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Pelletier R, Gicquel T, Carvelli J, Balaz P, Pelissier-Alicot AL, Morel I, Bottinelli C, Solas C, Le Daré B, Fabresse N. Severe 25E-NBOH intoxication associated with MDPHP intake: a case report, metabolism study, and literature review. Int J Legal Med 2024; 138:815-822. [PMID: 38117418 DOI: 10.1007/s00414-023-03151-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/06/2023] [Indexed: 12/21/2023]
Abstract
N-Benzylphenethylamine derivatives are 5-HT2A receptor agonists with hallucinogenic properties, including NBOMe (N-(2-methoxybenzyl)-2-(3,4,5-trimethoxyphenyl)ethan-1-amine) and NBOH (2-(((2,5-dimethoxyphenethyl)amino)methyl)phenol). We reported here the case of a 23-year-old man who presented a serotoninergic syndrome and a loss of consciousness following the consumption of a powder labelled as 25I-NBOH. Toxicological analyses of biological samples were carried out using a liquid chromatography high-resolution mass spectrometry. Two new psychoactive substances were identified and confirmed with certified reference materials: 25E-NBOH (2-(((4-ethyl-2,5-dimethoxyphenethyl)amino)methyl)phenol) and MDPHP (1-(benzo[d][1,3]dioxol-5-yl)-2-(pyrrolidin-1-yl)hexan-1-one). Pharmaceuticals administered to the patient during his medical care were found in plasma and urine. 25E-NBOH and MDPHP concentrations were respectively at 2.3 ng/mL and 3.4 ng/mL in plasma, and 25.7 ng/mL and 30.5 ng/mL in urine. 25I-NBOH (2-(((4-iodo-2,5-dimethoxyphenethyl)amino)methyl)phenol) was specifically searched in both samples and was not detected. These results are discussed along with a literature review on human cases of exposure to N-benzylphenethylamine derivatives. Using molecular networking approach, we propose the first 25E-NBOH metabolism study using authentic biological samples (plasma and urine). We described seven metabolites (M1 to M7), including two phase I (m/z 330.172; m/z 288.160) and five phase II metabolites (m/z 464.191, m/z 478.207, m/z 492.223, m/z 508.218; m/z 396.156). The M6 (m/z 492.223) was the most intense ion detected in plasma and urine and could be proposed as a relevant 25E-NBOH consumption marker. Overall, we described an original case of 25E-NBOH poisoning and identified metabolites that could potentially be used as consumption markers to detect 25E-NBOH intoxications with a higher confidence level and probably a longer detection window.
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Affiliation(s)
- Romain Pelletier
- INSERM, INRAE, CHU Rennes, Institut NuMeCan (Nutrition, Metabolism and Cancer), PREVITOX Network, F-35033, Rennes, France.
- Rennes University Hospital, Clinical and Forensic Toxicology Laboratory, F-35033, Rennes, France.
| | - Thomas Gicquel
- INSERM, INRAE, CHU Rennes, Institut NuMeCan (Nutrition, Metabolism and Cancer), PREVITOX Network, F-35033, Rennes, France
- Rennes University Hospital, Clinical and Forensic Toxicology Laboratory, F-35033, Rennes, France
| | - Julien Carvelli
- AP-HM, DepaICMrtment of Intensive Care, Réanimation des Urgences, Medicine Intensive & Reanimation, Timone University Hospital, Marseille, France
| | - Pierre Balaz
- Bataillon des Marins Pompiers, Groupement Santé, Service Médical d'Urgence, 9 Boulevard de Strasbourg, 13233, Marseille Cedex 20, France
| | - Anne-Laure Pelissier-Alicot
- Aix Marseille Univ, APHM, INSERM, INMED UMR 901, La Timone University Hospital, Legal Medicine Department, 13005, Marseille, France
| | - Isabelle Morel
- INSERM, INRAE, CHU Rennes, Institut NuMeCan (Nutrition, Metabolism and Cancer), PREVITOX Network, F-35033, Rennes, France
- Rennes University Hospital, Clinical and Forensic Toxicology Laboratory, F-35033, Rennes, France
| | | | - Caroline Solas
- Laboratory of Pharmacokinetics and Toxicology, La Timone University Hospital, 264 rue Saint Pierre, 13385, Marseille Cedex 5, France
