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Zhang H, Niu JJ, Zhou H, Hu YK, Li WC, Ma JL, Liao XB, Ma KJ, Chen L. 8-oxoguanine DNA glycosylase-1 may serve as biomarker of mechanical asphyxia. Forensic Sci Int 2024; 361:112071. [PMID: 38870577 DOI: 10.1016/j.forsciint.2024.112071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Accepted: 05/26/2024] [Indexed: 06/15/2024]
Abstract
AIM To identify mtDNA and OGG1 as potential biomarker candidates for mechanical asphyxia. METHOD The human tissues are divided into experimental group (hanging and strangulation) and control groups (hemorrhagic shock, brain injury group, and poisoning group). Detected the expression of OGG1 and integrity of mtDNA in cardiac tissue of each group. We used over-OGG1 vector and siRNA-OGG1 transfecting H9C2 cell line to observe the function of OGG1 in hypoxic cells. RESULTS 1. mtDNA integrity decreased in the mechanical asphyxia group, OGG1 expression increased in mechanical asphyxia groups. They can be biomarkers for mechanical asphyxia. 2. OGG1 increased first and decreased in hypoxia-induced H9C2 cells. OGG1 upregulated the TFAM, NRF1, and Bcl2 in hypoxia-induced H9C2. OGG1 downregulated cleaved-Caspase3 in hypoxia-induced H9C2 cells. 3. In the normoxia condition, NAC maintained mtDNA integrity and decreased the mitochondrial membrane potential and amount of ATP. CONCLUSION mtDNA integrity and OGG1 expression can be biomarkers for mechanical asphyxia. OGG1 can maintain mtDNA integrity and maintain the stability of the mitochondrial membrane.
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Affiliation(s)
- Heng Zhang
- Department of Forensic Medicine, School of Basic Medicine, Anhui Medical University, Hefei, China
| | - Jing-Jing Niu
- Department of Forensic Medicine, School of Basic Medicine, Anhui Medical University, Hefei, China
| | - Hao Zhou
- Hefei Public Security Bureau of Anhui Province, Hefei, China
| | - Yi-Kai Hu
- Department of Forensic Medicine, School of Basic Medicine, Fudan University, Shanghai, China
| | - Wen-Can Li
- Pudong Branch of Shanghai Municipal Public Security Bureau, Shanghai, China
| | - Jian-Long Ma
- Shenzhen Institute of Criminal Science and Technology, Investigation Department of Shenzhen Public Security Bureau, Key Laboratory of Forensic Pathology, Ministry of Public Security, Shenzhen, China
| | - Xin-Biao Liao
- Criminal Technology Center of Guangdong Provincial Public Security Department, Guangzhou, China.
| | - Kai-Jun Ma
- Shanghai Public Security Bureau, Shanghai, China.
| | - Long Chen
- Department of Forensic Medicine, School of Basic Medicine, Fudan University, Shanghai, China.
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Hu Y, Han L, Zhang H, Li W, Wu T, Ma J, Zhang D, Ma K, Xiao B, Yu Y, Xu H, Tian L, Liao X, Chen L. The down-regulation of STC2 mRNA may serve as a biomarker for death from mechanical asphyxia. Leg Med (Tokyo) 2024; 67:102382. [PMID: 38159418 DOI: 10.1016/j.legalmed.2023.102382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/07/2023] [Accepted: 12/22/2023] [Indexed: 01/03/2024]
Abstract
Death from mechanical asphyxia (DMA) is a common cause of death in forensic pathology. However, due to the lack of biomarkers, the authentication of DMA now relies on a series of non-specific signs, which may cause troubles in the judicial trials, especially when the criminal scene is not fully elucidated. To search for the potential biomarkers for DMA, brain samples of DMA and craniocerebral injury groups were screened by microarray. The obtained mRNAs were validated by animal and human samples. Primary cell culture was conducted to explore the biochemical changes under hypoxia. 415 differentially expressed mRNAs between two groups were discovered. Ten mRNAs were examined in both human and animal samples died of different causes of death. Stanniocalcin-2 (STC2) showed significant down-regulation in DMA samples compared to other groups, regardless of PMI, age, or temperature. Cellular experiments indicated that ROS level peaked after 15-min-hypoxic culture, when the expression level of STC2 was significant down-regulated simultaneously. The ER-stress-related proteins also showed potential connection with STC2. In general, it is indicated that the down-regulation of STC2 may serve as a biomarker for DMA.
