  The study group consisted of 35 children with IH. Oral propranolol was give at a dose of 2.0 mg/kg/day and was divided in three doses. Outcome was assessed using the visual analog scale (VAS) of size and color. Plasma VEGF concentration was analyzed on enzyme-linked immunoabsorbent assay, and compared between the groups.
  
  
  RESULTS
  Improvement in VAS in patients who started propranolol before 6 months of age was superior to that in those who started propranolol after 6 months of age. VEGF concentration was significantly correlated with lesion size (P = 0.002), whereas no correlation was observed with age. VEGF concentration 4 weeks after treatment was significantly lower than that before treatment (P < 0.01).
  
  
  CONCLUSIONS
  Measurement of VEGF may be a useful tool for predicting the course of IH and monitoring the effectiveness of treatment.
authors.affiliation: Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Ozeki
authors.affiliation: Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Akifumi
authors.initials: A
authors.lastname: Nozawa
authors.affiliation: Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Hori
authors.affiliation: Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Kanda
authors.affiliation: Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
authors.affiliation: Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Kawamoto
authors.affiliation: Department of Pediatrics, Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Fukao
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006391:Hemangioma / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D007223:Infant; D008297:Male; D011433:Propranolol / Q000008:administration & dosage*; D042461:Vascular Endothelial Growth Factor A / Q000097:blood* / Q000187:drug effects; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists; D042461:Vascular Endothelial Growth Factor A; D011433:Propranolol
keywords: angiogenesis; angiogenic factor; proliferation phase; vascular anomaly; vascular tumor