The immunohistochemical localization of alpha1-antichymotrypsin and fibronectin and its meaning for the determination of the vitality of human skin wounds

Abstract

Summary.A total of 39 vital human skin wounds (20 cases with short survival times ranging from a few seconds to approximately 30 min and 19 cases with wound ages between 50rain and 13 days) were investigated. Alphalantichymotrypsin (A1-ACT) was visualized by immunohistochemistry. Additionally, fibronectin was localized in 13 of these wounds (8 cases with short and 5 cases with longer survival times). Furthermore, 13 postmortem lesions (stab wounds) were removed from corpses approximately 4 h after infliction and analyzed for A1-ACT and fibronectin. The "vital" reaction previously described for A1-ACT in form of a band-shaped staining pattern at the wound edges was observed in both vital wounds and in most postmortem lesions. A similar reaction was also obtained for fibronectin in wounds inflicted after death, but could be unambiguously distinguished from vital fibronectin staining by morphological criteria. Therefore, it seems questionable that the vitality of skin wounds can be determined by the immunohistochemical detection of A~-ACT and probably other proteinase inhibitors. The meaning of the localization of fibronectin for the determination of the vitality of human skin wounds with a survival time of at least a few minutes could be confirmed.

Immunohistochemical expression of fibronectin in the lungs of fire victims proves intravital reaction in fatal burns

“…As it is the case in burn trauma, high temperatures and toxic fumes damage the lung tissue, which thereby can be regarded as wounds. This may explain our observation of an increased expression of non-cell-bound fibronectin in the tissue surrounding the peripheral bronchi and is in accordance with similar findings in the literature [1,3]. Another explanation for this may be that the inflammatory reaction induced by the inhalation trauma attracts both alveolar macrophages and fibroblasts.…”

“…Deno et al [7] attributed the increase of free fibronectin in the vicinity of the airways after heat exposure to the fact that plasma fibronectin in the presence of intense heat attaches to components of the surrounding traumatized tissue and thus can be more easily detected [7]. This is in analogy with the results of studies on wound age determination, which proved that skin wounds with survival times of only a few minutes already showed a clear fibronectin release that was distinguishable from unspecific postmortem artifacts [1,3]. As it is the case in burn trauma, high temperatures and toxic fumes damage the lung tissue, which thereby can be regarded as wounds.…”

“…Fibronectin is regarded as one of the earliest markers that become expressed in an inflammatory process. Betz et al reported that skin wounds of victims after exposure to lethal traumatization showed clear fibronectin reactions already within survival times of only a few minutes and had markedly different immunohistochemical staining patterns than injuries sustained postmortem [1][2][3].…”

Estimating wound age: looking into the future

“…It has also made specific localization of tissutal substances indicative of the stage of response (fibrin, fibrinogen, fibronectin, tenascin, complement, different types of collagen, etc.) possible [58][59][60][61][62][63][64] and the phases of activation of individual cells (positivity of myofibroblasts for laminin, heparan sulphate proteoglycan, collagen type IV, α-smooth muscle actin, or macrophages in various stages of activation positive for myeloid-related proteins (MRP-8, MRP-14), 27E10, integral membrane protein (RM3/1), 25F9, etc.) [65].…”

Morphological identification of right ventricular failure in cases of fatal pulmonary thromboembolism

“…Fibronectin is a wellstudied glycoprotein present in the extracellular matrix where it plays a major role in the processes of cell migration, adhesion and wound healing [22]. In legal medicine, it has been extensively investigated in the field of the wound age estimation, with a special application for the detection of the vitality of skin wounds [23]. Recently, Bohnert et al [24] have proposed a further application for the evaluation of vitality in burnt bodies.…”