1
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Violence against women and drug-facilitated sexual assault (DFSA): A review of the main drugs. J Forensic Leg Med 2020; 74:102020. [DOI: 10.1016/j.jflm.2020.102020] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/18/2020] [Accepted: 07/03/2020] [Indexed: 12/16/2022]
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2
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Lee DH, Kim H, Yun HY, Park M, Choe S, In S, Kim E, Han E, Shin KH. Complementary approach for accurate determination of carbon isotopic compositions in γ-hydroxybutyric acid using gas chromatography/combustion-isotope ratio mass spectrometry. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2019; 33:1434-1439. [PMID: 31070267 DOI: 10.1002/rcm.8481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 05/03/2019] [Accepted: 05/03/2019] [Indexed: 06/09/2023]
Abstract
RATIONALE γ-Hydroxybutyric acid (GHB) is a naturally endogenous neurotransmitter that is popular as a recreational drug due to its sedative, hypnotic, and euphoric effects. GHB derived from endogenous production or exogenous ingestion has been effectively discriminated by carbon isotopic compositions (δ13 C values) through gas chromatography/combustion-isotope ratio mass spectrometry (GC/C-IRMS). However, an unintended uncertainty of isotopic signatures caused by a wide range of GHB quantities remains unsolved when using only single-isotope corrections of the di-TMS derivative. METHODS The δ13 C values of the original GHB standard were first determined by elemental analyzer/isotope ratio mass spectrometry (EA/IRMS). The δ13 C values of silylated GHB in concentrations from 10 to 500 ppm were determined by GC/C-IRMS. With respect to the silylated reaction products, the correction of δ13 C values for the introduced carbons was calculated from a stoichiometric mass balance equation. RESULTS The results showed a significant quantity-dependent trend in δ13 C values of introduced carbon (δ13 Cdi-TMS values) with increased GHB standard concentrations (r2 = 0.70, p <0.05). We applied a logarithmic equation to determine isotopic data in low-GHB urine specimens from five healthy female volunteers. The δ13 CGHB values in urine samples corrected with quantity-dependent δ13 Cdi-TMS values were different by an average of 2.7‰ from those corrected with single δ13 Cdi-TMS values (p <0.05). CONCLUSIONS Our results suggest that the overall residual amount-dependent isotope fractionation should be mathematically corrected by the logarithmic function and this may improve the reliability of isotopic analysis to evaluate the origin of GHB before applying the approach to routine toxicological and forensic studies.
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Affiliation(s)
- Dong-Hun Lee
- Hanyang University, 55 Hanyangdaehak-ro, Sangrok-gu, Ansan, 15588, Republic of Korea
| | - Hyojeong Kim
- College of Pharmacy, Duksung Women's University, 144 Samyang-ro, Dobong-gu, Seoul, 01369, Republic of Korea
- Innovative Drug Center, Duksung Women's University, Seoul, South Korea
| | - Hee Young Yun
- Hanyang University, 55 Hanyangdaehak-ro, Sangrok-gu, Ansan, 15588, Republic of Korea
| | | | | | - Sanghwan In
- National Forensic Service, Republic of Korea
| | - Eunmi Kim
- National Forensic Service, Republic of Korea
| | - Eunyoung Han
- College of Pharmacy, Duksung Women's University, 144 Samyang-ro, Dobong-gu, Seoul, 01369, Republic of Korea
- Innovative Drug Center, Duksung Women's University, Seoul, South Korea
| | - Kyung-Hoon Shin
- Hanyang University, 55 Hanyangdaehak-ro, Sangrok-gu, Ansan, 15588, Republic of Korea
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3
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Strano Rossi S, Vecchio S, Odoardi S, Anzillotti L, Chiarotti M, Serpelloni G, Locatelli C. Analytical protocol for the screening of psychotropic/incapacitating drugs in alleged drug-facilitated crimes. Forensic Chem 2019. [DOI: 10.1016/j.forc.2019.100168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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4
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Kim H, Lee DH, Go A, Park M, Choe S, In S, Kim E, Lee H, Shin KH, Han E. Differentiation of endogenous and exogenous γ-Hydroxybutyrate in rat and human urine by GC/C/IRMS. Int J Legal Med 2019; 133:1785-1794. [PMID: 30937594 DOI: 10.1007/s00414-019-02052-x] [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: 02/11/2019] [Accepted: 03/22/2019] [Indexed: 10/27/2022]
Abstract
Gamma (γ)-hydroxybutyric acid (GHB) has been reported to be an endogenous compound in the mammalian brain. It used to treat symptoms of alcohol, opioid, and drug withdrawal and cataplexy of narcolepsy. However, it is often used for criminal purposes because it is colorless, tasteless, and has short half-life. For this reason, there is a need for a method of distinguishing between endogenous and exogenous GHB administration. Therefore, urine from rat before administration of GHB and GHB urine after the single intraperitoneal injection of GHB as 30 mg/100 g were collected from Sprague-Dawley rats (7 weeks old, 10 males and females). Negative control urine, urine from individuals suspected of taking GHB, and urine from victims who were GHB-involved crime were collected. In urine samples, GHB was extracted with two-step SPE and collected fraction was derivatized and analyzed by GC/MS and GC/C/IRMS. In GC/MS and GC/C/IRMS analysis of rat urine, there was a statistically significant difference between urine from rat before administration of GHB and GHB rat urine (p < 0.05). In GC/MS analysis of human urine samples, there was no significant difference among human urine groups (negative control, suspects' urine, and victims' urine), but in GC/C/IRMS analysis of human urine samples, there was a statistically significant difference among human urine groups (p = 0.0001). Through these results, GC/C/IRMS can be more effective tool to identify endogenous and exogenous GHB in urine than GC/MS. This study can build a drug management system in forensic investigation agency and offer interpretation method to forensic science and court.