| | - Brendan Le Daré
- INSERM, INRAE, CHU Rennes, Institut NuMeCan (Nutrition, Metabolism and Cancer), PREVITOX Network, F-35033, Rennes, France
- Rennes University Hospital, Pharmacy department, F-35033, Rennes, France
| | - Nicolas Fabresse
- Laboratory of Pharmacokinetics and Toxicology, La Timone University Hospital, 264 rue Saint Pierre, 13385, Marseille Cedex 5, France
- Aix Marseille University, INSERM, IRD, SESSTIM, Economic and Social Sciences of Health and Medical Information Processing, Marseille, France
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Arillotta D, Totti A, Dimitrova A, Croce EB, Di Milia MG, Gambassi F, Gualco B, Pieraccini G, Mannaioni G, Vaiano F. Clinical manifestations and analytical reports for MDPHP acute intoxication cases. J Pharm Biomed Anal 2024; 241:115974. [PMID: 38277706 DOI: 10.1016/j.jpba.2024.115974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 01/28/2024]
Abstract
MDPHP is a synthetic cathinone (SC) belonging to α-pyrrolidinophenone derivatives. It is a central nervous system stimulant and may induce hallucinations, paranoia, tachycardia, hypertension, chest pain, and rhabdomyolysis. In literature, a few cases of intoxication have been reported. In the present study, 17 cases of MDPHP intake were described including the analytical findings and clinical manifestations. MDPHP was quantified by liquid chromatography-tandem mass spectrometry in blood (range 1.26-73.30 ng/mL) and urine (range 19.31-8769.64 ng/mL) samples. In three cases the presence of α-PHP was observed. In one case, MDPHP was the only detected substance. Concomitant use of MDPHP with other substances, particularly psychostimulants, was common and it was difficult to describe the peculiar clinical characteristics of this SC. Most of the symptoms overlapped those expected, some of them were unusual and all of them particularly severe thus inducing the research of NPS in laboratory tests. We demonstrated the presence of psychiatric, neurological, and respiratory symptoms, as well as the possible presence of rhabdomyolysis and cardiotoxicity associated with the use of MDPHP. ED admissions were also more frequent in patients with addiction problems. In some cases, MDPHP intake required intensive supportive care. A multidisciplinary approach, including specialist consultation, is recommended for patients showing challenging features. Moreover, we demonstrated that the adoption of advanced analytical techniques, i.e., liquid chromatography-tandem mass spectrometry, is necessary to detect these molecules. Further studies are needed to understand MDPHP intake patterns and associated symptoms. It is essential to raise awareness in addiction treatment centers and among potential users, especially young people, and chemsex addicted.
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Affiliation(s)
- Davide Arillotta
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Florence, Italy
| | - Arianna Totti
- Toxicology Unit, Poison Control Center, Careggi University Hospital, Florence, Italy
| | - Alexandra Dimitrova
- FT-LAB Forensic Toxicology Laboratory, Department of Health Science, University of Florence, Florence, Italy
| | - Emma B Croce
- FT-LAB Forensic Toxicology Laboratory, Department of Health Science, University of Florence, Florence, Italy
| | - Maria Grazia Di Milia
- FT-LAB Forensic Toxicology Laboratory, Department of Health Science, University of Florence, Florence, Italy
| | - Francesco Gambassi
- Toxicology Unit, Poison Control Center, Careggi University Hospital, Florence, Italy
| | - Barbara Gualco
- Department of Health Science, University of Florence, Florence, Italy
| | | | - Guido Mannaioni
- Toxicology Unit, Poison Control Center, Careggi University Hospital, Florence, Italy
| | - Fabio Vaiano
- FT-LAB Forensic Toxicology Laboratory, Department of Health Science, University of Florence, Florence, Italy.
