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  Česky / Czech version Soud. Lék., 49, 2004, No. 2, p. 18 - 21
 
Demonstration of Myocardium and Lung Damage by Psychotropic and Intoxicating (Narcotic) Drugs by Immunohistochemical Detection of Metalloproteinases 
Strejc P.1, Klír P.2, Vlčková A.1 

1Ústav soudního lékařství a toxikologie 1. LF UK a VFN, Praha 2Subkatedra soudního lékařství IPVZ, Praha
 


Summary:

       Positive findings of intoxicant (narcotic) and psychotropic drugs (OPL) have been regularly recorded in clinical patients and deceased persons over the last years at the Institute of Forensic Medicine and Toxicology, 1st Medical faculty and General Teaching Hospital, Prague; stimulants and opioids represent the most frequent cause of death. Their misuse results in damage to various organs. In order to follow the development of pathological changes in the process of remodeling extracellular matrix directly in tissues, the methods of immunohistochemical detection of the matrix metalloproteinases in myocardium and lungs as well as fibrinogen in cardiomyocytes were selected for analysis in a group of 18 deceased individuals. In the intoxication with stimulants we usually demonstrated MMP 2 in the myocardium interstitium, MMP 9 being observed in two cases and MMP 1 in one case. The analysis of lungs always demonstrated MMP 1, especially in the lung interstitium and also on the surface of some alveoli, which accepted the appearance reaching up to “hyaline membranes” as well as in cellular elements of macrophage type and and the same was true for MMP2. Fibrinogen was not always demonstrated in cardiomyocytes. The detection of metalloproteinases was less prominent in the case of opioids. The demonstration of MMP explains well the evolution to more advanced pathomorphological changes, which have been found in myocardium and lungs of OPL users and fits to the nosological status of earlier phases of intoxications with these drugs.

        Key words: drugs – metalloproteinases – immunohistochemical detection – myocardium and lung damage
       

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