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Caputo F, Barranco R, Ventura F, Fracasso T. Immunohistochemical detection of Fibronectin, P-Selectin, FVIII, HSP-70 and MRP-8 in the skin of ligature marks of suicidal hangings. J Forensic Leg Med 2023; 96:102524. [PMID: 37075596 DOI: 10.1016/j.jflm.2023.102524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 03/08/2023] [Accepted: 04/14/2023] [Indexed: 04/21/2023]
Abstract
The determination of vitality of skin injuries is one of the most central research areas in forensic pathology for it is often necessary to discern antemortem from postmortem damage. Typical is the case of a hanging, which should be distinguished from the postmortem suspension of a body. In this study, 15 human skin samples from ligature marks (study group) of victims of suicidal hanging and 15 uninjured skin samples (negative control group) were analyzed. In addition, 15 skin samples from ecchymoses in homicide victims with short survival intervals were investigated as a positive control group. Sections were processed for immunohistochemistry in order to detect the expression of Fibronectin, P-Selectin, FVIII, HSP-70, and MRP8. Immunohistochemical reactions were classified semiquantitatively (mild - score 1, moderate - score 2, and intense - score 3). In the ligature marks, Fibronectin was significantly less expressed compared to ecchymoses. The expression was similar to hanging marks and uninjured skin. In both ligature marks and ecchymoses, the expression of P-Selectin was significantly increased compared to uninjured skin. In both ligature marks and ecchymoses, expression of HSP-70 was significantly decreased in the epidermis compared to uninjured skin. In both ligature marks and ecchymoses, the expression of FVIII and MRP8 was significantly increased in the dermis and hypodermis compared to uninjured skin. The results of this study show that the immunohistochemical study of early inflammatory and coagulation factors could help determine the vitality of ligature marks. The combined analysis of P-Selectin, FVIII, HSP-70, and MRP-8 can be considered for this purpose.
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Affiliation(s)
- Fiorella Caputo
- University of Genova, Department of Legal and Forensic Medicine, Via De Toni 12, Genova, 16132, Italy; University of Catanzaro, Department of Legal and Forensic Medicine, Viale Europa, Catanzaro, 88100, Italy
| | - Rosario Barranco
- University of Genova, Department of Legal and Forensic Medicine, Via De Toni 12, Genova, 16132, Italy.
| | - Francesco Ventura
- University of Genova, Department of Legal and Forensic Medicine, Via De Toni 12, Genova, 16132, Italy
| | - Tony Fracasso
- University Center of Legal Medicine, Lausanne Geneva, Geneva University Hospitals, Switzerland
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Maiese A, Manetti AC, Iacoponi N, Mezzetti E, Turillazzi E, Di Paolo M, La Russa R, Frati P, Fineschi V. State-of-the-Art on Wound Vitality Evaluation: A Systematic Review. Int J Mol Sci 2022; 23:6881. [PMID: 35805886 PMCID: PMC9266385 DOI: 10.3390/ijms23136881] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/17/2022] [Accepted: 06/17/2022] [Indexed: 12/29/2022] Open
Abstract
The vitality demonstration refers to determining if an injury has been caused ante- or post-mortem, while wound age means to evaluate how long a subject has survived after the infliction of an injury. Histology alone is not enough to prove the vitality of a lesion. Recently, immunohistochemistry, biochemistry, and molecular biology have been introduced in the field of lesions vitality and age demonstration. The study was conducted according to the preferred reporting items for systematic review (PRISMA) protocol. The search terms were "wound", "lesion", "vitality", "evaluation", "immunohistochemistry", "proteins", "electrolytes", "mRNAs", and "miRNAs" in the title, abstract, and keywords. This evaluation left 137 scientific papers. This review aimed to collect all the knowledge on vital wound demonstration and provide a temporal distribution of the methods currently available, in order to determine the age of lesions, thus helping forensic pathologists in finding a way through the tangled jungle of wound vitality evaluation.
