Preliminary study on diagnosis of fatal arrhythmia in forensic autopsy

• Project/Area Number: 18K19694
• Research Category: Grant-in-Aid for Challenging Research (Exploratory)
• Allocation Type: Multi-year Fund
• Review Section: Medium-sized Section 58:Society medicine, nursing, and related fields
• Research Institution: Wakayama Medical University
• Principal Investigator: Kondo Toshikazu 和歌山県立医科大学, 医学部, 教授 (70251923)
• Project Period (FY): 2018-06-29 – 2021-03-31
• Project Status: Completed (Fiscal Year 2020)
• Budget Amount: ¥6,370,000 (Direct Cost: ¥4,900,000、Indirect Cost: ¥1,470,000); Fiscal Year 2020: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000); Fiscal Year 2019: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000); Fiscal Year 2018: ¥2,210,000 (Direct Cost: ¥1,700,000、Indirect Cost: ¥510,000)
• Keywords: 突然死 / 致死性不整脈 / 急性心筋梗塞 / HO-1 / ヘムオキシゲナーゼ / 時計遺伝子 / 心臓 / 中枢神経 / ケモカインレセプター / 心臓突然死 / 法医診断学

Outline of Final Research Achievements

We examined the immunohistochemical expression of Heme oxygenase-1 (HO-1) in the heart samples to discuss their forensic significance to determine acute cardiac ischemia. The heart samples were obtained from 23 acute ischemic heart diseases (AIHD) cases and 33 non-AIHD cases as controls. HO-1 positive signals in cardiomyocyte nuclear were detected in 78.2% of AIHD cases, however, that were detected in only 24.2% control cases with statistical difference between AIHD and non-AIHD groups. In contrast to HO-1 protein expression, there was no significant difference in the appearance of myoglobin pallor regions and leukocyte infiltration in the hearts between AIHD and non-AIHD groups. From the viewpoints of forensic pathology, intracardiac HO-1 expression would be considered a valuable marker to diagnose AIHD as the cause of death.

Academic Significance and Societal Importance of the Research Achievements

法医実務において死因確定は最も重要な実務の一つであり，その際，客観性且つ正確性が求められる．致死性不整脈の法医診断法については未解決で，その最大の理由は生前に致死性不整脈が生じていたか否かの客観的証拠が極めて乏しいものであるからである．突然死の死因の約半数は，心臓・大血管系疾患で占められている．しかしながら，心臓性突然死例と考えられる事例で形態学的に明らかな変化を伴わない，心室細動等の「致死性不整脈」で死亡したと推測される事例にしばしば遭遇する．本研究では，酸化ストレスによる細胞傷害に関与するHO-1の心臓における発現を，心臓死と非心臓死群で検討した．

Research Products

• [Journal Article] Protective Roles of Interferon-γ in Cardiac Hypertrophy Induced by Sustained Pressure Overload (2018)
  • Author(s): Kimura A, Ishida Y, Furuta M, Nosaka M, Kuninaka Y, Taruya A, Mukaida N, Kondo T
  • Journal Title: J Am Heart Assoc Volume: 7(6) Issue: 6
  • DOI: 10.1161/jaha.117.008145
  • Peer Reviewed / Open Access
• [Presentation] 急性心筋梗塞におけるheme oxygenase-1の免疫組織化学的検出 (2021)
  • Author(s): 石田裕子，國中由美，野坂みずほ，島田栄美，石上安希子，山本寛記，橋爪佑示子，川口真理子，近藤稔和
  • Organizer: 第105次日本法医学会学術全国集会
• [Presentation] Immunohistochemical detection of heme oxygenase-1 in acute ischemic myocardial infarction (2021)
  • Author(s): Yumi Kuninaka*, Yuko Ishida*, Mizuho Nosaka, Emi Shimada, Akiko Ishigami, Akihiko Kimura, Hiroki Yamamoto, Mitsunori Ozaki, Fukumi Furukawa, Toshikazu Kondo
  • Organizer: 100th Annual Meeting of German Society of Legal Medicine
  • Int'l Joint Research
• [Presentation] 圧負荷による心不全の病態形成におけるSpi-Bの役割解析－プロテオグリカンと炎症性サイトカインの発現制御－ (2018)
  • Author(s): 379.木村章彦，石田裕子，野坂みずほ，佐々木 泉，樽谷 玲，山本寛記，國中由美，加藤 喬，福田有里，改正恒康，近藤稔和．
  • Organizer: 第39回日本炎症・再生医学会