Detection Of Mast Cell Carboxypeptidase,Chymase,PGD₂and LTE₄in Human Died From Anaphylactic Shock

Objective To assess separately the change of mast cell carboxypeptidase and chymase concentration in serum, aquae pericardii and peritoneal fluid,as well as PGD2, LTE4in urine of the individuals in test groups and control group,to look for the rule of these biomarkers in human died from anaphylactic shock and explore the significance of them in the diagnosis of the sudden erethistic death for the medicolegal expertise.Methods Dividing samples into four groups, which contains13cases died from anaphylactic shock,12cases died from brain injury,15cases died from sudden coronary death,29cases died from other reasons excluding the above causes of death. Collecting the blood of right ventricle,aquae pericardii, peritoneal fluid and urine,then getting the supernatant after centrifugation.(1)The contents of mast cell carboxypeptidase and chymase were detected respectively in serum,aquae pericardii and peritoneal fluid with ELISA kit;(2)Urinary level of PGD2and LTE4were measured by sandwich enzyme immunoassay technique and PGD2kit and LTE4kit,the level of creatinine were measured by picric acid method, the result of which was expressed by PGD2/creatinine, LTE4/creatinine (ng/mg);(3)All the data were described and analyzed by the statistical software.Results (1)The serum mast cell carboxypeptidase and chymase level in cases deid from anaphylactic shock were significantly higher than normal group, control group and cases died from brain injury and sudden coronary death (P<0.05);(2)The aquae pericardii mast cell carboxypeptidase and chymase level of anaphylactic shock group were significantly higher than control group and cases died from brain injury (P<0.05), but there were no statistic significance between cases died from anaphylactic shock and sudden coronary death(P>0.05);(3)The peritoneal fluid mast cell carboxypeptidase level of cases died from anaphylactic shock were significantly higher than control group and cases died from brain injury (P<0.05), but there were no statistic significance between cases died from anaphylactic shock and sudden coronary death(P>0.05); The peritoneal fluid chymase level of cases died from anaphylactic shock were significantly higher than cases died from other reasons which excludes anaphylactic shock (P<0.05);(4)The urinary levels of PGD2/creatinine and LTE4/creatinine in cases deid from anaphylactic shock were significantly higher than those in healthy adults and cases died from other reasons which excludes anaphylactic shock (P<0.05);(5)There was a significantly positive correlation between mast cell carboxypeptidase and chymase levels of serum, aquae pericardii and peritoneal fluid in human died from anaphylactic shock(r=0.877, p<0.01), so did their urinary levels of PGD2/creatinine and LTE4/creatinine (r=0.985, p<0.01).Conclusion(1)As the specific biomarkers of mast cells,the serum mast cell carboxypeptidase and chymase level maybe used to diagnose the anaphylactic shock;(2)The PGD2and LTE4in urine can be selected as biomarkers to diagnose the anaphylactic shock, making sure there is no influence of renal excretion rate;(3)In the case of no blood available and hemolysis, the biological indicator inaquae pericardii,peritoneal fluid and urine may just serve as supplementary indexes excluding sudden coronary death.