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Affiliation(s)
- Aniello Maiese
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy; (A.M.); (A.C.M.); (N.I.); (E.M.); (E.T.); (M.D.P.)
| | - Alice Chiara Manetti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy; (A.M.); (A.C.M.); (N.I.); (E.M.); (E.T.); (M.D.P.)
| | - Naomi Iacoponi
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy; (A.M.); (A.C.M.); (N.I.); (E.M.); (E.T.); (M.D.P.)
| | - Eleonora Mezzetti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy; (A.M.); (A.C.M.); (N.I.); (E.M.); (E.T.); (M.D.P.)
| | - Emanuela Turillazzi
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy; (A.M.); (A.C.M.); (N.I.); (E.M.); (E.T.); (M.D.P.)
| | - Marco Di Paolo
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Institute of Legal Medicine, University of Pisa, 56126 Pisa, Italy; (A.M.); (A.C.M.); (N.I.); (E.M.); (E.T.); (M.D.P.)
| | - Raffaele La Russa
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
| | - Paola Frati
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Institute of Legal Medicine, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy;
| | - Vittorio Fineschi
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Institute of Legal Medicine, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy;
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Abd-Elhakim YM, Omran BHF, Ezzeldein SA, Ahmed AI, El-Sharkawy NI, Mohamed AAR. Time-dependent expression of high-mobility group box-1 and toll-like receptors proteins as potential determinants of skin wound age in rats: Forensic implication. Int J Legal Med 2022; 136:1781-1789. [PMID: 35132471 PMCID: PMC9576669 DOI: 10.1007/s00414-022-02788-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/21/2022] [Indexed: 12/03/2022]
Abstract
The skin wound age determination in living subjects is an imperative task for forensic experts. In this study, we investigated the time-dependent expression of high-mobility group box-1 (HMGB1) and toll-like receptors 2 and 4 (TLR2 and 4) in rat skin wounds using real-time PCR and seek their forensic potentials during the skin wound repair process. In addition, the levels of serum pro-inflammatory cytokines (tumor necrosis factor-alpha (TNF-α) and interleukin 6 (IL-6)), as well as nitric oxide (NO) production, were measured. The wound tissue and serum samples were collected after 30 min, 2 h, 6 h, 12 h, 1 day, 3 days, 5 days, and 7 days after incision. As a control (zero time), skin specimens and blood samples were collected without incision. The results reveal that the HMGB1, TLR2, and TLR4 expression levels were increased in a time-dependent manner until the first day where the peak level was achieved for the three tested genes compared with the zero time. On the 7th day, the statistical significance was lost for TLR2 and TLR4 but persisted for HMGB1. The serum TNF-α, IL6, and NO levels peaked within 30 min and 1st and 3rd day after injury, respectively. On the 7th day after incision, no significant differences exist in the TNF-α serum level compared to the control group, but the statistical significance persisted for IL6 and NO. It was apparent that the analyzed genes in the wound tissues showed higher R2 values rather than the serum biochemical indicators. Of note, a strong positive correlation was evident between the HMGB1 and that of TLR2 and TLR4 relative expression as well as IL-6 serum level. Conclusively, based on the observed changes in the analyzed markers in wound tissues and serum and R2 values obtained from mathematical models established to determine the wound age, the relative expression of HMGB1, TLR2, and TLR4 could be a reliable indicator for wound age determination in living subjects. Further investigation of these markers and mathematical models in human tissues is necessary.
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Affiliation(s)
- Yasmina M Abd-Elhakim
- Department of Forensic Medicine and Toxicology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt.
| | - Bothina H F Omran
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Human Medicine, Zagazig University, Zagazig, Egypt
| | - Shimaa A Ezzeldein
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Amany I Ahmed
- Department of Biochemistry, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Nabela I El-Sharkawy
- Department of Forensic Medicine and Toxicology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Amany Abdel-Rahman Mohamed
- Department of Forensic Medicine and Toxicology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt.
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Ishida Y, Nosaka M, Kondo T. Bone Marrow-Derived Cells and Wound Age Estimation. Front Med (Lausanne) 2022; 9:822572. [PMID: 35155503 PMCID: PMC8828650 DOI: 10.3389/fmed.2022.822572] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/03/2022] [Indexed: 12/20/2022] Open
Abstract
Appropriate technology as well as specific target cells and molecules are key factors for determination of wound vitality or wound age in forensic practice. Wound examination is one of the most important tasks for forensic pathologists and is indispensable to distinguish antemortem wounds from postmortem damage. For vital wounds, estimating the age of the wound is also essential in determining how the wound is associated with the cause of death. We investigated bone marrow-derived cells as promising markers and their potential usefulness in forensic applications. Although examination of a single marker cannot provide high reliability and objectivity in estimating wound age, evaluating the appearance combination of bone marrow-derived cells and the other markers may allow for a more objective and accurate estimation of wound age.
