Quantitative RT-PCR assays of hypoxia-inducible factor‐1α, erythropoietin and vascular endothelial growth factor mRNA transcripts in the kidneys with regard to the cause of death in medicolegal autopsy

Accumulating studies demonstrate that the expressions of hypoxia-inducible factor 1 (HIF-1), erythropoietin (EPO) and vascular endothelial growth factor (VEGF) depend on cellular oxygen tension, which is involved in the pathological process of tissue hypoxia and/or ischemia. The present study investigated hypoxia-inducible factor-1α (HIF-1α), EPO and VEGF mRNA expressions in the kidney with regard to the cause of death in medicolegal autopsy. Relative quantifications of HIF-1α, EPO and VEGF mRNAs, based on real-time TaqMan reverse transcription-polymerase chain reaction (RT-PCR), were performed on tissue specimens obtained from consistent sites of the bilateral renal cortices. The cases (total, n = 245, 6–48 h postmortem) included fatal blunt/sharp instrument injuries (n = 53/31), asphyxia (n = 28: aspiration, n = 8; strangulation/hanging, n = 20), drowning (n = 27), fire fatality (n = 62), acute myocardial infarction/ischemia (AMI, n = 39), and gastrointestinal hemorrhage (n = 5). Both HIF-1α and EPO mRNA levels were significantly lower in drowning cases. More characteristic findings were found for VEGF mRNA: it showed higher expression levels for AMI, acute blunt/sharp instrument injury, and aspiration, whereas it was lower for neck compression (strangulation/hanging), drowning, fire fatality with higher blood carboxyhemoglobin (COHb) levels ( > 60%), peracute blunt injury, and gastrointestinal hemorrhage. Quantitative assays of renal HIF-1α, EPO and VEGF mRNA transcripts are potentially useful for investigating the pathophysiology of death, and VEGF mRNA may be especially useful as an indication of acute circulatory failure.