title: Pulmonary surfactant-associated protein A as a marker of respiratory distress in forensic pathology: assessment of the immunohistochemical and biochemical findings.
abstract: The aim of the present study was to review the immunohistochemical and biochemical findings with reference to the causes of death in routine casework (total, n=492). In the immunohistochemistry (n=283), an increase in intra-alveolar granular SP-A (SP-A score) was often observed in asphyxiation (n=21/34, 61.8%) and freshwater drowning (n=15/24, 62.5%), and also in fire and methamphetamine (MA) fatalities (n=22/76, 28.9% and n=5/16, 31.3%). Serum SP-A level (n=134) was elevated in acute respiratory distress syndrome and in some cases of drowning, fire and MA fatalities, hyperthermia and chest traumas. A quantitative analysis of SP-A subclass-gene expression (SP-A1/A2 mRNA) in the lung tissue specimens (n=126) revealed an increase in the SP-A1/A2 mRNA ratio in asphyxiation (n=17/21, 80.9%), freshwater drowning (n=7/9, 77.7%), fire and MA fatalities (n=20/35, 57.1% and n=8/10, 80.0%). These findings suggested the usefulness of SP-A as a marker of asphyxiation, respiratory distress and alveolar injury.
authors.affiliation: Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, 545-8585 Osaka, Japan. legalmed@med.osaka-cu.ac.jp
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Maeda
authors.forename: Masaki Q
authors.initials: MQ
authors.lastname: Fujita
authors.forename: Bao-Li
authors.initials: BL
authors.lastname: Zhu
authors.forename: Kaori
authors.initials: K
authors.lastname: Ishida
authors.forename: Li
authors.initials: L
authors.lastname: Quan
authors.forename: Shigeki
authors.initials: S
authors.lastname: Oritani
authors.forename: Mari
authors.initials: M
authors.lastname: Taniguchi
mesh_terms: D001237:Asphyxia / Q000473:pathology*; D015415:Biomarkers / Q000032:analysis; D000697:Central Nervous System Stimulants / Q000506:poisoning; D004332:Drowning / Q000473:pathology; D005390:Fires; D005618:Fresh Water; D015870:Gene Expression; D006801:Humans; D007150:Immunohistochemistry; D008168:Lung / Q000473:pathology*; D008694:Methamphetamine / Q000506:poisoning; D011041:Poisoning / Q000473:pathology; D037662:Pulmonary Surfactant-Associated Protein A / Q000032:analysis* / Q000235:genetics; D012333:RNA, Messenger / Q000032:analysis; D012128:Respiratory Distress Syndrome / Q000473:pathology*
chemical_list: D015415:Biomarkers; D000697:Central Nervous System Stimulants; D037662:Pulmonary Surfactant-Associated Protein A; D012333:RNA, Messenger; D008694:Methamphetamine