Expression of Hsp27 and Hsp70 and vacuolization in the pituitary glands in cases of fatal hypothermia
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ORIGINAL ARTICLE
Expression of Hsp27 and Hsp70 and vacuolization in the pituitary glands in cases of fatal hypothermia Elke Doberentz 1 & Philipp Markwerth 1 & Rebecca Wagner 1 & Burkhard Madea 1
Accepted: 15 May 2017 # Springer Science+Business Media, LLC 2017
Abstract Hypothermia causes systemic cellular stress. The pituitary gland is an endocrine gland and plays an important role in thermoregulation. When the core body temperature drops, the pituitary gland is activated by stimulation of hypothalamic hormones. In this study, we investigated morphological alterations of the pituitary gland in cases of fatal hypothermia. Several morphological alterations of the anterior lobe of the pituitary gland, such as hemorrhage, vacuolization, and hyperemia, have been previously described in fatal hypothermia. However, the diagnostic value of these findings is controversial. We compared 11 cases of fatal hypothermia with 10 cases lacking antemortem hypothermic influences. In the presence of thermal cellular stress, the expression of heat shock proteins increases to protect cellular structures. Therefore, we immunohistochemically analyzed Hsp27 and Hsp70. Hsp27 expression was detected in 27.3% of the cases of fatal hypothermia and in 10.0% of the control cases, whereas Hsp70 expression was not detected in any case. Additionally, Sudan staining was performed to quantify fatty degeneration. A positive reaction was found in 45.5% of the study group and in 10.0% of the control group. This indicates that fatty degeneration might be a valuable marker when other macroscopic signs of hypothermia are absent.
Keywords Adenohypophysis . Fatty degeneration . Heat shock protein . Hypothermia . Pituitary gland . Vacuolization
* Burkhard Madea [email protected] 1
Institute of Legal Medicine, University of Bonn, Stiftsplatz 12, 53111 Bonn, Germany
Introduction Macroscopic findings in cases of fatal hypothermia include Wischnewsky spots, erythema of the skin, and hemorrhage in the iliopsoas muscles [1–5]. Among the most welldescribed histological findings in cases of hypothermia are fatty degeneration of myocytes, epithelial cells of the proximal renal tubules, and pancreatic cells [6–10]. Hypothermia induces cardiovascular dysfunction and eventual failure due to a reduced supply of oxygen. This leads to fatty degeneration of cells caused by the disturbance of oxygen-dependent fatty acid metabolism [7, 9]. In our previous study investigating the expression of Hsp in cases of death by fire [11], the study group exposed to premortal heat showed higher heat shock protein (Hsp) expression levels in several organs compared with the control group. Preuss et al. [12] found increased Hsp70 expression levels in renal tissue in cases of fatal hypothermia. In general, Hsps play an important role as chaperones in protein folding and prevention of unwanted protein aggregation [13–15]. In cases of cellular stress, such as hypothermia, Hsp expression is upregulated to participate in the heat-shock response [11]. In some cases, especially after a ra
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