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Medicina Legal de Costa Rica

On-line version ISSN 2215-5287Print version ISSN 1409-0015

Abstract

ROMERO TIRADO, M.A. et al. Beta-amiloid precursor protein ( β-App) and diffuse axonal damage after head injuries: a forensic point of view. Med. leg. Costa Rica [online]. 2022, vol.39, n.2, pp.37-50. ISSN 2215-5287.

β-Amyloid Precursor Protein (β-APP) is a membrane glycoprotein and a common component of neurons. It is involved in adhesion and cell growth processes after traumatic events. It is carried by anterograde fast axonal transport, and it accumulates inside neurons when the cytoskeleton is damaged. This is a vital biochemical process that consumes energy.

β-APP is not specific of traumatic events. It accumulates in any case of axonal damage, whatever its cause may be, like hypoxia, metabolic disorders, and any other circumstances that lead to brain swelling and intracranial pressure rising and in consequence to Diffuse Axonal Injury (DAI). In this study we review the expression of this protein in cases of traumatic brain injury with different chronological evolution.

The damage of cytoskeleton due to proteolysis in addition to the disturbance of kinases and phosphatases increase the permeability of the membrane. Calcium gets into the cell and activates calmodulin, thus neurofilaments compact, microtubules disappear and spectrin breaks. This disruption of the cytoskeleton has as consequence that the transported substances accumulate in the most affected areas by DAI. At the end of this process axon breaks, which is known as secondary axotomy.

The study of the accumulation of β-APP is useful to assess the extent of DAI and to determine the time elapsed after trauma or another insult to CNS.

Keywords : brain injury; immunohistochemistry; beta amyloid precursor protein; diffuse axonal injury; traumatic brain injury dating.

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