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Affiliation(s)
- Yikai Hu
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Liujun Han
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Heng Zhang
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China; Department of Pathology, Anhui Medical University, Hefei 230032, China
| | - Wencan Li
- Institute of Criminal Scientific Technology, Shanghai Municipal Public Security Bureau Pudong Branch, Shanghai 200125, China
| | - Tianpu Wu
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Jianlong Ma
- Institute of Criminal Science and Technology, Investigation Department of Shenzhen Municipal Public Security Bureau, Key Laboratory of Forensic Pathology, Ministry of Public Security, Shenzhen 518040, China
| | - Dongchuan Zhang
- Forensic Lab, Criminal Science and Technology Institute, Shanghai Municipal Public Security Bureau, Shanghai 200082, China
| | - Kaijun Ma
- Forensic Lab, Criminal Science and Technology Institute, Shanghai Municipal Public Security Bureau, Shanghai 200082, China
| | - Bi Xiao
- Forensic Lab, Criminal Science and Technology Institute, Shanghai Municipal Public Security Bureau, Shanghai 200082, China
| | - Yangeng Yu
- Institute of Forensic Science, Guangdong Provincial Public Security Department, Key Laboratory of Forensic Pathology, Ministry of Public Security, Guangzhou 510050, China
| | - Hongmei Xu
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Lu Tian
- Institute of Criminal Scientific Technology, Shanghai Municipal Public Security Bureau Pudong Branch, Shanghai 200125, China.
| | - Xinbiao Liao
- Institute of Forensic Science, Guangdong Provincial Public Security Department, Key Laboratory of Forensic Pathology, Ministry of Public Security, Guangzhou 510050, China.
| | - Long Chen
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.
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Cioffi A, Cecannecchia C, Bosco MA, Gurgoglione G, Baldari B, De Simone S. Lethal nitrous oxide (N 2O) intoxication during surgery: the contribution of immunohistochemistry in identifying the cause of death: a case report. J Med Case Rep 2023; 17:424. [PMID: 37814318 PMCID: PMC10563339 DOI: 10.1186/s13256-023-04159-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 09/01/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Nitrous oxide (N2O) is a gas used in medicine for its analgesic, anxiolytic and amnesic properties. It is a drug considered safe if adequately administered. In the literature, accidental N2O-related deaths are rare. They are mostly related to inhalation of this substance for recreational and autoerotic purposes; rarely are reported deaths due to incorrect administration of medical gas in anesthesia. The diagnosis of death from acute N2O intoxication is complex and is generally an exclusion diagnosis: the macroscopic and microscopic post-mortem signs are entirely nonspecific. Furthermore, the circumstantial data are not always supportive and can even be confusing, mainly if the death occurred inside a hospital. CASE PRESENTATION We describe a particular case of death from acute nitrous oxide poisoning in a hospital environment, of a Caucasian male of 72-years-old. The intoxication occurred during a minimally invasive vascular surgery due to an incorrect assembly of the supply lines of medical gases (O2 and N2O). The identification of the cause of death resulted from the analysis of circumstantial data, macroscopic and microscopic autoptic findings, and immunohistochemical investigations based on the search for antibodies anti E-selectin, P-selectin, and HIF 1-α. CONCLUSION Although not pathognomonic of asphyxiation by N2O, the latter molecules are a valid and early marker of hypoxic insult. Therefore, in concert with all other findings, it may constitute valid support for the forensic pathologist to ascertain the cause of death in case of suspected intoxication by N2O.
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Affiliation(s)
- Andrea Cioffi
- Section of Forensic Science, Section of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Viale Europa 12, 71122, Foggia, Italy
| | - Camilla Cecannecchia
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Maria Antonella Bosco
- Section of Forensic Science, Section of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Viale Europa 12, 71122, Foggia, Italy
| | - Giovanni Gurgoglione
- Section of Forensic Science, Section of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Viale Europa 12, 71122, Foggia, Italy
| | - Benedetta Baldari
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Stefania De Simone
- Section of Forensic Science, Section of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Viale Europa 12, 71122, Foggia, Italy.
