1
|
Alzu’bi A, Zoubi MSA, Al-Trad B, AbuAlArjah MI, Shehab M, Alzoubi H, Albals D, Abdelhady GT, El-Huneidi W. Acute Hepatic Injury Associated with Acute Administration of Synthetic Cannabinoid XLR-11 in Mouse Animal Model. TOXICS 2022; 10:668. [PMID: 36355959 PMCID: PMC9692363 DOI: 10.3390/toxics10110668] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/01/2022] [Accepted: 11/05/2022] [Indexed: 06/16/2023]
Abstract
The widespread recreational use of synthetic cannabinoids (SCs) has become a serious health issue. Reports of life-threatening intoxications related to SC consumption have markedly increased in recent years, including neurotoxicity, cardiotoxicity, nephrotoxicity, and hepatotoxicity. We investigated the impact of acute administration of the synthetic cannabinoid XLR-11 (3 mg/kg, i.p. for 5 consecutive days) on the liver in BALB/c mouse animal model. Using real-time quantitative RT-PCR, MDA assay, and TUNEL assay, we found consistent up-regulation of a variety of genes involved in oxidative stress (NOX2, NOX4, and iNOS), inflammation (TNF-α, IL-1β, IL-6), and apoptosis (Bax) in the liver of XLR-11 treated mice compared to control mice. These finding were supported with an elevation of MDA levels and TUNEL positive cells in the liver of XLR-11 treated mice which further confirm increased oxidative stress and apoptosis, respectively. Histopathological analysis of the liver of XLR-11 treated mice confirmed pronounced hepatic necrosis associated with inflammatory cell infiltration. Furthermore, elevated ALT and AST serum levels were also identified in XLR-11 treated mice indicating possible liver damage. Overall, SC-induced hepatotoxicity seems to be mainly mediated by activated oxidative stress and inflammatory processes in the liver, but the specific mechanisms involved require further investigations. However, the present study shed light on the potential deleterious role of acute administration of SCs in the progression to acute hepatic injury which enhances our understanding of the adverse effect of SC consumption.
Collapse
Affiliation(s)
- Ayman Alzu’bi
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid 211-63, Jordan
| | - Mazhar Salim Al Zoubi
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid 211-63, Jordan
| | - Bahaa Al-Trad
- Department of Biological Sciences, Faculty of Science, Yarmouk University, Irbid 211-63, Jordan
| | - Manal Isam AbuAlArjah
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid 211-63, Jordan
| | - Malek Shehab
- Department of Biological Sciences, Faculty of Science, Yarmouk University, Irbid 211-63, Jordan
| | - Hiba Alzoubi
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid 211-63, Jordan
| | - Dima Albals
- Department of Medicinal Chemistry and Pharmacognosy, Faculty of Pharmacy, Yarmouk University, Irbid 211-63, Jordan
| | - Gamal T. Abdelhady
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid 211-63, Jordan
- Department of Anatomy and Embryology, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt
| | - Waseem El-Huneidi
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates
| |
Collapse
|
2
|
Fabregat-Safont D, Mata-Pesquera M, Barneo-Muñoz M, Martinez-Garcia F, Mardal M, Davidsen AB, Sancho JV, Hernández F, Ibáñez M. In-depth comparison of the metabolic and pharmacokinetic behaviour of the structurally related synthetic cannabinoids AMB-FUBINACA and AMB-CHMICA in rats. Commun Biol 2022; 5:161. [PMID: 35210552 PMCID: PMC8873228 DOI: 10.1038/s42003-022-03113-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/01/2022] [Indexed: 12/01/2022] Open
Abstract
Synthetic cannabinoids receptor agonists (SCRAs) are often almost completely metabolised, and hence their pharmacokinetics should be carefully evaluated for determining the most adequate biomarker in toxicological analysis. Two structurally related SCRAs, AMB-FUBINACA and AMB-CHMICA, were selected to evaluate their in vivo metabolism and pharmacokinetics using male Sprague-Dawley rats. Brain, liver, kidney, blood (serum) and urine samples were collected at different times to assess the differences in metabolism, metabolic reactions, tissue distribution and excretion. Both compounds experimented O-demethyl reaction, which occurred more rapidly for AMB-FUBINACA. The parent compounds and O-demethyl metabolites were highly bioaccumulated in liver, and were still detected in this tissue 48 h after injection. The different indazole/indole N-functionalisation produced diverse metabolic reactions in this moiety and thus, different urinary metabolites were formed. Out of the two compounds, AMB-FUBINACA seemed to easily cross the blood-brain barrier, presenting higher brain/serum concentrations ratio than AMB-CHMICA. Synthetic cannabinoids are amongst the most widely used psychoactive drugs which are tightly controlled by government agencies around the world. Here, pharmacokinetics of two synthetic cannabinoids in rats are evaluated along with their metabolites and tissue distribution, aiding in identifying distinct biomarkers that reflect the consumption of synthetic cannabinoids based on the tissue.
