Forensic significance of intracardiac stress protein expression in acute myocardial ischemia

2023 Fiscal Year Final Research Report

• Project/Area Number: 22K19676
• 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: Ishida Yuko 和歌山県立医科大学, 医学部, 准教授 (10364077)
• Project Period (FY): 2022-06-30 – 2024-03-31
• Keywords: Heme oxygenase-1 / 突然死 / 急性虚血性心疾患

Outline of Final Research Achievements

Heme oxygenase-1 (HO-1), an inducible stress-response protein, exerts anti-oxidant and anti-apoptotic effects. However, its significance in forensic diagnosis of acute ischemic heart diseases (AIHD) such as myocardial infarction is still unknown. We examined the immunohistochemical expression of HO-1 in the heart samples to discuss their forensic significance to determine acute cardiac ischemia. The heart samples were obtained from 23 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. From the viewpoints of forensic pathology, intracardiac HO-1 expression would be considered a valuable marker to diagnose AIHD as the cause of death.

Free Research Field

法医病理学

Academic Significance and Societal Importance of the Research Achievements

本研究では、急性心筋虚血の法医学的診断に有用なマーカーHO-1を提案した。法医学の現場では、単一のマーカーで死因や傷の年齢、傷口の活力などを明確に評価することは困難である。これに伴い、法医学的安全性の観点から、早期心筋虚血の診断に理想的な単一の免疫組織化学反応は存在しない。HO-1だけでなく、C5b-9やフィブロネクチンなど複数の異なるマーカーを併用することで、より客観的で正確な早期心筋障害の評価が可能となり、肉眼的あるいは顕微鏡的な証拠が不十分な場合のAIHDの死後診断の進歩に貢献することが期待される。