Simon Gábor, Kuzma Mónika, Mayer Mátyás, Petrus Karola, Tóth Dénes
Department of Forensic Medicine, Medical School, University of Pécs, Szigeti str. 12, H-7624 Pécs, Hungary.
Department of Laboratory Medicine, Medical School, University of Pécs, Szigeti str. 12, H-7624 Pécs, Hungary.
Toxics. 2023 Aug 5;11(8):673. doi: 10.3390/toxics11080673.
A case of a 26-year-old male who died from consuming synthetic cannabinoid receptor agonists MDMB-4en-PINACA and 4F-ABUTINACA is reported. MDMB-4en-PINACA and 4F-ABUTINACA are potent synthetic cannabinoid receptor agonists (SCRAs). This is the first detailed reporting of MDMB-4-en-PINACA and 4F-ABUTINACA associated fatality, which can help the routine forensic work. The scientific literature on the symptoms associated with these substances are evaluated, along with the pharmacological properties and possible mechanism of death. A forensic autopsy was performed according to Recommendation No. R (99)3 of the Council of Europe on medico-legal autopsies. Histological samples were stained with hematoxylin and eosin (HE). Complement component C9 immunohistochemistry was applied to all heart samples. Toxicological analyses were carried out by supercritical fluid chromatography coupled with tandem mass spectrometry (SFC-MS/MS) and headspace gas chromatography with a flame ionization detector (HS-GC-FID). The literature was reviewed to identify reported cases of MDMB-4en-PINACA and 4F-ABUTINACA use. Autopsy findings included brain edema, internal congestion, petechial bleeding, pleural ecchymoses, and blood fluidity. Toxicological analyses determined 7.2 ng/mL of MDMB-4en-PINACA and 9.1 ng/mL of 4F-ABUTINACA in the peripheral blood. MDMB-4en-PINACA and 4F-ABUTINACA are strong, potentially lethal SCRA, and their exact effects and outcome are unpredictable.
报告了一例26岁男性因摄入合成大麻素受体激动剂MDMB - 4en - PINACA和4F - ABUTINACA死亡的病例。MDMB - 4en - PINACA和4F - ABUTINACA是强效合成大麻素受体激动剂（SCRAs）。这是关于MDMB - 4 - en - PINACA和4F - ABUTINACA相关死亡的首次详细报告，有助于常规法医工作。评估了关于这些物质相关症状的科学文献，以及它们的药理学特性和可能的死亡机制。根据欧洲委员会关于法医解剖的R(99)3号建议进行了法医解剖。组织学样本用苏木精和伊红（HE）染色。对所有心脏样本进行补体成分C9免疫组织化学检测。通过超临界流体色谱 - 串联质谱联用（SFC - MS/MS）和带火焰离子化检测器的顶空气相色谱（HS - GC - FID）进行毒理学分析。查阅文献以确定已报道的使用MDMB - 4en - PINACA和4F - ABUTINACA的病例。尸检结果包括脑水肿、内部充血、瘀点出血、胸膜瘀斑和血液流动性。毒理学分析在外周血中检测到7.2 ng/mL的MDMB - 4en - PINACA和9.1 ng/mL的4F - ABUTINACA。MDMB - 4en - PINACA和4F - ABUTINACA是强效的、潜在致命的SCRAs及其确切影响和结果是不可预测的。