Collapse
Affiliation(s)
- David Fabregat-Safont
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water (IUPA), University Jaume I, Avda. Sos Baynat s/n, 12071, Castellón, Spain
| | - María Mata-Pesquera
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water (IUPA), University Jaume I, Avda. Sos Baynat s/n, 12071, Castellón, Spain
| | - Manuela Barneo-Muñoz
- Predepartmental Unit of Medicine, Unitat Mixta de Neuroanatomia Funcional NeuroFun-UVEG-UJI, University Jaume I, Castellón, Spain
| | - Ferran Martinez-Garcia
- Predepartmental Unit of Medicine, Unitat Mixta de Neuroanatomia Funcional NeuroFun-UVEG-UJI, University Jaume I, Castellón, Spain
| | - Marie Mardal
- Section of Forensic Chemistry, Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anders B Davidsen
- Section of Forensic Chemistry, Department of Forensic Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Juan V Sancho
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water (IUPA), University Jaume I, Avda. Sos Baynat s/n, 12071, Castellón, Spain
| | - Félix Hernández
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water (IUPA), University Jaume I, Avda. Sos Baynat s/n, 12071, Castellón, Spain
| | - María Ibáñez
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water (IUPA), University Jaume I, Avda. Sos Baynat s/n, 12071, Castellón, Spain.
| |
Collapse
|
3
|
Fabregat-Safont D, Sancho JV, Hernández F, Ibáñez M. The key role of mass spectrometry in comprehensive research on new psychoactive substances. JOURNAL OF MASS SPECTROMETRY : JMS 2021; 56:e4673. [PMID: 33155376 DOI: 10.1002/jms.4673] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/14/2020] [Accepted: 10/19/2020] [Indexed: 06/11/2023]
Abstract
New psychoactive substances (NPS) are a wide group of compounds that try to mimic the effects produced by the 'classical' illicit drugs, including cannabis (synthetic cannabinoids), cocaine and amphetamines (synthetic cathinones) or heroin (synthetic opioids), and which health effects are still unknown for most of them. Nowadays, more than 700 compounds are being monitored by official organisms, some of which have been recently identified in seizures and/or intoxication cases. Toxicological analysis plays a pivotal role in NPS research. A comprehensive investigation on NPS, from the first identification of a novel substance until its detection in drug users to help in diagnostics and medical treatment, requires the use of a wide variety of instruments and analytical strategies. This paper illustrates the key role of mass spectrometry (MS) along a comprehensive investigation on NPS. The synthetic cannabinoid XLR-11 and the synthetic cathinone 5-PPDi have been chosen as representative substances of the most consumed NPS families. Moreover, both compounds have been investigated at our laboratory in different stages of the three-step strategy considered in this article. The initial identification and characterisation of the compound in consumption products, the first reported metabolic pathway and the development of analytical methodologies for its determination (and/or their metabolites) in different toxicological samples are described. The analytical strategies and MS instruments are briefly discussed to show the reader the possibilities that MS instrumentation offer to analytical scientists. This publication aims to be a starting point for those interested on the NPS research field from an analytical chemistry point of view.
Collapse
Affiliation(s)
- David Fabregat-Safont
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water, University Jaume I, Avda. Sos Baynat s/n, Castellón, 12071, Spain
| | - Juan V Sancho
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water, University Jaume I, Avda. Sos Baynat s/n, Castellón, 12071, Spain
| | - Félix Hernández
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water, University Jaume I, Avda. Sos Baynat s/n, Castellón, 12071, Spain
| | - María Ibáñez
- Environmental and Public Health Analytical Chemistry, Research Institute for Pesticides and Water, University Jaume I, Avda. Sos Baynat s/n, Castellón, 12071, Spain
| |
Collapse
|
4
|
Gent L, Paul R. Air monitoring for illegal drugs including new psychoactive substances: A review of trends, techniques and thermal degradation products. Drug Test Anal 2021; 13:1078-1094. [PMID: 33870654 DOI: 10.1002/dta.3051] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 03/17/2021] [Accepted: 04/14/2021] [Indexed: 12/23/2022]
Abstract
The detection of illicit psychotropic substances in both indoor and outdoor air is a challenging analytical discipline, and the data from such investigation may provide intelligence in a variety of fields. Applications of drug monitoring in air include providing data on national and international drug consumption trends, as monitored by organisations such as the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and the United Nations Office on Drugs and Crime (UNODC). Air monitoring enables mapping of illicit drug manufacturing, dealing or consumption in cities and the identification of emergent compounds including the recent proliferation of new psychoactive substances (NPS). The rapid spread of NPS has changed the global drug market with greater diversity and dynamic spread of such compounds over several nations. This review provides an up to date analysis of key thematic areas within this analytical discipline. The process of how illicit psychotropic substances spread from emission sources to the atmosphere is considered alongside the sampling and analytical procedures involved. Applications of the technique applied globally are reviewed with studies ranging from the analysis of individual dwellings through to major international air-monitoring campaigns providing evidence on global drug trends. Finally, we consider thermal breakdown products of illicit psychotropic substances including NPS that are released upon heating, combustion or vaping and related potential for exposure to these compounds in the air.
