Are mast cells implicated in asphyxia?

• Published in: International journal of legal medicine 2016, Vol.130 (1), p.153-161
• Main Authors: Muciaccia, Barbara, Sestili, Cristina, De Grossi, Stefania, Vestri, Annarita, Cipolloni, Luigi, Cecchi, Rossana
• Format: Article
• Language: English
• Subjects: Anaphylaxis; Asphyxia - pathology; Asthma; Autopsies; Case-Control Studies; Endothelial Cells - metabolism; Enzymes; Fluorescent Antibody Technique; Forensic Medicine; Forensic Pathology; Humans; Hypoxia; Hypoxia-Inducible Factor 1, alpha Subunit - metabolism; Immunohistochemistry; Investigations; Kinases; Lung - metabolism; Lung - pathology; Lungs; Mast Cells - metabolism; Mast Cells - pathology; Medical Law; Medicine & Public Health; Original Article; Physiology; Proto-Oncogene Proteins c-kit - metabolism; Pulmonary hypertension
• ISSN: 0937-9827; 1437-1596
• DOI: 10.1007/s00414-015-1211-5

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.