Pennisi Giuliana, Torrisi Marco, Cocimano Giuseppe, Esposito Massimiliano, Salerno Monica, Sessa Francesco
Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania - A.O.U. Policlinico "G. Rodolico - San Marco" via S. Sofia, 87 - Sector 10, Building B, 95123, Catania, Italy.
Forensic Sci Med Pathol. 2023 Mar;19(1):103-116. doi: 10.1007/s12024-022-00551-9. Epub 2022 Nov 4.
Determining whether an injury was sustained in life or not is one of the most important topics in forensic medicine. Morphological, cytological, and biological techniques are used to assess wound vitality. Several markers involved in vital and supravital reactions increase the accuracy of wound age estimation. This systematic review aimed to investigate the main vitality markers used in forensic medicine to date. This review was conducted by performing a systematic literature search on online resources (PubMed Central database and Google Scholar) until May 2022. We identified 46 articles published between 1987 and May 2022, analyzing a total of 53 markers. Based on the data of this review, the most studied vitality markers were adhesion molecules (fibronectin, p-selectin, CD 15), pro-inflammatory cytokines (IL-6, IL-1β, TNF-α), cathepsin D, tryptase, and microRNAs (miRNAs). The most interesting studies were based on animal models: the different markers were investigated through immunohistochemical and qRT-PCR methods. The experimental methods were usually based on skin incisions, ligature marks, and burned skin areas. To date, it has not been possible to identify any gold standard markers based on the criteria of efficacy, specificity, and reliability; however, studies are still in progress. In the future, the use of miRNAs is promising as well as the combination of multiple markers. In this way, it will be possible to increase the sensitivity and specificity to validate systems or models for determining wound vitality in forensic practice.
确定损伤是否发生在生前是法医学中最重要的课题之一。形态学、细胞学和生物学技术被用于评估伤口的生机。一些参与生命反应和超生命反应的标志物提高了伤口年龄估计的准确性。本系统综述旨在研究迄今为止法医学中使用的主要生机标志物。本综述通过在在线资源（PubMed Central数据库和谷歌学术）上进行系统的文献检索，直至2022年5月。我们确定了1987年至2022年5月发表的46篇文章，共分析了53种标志物。基于本综述的数据，研究最多的生机标志物是黏附分子（纤连蛋白、p-选择素、CD 15）、促炎细胞因子（IL-6、IL-1β、TNF-α）、组织蛋白酶D、类胰蛋白酶和微小RNA（miRNA）。最有趣的研究基于动物模型：通过免疫组织化学和qRT-PCR方法研究不同的标志物。实验方法通常基于皮肤切口、结扎痕迹和烧伤皮肤区域。迄今为止，根据有效性、特异性和可靠性标准，尚未确定任何金标准标志物；然而，研究仍在进行中。未来，miRNA的应用以及多种标志物的联合应用前景广阔。通过这种方式，将有可能提高敏感性和特异性，以验证法医学实践中确定伤口生机的系统或模型。
