Vascular Adhesive Peptide-1 (VAP-1) Expression in Wounds – A New Vital Reaction Marker?

Introduction. Few topics in forensic medicine have spilled as much ink as that of vital response in wounds. We join these efforts and aim to study a new marker included in the group of adhesion molecules, Vascular Adhesive Peptide-1 (VAP-1) versus an already extensively studied marker, P-selectin. Material and method. For this prospective study, skin samples were collected from autopsied cadavers at the County Clinical Service of Forensic Medicine Constanta (SCJML Constanta). The main inclusion criteria were: accessible chronological documentation of the lesion and the absence of inflammatory, neoplastic, or liver conditions. Between 2018 and 2021, 122 cases fell within these criteria and were divided into 5 groups based on survival time. Each fragment from the wound was accompanied by a control fragment harvested from the site of an autopsy incision. Routine Hematoxylin-Eosin (HE) and Perls staining, as well as immunohistochemistry with VAP-1 and P-selectin markers, were performed on each fragment and a score based on staining intensity was established. Results. Routine staining was not useful in assessing vitality in the segment with a survival time of less than 5 minutes, a segment that was also defined by the absence of inflammatory infiltrate. Immunohistochemically, both markers showed significantly increased values compared to control values (p<0.001). VAP-1 was found to have a statistically significant (p<0.001) peak of positivity in the under 5 min segment and between 3-24 h (p<0.05) compared to P-selectin. Conclusions. It can be concluded that VAP-1 can be a reliable alternative for establishing the timing of the injury, at least for the segment with a short survival time of a few minutes.