Abstract |
The aim of the given study was to test the in situ stability of biochemical markers of cerebral damage and acute phase response in the early post-mortem interval to assess their usability for forensic pathology. A monocentric, prospective study investigated post-mortem femoral venous blood samples at four time points obtained within 48 h post-mortem starting at the death of 20 deceased, using commercial immunoassays for the ten parameters: S100 calcium-binding protein B (S100B), glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE), brain-derived neurotrophic factor ( BDNF), interleukin-6 (IL-6), C-reactive protein (CRP), procalcitonin (PCT), ferritin, soluble tumor necrosis factor receptor type 1 (sTNFR1), and lactate dehydrogenase (LDH). Significant changes in serum levels were observed only later than 2 h after death for all markers. Inter-laboratory comparability was high, and intra-assay precision was sufficient for most markers. Most of the biomarker levels depended on the severity of hemolysis and lipemia but were robust against freeze-thaw cycles. Serum levels increased with longer post-mortem intervals for S100B, NSE, ferritin, sTNFR1, and LDH (for all p < 0.001) but decreased over this period for CRP (p = 0.089) and PCT (p < 0.001). Largely unchanged median values were found for GFAP (p = 0.139), BDNF (p = 0.106), and IL-6 (p = 0.094). Serum levels of CRP (p = 0.059) and LDH (p = 0.109) did not differ significantly between the final ante-mortem ( resuscitation) and the first post-mortem sample (moment of death). Collecting the post-mortem blood sample as soon as possible will reduce the influence of post-mortem blood changes. Serum GFAP for detection of cerebral damage as well as serum IL-6 and CRP as proof of acute phase response seemed to be preferable due to their in situ stability in the first 2 days after death.
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Authors | Benjamin Ondruschka, Lina Woydt, Michael Bernhard, Heike Franke, Holger Kirsten, Sabine Löffler, Dirk Pohlers, Niels Hammer, Jan Dreßler |
Journal | International journal of legal medicine
(Int J Legal Med)
Vol. 133
Issue 3
Pg. 871-881
(May 2019)
ISSN: 1437-1596 [Electronic] Germany |
PMID | 30167776
(Publication Type: Journal Article)
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Chemical References |
- Biomarkers
- Brain-Derived Neurotrophic Factor
- Glial Fibrillary Acidic Protein
- Interleukin-6
- Procalcitonin
- Receptors, Tumor Necrosis Factor, Type I
- S100 Calcium Binding Protein beta Subunit
- S100B protein, human
- C-Reactive Protein
- Ferritins
- L-Lactate Dehydrogenase
- Phosphopyruvate Hydratase
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Topics |
- Acute-Phase Reaction
- Adult
- Aged
- Aged, 80 and over
- Biomarkers
(blood)
- Brain Injuries
(blood)
- Brain-Derived Neurotrophic Factor
(blood)
- C-Reactive Protein
(analysis)
- Female
- Ferritins
(blood)
- Glial Fibrillary Acidic Protein
(blood)
- Humans
- Immunoassay
- Interleukin-6
(blood)
- L-Lactate Dehydrogenase
(blood)
- Male
- Middle Aged
- Phosphopyruvate Hydratase
(blood)
- Postmortem Changes
- Procalcitonin
(blood)
- Prospective Studies
- Receptors, Tumor Necrosis Factor, Type I
(blood)
- S100 Calcium Binding Protein beta Subunit
(blood)
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