Toxicologie Analytique et Clinique最新文献

{"title":"Surdosage fatal en ropivacaïne au décours d’une opération chirurgicale","authors":"Frédéric Aknouche , Christophe Maruejouls , Claire Trebuchet , Kévin Fargeot , Corry Valancony , Laureen Thion , Morgane Baudry , Pascal Kintz","doi":"10.1016/j.toxac.2025.09.002","DOIUrl":"10.1016/j.toxac.2025.09.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Présentée avec des effets cardio-toxiques moins marqués que la bupivacaïne, l’usage thérapeutique de la ropivacaïne est bien maîtrisé en anesthésie locorégionale et présente, tant sur le contrôle de l’analgésie que sur l’amélioration des conditions postopératoires, une efficacité très appréciée des cliniciens. Les accidents sous ropivacaïne semblent limités et la littérature rapportant des décès induits est très pauvre. Dans ces conditions, même si les circonstances et les conditions de traitement de ce dossier ne sont pas bien documentées, il a semblé important aux auteurs de décrire cette expertise pour apporter une contribution, certes limitée, à la littérature médicale.</div></div><div><h3>Méthode</h3><div>Les auteurs ont été confrontés à un décès accidentel survenu au décours d’une opération suite à une fracture de la cheville chez un homme de 69 ans. Si les circonstances et la maîtrise hospitalière de l’évènement restent un peu flous (absence de dossier médical documenté, absence de suivi judiciaire), l’autopsie, réalisée plus de 3 semaines après le décès, a mis en évidence une congestion viscérale marquée et un possible infarcissement rénal sur un cadavre en mauvais état général (foie d’allure stéatosique, héliodermite).</div></div><div><h3>Résultats</h3><div>Une expertise toxicologique de référence a permis de mettre en évidence par chromatographie liquide couplée à la spectrométrie de masse en tandem un surdosage massif en ropivacaïne avec une concentration à 6,53<!--> <!-->mg/L dans le sang fémoral. Il n’a pas été observé de séquestration tissulaire (foie à 0,46<!--> <!-->mg/kg, cœur à 0,41<!--> <!-->mg/kg, rein à 0,48<!--> <!-->mg/kg, encéphale à 0,50<!--> <!-->mg/kg et poumon à 0,60<!--> <!-->mg/kg) permettant d’évoquer un décès rapide après administration.</div></div><div><h3>Conclusion</h3><div>Les médecins légistes ont conclu à une embolie pulmonaire consécutive à des troubles du rythme cardiaque.</div></div><div><h3>Introduction</h3><div>Ropivacaine is presented with less cardio-toxicity when compared to bupivacaine. The therapeutic use of ropivacaine for local or regional surgery is well established and presents suitable efficacy for analgesia control and postoperative conditions. Accidents involving ropivacaine seems limited and a comprehensive literature review about death due to ropivacaine returned with few citations. Although numerous details are missing, it was considered by the authors that the presented case could contribute to the medical literature.</div></div><div><h3>Method</h3><div>The authors were recently involved in a fatal event of a 69-year-old man where ropivacaine was used during ankle surgery. Although the circumstances and the hospital intervention are unclear (lack of medical records), the autopsy, performed about 3 weeks after the death, demonstrated visceral congestion and possible kidney infarction on a cadaver with bad general conditions (steatosis liver and photodermatose","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"38 1","pages":"Pages 128-133"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147417363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute drug-induced dystonia: Emergency department presentation and management","authors":"Habib Hammami , Camillia Jeddi , Mohamed Kilani , Hafedh Thabet","doi":"10.1016/j.toxac.2025.08.002","DOIUrl":"10.1016/j.toxac.2025.08.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Acute drug-induced dystonia (ADID) is a neurological presentation triggered primarily by antipsychotics, leading to focal rigidity, oromandibular dystonia, torticollis, and opisthotonos. This study aimed to describe dystonic manifestations in emergency department patients and evaluate severity and management strategies.</div></div><div><h3>Methods</h3><div>A retrospective study (2022–2024) at the emergency department of Mahmoud Yaacoub Center for Urgent Medical Assistance included patients with ADID. Patients’ demographics, clinical manifestation, severity parameters and treatment data were collected and analyzed.</div></div><div><h3>Results</h3><div>We included 160 patients (median age 30, 71.8% male). Antipsychotics, especially Haloperidol (61.2%), were the main drugs involved. Common symptoms included focal rigidity (23.7%) and oromandibular dystonia (21.2%). Severe cases (18.1%) involved neurological alteration (7%), rhabdomyolysis (8.7%), and renal failure (4.4%). Treatment included benzodiazepines (36.2%) and anticholinergics (23.7%). Psychiatric history was linked to a higher risk of severe dystonia (<em>P</em> <!