title: Are mast cells implicated in asphyxia?
abstract: In a previous immunohistochemical (IHC) study, we documented the reaction of lung tissue vessels to hypoxia through the immunodetection of HIF1-α protein, a key regulator of cellular response to hypoxic conditions. Findings showing that asphyxia deaths are associated with an increase in the number of mast cell (MC)-derived tryptase enzymes in the blood suggests that HIF1-α production may be correlated with MC activation in hypoxic conditions. This hypothesis prompted us to investigate the possible role of pulmonary MC in acute asphyxia deaths. Lung of 47 medico-legal autopsy cases (35 asphyxia/hypoxia deaths, 11 controls, and 1 anaphylactic death) were processed by IHC analysis using anti-CD117 (c-Kit) antibody to investigate peri-airway and peri-vascular MC together with their counts and features. Results showed a significant increase in peri-vascular c-kit(+) MC in some asphyxia deaths, such as hanging, strangulation, and aspiration deaths. A strong activation of MC in peri-airway and peri-vascular areas was also observed in lung samples from the anaphylaxis case, which was used as a positive control. Our study points to the potential role of MC in hypoxia and suggests that an evaluation of MC in the lungs may be a useful parameter when forensic pathologists are required to make a differential diagnosis between acute asphyxia deaths and other kinds of death.
authors.affiliation: Sapienza University, Rome, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Muciaccia
authors.affiliation: Sapienza University, Rome, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Sestili
authors.affiliation: Sapienza University, Rome, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: De Grossi
authors.affiliation: Sapienza University, Rome, Italy.
authors.forename: Annarita
authors.initials: A
authors.lastname: Vestri
authors.affiliation: Sapienza University, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Cipolloni
authors.affiliation: Sapienza University, Rome, Italy. rossana.cecchi@uniroma1.it.
authors.forename: Rossana
authors.initials: R
authors.lastname: Cecchi
mesh_terms: D001237:Asphyxia / Q000473:pathology*; D016022:Case-Control Studies; D042783:Endothelial Cells / Q000378:metabolism; D005455:Fluorescent Antibody Technique; D049429:Forensic Pathology; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000378:metabolism; D007150:Immunohistochemistry; D008168:Lung / Q000378:metabolism / Q000473:pathology*; D008407:Mast Cells / Q000378:metabolism / Q000473:pathology*; D019009:Proto-Oncogene Proteins c-kit / Q000378:metabolism
chemical_list: C497442:HIF1A protein, human; D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D019009:Proto-Oncogene Proteins c-kit
keywords: Asphyxia death; CD117; Forensic pathology; HIF1-α; Lungs; Mast cell