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Affiliation(s)
- Hyojeong Kim
- College of Pharmacy, Duksung Women's University, Seoul, 01369, South Korea.,Innovative Drug Center, Duksung Women's University, Seoul, South Korea
| | - Dong-Hun Lee
- Department of Marine Science and Convergent Technology, Hanyang University, Ansan, 15588, South Korea
| | - Ahra Go
- College of Pharmacy, Duksung Women's University, Seoul, 01369, South Korea
| | | | | | - Sanghwan In
- National Forensic Service, Wonju, South Korea
| | - Eunmi Kim
- National Forensic Service, Wonju, South Korea
| | - Hunjoo Lee
- CHEM.I.NET,Ltd, Room 302, 773-3, Mok-dong, Yangcheon-gu, Seoul, South Korea
| | - Kyung-Hoon Shin
- Department of Marine Science and Convergent Technology, Hanyang University, Ansan, 15588, South Korea.
| | - Eunyoung Han
- College of Pharmacy, Duksung Women's University, Seoul, 01369, South Korea. .,Innovative Drug Center, Duksung Women's University, Seoul, South Korea.
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5
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Lopez Nunez OF, Rymer JA, Tamama K. Case of Sudden Acute Coma Followed by Spontaneous Recovery. J Appl Lab Med 2018; 3:507-510. [PMID: 33636916 DOI: 10.1373/jalm.2017.025718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 04/13/2018] [Indexed: 11/06/2022]
Affiliation(s)
- Oscar F Lopez Nunez
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA.,Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, PA
| | - Jacqueline A Rymer
- Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, PA
| | - Kenichi Tamama
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA.,Clinical Laboratories, University of Pittsburgh Medical Center Presbyterian Hospital, Pittsburgh, PA.,McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA.,Clinical Laboratory, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA
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6
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Van Elsué N, Crunelle CL, Verbrugge CA, van Baarle K, Rodrigues A, Neels H, Yegles M. Gammahydroxybutyrate in hair of non-GHB and repeated GHB users: A new and optimized method. Forensic Sci Int 2018; 291:193-198. [DOI: 10.1016/j.forsciint.2018.08.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/19/2018] [Accepted: 08/20/2018] [Indexed: 12/17/2022]
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7
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Affiliation(s)
- NW Brown
- Toxicology, Clinical Chemistry, Wansbeck General Hospital, Ashington, UK
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8
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Postmortem concentrations of gamma-hydroxybutyrate (GHB) in peripheral blood and brain tissue — Differentiating between postmortem formation and antemortem intake. Forensic Sci Int 2017; 272:154-158. [DOI: 10.1016/j.forsciint.2016.12.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 12/27/2016] [Accepted: 12/29/2016] [Indexed: 11/19/2022]
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9
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Microwave-assisted on-spot derivatization for gas chromatography–mass spectrometry based determination of polar low molecular weight compounds in dried blood spots. J Chromatogr A 2016; 1465:175-83. [DOI: 10.1016/j.chroma.2016.08.057] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 08/23/2016] [Accepted: 08/25/2016] [Indexed: 12/26/2022]
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10
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Busardò FP, Bertol E, Mannocchi G, Tittarelli R, Pantano F, Vaiano F, Baglio G, Kyriakou C, Marinelli E. Determination of GHB levels in breast milk and correlation with blood concentrations. Forensic Sci Int 2016; 265:172-81. [DOI: 10.1016/j.forsciint.2016.02.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Revised: 02/09/2016] [Accepted: 02/10/2016] [Indexed: 10/22/2022]
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11
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Alzeer S, Ellis EM. Metabolism of gamma hydroxybutyrate in human hepatoma HepG2 cells by the aldo-keto reductase AKR1A1. Biochem Pharmacol 2014; 92:499-505. [PMID: 25256836 DOI: 10.1016/j.bcp.2014.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Revised: 09/04/2014] [Accepted: 09/05/2014] [Indexed: 12/28/2022]
Abstract
Gamma hydroxybutyrate (GHB) is a recreational and date-rape drug, for which the detection following ingestion is hampered by rapid metabolism and its endogenous presence. GHB catabolism occurs mainly by its oxidation to succinic semialdehyde (SSA), which converts to succinate and enters the tricarboxylic acid cycle. A high Km aldehyde reductase has previously been reported to catalyse the NADP-dependent oxidation of GHB at high concentrations. It is assumed that this enzyme is identical to the aldo-keto reductase AKR1A1, but its role in GHB oxidation has not been fully evaluated. In this study, the extent of AKR1A1 in GHB metabolism has been determined in HepG2 cells using RNA-interference technology. The gene encoding AKR1A1 was targeted by siRNA. Results demonstrate a successful knock-down of the AKR1A1 gene with 92% reduction in total mRNA and 93% reduction in protein expression. Demolishing AKR1A1 expression in HepG2 cells leads to significant 82% decrease in NADP-dependent GHB-dehydrogenase activity at high concentration (10mM) of GHB. Moreover, when exposing the cells to 50 μM of GHB for 24h, and measuring intracellular and extracellular GHB levels by GC/MS, a significant two-fold increase was observed on GHB intracellular level in silenced cells. In contrast, measuring SSA-reductase activity in silenced cells indicated that AKR1A1 is not involved in endogenous GHB production. These findings describe a pathway for GHB metabolism in the liver which should be useful in GHB exposure cases, and will enable a better understanding of the enzymes participating in its metabolism at natural and overexposed levels.