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4
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Shekhawat RS, Meshram VP, Rao M, Shedge R, Panwar R, Rathore M, Kanchan T. Further explorations into the role of mast cells in deaths associated with fatal asphyxia: an immunohistochemical study utilizing CD 117 marker. Forensic Sci Int 2023; 350:111689. [PMID: 37478731 DOI: 10.1016/j.forsciint.2023.111689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/02/2023] [Accepted: 04/11/2023] [Indexed: 07/23/2023]
Abstract
Asphyxia-related deaths have always been a challenging task in the speciality of forensic pathology. Apart from helpful macroscopical signs (e.g., strangulation mark, cyanosis, petechial haemorrhage, and lung oedema), recent literature indicates that prolonged asphyxia is sufficient to induce an increase in mast cells (MC). Inflammatory cells migrate from the bone marrow to the lungs, aiding in the diagnosis of fatal asphyxial deaths. HIF1-α, a key regulator protein, is released from lung tissue capillaries during catastrophic hypoxia circumstances, as previously demonstrated in immunohistochemistry (IHC) research. The present study analyzed lung samples from 164 medico-legal autopsy cases, including 57 asphyxia/hypoxia deaths and 107 controls (non-asphyxial deaths). Peribronchial, perivascular and perialveolar MCs were detected using CD117 antibody, and the average of MCs in each of these locations was noted in each case. The results indicated a statistically significant increase in peribronchial and perialveolar mast cells (MC) in fatal asphyxial deaths, including those caused by hanging, drowning, or postural asphyxia. Peri-bronchial MC in lung sections of asphyxial deaths were in the range of 0.2-5.4 and in non-asphyxial samples were in the range of 0.0-2.2. Peri-alveolar MCs in lung sections of asphyxial deaths were in the range of 0.0-0.6 and in non-asphyxial samples were in the range of 0.0-0.2. Our data suggest that mast cells (MC) play an important role in fatal hypoxia-related mortality and CD 117 may be a reliable marker for detection of mast cells in asphyxial deaths. It could be very beneficial to forensic pathologists tasked with differentiating fatal asphyxia fatalities from other causes of death.
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Affiliation(s)
- Raghvendra Singh Shekhawat
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur 342005, India.
| | - Vikas P Meshram
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
| | - Meenakshi Rao
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Rutwik Shedge
- Department of Forensic Science, National Forensic Sciences University, Tripura, India
| | - Rahul Panwar
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Mohini Rathore
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Tanuj Kanchan
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, India
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5
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Panwar R, Shekhawat RS, Shukla KK, Rao M, Rathore M, Kanchan T. Quantitative estimation of TNF-α and IL-3 by using ELISA from human lung tissue in fatal asphyxial deaths. J Forensic Leg Med 2023; 98:102559. [PMID: 37453342 DOI: 10.1016/j.jflm.2023.102559] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/28/2023] [Accepted: 07/09/2023] [Indexed: 07/18/2023]
Abstract
Asphyxia-related deaths have always been a challenging task in the specialty of forensic pathology. Apart from helpful macroscopical signs (e.g., strangulation marks, cyanosis, petechial haemorrhage, and lung edema), recent literature indicates that prolonged asphyxia is sufficient to induce an increase in mast cells (MC). Inflammatory cells migrate from the bone marrow to the lungs, aiding in the diagnosis of fatal asphyxial death. The present study analyzed human lung tissue samples from 90 medico-legal autopsy cases, including 45 asphyxial deaths and 45 controls (non-asphyxial deaths). The cases ranged from 2 to 68 years, with a mean age of 33.23 years. In 90 cases, 74 cases were of males, and 16 were of females. Human lung tissue samples were analyzed by using the sandwich ELISA method. The results indicated a statistically significant increase in TNF-α and IL-3 concentration in fatal asphyxial deaths, including those caused by hanging, drowning, and smothering. Mean ± SD in asphyxial and non-asphyxial cases for the TNF-α and IL-3 concentration statistically analysed. In asphyxial cases, the average IL-3 concentration (Conc.) was 1558.50 ± 350.53 pg/ml, and the average TNF-α concentration (Conc.) was 499.75 ± 479.41 pg/ml. In contrast, in non-asphyxial cases, the average IL-3 concentration (Conc.) was found to be 849.73 ± 484.99 pg/ml, and the average TNF-α concentration (Conc.) was 208.08 ± 81.23 pg/ml. The mean change in IL-3 and TNF-α (Conc.) values are found to significant (<0.01) in asphyxial cases as compared to non-asphyxial cases. The ROC (Receiver operating characteristic curve) analysis revealed that TNF-α (AUC = 0.89) and IL-3 (AUC = 0.87) concentration (conc.) were stronger predictors of asphyxial deaths with an optimal cut-off value of 455.20 pg/ml for TNF-alpha and 1700.62 pg/ml for IL-3 respectively. Our findings imply that mast cells (MC) are critical in fatal hypoxia-related mortality and that TNF-α and IL-3 can be reliable markers for detecting mast cells in asphyxial deaths. It could be very beneficial to forensic pathologists tasked with differentiating fatal asphyxial fatalities from other causes of death.
