Medicolegal Importance of the Role of Ubiquitin Expression in Suprarenal and Renal Tissues in Blunt and Sharp Traumatic Deaths: Immunohistochemical Study

Abstract

Introduction: Injuries and violence represent a major public health problem worldwide. It is still a leading cause of mortality specially in developing countries. Ubiquitin is a heat shock protein, which is induced by various kinds of traumatic stress. Aim of the work: The aim of this study is to investigate the immunohistochemical expression of ubiquitin in suprarenal and renal tissues in blunt and sharp traumatic deaths. Subjects and methods: Cross sectional post-mortem study was conducted on the traumatic medicoegal autopsy cases and natural cases in Banha medicolegal unit (Ministry of Justice) over six months interval from February 2016 to August 2016. For all medicolegal cases, the data collection sheet included age, sex, date of death, survival time and cause of death. Histological examinations and ubiquitin immunostaining were performed on the suprarenal and renal tissues. Results: Forty-five autopsy cases were included in this study. The majority of victims were males (84.4%) from rural regions (70.5%). Blunt injuries represented the majority of traumatic deaths (57.14%). The greater part of traumatic cases (74.3%) died within 24 hours post injuries. Traumatic cases revealed acute tubular necrosis and vascular degeneration in renal tissue and exhaustion of lipid contents of zona fasiculata in suprarenal tissue specimens. Traumatic deaths showed significant increase in ubiquitin expression in compared to natural deaths in renal distal convoluted tubules and suprarenal cortex. Moreover, there was significant positive correlation between survival period and positive ubiquitin immune expression in each of renal distal convoluted tubules (r=0.461, p=0.005) and suprarenal cortex (r=0.459, p=0.006). Conclusion: Ubiquitin immunoexpression can serve as a stress indicator of traumatic deaths and it may be useful for determination of survival period.