Diagnosis of Vitality in Skin Wounds in the Ligature Marks Resulting From Suicide Hanging

Legáz, Isabel; Falcón, M; Giménez, Mariano Eduardo; Díaz, Francisco Martínez; Pérez-Cárceles, María D.; Osuna, Eduardo; Nuno-Vieira, D.; Luna, Aurelio

doi:10.1097/paf.0000000000000322

Cited by 23 publications

(9 citation statements)

References 38 publications

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“…Hanging is generally performed as a means of suicide because it is an extremely simple method to implement; however, cases of suspension of a corpse are not uncommon in forensic practice. A definitive differential diagnosis between suicidal hanging and simulated hanging (hanging the victim after murder) is very delicate and critical and a challenging issue for forensic pathologists [31,32].…”

Section: Discussionmentioning

confidence: 99%

Hypo-Expression of Flice-Inhibitory Protein and Activation of the Caspase-8 Apoptotic Pathways in the Death-Inducing Signaling Complex Due to Ischemia Induced by the Compression of the Asphyxiogenic Tool on the Skin in Hanging Cases

et al. 2020

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The FLICE-inhibitory protein (c-FLIPL) (55 kDa) is expressed in numerous tissues and most abundantly in the kidney, skeletal muscles and heart. The c-FLIPL has a region of homology with caspase-8 at the carboxy-terminal end which allows the molecule to assume a tertiary structure similar to that of caspases-8 and -10. Consequently, c-FLIPL acts as a negative inhibitor of caspase-8, preventing the processing and subsequent release of the pro-apoptotic molecule active form. The c-FLIP plays as an inhibitor of apoptosis induced by a variety of agents, such as tumor necrosis factor (TNF), T cell receptor (TCR), TNF-related apoptosis inducing ligand (TRAIL), Fas and death receptor (DR). Increased expression of c-FLIP has been found in many human malignancies and shown to be involved in resistance to CD95/Fas and TRAIL receptor-induced apoptosis. We wanted to verify an investigative protocol using FLIP to make a differential diagnosis between skin sulcus with vitality or non-vital skin sulcus in hanged subjects and those undergoing simulated hanging (suspension of the victim after murder). The study group consisted of 21 cases who died from suicidal hanging. The control group consisted of traumatic or natural deaths, while a third group consisted of simulated hanging cases. The reactions to the Anti-FLIP Antibody (Abcam clone-8421) was scored for each section with a semi-quantitative method by means of microscopic observation carried out with confocal microscopy and three-dimensional reconstruction. The results obtained allow us to state that the skin reaction to the FLIP is extremely clear and precise, allowing a diagnosis of unequivocal vitality and a very objective differentiation with the post-mortal skin sulcus.

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Section: Discussionmentioning

confidence: 99%

Hypo-Expression of Flice-Inhibitory Protein and Activation of the Caspase-8 Apoptotic Pathways in the Death-Inducing Signaling Complex Due to Ischemia Induced by the Compression of the Asphyxiogenic Tool on the Skin in Hanging Cases

et al. 2020

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“…The forensic science community has focused its attention on various immunohistochemical markers to differentiate pre-and post-mortem injuries and to estimate the time interval between the infliction of the wound and the death. Among the investigated molecules are inflammatory cytokines, coagulation factors, metal ions, structural proteins of erythrocytes, and proteolytic enzymes that were involved in the physiological response of a living tissue to external stimuli (6,(18)(19)(20). Immunohistochemical methods gave satisfying results in recently deceased bodies; however, their use is challenging in putrefied corpses, as the alteration of the tissues can compromise the interpretation of the results.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors found increased Fe concentrations in antemortem wounded skin and muscle, but no difference in Zn and Mg ions. Moreover, the K/Na ratio was found to be reduced in antemortem muscle samples, but not in the skin samples (5,6).…”