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Affiliation(s)
- Rahul Panwar
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, 342005, India.
| | - Raghvendra Singh Shekhawat
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, 342005, India.
| | - Kamla Kant Shukla
- Department of Trauma and Emergency Biochemistry, All India Institute of Medical Sciences, Jodhpur, India.
| | - Meenakshi Rao
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Jodhpur, India.
| | - Mohini Rathore
- Biochemistry, All India Institute of Medical Sciences, Jodhpur, India.
| | - Tanuj Kanchan
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Jodhpur, 342005, India.
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Suicide and Neurotrophin Factors: A Systematic Review of the Correlation between BDNF and GDNF and Self-Killing. Healthcare (Basel) 2022; 11:healthcare11010078. [PMID: 36611538 PMCID: PMC9818650 DOI: 10.3390/healthcare11010078] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022] Open
Abstract
According to WHO data, suicide is a public health priority. In particular, suicide is the fourth-leading cause of death in young people. Many risk factors of suicide are described, including individual-, relationship-, community-, and societal-linked ones. The leading factor is the diagnosis of mental illness. Nevertheless, not all people who attempt suicide are psychiatric patients; these characteristics help define high-risk populations. There are currently no useful biomarkers to indicate the risk of suicide. In recent years, neurotrophic factors have increasingly become of scientific interest. This review aims to summarize the current scientific knowledge on the correlation between BDNF and GDNF and suicide, to theorize whether neurotrophins could be a reliable marker for an early diagnosis of suicidal risk. The authors conducted a systematic review following PRISMA criteria. They found eight research papers in agreement with the inclusion criteria. According to the results of these studies, there may be a connection between BDNF brain levels and complete suicide, although there are discrepancies. A lack of interest in GDNF may suggest less involvement in the suicidal dynamic. Further studies may provide helpful information to researchers.
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7
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Luigi C, Stefania DS. Nitrous oxide intoxication: systematic literature review and proposal of new diagnostic possibilities. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2022. [DOI: 10.1186/s41935-022-00315-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Abstract
Background
Nitrous oxide (N2O), also called “laughing gas,” is the most commonly used inhalation anesthetic in dentistry. The N2O is no longer used, because of the long-term neurologic and cardiovascular sequelae. Due to its sedative and euphoric properties, N2O is often used for recreational use or in some erotic activities. Accidental deaths are mainly associated with the uses of N2O: death can occur from sudden cardiac arrhythmia or, most commonly, acute asphyxiation due to hypoxia. This paper aims to study the literature concerning deaths due to N2O intoxication and highlight pathological findings useful for diagnosis when the crime scene investigation does not reveal any evidence.
Materials and methods
The authors conducted the literature search by PubMed and Scopus databases, searching for articles from 1 January 1970 to 1 March 2020 using the key terms: “Nitrous oxide,” “Laughing gas,” “Hypoxic damage,” “Nitrous oxide anesthesia,” and “Nitrous oxide death.”
Results and discussion
A total of 244 articles were collected. Only 26 articles were included in the systematic review. Most of the deaths from intoxication are due to asphyxiation; the diagnosis is often difficult and immunohistochemistry could be helpful. Nitrous oxide increases the intracellular adhesion molecule expression, E- and P-Selectin (markers of the early inflammatory response), and HIF-1 α (indicative of oxidative stress during ischemia-reperfusion).
Conclusion
The macroscopic and microscopic signs of N2O intoxication are non-specific, but N2O has been proven to cause hypoxic damage to the brain. The suspicion of the presence of the gas in the environment should guide the pathologist. Tissue analyzes provide important information; immunohistochemical stains can confirm hypoxic damage through the use of markers such as HIF-1 α, E-Selectin, and P-Selectin.
