LA PROTEOMICA

Lo sviluppo della proteomica e, cioè lo studio delle proteine espresse in un tessuto, in una cellula o in un organismo in un dato momento, può fornire al patologo forense ulteriori possibilità di affinamento e di perfezionamento della diagnosi di morte sepsi-correlata in quanto consente una valutazione dell’espressione funzionale delle proteine presenti in un determinato momento. La proteomica coinvolge tecniche di diversa natura, il cui scopo principale, molto schematicamente è quello di separare ed identificare le proteine oggetto dell’indagine73

.

Negli ultimi anni, la proteomica è stata sempre più utilizzata per la ricerca dei biomarkers in vari settori clinici; numerose sono le applicazioni operative dell’indagine proteomica nella sepsi, sia nell’uomo74

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diversamente espresse nel siero di ratti settici. Nello stesso modello animale, è stato dimostrato che 12/13 proteine, rispettivamente nel tessuto cardiaco ed epatico, erano espresse in maniera diversa nei ratti settici rispetto ai controlli74; nel tessuto cerebrale, la espressione di ben 35 proteine, principalmente coinvolte nella risposta infiammatoria, è risultata diversa fra ratti settici e controlli. Ulteriori sviluppi, cui i clinici confidano grandi speranze per l’affinamento della diagnosi di sepsi, sono rappresentati dallo studio metabolomico della sepsi. In modelli animali (ratti settici) sono state, infatti, dimostrate caratteristiche alterazioni di molti metaboliti (ad esempio, alanina, creatina, etc.) rispetto a ratti di controllo.

In conclusione dalla letteratura clinica emerge una sempre maggiore valorizzazione delle potenzialità diagnoatiche (ed anche prognostiche) offerte da tecnologie quali la proteomica e la matabolomica. Questi spunti devono trovare ampia applicazione nella ricerca forense che può, da un lato, offrire un utile contributo alla esatta comprensione dei meccanismi fisiopatologici della sepsi e, dall’altro, consentire di affinare la diagnosi post-mortem di sepsi attraverso lo studio, mediante tecniche di analisi proteomica applicabili anche al materiale autoptico, della espressione di markers e proteine della sepsi76.

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