Abstract: Ling Bin, Yin Xiaopeng, Liu Jie, Zhang Jing, Gong Zhongcheng, Lin Zhaoquan. Oncology Department of Oral & Maxillofacial Surgery, First Affiliated Hospital of Xinjiang Medical University; Stomatology College of Xinjiang Medical University; Stomatology Research Institute of Xinjiang Uygur Autonomous Region, Urumqi 830054, China Corresponding author: Lin Zhaoquan, Email: lzqxhj@163.com 【Abstract】 Objective To evaluate the clinical efficacy of propranolol in treating proliferating infantile haemangiomas, and to measure the expression levels of vascular endothelial growth factor-A （VEGF-A） and hypoxia-inducible factor 1α（HIF-1α） in sera and urine of patients during the treatment. Methods Thirty infants with proliferating haemangiomas were treated with propranolol at doses of 0.5 － 2 mg/kg per day. The radius of haemangiomas was measured, and blood and urine samples were obtained from these patients before, and at 4 and 12 weeks after the beginning of treatment. Clinical efficacy was estimated according to a four-graded scale as well as the feedback from parents of these patients. Enzyme-linked immunosorbent assay （ELISA） was performed to determine the serum and urine concentrations of VEGF-A and HIF-1α. Thirty check-up infants collected from the Department of Child Health Care served as the healthy controls. Statistical analysis was done by two-way analysis of variance followed by the least significant difference （LSD） test. Results After 12 weeks of treatment, clinical response was excellent in 2 patients, good in 11, moderate in 14, and poor in 3. The serum levels of VEGF-A and HIF-1α were （268.174 ± 95.056） μg/L and （10.809 ± 1.686） mg/L respectively in the control group, sequentially decreased in the patients from baseline to 4 and 12 weeks after the beginning of treatment （VEGF-A: （385.692 ± 136.146） vs. （264.853 ± 122.12） vs. （211.345 ± 104.035） μg/L; HIF-1α: （31.462 ± 7.458） vs. （21.454 ± 5.489） vs. （12.052 ± 3.623） mg/L）. The trend in expression changes of VEGF-A and HIF-1α in urine samples was similar to that in blood samples in these patients. Positive correlation was observed between the expression level of VEGF-A and HIF-1α in sera （r = 0.730, P < 0.05） and urine （r = 0.667, P < 0.05） of these patients. Moreover, the levels of serum VEGF-A, urine VEGF-A, serum HIF-1α and urine HIF-1α were all negatively correlated with the time course following propranolol administration （r = －0.390, －0.689, －0.806, －0.683, P < 0.05, 0.01, 0.05, 0.01 respectively）. Conclusion Propranolol is effective for the treatment of proliferating infantile haemangiomas, likely by reducing serum and urinary concentrations of VEGF-A and HIF-1α in children.

Key words: Propranolol, Hemangioma, Vascular endothelial growth factor A, Hypoxia-inducible factor 1α