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Affiliation(s)
- Samar Alzeer
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, University of Damascus, Damascus, Syria.
| | - Elizabeth M Ellis
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow G4 0RE, UK
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12
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Screening and confirmation methods for GHB determination in biological fluids. Anal Bioanal Chem 2014; 406:3553-77. [PMID: 24500753 DOI: 10.1007/s00216-013-7586-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 12/09/2013] [Accepted: 12/14/2013] [Indexed: 10/25/2022]
Abstract
The purpose of this review is to provide a comprehensive overview of reported methods for screening and confirmation of the low-molecular-weight compound and drug of abuse gamma-hydroxybutyric acid (GHB) in biological fluids. The polarity of the compound, its endogenous presence, its rapid metabolism after ingestion, and its instability during storage (de novo formation and interconversion between GHB and its lactone form gamma-butyrolactone) are challenges for the analyst and for interpretation of a positive result. First, possible screening procedures for GHB are discussed, including colorimetric, enzymatic, and chromatography-based procedures. Confirmation methods for clinical and forensic cases mostly involve gas chromatography (coupled to mass spectrometry), although liquid chromatography and capillary zone electrophoresis have also been used. Before injection, sample-preparation techniques include (a combination of) liquid-liquid, solid-phase, or headspace extraction, and chemical modification of the polar compound. Also simple "dilute-and-shoot" may be sufficient for urine or serum. Advantages, limitations, and trends are discussed.
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13
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Wille SMR, Di Fazio V, Samyn N. Drug-facilitated sexual crime by use of ketamine and diazepam by a gynaecologist. Drug Test Anal 2013; 5:730-5. [DOI: 10.1002/dta.1554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 07/19/2013] [Accepted: 08/22/2013] [Indexed: 11/08/2022]
Affiliation(s)
- Sarah M. R. Wille
- National Institute of Criminalistics and Criminology; Laboratory of Toxicology; Vilvoordsesteenweg 100; 1120; Brussels; Belgium
| | - Vincent Di Fazio
- National Institute of Criminalistics and Criminology; Laboratory of Toxicology; Vilvoordsesteenweg 100; 1120; Brussels; Belgium
| | - Nele Samyn
- National Institute of Criminalistics and Criminology; Laboratory of Toxicology; Vilvoordsesteenweg 100; 1120; Brussels; Belgium
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14
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Allegrini G, Di Desidero T, Barletta MT, Fioravanti A, Orlandi P, Canu B, Chericoni S, Loupakis F, Di Paolo A, Masi G, Fontana A, Lucchesi S, Arrighi G, Giusiani M, Ciarlo A, Brandi G, Danesi R, Kerbel RS, Falcone A, Bocci G. Clinical, pharmacokinetic and pharmacodynamic evaluations of metronomic UFT and cyclophosphamide plus celecoxib in patients with advanced refractory gastrointestinal cancers. Angiogenesis 2012; 15:275-86. [PMID: 22382585 PMCID: PMC3338912 DOI: 10.1007/s10456-012-9260-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Accepted: 02/18/2012] [Indexed: 01/06/2023]
Abstract
Aims To evaluate UFT and cyclophosphamide (CTX) based metronomic chemotherapy plus celecoxib (CXB) for the treatment of patients with heavily pre-treated advanced gastrointestinal malignancies. Methods Thirty-eight patients received 500 mg/mq2 CTX i.v bolus on day 1 and, from day 2, 50 mg/day CTX p.o. plus 100 mg/twice a day UFT p.o. and 200 mg/twice a day CXB p.o. Tegafur, 5-FU, 5-FUH2, GHB and uracil pharmacokinetics were assessed. Plasma vascular endothelial growth factor (VEGF), soluble VE-cadherin (sVE-C) and thrombospondin-1 (TSP-1) levels were detected by ELISA and real-time PCR of CD133 gene expression on peripheral blood mononuclear cell was also performed. Results Seventeen patients (45%) obtained stable disease (SD) with a median duration of 5.8 ms (range, 4.2–7.4). Median progression free survival (PFS) and overall survival (OS) were 2.7 ms (95% CI, 1.6–3.9 ms) and 7.1 ms (95% CI, 4.3–9.9 ms), respectively. No toxicities of grade >1 were observed. Pharmacokinetics of 27 patients (13/14, SD/progressive disease, PD) after the first treatment of UFT revealed that 5-FU AUC and Cmax values greater than 1.313 h × μg/ml and 0.501 μg/ml, respectively, were statistically correlated with stabilization of disease and prolonged PFS/OS. VEGF and sVE-C plasma levels were greater in the PD group when compared to SD group. CD133 expression increased only in the PD patients. Conclusion Metronomic UFT and CTX with CXB in heavily pre-treated gastrointestinal patients were well tolerated and associated with interesting activity. Potential predictive pharmacokinetic parameters and pharmacodynamic biomarkers have been found.
