PMID- 37564231
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230812
IS  - 0974-2727 (Print)
IS  - 0974-7826 (Electronic)
IS  - 0974-2727 (Linking)
VI  - 15
IP  - 3
DP  - 2023 Sep
TI  - Pathological Spectrum and beta-APP Immunoreactivity as a Diagnostic Tool of Diffuse 
      Axonal Injury following Traumatic Brain Injury: A Novel Classification.
PG  - 399-408
LID - 10.1055/s-0043-1761926 [doi]
AB  - Aim  Different deposition patterns and grading systems used to define and 
      identify DAI remain discordant and to date these are a challenge in clinical 
      practice. Our main objective was to study the post-mortem axonal changes and 
      develop a grading system to identify DAI on the basis of histopathological and 
      immunoreactive beta-amyloid precursor protein (beta-APP) observations in severe TBI 
      cases. Methods  Prospective study with 35 decedents with sTBI (GCS score </= 8) was 
      conducted and samples were collected from three different sites-corpus callosum, 
      thalamus and brain stem. Serial sections from each site were stained with 
      hematoxylin and eosin (H&E), and immunohistochemistry (IHC) of beta-APP. Results  We 
      developed a grading system based on histopathological characteristics to assess 
      the overall damage of axonal injury. We found maximum histopathological changes 
      in cases with prolonged stay. Corpus callosum showed maximum changes in both 
      gradings. Curiously, we also detected axonal swellings with H&E staining. Usually 
      neglected, the thalamus also showed significant histopathological and 
      immunoreactive changes for sTBI. Conclusion  Our study based on histopathological 
      and beta-APP scoring system to define and identify DAI thus facilitates accurate 
      diagnosis of DAI post mortem, which has forensic implications, and may further 
      contribute toward survival and improvement of quality of life of sTBI patients.
CI  - The Indian Association of Laboratory Physicians. This is an open access article 
      published by Thieme under the terms of the Creative Commons 
      Attribution-NonDerivative-NonCommercial License, permitting copying and 
      reproduction so long as the original work is given appropriate credit. Contents 
      may not be used for commercial purposes, or adapted, remixed, transformed or 
      built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).
FAU - Sharma, Meenakshi
AU  - Sharma M
AD  - Division of Forensic Pathology and Molecular DNA Laboratory, Jai Prakash Narayan 
      Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
FAU - Subramaniam, Arulselvi
AU  - Subramaniam A
AUID- ORCID: 0000-0001-7797-6683
AD  - Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, All 
      India Institute of Medical Sciences, New Delhi, India.
FAU - Sengar, Kangana
AU  - Sengar K
AD  - Department of Laboratory Medicine, Jai Prakash Narayan Apex Trauma Centre, All 
      India Institute of Medical Sciences, New Delhi, India.
FAU - Suri, Vaishali
AU  - Suri V
AD  - Neuropathology Laboratory, Center for Neurosciences, All India Institute of 
      Medical Sciences, New Delhi, India.
FAU - Agrawal, Deepak
AU  - Agrawal D
AD  - Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, 
      India.
FAU - Chakraborty, Nabarun
AU  - Chakraborty N
AD  - Division of Forensic Pathology and Molecular DNA Laboratory, Jai Prakash Narayan 
      Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
FAU - Pandey, Ravindra Mohan
AU  - Pandey RM
AD  - Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, 
      India.
FAU - Malhotra, Rajesh
AU  - Malhotra R
AD  - Department of Orthopaedics, Jai Prakash Narayan Apex Trauma Centre, All India 
      Institute of Medical Sciences, New Delhi, India.
FAU - Lalwani, Sanjeev
AU  - Lalwani S
AD  - Division of Forensic Pathology and Molecular DNA Laboratory, Jai Prakash Narayan 
      Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India.
LA  - eng
PT  - Journal Article
DEP - 20230224
PL  - Germany
TA  - J Lab Physicians
JT  - Journal of laboratory physicians
JID - 101551511
PMC - PMC10411120
OTO - NOTNLM
OT  - H&E stain
OT  - diffuse axonal injury
OT  - forensic pathology
OT  - traumatic brain injury
OT  - beta-app
COIS- Conflict of Interest None declared.
EDAT- 2023/08/11 06:42
MHDA- 2023/08/11 06:43
PMCR- 2023/02/01
CRDT- 2023/08/11 03:57
PHST- 2023/08/11 06:43 [medline]
PHST- 2023/08/11 06:42 [pubmed]
PHST- 2023/08/11 03:57 [entrez]
PHST- 2023/02/01 00:00 [pmc-release]
AID - JLP-22-5-1254 [pii]
AID - 10.1055/s-0043-1761926 [doi]
PST - epublish
SO  - J Lab Physicians. 2023 Feb 24;15(3):399-408. doi: 10.1055/s-0043-1761926. 
      eCollection 2023 Sep.