1
|
Yamamoto T, Emoto Y, Murase T, Umehara T, Miura A, Nishiguchi M, Ikematsu K, Nishio H. Molecular autopsy for sudden death in Japan. J Toxicol Pathol 2024; 37:1-10. [PMID: 38283375 PMCID: PMC10811381 DOI: 10.1293/tox.2023-0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/17/2023] [Indexed: 01/30/2024] Open
Abstract
Japan has various death investigation systems; however, external examinations, postmortem computed tomography, macroscopic examinations, and microscopic examinations are performed regardless of the system used. These examinations can reveal morphological abnormalities, whereas the cause of death in cases with non-morphological abnormalities can be detected through additional examinations. Molecular autopsy and postmortem genetic analyses are important additional examinations. They are capable of detecting inherited arrhythmias or inherited metabolic diseases, which are representative non-morphological disorders that cause sudden death, especially in infants and young people. In this review, we introduce molecular autopsy reports from Japan and describe our experience with representative cases. The relationships between drug-related deaths and genetic variants are also reviewed. Based on the presented information, molecular autopsy is expected to be used as routine examinations in death investigations because they can provide information to save new lives.
Collapse
Affiliation(s)
- Takuma Yamamoto
- Department of Legal Medicine, Hyogo College of Medicine, 1-1
Mukogawa-cho, Nishinomiya-shi, Hyogo 663-8501, Japan
| | - Yuko Emoto
- Department of Legal Medicine, Kansai Medical University,
2-5-1 Shinmachi, Hirakata-shi, Osaka 573-1010, Japan
| | - Takehiko Murase
- Division of Forensic Pathology and Science, Department of
Medical and Dental Sciences, Graduate School of Biomedical Sciences, School of Medicine,
Nagasaki University, 1-12-4 Sakamoto, Nagasaki-shi, Nagasaki 852-8523, Japan
| | - Takahiro Umehara
- Department of Forensic Medicine, School of Medicine,
University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku,
Kitakyushu-shi, Fukuoka 807-8555, Japan
| | - Aya Miura
- Department of Legal Medicine, Hyogo College of Medicine, 1-1
Mukogawa-cho, Nishinomiya-shi, Hyogo 663-8501, Japan
| | - Minori Nishiguchi
- Department of Legal Medicine, Hyogo College of Medicine, 1-1
Mukogawa-cho, Nishinomiya-shi, Hyogo 663-8501, Japan
| | - Kazuya Ikematsu
- Division of Forensic Pathology and Science, Department of
Medical and Dental Sciences, Graduate School of Biomedical Sciences, School of Medicine,
Nagasaki University, 1-12-4 Sakamoto, Nagasaki-shi, Nagasaki 852-8523, Japan
| | - Hajime Nishio
- Department of Legal Medicine, Hyogo College of Medicine, 1-1
Mukogawa-cho, Nishinomiya-shi, Hyogo 663-8501, Japan
| |
Collapse
|
2
|
Ye X, Mi X, Sun J, ShenTu Y, Fei Y, Tang D, Ye X, Ma X, Shi J, Chen G, Gong L. PROS1 variant c.1574C>T p.Ala525Val causes portal vein thrombosis with Protein S Deficiency. Clin Res Hepatol Gastroenterol 2023; 47:102141. [PMID: 37207893 DOI: 10.1016/j.clinre.2023.102141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 05/21/2023]
Abstract
BACKGROUND Protein S (PS) is a vitamin K-dependent plasma glycoprotein, and the deficiency of PS increases the risk of venous thromboembolism (VTE). PS deficiency has been found in 1.5-7% of selected groups of thrombophilic patients. However, the reported PS deficiency patients with portal vein thrombosis are scarce. CASE REPORT AND RESULTS Our case described a 60-year-old male patient presented portal vein thrombosis with protein S deficiency. Imaging findings of the patient revealed extensive thrombosis involving the portal vein and superior mesenteric vein. His medical history revealed lower extremity venous thrombosis 10 years ago. The level of PS activity was greatly reduced (14%, reference: 55-130%). Acquired thrombophilia caused by antiphospholipid syndrome, hyperhomocysteinemia, or malignancy were excluded. Whole exome sequencing revealed a heterozygous missense variation c.1574C>T, p.Ala525Val in the PROS1 gene. The in-silico analysis of the variant was performed by SIFT and PolyPhen-2. The results showed that the variant is a pathogenic and likely pathogenic variation respectively (SIFT, -3.404; PolyPhen-2, 0.892), the amino acid substitution A525V is presumed to result in unstable PS protein which is degraded intracellularly. Mutation site of the proband and his family members was validated by Sanger sequencing. CONCLUSION According to the clinical manifestation, imaging findings, protein S level, and the genetic results, a diagnosis of portal vein thrombosis with PS deficiency was made. To the best of our knowledge, our case is the second reported PS deficiency patient caused by PROS1 c.1574C>T, p.Ala525Val variant in Asia, and the case is also the only reported case with PROS1 c.1574C>T, p.Ala525Val variant presents portal vein thrombosis.
