Falk M, Huhn R, Behmenburg F, Ritz-Timme St, Mayer F
Institute for Legal Medicine, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
Department of Anaesthesiology, University Hospital Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
Int J Legal Med. 2018 Mar;132(2):509-518. doi: 10.1007/s00414-017-1726-z. Epub 2017 Nov 18.
Myocardial infarctions go along with biomechanical stress, i.e. stretching of muscle fibres, and the expression of certain marker molecules. We tested if two of those markers, endothelin-1 (ET-1) and growth differentiation factor 15 (GDF-15), can be used as immunohistochemical markers for myocardial ischaemia/infarctions. The study included experiments with an animal model, the isolated perfused Langendorff heart, as well as the investigation of human tissue samples drawn during autopsies. The overall picture of our results showed that GDF-15 is very sensitive and expressed very fast, not only as a consequence of ischaemia/infarctions, but also under other circumstances. Even an expression only caused by agony had to be discussed. ET-1, on the other hand, was less sensitive but only positive in those human cases with ischaemia/infarction that also showed typical alterations in conventional histology. Therefore, both markers did not proof to be a suitable diagnostic tool for myocardial infarctions. However, positive staining for ET-1 was also seen in rats' hearts that suffered from arrhythmias after electric shock and in the myocardium of the right ventricle in human control cases in which a right heart failure has to be discussed. Thus, especially ET-1 should be subject of further studies that focus on these pathologies.
心肌梗死与生物力学应激相关,即肌纤维的拉伸以及某些标记分子的表达。我们测试了其中两种标记物,内皮素 -1(ET-1)和生长分化因子15(GDF-15),是否可作为心肌缺血/梗死的免疫组织化学标记物。该研究包括使用动物模型(离体灌注的Langendorff心脏)进行实验,以及对尸检期间采集的人体组织样本进行研究。我们结果的总体情况表明,GDF-15非常敏感且表达迅速,不仅是缺血/梗死的结果,在其他情况下也是如此。甚至仅由痛苦引起的表达也需要探讨。另一方面,ET-1不太敏感,仅在那些同时伴有传统组织学典型改变的缺血/梗死人体病例中呈阳性。因此,这两种标记物都不能证明是心肌梗死的合适诊断工具。然而,在电击后出现心律失常的大鼠心脏以及在必须讨论右心衰竭的人体对照病例的右心室心肌中也观察到ET-1阳性染色。因此,特别是ET-1应该成为针对这些病理情况的进一步研究的主题。