Abe Shuntaro, Saito Takashi, Sato Takako, Suzuki Koichi
Division of Preventive and Social Medicine, Department of Legal Medicine, Faculty of Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, Japan.
Int J Legal Med. 2018 Nov;132(6):1665-1670. doi: 10.1007/s00414-018-1793-9. Epub 2018 Feb 19.
The thymus, the organ that is the most sensitive to stress, presents acute involution as a result of exposure to strong stress in childhood. Thymic involution is thus often considered evidence of child abuse/neglect in forensic autopsies. A portion of the thymic epithelial cells express leptin receptor, and leptin showed a thymo-protective function against stress-induced thymic involution in an animal model. Leptin receptor-expressing thymic epithelial cells (LR-TECs) may play a key role in the thymic remodeling provoked by a stressful environment. Here, we sought to clarify the changes of histopathological findings and human LR-TECs in stressful environment. We examined human thymus specimens obtained from 40 forensic autopsy cases (26 male, 14 female; age 21 to 3221 days). We divided the cases into stressor-positive (SP, n = 29) and stressor-negative (SN, n = 11) groups. Cases were classified according to the histological classification of thymic involution and investigated by leptin receptor immunostaining. The results revealed that (1) the SP group showed obvious histological thymic involution (p < 0.01) and (2) the LR-TECs/TECs ratio in the cortex was markedly and significantly increased in the SP group compared to the SN group (p < 0.01). The increase in the cortical LR-TECs/TECs ratio in the SP group may be part of the stress response mechanism in the human thymus. We thus speculate that the quantification of LR-TECs in the thymic cortex is a valuable stress marker for forensic autopsy cases.
胸腺是对压力最为敏感的器官,儿童时期若遭受强烈压力,胸腺会出现急性萎缩。因此,在法医尸检中,胸腺萎缩常被视为虐待/忽视儿童的证据。一部分胸腺上皮细胞表达瘦素受体,在动物模型中,瘦素对压力诱导的胸腺萎缩具有胸腺保护作用。表达瘦素受体的胸腺上皮细胞(LR-TECs)可能在应激环境引发的胸腺重塑中起关键作用。在此,我们试图阐明应激环境下组织病理学发现及人LR-TECs的变化。我们检查了40例法医尸检病例(男26例,女14例;年龄21至3221天)的人胸腺标本。我们将病例分为应激源阳性(SP,n = 29)和应激源阴性(SN,n = 11)两组。根据胸腺萎缩的组织学分类对病例进行分类,并通过瘦素受体免疫染色进行研究。结果显示:(1)SP组呈现明显的胸腺组织学萎缩(p < 0.01);(2)与SN组相比,SP组皮质中的LR-TECs/TECs比值显著升高(p < 0.01)。SP组皮质中LR-TECs/TECs比值的增加可能是人类胸腺应激反应机制的一部分。因此,我们推测胸腺皮质中LR-TECs的定量分析对于法医尸检病例是一种有价值的应激标志物。