Department of Forensic Pharmacology and Toxicology, Zurich Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, 8057, Zurich, Switzerland.
Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, 8032, Zurich, Switzerland.
Sci Rep. 2023 Jun 2;13(1):8983. doi: 10.1038/s41598-023-36213-1.
Gamma-hydroxybutyrate (GHB) remains a challenging clinical/forensic toxicology drug. Its rapid elimination to endogenous levels mainly causes this. Especially in drug-facilitated sexual assaults, sample collection often occurs later than the detection window for GHB. We aimed to investigate new GHB conjugates with amino acids (AA), fatty acids, and its organic acid metabolites for their suitability as ingestion/application markers in urine following controlled GHB administration to humans. We used LC-MS/MS for validated quantification of human urine samples collected within two randomized, double-blinded, placebo-controlled crossover studies (GHB 50 mg/kg, 79 participants) at approximately 4.5, 8, 11, and 28 h after intake. We found significant differences (placebo vs. GHB) for all but two analytes at 4.5 h. Eleven hours post GHB administration, GHB, GHB-AAs, 3,4-dihydroxybutyric acid, and glycolic acid still showed significantly higher concentrations; at 28 h only GHB-glycine. Three different discrimination strategies were evaluated: (a) GHB-glycine cut-off concentration (1 µg/mL), (b) metabolite ratios of GHB-glycine/GHB (2.5), and (c) elevation threshold between two urine samples (> 5). Sensitivities were 0.1, 0.3, or 0.5, respectively. Only GHB-glycine showed prolonged detection over GHB, mainly when compared to a second time- and subject-matched urine sample (strategy c).
γ-羟基丁酸(GHB)仍然是一种具有挑战性的临床/法医毒理学药物。其主要原因是其快速消除至内源性水平。特别是在药物辅助的性侵犯中,样本采集通常发生在检测 GHB 的窗口期之后。我们旨在研究与氨基酸(AA)、脂肪酸及其有机酸代谢物结合的新 GHB 缀合物,以作为在人体受控给予 GHB 后尿液中摄入/应用的标志物。我们使用 LC-MS/MS 对两项随机、双盲、安慰剂对照交叉研究(GHB 50mg/kg,79 名参与者)中收集的人尿液样本进行了验证定量,这些样本在摄入后约 4.5、8、11 和 28 小时采集。我们发现除了两个分析物外,所有分析物在 4.5 小时时均存在显著差异(安慰剂与 GHB)。在 GHB 给药 11 小时后,GHB、GHB-AA、3,4-二羟基丁酸和甘醇酸仍显示出明显更高的浓度;在 28 小时时,只有 GHB-甘氨酸。评估了三种不同的区分策略:(a)GHB-甘氨酸截止浓度(1μg/mL),(b)GHB-甘氨酸/GHB 代谢物比(2.5),以及(c)两个尿液样本之间的升高阈值(>5)。灵敏度分别为 0.1、0.3 或 0.5。只有 GHB-甘氨酸的检测时间比 GHB 延长,主要是与第二次时间和受试者匹配的尿液样本相比(策略 c)。