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. 2019 Nov 1;3:27. doi: 10.1038/s41698-019-0099-9

Fig. 9.

Fig. 9

Proposed mechanism of action of propranolol in hemangioma of infancy. Proliferative hemangiomas are glycolytic and have elevated levels of VEGF, Ang2, and ANGPTL4, resulting in a highly angiogenic tumor with leaky vessels. Treatment with propranolol results in conversion to a respiratory phenotype, with downregulation of VEGF and ANGPTL4, but retaining Ang2, which then mediates regression of hemangiomas in the absence of angiogenic stimulation