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8
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De Simone S, Giacani E, Bosco MA, Vittorio S, Ferrara M, Bertozzi G, Cipolloni L, La Russa R. The Role of miRNAs as New Molecular Biomarkers for Dating the Age of Wound Production: A Systematic Review. Front Med (Lausanne) 2022; 8:803067. [PMID: 35096893 PMCID: PMC8795691 DOI: 10.3389/fmed.2021.803067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 12/22/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The timing of wounds production is a significant issue in forensic pathology. Although various methods have been evaluated, obtaining an accurate dating of lesions is still a challenge. The pathologist uses many parameters to value wound age, such as histological and immunohistochemical. In recent years, there have been many studies regarding the use of miRNAs in wound-age estimation; indeed, miRNAs have multiple potential uses in forensic pathology. SCOPE This review aims to verify the efficacy and feasibility of miRNAs as a tool for determining the timing of lesions. MATERIALS AND METHODS The authors conducted the systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. PubMed was used as a search engine to find articles published between January, 1st 2016 and October, 1st 2021, to evaluate the current state of the art regarding wound-age estimation. RESULTS A total of 256 articles were collected; after screening according to PRISMA guidelines, the systematic review included 8 articles. The studies included in this review were all Original articles evaluating the use of biomarkers for wound-age determination. DISCUSSION AND CONCLUSION The literature review showed that analysis of miRNA is an innovative field of study with significant potentiality in forensic pathology. There are few studies, and almost all of them are at an early stage. The challenge is to understand how to standardize the samples' selection to obtain reliable experimental data. This observation represents a necessary prerequisite to planning further clinical trials.
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Affiliation(s)
- Stefania De Simone
- Department of Clinical and Experimental Medicine, Section of Legal Medicine, University of Foggia, Foggia, Italy
| | - Elena Giacani
- Department of Clinical and Experimental Medicine, Section of Legal Medicine, University of Foggia, Foggia, Italy
| | - Maria Antonella Bosco
- Department of Clinical and Experimental Medicine, Section of Legal Medicine, University of Foggia, Foggia, Italy
| | - Simona Vittorio
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy
| | - Michela Ferrara
- Department of Clinical and Experimental Medicine, Section of Legal Medicine, University of Foggia, Foggia, Italy
| | - Giuseppe Bertozzi
- Department of Clinical and Experimental Medicine, Section of Legal Medicine, University of Foggia, Foggia, Italy
| | - Luigi Cipolloni
- Department of Clinical and Experimental Medicine, Section of Legal Medicine, University of Foggia, Foggia, Italy
| | - Raffaele La Russa
- Department of Clinical and Experimental Medicine, Section of Legal Medicine, University of Foggia, Foggia, Italy
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10
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Tambuzzi S, Gentile G, Boracchi M, Di Candia D, Bianchi R, Zoja R. Postmortem diagnostics of assumed suicidal food anaphylaxis in prison: a unique case of anaphylactic death due to peach ingestion. Forensic Sci Med Pathol 2021; 17:449-455. [PMID: 33939114 PMCID: PMC8413180 DOI: 10.1007/s12024-021-00373-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2021] [Indexed: 02/02/2023]
Abstract
Suicidal ingestion of food which the victim is aware they are allergic to is an exceptional occurrence in the forensic field. To the best of our knowledge, no cases of suicidal food anaphylaxis have been reported to date. Therefore we present the first case described in the literature. A 30-year-old prisoner was found dead inside his cell with the remains of a peach remains next to his body, and a handwritten farewell note in his pocket. The autopsy revealed only non-specific findings, while laboratory investigations (serological, toxicological, histological, and immunohistochemical) played a pivotal role in determing the cause and manner of death. In particular, a high titer of both total and specific IgE antibodies was detected, as well as an increase of the tryptase level in cadaveric blood. Moreover, a massive concentration of salicylates was measured in the gastric contents. Microscopically, cellular residues characterized by a vegetal structure were observed in the gastric contents and elements suggestive of mast cells were detected in the glottis, lungs, and myocardium. The immunohistochemical investigation with anti-CD117 and anti-tryptase antibodies showed positivity for mast cells, some of which appeared degranulated. Such findings were entirely consistent with an acute systemic anaphylactic reaction triggered by allergy. Therefore, the prisoner’s death was attributed to self-induced food anaphylaxis caused by the ingestion of peaches. This conclusion was achieved based only on circumstantial data, anamnestic information, autopsy findings, and multiple laboratory results. This integrated approach should be used to pursue a post-mortem diagnosis of anaphylaxis.
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Affiliation(s)
- Stefano Tambuzzi
- Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37 - 20133, Milano, Italy
| | - Guendalina Gentile
- Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37 - 20133, Milano, Italy
| | - Michele Boracchi
- Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37 - 20133, Milano, Italy
| | - Domenico Di Candia
- Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37 - 20133, Milano, Italy
| | - Rachele Bianchi
- Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37 - 20133, Milano, Italy
| | - Riccardo Zoja
- Dipartimento di Scienze Biomediche per la Salute, Sezione di Medicina Legale e delle Assicurazioni, Università degli Studi di Milano, Via Luigi Mangiagalli, 37 - 20133, Milano, Italy.
