title: Immunohistochemistry of pulmonary surfactant apoprotein A in forensic autopsy: reassessment in relation to the causes of death.
abstract: To reassess the immunohistochemical distribution of pulmonary surfactant apoprotein A (SP-A) in relation to the causes of death, 282 forensic autopsy cases were reviewed. The most intense and dense granular immunostaining of intra-alveolar SP-A was observed in the hyaline membrane syndrome from various traumas, protracted death from drowning, and perinatal aspiration of amniotic fluid. Similar granular staining pattern was found in fatal poisoning by a muscle relaxant and organophosphate pesticides. An evident increase of intra-alveolar granular staining was noted in most fatalities from mechanical asphyxia and drowning, and some cases of fire death. SP-A staining was usually very weak or sparse in alcohol intoxication, poisoning by hypnotics and also carbon monoxide poisoning. These findings suggest that the amount of intra-alveolar granular SP-A staining may be a possible indicator of severity and duration of respiratory distress (agony) from peripheral (non-central nervous system) origin and alveolar damage.
authors.affiliation: Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, 545-8585, Osaka, Japan. baolizhu@med.osaka-cu.ac.jp
authors.forename: B L
authors.initials: BL
authors.lastname: Zhu
authors.forename: K
authors.initials: K
authors.lastname: Ishida
authors.forename: L
authors.initials: L
authors.lastname: Quan
authors.forename: M Q
authors.initials: MQ
authors.lastname: Fujita
authors.forename: H
authors.initials: H
authors.lastname: Maeda
mesh_terms: D001237:Asphyxia / Q000473:pathology; D001344:Autopsy / Q000379:methods*; D002423:Cause of Death; D004332:Drowning / Q000473:pathology; D006801:Humans; D006819:Hyaline Membrane Disease / Q000473:pathology; D007150:Immunohistochemistry / Q000379:methods*; D007231:Infant, Newborn; D008471:Meconium Aspiration Syndrome; D011041:Poisoning / Q000473:pathology; D011510:Proteolipids / Q000032:analysis*; D037662:Pulmonary Surfactant-Associated Protein A; D037661:Pulmonary Surfactant-Associated Proteins; D011663:Pulmonary Surfactants / Q000032:analysis*; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D011510:Proteolipids; D037662:Pulmonary Surfactant-Associated Protein A; D037661:Pulmonary Surfactant-Associated Proteins; D011663:Pulmonary Surfactants