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Affiliation(s)
- Yuko Ishida
- *Correspondence: Yuko Ishida ; orcid.org/0000-0001-6104-7599
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Diagnosis of Vitality in Skin Wounds in the Ligature Marks Resulting From Suicide Hanging. ACTA ACUST UNITED AC 2017; 38:211-218. [DOI: 10.1097/paf.0000000000000322] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Casse JM, Martrille L, Vignaud JM, Gauchotte G. Skin wounds vitality markers in forensic pathology: An updated review. MEDICINE, SCIENCE, AND THE LAW 2016; 56:128-37. [PMID: 26101444 DOI: 10.1177/0025802415590175] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Wound age evaluation is one of the most challenging issues in forensic pathology. In the first minutes or hours, standard histological examination may not determine whether the wound was inflicted in the pre- or post-mortem period. While red blood cell infiltration is classically considered as a sign of vital reaction, several studies have shown that extravasation of blood cells may also occur after death and cannot be used as a reliable marker in the diagnosis of wound vitality. Numerous studies about wound vitality are available in the literature. They have evaluated markers involved in coagulation or inflammation, using various methods such as enzymology, molecular biology or immunohistochemistry. In this update, we first introduce some methodological principles. Then, we review the main studies available in the literature. Immunohistochemistry seems to be the most valuable method, given its easy application and the possibility to analyse the localization of the molecules of interest. Some markers are promising, such as CD15, TNFα, IL-6, IL-1β, TGFα or TGFβ1. Prior to their application in daily practice, these early results need to be confirmed with other studies, conducted by independent teams and integrating multiple controls. Most notably, the antibodies have to be tested in numerous post-mortem wounds. Indeed, a critical risk of overexpression in post-mortem wounds is present. Some promising markers have been later invalidated because of post-mortem false positivity. Finally, optimal sensitivity and specificity values could probably be reached by combining several markers, validated by large groups of pre- and post-mortem wounds.
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Affiliation(s)
- Jean-Matthieu Casse
- Department of Pathology, CHU Nancy; INSERM U954, Faculty of Medicine, Université de Lorraine, France
| | - Laurent Martrille
- Department of Legal Medicine, CHU Nancy; Université de Lorraine, France
| | - Jean-Michel Vignaud
- Department of Pathology, CHU Nancy; INSERM U954, Faculty of Medicine, Université de Lorraine, France
| | - Guillaume Gauchotte
- Department of Pathology, CHU Nancy; INSERM U954, Faculty of Medicine, Université de Lorraine, France
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7
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Analysis of morphological characteristics and expression levels of extracellular matrix proteins in skin wounds to determine wound age in living subjects in forensic medicine. Forensic Sci Int 2014; 246:86-91. [PMID: 25485947 DOI: 10.1016/j.forsciint.2014.11.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 10/29/2014] [Accepted: 11/13/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Wound age determination in living subjects is important in routine diagnostics in forensic medicine. Macroscopical description of a wound to determine wound age however is inadequate. The aim of this study was to assess whether it would be feasible to determine wound age via analysis of morphological characteristics and extracellular matrix proteins in skin biopsies of living subjects referred to a forensic outpatient clinic. METHODS Skin biopsies (n=101), representing the border area of the wound, were taken from skin injuries of known wound age (range: 4.5h-25 days) in living subjects. All biopsies were analyzed for 3 morphological features (ulceration, parakeratosis and hemorrhage) and 3 extracellular matrix markers (collagen III, collagen IV and α-SMA). For quantification, biopsies were subdivided in 4 different timeframes: 0.2-2 days, 2-4 days, 4-10 days and 10-25 days old wounds. Subsequently, a probability scoring system was developed. RESULTS For hemorrhage, collagen III, collagen IV and α-SMA expression no relation with wound age was found. Ulceration was only found in wounds of 0.2-2, 2-4 and 4-10 days old, implying that the probability that a wound was more than 10 days old in case of ulceration is equal to 0%. Also parakeratosis was almost exclusively found in wounds of 0.2-2, 2-4 and 4-10 days old, except for one case with a wound age of 15 days old. The probability scoring system of all analyzed markers, as depicted above, however can be used to calculate individual wound age probabilities in biopsies of skin wounds of living subjects. CONCLUSIONS We have developed a probability scoring system, analysing morphological characteristics and extracellular matrix proteins in superficial skin biopsies of wounds in living subjects that can be applied in forensic medicine for wound age determination.