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Brueckner I, Welter-Luedeke J, Zangl A, Graw M, Paul LD. α-Pyrrolidinohexanophenone (α-PHP) vs. α-pyrrolidinoisohexanophenone (α-PiHP): A toxicological investigation about plasma concentrations and behavior in forensic routine cases. J Anal Toxicol 2024:bkae011. [PMID: 38491987 DOI: 10.1093/jat/bkae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/10/2023] [Accepted: 02/13/2024] [Indexed: 03/18/2024] Open
Abstract
New psychoactive substances (NPS), like pyrrolidinophenones, are still very present on the illegal drug market. The presented study reports on two members of this substance group, α-pyrrolidinohexanophenone (α-PHP) and α-pyrrolidinoisohexanophenone (α-PiHP), which occurred in forensic routine cases in the last 6 years. α-PHP could be detected predominantly by a validated liquid chromatography-tandem mass spectrometry (LC-MS-MS) method in 33 authentic human plasma samples and α-PiHP in 8. α-PHP concentrations ranged from ca. 0.75 to 128 µg/L (mean: 23.2, median: 16.3) and α-PiHP concentrations from 7.33 to 118 µg/L (mean: 44.7, median: 33.7, quantified via α-PHP). Individuals were predominantly male and middle aged. As different studies have shown, some pyrrolidinophenones are able to cause aggressive behavior. Therefore, we set out to investigate the relation of α-PHP and α-PiHP plasma concentrations and the behavior of the consumers, reported by police and medical experts. Part of the subjects showed aggressive behavior, including agitation and restlessness. Lethargic and unremarkable behavior might be explained by co-consumption of other drugs, such as opiates/opioids, benzodiazepines, pregabalin or alcohol as well as by drug tolerance and subacute effects of stimulants. Multi-drug use could be detected in all cases; also stimulating substances and multiple different pyrrolidinophenones were determined. Nevertheless, users of α-PHP and α-PiHP showed a tendency to act aggressively, possibly triggered by a high selectivity for dopamine transporter inhibition. In accordance, committed offenses were often violent crimes. This might be considered in terms of toxicological assessment of criminal responsibility and driving ability.
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Affiliation(s)
- Isabel Brueckner
- Department of Forensic Toxicology, Institute of Legal Medicine, Faculty of Medicine, Ludwig-Maximilians-Universität in Munich, Nussbaumstraße 26, Munich 80336, Germany
| | - Jessica Welter-Luedeke
- Department of Forensic Toxicology, Institute of Legal Medicine, Faculty of Medicine, Ludwig-Maximilians-Universität in Munich, Nussbaumstraße 26, Munich 80336, Germany
| | - Anna Zangl
- Department of Forensic Toxicology, Institute of Legal Medicine, Faculty of Medicine, Ludwig-Maximilians-Universität in Munich, Nussbaumstraße 26, Munich 80336, Germany
| | - Matthias Graw
- Department of Forensic Toxicology, Institute of Legal Medicine, Faculty of Medicine, Ludwig-Maximilians-Universität in Munich, Nussbaumstraße 26, Munich 80336, Germany
| | - Liane D Paul
- Department of Forensic Toxicology, Institute of Legal Medicine, Faculty of Medicine, Ludwig-Maximilians-Universität in Munich, Nussbaumstraße 26, Munich 80336, Germany
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4
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Daziani G, Lo Faro AF, Montana V, Goteri G, Pesaresi M, Bambagiotti G, Montanari E, Giorgetti R, Montana A. Synthetic Cathinones and Neurotoxicity Risks: A Systematic Review. Int J Mol Sci 2023; 24:ijms24076230. [PMID: 37047201 PMCID: PMC10093970 DOI: 10.3390/ijms24076230] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
According to the EU Early Warning System (EWS), synthetic cathinones (SCs) are the second largest new psychoactive substances (NPS) class, with 162 synthetic cathinones monitored by the EU EWS. They have a similar structure to cathinone, principally found in Catha Edulis; they have a phenethylamine related structure but also exhibit amphetamine-like stimulant effects. Illegal laboratories regularly develop new substances and place them on the market. For this reason, during the last decade this class of substances has presented a great challenge for public health and forensic toxicologists. Acting on different systems and with various mechanisms of action, the spectrum of side effects caused by the intake of these drugs of abuse is very broad. To date, most studies have focused on the substances’ cardiac effects, and very few on their associated neurotoxicity. Specifically, synthetic cathinones appear to be involved in different neurological events, including increased alertness, mild agitation, severe psychosis, hyperthermia and death. A systematic literature search in PubMed and Scopus databases according to PRISMA guidelines was performed. A total of 515 studies published from 2005 to 2022 (350 articles from PubMed and 165 from Scopus) were initially screened for eligibility. The papers excluded, according to the criteria described in the Method Section (n = 401) and after full text analyses (n = 82), were 483 in total. The remaining 76 were included in the present review, as they met fully the inclusion criteria. The present work provides a comprehensive review on neurotoxic mechanisms of synthetic cathinones highlighting intoxication cases and fatalities in humans, as well as the toxic effects on animals (in particular rats, mice and zebrafish larvae). The reviewed studies showed brain-related adverse effects, including encephalopathy, coma and convulsions, and sympathomimetic and hallucinogenic toxidromes, together with the risk of developing excited/agitated delirium syndrome and serotonin syndrome.
