Dephosphorylation of connexin 43 ratio in forensic autopsy cases of sudden cardiac death without coronary artery involvement: a marker of early ischemic injury in cardiomyocytes

IF 1.3 4区医学 Q3 MEDICINE, LEGAL

Legal Medicine Pub Date : 2025-06-25 DOI:10.1016/j.legalmed.2025.102664

Toshiaki Takeichi, Atsushi Yamada, Masaki Yoshida, Satoshi Takashino, Kyoka Kiryu, Osamu Kitamura

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Abstract

Lethal arrhythmia is a common cause of sudden cardiac death. However, no identifiable histological abnormalities were found. This study aimed to clarify whether ischemia-induced changes in myocardial cells caused by a sudden decrease in coronary blood flow are observed in cases of sudden cardiac death without coronary artery involvement.

The autopsy cases included sudden cardiac death without coronary artery involvement, acute coronary syndrome, or other sudden deaths. We performed double fluorescent immunostaining for connexin 43 (Cx43) and its dephosphorylated form (npCx43) and calculated the npCx43 rate. Additionally, immunohistochemical analysis was performed on the complement system activation in cardiomyocytes using an anti-C5b-9 antibody, and mRNA expression of hypoxia-inducible factor-1 (HIF-1) was assessed.

The results showed a significant increase in npCx43 rate, whereas C5b-9 or HIF-1 mRNA expression did not significantly change. These findings suggest that the npCx43 expression rate may be a useful indicator of rapid ischemic changes induced in the myocardium of patients who die of sudden cardiac death without coronary artery involvement.

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不累及冠状动脉的心源性猝死法医尸检病例中连接蛋白43比率的去磷酸化：心肌细胞早期缺血性损伤的标志

致死性心律失常是心源性猝死的常见原因。然而，未发现可识别的组织学异常。本研究旨在阐明在无冠状动脉受累的心源性猝死病例中，是否观察到由冠状动脉血流突然减少引起的心肌细胞缺血诱导的变化。尸检病例包括不累及冠状动脉的心源性猝死、急性冠状动脉综合征或其他猝死。我们对连接蛋白43 （Cx43）及其去磷酸化形式（npCx43）进行了双荧光免疫染色，并计算了npCx43的率。此外，使用抗c5b -9抗体对心肌细胞补体系统激活进行免疫组化分析，并评估缺氧诱导因子-1 (HIF-1) mRNA表达。结果显示npCx43率显著升高，而C5b-9或HIF-1 mRNA表达无显著变化。这些结果表明，npCx43的表达率可能是心脏性猝死患者心肌快速缺血变化的一个有用指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Legal Medicine Nursing-Issues, Ethics and Legal Aspects

CiteScore

2.80

自引率

6.70%

发文量

119

审稿时长

7.9 weeks

期刊介绍： Legal Medicine provides an international forum for the publication of original articles, reviews and correspondence on subjects that cover practical and theoretical areas of interest relating to the wide range of legal medicine. Subjects covered include forensic pathology, toxicology, odontology, anthropology, criminalistics, immunochemistry, hemogenetics and forensic aspects of biological science with emphasis on DNA analysis and molecular biology. Submissions dealing with medicolegal problems such as malpractice, insurance, child abuse or ethics in medical practice are also acceptable.