Open Access

Propranolol therapy for cerebral cavernous malformations

  • Authors:
    • Filipa Lopes‑Coelho
    • Sofia Nunes
    • Filipa Martins
    • Ana Hipólito
    • Sofia Gouveia‑Fernandes
    • Germana Domingues
    • Bernardete F. Melo
    • Joana F. Sacramento
    • Sílvia V. Conde
    • Sofia A. Pereira
    • Sofia Vinhais
    • Duarte Salgado
    • Jacinta Serpa
  • View Affiliations

  • Published online on: April 6, 2022     https://doi.org/10.3892/wasj.2022.158
  • Article Number: 23
  • Copyright: © Lopes‑Coelho et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Cerebral cavernous malformations (CCMs) are vascular malformations characterized by the abnormal growth of vascular structures in the central nervous system. However, the precise mechanism(s) responsible for the development of CCM vascular abnormalities remain poorly understood. Although the mechanisms of action of propranolol in CCM have not yet been fully explored it is not commonly prescribed, it has been shown to be effective in children and appears to play a protective role in the prevention of CCM‑derived hemorrhage in adults. The present study performed in vitro and ex vivo assays in order to examine the effects of propranolol on endothelial cells (ECs). The percentage of CD14+/CD31+ cells and the levels of VEGF in the peripheral blood (PB) of a child patient with CCM, with recurrent seizures and hemorrhages, who was maintained under propranolol therapy, were also analyzed. In addition to the effects of propranolol on differentiated ECs, and the decrease angiogenic‑related features in vitro and ex vivo, it was observed that in the PB of this patient, propranolol administration decreased the percentage of circulating cells sharing monocytic and EC features (CD14+/CD31+ cells), as well as the VEGF levels; this was concomitant with a good prognosis and with the reversion of CCM lesions. A decrease in VEGF levels by propranolol may also be involved in the impairment of the recruitment of CD14+/CD31+ monocytes functioning as endothelial progenitor cells to sustain the vascular lesion. On the whole, the present study demonstrates that propranolol impairs angiogenesis in vitro and may thus be a useful tool for the clinical management of CCM. Moreover, the present study highlights the monitorization of the levels of CD14+/CD31+ monocytes and VEGF levels as a useful tool for predicting the clinical efficacy of propranolol in patients with CCM.
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May-June 2022
Volume 4 Issue 3

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Spandidos Publications style
Lopes‑Coelho F, Nunes S, Martins F, Hipólito A, Gouveia‑Fernandes S, Domingues G, Melo BF, Sacramento JF, Conde SV, Pereira SA, Pereira SA, et al: Propranolol therapy for cerebral cavernous malformations. World Acad Sci J 4: 23, 2022.
APA
Lopes‑Coelho, F., Nunes, S., Martins, F., Hipólito, A., Gouveia‑Fernandes, S., Domingues, G. ... Serpa, J. (2022). Propranolol therapy for cerebral cavernous malformations. World Academy of Sciences Journal, 4, 23. https://doi.org/10.3892/wasj.2022.158
MLA
Lopes‑Coelho, F., Nunes, S., Martins, F., Hipólito, A., Gouveia‑Fernandes, S., Domingues, G., Melo, B. F., Sacramento, J. F., Conde, S. V., Pereira, S. A., Vinhais, S., Salgado, D., Serpa, J."Propranolol therapy for cerebral cavernous malformations". World Academy of Sciences Journal 4.3 (2022): 23.
Chicago
Lopes‑Coelho, F., Nunes, S., Martins, F., Hipólito, A., Gouveia‑Fernandes, S., Domingues, G., Melo, B. F., Sacramento, J. F., Conde, S. V., Pereira, S. A., Vinhais, S., Salgado, D., Serpa, J."Propranolol therapy for cerebral cavernous malformations". World Academy of Sciences Journal 4, no. 3 (2022): 23. https://doi.org/10.3892/wasj.2022.158