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Affiliation(s)
- Gloria Daziani
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Alfredo Fabrizio Lo Faro
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Vincenzo Montana
- Dipartimento di Anestesia, Rianimazione e Emergenza-Urgenza, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Gaia Goteri
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Mauro Pesaresi
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Giulia Bambagiotti
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Eva Montanari
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Raffaele Giorgetti
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Angelo Montana
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
- Correspondence:
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5
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Grapp M, Kaufmann C, Schwelm HM, Neukamm MA. Toxicological Investigation of a Case Series Involving the Synthetic Cathinone α-Pyrrolidinohexiophenone (α-PHP) and Identification of Phase I and II Metabolites in Human Urine. J Anal Toxicol 2023; 47:162-174. [PMID: 35921233 DOI: 10.1093/jat/bkac057] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/06/2022] [Accepted: 08/03/2022] [Indexed: 11/14/2022] Open
Abstract
α-Pyrrolidinohexiophenone (α-PHP) is a derivative of the class of α-pyrrolidinophenones, a subgroup of synthetic cathinones. These substances are the second most abused drugs of new psychoactive substances. Here, we report the toxicological investigation of a series of 29 authentic forensic and clinical cases with analytically confirmed intake of α-PHP including two cases of drug testing in newborns using meconium. The age range of subjects where serum samples were available was 23-51 years (median 39.5), and 90% were male. Serum α-PHP concentrations, determined by a validated LC-MS-MS method, showed a high variability ranging from 1 to 83 ng/mL (mean, 40 ng/mL; median, 36 ng/mL). Comprehensive toxicological analysis revealed co-consumption of other psychotropic drugs in almost all cases with frequent occurrence of opiates (60%), benzodiazepines (35%), cannabinoids (30%), and cocaine (20%). Hence, forensic and clinical symptoms like aggressive behavior, sweating, delayed physical response, and impaired balance could not be explained by the abuse of α-PHP alone but rather by poly-intoxications. Liquid chromatography-quadrupole time-of-flight mass spectrometry and gas chromatography-mass spectrometry were used to investigate the metabolism of α-PHP in vivo using authentic human urine samples. Altogether, 11 phase I metabolites and 5 phase II glucuronides could be identified by this approach. Apart from the parent drug, most abundant findings in urine were the metabolites dihydroxy-pyrrolidinyl-α-PHP and dihydro-α-PHP and, to a lesser extent, 2'-oxo-dihydro-α-PHP and 2'-oxo-α-PHP. Monitoring of these metabolites along with the parent drug in forensic and clinical toxicology could unambiguously prove the abuse of the novel designer drug α-PHP.
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Affiliation(s)
- Marcel Grapp
- Forensic Toxicological Laboratory, University Medical Center Göttingen, Georg-August-University, Robert-Koch-Straße 40, Göttingen 37075, Germany
| | - Christoph Kaufmann
- Forensic Toxicological Laboratory, University Medical Center Göttingen, Georg-August-University, Robert-Koch-Straße 40, Göttingen 37075, Germany
| | - Hannes M Schwelm
- Institute of Forensic Medicine, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Albertstr. 9, Freiburg 79104, Germany
- Herrmann Staudinger Graduate School, University of Freiburg, Albertstr. 9, Freiburg 79104, Germany
| | - Merja A Neukamm
- Institute of Forensic Medicine, Freiburg University Medical Center, Faculty of Medicine, University of Freiburg, Albertstr. 9, Freiburg 79104, Germany