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11
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Focardi M, Bugelli V, Venturini M, Bianchi I, Defraia B, Pinchi V, Bacci S. Increased expression of iNOS by Langerhans cells in hanging marks. AUST J FORENSIC SCI 2020. [DOI: 10.1080/00450618.2020.1817556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- M. Focardi
- Department of Health Sciences, Section of Forensic Medicine, University of Florence, Florence, Italy
| | - V. Bugelli
- Department of Health Sciences, Section of Forensic Medicine, University of Florence, Florence, Italy
| | - M. Venturini
- Department of Biology, Research Unit of Histology and Embryology, University of Florence, Florence, Italy
| | - I. Bianchi
- Department of Health Sciences, Section of Forensic Medicine, University of Florence, Florence, Italy
| | - B. Defraia
- Department of Health Sciences, Section of Forensic Medicine, University of Florence, Florence, Italy
| | - V. Pinchi
- Department of Health Sciences, Section of Forensic Medicine, University of Florence, Florence, Italy
| | - S. Bacci
- Department of Biology, Research Unit of Histology and Embryology, University of Florence, Florence, Italy
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12
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Han L, Zhang H, Zeng Y, Lv Y, Tao L, Ma J, Xu H, Ma K, Shi Q, Xiao B, Chen L. Identification of the miRNA-3185/CYP4A11 axis in cardiac tissue as a biomarker for mechanical asphyxia. Forensic Sci Int 2020; 311:110293. [PMID: 32320934 DOI: 10.1016/j.forsciint.2020.110293] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 12/19/2022]
Abstract
Death by mechanical asphyxia is one of the most difficult conclusions to make in forensic science, especially in corpses displaying slight or no trauma to the surface of the body. Therefore, death by mechanical asphyxia is difficult to prove in medico-legal practice. MicroRNAs (miRNAs) are a class of small, non-coding RNAs involved in the regulation of numerous physiological and pathological cellular processes. In the present study, we demonstrate that significantly increased expression of miR-3185 in cardiac tissues was detected among cases of mechanical asphyxia compared to case of craniocerebral injury, hemorrhagic shock, sudden cardiac death and poisoning. We observed no correlation between the expression of miR-3185 and postmortem interval, age or temperature. Further work indicated that CYP4A11 is a putative target gene of miR-3185 and expressed at a relatively low level in cardiac tissue specimens from cases of mechanical asphyxia compared with specimens from cases of craniocerebral injury, hemorrhagic shock, sudden cardiac death and poisoning. Our results suggest that the miRNA-3185/CYP4A11 axis is associated with mechanical asphyxia-induced death and may provide new insight into asphyxial death investigations.
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Affiliation(s)
- Liujun Han
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Heng Zhang
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Yan Zeng
- Children's Hospital of Fudan University, Shanghai 201102, China
| | - Yehui Lv
- Shanghai University of Medicine & Health Sciences, Shanghai 201318, China
| | - Li Tao
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Jianlong Ma
- Criminal Investigation Department of Shenzhen Public Security Bureau, Shenzhen Institute of Criminal Science and Technology, Shenzhen 518000, China
| | - Hongmei Xu
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China
| | - Kaijun Ma
- Forensic Lab, Criminal Science and Technology Institute, Shanghai Public Security Bureau, Shanghai 200082, China
| | - Qun Shi
- Forensic Lab, Criminal Science and Technology Institute, Shanghai Public Security Bureau, Shanghai 200082, China
| | - Bi Xiao
- Forensic Lab, Criminal Science and Technology Institute, Shanghai Public Security Bureau, Shanghai 200082, China.
| | - Long Chen
- Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.
