Key result
Severe hypothermia is linked to higher cardiac AREG mRNA, a postmortem marker with ~70% sensitivity.
Why the study?
Amphiregulin is linked to cardioprotection and heart pathology during myocardial stress, but its cardiac expression, potential as a postmortem hypothermia marker, and stress hormone dependency across different types of deaths remained uninvestigated.
Observational
Severe hypothermia activates cardiac AREG expression, which may serve as a postmortem marker for hypothermia and is associated with stress hormones in cardiac deaths.
Hypothesis-generating for AREG as postmortem hypothermia marker; prospective validation needed before adoption.
Background Amphiregulin (AREG) is a growth factor linked to cardioprotection and heart pathology during myocardial stress. Our aim was to investigate cardiac AREG expression, its potential as a postmortem hypothermia marker and its possible stress hormone dependency in different types of deaths.Materials and methods Heart RNA was isolated from hypothermic, cardiac and non-cardiac deaths. Relative AREG mRNA levels and urine stress hormone concentrations were measured by qPCR and enzyme-linked immunosorbent assays from eight different death cause groups. Receiver operating characteristic curve was used to evaluate a cut-off point for AREG expression as a hypothermia marker. Regulatory elements were predicted by PROMO.Results The AREG mRNA levels were significantly higher in hypothermic deaths than in most cardiac and non-cardiac deaths. AREG expression indicated hypothermic deaths with nearly 70% sensitivity and specificity. However, high expression levels were also detected in non-ischaemic deaths. The highest concentrations of adrenaline and cortisol were detected in hypothermic deaths, while the highest noradrenaline concentrations associated with atherosclerotic heart disease (AHD) deaths with acute myocardial infarction and trauma deaths. There were no significant correlations between stress hormones and AREG mRNA in hypothermic and non-cardiac deaths, whereas moderate-to-high associations were detected in cardiac deaths. Putative response elements for cortisol and catecholamines were found in AREG.Conclusions Severe hypothermia activates cardiac AREG expression practicable as a postmortem hypothermia marker. Cortisol and catecholamines may act as transcriptional modifiers of this gene, especially in long-term ischaemic heart disease. However, the exact role of these hormones in upregulation of AREG during hypothermia remains unclear.
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Porvari et al. (2024) conducted an observational in Hypothermic, cardiac, and non-cardiac deaths. Hypothermia vs. Cardiac and non-cardiac deaths was evaluated on Cardiac AREG expression as a postmortem hypothermia marker. Severe hypothermia was associated with significantly higher cardiac AREG mRNA levels compared to other causes of death, serving as a postmortem marker with nearly 70% sensitivity and specificity.
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