4.3 Article

Expression of β1 adrenergic receptor in vascular anomalies in children

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SAGE PUBLICATIONS LTD
DOI: 10.1177/03000605211047713

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Vascular anomaly; beta-blocker; beta 1 adrenergic receptor; propranolol; infantile hemangioma; immunohistochemistry

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This study demonstrates for the first time the heterogeneous expression of beta 1-AR among pediatric vascular malformations, supporting the need for beta 1-AR assessment to select cases with a robust response to beta 1-selective blockers. The assessment of beta 1-AR may have a significant impact on therapeutic refinement for pediatric vascular anomalies by selecting cases with a stronger response to beta-blockers.
Objective: Controversial, heterogeneous, and inconsistent responses to beta-blockers have been reported in some cases of infantile proliferative hemangiomas. On the basis of these clinical observations, we aimed to examine the beta 1 adrenergic receptor (beta 1-AR) protein expression distribution among different types of pediatric vascular anomalies. Methods: Immunohistochemistry (IHC) was performed for beta 1-AR on 43 surgical specimens. Results: We found positive beta 1-AR IHC staining in all intramuscular hemangiomas, capillary-lymphatic, lymphatic, venous, and combined malformations, and Masson's tumor cases, as well as in 7 of 10 cases of proliferative infantile hemangiomas. Conclusions: Our research demonstrates, for the first time, the degree of heterogeneous expression of beta 1-AR among pediatric vascular malformations. Our results support the need for beta 1-AR assessment in pediatric vascular anomalies to select cases with a robust response to beta 1-selective blockers. beta 1-AR assessment may have a strong impact on therapeutic refinement for pediatric vascular anomalies by selecting cases with a stronger response to beta-blockers.

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