Salivary Levels of Angiopoietin 2 in Infants with Infantile Hemangiomas Treated with and without Systemic Propranolol

Abstract

Background

Infantile hemangiomas (IH) with functional or cosmetic concerns necessitate systemictreatment for which propranolol is the preferred treatment. However, the mechanism ofaction is unknown. Mouse models suggest the angiopoietin-2 (Ang2)/Tie-2 system isimplicated. Ang2 can promote endothelial growth or induce apoptosis depending on thepresence of vascular endothelial growth factor (VEGF). This pilot study investigates thesaliva Ang2 levels in infants with IH treated with and without systemic propranolol.

Methods

Patients with clinically confirmed IH were recruited from an academic pediatric.dermatology center. Treatment was based on clinical evaluation. Saliva samples werecollected over six months. An ELISA determined Ang2 levels.

Results

Ang2 levels were detectable in 45% of samples. However, by the late time point only28% had detectable levels. There were no changes of Ang2 over time and there wereno differences in Ang2 levels between groups. However, Ang2 levels were correlatedwith baseline size and changes in size from baseline.

Conclusions

Ang2 is detectable in saliva of affected infants, but does not decrease with propranololtreatment. However, Ang2 levels are positively correlated with size and changes in size.Thus, Ang2 is not the primary factor in the mechanism of propranolol resulting in IHreduction.

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