Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Av. do Café s/n, Monte Alegre, Ribeirão Preto, São Paulo 14040-903, Brazil.
Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes 3900, Ribeirão Preto, São Paulo 14040-901, Brazil.
Forensic Toxicol. 2022 Jan;40(1):1-18. doi: 10.1007/s11419-021-00596-5. Epub 2021 Aug 19.
The use of alternative matrices in toxicological analyses has been on the rise in clinical and forensic settings. Specimens alternative to blood and urine are useful in providing additional information regarding drug exposure and analytical benefits. The goal of this paper is to present a critical review on the most recent literature regarding the application of six common alternative matrices, i.e., oral fluid, hair, sweat, meconium, breast milk and vitreous humor in forensic toxicology.
The recent literature have been searched and reviewed for the characteristics, advantages and limitations of oral fluid, hair, sweat, meconium, breast milk and vitreous humor and its applications in the analysis of traditional drugs of abuse and novel psychoactive substances (NPS).
This paper outlines the properties of six biological matrices that have been used in forensic analyses, as alternatives to whole blood and urine specimens. Each of this matrix has benefits in regards to sampling, extraction, detection window, typical drug levels and other aspects. However, theses matrices have also limitations such as limited incorporation of drugs (according to physical-chemical properties), impossibility to correlate the concentrations for effects, low levels of xenobiotics and ultimately the need for more sensitive analysis. For more traditional drugs of abuse (e.g., cocaine and amphetamines), there are already data available on the detection in alternative matrices. However, data on the determination of emerging drugs such as the NPS in alternative biological matrices are more limited.
Alternative biological fluids are important specimens in forensic toxicology. These matrices have been increasingly reported over the years, and this dynamic will probably continue in the future, especially considering their inherent advantages and the possibility to be used when blood or urine are unavailable. However, one should be aware that these matrices have limitations and particular properties, and the findings obtained from the analysis of these specimens may vary according to the type of matrix. As a potential perspective in forensic toxicology, the topic of alternative matrices will be continuously explored, especially emphasizing NPS.
在临床和法医环境中，替代基质在毒理学分析中的应用呈上升趋势。替代血液和尿液的标本在提供有关药物暴露和分析益处的额外信息方面非常有用。本文的目的是对最近关于六种常见替代基质（即唾液、头发、汗液、胎粪、母乳和玻璃体液）在法医毒理学中的应用的文献进行批判性综述。
搜索并综述了最近的文献，以了解唾液、头发、汗液、胎粪、母乳和玻璃体液的特点、优势和局限性，及其在传统滥用药物和新型精神活性物质（NPS）分析中的应用。
本文概述了六种已用于法医分析的生物基质的特性，作为全血和尿液标本的替代品。每种基质在采样、提取、检测窗口、典型药物水平和其他方面都有优势。然而，这些基质也存在局限性，例如根据物理化学性质，药物的纳入有限、无法将浓度与作用相关联、外源性物质的浓度低，最终需要更敏感的分析。对于更传统的滥用药物（如可卡因和苯丙胺），已经有关于替代基质中检测的可用数据。然而，关于替代生物基质中新兴药物（如 NPS）的测定数据则更为有限。
替代生物液是法医毒理学中的重要标本。这些基质多年来的报道越来越多，这种趋势在未来可能还会继续，尤其是考虑到它们固有的优势以及在血液或尿液不可用时使用的可能性。然而，人们应该意识到这些基质存在局限性和特定的性质，并且从这些标本分析中获得的结果可能因基质类型而异。作为法医毒理学的一个潜在研究方向，替代基质的主题将不断得到探索，尤其是新型精神活性物质。
