CD26 Is Differentially Expressed throughout the Life Cycle of Infantile Hemangiomas and Characterizes the Proliferative Phase

Author:

Lorusso Bruno1ORCID,Nogara Antonella1ORCID,Fioretzaki Rodanthi12ORCID,Corradini Emilia1,Bove Roberta1ORCID,Roti Giovanni134,Gherli Andrea13ORCID,Montanaro Anna13ORCID,Monica Gregorio13ORCID,Cavazzini Filippo13,Bonomini Sabrina4,Graiani Gallia5,Silini Enrico Maria6ORCID,Gnetti Letizia6,Pilato Francesco Paolo6,Cerasoli Giuseppe7,Quaini Federico1ORCID,Lagrasta Costanza Anna Maria1ORCID

Affiliation:

1. Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy

2. Department of Medical Oncology, Metaxa Cancer Hospital of Piraeus, 185 37 Piraeus, Greece

3. Translational Hematology and Chemogenomics (THEC), University of Parma, 43126 Parma, Italy

4. Hematology and BMT Unit, University Hospital of Parma, 43126 Parma, Italy

5. Center of Dental Medicine, University of Parma, 43126 Parma, Italy

6. Pathology Section, University Hospital of Parma, 43126 Parma, Italy

7. Pediatric Surgery, Ospedale dei Bambini of Parma, University Hospital of Parma, 43126 Parma, Italy

Abstract

Infantile hemangiomas (IHs) are benign vascular neoplasms of childhood (prevalence 5–10%) due to the abnormal proliferation of endothelial cells. IHs are characterized by a peculiar natural life cycle enclosing three phases: proliferative (≤12 months), involuting (≥13 months), and involuted (up to 4–7 years). The mechanisms underlying this neoplastic disease still remain uncovered. Twenty-seven IH tissue specimens (15 proliferative and 12 involuting) were subjected to hematoxylin and eosin staining and a panel of diagnostic markers by immunohistochemistry. WT1, nestin, CD133, and CD26 were also analyzed. Moreover, CD31pos/CD26pos proliferative hemangioma–derived endothelial cells (Hem-ECs) were freshly isolated, exposed to vildagliptin (a DPP-IV/CD26 inhibitor), and tested for cell survival and proliferation by MTT assay, FACS analysis, and Western blot assay. All IHs displayed positive CD31, GLUT1, WT1, and nestin immunostaining but were negative for D2-40. Increased endothelial cell proliferation in IH samples was documented by ki67 labeling. All endothelia of proliferative IHs were positive for CD26 (100%), while only 10 expressed CD133 (66.6%). Surprisingly, seven involuting IH samples (58.3%) exhibited coexisting proliferative and involuting aspects in the same hemangiomatous lesion. Importantly, proliferative areas were characterized by CD26 immunolabeling, at variance from involuting sites that were always CD26 negative. Finally, in vitro DPP-IV pharmacological inhibition by vildagliptin significantly reduced Hem-ECs proliferation through the modulation of ki67 and induced cell cycle arrest associated with the upregulation of p21 protein expression. Taken together, our findings suggest that CD26 might represent a reliable biomarker to detect proliferative sites and unveil non-regressive IHs after a 12-month life cycle.

Funder

University of Parma

Publisher

MDPI AG

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