Infantile hemangioma: the common and enigmatic vascular tumor
Annegret Holm, … , John B. Mulliken, Joyce Bischoff
Annegret Holm, … , John B. Mulliken, Joyce Bischoff
Published April 15, 2024
Citation Information: J Clin Invest. 2024;134(8):e172836. https://doi.org/10.1172/JCI172836.
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Review Series

Infantile hemangioma: the common and enigmatic vascular tumor

Abstract

Infantile hemangioma (IH) is a benign vascular tumor that occurs in 5% of newborns. The tumor follows a life cycle of rapid proliferation in infancy, followed by slow involution in childhood. This unique life cycle has attracted the interest of basic and clinical scientists alike as a paradigm for vasculogenesis, angiogenesis, and vascular regression. Unanswered questions persist about the genetic and molecular drivers of the proliferating and involuting phases. The beta blocker propranolol usually accelerates regression of problematic IHs, yet its mechanism of action on vascular proliferation and differentiation is unclear. Some IHs fail to respond to beta blockers and regrow after discontinuation. Side effects occur and long-term sequelae of propranolol treatment are unknown. This poses clinical challenges and raises novel questions about the mechanisms of vascular overgrowth in IH.

Authors

Annegret Holm, John B. Mulliken, Joyce Bischoff

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Figure 1

Life cycle, cellular components, and molecular players in IH.

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Life cycle, cellular components, and molecular players in IH. (A) Series...
(A) Series of clinical images of a healthy female newborn (left) and the same individual at 5 months of age with an extensive facial and upper airway IH requiring tracheostomy (middle). This patient was treated with systemic corticosteroids, which was the mainstay of treatment at the time. The final image shows the patient at 5 years of age, with the IH in the involuted phase (right). Reproduced with permission from Elsevier (131). (B) H&E staining of proliferating and involuting IH demonstrates the differences in cellularity and vessel morphology in both phases in the IH cycle. Scale bars: 100 μm. Reproduced with permission from Angiogenesis (132). (C) Schematic of hemangioma stem cells, hemangioma endothelial cells, and hemangioma pericytes and molecular features of each cell type. Adapted with permission from the British Journal of Dermatology (133).