National Centre on Drug Addiction and Doping, Istituto Superiore di Sanita, Rome, Italy.
Unit of Forensic Toxicology (UoFT), Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy.
Curr Pharm Des. 2017;23(36):5468-5479. doi: 10.2174/1381612823666170704123126.
The analysis of nails as a keratinized matrix to detect drugs or illicit substances has been increasingly used in forensic and clinical toxicology as a complementary test, especially for the specific characteristics of stably accumulating substances for long periods of time. This allows a retrospective investigation of chronic drug abuse, monitoring continuous drug or pharmaceutical use, reveal in utero drug exposure or environmental exposures.
We herein review the recent literature investigating drug incorporation mechanisms and drug detection in nails for forensic toxicological purposes.
Mechanisms of drug incorporation have not yet been fully elucidated. However, some research has lately contributed to a better understanding of how substances are incorporated into nails, suggesting three potential mechanisms of drug incorporation: contamination from sweat, incorporation from nail bed and incorporation from germinal matrix. In addition, numerous methods dealing with the determination of drugs of abuse, medications and alcohol biomarkers in nails have been reported in studies over the years. The latter methods could find application in clinical and forensic toxicology.
The studies herein reviewed point out how important it is to standardize and harmonize the methodologies (either pre-analytical or analytical) for nails analysis and the optimization of sampling as well as the development of proficiency testing programs and the determination of cut-off values.
指甲作为角蛋白基质分析，用于检测毒品或非法物质，在法医毒理学和临床毒理学中越来越多地被用作补充测试，特别是对于稳定积累物质的特定特征，可以长时间进行检测。这可以对慢性药物滥用进行回溯性调查，监测持续的药物或药物使用情况，发现胎儿期药物暴露或环境暴露。
本文综述了最近研究指甲中药物摄入机制和药物检测的文献，用于法医毒理学目的。
药物摄入机制尚未完全阐明。然而，最近的一些研究有助于更好地理解物质是如何被纳入指甲的，提出了三种潜在的药物摄入机制：汗液污染、指甲床摄入和生发基质摄入。此外，多年来的研究报告了许多涉及指甲中滥用药物、药物和酒精生物标志物测定的方法。这些方法可能在临床和法医毒理学中得到应用。
本文综述的研究表明，标准化和协调指甲分析的方法（无论是在分析前还是分析中）以及优化采样、开发能力验证计划和确定截止值是多么重要。
