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. 2022 Sep;26(17):4666-4677.
doi: 10.1111/jcmm.17351. Epub 2022 Aug 2.

6-Monoacetylmorphine-antibody distribution in tissues from heroin-related death cases: An experimental study to investigate the distributive response

Aniello Maiese  1 , Raffaele La Russa  2 , Maria Chiara David  3 , Santina Cantatore  2 , Alice Chiara Manetti  1 , Alessandra De Matteis  4 , Costantino Ciallella  4 , Paola Frati  4 , Vittorio Fineschi  4
Affiliations

6-Monoacetylmorphine-antibody distribution in tissues from heroin-related death cases: An experimental study to investigate the distributive response

Aniello Maiese et al. J Cell Mol Med. 2022 Sep.

Abstract

Heroin, a semisynthetic opioid drug synthesized from morphine, is the 3,6-diacetyl ester of morphine (diacetylmorphine). The post-mortem diagnosis of heroin-related death could be an issue and usually rely on a combination of investigations, including the autopsy, histological and toxicological analysis. We conducted the present study to evaluate the correlation between the heroin concentration in biological fluids (peripheral blood, bile and urine) and the post-mortem anti-6-MAM antibody expression in various tissues (brain, heart, lung, liver and kidney) using immunohistochemical staining. A quantitative analysis of the immunohistochemical reaction was carried out. 45 cases of heroin-related death investigated at the Forensic Pathology Institutes of the University of Rome, Foggia and Pisa were included. The control group was composed of 15 cases of death due to other causes, without brain lesions and negative toxicological analysis for drugs. We found a positive immunohistochemical reaction in different organs and it was related to the timing of heroin metabolization. No reaction was found in the control group. Our findings show that immunohistochemistry can be a valuable tool for the post-mortem diagnosis of acute heroin abuse. A better understanding of the timing of heroin's metabolism can be useful in the forensic field and for future therapeutic applications.

Keywords: anti-6-MAM antibody; heroin-related death; immunohistochemistry; marker; post-mortem diagnosis.

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Conflict of interest statement

The authors confirm that there are no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Confocal laser scanning microscopy (CLSM): intense immunoreactivity in the hypothalamus demonstrated by purple spots (arrows) in the parenchyma (neuronal nuclei in white, cytoplasm in bleu) (×100). Insert: ×150
FIGURE 2
FIGURE 2
Lung: (A, B) evident staining (arrows) in the cytoplasm of macrophages (CLSM positivity in brown, ×100) and higher magnification (×200) in (C) and (D) spots (in bleu) in the intra‐alveolar spaces (arrows) (CLSM positivity in bleu, ×60)
FIGURE 3
FIGURE 3
(A) Positivity reactions are evident (in brown, ×60); (B) visualization of focal positivity (arrows) with confocal laser scanning microscope (green spots) (×80). (C) Intense positivity (in bleu, ×200) near a portal space (delimited by white circle)
FIGURE 4
FIGURE 4
(A) Glomerular positivity (in brown, arrows) and at the level of both proximal and distal convoluted tubules (arrows, ×300). (B–D) Confocal laser scanning microscopy study of the kidneys. (B) Intense positivity (in green) within the tubular epithelial cells in the proximal tubules (arrows, ×300) and (C, D) at the level of both proximal and distal convoluted tubules (arrows, ×200)
FIGURE 5
FIGURE 5
Box and whiskers plot showing the immunohistochemical reaction in the brain, lung, liver, kidney and intravascular
See this image and copyright information in PMC

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