| Mast cells (MC) are one of important immunocells, which can secretmany bioactive substance ,such as histamine,5-HT,SRS-A and heparin . Theyhave a pivotal role in allergic reactions and take part in many otherpathophysiological conditions such as wound healing, fibrosis, tumors andautoimmune diseases.MC 's surface express highly affinity acceptors of IgE,the cross-linking ofwhich is playing a key role on the activation and degranulation of MC. Thebinding of IgE and their acceptors through a series of transmission of signalstrigged the degranulation of MC .When MC are activated,they can release anarray of secrtions. Tryptase and chymase , important and highly specificproteins in MC, are important markers to differentiate of MC subtype,whilebasophils have little of them .Tryptase is a kind of serine proteases which canbe found in many mammal 's MC as an active granule .Compared withhistamine,tryptase is a more selective marker of MC .Thus ,tryptase arefrequently regarded as a characteristic marker of human MC presently. MC canproduce many cell activing factors.Now we have found after the activation ofMC,it can synthesize many proinflamatory factors, such as TNF-α ,IL-1,IL-6,GM-CSF and IFNγ. Through the secreation of these cytokines,MCtake part in many pathophysiological conditions.It is major characteristic of anaphylactic shock that eosinophils ofinflammatory cells detriment inflammation effector cell. Eosinophils may releasemediators including leukotriene(LTs),ECP,EPO,EDN,MBP,etc. These mediatorsand poison grana protein can injury tisse and intiate inflammation. Epithelialcells secrete eotaxin.Expression of eotaxin increased in airway mucosa in I typeof allergy.The expression of eotaxin positively correlated with cell population ofeosinophils and severity of allergy.Interleukin 2 (IL-2) is the early marks of surface expression of activatedTlymphocytes(T cell)that recognize foreign antigen. So,IL-2R is mark ofactivated T cell. Th1 cells divison,reduplication is caused by effect of theself-secreted IL-2.IL-2 and TNF that Th1cells secrete cause allergy.IL-2 adjuststhe activation and reduplication of Tcells,Bcells,monocytics and nature killercell.this kind of effect is mainly decided by conbining of IL-2 and Il-2RAnaphylactic shock,especially drug-induced anaphylactic shock, is one ofclinical emergence.It occurs suddenly,difficult to predict and threat the life ofpatients.The drug often induces anaphylactic shock include antibioticantibiotic,serum, antitoxin , local anesthetic and antipyretic analgesic .Drug inducedanaphylactic shock is one of important reasons of medical tangle. While thecurrent diagnosis standard mainly according to clinical symptom and objectivesigns.Because it has no exactly laboratory diagonosis.,some medical tangles areoften not solved for a long time. Thus ,it has become a urgent problem offorsensic pathology that studying the mechanism of anaphylactic shock ,findinga exactly diagnosis standard and putting out a easy to use diagnosis method.This experiment study the distribution of MC when anaphylactic shockoccurred through the immunohistochemistry of tryptase,IL-2R,TNF-α,Eotaxinand In-stiu hybridization of Eotaxin mRNA of 30 cases died of anaphylacticshock and 8 cases died of other diseases.The results are as follows:1. HEPeople died of other diseases :lung and intestinal mucosa are normalPeople died of anaphylactic shock:lung is congestion and edema, alveolarectasia and the intervals collaped forming lung edema The alveoli are filled withexudates.Bronchial muscosa is infiltrated by eosinophils. Lamina propria ofintestinal mucosa,throat mucosa is infiltrated by large number of eosinphils.Kidney interstitial edema.2.tryptasePeople died of other diseases :there is no positive cell in lung and intestinalmucosa.People died of anaphylactic shock:there are a lot of positive cells inlung ,mainly around the vessels. There are a lot of positive cells on intestinalmucosa. There are also positive cells in submucosa of laryna3.IL-2αPeople died of other diseases :the positive is weakPeople died of anaphylactic shock: lymph-cells of lung are strong positive .Lymph-cells of the intestinal submucosa is also strong positive. Lymph-cells ofsubmucosa of laryna are also strong positive.Compared with first group,thedifferent is significance. (p<0.01)4. Eotaxin mRNACompared with the People died of anaphylactic shock and the People died ofnormal disease, Eotaxin mRNA were expressed at high levels in tunica mucosabronchiorum and bronchisubmucosa , intestines mucosa and intestinessubmucosa,larynx mucosa and larynx submucosa of anaphylactic shock .Eotaxin mRNA were expressed at high levels in dust cell intracytoplasm andnephric tubule endepidermis of anaphylactic shock (p<0.01)5.EotaxinCompared with the People died of anaphylactic shock and the People diedof normal disease, Eotaxin were expressed at high levels in tunica mucosabronchiorum and bronchisubmucosa , intestines mucosa and intestinessubmucosa,larynx mucosa and larynx submucosa of anaphylactic shock.Eotaxin were expressed at high leves in nephic tubule endepidermis ofanaphylactic shock (p<0.01)6.TNF-αMacrophages of lung are strong positive .Compared with the People died ofanaphylactic shock and the People died of normal disease,the different issignificance. (p<0.01)According to the study above,the conclusion is as follows:1.The cases died of anaphylactic shock MC is increased in thetissues,especially in lung and intestine.2.Tryptase can be selected to special mark MC,using this we can count thenumber of MC in tissues,and then proving anaphylactic shock3.A large number of eosinophils indict death of allergy4.TNF-α IL-2Rα have a close relation with disease process ofanaphylactic shock5.Expression of Eotaxin mRNA and Eotaxin is positive in many tissue oforgan in anaphylactic shockThis experiment using immunohistochemistry and to study the Morphologicchange of MC and eosinophils ,confirm the function of trypase,TNF-α,IL-2Rα,Eotaxin in anaphylactic shock. . It provide exact theoretical base forthe application of MC in forsensic pathology.
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