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Shetty RA, Hoch AC, Sumien N, Forster MJ, Gatch MB. Comparison of locomotor stimulant and drug discrimination effects of four synthetic cathinones to commonly abused psychostimulants. J Psychopharmacol 2023; 37:520-528. [PMID: 36738095 DOI: 10.1177/02698811221142566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The underground market is constantly flooded with newer synthetic as alternatives to the older cathinones. Drug Enforcement Administration (DEA) has identified four cathinone compounds of particular concern: 3,4-methylenedioxy-alpha-pyrrolidinohexanophenone (3,4-MD-α-PHP), 4-chloro-α-pyrrolidinopropiophenone (4-Cl-α-PPP), alpha-pyrrolidinoisohexiophenone (α-PiHP) and 4-chloro-pentedrone (4-Cl-pentedrone). AIMS The current study aimed to evaluate the behavioral pharmacology of four synthetic cathinones. METHODS 3,4-MD-α-PHP, 4-Cl-α-PPP, α-PiHP, and 4-CPD were tested for locomotor activity in mice and in a drug discrimination assay with rats trained to discriminate either methamphetamine or cocaine. RESULTS Locomotor stimulant effects of 3,4-MD-α-PHP ((effective dose) ED50 = 1.98 mg/kg), α-PiHP (ED50 = 2.46 mg/kg), and 4-Cl-α-PPP (ED50 = 7.18 mg/kg) were observed within 10 min following injection and lasted from 2 to 3.5 h. The stimulant action of 4-CPD (ED50 = 17.24 mg/kg) was delayed, occurring 40-70 min following injection. The maximal motor stimulant actions of 3,4-MD-α-PHP and α-PiHP 1 were equivalent to that of cocaine and methamphetamine, whereas 4-CPD (50% of cocaine) and 4-Cl-α-PPP (73% of cocaine) were less efficacious. All of the test compounds fully substituted for the discriminative stimulus effects of cocaine, 3,4-MD-α-PHP (ED50 = 2.28 mg/kg), α-PiHP (ED50 = 3.84 mg/kg), and 4-Cl-α-PPP (ED50 = 15.56 mg/kg). Only 3,4-MD-α-PHP (ED50 = 1.65 mg/kg), α-PiHP (ED50 = 1.87 mg/kg), and 4-Cl-α-PPP (ED50 = 9.79 mg/kg) fully substituted for the discriminative stimulus effects of methamphetamine. 4-Cl-pentedrone caused 55-70% methamphetamine-appropriate responding at doses that also suppressed responding and produced convulsions. CONCLUSIONS These data indicate that 3,4-MD-α-PHP, α-PiHP, and 4-Cl-α-PPP have a potential for abuse similar to that of methamphetamine and cocaine. In contrast, 4-Cl-pentedrone may not be popular for recreational use due to its convulsant effects.
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Affiliation(s)
- Ritu A Shetty
- Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Adam C Hoch
- Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Nathalie Sumien
- Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Michael J Forster
- Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Michael B Gatch
- Pharmacology & Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA
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Kuropka P, Zawadzki M, Szpot P. A review of synthetic cathinones emerging in recent years (2019-2022). Forensic Toxicol 2023; 41:25-46. [PMID: 36124107 PMCID: PMC9476408 DOI: 10.1007/s11419-022-00639-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 08/28/2022] [Indexed: 01/24/2023]
Abstract
Purpose The emergence of novel psychoactive substances (NPS) has been being a continuous and evolving problem for more than a decade. Every year, dozens of new, previously unknown drugs appear on the illegal market, posing a significant threat to the health and lives of their users. Synthetic cathinones are one of the most numerous and widespread groups among NPS. The purpose of this work was to identify and summarize available data on newly emerging cathinones in very recent years. Methods Various online databases such as PubMed, Google Scholar, but also databases of government agencies including those involved in early warning systems, were used in search of reports on the identification of newly emerging synthetic cathinones. In addition, threads on various forums created by users of these drugs were searched for reports on the effects of these new substances. Results We have identified 29 synthetic cathinones that have been detected for the first time from early 2019 to mid-2022. We described their structures, known intoxication symptoms, detected concentrations in biological material in poisoning cases, as well as the countries and dates of their first appearance. Due to the lack of studies on the properties of the novel compounds, we compared data on the pharmacological profiles of the better-known synthetic cathinones with available information on the newly emerged ones. Some of these new agents already posed a threat, as the first cases of poisonings, including fatal ones, have been reported. Conclusions Most of the newly developed synthetic cathinones can be seen as analogs and replacements for once-popular compounds that have been declining in popularity as a result of legislative efforts. Although it appears that some of the newly emerging cathinones are not widely used, they may become more popular in the future and could become a significant threat to health and life. Therefore, it is important to continue developing early warning systems and identifying new compounds so that their widespread can be prevented.
