Two patterns of beta-amyloid precursor protein (APP) immunoreactivity in cases of blunt head injury.
Two patterns of beta-amyloid precursor protein (APP) immunoreactivity in cases of blunt head injury.
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DOI：
10.1016/j.legalmed.2009.01.076
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发表时间：
2009-04-01
期刊：
影响因子：
--
通讯作者：
Ogata, Mamoru
中科院分区：
文献类型：
--
作者：
Hayashi, Takahito;Ago, Kazutoshi;Ogata, Mamoru
β-淀粉样前体蛋白(APP)免疫组织化学染色被广泛认为是检测弥漫性创伤性轴索损伤(TAI)的有效工具。APP选择性地标记受损的轴突，如轴突球茎和静脉曲张轴突。然而，据报道，在没有头部损伤的脑缺氧的情况下，可以检测到轴突灯泡。因此，我们研究了创伤和缺氧对轴突形态的影响是否存在差异。对25例颅脑损伤患者和23例正常对照组的胼胝体切片进行APP免疫组织化学染色。APP染色在14例头部损伤患者中检测到轴突，这些患者存活了几个小时以上，尽管它未能标记对照病例的轴突。此外，在几个头部损伤病例中发现了两种免疫反应模式。第一种模式显示标记的轴突与白质束一起定向；第二种模式显示轴突不规则散布。14例中有5例仅发现第一种类型，而仅有第二种类型则未观察到。5例同时发现两种模式，其余4例未发现明显的模式。根据这些发现，我们推测第一种模式可能代表TAI。需要进一步检查以确定这两种模式是否与[Oehmichen M，Meissner C，Schmidt V，Pedal I，Konig HG，Saternus KS]所示的创伤和缺氧性脑损伤模式相同。轴突损伤--法医神经病理学的诊断工具？回顾一下。法医科学期刊1998；95：67-83]和[Graham DI，Smith C，Reichard R，Leclercq PD，Gentleman SM.应用β-淀粉样前体蛋白免疫组织化学评估成人创伤性脑损伤的试验和磨难。法医科学学报2004年；第146期：-96。
Immunostaining for beta-amyloid precursor protein (APP) is widely recognized as an effective tool for detecting diffuse traumatic axonal injury (TAI). APP selectively labels injured axons, such as axonal bulbs and varicose axons. However, it has been reported that axonal bulbs are detected in cases of cerebral hypoxia without head injury. Therefore, we examined whether there are differences in the morphological pattern of axonal bulbs between trauma and hypoxia. Sections of the corpus callosum from 25 cases of head injury and 23 control cases were immunostained for APP. APP staining detected axonal bulbs in 14 cases of head injury, who survived more than several hours, although it failed to label axons in control cases. In addition, two patterns of immunoreactivity were identified in several cases of head injury. The first pattern showed that labeled axons were oriented along with white matter bundles; the second demonstrated that the axons were scattered irregularly. The first pattern alone was found in 5 of 14 cases, while cases of the second pattern alone were not observed. Both patterns were detected in 5 cases and in the remaining 4 cases, clear patterns were not found. From these findings, we speculated that the first pattern may represent TAI. Further examinations are required for determining whether these two patterns are identical with patterns of trauma and hypoxic brain damage as indicated by [Oehmichen M, Meissner C, Schmidt V, Pedal I, Konig HG, Saternus KS. Axonal injury--a diagnostic tool in forensic neuropathology? A review. Forensic Sci Int 1998;95:67-83] and [Graham DI, Smith C, Reichard R, Leclercq PD, Gentleman SM. Trials and tribulations of using beta-amyloid precursor protein immunohistochemistry to evaluate traumatic brain injury in adults. Forensic Sci Int 2004;146:89-96].