Medico-legal implications of toluene abuse and toxicity. Review of cases along with blood concentrations

Forensic issues in autoerotic deaths: A 44-year systematic review and a case series from the legal medicine institutes of Bologna and Milan, Italy

Autoerotic deaths, defined as accidental fatalities occurring during solitary sexual activities, show complex forensic challenges due to their different mechanisms and variable death scene presentations. This study combines a systematic review of global literature spanning 44 years (from 1980 to 2024) with a detailed case series analysis from the Legal Medicine Institutes of Bologna and Milan, Italy, to provide comprehensive insights into this phenomenon.The systematic review identified 67 relevant reports from databases namely Scopus, Web of Science, and PubMed. In parallel, a case series of 7 autoerotic fatalities was analyzed, highlighting victims' demographics, causes of death, and associated factors.Findings from 101 cases of autoerotic deaths included in the systematic review indicate a predominant prevalence of asphyxial deaths, with hanging being the most common method, followed by intoxication. The study underscores significant gender disparities, with men comprising most cases (n = 91), spanning a broader age range (12-87 y.o.) compared to women (17-48 y.o.). The findings are fully consistent with the Italian case series presented here, in which all the subjects were men aged 18 to 72 years, and the cause of death was asphyxia in 6 cases.Toxicological analyses played a crucial role in elucidating the cause and manner of death in most cases, yet their utilization varies widely, impacting data reliability and evaluation of the cause of death. Notably, the evidence of volatile substances, especially inhalants, creates an emerging area of interest with potential epidemiological and preventive implications. The systematic analysis revealed substantial variability in death scene characteristics and forensic procedures, emphasizing the need for standardized investigative protocols.This study highlights the multifaceted nature of autoerotic deaths and the importance of a holistic forensic approach encompassing death scene investigation, autopsy, and toxicological analysis. By enhancing the understanding and awareness about this phenomenon, this research aims to inform evidence-based practices in forensics, mitigate diagnostic uncertainties, and facilitate preventive interventions.

Can some food/medicinal plants directly affect porcine ovarian granulosa cells and mitigate the toxic effect of toluene?

The action of buckwheat, rooibos and vitex on healthy female reproductive systems, as well as their ability to mitigate the reproductive toxicity of environmental contaminant toluene have not yet been examined. We analysed the influence of toluene (0, 10, 100 or 1000 ng/mL) with and without these plant extracts (10 μg/mL) on cultured porcine ovarian granulosa cells. Cell viability, proliferation (PCNA accumulation), apoptosis (accumulation of bax) and release of progesterone (P) and oestradiol (E) were measured. Toluene reduced ovarian cell viability and proliferation, increased apoptosis and suppressed E but not P release. Plant extracts, given alone, were also able to directly suppress some ovarian cell functions. The addition of buckwheat promoted toluene action on cell viability, proliferation and P release, but it did not modify other toluene effects. Rooibos mitigated toluene action on cell viability, proliferation and apoptosis but promoted its action on P and E. The addition of vitex mitigated all the tested toluene effects. These observations: (1) demonstrate the direct toxic influence of toluene on ovarian cells, (2) demonstrate the ability of food/medicinal plants to either promote or mitigate toluene effects and (3) suggest that vitex could be a natural protector against the suppressive effect of toluene on female reproduction.

Ginkgo, fennel, and flaxseed can affect hormone release by porcine ovarian cells and modulate the effect of toluene

Experimental studies have documented the toxic effects of toluene on the mammalian female reproductive processes. The aim of this in vitro study was to examine the potential of functional food plant extracts, namely, of ginkgo, fennel, and flaxseed, in modifying the toluene-induced effects on ovarian hormone release. Porcine granulosa cells were incubated with ginkgo, fennel, or flaxseed extracts (0, 1, 10, or 100 µg/mL) and/or toluene (10 µg/mL). Enzyme immunoassays were used in order to measure the release of progesterone (P), oxytocin (OT), and prostaglandin F (PGF) in the culture media. Toluene suppressed the release of P and enhanced the release of OT and PGF. All tested plant extracts reduced P and increased OT release, while the PGF output was found inhibited by ginkgo and stimulated by fennel and flaxseed. When the cells were incubated with toluene and each one of the plant extracts, toluene was able to prevent their action on P release, as well as those of fennel and flaxseed on OT and PGF release. Moreover, ginkgo enhanced but fennel or flaxseed prevented the toluene-induced effects on OT and PGF release. These observations (i) document novel aspects of the toluene-induced toxicity; (ii) demonstrate the direct influence of ginkgo, fennel, and flaxseed extracts on the ovarian secretory activity; (iii) inform our understanding of the interrelationship between toluene and the tested plant extracts with regard to their effects on ovarian hormone release; (iiii) demonstrate the ability of fennel and flaxseed to prevent adverse effect of toluene on ovarian hormones.