Collapse
Affiliation(s)
- Xiaoying Ye
- Hangzhou Normal University, Zhejiang, China.
| | - Xiaoxiao Mi
- Institute of Translational Medicine, Hangzhou Normal University Affiliated Hospital, Zhejiang, China.
| | - Jiawei Sun
- Hangzhou Normal University, Zhejiang, China.
| | - Yiling ShenTu
- Department of Respiratory Medicine, Fuyang First People's Hospital, Hangzhou, China.
| | - Yingming Fei
- Department of Infectious Disease (Liver Diseases), Shaoxing University Affiliated Hospital, Zhejiang, China.
| | - Dong Tang
- Department of Medical Imaging (Radiology), Hangzhou Normal University Affiliated Hospital, Zhejiang, China.
| | - Xiaoping Ye
- Department of Infectious Disease (Liver Diseases), Hangzhou Normal University Affiliated Hospital, Zhejiang, China.
| | - Xiaojie Ma
- Department of Infectious Disease (Liver Diseases), Hangzhou Normal University Affiliated Hospital, Zhejiang, China.
| | - Junping Shi
- Department of Infectious Disease (Liver Diseases), Hangzhou Normal University Affiliated Hospital, Zhejiang, China.
| | - Gongying Chen
- Department of Infectious Disease (Liver Diseases), Hangzhou Normal University Affiliated Hospital, Zhejiang, China.
| | - Ling Gong
- Department of Infectious Disease (Liver Diseases), Hangzhou Normal University Affiliated Hospital, Zhejiang, China.
| |
Collapse
|
3
|
Miura A, Funayama K, Nyuzuki H, Takahashi N, Yamamoto T, Koyama A, Ikeuchi T, Takatsuka H, Nishio H. PROS1 variant in sudden death case of pulmonary embolism caused by calcification in the inferior vena cava: the importance of postmortem genetic analysis. Leg Med (Tokyo) 2022; 55:102029. [DOI: 10.1016/j.legalmed.2022.102029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/29/2021] [Accepted: 01/22/2022] [Indexed: 10/19/2022]
|
4
|
Wu D, Hu S, Hou Y, He Y, Liu S. Identification of potential novel biomarkers to differentiate malignant thyroid nodules with cytological indeterminate. BMC Cancer 2020; 20:199. [PMID: 32164602 PMCID: PMC7066786 DOI: 10.1186/s12885-020-6676-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 02/24/2020] [Indexed: 12/23/2022] Open
Abstract
Background The fine-needle aspiration (FNA) biopsy was broadly applied to clinical diagnostics evaluation for thyroid carcinomas nodule, while companioning with higher uncertainty rate (15~30%) to identify malignancy for cytological indeterminate cases. It is requirement to discover novel molecular biomarkers to differentiate malignant thyroid nodule more precise. Methods We employed weighted gene co-expression network analysis (WGCNA) to discover genes significantly associated with malignant histopathology for cytological indeterminate nodules. In addition, identified significantly genes were validated through another independently investigations of thyroid carcinomas patient’s samples via cBioportal and Geipa. The key function pathways of significant genes involving were blast through GenClip. Results Twenty-four signature genes were identified significantly related to thyroid nodules malignancy. Furthermore, five novel genes with missense mutation, FN1 (R534P), PROS1((K200I), (Q571K)), SCEL (T320S), SLC34A2(T688M) and TENM1 (S1131F), were highlighted as potential biomarkers to rule out nodules malignancy. It was identified that the key functional pathways involving in thyroid carcinomas. Conclusion These results will be helpful to better understand the mechanism of thyroid nodules malignant transformation and characterize the potentially biomarkers for thyroid carcinomas early diagnostics.
