Hemangiomas are the most common tumors in infants. These tumors can threaten the child's life (1%), threaten the development of vital structures (10%) and cause residual deformity in 50% of affected children. The majority occur in the head and neck area resulting in obvious physical deformity that causes tremendous distress for parents. Despite these significant complications, the majority of affected children do not receive treatment because of the high risks associated with current pharmacologic therapies. The absence of safe therapeutic alternatives is a critical barrier to care and good clinical outcomes for children with hemangiomas. In the previous cycle of funding we discovered markedly elevated levels of microRNA (miR)126 in the urine of children with proliferating hemangiomas indicating its potential usefulness as a biomarker. It is also markedly upregulated (104 x) in our validated murine model using EOMA cells and transdermal delivery of miR 126 inhibitor resulted in complete tumor regression in the murine model. miR126 is the predominant miR transcript expressed by endothelial cells during development and the transcription factor GATA binding protein 2 (GATA2) is critical driver of fetal endothelial cell development. Both are upregulated in EOMA cells, which supports the conceptual paradigm that endothelial cells in hemangiomas retain a persistent fetal phenotype, i.e. they are fetal rests. This proposal will establish miR126 as a critical driver of hemangioma development and proliferation and GATA2 as a key transcriptional regulator of miR126 biogenesis. We have previously reported that a standardized natural berry extract (NBE) can effectively limit hemangioma development and proliferation using the EOMA model. This safe nutritional intervention also inhibits the GATA2/miR126 axis in EOMA cells. This proposal will test the ability of NBE to inhibit hemangioma proliferation in the murine model and in children with hemangiomas. Changes in urinary levels of miR126 in response to NBE therapy will be measured to establish utility as a biomarker. The innovation in this proposal includes: the use of important contextual cues from fetal development to inform lines of investigation, establishing the critical significance of miR regulation of hemangioma proliferation, the identification of a safe nutritional intervention with pharmacokinetic data to determine first in human dosing, and the identification and testing of a biomarker for hemangioma. Successful completion of this proposal will change clinical management of hemangioma by making treatment safely available to all affected children in an effort to prevent death, disability or deformity caused by these tumors.

Public Health Relevance

Hemangiomas are the most common tumors in infants. However, most children are not treated because of the high risks associated with the most effective therapies. This proposal will establish microRNA 126 as a critical driver of hemangioma proliferation and test the effectiveness of a standardized natural berry extract to inhibit microRNA 126 biogenesis and hemangioma growth. If successful this proposal will provide a safe nutritional therapy that can be given to all children with hemangiomas.

Agency
National Institute of Health (NIH)
Institute
National Institute of General Medical Sciences (NIGMS)
Type
Research Project (R01)
Project #
2R01GM095657-05A1
Application #
9390625
Study Section
Surgery, Anesthesiology and Trauma Study Section (SAT)
Program Officer
Somers, Scott D
Project Start
2011-02-01
Project End
2021-06-30
Budget Start
2017-09-01
Budget End
2018-06-30
Support Year
5
Fiscal Year
2017
Total Cost
Indirect Cost
Name
Ohio State University
Department
Plastic Surgery
Type
Schools of Medicine
DUNS #
832127323
City
Columbus
State
OH
Country
United States
Zip Code
43210
Gordillo, Gayle M (2018) Reply: Urinary Excretion of MicroRNA-126 Is a Biomarker for Hemangioma Proliferation. Plast Reconstr Surg 141:320e
Biswas, Ayan; Pan, Xueliang; Meyer, Melissa et al. (2017) Urinary Excretion of MicroRNA-126 Is a Biomarker for Hemangioma Proliferation. Plast Reconstr Surg 139:1277e-1284e
Biswas, Ayan; Clark, Emma C; Sen, Chandan K et al. (2017) Phytochemical Inhibition of Multidrug Resistance Protein-1 as a Therapeutic Strategy for Hemangioendothelioma. Antioxid Redox Signal 26:1009-1019
Gordillo, Gayle M; Biswas, Ayan; Khanna, Savita et al. (2016) Multidrug Resistance-associated Protein-1 (MRP-1)-dependent Glutathione Disulfide (GSSG) Efflux as a Critical Survival Factor for Oxidant-enriched Tumorigenic Endothelial Cells. J Biol Chem 291:10089-103
Biswas, Ayan; Khanna, Savita; Roy, Sashwati et al. (2015) Endothelial cell tumor growth is Ape/ref-1 dependent. Am J Physiol Cell Physiol 309:C296-307
Gordillo, Gayle M; Biswas, Ayan; Khanna, Savita et al. (2014) Dicer knockdown inhibits endothelial cell tumor growth via microRNA 21a-3p targeting of Nox-4. J Biol Chem 289:9027-38
Embi, Peter J; Hebert, Courtney; Gordillo, Gayle et al. (2013) Knowledge management and informatics considerations for comparative effectiveness research: a case-driven exploration. Med Care 51:S38-44
Ganesh, Kasturi; Das, Amitava; Dickerson, Ryan et al. (2012) Prostaglandin E? induces oncostatin M expression in human chronic wound macrophages through Axl receptor tyrosine kinase pathway. J Immunol 189:2563-73
Jacobs, Benjamin J; Anzarut, Alex; Guerra, Sara et al. (2010) Vascular anomalies of the upper extremity. J Hand Surg Am 35:1703-9; quiz 1709