A Japanese research team has finally solved the mystery of how and why the often fatal so-called crush syndrome occurs.

The medical condition that had long baffled scientists is characterized by shock and renal failure, which results from body tissue dying when people are crushed in the rubble of an earthquake or the wreckage of a traffic accident.

The scientists, primarily from Keio University, also identified a substance that could prevent or treat the condition.

Following the 1995 Great Hanshin Earthquake, many individuals developed renal failure and died after their muscles underwent necrosis after their bodies were compressed under rubble. It was crush syndrome and drew considerable attention at the time.

In some cases, chemicals in the dead muscle cells were released into the blood, causing acute renal disorder and death. But the detailed mechanism that causes crush syndrome had not been determined until now.

The scientists found that a substance called myoglobin released from dead muscle cells activates blood platelets that kill macrophages, a type of white blood cell, in the kidneys.

When this happens, the macrophages release a DNA-protein complex called chromatin that damages renal tubes and causes kidney failure.

When a gene associated with the release of chromatin was inactivated in mice, they suffered from a milder renal disorder when their muscles underwent necrosis.

Chromatin-derived chemicals are found in large amounts in the blood of those whose muscles have been damaged in accidents.

The scientists also confirmed that lactoferrin, a protein found in breast milk, can inhibit the release of chromatin. The renal disorder for lactoferrin-injected mice was milder than untreated ones, according to the team.

“The findings could prove useful in preventing and treating renal disorder caused by the necrosis of muscles,” said Junichi Hirahashi, a full-time lecturer of medicine at the university and member of the research group. “I want to use the achievement to develop a therapeutic drug that can be used during times of disaster or at accident sites.”

The team’s findings have been published in the U.S. medical journal Nature Medicine.

As many houses collapsed in the Great Hanshin Earthquake, more than 370 people are estimated to have developed crush syndrome and 50 of them are said to have died.

There is no medicine to prevent crush syndrome, so only symptomatic treatment, such as dialysis, can be provided after its onset. However, offering such therapy in time is often difficult at disaster sites.