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15
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Hughes RR, Walker GS. Rapid Screening for the Detection and Differentiation of Gamma-Hydroxybutyrate using Ion Chromatography*,†. J Forensic Sci 2011; 56:1256-60. [DOI: 10.1111/j.1556-4029.2011.01845.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Wood DM, Brailsford AD, Dargan PI. Acute toxicity and withdrawal syndromes related to γ-hydroxybutyrate (GHB) and its analogues γ-butyrolactone (GBL) and 1,4-butanediol (1,4-BD). Drug Test Anal 2011; 3:417-25. [PMID: 21548140 DOI: 10.1002/dta.292] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2010] [Revised: 03/21/2011] [Accepted: 03/22/2011] [Indexed: 02/05/2023]
Abstract
Gamma-hydroxybutyrate (GHB) has been used as a recreational drug since the 1990s and over the last few years there has been increasing use of its analogues gamma-butyrolactone (GBL) and to a lesser extent 1,4-butanediol (1,4BD). This review will summarize the literature on the pharmacology of these compounds; the patterns and management of acute toxicity associated with their use; and the clinical patterns of presentation and management of chronic dependency associated with GHB and its analogues.
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Affiliation(s)
- David M Wood
- Guy's and St Thomas' NHS Foundation Trust, London, UK.
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17
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Marclay F, Saudan C, Vienne J, Tafti M, Saugy M. Source inference of exogenous gamma-hydroxybutyric acid (GHB) administered to humans by means of carbon isotopic ratio analysis: novel perspectives regarding forensic investigation and intelligence issues. Anal Bioanal Chem 2011; 400:1105-12. [DOI: 10.1007/s00216-011-4891-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 03/08/2011] [Accepted: 03/09/2011] [Indexed: 11/29/2022]
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18
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Andresen H, Aydin BE, Mueller A, Iwersen-Bergmann S. An overview of gamma-hydroxybutyric acid: pharmacodynamics, pharmacokinetics, toxic effects, addiction, analytical methods, and interpretation of results. Drug Test Anal 2011; 3:560-8. [DOI: 10.1002/dta.254] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2010] [Revised: 12/05/2010] [Accepted: 12/06/2010] [Indexed: 11/11/2022]
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Alzeer S, Ellis EM. The role of aldehyde reductase AKR1A1 in the metabolism of γ-hydroxybutyrate in 1321N1 human astrocytoma cells. Chem Biol Interact 2011; 191:303-7. [PMID: 21276435 DOI: 10.1016/j.cbi.2011.01.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Revised: 01/18/2011] [Accepted: 01/19/2011] [Indexed: 12/18/2022]
Abstract
The role of the aldehyde reductase AKR1A1 in the biosynthesis of gamma-hydroxybutyrate (GHB) has been investigated in cell lines using a specific double stranded siRNA designed to knock down expression of the enzyme. This enzyme, along with the aldo-keto reductase AKR7A2, has been proposed previously to be one of the major succinic semialdehyde reductases in brain. The AKR1A1 siRNA was introduced into the human astrocytoma cell line (1321N1) and AKR1A1 expression was monitored using quantitative reverse-transcriptase PCR and Western blots. Results show an 88% reduction in mRNA levels and a 94% reduction in AKR1A1 protein expression 72 h after transfection with the siRNA. Aldehyde reductase activity was examined in silenced cells by following the aldehyde-dependent conversion of NADPH to NADP at 340 nm. This revealed a 30% decrease in pNBA reductase activity in cell extracts after AKR1A1 silencing. Succinic semialdehyde reductase activity was significantly lower in silenced cells when measured using high concentrations (1mM) of succinic semialdehyde, but not with low concentrations (10 μM). The effect of silencing on intracellular and extracellular GHB levels was measured using gas chromatography-mass spectrometry. Results show that AKR1A1 has little effect on the production of GHB, indicating that in this cell line alternative enzymes such as the AKR7A2 are likely to play a more significant role in GHB biosynthesis.