Collapse
Affiliation(s)
- Luke Gent
- Faculty of Science and Technology, Bournemouth University, Dorset, UK
| | - Richard Paul
- Faculty of Science and Technology, Bournemouth University, Dorset, UK
| |
Collapse
|
5
|
Overview of Synthetic Cannabinoids ADB-FUBINACA and AMB-FUBINACA: Clinical, Analytical, and Forensic Implications. Pharmaceuticals (Basel) 2021; 14:ph14030186. [PMID: 33669071 PMCID: PMC7996508 DOI: 10.3390/ph14030186] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/19/2021] [Accepted: 02/20/2021] [Indexed: 01/08/2023] Open
Abstract
ADB-FUBINACA and AMB-FUBINACA are two synthetic indazole-derived cannabinoid receptor agonists, up to 140- and 85-fold more potent, respectively, than trans-∆9-tetrahydrocannabinol (∆9-THC), the main psychoactive compound of cannabis. Synthesised in 2009 as a pharmaceutical drug candidate, the recreational use of ADB-FUBINACA was first reported in 2013 in Japan, with fatal cases being described in 2015. ADB-FUBINACA is one of the most apprehended and consumed synthetic cannabinoid (SC), following AMB-FUBINACA, which emerged in 2014 as a drug of abuse and has since been responsible for several intoxication and death outbreaks. Here, we critically review the physicochemical properties, detection methods, prevalence, biological effects, pharmacodynamics and pharmacokinetics of both drugs. When smoked, these SCs produce almost immediate effects (about 10 to 15 s after use) that last up to 60 min. They are rapidly and extensively metabolised, being the O-demethylated metabolite of AMB-FUBINACA, 2-(1-(4-fluorobenzyl)-1H-indazole-3-carboxamide)-3-methylbutanoic acid, the main excreted in urine, while for ADB-FUBINACA the main biomarkers are the hydroxdimethylpropyl ADB-FUBINACA, hydroxydehydrodimethylpropyl ADB-FUBINACA and hydroxylindazole ADB-FUBINACA. ADB-FUBINACA and AMB-FUBINACA display full agonism of the CB1 receptor, this being responsible for their cardiovascular and neurological effects (e.g., altered perception, agitation, anxiety, paranoia, hallucinations, loss of consciousness and memory, chest pain, hypertension, tachycardia, seizures). This review highlights the urgent requirement for additional studies on the toxicokinetic properties of AMB-FUBINACA and ADB-FUBINACA, as this is imperative to improve the methods for detecting and quantifying these drugs and to determine the best exposure markers in the various biological matrices. Furthermore, it stresses the need for clinicians and pathologists involved in the management of these intoxications to describe their findings in the scientific literature, thus assisting in the risk assessment and treatment of the harmful effects of these drugs in future medical and forensic investigations.
Collapse
|
6
|
Alves VL, Gonçalves JL, Aguiar J, Teixeira HM, Câmara JS. The synthetic cannabinoids phenomenon: from structure to toxicological properties. A review. Crit Rev Toxicol 2020; 50:359-382. [PMID: 32530350 DOI: 10.1080/10408444.2020.1762539] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The word "cannabinoid" refers to every chemical substance, regardless of structure or origin, that joins the cannabinoid receptors of the body and brain and that have similar effects to those produced by the Cannabis plant and based on their source of production, cannabinoids can be classified into endocannabinoids, phytocannabinoids and synthetic cannabinoids. Synthetic cannabinoids represent the largest class of drugs detected through the EU Early Warning System with a total of 190 substances notified from 2008 to 2018 and about 280 have been reported worldwide to the United Nations Office on Drugs and Crime. Sprayed on natural herb mixtures with the aim to mimic the euphoria effect of cannabis and sold as "herbal smoking blends" or "herbal incense" under brand names like "Spice" or "K2", synthetic cannabinoids are available from websites for the combination with herbal materials or more recently, for the use in e-cigarettes. Currently labeled as "not for human consumption" to circumvent legislation, their legal status varies by country with many government institutions currently pushing for their control. However, due to the emergence of new substances, it requires a constant update of the list of controlled drugs. Little is known about how these substances work and their toxic effects in humans and the same product could vary not only in the amount and in the type of substance added. In the last years, synthetic cannabinoids have been associated with deaths and acute intoxications in Europe and, despite a range of new measures introduced in this area, continue to represent a challenge to current drug policy models. These synthetic substances are much more potent than natural cannabis, as well as displayed greater efficacy, acting as full agonists at the cannabinoid receptors. It is possible that, along with being highly potent, some may also have long half-lives, potentially leading to a prolonged psychoactive effect. The present work provides a review on existing literature about the development of synthetic cannabinoids as substances of abuse, current patterns of abuse and their legal status, chemical classification, and some pharmacological and toxicological properties.