Section: Introductionmentioning

confidence: 85%

Wound Vitality in Decomposed Bodies: New Frontiers Through Immunohistochemistry

et al. 2021

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Background: The question about wound vitality and the estimation of wound age of production are two of the classic investigation fields of forensic sciences. To answer this, the techniques most frequently used in research studies are immunohistochemistry (IHC), molecular biology, and biochemistry. Despite the great data on the literature about the usefulness of IHC in forensic pathology, there is always a request for further studies, especially on tissues altered by putrefactive phenomena. In fact, the degradation of the tissues is intended as the main limiting factor to the use of this technique.Scope: The aim of this pilot study was to evaluate the immunohistochemical behavior of samples collected from decomposed bodies (in different putrefaction phases) and to relate these findings to wound vitality and postmortem interval.Materials and Methods: Samples of skin and soft tissues were collected during autopsies, which were executed on decomposed bodies, whose cause of death was concluded to be traumatic. An immunohistochemical study was performed using antibodies against CD15, CD45, IL-15, tryptase, and glycophorin-A MMPs (endopeptidases involved in degrading extracellular matrix proteins: MMP-9 and MMP-2). An immunohistochemistry (IHC) reaction was evaluated according to a qualitative method as the following legend: (0): not expressed, (+): isolated and disseminated expression, (++): expression in groups or widespread foci, and (+++): widespread expression.Results: Most of the tested markers (tryptase, glycophorin, IL15, CD 15, CD 45, and MMP9) showed to be highly expressed in the tissue of putrefied skin for 15 days.Discussion and Conclusion: Although certainly inconclusive, this experimental application demonstrated that a nonexclusive but combined use of multiple antibodies is appropriate to verify wound vitality in decomposed bodies. Among them, GPA exhibited major reliability.

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“…Legaz Pérez et al ( 83 ) determined that Fe and Zn concentrations were significantly higher in injured skin from suicide-hanging ligation marks than healthy skin. Furthermore, Ca and Zn decreased, while Fe increased with the severity of the neck injury.…”

Section: Wound Characterization In Post-mortem Forensic Studiesmentioning

confidence: 99%

Forensic Impact of the Omics Science Involved in the Wound: A Systematic Review

et al. 2022

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Background: In forensic autopsies, examining the wounds is one of the most critical aspects to clarify the causal relationship between the cause of death and the wounds observed on the corpse. However, on many occasions, it is difficult to differentiate antemortem injuries from post-mortem injuries, mainly when they occur very close to the moment of death. At present, various studies try to find biomarkers and clarify the molecular mechanisms involved in a wound due to the high variability of conditions in which they occur, thus being one of the most challenging problems in forensic pathology. This review aimed to study the omics data to determine the main lines of investigation emerging in the diagnosis of vital injuries, time of appearance, estimation of the age and vitality of the wound, and its possible contributions to the forensic field.Methods: A systematic review of the human wound concerning forensic science was carried out by following PRISMA guidelines.Results: This study sheds light on the role of omics research during the process of wounding, identifying different cytokines and other inflammatory mediators, as well as cells involved in the specific stage of the wound healing process, show great use in estimating the age of a wound. On the other hand, the expression levels of skin enzymes, proteins, metal ions, and other biomarkers play an essential role in differentiating vital and post-mortem wounds. More recent studies have begun to analyze and quantify mRNA from different genes that encode proteins that participate in the inflammation phase of a wound and miRNAs related to various cellular processes.Conclusions: This study sheds light on the role of research in the molecular characterization of vital wounds, heralding a promising future for molecular characterization of wounds in the field of forensic pathology, opening up an important new area of research.Systematic Review Registration: URL: https://www.crd.york.ac.uk/prospero/#myprospero, Identifier: CRD42021286623.

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Diagnosis of Vitality in Skin Wounds in the Ligature Marks Resulting From Suicide Hanging

Cited by 23 publications

References 38 publications

Hypo-Expression of Flice-Inhibitory Protein and Activation of the Caspase-8 Apoptotic Pathways in the Death-Inducing Signaling Complex Due to Ischemia Induced by the Compression of the Asphyxiogenic Tool on the Skin in Hanging Cases

Hypo-Expression of Flice-Inhibitory Protein and Activation of the Caspase-8 Apoptotic Pathways in the Death-Inducing Signaling Complex Due to Ischemia Induced by the Compression of the Asphyxiogenic Tool on the Skin in Hanging Cases

Wound Vitality in Decomposed Bodies: New Frontiers Through Immunohistochemistry

Forensic Impact of the Omics Science Involved in the Wound: A Systematic Review

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