Evaluation of pulmonary GLUT1 and VEGF mRNA levels in relation to lung weight in medicolegal autopsy cases

The present study focuses attention upon the relationship among postmortem mRNA levels of pulmonary glucose transporter (GLUT1) and vascular endothelial growth factor (VEGF) to lung weight to investigate pulmonary pathophysiology in the death process. Autopsy cases (n = 173, within 48 h postmortem) of blunt injury, including head injury (brain contusions and acute subdural hemotoma) and non-head injury, sharp instrument injury, mechanical asphyxiation, drowning, acute myocardial infarction/ischemia (AMI) and idiopathic cerebral hemorrhage (ICH) were examined. GLUT1 and VEGF mRNAs were quantified by TaqMan real-time RT-PCR for the upper lobes of the bilateral lungs. Combined lung weight was normalized against height for statistical analyses. GLUT1 mRNA showed a higher level for ICH. GLUT1 and VEGF mRNA levels were higher for brain contusions than for acute subdural hematoma, which showed a significantly lower VEGF mRNA level. Lung weight showed a larger value for saltwater drowning and ICH, and was larger for acute subdural hematoma than for brain contusions. GLUT1 mRNA level was correlated with lung weight in cases of ICH and brain contusions (survival time <24 h), and VEGF mRNA showed a similar tendency. Such findings were not detected for other groups. These findings indicate parallel increases in hypoxia-induced responses and lung weight in ICH and brain contusions, suggesting different pulmonary hemodynamics with milder alveolar damage compared with other groups, including AMI and acute subdural hematoma. Different mechanisms might be involved in non-cardiogenic or neurogenic pulmonary congestion and edema for ICH/brain contusions and subdural hematoma.