Wachholz Paulina, Celiński Rafał, Skowronek Rafał, Pawlas Natalia
Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 38 Jordana Street, Zabrze, 41-808, Poland.
Toxicology Laboratory ToxLab, 6 Kossutha Street, Katowice, 40-844, Poland.
Forensic Sci Med Pathol. 2025 Mar;21(1):23-32. doi: 10.1007/s12024-024-00801-y. Epub 2024 Mar 12.
This study aimed to compare the concentration of various xenobiotics in both cerebrospinal fluid (CSF) and blood. We examined 175 autopsy cases covering a wide range of ages, causes of death, and drug ingestion histories, with cerebrospinal fluid and blood samples available for toxicological testing. Analytes studied included opioids, benzodiazepines, antidepressants, antipsychotics, and illicit substances such as cannabinoids, stimulants and new psychoactive substances, including synthetic cathinones and synthetic cannabinoids. We found that concentrations in CSF were generally lower than in blood. A significant correlation was observed between drug concentrations in CSF and blood for many analytes (p < 0.05). However, the strength and direction of the correlation varied considerably depending on the physicochemical properties of the drugs, suggesting that a 'one size fits all' model may not be applicable. The results indicate that cerebrospinal fluid (CSF) can be used to detect a variety of xenobiotics, particularly amphetamines, synthetic cathinones and synthetic cannabinoids, in cases where conventional biological materials are not available. Additionally, using the results obtained in the future can lead to a better understanding of pharmacokinetic processes and the effect of post-mortem redistribution. Further research is needed to refine our understanding of these relationships.
本研究旨在比较脑脊液（CSF）和血液中各种外源性物质的浓度。我们检查了175例尸检病例，这些病例涵盖了广泛的年龄、死因和药物摄入史，且有脑脊液和血液样本可用于毒理学检测。所研究的分析物包括阿片类药物、苯二氮䓬类药物、抗抑郁药、抗精神病药以及非法物质，如大麻素、兴奋剂和新型精神活性物质，包括合成卡西酮和合成大麻素。我们发现脑脊液中的浓度通常低于血液中的浓度。许多分析物在脑脊液和血液中的药物浓度之间存在显著相关性（p < 0.05）。然而，相关性的强度和方向因药物的物理化学性质而有很大差异，这表明“一刀切”的模型可能并不适用。结果表明，在无法获得传统生物材料的情况下，脑脊液（CSF）可用于检测多种外源性物质，特别是苯丙胺、合成卡西酮和合成大麻素。此外，利用未来获得的结果可以更好地理解药代动力学过程以及死后再分布的影响。需要进一步研究以完善我们对这些关系的理解。
