Forensic application of intrarenal aquaporin-2 expression for differential diagnosis between freshwater and saltwater drowning

Aquaporins (AQPs) are a family of homologous water channel proteins. In this study, the expressions of AQP1, 2, and 4 were immunohistochemically examined in kidney samples to evaluate their forensic applicability to differentiate between freshwater drowning (FWD) and saltwater drowning (SWD). Kidney samples were obtained from 51 drowning cases (23 FWD and 28 SWD) and 19 non-drowning cases. AQP1 was expressed in the proximal tubules and glomeruli, and AQP4 was localized in the collecting ducts. However, there were no significant differences in AQP1 and AQP4 expressions among FWD, SWD, and control groups. Immunohistochemically, AQP2 was predominantly expressed in the apical plasma membrane of the collecting duct principal cells in all kidney samples of FWD and SWD. Morphometrically, AQP2 expression at the apical plasma membrane of collecting ducts was significantly enhanced in SWD group, compared with FWD and control groups. On the other hand, AQP-2 expression was significantly lower in FWD group than in control group. Moreover, in drowning cases, there was no correlation between post-submersion intervals and AQP expression. From a forensic aspect, immunohistochemical detection of AQP2 in the kidney can be considered a valuable marker to differentiate between FWD and SWD.