Postmortem determination of concentrations of stress hormones in various body fluids—is there a dependency between adrenaline/noradrenaline quotient, cause of death and agony time?

Abstract

To find out whether a certain cause of death or a certain length of an agonal period shows specific adrenaline or noradrenaline profiles, heart blood, femoral vein blood, liquor, urine and vitreous humour were taken from corpses (n = 98) at the Medical School Hannover, and noradrenaline and adrenaline were determined using high-performance liquid chromatography (HPLC). Corpses were classified according to the following five categories: short agony, long agony, state after hanging, state after asphyxiation and state after CPR with documented administration of epinephrine. Once results were collected the adrenaline/noradrenaline quotient was determined. It became clear that there were no significant differences regarding the concentration of adrenaline and noradrenaline in the various body fluids in relation to the above-mentioned categories. The means adrenaline/noradrenaline quotients in femoral vein blood were 0.21 +/- 0.29 for hanged persons, 0.38 +/- 0.47 for asphyxiated persons, 0.17 +/- 0.19 for those with short agony and 0.42 +/- 0.43 for those with long agony, significantly below 1 (p < 0.001; p = 0.001; p = 0.003). For condition after CPR we found an adrenaline/noradrenaline quotient of 2.81 +/- 5.8. In liquor the adrenaline/noradrenaline quotients for short agony was 0.17 +/- 0.17, for hanged persons 0.18 +/- 0.19 and for asphyxiated ones 0.30 +/- 0.38, significantly lower than 1 (p < 0.001). In urine the adrenaline/noradrenaline quotients for all categories are lower than 1 (p < 0.001); short agony (0.13 +/- 0.09), long agony (0.21 +/- 0.16), hanged (0.15 +/- 0.16), asphyxiated (0.14 +/- 0.08) and CPR (0.14 +/- 0.06). In vitreous humour the quotients for short agony (0.14 +/- 0.28), long agony (0.13 +/- 0.12), hanged (0.07 +/- 0.09) and asphyxiated (0.09 +/- 0.11) are lower than 1 (p < 0.001). The spread of data for the adrenaline/noradrenaline quotient did not allow for any conclusions about cause of death and length of agony in individual cases.

Postmortem chemistry update part II

“…Postmortem serum catecholamine levels in relation to the cause of death have been investigated by Zhu et al [133] and Wilke et al [134]. Zhu et al [133] analysed catecholamine levels in 542 autopsy cases in postmortem serum from different sampling sites and found that increases in catecholamine fractions (adrenaline, noradrenaline, and dopamine) depended on the cause of death as well as the magnitude of physical stress responses during the death process in individual cases.…”

“…Zhu et al [133] analysed catecholamine levels in 542 autopsy cases in postmortem serum from different sampling sites and found that increases in catecholamine fractions (adrenaline, noradrenaline, and dopamine) depended on the cause of death as well as the magnitude of physical stress responses during the death process in individual cases. Wilke et al [134] analysed catecholamine levels in femoral blood, heart blood, cerebrospinal fluid, urine, and vitreous in 98 autopsy cases divided into four groups (short agony, long agony, hanging asphyxiation, and cardiopulmonary resuscitation). Absolute values for adrenaline and noradrenaline in heart and femoral blood displayed no significant differences in relation to the cause of death and length of agony.…”

<b>Alterações em adrenais de cães relacionadas à morte súbita ou agônica:</b> análise morfométrica, histopatológica, imunoistoquímica e correlação com os níveis de adrenalina e noradrenalina na medula adrenal

“…O peso e as dimensões das adrenais encontrados neste estudo são compatíveis com as médias descritas na literatura para a espécie canina (BAKER, 1937;GROOTERS;BILLER;MERRYMAN, 1995 DUTTA, 2015). Por outro lado, algumas condições patológicas, como doenças inflamatórias, hipotensão e hipóxia, podem levar à estimulação de apoptose nas células do córtex adrenal (WILLENBERG et al, 1998;BOZZO et al, 2006;YU et al, 2012).…”

“…Além do exame necroscópico em si, há uma série de exames complementares que podem auxiliar na investigação médico-legal referente à causa de morte de um indivíduo, e as análises de marcadores bioquímicos, como as catecolaminas, podem ser úteis para a investigação das diversas respostas referentes ao estresse desencadeado pelo processo de morte HUTTUNEN, 1996;GOLDSTEIN, 2003;WILKE et al, 2007;ZHU et al, 2007).…”

“…A adrenalina (ADR) e a noradrenalina (NOR) são catecolaminas envolvidas na resposta ao estresse, sendo sintetizadas pela medula adrenal e, no caso da NOR, também pelos nervos simpáticos (ALOUSI; WEINER, 1966;WEINER, 1970;BLASCHKO;SAYERS, 1975 Os níveis plasmáticos de ADR e NOR refletem a secreção pela medula adrenal e, embora existam diversos trabalhos relacionados à quantificação plasmática de ADR e NOR em relação à causa de morte ou a demais situações de estresse em humanos ou em modelos animais (TOSO et al, 1993;HUTTUNEN, 1996;BEERDA et al, 1999;LUCOT et al, 2005;WILKE et al, 2007;ZHU et al, 2007), a obtenção de quantidades significativas de soro no sangue após a morte é dificultada pela coagulação disseminada. Na rotina de necropsia de pequenos animais, a possibilidade de coleta de sangue no pós-morte imediato é rara.…”