Vascular malformations in the field of ENT – biomarker expression as a possible first step towards a targeted therapy

Introduction:

Vascular malformations (VMs) are congenital, benign abnormalities of the vascular system. The occur ubiquitously and involve either exclusively lymphatic vessels, venous/arterios vessels or occur in a mixed pattern.

If located in the head and neck region, VMs are a challenging disease to treat, due to the complex anatomical structure of that area. To date, there is no standardized therapy.

Methods:

Peri-interventional obtained punctate directly from the VM as well as peripheral venous blood was taken from 6 patients. The material was analyzed using flow cytometry and the percentage of circulating progenitor cells (CD45, CD34, CD 133) was computed. A control group of healthy patients' peripheral venous blood was also analyzed.

Results:

Compared to the peripheral venous blood, there was an overexpression of CD45RA on the progenitor cells obtained directly from the lesion (p = 0,068). Furthermore, the absolute population of CD45RA+ progenitor cells was elevated too. The same trend could be shown for CD34+CD45RA+ progenitor cells (p = 0,068).

Conclusions:

The data suggests, that the VMs attract circulating progenitor cells and therefore are characterized by a systemic immunoregulatory reaction rather than an entirely regional aspect.

Current therapy like the widely used sclerotherapy with STS (Fibrovein®) are based on a physical damage to the endothelium of the VMs and do not address the underlying, yet to be understood pathomechanism.

A possible “targeted therapy” could lead to a less invasive and more specific therapy and longer lasting treatment success.

Publication History

Publication Date:
23 April 2019 (online)