Beta-amyloid precursor protein staining in nonhomicidal pediatric medicolegal autopsies.
Immunohistochemical staining for beta-amyloid precursor protein (betaAPP) has been validated as a marker for axonal injury in adults surviving > or = 2 hours after white matter damage. The significance of betaAPP staining in pediatric brains and spinal cords is not as well established. We evaluated the white matter immunoreactivity for betaAPP from a variety of pediatric medicolegal autopsies: natural disease (non-Sudden Infant Death Syndrome [SIDS]), SIDS, motor vehicle accidents, drowning, near-drowning, overlay, carbon monoxide toxicity, miscellaneous trauma, and mechanical asphyxia. The cases of carbon monoxide toxicity, motor vehicle accidents (death at scene), drowning (with resuscitation), and a natural (non-SIDS) death had no significant white matter staining. The traumatic deaths with a significant survival interval, a variety of natural deaths, the near-drowning case, and surprisingly, all SIDS had detectable betaAPP white matter immunostaining. These results demonstrate that features other than traumatic axonal injury, such as metabolic insults and hypoxic-ischemic injury secondary to vascular compromise, must contribute to betaAPP immunostaining. In addition, we describe a variety of betaAPP-immunoreactive structures not previously reported in the pediatric population. This study illustrates that betaAPP immunostaining enhances detection of a variety of white matter changes, and provides a basis for interpretation of these results.
Reichard
R Ross
RR
Neuropathology Laboratory, University of Texas Southwestern Medical School, Department of Pathology, Dallas, Texas, USA. Ross@ud.net
White
Charles L
CL
Hladik
Christa L
CL
Dolinak
David
D
D016564:Amyloid beta-Protein Precursor / Q000032:analysis* / Q000096:biosynthesis; D001344:Autopsy; D001921:Brain / Q000378:metabolism / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011446:Prospective Studies; D013116:Spinal Cord / Q000737:chemistry / Q000378:metabolism / Q000473:pathology*; D013194:Staining and Labeling / Q000379:methods
D016564:Amyloid beta-Protein Precursor