Collapse
Affiliation(s)
- Vera L Alves
- CQM - Centro de Química da Madeira, Universidade da Madeira, Funchal, Portugal
| | - João L Gonçalves
- CQM - Centro de Química da Madeira, Universidade da Madeira, Funchal, Portugal
| | - Joselin Aguiar
- CQM - Centro de Química da Madeira, Universidade da Madeira, Funchal, Portugal
| | - Helena M Teixeira
- Faculdade de Medicina da Universidade de Coimbra, Azinhaga de Santa Comba, Coimbra, Portugal.,Instituto Nacional de Medicina Legal e Ciências Forenses, Coimbra, Portugal
| | - José S Câmara
- CQM - Centro de Química da Madeira, Universidade da Madeira, Funchal, Portugal.,Faculdade de Ciências Exactas e da Engenharia, Universidade da Madeira, Funchal, Portugal
| |
Collapse
|
7
|
Investigation on the consumption of synthetic cannabinoids among teenagers by the analysis of herbal blends and urine samples. J Pharm Biomed Anal 2020; 186:113298. [PMID: 32325401 DOI: 10.1016/j.jpba.2020.113298] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 03/30/2020] [Accepted: 04/02/2020] [Indexed: 01/02/2023]
Abstract
The use of synthetic cannabinoids (SCs), which escape conventional detection systems, may be a good alternative to elude routine drug analysis for cannabis. The detection of these drugs in urine is unusual due to their complete and fast metabolism, therefore requiring alternative strategies. In this work, an investigation has been made on SCs consumption by minors (less than 18 years old) in juvenile offenders' centres. 667 urine samples (from 127 minors) were collected after their permits with stay at home. We also studied the SCs from 7 herbal blends available at the smartshop frequented by the minors. Both, urine and herbal blends, were analysed by liquid chromatography coupled to high resolution mass spectrometry. The analysis of urine confirmed the absence of more than 200 SCs investigated. Thus, the focus was made on metabolites reported for those SCs identified in the herbal blends collected from the smart-shop. The major metabolites of XLR-11 and UR-144 (N-pentanoic acid and N-(5-hydroxypentyl)) were found in several urine samples. Apart from the main metabolites included in the initial searching, a thorough investigation of more metabolites for these SCs was additionally performed, including MS/MS experiments for the tentative identification of compounds detected in the urine samples. The 16 samples positive to the XLR-11 metabolites were assigned to 6 minors, only 2 of which had recognized consumption. On the basis of the results obtained, preventive and therapeutic interventions must be implemented to reduce the consumption of psychoactive substances and to improve the risk-perception of these substances by minors.
Collapse
|
8
|
AL-Eitan LN, Asa’ad AS, Battah AH, Aljamal HA. Application of Gas Chromatography-Mass Spectrometry for the Identification and Quantitation of Three Common Synthetic Cannabinoids in Seized Materials from the Jordanian Market. ACS OMEGA 2020; 5:4172-4180. [PMID: 32149247 PMCID: PMC7057677 DOI: 10.1021/acsomega.9b03881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 02/12/2020] [Indexed: 06/10/2023]
Abstract
Synthetic cannabinoids (SCs) were developed to mimic the effects of Δ9-tetrahydrocannabinol on humans. SCs were distributed in the form of herbal blends, with smoking being the main method of consumption. These synthetic compounds have a wide range of physical, behavioral, and harmful effects on the body. However, this study aimed to identify and quantify three common SCs including AB-FUBINACA, AB-CHMINACA, and XLR-11 in the seized materials from the Jordanian market by gas chromatography coupled with mass spectrometry (GC-MS). A liquid-liquid extraction sample preparation technique was applied to 100 different seized samples obtained from the Anti-Narcotics Department of Public Security in a period between 2017 and 2018. Profiling of the seized samples revealed different distributions of the targeted SCs in the obtained samples. Upon quantitation, concentrations of these SCs varied greatly within and among the samples. The use of GC-MS analysis provided a powerful technique in the detection and identification of SCs. This study revealed the current and trends of SC use in the Jordanian illicit substance market, which was previously unclear. Future studies are required to explore new SCs and their influence in different biological samples.
Collapse
Affiliation(s)
- Laith N. AL-Eitan
- Department
of Applied Biological Sciences, Jordan University
of Science and Technology, Irbid 22110, Jordan
- Department
of Biotechnology and Genetic Engineering, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Abdelqader S. Asa’ad
- Department
of Legal Medicine, Toxicology and Forensic Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
- Drug
and Alcohol Analysis Department, Forensic Science Laboratories, Public Security Directorate, Amman 11942, Jordan
| | - AbdelKader H. Battah
- Department
of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Hanan A. Aljamal
- Department
of Applied Biological Sciences, Jordan University
of Science and Technology, Irbid 22110, Jordan
| |
Collapse
|
9
|
Gaunitz F, Kieliba T, Thevis M, Mercer‐Chalmers‐Bender K. Solid‐phase extraction–liquid chromatography–tandem mass spectrometry method for the qualitative analysis of 61 synthetic cannabinoid metabolites in urine. Drug Test Anal 2019; 12:27-40. [DOI: 10.1002/dta.2680] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 08/03/2019] [Accepted: 08/05/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Franziska Gaunitz
- Institute of Legal Medicine, Faculty of Medicine University of Cologne Cologne Germany
| | - Tobias Kieliba
- Institute of Legal Medicine, Faculty of Medicine University of Cologne Cologne Germany
| | - Mario Thevis
- Institute of Biochemistry, German Sport University Cologne Cologne Germany
| | - Katja Mercer‐Chalmers‐Bender
- Institute of Legal Medicine, Faculty of Medicine University of Cologne Cologne Germany
- Health Department Basel‐Stadt Institute of Forensic Medicine, University of Basel Switzerland, Basel Switzerland
| |
Collapse
|
10
|
Fabregat-Safont D, Mardal M, Noble C, Cannaert A, Stove CP, Sancho JV, Linnet K, Hernández F, Ibáñez M. Comprehensive investigation on synthetic cannabinoids: Metabolic behavior and potency testing, using 5F-APP-PICA and AMB-FUBINACA as model compounds. Drug Test Anal 2019; 11:1358-1368. [PMID: 31192526 DOI: 10.1002/dta.2659] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 06/04/2019] [Accepted: 06/04/2019] [Indexed: 12/30/2022]
Abstract
Synthetic cannabinoids (SCs) represented 45% of new psychoactive substances seizures in Europe (data from 2016). The consumption of SCs is an issue of concern due to their still unknown toxicity and effects on human health, the great variety of compounds synthetized, and the continuous modifications being made to their chemical structure to avoid regulatory issues. These compounds are extensively metabolized in the organism and often cannot be detected as the intact molecule in human urine. The monitoring of SCs in forensic samples must be performed by the analysis of their metabolites. In this work, a workflow for the comprehensive study of SC consumption is proposed and applied to 5F-APP-PICA (also known as PX 1 or SRF-30) and AMB-FUBINACA (also known as FUB-AMB or MMB-FUBINACA), based not only on the elucidation of their metabolites but also including functional data using the NanoLuc approach, previously published. Both cannabinoids were completely metabolized by human hepatocytes (12 and 8 metabolites were elucidated by high resolution mass spectrometry for 5F-APP-PICA and AMB-FUBINACA, respectively) and therefore suitable consumption markers are proposed. The bioassays revealed that 5F-APP-PICA presented lower activity than AMB-FUBINACA at CB1 and CB2 receptors, based on the half maximal effective concentration (EC50 ) and the maximum response (Emax ). These results are in agreement with the different intoxication cases found in the literature for AMB-FUBINACA.