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8
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van de Goot FR, Korkmaz HI, Fronczek J, Witte BI, Visser R, Ulrich MM, Begieneman MP, Rozendaal L, Krijnen PA, Niessen HW. A new method to determine wound age in early vital skin injuries: A probability scoring system using expression levels of Fibronectin, CD62p and Factor VIII in wound hemorrhage. Forensic Sci Int 2014; 244:128-35. [DOI: 10.1016/j.forsciint.2014.08.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 07/21/2014] [Accepted: 08/19/2014] [Indexed: 12/19/2022]
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9
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Supp DM, Neely AN. Cutaneous antimicrobial gene therapy: engineering human skin replacements to combat wound infection. ACTA ACUST UNITED AC 2014. [DOI: 10.1586/17469872.3.1.73] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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10
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Lenselink EA. Role of fibronectin in normal wound healing. Int Wound J 2013; 12:313-6. [PMID: 23742140 DOI: 10.1111/iwj.12109] [Citation(s) in RCA: 158] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 05/06/2013] [Indexed: 01/31/2023] Open
Abstract
Fibronectin is an adhesive molecule that plays a crucial role in wound healing, particularly in extracellular matrix (ECM) formation and also in reepithelialisation. Fibronectin plays many different roles in the wound healing process because of the presence of specific function domains and binding sites in its structure. Fibronectin interacts with different cell types, cytokines and the ECM. The main role of fibronectin is ECM formation. First, plasma fibronectin forms a provisional fibrin-fibronectin matrix, which will later be replaced by the mature ECM-containing tissue fibronectin.
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11
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Gauchotte G, Martrille L, Plénat F, Vignaud JM. Les marqueurs de vitalité des blessures en pathologie médicolégale. Ann Pathol 2013; 33:93-101. [DOI: 10.1016/j.annpat.2013.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Revised: 01/18/2013] [Accepted: 02/11/2013] [Indexed: 10/27/2022]
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12
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Cecchi R. Estimating wound age: looking into the future. Int J Legal Med 2010; 124:523-36. [DOI: 10.1007/s00414-010-0505-x] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Accepted: 08/10/2010] [Indexed: 12/16/2022]
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13
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Oehmichen M, Gronki T, Meissner C, Anlauf M, Schwark T. Mast cell reactivity at the margin of human skin wounds: An early cell marker of wound survival? Forensic Sci Int 2009; 191:1-5. [DOI: 10.1016/j.forsciint.2009.05.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2008] [Revised: 05/25/2009] [Accepted: 05/26/2009] [Indexed: 11/26/2022]
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The science behind the quest to determine the age of bruises—a review of the English language literature. Forensic Sci Med Pathol 2007; 3:241-51. [DOI: 10.1007/s12024-007-9019-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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15
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Takamiya M, Kumagai R, Nakayashiki N, Aoki Y. A study on mRNA expressions of fibronectin in dermal and cerebral wound healing for wound age estimation. Leg Med (Tokyo) 2006; 8:214-9. [PMID: 16807048 DOI: 10.1016/j.legalmed.2006.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2006] [Revised: 05/09/2006] [Accepted: 05/10/2006] [Indexed: 11/20/2022]
Abstract
We investigated mRNA expressions of fibronectin for wound age estimation during dermal and cerebral wound healing. Fibronectin mRNA expressions in the injured skin peaked at 8h post-injury. The expressions were detected in endothelial cells before and after injury, whereas they were detectable in the epidermal cells at 1-240 h, in fibroblasts at 1-72 h, in neutrophils and macrophages at 8-72 h, respectively. However, the expressions in epidermal cells became relatively weak in the subacute phase. Fibronectin mRNA expressions of the injured cerebrum increased after the intervention and peaked at 48 h, whereas there was a slight decrease during 24h post-injury. Although fibronectin mRNA was seen exclusively in the endothelial cells of the intact cerebrum, it was also detected in astrocytes during wound healing. From these findings, it was considered that fibronectin played an important role in dermal and cerebral wound healing. Expression of fibronectin mRNA was considered to indicate the acute phase of dermal wound healing, and the subacute phase of cerebral wound healing.