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13
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Gutjahr E, Madea B. Inflammatory reaction patterns of the lung as a response to alveolar hypoxia and their significance for the diagnosis of asphyxiation. Forensic Sci Int 2019; 297:315-325. [PMID: 30852415 DOI: 10.1016/j.forsciint.2019.02.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/30/2019] [Accepted: 02/12/2019] [Indexed: 10/27/2022]
Abstract
Providing evidence of asphyxia death is a challenging issue in forensic pathology. Besides helpful macroscopical signs (e.g. strangulation mark, lung edema), recent data from literature indicate that the time of protracted asphyxia suffices to trigger an increase of giant cells and a migration of inflammatory cells from the bone marrow to the lung, thus offering a help in diagnosis of asphyxia death. In search of new valid asphyxia markers, the present study examined this hypothesis and investigated the leading role of pre-existing lung tissue cells and their functional state in reaction patterns to asphyxia. In specimens of suffocated human lungs following a short (n = 13) and a long asphyxia terminal episode (n = 15), and controls (sudden cardiovascular (n = 11) and traumatic deaths (n = 7)), the count of alveolar phagocytes, megakaryocytes, giant and mast cells, using H&E and toluidine blue staining, was performed. To show macrophage activation, immunohistochemical stainings for CD68, late (25F9) and early (MRP-8/-14) stage inflammatory markers were used. Measuring concentration of tryptase in femoral blood acted as a parameter for mast cell degranulation and consequently their activation. Results showed the lack of specificity of macroscopical parameters despite an association of suffocation with heavy lung edema. No significant differences in the numbers of inflammatory cells in the lungs of different case groups were detected. The doubling of MRP-8- and a five-fold elevation of MRP-14-positive cells compared to cardiovascular controls, proved an early activation state of pre-exiting monocytes in protracted asphyxia. These activated monocytes induced the degranulation of mast cells, resulting in slightly elevated tryptase levels in suffocation compared to cardiovascular controls. In summary, the duration of asphyxia (max. 20 min in cases investigated) only suffices to cause changes on molecular level, being not detectable in any specific macroscopical or histological form in the lung. Despite a potential utility of this molecular insight in individual cases, these results point to the classic doctrine of the evaluation of a rounded overall picture, accentuating on the proof of the ligature tool and the marks of suffocation process.
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Affiliation(s)
- Ewgenija Gutjahr
- Institute of Forensic Medicine, University of Bonn, Stiftsplatz 12, 53111, Bonn, Germany.
| | - Burkhard Madea
- Institute of Forensic Medicine, University of Bonn, Stiftsplatz 12, 53111, Bonn, Germany
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14
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Focardi M, Puliti E, Grifoni R, Palandri M, Bugelli V, Pinchi V, Norelli G, Bacci S. Immunohistochemical localization of Langerhans cells as a tool for vitality in hanging mark wounds: a pilot study. AUST J FORENSIC SCI 2019. [DOI: 10.1080/00450618.2019.1567811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- M. Focardi
- Department of Health Sciences, Section of Forensic Medicine, University of Florence, Florence, Italy
| | - E. Puliti
- Department of Clinical and Experimental Medicine, Research Unit of Histology and Embryology, University of Florence, Florence, Italy
| | - R. Grifoni
- Department of Health Sciences, Section of Forensic Medicine, University of Florence, Florence, Italy
| | - M. Palandri
- Department of Health Sciences, Section of Forensic Medicine, University of Florence, Florence, Italy
| | - V. Bugelli
- Department of Health Sciences, Section of Forensic Medicine, University of Florence, Florence, Italy
| | - V. Pinchi
- Department of Health Sciences, Section of Forensic Medicine, University of Florence, Florence, Italy
| | - G.A. Norelli
- Department of Health Sciences, Section of Forensic Medicine, University of Florence, Florence, Italy
| | - S. Bacci
- Department of Clinical and Experimental Medicine, Research Unit of Histology and Embryology, University of Florence, Florence, Italy
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15
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Bogomolov DV, Fetisov VA, Denisova OP, Zbrueva YV, Semenov GG. [The principal and auxiliary immunohistochemical markers of intravital mechanical strangulation asphyxia]. Sud Med Ekspert 2018; 61:11-13. [PMID: 29667630 DOI: 10.17116/sudmed201861211-13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED The objective of the present study was the evaluation of the auxiliary methods for the diagnostics of the intravital formation of the constriction marks; the secondary objective was to determine the pace at which the death and asphyxia occur. MATERIAL AND METHODS The materials on which the study was based included 17 cases of mechanical strangulation asphyxia involving 13 men and 4 women at the age from 8 to 28 years. All cases of hanging were associated with different blood alcohol levels. Their characteristic feature was the formation of the obliquely ascending constriction marks. The group of comparison was comprised of three cases of death by drowning and one case of manual strangulation. The control group consisted of 10 patients who died from the acute form of coronary heart disease and 5 cases of death from traumatic shock. All the corpses were examined with the use of the traditional methods within the first 24 hours after death. The special laboratory studies were performed by means of the standard histological and immunohistochemical methods with the use of the polyclonal antibodies against total cytokeratin, fibrinogen, immunoglobulin-lambda, fibronectin, and CD-117 antigen. The histological preparations were stained by the method of Spielmeyer and with toluidine blue. RESULTS The results of the study give evidence of the possibility of diagnostics of mechanical strangulation asphyxia making use of the reaction with anti-fibrinogen antibodies in the stromal tissue of the constriction mark even in the absence of other intravital signs of death. Such diagnostics is also possible with the use of the CD-117 antigen in the pulmonary tissue. The expression of this antigen is characteristic of the cases of alveolar hypoxia. The possibility of application of other markers for the differential diagnostics of mechanical strangulation asphyxia from other causes of death is discussed.