Collapse
Affiliation(s)
| | - Marie Mardal
- Department of Forensic Medicine, Section of Forensic Chemistry, Faculty of Health and Medicinal Sciences, University of Copenhagen, Denmark
| | - Carolina Noble
- Department of Forensic Medicine, Section of Forensic Chemistry, Faculty of Health and Medicinal Sciences, University of Copenhagen, Denmark
| | - Annelies Cannaert
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Christophe P Stove
- Laboratory of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Juan V Sancho
- Research Institute for Pesticides and Water, University Jaume I, Castellón, Spain
| | - Kristian Linnet
- Department of Forensic Medicine, Section of Forensic Chemistry, Faculty of Health and Medicinal Sciences, University of Copenhagen, Denmark
| | - Félix Hernández
- Research Institute for Pesticides and Water, University Jaume I, Castellón, Spain
| | - María Ibáñez
- Research Institute for Pesticides and Water, University Jaume I, Castellón, Spain
| |
Collapse
|
11
|
Grigoryev A, Kavanagh P, Labutin A, Pechnikov A, Dowling G, Shevyrin V, Krupina N. Tentative identification of the metabolites of (1-(cyclohexylmethyl)-1H-indol-3-yl)-(2,2,3,3-tetramethylcyclopropyl)methanone, and the product of its thermal degradation, by in vitro and in vivo methods. Drug Test Anal 2019; 11:1387-1402. [PMID: 31243890 DOI: 10.1002/dta.2668] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/17/2019] [Accepted: 06/18/2019] [Indexed: 11/06/2022]
Abstract
Synthetic cannabinoids (SCs), mimicking the psychoactive effects of cannabis, consist of a vast array of structurally diverse compounds. A novel compound belonging to the SC family, (1-(cyclohexylmethyl)-1H-indol-3-yl)-(2,2,3,3-tetramethylcyclopropyl)methanone (named TMCP-CHM in this article) contains a cyclopropane ring that isomerizes during the smoking process, resulting in a ring-opened thermal degradant with a terminal double bond in its structure. Metabolites of TMCP-CHM were tentatively identified in vitro (after incubation of the parent substance with S9 pooled human liver fraction) and in vivo (rat experimental model) studies by accurate-mass liquid chromatography-tandem mass spectrometry (LC-MS/MS). For the identification of the degradant metabolites, and to study biotransformation of parent substance in the human, urine and hair samples from patients, who had ingested the compound and were subsequently admitted to hospital with drug intoxications, were analyzed. Products of mono-, di-, trihydroxylation, carboxylation, and carboxylation combined with hydroxylation of TMCP-CHM and its degradant were detected in human urine. Metabolism of the degradant included addition of water to the terminal double bond followed by dehydration and formation of a cyclic metabolite. Degradant metabolites prevailed in comparison with metabolites of the parent substance in each metabolite group examined, except carboxylation. N-Dealkylated metabolites found in human urine originated only from the degradant. Most of the hydroxy metabolites were detected in human urine in both the free form and as glucuronides. The detection of monohydroxylated (M1.1-M1.3, M/A1.10) and carboxylated/hydroxylated (M4.2, M/A4.3) metabolites of TMCP-CHM and the hydrated form of the monohydroxylated metabolite of the degradant was found to be convenient for routine analysis.