Anaerobic mineralization of toluene by enriched soil-free consortia with solid-phase humin as a terminal electron acceptor

The anaerobic biodegradation of toluene proceeds very slowly owing to limited electron acceptors in contaminated aquifer. The liquid reagents traditionally used to enhance this process readily migrate away from the contaminated site, and continuous addition would cause secondary pollution. In our previous study, the reduced solid-phase humic substances (humin), which are redox active, were found to act as electron donors to promote the microbial reactions. Here, we provide new evidence that humin can promote the anaerobic biodegradation of toluene as a terminal electron acceptor. When inoculating nitrate-reducing (NR) and iron-reducing (IR) consortia with toluene degradation activities, the average toluene degradation rates reached 21.20 ± 1.18 μmol/(L·d) and 15.43 ± 0.41 μmol/(L·d) in the presence of a sediment humin (HMcj), and 94.69% ± 4.26% and 93.20% ± 3.73% of the electrons released from toluene oxidation to CO₂ could be recovered by the reduction of HMcj, respectively. Spectroscopy analyses revealed that quinone moieties and nitrogen-containing moieties may be the electron-accepting groups of HMcj. Based on 16S rRNA sequencing, Cellulomonas spp. were the possible functional bacteria in the culture with NR consortium as the inoculum, while Azospira spp., Cellulomonas spp. and Bacillus spp. were the possible functional bacteria in the culture with IR consortium as the inoculum. Further Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) analyses indicated that toluene oxidation and extracellular electron transfer functions were more abundant in HMcj amended cultures, suggesting a possible enhancement mechanism by HMcj. Additionally, experiments using natural groundwater illustrated that toluene degradation was highly dependent on its concentration, HMcj dosage, pH, and salinity. The study of a column filled with HMcj-coated quartz sand demonstrated a desirable level of toluene degradation in a continuous-flow mode without the presence of other electron acceptors. This study provided an effective and green approach for the remediation of the toluene-contaminated groundwater.

Neurotoxicity induced by toluene: In silico and in vivo evidences of mitochondrial dysfunction and dopaminergic neurodegeneration

Toluene is an air pollutant widely used as an organic solvent in industrial production and emitted by fossil fuel combustion, in addition to being used as a drug of abuse. Its toxic effects in the central nervous system have not been well established, and how and which neurons are affected remains unknown. Hence, this study aimed to fill this gap by investigating three central questions: 1) How does toluene induce neurotoxicity? 2) Which neurons are affected? And 3) What are the long-term effects induced by airborne exposure to toluene? To this end, a Caenorhabditis elegans model was employed, in which worms at the fourth larval stage were exposed to toluene in the air for 24 h in a vapor chamber to simulate four exposure scenarios. After the concentration-response curve analysis, we chose scenarios 3 (E3: 792 ppm) and 4 (E4: 1094 ppm) for the following experiments. The assays were performed 1, 48, or 96 h after removal from the exposure environments, and an irreversible reduction in neuron fluorescence and morphologic alterations were observed in different neurons of exposed worms, particularly in the dopaminergic neurons. Moreover, a significant impairment in a dopaminergic-dependent behavior was also associated with negative effects in healthspan endpoints, and we also noted that mitochondria may be involved in toluene-induced neurotoxicity since lower adenosine 5'-triphosphate (ATP) levels and mitochondrial viability were observed. In addition, a reduction of electron transport chain activity was evidenced using ex vivo protocols, which were reinforced by in silico and in vitro analysis, demonstrating toluene action in the mitochondrial complexes. Based on these findings model, it is plausible that toluene neurotoxicity can be initiated by complex I inhibition, triggering a mitochondrial dysfunction that may lead to irreversible dopaminergic neuronal death, thus impairing neurobehavioral signaling.

Crinum jagus (J. Thomps. Dandy): Antioxidant and protective properties as a medicinal plant on toluene-induced oxidative stress damages in liver and kidney of rats

