University of Modena and Reggio Emilia, Modena, Italy.
University of Parma, Parma, Italy.
Leg Med (Tokyo). 2024 Nov;71:102508. doi: 10.1016/j.legalmed.2024.102508. Epub 2024 Aug 8.
The postmortem diagnosis of acute myocardial ischemia (AMI) represents a challenging issue in forensic practice. Immunohistochemical studies and gene expression studies are becoming a promising field of research in forensic pathology. The present study aims to evaluate HIF-1α expression through immunohistochemistry (IHC), and mRNA-210 level using real-time polymerase chain reaction (RT-PCR), in order to define if HIF-1α and mRNA-210 in post-mortem myocardium could be adopted in the diagnosis of AMI.
Thirty-five deceased individuals, who underwent forensic autopsy at the Legal Medicine Service of the University of Parma, between 2010 and 2018, were investigated. The cohort was divided into two groups according to the cause of death (sudden deaths caused by AMI vs control cases). Cardiac specimens were collected during autopsy, then samples were processed for morphological evaluation using haematoxylin-eosin staining, for IHC, and for RT-PCR. HIF-1α expression and mRNA-210 levels were investigated.
Statistical evaluation demonstrated statistically significant differences in terms of number of IHC positive vessels, leukocytes, and cardiomyocytes between the two groups. Moreover, in the majority of cases, immunostaining positivity was observed only in myocardial and subendocardial samples. With reference to mRNA-210, the difference between the two groups proved to be statistically significant.
The present study indicates that HIF-1α and mRNA-210 in post-mortem cardiac specimens could represent appropriate biomarkers in the diagnosis of AMI. The current study was primarily limited by the scarcity of the cohort, so further research is required to confirm these preliminary observations.
在法医实践中,对急性心肌缺血(AMI)的死后诊断是一个具有挑战性的问题。免疫组织化学研究和基因表达研究正成为法医病理学中一个有前途的研究领域。本研究旨在通过免疫组织化学(IHC)评估缺氧诱导因子 1α(HIF-1α)的表达,并使用实时聚合酶链反应(RT-PCR)检测 mRNA-210 的水平,以确定死后心肌中的 HIF-1α 和 mRNA-210 是否可用于 AMI 的诊断。
研究调查了 2010 年至 2018 年间在帕尔马大学法医学服务处进行法医尸检的 35 名死者。根据死因(由 AMI 引起的猝死与对照组)将队列分为两组。尸检时采集心脏标本,然后对标本进行苏木精-伊红染色进行形态学评估,进行 IHC 和 RT-PCR。研究了 HIF-1α 的表达和 mRNA-210 水平。
统计评估表明,两组之间在 IHC 阳性血管、白细胞和心肌细胞的数量方面存在统计学显著差异。此外,在大多数情况下,免疫染色阳性仅在心肌和心内膜下样本中观察到。关于 mRNA-210,两组之间的差异具有统计学意义。
本研究表明,死后心脏标本中的 HIF-1α 和 mRNA-210 可能是 AMI 诊断的合适生物标志物。本研究主要受到队列规模较小的限制,因此需要进一步研究来证实这些初步观察结果。