Markers of mechanical asphyxia: immunohistochemical study on autoptic lung tissues

Forensic pathologists are often asked to provide evidence of asphyxia death in the trial and a histological marker of asphyxiation would be of great help. Data from the literature indicate that the reaction of lung tissue cells to asphyxia may be of more interest for forensic purposes than migrating...

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Bibliographic Details
Published in:International journal of legal medicine 2014-01, Vol.128 (1), p.117-125
Main Authors: Cecchi, R., Sestili, C., Prosperini, G., Cecchetto, G., Vicini, E., Viel, G., Muciaccia, B.
Format: Article
Language:English
Subjects:
Asphyxia - pathology
Autopsy - methods
Cause of Death
Drowning - pathology
Endothelium
Expert Testimony - legislation & jurisprudence
Forensic Medicine
Forensic pathology
Histopathology
Humans
Hypoxia
Hypoxia - pathology
Hypoxia-Inducible Factor 1, alpha Subunit - analysis
Immunoenzyme Techniques
Lung - pathology
Medical Law
Medicine
Medicine & Public Health
Morphology
Original Article
Proteins
Pulmonary Alveoli - pathology
Pulmonary arteries
Pulmonary Artery - pathology
Pulmonary Surfactant-Associated Protein A - analysis
Reference Values
Selectins - analysis
Surfactants
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Summary:Forensic pathologists are often asked to provide evidence of asphyxia death in the trial and a histological marker of asphyxiation would be of great help. Data from the literature indicate that the reaction of lung tissue cells to asphyxia may be of more interest for forensic purposes than migrating cells. The lungs of 62 medico-legal autopsy cases, 34 acute mechanical asphyxia (AMA), and 28 control cases (CC), were immunostained with anti-P-selectin, anti-E-selectin, anti-SP-A, and anti-HIF1-α antibodies, in order to verify if some of them may be used as markers of asphyxia death. Results show that P- and E-selectins expression in lung vessels, being activated by several types of trigger stimuli not specific to hypoxia, cannot be used as indicator of asphyxia. Intra-alveolar granular deposits of SP-A seem to be related to an intense hypoxic stimulus, and when massively present, they can suggest, together with other elements, a severe hypoxia as the mechanism of death. HIF1-α was expressed in small-, medium-, and large-caliber lung vessels of the vast majority of mechanical asphyxia deaths and CO intoxications, with the number and intensity of positive-stained vessels increasing with the duration of the hypoxia. Although further confirmation studies are required, these preliminary data indicate an interesting potential utility of HIF1-α as a screening test for asphyxia deaths.
ISSN:0937-9827
1437-1596
DOI:10.1007/s00414-013-0876-x