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Affiliation(s)
- Samar Alzeer
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
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20
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Brown SD, Melton TC. Trends in bioanalytical methods for the determination and quantification of club drugs: 2000-2010. Biomed Chromatogr 2010; 25:300-21. [DOI: 10.1002/bmc.1549] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Revised: 09/09/2010] [Accepted: 09/10/2010] [Indexed: 11/10/2022]
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21
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Determination of gamma-hydroxybutyric acid in serum and urine by headspace solid-phase dynamic extraction combined with gas chromatography–positive chemical ionization mass spectrometry. J Chromatogr A 2009; 1216:4090-6. [DOI: 10.1016/j.chroma.2009.03.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2008] [Revised: 02/20/2009] [Accepted: 03/05/2009] [Indexed: 11/24/2022]
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22
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Rossi R, Lancia M, Gambelunghe C, Oliva A, Fucci N. Identification of GHB and morphine in hair in a case of drug-facilitated sexual assault. Forensic Sci Int 2009; 186:e9-e11. [DOI: 10.1016/j.forsciint.2009.01.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2008] [Revised: 01/20/2009] [Accepted: 01/25/2009] [Indexed: 11/15/2022]
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23
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Mass spectrometric approaches in impaired driving toxicology. Anal Bioanal Chem 2008; 393:97-107. [DOI: 10.1007/s00216-008-2338-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2008] [Revised: 08/04/2008] [Accepted: 08/05/2008] [Indexed: 12/22/2022]
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Bodson Q, Denooz R, Serpe P, Charlier C. Gamma-hydroxybutyric acid (GHB) measurement by GC-MS in blood, urine and gastric contents, following an acute intoxication in Belgium. Acta Clin Belg 2008; 63:200-8. [PMID: 18714853 DOI: 10.1179/acb.2008.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Gamma-hydroxybutyrate (GHB, sodium oxybate) is a compound related to neuromodulator gamma-aminobutyric acid (GABA), emerging as a recreational drug of abuse and as a rape drug. GHB-related emergencies have dramatically increased in the 1990s, but a decrease is observed since 2000. We describe the case of an acute GHB intoxication in a 28-year-old male who fell unconscious after ingestion of a mouthful of an unknown beverage, and required medical support for 2 days. A cocaine abuse was also detected by preliminary toxicological screening, but the clinical presentation was not typical of cocaine intoxication. A simple liquid-liquid extraction was used for quantitation of GHB, followed by disilyl-derivatization and analysis in selective ion monitoring (SIM) mode by gas chromatography-mass spectrometry (GC-MS), using GHB-d6 as internal standard. High concentrations of GHB were detected in urine (3020 mg/L) and gastric contents (71487 mg/L) at admission. After a 6-hours delay, GHB was still present in urine at 2324 mg/L and in blood at 43 mg/L. The clinical symptoms of cocaine intoxication were diminished by GHB consumption, and the cerebral scan was modified. Attention must thus be paid to acute intoxications with surprising clinical symptoms, and GHB has probably to be added to the preliminary toxicological screening. Data available regarding GHB are briefly reviewed, and our results are compared with previously published reports of non-fatal GHB intoxication.
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Affiliation(s)
- Q Bodson
- Laboratoire de Toxicologie, Université de Liège, CHU Sart-Tilman, Belgium.
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Zacharis CK, Raikos N, Giouvalakis N, Tsoukali-Papadopoulou H, Theodoridis GA. A new method for the HPLC determination of gamma-hydroxybutyric acid (GHB) following derivatization with a coumarin analogue and fluorescence detection. Talanta 2008; 75:356-61. [DOI: 10.1016/j.talanta.2007.11.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2007] [Revised: 10/25/2007] [Accepted: 11/07/2007] [Indexed: 11/25/2022]
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26
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Kankaanpää A, Liukkonen R, Ariniemi K. Determination of γ-hydroxybutyrate (GHB) and its precursors in blood and urine samples: A salting-out approach. Forensic Sci Int 2007; 170:133-8. [DOI: 10.1016/j.forsciint.2007.06.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lyon RC, Johnston SM, Watson DG, McGarvie G, Ellis EM. Synthesis and catabolism of gamma-hydroxybutyrate in SH-SY5Y human neuroblastoma cells: role of the aldo-keto reductase AKR7A2. J Biol Chem 2007; 282:25986-92. [PMID: 17591773 DOI: 10.1074/jbc.m702465200] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
gamma-Hydroxybutyrate (GHB) is an endogenous metabolite synthesized in the brain. There is strong evidence to suggest that GHB has an important role as a neurotransmitter or neuromodulator. The human aldo-keto reductase AKR7A2 has been proposed previously to catalyze the NADPH-dependent reduction of succinic semialdehyde (SSA) to GHB in human brain. In this study we have used RNA interference to evaluate the role of AKR7A2 in GHB biosynthesis in human neuroblastoma SH-SY5Y cells. Quantitative reverse transcription-PCR analysis and immunoblotting revealed that short interfering RNA molecules directed against AKR7A2 led to a significant reduction in both AKR7A2 transcript and protein levels 72 h post-transfection. We have shown that reduced expression of AKR7A2 results in a 90% decrease in SSA reductase activity of cell extracts. Furthermore, we have shown using gas chromatography-mass spectrometry that a decrease in the level of AKR7A2 was paralleled with a significant reduction in intracellular GHB concentration. This provides conclusive evidence that AKR7A2 is the major SSA reductase in these cells. In contrast, short interfering RNA-dependent reduction in AKR7A2 levels had no effect on the GHB dehydrogenase activity of the extracts, and inhibitor studies suggest that another enzyme characteristic of an NAD-dependent alcohol dehydrogenase may be responsible for catalyzing this reverse reaction. Together these findings delineate pathways for GHB metabolism in the brain and will enable a better understanding of the relationship between GHB biosynthesis and catabolism in disease states and in drug overdose.