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Affiliation(s)
- Masataka Takamiya
- Department of Legal Medicine, Iwate Medical University School of Medicine, 19-1 Uchimaru Morioka, Iwate 020-8505, Japan.
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Nakajima T, Hayakawa M, Yajima D, Motani-Saitoh H, Sato Y, Kiuchi M, Ichinose M, Iwase H. Time-course changes in the expression of heme oxygenase-1 in human subcutaneous hemorrhage. Forensic Sci Int 2006; 158:157-63. [PMID: 16039813 DOI: 10.1016/j.forsciint.2005.05.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2004] [Accepted: 05/19/2005] [Indexed: 01/12/2023]
Abstract
To determine the time-course of human subcutaneous hemorrhage, heme oxygenase (HO)-1 expression and macrophage infiltration were observed using an immunohistochemical technique and semiquantitative analysis. The number of immunoreactive cells and the number of all infiltrating cells of each microscopic field were counted, and the ratio of the former to the latter was calculated as the positive cells ratio. An increase in the HO-1-positive cells ratio was observed starting at 3 h after injury, and the maximum ratio was observed 3 days after injury. The pattern of the increase in the macrophage ratio was similar to that of the HO-1-positive cells ratio in the early period after injury. Observation of serial sections revealed that the expression of HO-1 in the cells corresponded to the localization of macrophage. The present results suggest that the determination of HO-1 expression, as derived from macrophages, might be useful for the estimation of the time-course of subcutaneous hemorrhage.
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Affiliation(s)
- Toru Nakajima
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuo-ku, Chiba 260-8670, Japan.
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Barak O, Treat JR, James WD. Antimicrobial peptides: effectors of innate immunity in the skin. ACTA ACUST UNITED AC 2006; 21:357-74. [PMID: 16350450 DOI: 10.1016/j.yadr.2005.07.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The ability of the cutaneous barrier to help defend the body against pathogens relies on both acquired and innate immune responses. Recently, a large body of research has suggested that a critical component of the innate immune response in the skin is 3 antimicrobial peptides: the cathelicidins, defensins, and dermcidins. These 3 classes of peptides have been shown to act as antimicrobials by directly inhibiting pathogen growth as well as potentiating other branches of the innate, humoral, and cell-mediated immune system. Here, we review the antimicrobial peptides with an emphasis on their role in the cutaneous immune response. We present an overview of defensin, cathelicidin, and dermcidin physiology, elucidating their various functions. In addition, we delve into the role of these peptides in specific dermatologic conditions including wound healing, atopy, and microbial infection. Finally, we discuss the future of antimicrobial peptide research including therapeutic options.
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Affiliation(s)
- Orr Barak
- University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
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18
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Abstract
The term "wound" describes the morphologic-functional disruption of the continuity of a tissue structure. A wound can be inflicted during life--when the cardiovascular and respiratory system is still intact--or after death, i.e. after cardiac and respiratory arrest. Traumatization during life triggers vital reactions that do not occur in postmortem wounds. Three types of vital reactions in wound healing can be distinguished: Reactions of the scavenger type, which are almost exclusively mediated by blood cells. Reactions by complex signal transduction pathways, which involves cascade-like release of chemokines, cytokines and adhesion molecules and may influence type 1 and type 3 reactions. Reactions of the scarring type, which involve the final repair of the damaged tissue and are carried out primarily by cells residing at the wound edges, i.e. partly concerning mesenchymal cells and partly tissue-specific cells dependent on the involved organ system. The three different types of reaction follow roughly parallel temporal courses that include cascade-like interactions among themselves. Whereas demonstration of a vital reaction suffices to differentiate an intravital wound from a postmortem wound, the vital reactions themselves follow strictly temporal courses. The regular time-dependent occurrence of each phenomenon allows--in limits--a reliable temporal classification of wound healing. A review will be given especially demonstrating the actual German scientific research in vitality and in skin wound timing as well as in timing of mechanical injury of the brain.
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Affiliation(s)
- M Oehmichen
- Department of Legal Medicine, Institute of Forensic Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 12, D-24105 Kiel, Germany.
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