Staeheli Sandra N, Boxler Martina I, Oestreich Andrea, Marti Michelle, Gascho Dominic, Bolliger Stephan A, Kraemer Thomas, Steuer Andrea E
Department of Forensic Pharmacology & Toxicology, Zurich Institute of Forensic Medicine, University of Zurich, Switzerland.
Department of Forensic Medicine & Imaging, Zurich Institute of Forensic Medicine, University of Zurich, Switzerland.
Forensic Sci Int. 2017 Oct;279:83-87. doi: 10.1016/j.forsciint.2017.08.007. Epub 2017 Aug 12.
Intoxication cases involving new psychoactive substances (NPS) provide several challenges for forensic toxicologists as data on pharmacodynamic and pharmacokinetic properties are lacking, especially on potency and toxicity. Furthermore, reference values and information on postmortem redistribution (PMR) do not exist so far for most NPS. A fatal case involving the amphetamine-derivatives MDAI (5,6-methylenedioxy-2-aminoindane) and 2-MAPB (1-(benzofuran-2-yl)-N-methylpropan-2-amine) was investigated at the Zurich Institute of Forensic Medicine. At admission at the institute approx. 11h after death (first time point, t1), femoral and heart blood (right ventricle) was collected using computed tomography (CT)-guided biopsy sampling. At autopsy (t2), samples from the same body regions as well as various tissue samples were collected manually. In addition, an antemortem blood sample collected 6h before death was available. MDAI and 2-MAPB were quantified using a validated LC-MS/MS method. A significant concentration decrease between the antemortem and the first peripheral postmortem blood sample was observed, which most probably can be explained by remaining metabolism and excretion within the last 6h prior to death. No significant concentration change was observed between the two postmortem heart blood and peripheral blood samples. Accordingly, MDAI and 2-MAPB did not seem to undergo relevant postmortem redistribution in peripheral and heart blood in the presented case. This is the first study on postmortem redistribution of the new psychoactive substances MDAI and 2-MAPB. However, more studies covering more cases are necessary to generate universal statements on the PMR with these two NPSs.
涉及新型精神活性物质（NPS）的中毒案例给法医毒理学家带来了诸多挑战，因为缺乏关于药效学和药代动力学特性的数据，尤其是效力和毒性方面的数据。此外，目前大多数新型精神活性物质尚无死后再分布（PMR）的参考值和相关信息。苏黎世法医学研究所对一起涉及苯丙胺衍生物MDAI（5,6-亚甲基二氧基-2-氨基茚满）和2-MAPB（1-(苯并呋喃-2-基)-N-甲基丙-2-胺）的致命案例进行了调查。在该研究所入院时，即死亡后约11小时（第一个时间点，t1），使用计算机断层扫描（CT）引导下的活检采样收集了股动脉血和心脏血（右心室）。尸检时（t2），手动收集了与之前相同身体部位的样本以及各种组织样本。此外，还获取了一份死亡前6小时采集的生前血液样本。使用经过验证的液相色谱-串联质谱（LC-MS/MS）方法对MDAI和2-MAPB进行了定量分析。观察到生前血液样本和死后首个外周血样本之间的浓度显著降低，这很可能可以解释为在死亡前的最后6小时内仍有代谢和排泄。在两份死后心脏血和外周血样本之间未观察到显著的浓度变化。因此，在本案例中，MDAI和2-MAPB在外周血和心脏血中似乎未发生明显的死后再分布。这是关于新型精神活性物质MDAI和2-MAPB死后再分布的首次研究。然而，需要开展更多涵盖更多案例的研究，以便对这两种新型精神活性物质的死后再分布得出普遍结论。
