对人体血液和毛发中的亚甲二氧基甲基苯丙胺和甲基苯丙胺进行尸检手性分析

IF 2.2 3区 医学 Q1 MEDICINE, LEGAL Forensic science international Pub Date : 2024-09-14 DOI:10.1016/j.forsciint.2024.112226
Julian Bickel , Alexander Müller , Hilke Jungen , Anne Szewczyk , Jörg Teske , Uta Küpper , Hilke Andresen-Streichert , Benjamin Ondruschka , Stefanie Iwersen-Bergmann
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引用次数: 0

摘要

在欧盟,与毒品有关的死亡事故主要与阿片类药物有关。尽管摇头丸(MDMA)被广泛使用,但其致死性中毒事件较少。本研究调查了与摇头丸相关的死亡事故,重点研究了摇头丸及其代谢物 MDA 的对映体比率,以探讨代谢在致命结果中的作用。亚甲二氧基甲基苯丙胺(MDMA)可引起兴奋、移情作用增强以及心动过速、高血压和高热等生理效应。代谢主要涉及 CYP1A2 和 CYP2D6,后者的多态性会影响代谢率。我们研究所发现了几起与摇头丸有关的死亡病例,这促使我们对药物代谢效率低下在这些病例中的潜在作用进行调查。针对人体血液中的 MDMA、MDA、苯丙胺和甲基苯丙胺对映体,开发并验证了一种新型手性定量分析方法。对 11 例与亚甲二氧基甲基苯丙胺(MDMA)相关的死亡病例的尸检血液样本进行分析后发现,其浓度和对映体比率范围很广。不过,R/S 亚甲二氧基甲基苯丙胺比率的变化可能与新陈代谢的时间段有关。毛发分析表明,无论之前是否有吸毒史,所有样本中的亚甲二氧基甲基苯丙胺浓度都很高。因此,毛发分析可能不适合用于评估与摇头丸有关的死亡事故中以往吸毒情况。研究结果表明,亚甲二氧基甲基苯丙胺对映体浓度升高与中毒者存活时间延长有关。不过,没有明确证据表明亚甲二氧基甲基苯丙胺代谢减慢是导致致命中毒的原因。虽然由于病例的多样性而仍然存在挑战,但本研究为摇头丸中毒提供了宝贵的见解,有助于今后对尸检分析的解释。
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Post mortem chiral analysis of MDMA and MDA in human blood and hair

Drug-related fatalities in the EU are predominantly associated with opioids. MDMA (Ecstasy) consumption results in fewer lethal intoxications despite its widespread use. This study investigates MDMA-related fatalities, focusing on enantiomer ratios of MDMA and its metabolite MDA to explore the role of metabolism in fatal outcomes. MDMA induces euphoria, increased empathy, and physiological effects such as tachycardia, hypertension, and hyperthermia. Metabolism mainly involves CYP1A2 and CYP2D6, with polymorphism of the latter influencing metabolism rates. Our institute observed several MDMA-related fatalities, which prompted an investigation into the potential role of inefficient drug metabolism in these cases. A novel quantitative chiral analysis method was developed and validated for MDMA, MDA, amphetamine and methamphetamine enantiomers in human blood. Analysis of post mortem blood samples from eleven MDMA-related fatalities exhibited a wide range of concentrations and enantiomer ratios. Variability in R/S MDMA ratios, however, could be linked to the time period of metabolism. Hair analysis revealed high MDMA concentrations in all segments, irrespective of prior drug abuse anamnesis. Therefore, hair analysis may not be suitable for the assessment of past drug use in ecstasy-related fatalities. The results indicated that elevated levels of the MDMA enantiomer are correlated with longer survival times in cases of intoxication. However, there was no clear evidence for slowed MDMA metabolism as a cause of lethal intoxications. While challenges remain due to the diversity of cases, this study contributes valuable insights into ecstasy intoxications, aiding future interpretation of post mortem analysis.

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来源期刊
Forensic science international
Forensic science international 医学-医学:法
CiteScore
5.00
自引率
9.10%
发文量
285
审稿时长
49 days
期刊介绍: Forensic Science International is the flagship journal in the prestigious Forensic Science International family, publishing the most innovative, cutting-edge, and influential contributions across the forensic sciences. Fields include: forensic pathology and histochemistry, chemistry, biochemistry and toxicology, biology, serology, odontology, psychiatry, anthropology, digital forensics, the physical sciences, firearms, and document examination, as well as investigations of value to public health in its broadest sense, and the important marginal area where science and medicine interact with the law. The journal publishes: Case Reports Commentaries Letters to the Editor Original Research Papers (Regular Papers) Rapid Communications Review Articles Technical Notes.
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