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Affiliation(s)
- Robert C Lyon
- Strathclyde Institute of Pharmacy and Biomedical Sciences, Univesity of Strathclyde, Glasgow G1 1XW, United Kingdom
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Dresen S, Kempf J, Weinmann W. Prevalence of gamma-hydroxybutyrate (GHB) in serum samples of amphetamine, metamphetamine and ecstasy impaired drivers. Forensic Sci Int 2007; 173:112-6. [PMID: 17383132 DOI: 10.1016/j.forsciint.2007.02.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2006] [Revised: 02/05/2007] [Accepted: 02/07/2007] [Indexed: 10/23/2022]
Abstract
Two hundred and forty-seven serum samples which have been collected by police during roadside testing and have been found positive for amphetamine, methamphetamine, 3,4-methylenedioxyamphetamine (MDA), 3,4-methylenedioxymethamphetamine (MDMA) and/or 3,4-methylenedioxyethamphetamine (MDE) were analyzed for gamma-hydroxybutyrate (GHB). Serum samples were spiked with deuterated GHB as internal standard and acetonitrile was added to achieve dilution and protein precipitation. Samples were analyzed with a LC-MS/MS system operated in the multiple reaction monitoring mode (MRM) using a TurboIonSpray source. Chromatographic separation was achieved using a Synergi Polar RP column applying a gradient elution with a runtime of 15 min. To differentiate between endogenous and exogenously administered GHB a cut-off concentration of 10 microg/mL was applied. Five samples exceeded this concentration and were found positive for GHB. These samples were only found positive for amphetamine but no other amphetamine derivatives were detected, while in three samples THC and in one sample cocaine, benzoylecgonine and ethanol were found.
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Affiliation(s)
- S Dresen
- Institute of Forensic Medicine, Forensic Toxicology, University Hospital, Albertstr. 9, D-79104 Freiburg, Germany
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29
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Abanades S, Farré M, Segura M, Pichini S, Pastor A, Pacifici R, Pellegrini M, de la Torre R. Disposition of Gamma-Hydroxybutyric Acid in Conventional and Nonconventional Biologic Fluids After Single Drug Administration: Issues in Methodology and Drug Monitoring. Ther Drug Monit 2007; 29:64-70. [PMID: 17304152 DOI: 10.1097/ftd.0b013e3180307e5e] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Little controlled drug administration data are available to aid in the interpretation of gamma-hydroxybutyric acid (GHB) distribution in conventional and nonconventional fluids and the potential correlation between the pharmacokinetics of GHB and drug effects. Single oral sodium GHB doses of 50 mg/kg were administered to five volunteers. Plasma, oral fluid, urine, and sweat were analyzed for GHB by gas chromatography-mass spectrometry. GHB stability in plasma was studied at different storage temperatures. Subjective effects were measured using a set of 13 different visual analog scales. Mean peak GHB plasma concentrations at 30 minutes were 83.1 microg/mL. After the absorption phase, concentrations declined to mean values of 0.9 microg/mL at 6 hours. GHB was found in oral fluid at peak value concentrations equivalent to one third to one fourth of those found in plasma. The oral fluid-to-plasma ratio varied two fold in the 1- to 6-hour time range but always was lower than unit. The mean half-life (t1/2) of GHB was approximately 0.7 hour in plasma and approximately 1.2 hours in oral fluid. GHB urinary excretion is less than 2% of the dose administered. GHB was also detected in sweat at low concentrations. GHB showed a mixed sedative-stimulant pattern with subjective effects peaking between 1 and 1.5 hours after drug administration and lasting for 2 hours. Oral fluid and sweat appeared not to be suitable biologic matrices for monitoring GHB consumption. GHB-mediated subjective effects are related to GHB plasma concentrations.
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Affiliation(s)
- Sergio Abanades
- Pharmacology Research Unit, Human Pharmacology and Clinical Neurosciences Research Group, Institut Municipal d'Investigació Mèdica, Barcelona, Spain
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Saudan C, Augsburger M, Mangin P, Saugy M. Carbon isotopic ratio analysis by gas chromatography/combustion/isotope ratio mass spectrometry for the detection of gamma-hydroxybutyric acid (GHB) administration to humans. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2007; 21:3956-3962. [PMID: 17990278 DOI: 10.1002/rcm.3298] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Since GHB (gamma-hydroxybutyric acid) is naturally produced in the human body, clinical and forensic toxicologists must be able to discriminate between endogenous levels and a concentration resulting from exposure. To suggest an alternative to the use of interpretative concentration cut-offs, the detection of exogenous GHB in urine specimens was investigated by means of gas chromatography/combustion/isotope ratio mass spectrometry (GC/C/IRMS). GHB was isolated from urinary matrix by successive purification on Oasis MCX and Bond Elute SAX solid-phase extraction (SPE) cartridges prior to high-performance liquid chromatography (HPLC) fractioning using an Atlantis dC18 column eluted with a mixture of formic acid and methanol. Subsequent intramolecular esterification of GHB leading to the formation of gamma-butyrolactone (GBL) was carried out to avoid introduction of additional carbon atoms for carbon isotopic ratio analysis. A precision of 0.3 per thousand was determined using this IRMS method for samples at GHB concentrations of 10 mg/L. The (13)C/(12)C ratios of GHB in samples of subjects exposed to the drug ranged from -32.1 to -42.1 per thousand, whereas the results obtained for samples containing GHB of endogenous origin at concentration levels less than 10 mg/L were in the range -23.5 to -27.0 per thousand. Therefore, these preliminary results show that a possible discrimination between endogenous and exogenous GHB can be made using carbon isotopic ratio analyses.
