Bloody Evidence: The Validity of Glycophorin A in the Determination of Wound Vitality-A Systematic Review of the Literature.

In forensic pathology, glycophorin A (GPA) presence in tissues has been studied through anti-GPA monoclonal antibodies with immunohistochemical techniques. The use of anti-GPA in distinguishing ante- from postmortem lesions, particularly in advanced stages of decomposition, is explored in this study. This systematic review assesses the current use of glycophorins, focusing on their application in forensic investigations to detect vital hemorrhagic infiltration. A total of 799 studies were identified, and after screening, 16 studies were included, encompassing case reports, experimental studies, and case-control analyses. The data extracted from these studies highlighted the diagnostic accuracy of GPA immunohistochemical staining in forensic cases. Of the 50 specimens analyzed, 48 were stained with anti-GPA serum and 2 with anti-glycophorin C (GPC) serum. The results showed that GPA staining was significantly more reliable in detecting vital hemorrhage compared to routine histology, which had a diagnostic accuracy of only 66%. Moreover, in an experimental study, GPA positivity was observed in 72.2% of bruises and vital tissues, even in highly decomposed specimens. The study further emphasized the robustness of GPA in distinguishing ante- from postmortem injuries, with particular relevance for cases involving significant decomposition. Overall, GPA's high sensitivity in detecting vital hemorrhage, especially in decomposed bodies, underscores its potential as a reliable tool in forensic pathology. Despite some limitations due to the small number of studies, the evidence supports the inclusion of anti-GPA antibodies in routine forensic examinations, potentially enhancing the accuracy of wound vitality assessments in criminal investigations.