Abstract
Purpose: :
Angiogenic and growth factors have an important role in directing inflammation and wound healing. At the present time there is limited knowledge of their respective roles in the evolution of pediatric orbital abscesses. Our study aims to characterize the growth and angiogenic factors present within pediatric subperiosteal orbital abscess fluid collections.
Methods: :
All pediatric cases of subperiosteal orbital abscess drainage performed at a single institution from July 2005 through May 2006 were included in this prospective laboratory study. An external approach was used to drain each fluid collection. In addition to submitting the abscess fluid for routine microbiological analysis, a portion of the abscess fluid was sampled in a sterile fashion and retained for characterization using a cytokine protein membrane array (RayBio Human Cytokine Arrays VI and VII, RayBiotech, Inc., Norcross, GA.) Chemiluminescence was employed to assess for the presence of specific proteins, and those proteins detected were further qualified as weakly, moderately, or strongly positive.
Results: :
Four patients with ages ranging from 8 months to 17 years were entered into this study. Three patients had culture specimens that showed no growth while one grew Bacteroides capillosus and group G Streptococci. The weakly positive angiogenic and growth factors detected included glial cell–derived neurotrophic factor (GDNF), granulocyte colony stimulating factor (GCSF), fibroblast growth factor–9 (FGF–9), insulin–like growth factor binding protein 3 (IGFBP–3), epidermal growth factor receptor (EGF–R) and vascular endothelial growth factor (VEGF). Moderately positive factors detected on this array were insulin–like growth factor binding protein 1 (IGFBP–1) and angiogenin. No strongly positive angiogenic or growth factors were detected. Angiostatin, platelet–derived growth factor (PDGF), brain–derived neurotrophic factor (BDNF), hepatocyte growth factor (HGF) and sertoli cell growth factor (SCF) were not detected in the specimens.
Conclusions: :
Our study demonstrates the presence of several angiogenic and growth factors in pediatric subperiosteal orbital abscesses. These factors may play an important role in inflammation, wound healing and the control of infection. Defining the substances that mediate the development of an orbital abscess is the first step needed to pursue additional and more targeted treatment options for use in clinical practice.
Keywords: orbit • cytokines/chemokines • inflammation