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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