Localization of host defense associated factors in the respiratory tract and its forensic pathological significance -In cases of sudden infant death-

1.肺组织中乳铁蛋白(LF)阳性细胞的法医病理学意义我们研究了乳铁蛋白阳性中性粒细胞在婴儿猝死(SID)肺组织中的分布。我们对感染组(7例)和感染状态不明组(16例)肺组织中的LF阳性细胞数进行了定量。石蜡包埋切片用人乳铁蛋白抗体染色。在左肺上叶和右肺中叶各3个随机区域内计数阳性细胞。感染组肺内白细胞LF阳性细胞率(%)为50.3±12.1(最大为70.2%，最小为36.5%)。未知组分为两组：第一组(8例)为59.5±20.2%(最高率79.7%，最小率39.3%)，第二组(8例)18.4±8.1%(最高率26.5%，最小率10.3%)。第二组中有2例中性粒细胞免疫阳性染色明显强于其他病例。因此，我们诊断为第一组，第二组2例处于感染状态，第二组6例处于非感染状态。提示乳铁蛋白在SID肺组织中性粒细胞上的表达可作为婴幼儿生前感染状态的标志物。2.肺内皮细胞von Willebrand因子(VWF)的表达为探讨von Willebrand因子(VWF)抗原作为婴幼儿猝死肺内皮细胞损伤标志物的价值，采用免疫组织化学方法(PAP法)观察了23例肺组织中vWF的表达。感染状态组大鼠肺毛细血管内皮细胞vWF表达明显增加。结果提示，在感染损伤条件下，vWF的表达和阳性结构的数量受到调节。

I. Forensic pathological significance of lactoferrin(Lf) positive cells in the lung tissue.We study the distribution of Lf-positive neutrophils within the sudden infant death (SID) lung tissue. We quantified Lf-positive cell numbers in the lung of infection-groups (7 cases) and unknown-groups of infectious state (16 cases). Paraffin-embedded sections were stained with an antibody to human lactoferrin. Positive cells were enumerated within respective 3 random fields of upper lobe of left lung and middle lobe of right lung. Lf -positive cell rate (%) of leukocytes in the lung of infection-groups was 50.3±12.1(maximum rate; 70.2%, minimum rate; 36.5%). Unknown-group was divided into two groups: the first (8 cases) was 59.5±20.2% (maximum rate; 79.7%, minimum rate; 39.3%); the second (8 cases) was 18.4±8.1% (maximum rate; 26.5%, minimum rate; 10.3%). In 2 cases of the second group the positive immunostaining of neutrophils was very stronger than other cases. Therefore, we diagnosed the first group and 2 cases in the second group are in infectious state and 6 cases of the second group are in non-infectious state. These date suggest that the expression of lactoferrin on neutrophils in the SID lung was useful as marker for the infant's infectious state before death.II. Expression of von Willebrand Factor (vWF) in Endothelial Cells of the LungTo determination the value of von Willebrand factor (vWF) antigen as marker of endothelial injury of the lung of sudden infant death, vWF expression in 23 lung tissues was observed by immunohistochemistry (PAP method) with monoclonal antibody against human vWF. The lung of infectious state groups showed a significant elevation of vWF expression in endothelial cells of capillary endothelium. The results suggest that vWF expression and the number of vWF positive structures is modulate under condition of injury in infection.