Forensic Biochemical Markers to Evaluate the Agonal Period: A Literature Review
Enrica Rosato,
Martina Bonelli,
Marcello Locatelli,
Ugo de Grazia,
Angela Tartaglia,
Fabio Savini,
Cristian D'Ovidio
Affiliations
Enrica Rosato
Department of Pharmacy, University of Chieti-Pescara “G. d’Annunzio”, Via dei Vestini 31, 66100 Chieti, Italy
Martina Bonelli
Section of Legal Medicine, Center for Advanced Studies and Technology (CAST), Department of Medicine and Aging Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via Polacchi, 66100 Chieti, Italy
Marcello Locatelli
Department of Pharmacy, University of Chieti-Pescara “G. d’Annunzio”, Via dei Vestini 31, 66100 Chieti, Italy
Ugo de Grazia
Laboratory of Neurological Biochemistry and Neuropharmacology, IRCCS Neurological Institute Foundation Carlo Besta, Via Celoria 11, 20133 Milan, Italy
Angela Tartaglia
Department of Pharmacy, University of Chieti-Pescara “G. d’Annunzio”, Via dei Vestini 31, 66100 Chieti, Italy
Fabio Savini
Pharmatoxicology Laboratory-Hospital “Santo Spirito”, Via Fonte Romana 8, 65124 Pescara, Italy
Cristian D'Ovidio
Section of Legal Medicine, Center for Advanced Studies and Technology (CAST), Department of Medicine and Aging Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via Polacchi, 66100 Chieti, Italy
Currently, forensic research is multidisciplinary with new methods and parameters useful to define the cause and time of death as well as survival/agony times. The identification of biochemical markers able to estimate agonal period has been studied by many forensic researchers. It is known that the estimation of agonal time in different types of death is not always easy, hence our interest in literature’s data. The studies analyzed in this review confirm the important role of thanatobiochemistry for the estimation of survival times. Regardless of the death cause, the survival/agony time between the primary event and death influences markers concentrations in biological samples (e.g., blood, urine, cerebrospinal fluid). Different biomarkers can be used for qualitative evaluations in deaths with short and long agony (e.g., C-reactive protein, ferritin, GFAP, etc.). Instead, the quantitative interpretation showed limits due to the lack of reference cut-offs. Thanatobiochemistry is a useful tool to confirm what emerged from autopsies findings (macroscopic and histological analysis), but further studies are desirable to confirm the evidence emerging from our review of the literature.