Renal immunohistochemical investigation for the differentiation of the cause of multiple trauma fatalities

Sugimura, Tomoko; Lu Wang, Elaine; Kashiwagi, Masayuki; Hara, Kenji; Matsusue, Aya; Waters, Brian; Kubo, Shin-ichi

doi:10.1016/j.legalmed.2011.09.003

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Volume 14, Issue 1 , Pages 1-5, January 2012

Renal immunohistochemical investigation for the differentiation of the cause of multiple trauma fatalities

Tomoko Sugimura
- Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, Japan
Elaine Lu Wang
- Department of Legal Medicine, Kanazawa Medical University, Japan
Masayuki Kashiwagi
- Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, Japan
Kenji Hara
- Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, Japan
Aya Matsusue
- Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, Japan
Brian Waters
- Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, Japan
Shin-ichi Kubo
- Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, Japan
- Corresponding author. Address: Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan. Tel.: +81 92 801 1011x3330; fax: +81 92 801 4266.

Received 6 June 2011; received in revised form 15 September 2011; accepted 15 September 2011. published online 14 October 2011.

Abstract

In fatalities with multiple traumatic injuries, it is important to determine the severity of trauma, the main damaged organ, and the antemortem pathophysiological condition. We examined 63 cases within 48h of the postmortem interval, which included assaults, slips and falls and falls from heights, traffic accidents, and sharp instrumental injuries. Immunohistochemically, each kidney was stained against hemoglobin (Hb), myoglobin (Mb), superoxide dismutase (SOD), 8-hydroxy-2′-deoxyguanosine (8-OHdG), 150kDa oxygen regulated protein (ORP150), pulmonary surfactant A (SP-A), and liver-type fatty acid binding protein (L-FABP). Bleeding or circulatory failure induced ORP150, 8-OHdG, and L-FABP in the kidney. Statistical analysis of the immunoreactivity revealed that in battered and/or abused cases, Hb could be considered a specific marker. Hb and Mb were observed in the cases with general severe trauma, such as slips and falls and falls from heights. In traffic accidents, ORP150 could reflect general circulatory failure with bleeding. SP-A was observed in the cases with severe thoracic injuries, such as lung injuries and multiple thoracic fractures. L-FABP appeared in cases with renal circulatory failure as well as renal injury. These findings suggest that immunohistochemical observation of the kidneys could be a useful tool in determining several key factors, such as the severity of injury, the specific damaged organ, and the pathological condition after injury.