Forensic Toxicology Laboratory, ChemCentre, Bentley, Western Australia, Australia.
Drug Test Anal. 2021 Mar;13(3):604-613. doi: 10.1002/dta.2974. Epub 2020 Nov 26.
The application of proteomic techniques to forensic science widens the range of analytical capabilities available to forensic laboratories when answering complex toxicology problems. Currently, these techniques are underutilised in post-mortem toxicology because of the historic focus on smaller (<1,000 amu) drug molecules. Definitive confirmation of an insulin overdose by analysis of post-mortem biological matrices is rare and challenging, however can assist coronial investigations pertaining to accidental or intentional overdoses in both diabetic and nondiabetic populations. A semiautomated micro-solid phase extraction paired with mass spectrometry-based insulin methodology was developed and validated for routine use in a Forensic Coronial Toxicology Laboratory. This resulting work reports the first Australian cases where synthetic insulins were confirmed by mass spectrometry in the vitreous humour of Type 1 diabetics who intentionally or accidentally overdosed on their prescription medication glargine and aspart. The detection of glargine M1 in Case 1, aspart in Case 2 and glargine M1 was indicated in Case 3. This paper highlights advancements in forensic coronial toxicology and the promising potential of proteomic analysis in a forensic context.
蛋白质组学技术在法医学中的应用拓宽了法医实验室在解决复杂毒理学问题时可用的分析能力范围。目前，由于历史上对较小的（<1000amu）药物分子的关注，这些技术在死后毒理学中未得到充分利用。通过对死后生物基质的分析来明确确认胰岛素过量的情况很少见且具有挑战性，但可以帮助法医调查涉及糖尿病和非糖尿病人群的意外或故意过量用药的情况。本文开发并验证了一种半自动化的微固相萃取与基于质谱的胰岛素方法，以便在法医尸检毒理学实验室中常规使用。这项工作报告了澳大利亚首例通过质谱法在 1 型糖尿病患者的玻璃体中确认合成胰岛素的案例，这些患者故意或意外过量服用了他们的处方药物甘精胰岛素和门冬胰岛素。在案例 1 中检测到甘精胰岛素 M1，在案例 2 中检测到门冬胰岛素，在案例 3 中检测到甘精胰岛素 M1。本文强调了法医尸检毒理学的进展以及蛋白质组学分析在法医环境中的有前途的潜力。
