title: State of the art in bile analysis in forensic toxicology.
abstract: In forensic toxicology, alternative matrices to blood are useful in case of limited, unavailable or unusable blood sample, suspected postmortem redistribution or long drug intake-to-sampling interval. The present article provides an update on the state of knowledge for the use of bile in forensic toxicology, through a review of the Medline literature from 1970 to May 2015. Bile physiology and technical aspects of analysis (sampling, storage, sample preparation and analytical methods) are reported, to highlight specificities and consequences from an analytical and interpretative point of view. A table summarizes cause of death and quantification in bile and blood of 133 compounds from more than 200 case reports, providing a useful tool for forensic physicians and toxicologists involved in interpreting bile analysis. Qualitative and quantitative interpretation is discussed. As bile/blood concentration ratios are high for numerous molecules or metabolites, bile is a matrix of choice for screening when blood concentrations are low or non-detectable: e.g., cases of weak exposure or long intake-to-death interval. Quantitative applications have been little investigated, but small molecules with low bile/blood concentration ratios seem to be good candidates for quantitative bile-based interpretation. Further experimental data on the mechanism and properties of biliary extraction of xenobiotics of forensic interest are required to improve quantitative interpretation.
authors.affiliation: Laboratoire LAT LUMTOX, 71 Avenue Rockefeller, 69003 Lyon, France; Département de médecine légale, Hôpital Edouard-Herriot, Hospices Civils de Lyon, Place d'Arsonval, 69437 Lyon Cedex 03, France. Electronic address: f.bevalot@latlumtox.com.
authors.forename: F
authors.initials: F
authors.lastname: Bévalot
authors.affiliation: Laboratoire de Toxicologie, ISPB-Faculté de Pharmacie, Université de Lyon, Université Claude Bernard Lyon 1, 8 Avenue Rockefeller, 69373 Lyon Cedex 08, France.
authors.forename: N
authors.initials: N
authors.lastname: Cartiser
authors.affiliation: Laboratoire LAT LUMTOX, 71 Avenue Rockefeller, 69003 Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Bottinelli
authors.affiliation: Laboratoire de Toxicologie, ISPB-Faculté de Pharmacie, Université de Lyon, Université Claude Bernard Lyon 1, 8 Avenue Rockefeller, 69373 Lyon Cedex 08, France; Laboratoire de Pharmacologie-Toxicologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, 165 Chemin Grand Revoyet, 69495 Pierre Bénite Cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Guitton
authors.affiliation: Département de médecine légale, Hôpital Edouard-Herriot, Hospices Civils de Lyon, Place d'Arsonval, 69437 Lyon Cedex 03, France; CREATIS CNRS UMR 5220, INSERM U1044, Université de Lyon, Université Claude Bernard Lyon 1, INSA Lyon, 7 Avenue Jean Capelle, 69621 Villeurbanne Cedex, France.
authors.forename: L
authors.initials: L
authors.lastname: Fanton
mesh_terms: D001646:Bile / Q000737:chemistry* / Q000502:physiology*; D053593:Forensic Toxicology / Q000379:methods*; D006801:Humans; D012680:Sensitivity and Specificity
keywords: Bile; Bile physiology; Drug; Forensic toxicology; Interpretation; Review