High risk and low prevalence diseases: Blast injuries

Forensic-medical characteristics of penetrating wounds as manifestations of explosive trauma in the case of decomposed bodies examination

The Russian invasion of Ukraine in 2022 caused a significant spike in the number of deaths from blast injury. The impossibility of evacuating the bodies of dead servicemen or civilians from the battlefield for a long time leads to the fact that forensic experts often have to deal with the examination of bodies in a state of decomposed changes. At the same time, the material and technical support of forensic medical institutions in different parts of Ukraine is heterogeneous: most experts do not have access to laboratory or instrumental research methods and can only rely on macroscopic research data. This article provides an overview of the cases of expert examination of cases of explosive trauma of decomposed bodies using macroscopic, microscopic, chemical and instrumental research, which indicates the high efficiency of their use for the purpose of solving expert questions of various nature. At the same time, the identified morphological characteristics of the damage are not purely specific and indicate the action of a blunt solid object with a limited contact surface, which had high kinetic energy and significant penetrating capacity.

Thrombospondin-1-mediated crosstalk between autophagy and oxidative stress orchestrates repair of blast lung injury

Coal mining carries inherent risks of catastrophic gas explosions capable of inflicting severe lung injury. Using complementary in vivo and in vitro models, we explored mechanisms underlying alveolar epithelial damage and repair following a gas explosion in this study. In a rat model, the gas explosion was demonstrated to trigger inflammation and injury within the alveolar epithelium. The following scRNA-sequencing revealed that alveolar epithelial cells exhibited the most profound transcriptomic changes after gas explosion compared to other pulmonary cell types. In the L2 alveolar epithelial cells, the blast was found to cause autophagic flux by inducing autophagosome formation, LC3 lipidation, and p62 degradation. Transcriptomic profiling of the L2 cells identified PI3K-Akt and p53 pathways as critical modulators governing autophagic and oxidative stress responses to blast damage. Notably, Thrombospondin-1 (Thbs1) was determined for the first time as a pivotal node interconnecting these two pathways. The findings of this study illuminate intricate mechanisms of alveolar epithelial injury and recovery after blast trauma, highlighting autophagic and oxidative stress responses mediated by Thbs1-associated PI3K-Akt and p53 pathways as high-value therapeutic targets, and strategic modulation of these pathways in future studies may mitigate lung damage by reducing oxidative stress while engaging endogenous tissue repair processes like autophagy.