Cargando…

Forensic Post-Mortem Investigation in AAS Abusers: Investigative Diagnostic Protocol. A Systematic Review

Anabolic–androgenic steroids (AASs) are a group of synthetic molecules derived from testosterone and its precursors. AASs are widely used illicitly by adolescents and athletes, especially by bodybuilders; AASs are among the most used drugs for improving physical performance, as well as for aesthetic...

Descripción completa

Detalles Bibliográficos
Autores principales: Esposito, Massimiliano, Licciardello, Gabriele, Privitera, Federico, Iannuzzi, Salvatore, Liberto, Aldo, Sessa, Francesco, Salerno, Monica
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8393338/
https://www.ncbi.nlm.nih.gov/pubmed/34441242
http://dx.doi.org/10.3390/diagnostics11081307
_version_ 1783743704216895488
author Esposito, Massimiliano
Licciardello, Gabriele
Privitera, Federico
Iannuzzi, Salvatore
Liberto, Aldo
Sessa, Francesco
Salerno, Monica
author_facet Esposito, Massimiliano
Licciardello, Gabriele
Privitera, Federico
Iannuzzi, Salvatore
Liberto, Aldo
Sessa, Francesco
Salerno, Monica
author_sort Esposito, Massimiliano
collection PubMed
description Anabolic–androgenic steroids (AASs) are a group of synthetic molecules derived from testosterone and its precursors. AASs are widely used illicitly by adolescents and athletes, especially by bodybuilders; AASs are among the most used drugs for improving physical performance, as well as for aesthetic purposes. The use of AASs by professional and recreational athletes is increasing worldwide. This review focused on deaths related to AAS abuse and to investigation of the autopsy results and histopathological findings using a rigorous methodology protocol covering: a complete autopsy, histological analysis, and a broad toxicological investigation. Moreover, we aimed to define an investigative diagnostic protocol supporting forensic pathologists during the post-mortem investigation of AAS abusers. This review was conducted using PubMed Central and Google Scholar databases to find articles published between 1 January 1968 and 30 June 2021, using the following key terms: “(anabolic-androgenic steroids) AND (autopsy); (anabolic-androgenic steroids) AND (forensic)”. A total of 939 articles were screened and 926 did not meet the inclusion criteria. In conclusion, 14 articles were included in this systematic review, reporting 137 fatal cases of AAS abuse in total. The histopathologic studies showed myocardial damage characterized by myocyte hypertrophy, focal myocyte damage with myofibrillar loss, interstitial fibrosis, mostly subepicardial, and small vessel disease. Indeed, in AAS-related cases, autopsy plays a pivotal role in the study of AAS adverse effects and organ damage related to their use or abuse. This systematic review aimed to define a specific workflow in death cases related to AASs, suggesting important future insights to better clarify sudden deaths related to AASs, such as the use of miRNAs. The forensic community needs a unified approach in cases of suspected death related to the use of AASs. There are several occasions to apply this workflow, for example in cases of death of bodybuilders and of young people who die in gymnasiums or during sports activities.
format Online
Article
Text
id pubmed-8393338
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-83933382021-08-28 Forensic Post-Mortem Investigation in AAS Abusers: Investigative Diagnostic Protocol. A Systematic Review Esposito, Massimiliano Licciardello, Gabriele Privitera, Federico Iannuzzi, Salvatore Liberto, Aldo Sessa, Francesco Salerno, Monica Diagnostics (Basel) Review Anabolic–androgenic steroids (AASs) are a group of synthetic molecules derived from testosterone and its precursors. AASs are widely used illicitly by adolescents and athletes, especially by bodybuilders; AASs are among the most used drugs for improving physical performance, as well as for aesthetic purposes. The use of AASs by professional and recreational athletes is increasing worldwide. This review focused on deaths related to AAS abuse and to investigation of the autopsy results and histopathological findings using a rigorous methodology protocol covering: a complete autopsy, histological analysis, and a broad toxicological investigation. Moreover, we aimed to define an investigative diagnostic protocol supporting forensic pathologists during the post-mortem investigation of AAS abusers. This review was conducted using PubMed Central and Google Scholar databases to find articles published between 1 January 1968 and 30 June 2021, using the following key terms: “(anabolic-androgenic steroids) AND (autopsy); (anabolic-androgenic steroids) AND (forensic)”. A total of 939 articles were screened and 926 did not meet the inclusion criteria. In conclusion, 14 articles were included in this systematic review, reporting 137 fatal cases of AAS abuse in total. The histopathologic studies showed myocardial damage characterized by myocyte hypertrophy, focal myocyte damage with myofibrillar loss, interstitial fibrosis, mostly subepicardial, and small vessel disease. Indeed, in AAS-related cases, autopsy plays a pivotal role in the study of AAS adverse effects and organ damage related to their use or abuse. This systematic review aimed to define a specific workflow in death cases related to AASs, suggesting important future insights to better clarify sudden deaths related to AASs, such as the use of miRNAs. The forensic community needs a unified approach in cases of suspected death related to the use of AASs. There are several occasions to apply this workflow, for example in cases of death of bodybuilders and of young people who die in gymnasiums or during sports activities. MDPI 2021-07-21 /pmc/articles/PMC8393338/ /pubmed/34441242 http://dx.doi.org/10.3390/diagnostics11081307 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Esposito, Massimiliano
Licciardello, Gabriele
Privitera, Federico
Iannuzzi, Salvatore
Liberto, Aldo
Sessa, Francesco
Salerno, Monica
Forensic Post-Mortem Investigation in AAS Abusers: Investigative Diagnostic Protocol. A Systematic Review
title Forensic Post-Mortem Investigation in AAS Abusers: Investigative Diagnostic Protocol. A Systematic Review
title_full Forensic Post-Mortem Investigation in AAS Abusers: Investigative Diagnostic Protocol. A Systematic Review
title_fullStr Forensic Post-Mortem Investigation in AAS Abusers: Investigative Diagnostic Protocol. A Systematic Review
title_full_unstemmed Forensic Post-Mortem Investigation in AAS Abusers: Investigative Diagnostic Protocol. A Systematic Review
title_short Forensic Post-Mortem Investigation in AAS Abusers: Investigative Diagnostic Protocol. A Systematic Review
title_sort forensic post-mortem investigation in aas abusers: investigative diagnostic protocol. a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8393338/
https://www.ncbi.nlm.nih.gov/pubmed/34441242
http://dx.doi.org/10.3390/diagnostics11081307
work_keys_str_mv AT espositomassimiliano forensicpostmorteminvestigationinaasabusersinvestigativediagnosticprotocolasystematicreview
AT licciardellogabriele forensicpostmorteminvestigationinaasabusersinvestigativediagnosticprotocolasystematicreview
AT priviterafederico forensicpostmorteminvestigationinaasabusersinvestigativediagnosticprotocolasystematicreview
AT iannuzzisalvatore forensicpostmorteminvestigationinaasabusersinvestigativediagnosticprotocolasystematicreview
AT libertoaldo forensicpostmorteminvestigationinaasabusersinvestigativediagnosticprotocolasystematicreview
AT sessafrancesco forensicpostmorteminvestigationinaasabusersinvestigativediagnosticprotocolasystematicreview
AT salernomonica forensicpostmorteminvestigationinaasabusersinvestigativediagnosticprotocolasystematicreview