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Affiliation(s)
- Christophe Saudan
- Laboratoire Suisse d'Analyse du Dopage, Institut Universitaire de Médecine Légale, Centre Hospitalier Universitaire Vaudois et Université de Lausanne, Chemin des Croisettes 22, 1066 Epalinges, Switzerland.
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Affiliation(s)
- T A Brettell
- Office of Forensic Sciences, New Jersey State Police, New Jersey Forensic Science and Technology Complex, 1200 Negron Road, Horizon Center, Hamilton, New Jersey 08691, USA
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Moriya F, Hashimoto Y. Site-dependent production of γ-hydroxybutyric acid in the early postmortem period. Forensic Sci Int 2005; 148:139-42. [PMID: 15639608 DOI: 10.1016/j.forsciint.2004.05.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2003] [Revised: 05/04/2004] [Accepted: 05/04/2004] [Indexed: 11/30/2022]
Abstract
This study compared endogenous gamma-hydroxybutyric acid (GHB) concentrations in various postmortem fluid samples of 25 autopsy cases. All bodies were stored between 10-20 degrees C until autopsy, and the intervals between death and autopsy were less than 2 days (6-48 h). GHB concentrations were measured by headspace gas chromatography after GHB was converted to gamma-butyrolactone. Endogenous GHB concentrations were significantly higher in femoral venous blood (4.6+/-3.4 microg/ml, n=23) than in cerebrospinal fluid (1.8+/-1.5 microg/ml, n=9), vitreous humor (0.9+/-1.7 microg/ml, n=8), bile (1.0+/-1.1 microg/ml, n=9) and urine (0.6+/-1.2 microg/ml, n=12). GHB concentrations were similar in blood samples taken from different sites. Cut-off limits of 30 and 10 microg/ml are proposed for blood and urine, respectively, to discriminate between exogenous and endogenous GHB in decedents showing no or little putrefaction (postmortem intervals usually 48 h or less). The criterion established for endogenous GHB in postmortem urine may also be applicable to analytical results in cerebrospinal fluid, vitreous humor and bile from deceased persons.
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Affiliation(s)
- Fumio Moriya
- Department of Legal Medicine, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku City, Kochi 783-8505, Japan.
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Fait A, Yellin A, Fromm H. GABA shunt deficiencies and accumulation of reactive oxygen intermediates: insight fromArabidopsismutants. FEBS Lett 2004; 579:415-20. [PMID: 15642352 DOI: 10.1016/j.febslet.2004.12.004] [Citation(s) in RCA: 96] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2004] [Revised: 11/24/2004] [Accepted: 12/02/2004] [Indexed: 11/22/2022]
Abstract
In plants, succinic semialdehyde dehydrogenase (SSADH)-deficiency results in the accumulation of reactive oxygen intermediates (ROI), necrotic lesions, dwarfism, and hypersensitivity to environmental stresses. We report that Arabidopsis ssadh knockout mutants contain five times the normal level of gamma-hydroxybutyrate (GHB), which in SSADH-deficient mammals accounts for phenotypic abnormalities. Moreover, the level of GHB in Arabidopsis is light dependent. Treatment with gamma-vinyl-gamma-aminobutyrate, a specific gamma-aminobutyrate (GABA)-transaminase inhibitor, prevents the accumulation of ROI and GHB in ssadh mutants, inhibits cell death, and improves growth. These results provide novel evidence for the relationship between the GABA shunt and ROI, which may, in part, explain the phenotype of SSADH-deficient plants and animals.
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Affiliation(s)
- Aaron Fait
- Department of Plant Sciences, Weizmann Institute of Science, 76100 Rehovot, Israel
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Kintz P, Villain M, Cirimele V, Ludes B. GHB in postmortem toxicology. Discrimination between endogenous production from exposure using multiple specimens. Forensic Sci Int 2004; 143:177-81. [PMID: 15240040 DOI: 10.1016/j.forsciint.2004.02.036] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2003] [Accepted: 02/12/2004] [Indexed: 11/26/2022]
Abstract
Since gamma-hydroxybutyrate (GHB) is present in both blood and urine of the general population as an endogenous compound, toxicologists must be able to discriminate between these endogenous levels and a concentration resulting from exogenous exposure. The implementation of a cut-off concentration must be done cautiously, due to the wide distribution of endogenous concentrations. To verify the accuracy of a proposed 50 mg/l postmortem blood cut-off, we tested 71 autopsy cases of subjects where the cause of death could exclude GHB exposure. The delay between death and autopsy ranged from 12 to 72 h. GHB was tested by gas chromatography-mass spectrometry (GC-MS) after precipitation. Briefly, 20 microl of blood, bile, or vitreous humor was pipetted in a glass tube, followed by 20 microl of GHB-d6 and 45 microl of acetonitrile. After vortexing and centrifugation, the supernatant was collected and evaporated to dryness. The residue was derivatized with bis(trimethylsilyl)trifluoroacetamide (BSTFA) with 1% trimethylchlorosilane (TMCS) for 20 min at 70 degrees C. After injection on a 30 m HP5 MS capillary column, GHB (m/z 233, 204, and 147) and GHB-d6 (m/z 239) were identified by MS. GHB tested positive in all the 71 whole blood (cardiac) specimens, with concentrations in the range 0.4-409 mg/l, with a major distribution in the range 10-40 mg/l. A concentration >50 mg/l was observed in 14 cases. As there was no data to support GHB exposure, this was considered as postmortem formation. In order to discriminate this contamination, when available, femoral blood, bile or/and, vitreous humor were tested. The following results were obtained: cardiac blood (55-409 mg/l) versus bile (6.1-238 mg/l) in seven cases; cardiac blood (51-409 mg/l) versus femoral blood (17-44 mg/l) in five cases, and cardiac blood (51-409 mg/l) versus vitreous humor (3.9-2 mg/l) in six cases. It is obvious that bile does not fit the requirements for discrimination and that femoral blood and mostly vitreous humor can be of particular interest. These results demonstrate that a positive (>50 mg/l) postmortem blood GHB concentration cannot support alone drug exposure and that it is essential to document the case with other specimens, including peripheral blood and vitreous humor.
