title: Evaluation of specific neural marker GAP-43 and TH combined with Masson-trichrome staining for forensic autopsy cases with old myocardial infarction.
abstract: It has been a puzzling forensic task to determine the cause of death as a result of old myocardial infarction (OMI) in the absence of recognizable acute myocardial infarction. Recent studies indicated that the heterogeneous cardiac nerve sprouting and sympathetic hyperinnervation at border zones of the infarcted site played important roles in sudden cardiac death (SCD). So, the present study explored the value of growth associated protein-43 (GAP-43) and tyrosine hydroxylase (TH) as objective and specific neural biomarkers combined with Masson-trichrome staining for forensic autopsy cases. Myocardium of left ventricle of 58 medicolegal autopsy cases, 12 OMI cases, 12 acute/OMI cases, and 34 control cases, were immunostained with anti-GAP-43 and anti-TH antibodies. Immunoreactivity of GAP-43 and TH identified nerve fibers and vascular wall in OMI cases and acute/OMI cases. Specifically, TH-positive nerve fibers were abundant at border zones of the infarcted site. There were a few GAP-43 and TH expressions in the control cases. With Masson-trichrome staining, collagen fibers were blue and cardiac muscle fibers were pink in marked contrast with the surrounding tissue, which improved the location of nerve fibers. Thus, these findings suggest that immunohistochemical detection of GAP-43 and TH combined with Masson-trichrome staining can provide the evidence for the medicolegal expertise of SCD due to OMI, and further demonstrate a close relationship between sympathetic hyperinnervation and SCD.
authors.affiliation: Shanghai Key Laboratory of Forensic Medicine, Institute of Forensic Science, Ministry of Justice, Shanghai, People's Republic of China.|Collaborative Innovation Center of Judicial Civilization, Beijing, 100088, China.|Key Laboratory of Evidence Science, Ministry of Education, China University of Political Science and Law, Beijing, 100088, China.
authors.forename: Tian-Shui
authors.initials: TS
authors.lastname: Yu
authors.affiliation: Collaborative Innovation Center of Judicial Civilization, Beijing, 100088, China.|Key Laboratory of Evidence Science, Ministry of Education, China University of Political Science and Law, Beijing, 100088, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Wang
authors.affiliation: Collaborative Innovation Center of Judicial Civilization, Beijing, 100088, China.|Key Laboratory of Evidence Science, Ministry of Education, China University of Political Science and Law, Beijing, 100088, China.
authors.forename: Hai-Dong
authors.initials: HD
authors.lastname: Zhang
authors.affiliation: Collaborative Innovation Center of Judicial Civilization, Beijing, 100088, China.|Key Laboratory of Evidence Science, Ministry of Education, China University of Political Science and Law, Beijing, 100088, China.
authors.forename: Ru-Feng
authors.initials: RF
authors.lastname: Bai
authors.affiliation: Department of Forensic Pathology, China Medical University School of Forensic Medicine, No. 77, Puhe Road, Shenbeixin District, Shenyang, 110122, Liaoning Province, People's Republic of China.
authors.forename: Rui
authors.initials: R
authors.lastname: Zhao
authors.affiliation: Department of Forensic Pathology, China Medical University School of Forensic Medicine, No. 77, Puhe Road, Shenbeixin District, Shenyang, 110122, Liaoning Province, People's Republic of China. dwguan2018@163.com.
authors.forename: Da-Wei
authors.initials: DW
authors.lastname: Guan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D016757:Death, Sudden, Cardiac / Q000473:pathology; D005260:Female; D019922:GAP-43 Protein / Q000378:metabolism*; D006321:Heart / Q000294:innervation; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000378:metabolism* / Q000473:pathology; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology; D009412:Nerve Fibers / Q000378:metabolism; D013194:Staining and Labeling / Q000379:methods*; D013564:Sympathetic Nervous System / Q000503:physiopathology; D014446:Tyrosine 3-Monooxygenase / Q000378:metabolism*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D019922:GAP-43 Protein; D014446:Tyrosine 3-Monooxygenase
keywords: Forensic pathology; Growth associated protein-43 (GAP-43); Nerve sprouting; Sympathetic hyperinnervation; Tyrosine hydroxylase (TH)