European Archives of Oto-Rhino-Laryngology

, Volume 268, Issue 1, pp 123–129 | Cite as

Treatment of lymphatic malformations of head and neck with OK-432 sclerotherapy induce systemic inflammatory response

  • Mervi Närkiö-MäkeläEmail author
  • Teppo Mäkelä
  • Pia Saarinen
  • Päivi Salminen
  • Ilkka Julkunen
  • Anne Pitkäranta
Head and Neck


Systemic immune responses after OK-432 (Picibanil) sclerotherapy in patients with head and neck lymphatic malformations (LM) were examined to achieve a better understanding of the mechanism of OK-432 sclerotherapy and to evaluate the long-term treatment outcome. Serum samples from 17 consecutive patients with head and neck LMs were collected during a total of 26 OK-432 treatment episodes. Serum C-reactive protein (CRP), interleukins (IL) 1β, 6, 8, 10, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, RANTES, immune protein (IP)-10 and macrophage chemoattractant protein (MCP)-1 as well as blood leukocyte counts were determined. Clinical outcome of the treatment was evaluated at the last visit and from patient files. Elevated serum levels of IP-10 (means at baseline 702 ng/L, after 1 day 1180 ng/L, after 4 weeks 691 ng/L) were seen on day one after OK-432 sclerotherapy (p < 0.05). C-reactive protein and leukocyte counts 1 day after treatment differed statistically significantly (p < 0.05) from the baseline. No significant differences with other cytokines investigated were observed. Patients with macrocystic LM responded better than patients with microcystic LM (p = 0.01). The elevated levels of IP-10, C-reactive protein and leukocyte levels indicate that OK-432 sclerotherapy induces systemic immune responses in patients with LM. The mechanisms of OK-432 sclerotherapy are still not precisely understood, but the IP-10 elevation may reflect local antiangiogenetic properties of immunoactivation induced by OK-432.


OK-432 IP-10 Systemic inflammatory response Lymphatic malformation 



We thank Kimmo Lappalainen, MD, for his kind help in processing the MRI scans.

Conflict of interest statement

The authors declare that they have no conflicts of interest.


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Mervi Närkiö-Mäkelä
    • 1
    Email author
  • Teppo Mäkelä
    • 2
  • Pia Saarinen
    • 3
  • Päivi Salminen
    • 4
  • Ilkka Julkunen
    • 5
  • Anne Pitkäranta
    • 6
  1. 1.Department of OtorhinolaryngologyKuopio University Hospital and University of KuopioKuopioFinland
  2. 2.Department of Diagnostic RadiologyKuopio University HospitalKuopioFinland
  3. 3.Department of Plastic SurgeryHelsinki University Central HospitalHelsinkiFinland
  4. 4.Department of Pediatric SurgeryHelsinki University Central HospitalHelsinkiFinland
  5. 5.The National Institute for Health and Welfare (THL)HelsinkiFinland
  6. 6.Department of OtorhinolaryngologyHelsinki University Central Hospital and University of HelsinkiHelsinkiFinland

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