-->=<!--> <!-->0.051, OR<!--> <!-->=<!--> <!-->1.74), with prior suicide attempts showing the greatest increase (<em>P</em> <!-->=<!--> <!-->0.011, OR<!--> <!-->=<!--> <!-->5.28). In contrast, substance abuse (<em>P</em> <!-->=<!--> <!-->0.046, OR<!--> <!-->=<!--> <!-->0.43), antipsychotic use (<em>P</em> <!-->=<!--> <!-->0.012, OR<!--> <!-->=<!--> <!-->0.41), especially haloperidol (<em>P</em> <!-->=<!--> <!-->0.051, OR<!--> <!-->=<!--> <!-->0.51), were associated with lower risk.</div></div><div><h3>Conclusion</h3><div>ADID mainly affects young males, with antipsychotics as the leading cause. While psychiatric history increased the risk of severe dystonia, substance abuse and antipsychotic use were linked to reduced risk.</div></div><div><h3>Introduction</h3><div>La dystonie aiguë induite par les médicaments (DAIM) est une manifestation neurologique principalement déclenchée par les antipsychotiques, se traduisant par une rigidité focale, une dystonie oromandibulaire, un torticolis et un opisthotonos. Cette étude visait à décrire les manifestations dystoniques chez les patients admis aux urgences et à évaluer la gravité ainsi que les stratégies de prise en charge.</div></div><div><h3>Méthodes</h3><div>Une étude rétrospective (2022–2024) menée aux urgences du centre Mahmoud Yaacoub d’aide médicale d’urgence a inclus des patients présentant une DAIM. Les données démographiques, cliniques, les paramètres de gravité et les traitements administrés ont été collectés et analysés.</div></div><div><h3>Résultats</h3><div>Nous avons inclus 160 patients (âge médian de 30 ans, 71,8 % d’hommes). Les antipsychotiques, en particulier l’halopéridol (61,2 %), étaient les principaux médicaments impliqués. Les causes d’intoxication étaient majoritairement l’usage récréatif (41,2 %) et les tentatives de suicide (20,6 %","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"38 1","pages":"Pages 48-56"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147416500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic profiling of 2C-EF in human liver microsomes: Identification of major metabolites and biotransformation pathways","authors":"Nadia Arbouche ,&nbsp;Laurie Gheddar ,&nbsp;Alice Ameline ,&nbsp;Jean-Sébastien Raul ,&nbsp;Pascal Kintz","doi":"10.1016/j.toxac.2025.08.005","DOIUrl":"10.1016/j.toxac.2025.08.005","url":null,"abstract":"<div><div>2C-EF (4-(2-fluoroethyl)-2,5-dimethoxyphenethylamine) is a synthetic psychoactive compound belonging to the 2C family of substituted phenethylamines. Despite its recent emergence on the recreational drug market, data on its pharmacological profile, toxicity, and metabolism is extremely limited. The growing popularity of novel psychoactive substances poses a serious public health concern. These compounds are often consumed without knowledge of their potency, toxicity, or interactions, leading to unpredictable physiological and psychological effects. In this context, the absence of toxicological and metabolic data on 2C-EF highlights the need for further investigation. To date, no study have explored its metabolic fate in biological systems. The metabolism of 2C-EF was investigated <em>in vitro</em> using pooled human liver microsomes (HLMs) and liquid-chromatography coupled to a high-resolution mass spectrometry system (HRMS). Eight metabolites were identified, resulting from phase I and II transformations. The identified metabolites suggest that 2C-EF undergoes demethylation at position 2 or 5, hydroxylation, and deamination, followed by either oxidation to the corresponding carboxylic acid or reduction to the corresponding alcohol, via an intermediate aldehyde. Additionally, metabolites resulting from acetylation and glucuronidation were also identified. The metabolic profile of 2C-EF mirrors that of structurally related 2C compounds, indicating conserved enzymatic pathways despite the presence of a fluoroethyl substituent. A comprehensive characterization of its metabolism is key to evaluating health risks and improving analytical identification in clinical and forensic contexts; nonetheless, additional <em>in viv</em>o investigations are needed to fully elucidate its metabolic and toxicological profile.</div></div>","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"38 1","pages":"Pages 57-64"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147417357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged metabolic acidosis following intramuscular tirzepatide injection: A social media driven case","authors":"Wael Hafez ,&nbsp;Surra Hassan ,&nbsp;Lougeen Z. Mohammad ,&nbsp;Sharika Subramani ,&nbsp;Rahmatullah Mohammad ,&nbsp;Hossam ElshekhAli ,&nbsp;Ali Nawaz","doi":"10.1016/j.toxac.2025.10.001","DOIUrl":"10.1016/j.toxac.2025.10.001","url":null,"abstract":"<div><h3>Background</h3><div>Tirzepatide is a dual GIP and GLP-1 receptor agonist approved for subcutaneous administration to patients with type 2 diabetes and obesity. Off-label administration may alter pharmacokinetics and increase the risk of adverse effects.