Collapse
Affiliation(s)
- Andrej Grigoryev
- Forensic-Chemical Division, Bureau of Forensic-Medical Expertise's, Moscow, Russia
| | - Pierce Kavanagh
- Department of Pharmacology and Therapeutics, School of Medicine, Trinity Centre for Health Sciences, Saint James's Hospital, Dublin, Ireland
| | | | | | - Geraldine Dowling
- Department of Pharmacology and Therapeutics, School of Medicine, Trinity Centre for Health Sciences, Saint James's Hospital, Dublin, Ireland.,School of Science, Institute of Technology Sligo, Sligo, Ireland
| | - Vadim Shevyrin
- Ural Federal University, Institute of Chemistry and Technology, Ekaterinburg, Russia
| | - Natalia Krupina
- Forensic-Chemical Division, Bureau of Forensic-Medical Expertise's, Moscow, Russia
| |
Collapse
|
12
|
A review on the abuse of three NPS (synthetic cannabinoids, kratom, poppers) among youths in Asia. Forensic Sci Int 2018; 292:45-49. [DOI: 10.1016/j.forsciint.2018.09.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 09/06/2018] [Accepted: 09/10/2018] [Indexed: 01/24/2023]
|
13
|
Vervliet P, Mortelé O, Gys C, Degreef M, Lanckmans K, Maudens K, Covaci A, van Nuijs ALN, Lai FY. Suspect and non-target screening workflows to investigate the in vitro and in vivo metabolism of the synthetic cannabinoid 5Cl-THJ-018. Drug Test Anal 2018; 11:479-491. [PMID: 30242979 DOI: 10.1002/dta.2508] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/13/2018] [Accepted: 09/14/2018] [Indexed: 02/06/2023]
Abstract
The use of synthetic cannabinoids causes similar effects as Δ9 -tetrahydrocannabinol and long-term (ab)use can lead to health hazards and fatal intoxications. As most investigated synthetic cannabinoids undergo extensive biotransformation, almost no parent compound can be detected in urine, which hampers forensic investigations. Limited information about the biotransformation products of new synthetic cannabinoids makes the detection of these drugs in various biological matrices challenging. This study aimed to identify the main in vitro biotransformation pathways of 5Cl-THJ-018 and to compare these findings with an authentic urine sample of a 5Cl-THJ-018 user. The synthetic cannabinoid was incubated with pooled human liver microsomes and cytosol to simulate phase I and phase II biotransformations. Resulting extracts were analyzed with liquid chromatography coupled to quadrupole time-of-flight mass spectrometry (LC-QTOF-MS). Three different data analysis workflows were applied to identify biotransformation products. A suspect screening workflow used an in-house database built from literature data and in silico biotransformation predictions. Two non-target screening workflows used a commercially available software and an open-source software for mass spectrometry data processing. A total of 23 in vitro biotransformation products were identified, with hydroxylation, oxidative dechlorination, and dihydrodiol formation pathways as the main phase I reactions. Additionally, five glucuronidated and three sulfated phase II conjugates were identified. The predominant in vivo pathway was through oxidative dechlorination and in total six metabolites of 5Cl-THJ-018 were identified. Biotransformation products both in vitro and in vivo were successfully identified using complementary suspect and non-target screening workflows.
Collapse
Affiliation(s)
| | - Olivier Mortelé
- Toxicological Centre, University of Antwerp, Antwerp, Belgium
| | - Celine Gys
- Toxicological Centre, University of Antwerp, Antwerp, Belgium
| | - Maarten Degreef
- Toxicological Centre, University of Antwerp, Antwerp, Belgium
| | | | - Kristof Maudens
- Toxicological Centre, University of Antwerp, Antwerp, Belgium
| | - Adrian Covaci
- Toxicological Centre, University of Antwerp, Antwerp, Belgium
| | | | - Foon Yin Lai
- Toxicological Centre, University of Antwerp, Antwerp, Belgium
| |
Collapse
|
14
|
Synthetic cannabinoids are substrates and inhibitors of multiple drug-metabolizing enzymes. Arch Pharm Res 2018; 41:691-710. [PMID: 30039377 DOI: 10.1007/s12272-018-1055-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Accepted: 07/11/2018] [Indexed: 01/06/2023]
Abstract
Synthetic cannabinoids, a new class of psychoactive substances, are potent agonists of cannabinoid receptors, which mimic the psychoactive effects of the principal psychoactive component of cannabis, ∆9-tetrahydrocannabinol. Despite governmental scheduling as illicit drugs, new synthetic cannabinoids are being produced. The abuse of synthetic cannabinoids with several drugs containing different chemical groups has resulted in large numbers of poisonings. This has increased the urgency for forensic and public health laboratories to identify the metabolites of synthetic cannabinoids and apply this knowledge to the development of analytical methods and for toxicity prediction. It is necessary to determine whether synthetic cannabinoids are involved in drug-metabolizing enzyme-mediated drug-drug interactions. This review describes the metabolic pathways of 13 prevalent synthetic cannabinoids and various drug-metabolizing enzymes responsible for their metabolism, including cytochrome P450 (CYP), UDP-glucuronosyltransferases (UGTs), and carboxylesterases. The inhibitory effects of synthetic cannabinoids on CYP and UGT activities are also reviewed to predict the potential of synthetic cannabinoids for drug-drug interactions. The drug-metabolizing enzymes responsible for metabolism of synthetic cannabinoids should be characterized and the effects of synthetic cannabinoids on CYP and UGT activities should be determined to predict the pharmacokinetics of synthetic cannabinoids and synthetic cannabinoid-induced drug-drug interactions in the clinic.
