Napoletano Gabriele, Marinelli Enrico, Palla Luigi, Zaami Simona, Maiese Aniello
Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, Rome, 00161, Italy.
Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, 04100, Italy.
Int J Legal Med. 2025 May;139(3):1105-1112. doi: 10.1007/s00414-024-03400-2. Epub 2024 Dec 16.
Traumatic Brain Injury (TBI) represents one of the leading causes of disability and death globally, with a significant impact on public health. We present 12 cases (age 5-80 years old) of death due to TBI with different post-traumatic interval (PTI). The expression of S-100B and RIPK-1 in pericontusional zones of TBI were studied in forensic cases to understand the vitality and timing of injuries. The anti-RIPK-1 antibodies mainly stained the cytoplasm of the nerve cells. In 3 cases (48 to 56 years old with no other comorbidities; PTI: 2 days to 4 days) antibodies positive for RIPK-1 were found. In 5 cases (48 to 71 years old; PTI: 2 days to 12 days) astrocyte, oligodendrocyte and neurons positive for anti-S-100B were found. In 3 of these 5 cases both antibodies tested were positive. In 7 cases (5-80 years old; one with history of drug abuse, other with no comorbidities, PTI 0 h; ) the glial cells were swollen and the submeningeal glial limitans became immunopositive for S100B. Stain accumulations were also observed adjacent to the walls of cerebral vessels, sometimes within the intravascular compartment. The results of the study show that in subjects who suffered a TBI, the expression of RIPK-1 and S-100B at the level of neurons in the pericontusional area was significantly increased compared to the control group. Neurons were not stained for RIPK-1 in cases of sudden cardiac deaths and sudden deaths due to TBI but observed neurons became immunopositive for RIPK-1 some days after TBI. S100-immunopositive neurons were not seen in immediate deaths but were found in cases with survival up to 12 days. Results regarding S100B are in line with existing knowledge. The study of necroptosis with anti-RIPK-1 antibodies could be useful in understanding the extent of secondary injuries and survival time in forensic contexts. However, this is a pilot study and should be extended to a larger number of cases to achieve more reliable results.
创伤性脑损伤（TBI）是全球致残和致死的主要原因之一，对公众健康有重大影响。我们呈现了12例（年龄5至80岁）因TBI导致死亡且具有不同创伤后间隔时间（PTI）的病例。在法医案例中研究了TBI挫伤周围区域中S - 100B和RIPK - 1的表达，以了解损伤的活力和时间。抗RIPK - 1抗体主要染神经细胞的细胞质。在3例（年龄48至56岁，无其他合并症；PTI：2天至4天）中发现RIPK - 1抗体呈阳性。在5例（年龄48至71岁；PTI：2天至12天）中发现抗S - 100B呈阳性的星形胶质细胞、少突胶质细胞和神经元。在这5例中的3例中，两种检测抗体均呈阳性。在7例（年龄5至80岁；1例有药物滥用史，其他无合并症，PTI为0小时）中，神经胶质细胞肿胀，软脑膜下神经胶质界膜对S100B呈免疫阳性。在脑血管壁附近也观察到染色积聚，有时在血管腔内。研究结果表明，与对照组相比，遭受TBI的受试者挫伤周围区域神经元水平的RIPK - 1和S - 100B表达显著增加。在心脏性猝死和TBI导致的猝死病例中，神经元未被RIPK - 1染色，但在TBI几天后观察到神经元对RIPK - 1呈免疫阳性。在即刻死亡病例中未见到S100免疫阳性神经元，但在存活长达12天的病例中发现了。关于S100B的结果与现有知识相符。用抗RIPK - 1抗体研究坏死性凋亡可能有助于在法医背景下了解继发性损伤的程度和存活时间。然而，这是一项初步研究，应扩展到更多病例以获得更可靠的结果。
