Průkaz poškození myokardu a plicpsychotropními a omamnými látkamiimunohistochemickou detekcí metaloproteináz

Demonstration of Myocardium and Lung Damage by Psychotropic andIntoxicating (Narcotic) Drugs by Immunohistochemical Detection ofMetalloproteinases

Positive findings of intoxicant (narcotic) and psychotropic drugs (OPL) have been regularly recordedin clinical patients and deceased persons over the last years at the Institute of ForensicMedicine and Toxicology, 1st Medical faculty and General Teaching Hospital, Prague; stimulantsand opioids represent the most frequent cause of death. Their misuse results in damage to variousorgans. In order to follow the development of pathological changes in the process of remodelingextracellular matrix directly in tissues, the methods of immunohistochemical detection of thematrix metalloproteinases in myocardium and lungs as well as fibrinogen in cardiomyocytes wereselected for analysis in a group of 18 deceased individuals. In the intoxication with stimulants weusually demonstrated MMP 2 in the myocardium interstitium, MMP 9 being observed in two casesand MMP 1 in one case. The analysis of lungs always demonstrated MMP 1, especially in the lunginterstitium and also on the surface of some alveoli, which accepted the appearance reaching upto “hyaline membranes” as well as in cellular elements of macrophage type and and the same wastrue for MMP2. Fibrinogen was not always demonstrated in cardiomyocytes. The detection ofmetalloproteinases was less prominent in the case of opioids. The demonstration of MMP explainswell the evolution to more advanced pathomorphological changes, which have been found inmyocardium and lungs of OPL users and fits to the nosological status of earlier phases of intoxicationswith these drugs.

Key words:
drugs – metalloproteinases – immunohistochemical detection – myocardium and lungdamage