title: Immunoassay for ethyl glucuronide in vitreous humor: a new tool for postmortem diagnostics of alcohol use.
abstract: Although excessive alcohol consumption plays a major role in fatal events, the role of alcohol use as a possible contributing factor at the time of death is not easy to establish due to lack of suitable biomarkers for postmortem analyses. We used an immunological approach to measure ethyl glucuronide (EtG) concentrations from vitreous humor (VH) and serum from 58 individuals representing a forensic autopsy population of cases with either a well-documented history of excessive alcohol use (n=37) or cases without such history (n=21), according to medical and police records and blood alcohol determinations (BAC). The immunoassay was based on the Microgenics DRI-EtG EIA reagents applied on an automated Abbott Architect c8000 clinical chemistry analyzer. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) determination of EtG and ethyl sulfate (EtS) was used as a reference method. At a cut-off of 0.3mg/l for VH-EtG, the immunoassay correctly identified 92% of the cases with a history of excessive alcohol use, whereas the BAC was positive (cut-off 10mg/dl) in 68% of the cases. A significant correlation emerged between VH-EtG and serum EtG (r=0.77, p<0.001) and between VH-EtG and BAC (r=0.62, p<0.001), although VH-EtG was frequently elevated also in cases with no detectable BAC. The EtG immunoassay showed a strong correlation with the LC-MS/MS reference method (r=0.94, p<0.001) and there was 100% agreement in the frequency of marker positive and negative findings between the immunoassay EtG results and the LC-MS/MS analysis of EtG and EtS. The present data indicate that the immunoassay for VH-EtG is a useful forensic tool for screening of antemortem alcohol use.
authors: Department of Forensic Medicine, School of Medicine, University of Tampere, 33014 Tampere, Finland.
authors: Juha
authors: J
authors: Rainio
authors: Johanna
authors: J
authors: Kultti
authors: Päivikki
authors: P
authors: Kangastupa
authors: Heidi
authors: H
authors: Tuomi
authors: Sanna
authors: S
authors: Ahola
authors: Pekka J
authors: PJ
authors: Karhunen
authors: Anders
authors: A
authors: Helander
authors: Onni
authors: O
authors: Niemelä
mesh_terms: D000368:Aged; D000437:Alcoholism / Q000175:diagnosis*; D015415:Biomarkers / Q000737:chemistry; D002492:Central Nervous System Depressants / Q000097:blood; D002853:Chromatography, Liquid; D000431:Ethanol / Q000097:blood; D005260:Female; D053593:Forensic Toxicology; D005965:Glucuronates / Q000032:analysis*; D006801:Humans; D007118:Immunoassay / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011180:Postmortem Changes; D012680:Sensitivity and Specificity; D013463:Sulfuric Acid Esters / Q000032:analysis; D053719:Tandem Mass Spectrometry; D014822:Vitreous Body / Q000737:chemistry*
chemical_list: D015415:Biomarkers; D002492:Central Nervous System Depressants; D005965:Glucuronates; D013463:Sulfuric Acid Esters; C093924:ethyl glucuronide; D000431:Ethanol; C011612:diethyl sulfate