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Time-dependent postmortem redistribution of morphine and its metabolites in blood and alternative matrices—application of CT-guided biopsy sampling


Staeheli, Sandra N; Gascho, Dominic; Ebert, Lars C; Kraemer, Thomas; Steuer, Andrea Eva (2017). Time-dependent postmortem redistribution of morphine and its metabolites in blood and alternative matrices—application of CT-guided biopsy sampling. International journal of legal medicine, 131(2):379-389.

Abstract

Time-dependent postmortem redistribution of morphine and itsmetabolites in blood and alternative matrices—applicationof CT-guided biopsy samplingSandra N. Staeheli1&Dominic Gascho2&Lars C. Ebert2&Thomas Kraemer1&Andrea E. Steuer1Received: 15 August 2016 /Accepted: 20 October 2016 /Published online: 3 December 2016#Springer-Verlag Berlin Heidelberg 2016AbstractInterpretation of postmortem morphine concentra-tions in forensic toxicology provides several pitfalls such asmissing information on tolerance, analyte stability, or post-mortem redistribution (PMR). Recently, it had been shownthat computed tomography (CT)-guided collection of biop-sies using arobotic arm (virtobot)providesavaluable strategyfor systematic studies on time-dependent PMR. Using thistechnique, time-dependent PMR of morphine and its metabo-lites was investigated in 12 cases. At admission to the institute(t1), femoral and heart blood (right ventricle) as well as biop-sies from the right lung, the right kidney, liver, spleen, andmuscle tissue were collected. At autopsy approximately 24 hlater (t2), samples from the same body regions were collectedagain. Additionally, gastric contents, urine, brain tissue, andheart blood from the left ventricle was collected. Morphine,normorphine, hydromorphone, morphine-3-glucuronide,morphine-6-glucuronide, and morphine-sulfate were quanti-fied with LC-MS/MS. In femoral blood, significant increaseof morphine concentrations was observed, although ultimate-ly not relevant for forensic interpretation. In the alternativematrices, increases as well as decreases were observed with-out a clear trend. The morphine metabolites did not exhibitrelevant concentration changes. Investigation of underlyingredistribution mechanisms indicated that concentrationchange (i.e., increase) of morphine in femoral blood ratherresulted from diffusion processes than from release ofmorphine from its conjugates. Concentration changes in heartblood might have been caused by redistribution from lungtissue or gastric content. This study also proved that CT-guidedcollectionofbiopsies using avirtobot arm isaninvalu-able tool for future studies onPMR redistribution of othersubstance groups.

Abstract

Time-dependent postmortem redistribution of morphine and itsmetabolites in blood and alternative matrices—applicationof CT-guided biopsy samplingSandra N. Staeheli1&Dominic Gascho2&Lars C. Ebert2&Thomas Kraemer1&Andrea E. Steuer1Received: 15 August 2016 /Accepted: 20 October 2016 /Published online: 3 December 2016#Springer-Verlag Berlin Heidelberg 2016AbstractInterpretation of postmortem morphine concentra-tions in forensic toxicology provides several pitfalls such asmissing information on tolerance, analyte stability, or post-mortem redistribution (PMR). Recently, it had been shownthat computed tomography (CT)-guided collection of biop-sies using arobotic arm (virtobot)providesavaluable strategyfor systematic studies on time-dependent PMR. Using thistechnique, time-dependent PMR of morphine and its metabo-lites was investigated in 12 cases. At admission to the institute(t1), femoral and heart blood (right ventricle) as well as biop-sies from the right lung, the right kidney, liver, spleen, andmuscle tissue were collected. At autopsy approximately 24 hlater (t2), samples from the same body regions were collectedagain. Additionally, gastric contents, urine, brain tissue, andheart blood from the left ventricle was collected. Morphine,normorphine, hydromorphone, morphine-3-glucuronide,morphine-6-glucuronide, and morphine-sulfate were quanti-fied with LC-MS/MS. In femoral blood, significant increaseof morphine concentrations was observed, although ultimate-ly not relevant for forensic interpretation. In the alternativematrices, increases as well as decreases were observed with-out a clear trend. The morphine metabolites did not exhibitrelevant concentration changes. Investigation of underlyingredistribution mechanisms indicated that concentrationchange (i.e., increase) of morphine in femoral blood ratherresulted from diffusion processes than from release ofmorphine from its conjugates. Concentration changes in heartblood might have been caused by redistribution from lungtissue or gastric content. This study also proved that CT-guidedcollectionofbiopsies using avirtobot arm isaninvalu-able tool for future studies onPMR redistribution of othersubstance groups.

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Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Institute of Legal Medicine
Dewey Decimal Classification:340 Law
610 Medicine & health
Scopus Subject Areas:Health Sciences > Pathology and Forensic Medicine
Language:English
Date:2017
Deposited On:09 Dec 2016 14:45
Last Modified:26 May 2020 14:55
Publisher:Springer
ISSN:0937-9827
Additional Information:This is a post-peer-review, pre-copyedit version of an article published in International Journal of Legal Medicine. The final authenticated version is available online at: https://doi.org/10.1007/s00414-016-1485-2.
OA Status:Green
Publisher DOI:https://doi.org/10.1007/s00414-016-1485-2
PubMed ID:27915431
Project Information:
  • : FunderSNSF
  • : Grant ID310030_165875
  • : Project TitleSystematic Studies on Postmortem Toxicology

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