Collapse
|
15
|
Cannaert A, Franz F, Auwärter V, Stove CP. Activity-Based Detection of Consumption of Synthetic Cannabinoids in Authentic Urine Samples Using a Stable Cannabinoid Reporter System. Anal Chem 2017; 89:9527-9536. [DOI: 10.1021/acs.analchem.7b02552] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Annelies Cannaert
- Laboratory
of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical
Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| | - Florian Franz
- Institute
of Forensic Medicine, Forensic Toxicology, Medical Center—University
of Freiburg, Faculty of Medicine, University of Freiburg, Albertstrasse
9, 79104 Freiburg, Germany
| | - Volker Auwärter
- Institute
of Forensic Medicine, Forensic Toxicology, Medical Center—University
of Freiburg, Faculty of Medicine, University of Freiburg, Albertstrasse
9, 79104 Freiburg, Germany
| | - Christophe P. Stove
- Laboratory
of Toxicology, Department of Bioanalysis, Faculty of Pharmaceutical
Sciences, Ghent University, Ottergemsesteenweg 460, 9000 Ghent, Belgium
| |
Collapse
|
16
|
Carlier J, Diao X, Wohlfarth A, Scheidweiler K, Huestis MA. In Vitro Metabolite Profiling of ADB-FUBINACA, A New Synthetic Cannabinoid. Curr Neuropharmacol 2017; 15:682-691. [PMID: 29403341 PMCID: PMC5771045 DOI: 10.2174/1570159x15666161108123419] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 04/26/2016] [Accepted: 10/07/2016] [Indexed: 11/29/2022] Open
Abstract
Metabolite profiling of novel psychoactive substances (NPS) is critical for documenting drug consumption. N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1-(4-fluorobenzyl)-1H-indazole-3-carboxamide (ADB-FUBINACA) is an emerging synthetic cannabinoid whose toxicological and metabolic data are currently unavailable. We aimed to determine optimal markers for identifying ADB-FUBINACA intake. Metabolic stability was evaluated with human liver microsome incubations. Metabolites were identified after 1 and 3 h incubation with pooled human hepatocytes, liquid chromatography- high resolution mass spectrometry in positive-ion mode (5600+ TripleTOF®, Sciex) and several data mining approaches (MetabolitePilot™, Sciex). Metabolite separation was achieved on an Ultra Biphenyl column (Restek®); full-scan TOF-MS and information-dependent acquisition MS/MS data were acquired. ADB-FUBINACA microsomal half-life was 39.7 min, with a predicted hepatic clearance of 9.0 mL/min/kg and a 0.5 extraction ratio (intermediate-clearance drug). Twenty-three metabolites were identified. Major metabolic pathways were alkyl and indazole hydroxylation, terminal amide hydrolysis, subsequent glucuronide conjugations, and dehydrogenation. We recommend ADB-FUBINACA hydroxyalkyl, hydroxydehydroalkyl and hydroxylindazole metabolites as ADB-FUBINACA intake markers. N-dealkylated metabolites are not specific ADB-FUBINACA metabolites and should not be used as definitive markers of consumption. This is the first ADB-FUBINACA in vitro metabolism study; in vivo experiments enabling pharmacokinetic and pharmacodynamics studies or urine from authentic clinical/forensic cases are needed to confirm our results.
Collapse
Affiliation(s)
- Jeremy Carlier
- Chemistry and Drug Metabolism Section, Clinical Pharmacology and Therapeutics Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Blvd, Suite 200 Room 05A727, Baltimore, MD 21224, USA
| | - Xingxing Diao
- Chemistry and Drug Metabolism Section, Clinical Pharmacology and Therapeutics Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Blvd, Suite 200 Room 05A727, Baltimore, MD 21224, USA
| | - Ariane Wohlfarth
- Chemistry and Drug Metabolism Section, Clinical Pharmacology and Therapeutics Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Blvd, Suite 200 Room 05A727, Baltimore, MD 21224, USA
- National Board of Forensic Medicine, Linköping, Sweden. Division of Drug Research, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Karl Scheidweiler
- Chemistry and Drug Metabolism Section, Clinical Pharmacology and Therapeutics Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Blvd, Suite 200 Room 05A727, Baltimore, MD 21224, USA
| | - Marilyn A. Huestis
- Chemistry and Drug Metabolism Section, Clinical Pharmacology and Therapeutics Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, 251 Bayview Blvd, Suite 200 Room 05A727, Baltimore, MD 21224, USA
- University of Maryland School of Medicine, Baltimore, MD 21224, USA
| |
Collapse
|
17
|
Carlier J, Diao X, Scheidweiler KB, Huestis MA. Distinguishing Intake of New Synthetic Cannabinoids ADB-PINACA and 5F-ADB-PINACA with Human Hepatocyte Metabolites and High-Resolution Mass Spectrometry. Clin Chem 2017; 63:1008-1021. [DOI: 10.1373/clinchem.2016.267575] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 12/21/2016] [Indexed: 02/01/2023]
Abstract
Abstract
BACKGROUND
ADB-PINACA and its 5-fluoropentyl analog 5F-ADB-PINACA are among the most potent synthetic cannabinoids tested to date, with several severe intoxication cases. ADB-PINACA and 5F-ADB-PINACA have a different legal status, depending on the country. Synthetic cannabinoid metabolites predominate in urine, making detection of specific metabolites the most reliable way for proving intake in clinical and forensic specimens. However, there are currently no data on ADB-PINACA and 5F-PINACA metabolism. The substitution of a single fluorine atom distinguishes the 2 molecules, which may share common major metabolites. For some legal applications, distinguishing between ADB-PINACA and 5F-PINACA intake is critical. For this reason, we determined the human metabolic fate of the 2 analogs.
METHODS
ADB-PINACA and 5F-PINACA were incubated for 3 h with pooled cryopreserved human hepatocytes, followed by liquid chromatography—high-resolution mass spectrometry analysis. Data were processed with Compound Discoverer.
