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International Journal of Legal Medicine

, Volume 133, Issue 3, pp 871–881 | Cite as

Post-mortem in situ stability of serum markers of cerebral damage and acute phase response

  • Benjamin OndruschkaEmail author
  • Lina Woydt
  • Michael Bernhard
  • Heike Franke
  • Holger Kirsten
  • Sabine Löffler
  • Dirk Pohlers
  • Niels Hammer
  • Jan Dreßler
Original Article

Abstract

The aim of the given study was to test the in situ stability of biochemical markers of cerebral damage and acute phase response in the early post-mortem interval to assess their usability for forensic pathology. A monocentric, prospective study investigated post-mortem femoral venous blood samples at four time points obtained within 48 h post-mortem starting at the death of 20 deceased, using commercial immunoassays for the ten parameters: S100 calcium-binding protein B (S100B), glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE), brain-derived neurotrophic factor (BDNF), interleukin-6 (IL-6), C-reactive protein (CRP), procalcitonin (PCT), ferritin, soluble tumor necrosis factor receptor type 1 (sTNFR1), and lactate dehydrogenase (LDH). Significant changes in serum levels were observed only later than 2 h after death for all markers. Inter-laboratory comparability was high, and intra-assay precision was sufficient for most markers. Most of the biomarker levels depended on the severity of hemolysis and lipemia but were robust against freeze-thaw cycles. Serum levels increased with longer post-mortem intervals for S100B, NSE, ferritin, sTNFR1, and LDH (for all p < 0.001) but decreased over this period for CRP (p = 0.089) and PCT (p < 0.001). Largely unchanged median values were found for GFAP (p = 0.139), BDNF (p = 0.106), and IL-6 (p = 0.094). Serum levels of CRP (p = 0.059) and LDH (p = 0.109) did not differ significantly between the final ante-mortem (resuscitation) and the first post-mortem sample (moment of death). Collecting the post-mortem blood sample as soon as possible will reduce the influence of post-mortem blood changes. Serum GFAP for detection of cerebral damage as well as serum IL-6 and CRP as proof of acute phase response seemed to be preferable due to their in situ stability in the first 2 days after death.

Keywords

Acute phase response Intra-individual stability Post-mortem biochemistry Serum Thanatochemistry Traumatic brain injury 

Notes

Acknowledgments

The authors would like to thank Ms. Aqeeda Singh (Department of Anatomy, University of Otago, New Zealand) for proofreading the paper as a native speaker and Prof. Ralph Burkhardt (Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Germany) for his kind support in aliquot checking of serum interference indices.

Compliance with ethical standards

All experiments were conducted in accordance with the human and ethical principles of the University of Leipzig (no. 388/15-ek).

Conflict of interest

BO has received reimbursement of travel costs from Randox Laboratories. The authors declare no competing interests.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Benjamin Ondruschka
    • 1
    Email author
  • Lina Woydt
    • 1
  • Michael Bernhard
    • 2
  • Heike Franke
    • 3
  • Holger Kirsten
    • 4
    • 5
  • Sabine Löffler
    • 6
  • Dirk Pohlers
    • 7
  • Niels Hammer
    • 8
    • 9
    • 10
  • Jan Dreßler
    • 1
  1. 1.Medical Faculty, Institute of Legal MedicineUniversity of LeipzigLeipzigGermany
  2. 2.Emergency DepartmentHeinrich Heine University DuesseldorfDuesseldorfGermany
  3. 3.Rudolf Boehm Institute of Pharmacology and ToxicologyUniversity of LeipzigLeipzigGermany
  4. 4.Institute for Medical Informatics, Statistics and EpidemiologyUniversity of LeipzigLeipzigGermany
  5. 5.LIFE Center (Leipzig Interdisciplinary Research Cluster of Genetic Factors, Phenotypes and Environment)University of LeipzigLeipzigGermany
  6. 6.Institute of AnatomyUniversity of LeipzigLeipzigGermany
  7. 7.Center of Diagnostics GmbHKlinikum ChemnitzChemnitzGermany
  8. 8.Department of AnatomyUniversity of OtagoDunedinNew Zealand
  9. 9.Department of Orthopedic and Trauma SurgeryUniversity Hospital of LeipzigLeipzigGermany
  10. 10.Fraunhofer Institute for Machine Tools and Forming TechnologyDresdenGermany

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