Institute for Legal Medicine at the University Hospital Essen, 45147, Essen, Germany.
Departement of Anesthesiology, the University Hospital Düsseldorf, 40225, Düsseldorf, Germany.
Int J Legal Med. 2021 Sep;135(5):1843-1853. doi: 10.1007/s00414-021-02563-6. Epub 2021 May 26.
The estimation of wound age and wound vitality is a recurring task in forensic routine work and has been subject of forensic research for a long time. By now, an unrestrictedly reliable marker or set of markers has not been found. In a study on myocardial infarctions, matrix metalloproteinases (MMP) 2 and 9 as well as tissue inhibitor of matrix metalloproteinases 1 (TIMP-1) were detected immunohistochemically in mechanically wounded myocardium (ECG electrodes, vessel ligations). Against this background, the potency of MMP-9, MMP-2, and TIMP-1 as markers for the estimation of wound age and wound vitality was tested in a broad approach with human tissue samples drawn during autopsies and with an animal model, the isolated perfused Langendorff heart. The study comprised samples of injured human skeletal muscle, injured human myocardium, rats' hearts with vital wounds, and rats' hearts with postmortem-inflicted wounds that were all stained immunohistochemically. The results showed great scattering, leading to the conclusion that MMP-2, MMP-9, and TIMP-1 are not suitable for wound age estimation. Merely the results for TIMP-1 suggested that this marker might be able to differentiate between vital and postmortem-inflicted wounds. With a view to the promising results of the preceding study, the results underline the necessity to test possible markers of wound age/wound vitality on a large and diverse sample set.
伤口年龄和活力的评估是法医学常规工作中的一项反复任务,长期以来一直是法医学研究的主题。到目前为止,还没有找到不受限制的可靠标志物或标志物集。在一项心肌梗死研究中,通过免疫组织化学方法检测到机械性损伤心肌(心电图电极、血管结扎)中的基质金属蛋白酶(MMP)2 和 9 以及基质金属蛋白酶组织抑制剂 1(TIMP-1)。在此背景下,通过对尸检时获得的人体组织样本和离体灌流 Langendorff 心脏的动物模型进行广泛的研究,测试了 MMP-9、MMP-2 和 TIMP-1 作为伤口年龄和活力评估标志物的效力。该研究包括受伤的人类骨骼肌、受伤的人类心肌、有活力伤口的大鼠心脏和死后造成伤口的大鼠心脏的样本,所有样本均进行了免疫组织化学染色。结果显示出很大的分散性,得出的结论是 MMP-2、MMP-9 和 TIMP-1 不适合用于伤口年龄估计。仅 TIMP-1 的结果表明,该标志物可能能够区分有活力和死后造成的伤口。鉴于先前研究的有希望的结果,这些结果强调了在大量和多样化的样本集中测试可能的伤口年龄/活力标志物的必要性。