Department of Medical and Surgical Sciences, Institute of Legal Medicine, "Magna Graecia" University, 88100 Catanzaro, Italy.
Int J Mol Sci. 2024 Oct 29;25(21):11607. doi: 10.3390/ijms252111607.
Asphyxia is a critical condition characterized by inadequate oxygen supply to the body. Post mortem diagnostics of asphyxia present significant challenges in forensic pathology, particularly when there are equivocal signs during autopsy or uncertain circumstantial data. The identification of biochemical biomarkers that indicate asphyxia has emerged as a promising area of research, as these markers can provide vital insights into the physiological changes occurring at the cellular level during asphyxiation. We performed a review of the scientific literature on the search engines Pubmed and Scopus in order to assess the state of the art on this topic. The aim of this study is to analyze which are the most promising markers and methods in the post mortem diagnosis of asphyxia. The literature review highlighted the great potential that molecular investigations can have in the analysis of this type of death, especially considering that hypoxia determines strong biochemical alterations in response to cellular stress. These changes are marked by specific biochemical alterations, which can be detected through various advanced technologies and methodologies, including mass spectrometry, immunohistochemistry, and metabolomic profiling. The review evidenced a combination of markers that can be used for diagnostic purposes in various cases, including mechanical asphyxia, carbon monoxide (CO) poisoning, perinatal asphyxia, and drowning analysis. However, we highlight that, to date, there are still no standard protocols for forensic biochemistry in asphyxia. By scrutinizing the reliability of identified biomarkers and their potential to reshape forensic investigative practices, this research aims to elucidate the critical role that post mortem biochemical analysis can play in diagnosing asphyxia, ultimately contributing to a more nuanced understanding of death-related scenarios and the development of standardized protocols in forensic examinations.
窒息是一种严重的病症，其特征是身体供氧不足。在法医学中，窒息的死后诊断具有很大的挑战性，尤其是在尸检时存在模棱两可的迹象或不确定的环境数据时。鉴定表明窒息的生化生物标志物已成为一个有前途的研究领域，因为这些标志物可以为细胞水平发生的生理变化提供重要的见解。我们在 Pubmed 和 Scopus 搜索引擎上对科学文献进行了综述，以评估该主题的最新研究进展。本研究的目的是分析在窒息的死后诊断中最有前途的标志物和方法。文献综述突出了分子研究在分析这种死亡类型方面的巨大潜力，特别是考虑到缺氧会导致细胞应激时产生强烈的生化变化。这些变化的特点是特定的生化改变，可以通过各种先进的技术和方法检测到，包括质谱、免疫组织化学和代谢组学分析。综述表明，在各种情况下，包括机械性窒息、一氧化碳（CO）中毒、围产期窒息和溺死分析，都可以将标志物组合起来用于诊断目的。然而，我们强调，迄今为止，窒息的法医生物化学仍然没有标准的协议。通过仔细检查鉴定的生物标志物的可靠性及其在重塑法医调查实践方面的潜力，这项研究旨在阐明死后生化分析在诊断窒息方面的关键作用，最终有助于更细致地了解与死亡相关的情况，并在法医检查中制定标准化协议。