Crinum jagus (C. jagus; J. Thomps.) Dandy (Liliaceae) is a pantropical plant known for its medicinal values and pharmacological properties. The study assessed the protective effects and changes in oxidative stress indices due to C. jagus leaf extracts on the toluene-induced liver and kidney injuries in rats. The study was conducted on 8-week-old male Wistar rats (n = 80), weighing 243.3 ± 1.42 g. Group I, 1 ml/kg distilled water for 7 days; Group II, 4.5 ml/kg toluene once, 1 ml/kg distilled water for 7 days; Group III, 4.5 ml/kg toluene once, 500 mg/kg methanolic extract for 7 days; Group IV, 4.5 ml/kg toluene once, 500 mg/kg aqueous extract for 7 days; Group V, 500 mg/kg methanolic extract for 7 days; Group VI, 500 mg/kg aqueous extract for 7 days; Group VII, 500 mg/kg of vitamin C for 7 days; Group, VIII, 4.5 ml/kg toluene once, 500 mg/kg vitamin C for 7 days, all administrations were given by oral gavage. The phytochemical contents, absolute and relative organ weights of liver and kidneys, liver and kidney function tests, antioxidant status, as well as histological tests were analyzed using standard protocols. The tannins, flavonoids, and polyphenols were in highest concentration in both extracts, content in methanol extract (57.04 ± 1.51 mgg-1, 35.43 ± 1.03 mgg-1, 28.2 ± 0.34 mgg-1 respectively) > aqueous extract (18.74 ± 1.01 mgg-1, 13.43 ± 0.47 mgg-1, 19.65 ± 0.21 mgg-1 respectively). In the negative control group (II), bodyweights significantly (P < 0.05) reduced by 22%, liver weight and kidney weight significantly (P < 0.05) increased by 42% and 83% respectively, liver-to-bodyweight and kidney-to-bodyweight ratios increased significantly (P < 0.05); serum liver function tests (LFTs) i.e., bilirubin, alkaline phosphatase (ALP), Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Gamma-glutamyl transferase (GGT), and serum kidney function tests (creatinine and urea) were significantly (P < 0.05) elevated; oxidant status (tissue malondialdehyde; MDA) was significantly (P < 0.05) elevated, antioxidant status i.e., tissue superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH) levels was significantly (P < 0.05) reduced; with markedly visible renal and hepatic histopathological findings, compared to the normal control group. In C. jagus extract test groups (III and IV), the parameters were significantly (P < 0.05) alleviated and reversed to normal/near normal compared to the negative control. The LFTs, kidney function tests, and antioxidant status were significantly (P < 0.05) more improved with the methanol extract test and standard control groups compared to the aqueous extract test group; Also, the methanol extract test group showed better histological features than the aqueous extract test and standard control groups. The methanolic extract shows better antioxidant potential due to the availability of more nonenzymatic antioxidants (tannins, flavonoids, and polyphenols). The findings showed that toluene is a very aggressive xenobiotic due to the promotion of oxidative stress and peroxidation of cellular lipids, but C. jagus leaves provide significant protection through the reducing power of nonenzymatic antioxidants and their ability to induce endogenous antioxidant enzymes (SOD, CAT, and glutathione reductase or GR) causing reduced cellular lipid peroxidation and tissue damages, quickened tissue repair, and improved cell biology of liver and kidneys during toluene toxicity. The methanol leaf extract provides better protection and should be advanced for more experimental and clinical studies to confirm its efficacy in alleviating oxidative stress tissue injuries, specifically due to toluene.

Profiling of cured residue of solvent-based adhesives by attenuated total reflectance-Fourier transform infrared spectroscopy with chemometrics for forensic investigation

Abuse of solvent-based adhesives jeopardizes world population, especially the young generation. Adhesive-related exhibits encountered in forensic cases might need to be determined if they could have come from a particular source or to establish link between cases or persons. This study was aimed to discriminate solvent-based adhesives, especially to aid forensic investigation of glue sniffing activities. In this study, thirteen brands with three samples each, totaling at 39 adhesive samples, were analyzed using attenuated total reflectance-Fourier transform infrared (ATR-FTIR) spectroscopy followed by chemometric methods. Experimental output showed that adhesive samples utilized in this study were less likely to change in their ATR-FTIR profiles over time, at least up to 2 months. No interference from plastic materials was noticed based on ATR-FTIR profile comparison. Physical examination could differentiate the samples into two groups, namely contact adhesives and cement adhesives. A principal component analysis-score linear discriminative analysis (PC-score LDA) model resulted in 100% and 98.6% correct classification in discriminating the two groups of adhesive samples, forming seven discriminative clusters. Test set with adhesive samples applied glass slide and plastic substrates also demonstrated a 100% correct classification into their respective groups. As a conclusion, the method allowed for discrimination of adhesive samples based on the spectral features, displaying relationship among samples. It is hoped that this comparative information is beneficial to trace the possible source of solvent-based adhesives, whenever they are recovered from a crime scene, for forensic investigation.

Deaths related to nitrogen inhalation: Analytical challenges

Dinitrogen (N₂) has been increasingly connected to suicidal deaths. The analysis of N₂ in post-mortem cases still represents a major challenge in forensic toxicology and circumstantial data has so far played a major role for the determination of the cause of death. In this paper, after presenting a review of cases of N₂ intoxication described in forensic literature, we report the application of two approaches in order to quantify an excess of N₂ in post-mortem whole blood collected from a case of suicide by nitrogen inhalation. N₂ analyses were performed by GC-MS on the suicidal case and on controls taken from 10 autopsy cases with similar PMI (5 traumatic deaths and 5 deaths by asphyxia). The percentage of N₂ was estimated by building a five-point N₂ peak area calibration curve (0, 15.6 %, 62.4 % 78.1 %, 100 %) and through an external QC, assessing linearity, accuracy and precision, LLOQ, specificity and stability of N₂ in the sample vial. Percentage of N₂ of the case was significantly higher than the post-mortem controls (p<0.05). The N₂/O₂ ratio of the case and controls was also calculated as an additional indicator, and was significantly higher in the case (p<0.05). The strengths and the limitation of both methods are reported in the paper. Toxicological confirmation for N₂ are rarely performed when the cause of death is evident, probably due to the lack of validated methods and the complexity of the interpretation of N₂ concentration in biological fluids. The presented methods can be rapidly and profitably applied with instrumentation normally available in forensic laboratories.