RESULTS
We identified 19 and 12 major ADB-PINACA and 5F-ADB-PINACA metabolites, respectively. Major metabolic reactions included pentyl hydroxylation, hydroxylation followed by oxidation (ketone formation), and glucuronidation of ADB-PINACA, and oxidative defluorination followed by carboxylation of 5F-ADB-PINACA.
CONCLUSIONS
We recommend ADB-PINACA ketopentyl and hydroxypentyl, and ADB-PINACA 5-hydroxypentyl and pentanoic acid, as optimal markers for ADB-PINACA and 5F-ADB-PINACA intake, respectively. Since the 2 compounds present positional isomers as the primary metabolites, monitoring unique product ions and optimized chromatographic conditions are required for a clear distinction between ADB-PINACA and 5F-ADB-PINACA intake.
Collapse
Affiliation(s)
- Jeremy Carlier
- Chemistry & Drug Metabolism Section, Clinical Pharmacology & Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD
| | - Xingxing Diao
- Chemistry & Drug Metabolism Section, Clinical Pharmacology & Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD
| | - Karl B Scheidweiler
- Chemistry & Drug Metabolism Section, Clinical Pharmacology & Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD
| | - Marilyn A Huestis
- Chemistry & Drug Metabolism Section, Clinical Pharmacology & Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD
- School of Medicine, University of Maryland, Baltimore, MD
| |
Collapse
|
18
|
Watanabe S, Kuzhiumparambil U, Nguyen MA, Cameron J, Fu S. Metabolic Profile of Synthetic Cannabinoids 5F-PB-22, PB-22, XLR-11 and UR-144 by Cunninghamella elegans. AAPS JOURNAL 2017; 19:1148-1162. [DOI: 10.1208/s12248-017-0078-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 03/15/2017] [Indexed: 11/30/2022]
|
19
|
Carlier J, Diao X, Sempio C, Huestis MA. Identification of New Synthetic Cannabinoid ADB-CHMINACA (MAB-CHMINACA) Metabolites in Human Hepatocytes. AAPS JOURNAL 2017; 19:568-577. [DOI: 10.1208/s12248-016-0037-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 12/23/2016] [Indexed: 11/30/2022]
|
20
|
New psychoactive substances: an overview on recent publications on their toxicodynamics and toxicokinetics. Arch Toxicol 2016; 90:2421-44. [PMID: 27665567 DOI: 10.1007/s00204-016-1812-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 08/04/2016] [Indexed: 02/07/2023]
Abstract
This review article covers English-written and PubMed-listed review articles and original studies published between January 2015 and April 2016 dealing with the toxicodynamics and toxicokinetics of new psychoactive substances. Compounds covered include stimulants and entactogens, synthetic cannabinoids, tryptamines, NBOMes, phencyclidine-like drugs, benzodiazepines, and opioids. First, an overview and discussion is provided on timely review articles followed by an overview and discussion on recent original studies. Both sections are then concluded by an opinion on these latest developments. This review shows that the NPS market is still highly dynamic and that the data published on their toxicodynamics and toxicokinetics can hardly keep pace with the appearance of new entities. However, data available are very helpful to understand and predict how NPS may behave in severe intoxication. The currently best-documented parameter is the in vitro metabolism of NPS, a prerequisite to allow detection of NPS in biological matrices in cases of acute intoxications or chronic consumption. However, additional data such as their chronic toxicity are still lacking.
Collapse
|
21
|
Schaefer N, Helfer AG, Kettner M, Laschke MW, Schlote J, Ewald AH, Meyer MR, Menger MD, Maurer HH, Schmidt PH. Metabolic patterns of JWH-210, RCS-4, and THC in pig urine elucidated using LC-HR-MS/MS: Do they reflect patterns in humans? Drug Test Anal 2016; 9:613-625. [DOI: 10.1002/dta.1995] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 04/19/2016] [Accepted: 04/19/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Nadine Schaefer
- Institute of Legal Medicine; Saarland University; Building 80.2 D-66421 Homburg (Saar) Germany
| | - Andreas G. Helfer
- Department of Experimental and Clinical Toxicology; Saarland University; Building 46 D-66421 Homburg (Saar) Germany
| | - Mattias Kettner
- Institute of Legal Medicine; Saarland University; Building 80.2 D-66421 Homburg (Saar) Germany
| | - Matthias W. Laschke
- Institute for Clinical & Experimental Surgery; Saarland University; Building 65/66 D-66421 Homburg (Saar) Germany
| | - Julia Schlote
- Institute of Legal Medicine; Saarland University; Building 80.2 D-66421 Homburg (Saar) Germany
| | - Andreas H. Ewald
- Institute of Legal Medicine; Saarland University; Building 80.2 D-66421 Homburg (Saar) Germany
| | - Markus R. Meyer
- Department of Experimental and Clinical Toxicology; Saarland University; Building 46 D-66421 Homburg (Saar) Germany
- Department of Clinical Pharmacology and Pharmacoepidemiology; Heidelberg University Hospital; Im Neuenheimer Feld 410 D-69120 Heidelberg Germany
| | - Michael D. Menger
- Institute for Clinical & Experimental Surgery; Saarland University; Building 65/66 D-66421 Homburg (Saar) Germany
| | - Hans H. Maurer
- Department of Experimental and Clinical Toxicology; Saarland University; Building 46 D-66421 Homburg (Saar) Germany
| | - Peter H. Schmidt
- Institute of Legal Medicine; Saarland University; Building 80.2 D-66421 Homburg (Saar) Germany
| |
Collapse
|