The Expression Of CX43, PKC And HSP70 In Cardiac Conduction System In The Role Of Sudden Cardiac Death And Its Forensic Significance

Objective: Sudden Cardiac Death (SCD) in forensic inspection cases are very common, Cardiac conduction system(CCS) abnormal account for 2.6%. Part of the SCDs autopsy after death havenot found apparent pathology phenomenon, usually attributable it to the unexplained death category. PKC will have the excessive activation in the sudden cardiac death process. Therefore excessive activation PKC can be as a diagnostic cardiac origin of sudden cardiac morphologic changes reference index. Heat shock protein70 has been taken as organ damage degree judgement index, Its application on the early diagnosis of the sudden cardiac death domestic and foreign scholars also have already had lots of research.The heart gap junction (GJ) channel is a special connection channel between myocardial cells, Its basic knot unit is to connect small body. The myocardial cells GJ channel of heart is the realization between the structure of electrical coupling foundation. Research shows that connexin43(CX43) content in adult heart the most abundant, mainly exists in work myocardial cell. Recent studies suggest that Cx43 the expression of for the diagnosis sudden cardiac death has the extremely vital significance. The most direct reason of arrhythmias is ion channel disorder in myocardial cell membranes previously. Yanada KA etc research shows that the high expression of CX43 and low expression of CX45 can lead to abnormal impulses rhythms and ventricular arrhythmia. it can even Trigger heart failure patients sudden death.Protein kinase C (PKC)is made of phospholipids ca2+ activated protein kinases, and plays its role through the dependence of the phosphorylated proteins. REUSS L think the change of CX43 phosphorylation through the mediated serine-368 confo rmation, Which led to decreases of the connection permeability, Reducing harmful material transfer so as to reduce the damage of myocardial. in the process of Sudden cardiac death will have the excessive activation PKC, Therefore excessive activation PKC can be as a diagnostic cardiac origin of sudden cardiac morphologic changes reference index.Heat shock protein (HSP) induced in cells synthesis stimulating by physiological stimulation or pathology and other environmental factors. HSP70 participate in protein steady maintenance in cells system,it plays an important role In the cells of information, growth and differentiation of regulation . HSP70 as molecular partner, Its expression can cause long-qt syndrome (LQTS), cause sudden cardiac death by shortage transport to potassium ion channels easily.Laing JG research says HSP70 can protect CX43, Prevent the degradation of CX43, protect the heart muscle.Mathods:1,selecting 70 cases autopsy case specimens (2007-2011) in dalian medical university sino-japanese pathology research center, The specimens 44 cases are young sudden cardiac death syndrome, By age, sex grouping, The control group 26 cases death of specimens are eliminate heart disease . check CCS by methods of SongYiXuan, YaoQingSong introduced, Conventional dehydration, paraffin embedding, serial section, pulsation take pieces.2,using immunohistochemistry, detecting the expression of CX43,PKC and HSP70 in myocardial and heart conduction system.3,compare experimental group between and control group For each age and the difference gender group Adopt SPSS11.5 software, And analyze the difference and correlation of different groups.Results:1,The expression of CX43 in different myocardial and heart conduction tissueCX43 have a lot of expression of myocardial in the control group, And little expression in adjuant SCD group of myocardial cell, Myocardial cell dyeing weakened dramatically, Positive shading strip color significantly shallow, Area significantly smaller, Only can be seen scattered d-type positive particles in the myocardial cells. the expression of CX43 is in turn increases in heart transmission organizations from antrum room knot to room room knot to herod's bouquet, Accord with cardiac electrophysiology conduction structure basis. Statistical results show that there exist significant differences between the control group and the CX43 positive group SCD myocardia(lP<0.01),There exists significant difference between each structure In the heart transmission organization of CX43 positive expression rate . 2,The expression of PKC in different myocardial and heart conduction tissuePKC Results showed that only a few scattered exists in the control group myocardial cells cytoplasm; But SCD group myocardial cell cytoplasm and cardiac muscle cell are visible more masculine expression. Compared with controls, immunohistochemical staining of PKC positive average gray level and Area of algebra increase in SCD group, compared with control group subjects ,The results are significant(P< 0.05);using multiple choice between poor analysis comparison,SCD in different parts of myocardial tissue, Results showed that SAN the average grayscale positive dyeing increased than other three regions, But with only AVN compared with A statistical significance(P<0.05)。3,The expression of PKC in different myocardial and heart conduction tissueThe HSP70 results show only scattered in a myocardial tissue cell cytoplasm in the control group; While based site groups SCD organization HSP70 tan positive particles flaky distributed in cell cytoplasm. AVN,SAN in SCD average of grey value higher than those in the control group, with A statistical significance(P< 0.05)。4,Analyse the positive expression of CX43, PKC and HSP70 in myocardialThe expression of PKC and HSP70 in myocardial and heart conduction system between normal group and SCD group has remarkable consistency(P<0.05),Positively correlated; CX43 with PKC,HSP70 expression was negatively correlated, with a statistical significance(P<0.05)。Conclusion:1,The high expression CX43 in normal victim myocardial and heart conduction system, The expression is reduce in myocardial and heart conduction system in sudden cardiac death group, This likely as one of the meansin sudden cardiac death forensic。2,low expression PKC and HSP70 in normal myocardial and heart conduction system, The expression is increase in myocardial and heart conduction system in sudden cardiac death group。Can be used as a kind of auxiliary means inidentification . 3,the expression of CX43 distribution in myocardial and heart transmission organizations accord with human body heart throb of electric physiology characteristic in the heart conduction, The structure of normal beating heart is based. 4,distribution of CX43, PKC and HSP70 have correlation, Can be used as a kind of auxiliary means inidentification together.