血清胸腺和活化调节趋化因子（TARC）对致命性哮喘的诊断价值

IF 2.2 3区医学 Q1 MEDICINE, LEGAL

Forensic science international Pub Date : 2024-10-29 DOI:10.1016/j.forsciint.2024.112276

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

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引用次数: 0

摘要

目的哮喘是一种慢性气道炎症性疾病，以气道高反应性和结构变化为特征。由于涉及法律和保险问题，准确的尸检诊断至关重要，必须与其他猝死原因区分开来。胸腺和活化调节趋化因子（TARC）是一种趋化因子，有可能成为哮喘的生物标志物。本研究评估了血清 TARC 与免疫球蛋白 E（IgE）水平结合作为生物标志物在法医鉴定中的诊断价值。结果研究对象为 100 例尸检病例，分为致命性哮喘（25 例）、急性心肌梗死（37 例）和创伤性死亡（38 例）。与急性心肌梗死（180.35 ± 109.37 pg/mL）和外伤（173.26 ± 105.01 pg/mL）病例相比，哮喘（525.68 ± 801.87 pg/mL）病例的 TARC 水平明显升高。同样，哮喘患者的血清 IgE 水平（3363.72 ± 7023.46 KU/L）也高于急性心肌梗死患者（130.92 ± 260.79 KU/L）和外伤患者（134.53 ± 195.41 KU/L）。ROC 曲线分析显示，血清 TARC 的灵敏度为 68.0%，特异性为 73.6%（AUC 0.763，临界值为 225 pg/mL）。相比之下，血清 IgE 的灵敏度为 80%，特异性为 86.1%（AUC 0.881，临界值为 307 KU/L）。结论血清 TARC 和 IgE 是法医诊断致命性哮喘的重要生物标记物。虽然血清 TARC 水平与 Th2 介导的炎症相关，但联合测量 TARC 和 IgE 可提高诊断准确性，为确诊哮喘提供显著的特异性。

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Diagnostic value of serum thymus and activation-regulated chemokine (TARC) in fatal asthma

Objectives

Asthma, a chronic inflammatory airway disease, is characterized by airway hyperresponsiveness and structural changes. Accurate postmortem diagnosis is crucial because of legal and insurance implications, necessitating differentiation from other causes of sudden death. Thymus and activation-regulated chemokine (TARC) is a chemokine that potentially acts as a biomarker of asthma. This study evaluated the diagnostic value of serum TARC combined with immunoglobulin E (IgE) levels as biomarkers in forensic settings.

Results

The subjects were 100 autopsy cases, categorized into fatal asthma (n = 25), acute myocardial infarction (AMI) (n = 37), and traumatic deaths (n = 38). TARC levels were significantly elevated in asthma (525.68 ± 801.87 pg/mL) compared with AMI (180.35 ± 109.37 pg/mL) and trauma (173.26 ± 105.01 pg/mL) cases. Similarly, serum IgE levels were higher in asthma (3363.72 ± 7023.46 KU/L) than in AMI (130.92 ± 260.79 KU/L) and trauma (134.53 ± 195.41 KU/L) cases. ROC curve analysis showed that serum TARC had a sensitivity of 68.0 % and specificity of 73.6 % (AUC 0.763, cut-off value of 225 pg/mL). In comparison, serum IgE had a sensitivity of 80 % and specificity of 86.1 % (AUC 0.881, cut-off value of 307 KU/L). The combined use of TARC and IgE increased the diagnostic specificity to 95.8 %.

Conclusions

Serum TARC and IgE are valuable biomarkers for diagnosing fatal asthma in forensic settings. While serum TARC levels correlate with Th2-mediated inflammation, the combined measurement of TARC and IgE enhances the diagnostic accuracy, providing significant specificity for confirming asthma diagnosis.

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来源期刊

Forensic science international 医学-医学：法

CiteScore

5.00

自引率

9.10%

发文量

285

审稿时长

49 days

期刊介绍： Forensic Science International is the flagship journal in the prestigious Forensic Science International family, publishing the most innovative, cutting-edge, and influential contributions across the forensic sciences. Fields include: forensic pathology and histochemistry, chemistry, biochemistry and toxicology, biology, serology, odontology, psychiatry, anthropology, digital forensics, the physical sciences, firearms, and document examination, as well as investigations of value to public health in its broadest sense, and the important marginal area where science and medicine interact with the law. The journal publishes: Case Reports Commentaries Letters to the Editor Original Research Papers (Regular Papers) Rapid Communications Review Articles Technical Notes.