title: Postmortem serum levels of pulmonary surfactant-associated proteins A and D with regard to the cause of death in medicolegal autopsy.
abstract: Pulmonary surfactant-associated proteins A and D (SP-A and -D) are tissue-specific components. Previous studies showed an increase in the postmortem serum SP-A level due to acute pulmonary alveolar damage and acute respiratory distress. The present study comparatively investigated serum SP-A and SP-D levels with regard to the cause of death in serial medicolegal autopsy cases (n=679, within 48 h postmortem). SP-A and SP-D levels were usually higher in left cardiac blood than at other sites, independent of postmortem interval. The left-to-right difference was significantly larger for mechanical asphyxiation, drowning, intoxication and spontaneous cerebral hemorrhage. Both SP-A and -D levels in bilateral cardiac blood were significantly higher for drowning and secondary pulmonary damage involving ARDS after traumas, but were lower for hypothermia (cold exposure). SP-A was predominantly elevated in fire fatality and delayed deaths from injury and fires, while pneumonia showed a predominant elevation of SP-D. These findings suggest that comparative analysis of serum SP-D and SP-A is useful for investigating primary or secondary pulmonary alveolar damage in the death process.
authors.affiliation: Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, 545-8585 Osaka, Japan.
authors.forename: Li
authors.initials: L
authors.lastname: Quan
authors.forename: Bao-Li
authors.initials: BL
authors.lastname: Zhu
authors.forename: Takaki
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Tomomi
authors.initials: T
authors.lastname: Michiue
authors.forename: Dong
authors.initials: D
authors.lastname: Zhao
authors.forename: Chiemi
authors.initials: C
authors.lastname: Yoshida
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Chen
authors.forename: Qi
authors.initials: Q
authors.lastname: Wang
authors.forename: Ayumi
authors.initials: A
authors.lastname: Komatsu
authors.forename: Yoko
authors.initials: Y
authors.lastname: Azuma
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Maeda
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000097:blood; D005260:Female; D005390:Fires; D049429:Forensic Pathology; D006801:Humans; D007035:Hypothermia / Q000097:blood; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000097:blood; D037662:Pulmonary Surfactant-Associated Protein A / Q000097:blood*; D037663:Pulmonary Surfactant-Associated Protein D / Q000097:blood*; D014947:Wounds and Injuries / Q000097:blood
chemical_list: D037662:Pulmonary Surfactant-Associated Protein A; D037663:Pulmonary Surfactant-Associated Protein D