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Affiliation(s)
- Patryk Kuropka
- Institute of Toxicology Research, 45 Kasztanowa Street, Lower Silesia Province, 55093 Borowa, Poland
| | - Marcin Zawadzki
- grid.4495.c0000 0001 1090 049XDepartment of Forensic Medicine, Wroclaw Medical University, 4 J. Mikulicza‑Radeckiego Street, 50345 Wroclaw, Poland ,Institute of Toxicology Research, 45 Kasztanowa Street, Lower Silesia Province, 55093 Borowa, Poland
| | - Paweł Szpot
- grid.4495.c0000 0001 1090 049XDepartment of Forensic Medicine, Wroclaw Medical University, 4 J. Mikulicza‑Radeckiego Street, 50345 Wroclaw, Poland ,Institute of Toxicology Research, 45 Kasztanowa Street, Lower Silesia Province, 55093 Borowa, Poland
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Effects of the Phenethylamine 2-Cl-4,5-MDMA and the Synthetic Cathinone 3,4-MDPHP in Adolescent Rats: Focus on Sex Differences. Biomedicines 2022; 10:biomedicines10102336. [PMID: 36289598 PMCID: PMC9598216 DOI: 10.3390/biomedicines10102336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/03/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022] Open
Abstract
The illicit drug market of novel psychoactive substances (NPSs) is expanding, becoming an alarming threat due to increasing intoxication cases and insufficient (if any) knowledge of their effects. Phenethylamine 2-chloro-4,5-methylenedioxymethamphetamine (2-Cl-4,5-MDMA) and synthetic cathinone 3,4-methylenedioxy-α-pyrrolidinohexanophenone (3,4-MDPHP) are new, emerging NPSs suggested to be particularly dangerous. This study verified whether these two new drugs (i) possess abuse liability, (ii) alter plasma corticosterone levels, and (iii) interfere with dopaminergic transmission; male and female adolescent rats were included to evaluate potential sex differences in the drug-induced effects. Findings show that the two NPSs are not able to sustain reliable self-administration behavior in rats, with cumulatively earned injections of drugs being not significantly different from cumulatively earned injections of saline in control groups. Yet, at the end of the self-administration training, females (but not males) exhibited higher plasma corticosterone levels after chronic exposure to low levels of 3,4-MDPHP (but not of 2-Cl-4,5-MDMA). Finally, electrophysiological patch-clamp recordings in the rostral ventral tegmental area (rVTA) showed that both drugs are able to increase the firing rate of rVTA dopaminergic neurons in males but not in females, confirming the sex dimorphic effects of these two NPSs. Altogether, this study demonstrates that 3,4-MDPHP and 2-Cl-4,5-MDMA are unlikely to induce dependence in occasional users but can induce other effects at both central and peripheral levels that may significantly differ between males and females.
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A unique case of death by MDPHP with no other co-ingestion: a forensic toxicology case. Int J Legal Med 2022; 136:1291-1296. [PMID: 35169902 PMCID: PMC9375735 DOI: 10.1007/s00414-022-02799-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 02/09/2022] [Indexed: 11/16/2022]
Abstract
Synthetic cathinones are a class of psychoactive drugs that have become, in recent years, of quite common observation in medical and toxicological forensic field. MDPHP (3,4-methylenedioxy-α-pyrrolidinohexanophenone) belongs to this class of substances but lethal acute intoxication caused by this specific substance without other co-ingestions has never been described in literature. We are presenting the unique case of a fatal acute intoxication caused by MDPHP in a 48-year-old man carried to the A&E department of a big Milanese hospital where he suddenly deceased after brief time. Clinical records, autopsy examination, histological findings, and toxicological analysis, assessed via a Q-Exactive Orbitrap with a HPLC system and LC/MS–MS system, are discussed. This case report may represent the first case of this type of intoxication and might help in improving recognition and treatment of these particular cases.
