Krohn Michael, Dreßler Jan, Bauer Manfred, Schober Kristin, Franke Heike, Ondruschka Benjamin
1 Institute of Legal Medicine, University of Leipzig , Germany .
J Neurotrauma. 2015 Apr 1;32(7):430-40. doi: 10.1089/neu.2014.3524. Epub 2015 Feb 4.
The availability of markers able to provide insight into protein changes in the central nervous system after fatal traumatic brain injury (TBI) is limited. The present study reports on the semi-quantitative assessments of the immunopositive neuroglial cells (both astrocytes and oligodendrocytes) and neurons for S100 protein (S100), as well as neuronal specific enolase (NSE), in the cerebral cortex, hippocampus, and cerebellum with regard to survival time and cause of death. Brain tissues of 47 autopsy cases with TBI (survival times ranged between several minutes and 34 d) and 10 age- and gender-matched controls (natural deaths) were examined. TBI cases were grouped according to their survival time in acute death after brain injury (ABI, n = 25), subacute death after brain injury (SBI, n = 18) and delayed death after brain injury (DBI, n = 4). There were no significant changes in the percentages of S100-stained astrocytes between TBI and control cases. The percentages of S100-positive oligodendrocytes in the pericontusional zone (PCZ) in cases with SBI were significantly lower than in controls (p < 0.05) and in the ABI group (p < 0.05). In the hippocampus, S100-positive oligodendrocytes were significantly lower in cases with ABI and SBI (both, p < 0.05), compared with controls. It is of particular interest that there were also S100-positive neurons in the PCZ and hippocampus in TBI cases after more than 2 h survival but not in ABI cases or controls. The percentages of NSE-positive neurons in the hippocampus were likewise significantly lower in cases with ABI, compared with controls (p < 0.05) but increased in cases with SBI in PCZ (p < 0.05). In conclusion, the present findings emphasize that S100 and NSE-immunopositivity might be useful for detecting the cause and process of death due to TBI. Further, S100-positivity in neurons may be helpful to estimate the survival time of fatal injuries in legal medicine.
能够深入了解致命性创伤性脑损伤（TBI）后中枢神经系统蛋白质变化的标志物非常有限。本研究报告了在大脑皮层、海马体和小脑中，根据存活时间和死亡原因，对免疫阳性神经胶质细胞（星形胶质细胞和少突胶质细胞）以及神经元进行S100蛋白（S100）和神经元特异性烯醇化酶（NSE）的半定量评估。对47例TBI尸检病例（存活时间从几分钟到34天不等）和10例年龄及性别匹配的对照（自然死亡）的脑组织进行了检查。TBI病例根据其在脑损伤后急性死亡（ABI，n = 25）、亚急性死亡（SBI，n = 18）和延迟死亡（DBI，n = 4）的存活时间进行分组。TBI病例和对照病例之间，S100染色星形胶质细胞的百分比没有显著变化。SBI病例中，挫伤周围区（PCZ）S100阳性少突胶质细胞的百分比显著低于对照组（p < 0.05）和ABI组（p < 0.05）。在海马体中，ABI和SBI病例的S100阳性少突胶质细胞显著低于对照组（均为p < 0.05）。特别值得注意的是，存活超过2小时的TBI病例的PCZ和海马体中也存在S100阳性神经元，但ABI病例或对照组中没有。与对照组相比，ABI病例海马体中NSE阳性神经元的百分比同样显著降低（p < 0.05），但PCZ中SBI病例的NSE阳性神经元百分比增加（p < 0.05）。总之，本研究结果强调，S100和NSE免疫阳性可能有助于检测TBI导致的死亡原因和过程。此外，神经元中的S100阳性可能有助于在法医学中估计致命伤的存活时间。
