Department of Clinical Neuropathology, King's College Hospital NHS Foundation Trust, London, UK.
London Neurodegenerative Diseases Brain Bank, Basic and Clinical Neuroscience Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Int J Legal Med. 2022 Sep;136(5):1321-1339. doi: 10.1007/s00414-022-02807-z. Epub 2022 Apr 30.
The accumulation of βAPP caused by axonal injury is an active energy-dependent process thought to require blood circulation; therefore, it is closely related to the post-injury survival time. Currently, the earliest reported time at which axonal injury can be detected in post-mortem traumatic brain injury (TBI) tissue by βAPP (Beta Amyloid Precursor Protein) immunohistochemistry is 35 min. The aim of this study is to investigate whether βAPP staining for axonal injury can be detected in patients who died rapidly after TBI in road traffic collision (RTC), in a period of less than 30 min.We retrospectively studied thirty-seven patients (group 1) died very rapidly at the scene; evidenced by forensic assessment of injuries short survival, four patients died after a survival period of between 31 min and 12 h (group 2) and eight patients between 2 and 31 days (group 3). The brains were comprehensively examined and sampled at the time of the autopsy, and βAPP immunohistochemistry carried out on sections from a number of brain areas.βAPP immunoreactivity was demonstrated in 35/37 brains in group 1, albeit with a low frequency and in a variable pattern, and with more intensity and frequency in all brains of group 2 and 7/8 brains from group 3, compared with no similar βAPP immunoreactivity in the control group. The results suggest axonal injury can be detected in those who died rapidly after RTC in a period of less than 30 min, which can help in the diagnosis of severe TBI with short survival time.
βAPP 的积累是由轴索损伤引起的，这是一个主动的能量依赖过程，被认为需要血液循环；因此，它与损伤后的存活时间密切相关。目前，通过βAPP（β淀粉样前体蛋白）免疫组化在死后创伤性脑损伤（TBI）组织中检测到轴索损伤的最早报道时间为 35 分钟。本研究旨在探讨βAPP 染色是否可以检测到在道路交通碰撞（RTC）中迅速死亡的 TBI 患者的轴索损伤，时间少于 30 分钟。我们回顾性研究了 37 例（组 1）非常迅速地在现场死亡的患者；根据损伤的法医学评估，存活时间短，4 例患者在 31 分钟至 12 小时之间（组 2）和 8 例患者在 2 至 31 天之间（组 3）死亡。在尸检时对大脑进行了全面检查和取样，并对来自多个脑区的切片进行了βAPP 免疫组织化学染色。在组 1 的 37 例脑中有 35 例显示βAPP 免疫反应性，尽管频率较低，模式不同，但组 2 和组 3 的所有脑中有更多的强度和频率，对照组没有类似的βAPP 免疫反应性。结果表明，在 RTC 后迅速死亡的患者中，在 30 分钟内可以检测到轴索损伤，这有助于诊断存活时间短的严重 TBI。
