Miyashita Tomoko, Kakimoto Nobuyuki, Ishida Yuko, Hayashi Takahito, Kimura Akihiko, Tsokos Michael, Kondo Toshikazu
Department of Forensic Medicine, Wakayama Medical University, 811-1 Kimiidera, 641-8509, Wakayama, Japan.
Forensic Sci Med Pathol. 2006 Jun;2(2):103-8. doi: 10.1385/FSMP:2:2:103.
Sepsis is asevere, systemic inflammatory disease caused by various kinds of microbes. In the present study, we immunohistochemically examined tumor necrosis factor (TNF)-α expression in sepsis-induced lung injury, and discuss its availability for the postmortem diagnosis of sepsis. Lung samples were obtained from different lung lobes of nine sepsis and eight control cases with postmortem intervals between 12 and 48 hours. Immunohistochemical analysis using anti-human TNF-α rabbit polyclonal antibodies was carried out. In sepsis and control groups, immunoreactivity for TNF-α was strongly detected in round-shaped mononuclear cells. The intensity of the immunohistochemical staining reaction was homogeneous in all lobes of the lungs examined. Furthermore, a double-color immunofluorescence analysis revealed that macrophages were a main cellular source of TNF-α in the lungs. To semiquantitatively evaluate the expression of TNF-α in the lungs, the ratios of the number of TNF-α-positive macrophages to total number of macrophages were calculated. Morphometrically, in lungs of the sepsis group, the ratio of TNF-α-positive macrophages was significantly higher, compared with the control group. TNF-α expression in the lungs can become a clue for the postmortem diagnosis of pulmonary inflammation, especially, TNF-α-positive ratios of 20% of more might suggest sepsis as the cause of death.
脓毒症是一种由各种微生物引起的严重全身性炎症性疾病。在本研究中,我们通过免疫组织化学方法检测了脓毒症诱导的肺损伤中肿瘤坏死因子(TNF)-α的表达,并探讨其在脓毒症死后诊断中的实用性。从9例脓毒症病例和8例对照病例的不同肺叶获取肺组织样本,死后间隔时间为12至48小时。使用抗人TNF-α兔多克隆抗体进行免疫组织化学分析。在脓毒症组和对照组中,在圆形单核细胞中均强烈检测到TNF-α的免疫反应性。在所检查的肺的所有叶中,免疫组织化学染色反应的强度是均匀的。此外,双色免疫荧光分析显示巨噬细胞是肺中TNF-α的主要细胞来源。为了半定量评估肺中TNF-α的表达,计算了TNF-α阳性巨噬细胞数量与巨噬细胞总数的比率。形态计量学分析显示,与对照组相比,脓毒症组肺中TNF-α阳性巨噬细胞的比率显著更高。肺中TNF-α的表达可成为肺部炎症死后诊断的线索,特别是,TNF-α阳性率超过20%可能提示脓毒症是死亡原因。