The application of proteomic techniques to forensic science widens the range of analytical capabilities available to forensic laboratories when answering complex toxicology problems. Currently, these techniques are underutilised in post‐mortem toxicology because of the historic focus on smaller (<1,000 amu) drug molecules. Definitive confirmation of an insulin overdose by analysis of post‐mortem biological matrices is rare and challenging, however can assist coronial investigations pertaining to accidental or intentional overdoses in both diabetic and nondiabetic populations. A semiautomated micro‐solid phase extraction paired with mass spectrometry‐based insulin methodology was developed and validated for routine use in a Forensic Coronial Toxicology Laboratory. This resulting work reports the first Australian cases where synthetic insulins were confirmed by mass spectrometry in the vitreous humour of Type 1 diabetics who intentionally or accidentally overdosed on their prescription medication glargine and aspart. The detection of glargine M1 in Case 1, aspart in Case 2 and glargine M1 was indicated in Case 3. This paper highlights advancements in forensic coronial toxicology and the promising potential of proteomic analysis in a forensic context.

中文翻译：

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检测死后玻璃体液中完整的胰岛素类似物——在法医毒理学案例中的应用

蛋白质组学技术在法医科学中的应用扩大了法医实验室在回答复杂毒理学问题时可用的分析能力范围。目前，这些技术在死后毒理学中未得到充分利用，因为历史上关注的是较小的（<1,000 amu）药物分子。通过分析死后生物基质来明确确认胰岛素过量是罕见且具有挑战性的，但是可以帮助与糖尿病和非糖尿病人群中意外或故意过量相关的冠状调查。开发并验证了半自动微固相萃取与基于质谱的胰岛素方法相结合，可在法医冠状毒理学实验室常规使用。这项由此产生的工作报告了澳大利亚第一例通过质谱法在 1 型糖尿病患者的玻璃体液中证实合成胰岛素的病例，这些患者有意或无意地过量服用处方药甘精和门冬氨酸。案例 1 中检测到甘精液 M1，案例 2 中检测到门冬氨酸，案例 3 中显示了甘精液 M1。本文重点介绍了法医冠状毒理学方面的进展以及蛋白质组学分析在法医背景下的潜力。