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Gicquel T, Pelletier R, Richeval C, Gish A, Hakim F, Ferron PJ, Mesli V, Allorge D, Morel I, Gaulier JM. Metabolite elucidation of 2-fluoro-deschloroketamine (2F-DCK) using molecular networking across three complementary in vitro and in vivo models. Drug Test Anal 2021; 14:144-153. [PMID: 34515415 DOI: 10.1002/dta.3162] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/26/2021] [Accepted: 09/07/2021] [Indexed: 11/06/2022]
Abstract
This work first aims to investigate metabolites of 2-fluoro-deschloroketamine (2F-DCK), a new arylcyclohexylamine derivatives (a group of dissociative ketamine-based substances) using two in vitro experimental approaches, and to compare obtained results by means of molecular networking. Metabolites of 2F-DCK were investigated using both human liver microsomes (HLMs) and hepatic (HepaRG) cell line incubates using molecular networking approach: 2F-DCK pure substance was incubated with HLMs for up to 1 h at two concentrations (100 and 500 μM) and with HepaRG cells for two time periods (8 and 24 h) at one concentration (20 μM). In vitro obtained results were subsequently applied to a 2F-DCK-related fatality case. In vitro-produced metabolites were investigated using high-resolution accurate mass spectrometry using Orbitrap mass analyzer technology. Thirteen metabolites were in vitro produced and several metabolic pathways can be postulated. Seven additional metabolites were found in post-mortem samples (bile and urine) of the case, comprising three Phase II metabolites, which appear to be minor in vivo metabolites. HLMs and HepaRG cell models appear to be complementary and obtained data allowed the identification of several specific 2F-DCK metabolites in biological samples. In practical terms, observed metabolic ratios suggested that nor-2F-DCK (208.1137 m/z) and a hydrogenated metabolite (224.1443 m/z) could be proposed as reliable metabolites to be recorded in HRMS libraries in order to improve detection of 2F-DCK use.
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Affiliation(s)
- Thomas Gicquel
- Forensic Toxicology Laboratory, CHU Rennes, Rennes, France.,NuMeCan Institute (Nutrition, Metabolisms and Cancer), Univ Rennes, INSERM, INRAE, CHU Rennes, Rennes, France
| | | | - Camille Richeval
- Toxicology Functional Unit, CHU Lille, Lille, France.,ULR 4483-IMPECS-IMPACT of the Chemical Environment on Human Health, Univ. Lille, Lille, France
| | - Alexandr Gish
- Toxicology Functional Unit, CHU Lille, Lille, France
| | - Florian Hakim
- Toxicology Functional Unit, CHU Lille, Lille, France.,ULR 4483-IMPECS-IMPACT of the Chemical Environment on Human Health, Univ. Lille, Lille, France
| | - Pierre-Jean Ferron
- NuMeCan Institute (Nutrition, Metabolisms and Cancer), Univ Rennes, INSERM, INRAE, CHU Rennes, Rennes, France
| | - Vadim Mesli
- Legal Medicine Service, CHU Lille, Lille, France
| | - Delphine Allorge
- Toxicology Functional Unit, CHU Lille, Lille, France.,ULR 4483-IMPECS-IMPACT of the Chemical Environment on Human Health, Univ. Lille, Lille, France
| | - Isabelle Morel
- Forensic Toxicology Laboratory, CHU Rennes, Rennes, France.,NuMeCan Institute (Nutrition, Metabolisms and Cancer), Univ Rennes, INSERM, INRAE, CHU Rennes, Rennes, France
| | - Jean-Michel Gaulier
- Toxicology Functional Unit, CHU Lille, Lille, France.,ULR 4483-IMPECS-IMPACT of the Chemical Environment on Human Health, Univ. Lille, Lille, France
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11
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Sogos V, Caria P, Porcedda C, Mostallino R, Piras F, Miliano C, De Luca MA, Castelli MP. Human Neuronal Cell Lines as An In Vitro Toxicological Tool for the Evaluation of Novel Psychoactive Substances. Int J Mol Sci 2021; 22:ijms22136785. [PMID: 34202634 PMCID: PMC8268582 DOI: 10.3390/ijms22136785] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 12/18/2022] Open
Abstract
Novel psychoactive substances (NPS) are synthetic substances belonging to diverse groups, designed to mimic the effects of scheduled drugs, resulting in altered toxicity and potency. Up to now, information available on the pharmacology and toxicology of these new substances is very limited, posing a considerable challenge for prevention and treatment. The present in vitro study investigated the possible mechanisms of toxicity of two emerging NPS (i) 4′-methyl-alpha-pyrrolidinoexanophenone (3,4-MDPHP), a synthetic cathinone, and (ii) 2-chloro-4,5-methylenedioxymethamphetamine (2-Cl-4,5-MDMA), a phenethylamine. In addition, to apply our model to the class of synthetic opioids, we evaluated the toxicity of fentanyl, as a reference compound for this group of frequently abused substances. To this aim, the in vitro toxic effects of these three compounds were evaluated in dopaminergic-differentiated SH-SY5Y cells. Following 24 h of exposure, all compounds induced a loss of viability, and oxidative stress in a concentration-dependent manner. 2-Cl-4,5-MDMA activates apoptotic processes, while 3,4-MDPHP elicits cell death by necrosis. Fentanyl triggers cell death through both mechanisms. Increased expression levels of pro-apoptotic Bax and caspase 3 activity were observed following 2-Cl-4,5-MDMA and fentanyl, but not 3,4-MDPHP exposure, confirming the different modes of cell death.
