Dynamics of Endothelium-Associated Molecules in Sudden Cardiac Death (Focusing on Thrombomodulin)

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K10685
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 58040:Forensics medicine-related
• Research Institution: Kobe University
• Principal Investigator: Kondo Takeshi 神戸大学, 医学研究科, 講師 (20335441)
• Co-Investigator(Kenkyū-buntansha): 上野 易弘 神戸大学, 医学研究科, 教授 (30184956) ; 高橋 玄倫 神戸大学, 医学研究科, 講師 (90509100)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: トロンボモジュリン

Outline of Final Research Achievements

Thrombomodulin (TM) is a transmembrane glycoprotein expressed on the surface of vascular endothelial cells. Myocardial tissue from cases of ischemic heart disease (IHD) was subjected to immunohistochemistry by thrombomodulin. We examined 40 neutral-formalin-fixed, paraffin-embedded myocardial tissue samples from autopsy cases that were diagnosed with IHD. TM expression was observed in vascular endothelial cells and in mesothelial cells of the epicardium. In necrotic myocardium, diffusion of TM was observed. Upregulated TM expression was observed around myocardial cells under ongoing remodeling, which suggested endothelial proliferation in these locations. Completed fibrotic foci of the myocardium did not show upregulated TM expression. In a mouse model of acute myocardial infarction, the same phenomena as that found in human samples were observed. Immunostaining of TM may be useful for supplementing conventional staining techniques in the diagnosis of IHD in forensic pathology.

Free Research Field

法医学

Academic Significance and Societal Importance of the Research Achievements

死因究明・法医実務上、診断精度の高い内因性急死の解析は重要な課題である。法医解剖における内因性急死の約半数は心臓疾患であり、その中核をなすのは虚血性心疾患であるが、法医解剖上、顕微鏡的な手法を用いても、その確定診断に難渋することが多い。従来のHE染色を用いる手法に加え、内皮関連分子トロンボモジュリンの動態を検討することは、虚血性心疾患に伴う内皮細胞の動態を明瞭にし内皮細胞障害を検出するという点で剖検における虚血性心疾患の補助診断に有用である可能性が示唆される。