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Objective@#To investigate whether N6-methyladenine DNA(6-mA DNA) modification is related to the occurrence of infantile hemangiomas (IH) at the epigenetic level.@*Methods@#The genomic 6-mA DNA data were obtained by MeDIP and high-throughput sequencing. The 6-mA DNA methylation levels in 3 proliferative hemangioma specimens and adjacent skin tissues were compared by u-test. The functional differences of 6-mA modified genes were analyzed by GO analysis.@*Results@#The level of 6-mA DNA modification in IH tissue was higher. The coverage of 6-mA Peaks in the genome was 0.037% in the tumor tissue, and the coverage of 6-mA Peaks in the surrounding skin tissue was 0.013% in the genome. The difference between the two groups was statistically significant (u=5999.87, P=0.00). The gene functions of differentially 6-mA modified genes in tumors were enriched in mesoderm development, stem cell differentiation, mesenchymal development, and cell cycle. These gene functions were closely related to the pathogenesis of IH.@*Conclusion@#Abnormal 6-mA DNA modification may be one of the pathogenesis of infantile hemangioma.
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Objective To assess the effectiveness and safety of propranolol in infantile hemangiomas by comparing with prednisone.Methods A systematic literature search of PubMed,Embase,Cochrane,Ovid,Google Scholar and CNKI,VIP,Wanfang database was conducted to identify studies about the treatment of propranolol in children with hemangiomas.We chose randomized controlled trials and clinical controlled trials.We selected literatures by certain standards.Results Eight papers including 9 studies were identified by the strategy mentioned above.These 8 literatures met our inclusion criteria after review by two independent reviewers.The studies comprised 407 patients.Six of the control group were oral prednisone,and there was no statistic heterogeneity (P =0.09,I2 =0％).The fixed model was used to do the statistic analysis.The outcome showed the effective rate of propranolol was higher than that of prednisone,with statistically significant difference (OR=7.56,95％ CI:3.18-17.98).Three of the control group included observation or oral placebo,without statistic heterogeneity (P=0.48,I2=0％) either.The outcome showed the effective rate of propranolol on hemangioma was higher than that of the control group (OR=23.15,95％CI:7.15-74.94).Of all the eight researches,five reported adverse effects,with statistic heterogeneity (P=0.0003,I2 =81 ％).In addition,the adverse rate of propranolol was lower than that of prednisone,with statistically significant difference (OR=0.12,95％ CI:0.02-0.75).Conclusions The results of this meta-analysis show that oral propranolol could obviously decrease the volume and improve the color of infantile hemangiomas.And propranolol is a significantly more effective for IH than steroids.The incidence of adverse effects of propranolol is also lower than that of prednisone.As a result,propranolol should be recommended as the first choice therapy for infantile hemangioma.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the significance of beta-adrenergic receptor 2 (beta2-AR) and vascular endothelial growth factor-2 (VEGFR-2) in the occurrence and development of infantile hemangioma through detecting the expression of beta2-AR and VEGFR-2 in the different stages of infantile hemangiomas.</p><p><b>METHODS</b>According to the Mulliken's classification standard, we classified the specimens as proliferating group (32 cases), involuting group (17 cases) and involuted group (11 cases). Normal skin tissue surrounding the hemangioma from 7 cases were chosen as control group. The expression of beta2-AR and VEGFR-2 was detected by immunohistochemical technique in proliferating hemangioma, involuting hemangioma, involuted hemangioma. The mean optical density was measured by image analysis system (Image Pro Plus 6.0) and SPSS 16.0 software was applied for statistical analysis.</p><p><b>RESULTS</b>The expression of beta2-AR and VEGFR-2 was strongly positive in proliferating hemangioma, while positive in involuting hemangioma and weakly positive in the involuted stage. The mean optical density of each phase was 0.064 751 2 +/- 0.012 747, 0.031 6017 +/- 0.006 848,0.011 869 8 +/- 0.039 349 for beta2-AR, and 0.068 940 9 +/- 0.029 274, 0.028 445 5 +/- 0.006 396, 0.011 184 1 +/- 0.004 198 for VEGFR-2. The differences between different stages had a statistically significance (P < 0.05). Correlation analysis on the mean optical density between beta2-AR and VEGFR-2 had a statistically significance (P < 0. 05).</p><p><b>CONCLUSIONS</b>Beta2-AR and VEGFR-2 may be involved in the occurrence and development of infantile hemangioma.</p>