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Affiliation(s)
- Valeria Sogos
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (V.S.); (P.C.); (C.P.); (R.M.); (F.P.); (M.A.D.L.)
| | - Paola Caria
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (V.S.); (P.C.); (C.P.); (R.M.); (F.P.); (M.A.D.L.)
| | - Clara Porcedda
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (V.S.); (P.C.); (C.P.); (R.M.); (F.P.); (M.A.D.L.)
| | - Rafaela Mostallino
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (V.S.); (P.C.); (C.P.); (R.M.); (F.P.); (M.A.D.L.)
| | - Franca Piras
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (V.S.); (P.C.); (C.P.); (R.M.); (F.P.); (M.A.D.L.)
| | - Cristina Miliano
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA 24060, USA;
| | - Maria Antonietta De Luca
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (V.S.); (P.C.); (C.P.); (R.M.); (F.P.); (M.A.D.L.)
| | - M. Paola Castelli
- Department of Biomedical Sciences, University of Cagliari, 09042 Monserrato, Italy; (V.S.); (P.C.); (C.P.); (R.M.); (F.P.); (M.A.D.L.)
- Guy Everett Laboratory, University of Cagliari, 09042 Monserrato, Italy
- Center of Excellence “Neurobiology of Addiction”, University of Cagliari, 09042 Monserrato, Italy
- Correspondence: ; Tel.: +39-070-6754065
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12
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Kavanagh P, Gofenberg M, Shevyrin V, Dvorskaya O, Dowling G, Grigoryev A. Tentative identification of the phase I and II metabolites of two synthetic cathinones, MDPHP and α-PBP, in human urine. Drug Test Anal 2020; 12:1442-1451. [PMID: 32621389 DOI: 10.1002/dta.2891] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/21/2020] [Accepted: 06/30/2020] [Indexed: 02/06/2023]
Abstract
Cathinone derivatives are one of the more prominent groups of new psychoactive substances in terms of the number of forensic case reports and the variety of chemical structures available. These substances often sold as "bath salts" are classified as psychostimulants. Using liquid chromatography-high resolution mass spectrometry, the metabolites of two pyrrolidine cathinone derivatives, α-PBP and the less common MDPHP, were tentatively identified in urine samples collected from patients admitted to hospital following drug intoxications. The major metabolic pathways for α-PBP and MDPHP were similar to those of their more common analogs (α-PVP and MDPV). Metabolites arising from hydroxylation, reduction of the carbonyl group to an alcohol, oxidation to form a lactam and subsequent ring-opening, and a combination of these processes were identified. In addition, biotransformations of the benzodioxole moiety in MDPHP included demethylenation with subsequent methylation and carboxylation of the butyl group. The majority of the hydroxylated metabolites of α-PBP and MDPHP were found to be glucuronidated. Both α-PBP and MDPHP undergo extensive metabolism and the chromatographic peak areas of the metabolites were found to be comparable to or exceeded those of the parent substances. Metabolites resulting from demethylenation and subsequent methylation (MDPHP), reduction of carbonyl group (α-PBP), and oxidation to form a lactam combined with ring-opening (α-PBP and MDPHP) were found to be the most useful target analytes for the confirmation of ingestion.
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Affiliation(s)
- Pierce Kavanagh
- Department of Pharmacology and Therapeutics, School of Medicine, Trinity Centre for Health Sciences, Saint James's Hospital, Dublin, Ireland
| | - Mariia Gofenberg
- Regional Clinical Psychiatric Hospital, Ekaterinburg, Russia.,Institute of Chemistry and Technology, Ural Federal University, Ekaterinburg, Russia
| | - Vadim Shevyrin
- Institute of Chemistry and Technology, Ural Federal University, Ekaterinburg, Russia
| | | | - 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
| | - Andrej Grigoryev
- Forensic-Chemical Division, Bureau of Forensic-Medical Expertise, Moscow, Russia
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