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Affiliation(s)
- D V Bogomolov
- Department of Research Organization, Russian Federal Centre of Forensic Medical Expertise, Ministry of Health of the Russia, Moscow, Russia, 125284
| | - V A Fetisov
- Department of Research Organization, Russian Federal Centre of Forensic Medical Expertise, Ministry of Health of the Russia, Moscow, Russia, 125284
| | - O P Denisova
- Department of Research Organization, Russian Federal Centre of Forensic Medical Expertise, Ministry of Health of the Russia, Moscow, Russia, 125284
| | - Yu V Zbrueva
- Department of Forensic Medicine, Astrakhan State Medical University, Ministry of Health of the Russia, Astrakhan , Russia, 414024
| | - G G Semenov
- Republican Bureau of forensic medical expertise of Chuvash Republic, Cheboksary, Russia, 428017
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16
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Back to the Future - Part 1. The medico-legal autopsy from ancient civilization to the post-genomic era. Int J Legal Med 2017; 131:1069-1083. [PMID: 28439696 DOI: 10.1007/s00414-017-1584-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 03/29/2017] [Indexed: 12/11/2022]
Abstract
Part 1 of the review "Back to the Future" examines the historical evolution of the medico-legal autopsy and microscopy techniques, from Ancient Civilization to the Post-Genomic Era. In the section focusing on "The Past", the study of historical sources concerning the origins and development of the medico-legal autopsy, from the Bronze Age until the Middle Ages, shows how, as early as 2000 BC, the performance of autopsies for medico-legal purposes was a known and widespread practice in some ancient civilizations in Egypt, the Far East and later in Europe. In the section focusing on "The Present", the improvement of autopsy techniques by Friedrich Albert Zenker and Rudolf Virchow and the contemporary development of optical microscopy techniques for forensic purposes during the 19th and 20th centuries are reported, emphasizing, the regulation of medico-legal autopsies in diverse nations around the world and the publication of international guidelines or best practices elaborated by International Scientific Societies. Finally, in "The Future" section, innovative robotized and advanced microscopy systems and techniques, including their possible use in the bio-medicolegal field, are reported, which should lead to the improvement and standardization of the autopsy methodology, thereby achieving a more precise identification of natural and traumatic pathologies.
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17
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Cecchi R. Diagnosis of anaphylactic death in forensics: Review and future perspectives. Leg Med (Tokyo) 2016; 22:75-81. [PMID: 27591544 DOI: 10.1016/j.legalmed.2016.08.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 08/17/2016] [Accepted: 08/17/2016] [Indexed: 12/18/2022]
Abstract
The diagnosis of anaphylaxis in a pre- or post-mortal phase involves the formulation of problems not yet solved by the international scientific literature, due to the complexity of pathogenic factors and pathophysiological processes that characterizes it. For forensic autopsies, further problems of differential diagnosis arise and often leave the forensic pathologist unable to express an opinion of certainty, as a result of lack of case history, circumstantial and autoptical-histopathological data. Nevertheless, in routine cases the postmortem diagnosis of anaphylactic death continues to be based on exclusion and circumstantial evidence. The author, after an extensive review of the literature relating to deaths from anaphylaxis of forensic pathological interest, and a discussion of the microscopical and biochemical findings, proposes a diagnostic protocol for forensic purposes and evaluates the diagnostic perspectives enabled by the newly available analytic techniques and markers. Maybe, the application of omics methodologies could help in the future for anaphylaxis diagnosis.
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Affiliation(s)
- Rossana Cecchi
- Department of Biomedical, Biotechnological and Translational Medicine, University of Parma, Via Gramsci 14, 43126 Parma, Italy.
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