title: Pharmacogenetics in medico-legal context.
abstract: Medico-legal autopsy is the primary method in determining the cause and manner of death when the death is suspected to be unnatural. In some of these autopsies, the death remains ambiguous, even after a complete autopsy including histological investigation and toxicological screenings. In cases where there are no morphological abnormalities, medico-legal genetics may offer additional means to provide knowledge of possible genetic mutations, which may have initiated the process or predisposed the individual to stress risk conditions leading to death. One class of ambiguous deaths consists of drug-related deaths where the interpretation of the toxicological results are not clear. In such situations post mortem genotyping and the analysis of metabolite rations may provide an insight to the findings. A few cases demonstrating the potential strength of pharmacogenetics in medico-legal context has been published. However, there is a paramount need for serious scientific studies before the field of post mortem pharmacogenetics can be utilized in routine medico-legal analyses casework and brought routinely into courtroom.
authors.affiliation: Hjelt Institute, Department of Forensic Medicine, P.O. Box 14, University of Helsinki, Finland. antti.sajantila@helsinki.fi
authors.forename: A
authors.initials: A
authors.lastname: Sajantila
authors.forename: J U
authors.initials: JU
authors.lastname: Palo
authors.forename: I
authors.initials: I
authors.lastname: Ojanperä
authors.forename: C
authors.initials: C
authors.lastname: Davis
authors.forename: B
authors.initials: B
authors.lastname: Budowle
mesh_terms: D000639:Amitriptyline / Q000097:blood / Q000493:pharmacokinetics; D000929:Antidepressive Agents, Tricyclic / Q000097:blood / Q000493:pharmacokinetics; D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics; D065731:Cytochrome P-450 CYP2C19; D019389:Cytochrome P-450 CYP2D6 / Q000235:genetics; D053803:Forensic Genetics; D053593:Forensic Toxicology; D005819:Genetic Markers; D014644:Genetic Variation; D005838:Genotype; D006801:Humans; D010597:Pharmacogenetics; D010599:Pharmacokinetics; D010641:Phenotype
chemical_list: D000929:Antidepressive Agents, Tricyclic; D005819:Genetic Markers; D000639:Amitriptyline; D001189:Aryl Hydrocarbon Hydroxylases; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D019389:Cytochrome P-450 CYP2D6