Collapse
Affiliation(s)
- Dandan Wu
- Institute of Life Sciences, Jiangsu University, 301 Xuefu Road, JinKou District, Zhenjiang, 212013, PR China
| | - Shudong Hu
- Department of Radiology, Affiliated Renmin Hospital of Jiangsu University, Zhenjiang, Jiangsu, PR China
| | - Yongzhong Hou
- Institute of Life Sciences, Jiangsu University, 301 Xuefu Road, JinKou District, Zhenjiang, 212013, PR China
| | - Yingying He
- Institute of Life Sciences, Jiangsu University, 301 Xuefu Road, JinKou District, Zhenjiang, 212013, PR China.
| | - Shubai Liu
- Institute of Life Sciences, Jiangsu University, 301 Xuefu Road, JinKou District, Zhenjiang, 212013, PR China.
| |
Collapse
|
5
|
Ohashi I, Wada S, Yoshino F, Kuwashiro T, Matsumoto S, Hotta T, Kang D, Okada Y, Shimohama S, Yasaka M. Ischemic Stroke with Protein S Deficiency Treated by Apixaban. J Stroke Cerebrovasc Dis 2020; 29:104608. [PMID: 31941580 DOI: 10.1016/j.jstrokecerebrovasdis.2019.104608] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/03/2019] [Accepted: 12/16/2019] [Indexed: 02/06/2023] Open
Abstract
A 57-year-old man with atherosclerosis obliterans was admitted with sudden-onset sensory aphasia and right hemiparesis. Brain MRI revealed acute cerebral infarctions in the left temporal lobe and magnetic resonance angiography showed occlusion of the posterior branch of the left middle cerebral artery. Transesophageal echocardiography and ultrasonography respectively confirmed a patent foramen ovale and deep vein thrombosis in the bilateral femoral veins. Blood findings showed low protein S antigen, low protein S activity, and a missense mutation of the PROS 1 gene. The administration of apixaban 10 mg BID prevented ischemic stroke recurrence and decreased the deep vein thrombosis. These outcomes indicated that apixaban may be alternative to warfarin for the secondary prevention of ischemic stroke in a patient with a protein S deficiency.
Collapse
Affiliation(s)
- Ikkei Ohashi
- Division of Cerebrovascular Medicine and Neurology, National Hospitalization Organization, Kyushu Medical Centre, Japan; Department of Neurology, Sapporo Medical University School of Medicine, Japan
| | - Shinichi Wada
- Division of Cerebrovascular Medicine and Neurology, National Hospitalization Organization, Kyushu Medical Centre, Japan.
| | - Fumitaka Yoshino
- Division of Cerebrovascular Medicine and Neurology, National Hospitalization Organization, Kyushu Medical Centre, Japan
| | - Takahiro Kuwashiro
- Division of Cerebrovascular Medicine and Neurology, National Hospitalization Organization, Kyushu Medical Centre, Japan
| | - Shinya Matsumoto
- Department of Clinical Chemistry and Laboratory Medicine, Graduates School of Medical Sciences, Kyushu University, Japan
| | - Taeko Hotta
- Department of Clinical Chemistry and Laboratory Medicine, Graduates School of Medical Sciences, Kyushu University, Japan
| | - Dongchong Kang
- Department of Clinical Chemistry and Laboratory Medicine, Graduates School of Medical Sciences, Kyushu University, Japan
| | - Yasushi Okada
- Division of Cerebrovascular Medicine and Neurology, National Hospitalization Organization, Kyushu Medical Centre, Japan
| | - Shun Shimohama
- Department of Neurology, Sapporo Medical University School of Medicine, Japan
| | - Masahiro Yasaka
- Division of Cerebrovascular Medicine and Neurology, National Hospitalization Organization, Kyushu Medical Centre, Japan
| |
Collapse
|