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Affiliation(s)
- Pascal Kintz
- Institut de Médecine Légale, 11 rue Humann, F-67000 Strasbourg Cedex, France.
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Wood M, Laloup M, Samyn N, Morris MR, de Bruijn EA, Maes RA, Young MS, Maes V, De Boeck G. Simultaneous analysis of gamma-hydroxybutyric acid and its precursors in urine using liquid chromatography–tandem mass spectrometry. J Chromatogr A 2004; 1056:83-90. [PMID: 15595536 DOI: 10.1016/j.chroma.2004.04.067] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We have developed a rapid method that enables the simultaneous analysis of gamma-hydroxybutyrate (GHB) and its precursors, i.e. gamma-butyrolactone (GBL) and 1,4-butanediol (1,4-BD) in urine. The method comprised a simple dilution of the urine sample, followed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis. Chromatographic separation was achieved using an Atlantis dC18 column, eluted with a mixture of formic acid and methanol. The method was linear from 1-80 mg/L for GHB and 1,4-BD and from 1-50 mg/L for GBL. The limit of quantification was 1 mg/L for all analytes. The procedure, which has a total analysis time (including sample preparation) of less than 12 min, was fully validated and applied to the analysis of 182 authentic urine samples; the results were correlated with a previously published GC-MS procedure and revealed a low prevalence of GHB-positive samples. Since no commercial immunoassay is available for the routine screening of GHB, this simple and rapid method should prove useful to meet the current increased demand for the measurement of GHB and its precursors.
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Affiliation(s)
- Michelle Wood
- Waters Corporation, MS Technologies Centre, Micromass UK Ltd., Atlas Park, Simonsway, Wythenshawe, Manchester M22 5PP, UK.
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Fung HL, Haas E, Raybon J, Xu J, Fung SM. Liquid chromatographic–mass spectrometric determination of endogenous γ-hydroxybutyrate concentrations in rat brain regions and plasma. J Chromatogr B Analyt Technol Biomed Life Sci 2004; 807:287-91. [PMID: 15203042 DOI: 10.1016/j.jchromb.2004.04.022] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2004] [Revised: 04/22/2004] [Accepted: 04/22/2004] [Indexed: 11/18/2022]
Abstract
A new liquid chromatographic-mass spectrometric (LC-MS) method for determining trace concentrations of gamma-hydroxybutyric acid (GHB) in biological samples has been developed. This method utilizes solid-phase extraction for separation, deuterated GHB as an internal standard (IS) and multiple reaction monitoring (MRM) in the negative ion mode to detect the parent and product ions (103 and 57 for GHB, and 109 and 61 for D6-GHB, respectively). The assay produces excellent linearity and reproducibility, with a limit of quantification (LOQ) of about 0.1 microg/ml. The method has been applied for the determination of endogenous GHB in various rat brain regions.
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Affiliation(s)
- Ho-Leung Fung
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, SUNY, Buffalo, NY 14260-1200, USA.
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Abstract
Laboratory detection of gamma-hydroxybutyrate (GHB) has been published as early as the 1960s. However, wide-scale use of GHB during the 1990s has led to the development of current analytic methods to test for GHB and related compounds. Detection of GHB and related compounds can be clinically useful in confirming the cause of coma in an overdose patient, determining its potential role in a postmortem victim, as well as evaluating its use in a drug-facilitated sexual assault victim. Analytical method sensitivity must be known in order to determine the usefulness and clinical application. Most laboratory cut-off levels are based on instrument sensitivity and will not establish endogenous versus exogenous GHB levels. Interpretation of GHB levels must include a knowledge base of endogenous GHB, metabolism of GHB and related compounds, as well as postmortem generation. Due to potential analytical limitations in various GHB methods, it is clinically relevant to specifically request for GHB as well as related GHB compounds if they are also in question. Various storage conditions (collection time, types of containers, use of preservatives, storage temperature) can also affect the analysis and interpretation of GHB and related compounds.
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Current literature in mass spectrometry. JOURNAL OF MASS SPECTROMETRY : JMS 2003; 38:1290-1301. [PMID: 14696212 DOI: 10.1002/jms.415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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Current literature in mass spectrometry. JOURNAL OF MASS SPECTROMETRY : JMS 2003; 38:1215-1224. [PMID: 14648831 DOI: 10.1002/jms.414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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