Cirielli Vito, Cima Luca, Chindemi Chiara, Danzi Olivia, Ghimenton Claudio, Eccher Albino, Mauriello Silvestro, Bortolotti Federica, De Leo Domenico, Brunelli Matteo, Tagliaro Franco
From the *Forensic Pathology Unit, Department of Diagnostics and Public Health, and †Anatomic Pathology Unit, Department of Diagnostics and Public Health, University and Hospital Trust of Verona; and ‡Department of Neurological, Biomedical and Movement Sciences, University of Verona, Verona; and §Institute of Legal Medicine, Department of Public Health Sciences, University of Roma Tor Vergata, Italy.
Am J Forensic Med Pathol. 2018 Mar;39(1):8-13. doi: 10.1097/PAF.0000000000000366.
The polysialylated isoform of the neural cell adhesion molecule (PSA-NCAM) has been shown to be a key player in neuroplastic changes and is expressed in various disorders. We investigated the PSA-NCAM expression on brain cortical tissue in a cohort of drug-related deaths. Brains from 25 drug abusers and 10 control subjects were removed at autopsy, and 2 samples of the right parietal lobe of each case were obtained. The polysialylated isoform of NCAM was evaluated on formalin-fixed and paraffin-embedded tissues. Eleven patients were polydrug abusers; 14 used a single substance. The mechanisms of death were acute respiratory failure (n = 19), cardiorespiratory failure (n = 4), acute heart failure (n = 1), and brain injury (n = 1). Toxicological analyses of blood were available for all cases, and urine and bile analyses for 19 of 25 cases. The polysialylated isoform of NCAM immunoexpression in the neuronal soma and dendritic spines was observed in 18 (72%) of 25 drug abusers and in 2 (20%) of 10 control subjects. Drug abusers were statistically more positive for PSA-NCAM than control subjects (P = 0.0082). The expression of PSA-NCAM in the parietal cortex could be an indicator of brain damage due to drug abuse, and its availability could allow the forensic pathologists to develop rapid and low-cost additional or alternative method to improve detection of drug-related deaths.
神经细胞黏附分子的多唾液酸化异构体（PSA-NCAM）已被证明是神经可塑性变化的关键因素，并在多种疾病中表达。我们调查了一组与药物相关死亡病例的脑皮质组织中PSA-NCAM的表达情况。在尸检时取出了25名药物滥用者和10名对照者的大脑，并从每个病例的右侧顶叶获取了2个样本。在福尔马林固定、石蜡包埋的组织上评估了NCAM的多唾液酸化异构体。11名患者为多药滥用者；14名使用单一物质。死亡机制为急性呼吸衰竭（n = 19）、心肺衰竭（n = 4）、急性心力衰竭（n = 1）和脑损伤（n = 1）。所有病例均进行了血液毒理学分析，25例中的19例进行了尿液和胆汁分析。在25名药物滥用者中的18例（72%）和10名对照者中的2例（20%）观察到了神经元胞体和树突棘中NCAM的多唾液酸化异构体免疫表达。药物滥用者的PSA-NCAM在统计学上比对照者更呈阳性（P = 0.0082）。顶叶皮质中PSA-NCAM的表达可能是药物滥用导致脑损伤的一个指标，其可用性可以让法医病理学家开发快速且低成本的额外或替代方法，以改进对与药物相关死亡的检测。
