Detection of the Vital Origin of the Strangulation Mark in Mechanical Asphyxia as an Indicator of the Development of Forensic Medicine

Death by mechanical asphyxia occupies one of the leading positions in the structure of violent deaths. In the structure of mechanical asphyxia, one of the most common is mechanical strangulation, which includes hanging, ligature strangulation and manual strangulation. Solving the problem of the ante-mortem nature of mechanical asphyxia remains relevant in the practical work of forensic experts. In the case of mechanical asphyxia by strangulation, the most common and effective methods are the study of changes in the area of local injuries on the neck, such as the ligature mark during hanging. Aim of the study. To shed light on the process of developing methods for determining the ante-mortem nature of mechanical strangulation asphyxia by studying changes in the area of the ligature mark and to determine effective ways of solving this problem at the current stage of development of forensic medicine. Methods. Analysis and synthesis of information from literary sources available in online databases. Results. The use of macroscopic and histological methods to study changes in the area of the ligature mark may not be sufficient to resolve the issue of ante-mortem formation of injuries in the neck area during hanging, due to the extremely short period of time that elapses between the onset of the asphyxia process and the onset of death. The time interval between the onset of asphyxia and death is often insufficient for the development of a specific reactive cellular and even vascular response. Immunohistochemical examination, aimed at identifying initial reactive signs in the area of injury, is more effective in establishing ante-mortem status during extremely short time intervals between the cause of injury and the onset of death. In the case of mechanical asphyxia by strangulation, significant results have been obtained in the study of ligature marks by immunohistochemical markers such as tryptase, IL-15, CD-15, MHC-II, CD1a, AQP1, AQP3, fibronectin D, P-selectin. In addition, biochemical methods for the detection of physiologically active substances, which allow the detection of early signs of reactive changes in the skin due to injury, such as the study of the concentration of histamine, serotonin, heparin, prostaglandins F and E, as well as the ratio of certain ions, can be highly effective in diagnosing the ante-mortem nature of the ligature mark. Conclusion. The use of immunohistochemical research methods to confirm the ante-mortem formation of a ligature mark is based on the detection of markers of the inflammatory reaction, which are released before the appearance of any vascular and cellular reactions, allowing the detection of the first signs of the inflammatory reaction even within a very short period of time between the cause of injury and the onset of death. Thus, the use of immunohistochemical methods can be effective in confirming the ante-mortem nature of mechanical asphyxia, especially in cases where the use of standard histological staining methods has been ineffective. The detection of certain biochemical markers in the skin from the area of the ligature mark may be considered a promising, rapid and effective method to confirm the ante-mortem nature of strangulation asphyxia. This direction requires further research to improve its effectiveness and can be used in forensic practice to confirm the ante-mortem formation of the ligature mark.