</div></div><div><h3>Case presentation</h3><div>A 31-year-old woman presented with a two-week history of dizziness, fatigue, headache, and gastrointestinal symptoms. Despite visiting multiple hospitals and receiving symptomatic treatment, the patient's condition persisted. On admission, she was dehydrated but hemodynamically stable. Laboratory investigations revealed metabolic acidosis (pH 7.28), low bicarbonate levels, and hypoglycemia. Imaging showed no abnormalities. She had self-administered tirzepatide intramuscularly based on advice from a social media video, aiming to prolong the drug's effect and reduce costs by extending injection intervals to two weeks.</div></div><div><h3>Management and outcome</h3><div>The patient received intravenous fluids, proton pump inhibitors, and supportive care. By day 3, her symptoms and laboratory findings had not improved. This off-label intramuscular injection likely alters the pharmacokinetics of the drug, contributing to the prolonged and intensified symptoms. Continued conservative management led to complete clinical and biochemical recovery by day five. The patient remained stable during follow-up.</div></div><div><h3>Conclusion</h3><div>This case highlights the potential harm caused by social-media-driven misinformation. Specifically, it demonstrates the risk of prolonged metabolic acidosis from inappropriate intramuscular tirzepatide injection, highlighting the clinical dangers of social-media-driven off-label misuse. It further emphasizes the importance of patient education and proactive healthcare engagement to counter digital health misinformation.</div></div>","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"38 1","pages":"Pages 134-140"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147417362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the research landscape of doping in athletes: A bibliometric study across two decades","authors":"Arun Nambron ,&nbsp;Sreerag C. Sreedharan ,&nbsp;Gavoutamane Vasanthi ,&nbsp;Ibnu Noufal Kambitta Valappil","doi":"10.1016/j.toxac.2025.12.001","DOIUrl":"10.1016/j.toxac.2025.12.001","url":null,"abstract":"<div><h3>Background</h3><div>The term doping is widely used by organizations that regulate sporting competitions. This bibliometric analysis examines the research landscape of doping in athletes using data from the Scopus database. A total of 1,213 research articles, published in English across 570 journals between 2004 and December 2024, were included in the analysis after applying exclusion criteria.</div></div><div><h3>Methods</h3><div>The study employs a range of bibliometric analysis techniques, including performance analysis and science mapping, to identify key contributors, research themes, influential publications, and potential future research directions.</div></div><div><h3>Results</h3><div>The United States, the University of Birmingham, the World Anti-Doping Agency, and the journal <em>Drug Testing and Analysis</em> were identified as leading contributors in terms of published work volume. The analysis reveals a significant increase in scholarly output on doping in athletes since 2020, with 37% of publications produced in the last five years.</div></div><div><h3>Conclusion</h3><div>Thematic concentration analysis highlights current research focus areas, such as the psychological, social, and ethical implications of doping, anti-doping policies and governance, ergogenic aids, and biochemical markers in doping detection.</div></div>","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"38 1","pages":"Pages 1-17"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147416501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remerciements de la rédaction aux relecteurs pour l’année 2025","authors":"","doi":"10.1016/j.toxac.2026.01.001","DOIUrl":"10.1016/j.toxac.2026.01.001","url":null,"abstract":"","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"38 1","pages":"Page 141"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147417364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of iso-butomidate as a novel etomidate analog: Simultaneous determination of seven etomidate-type new psychoactive substances and etomidate acid in human hair by HPLC-MS/MS","authors":"Yuxuan Chen ,&nbsp;Xiaoqiang Hu ,&nbsp;Xiaofei Hao ,&nbsp;Jinlei Liu ,&nbsp;Xiaolong Zhang ,&nbsp;Mengchao Wang ,&nbsp;Xiaoyu Zhou ,&nbsp;Jiajun Sun ,&nbsp;Jie Gu ,&nbsp;Huimin Zhang ,&nbsp;Shengnan Zhang ,&nbsp;Amin Wurita ,&nbsp;Koutaro Hasegawa","doi":"10.1016/j.toxac.2025.09.003","DOIUrl":"10.1016/j.toxac.2025.09.003","url":null,"abstract":"<div><h3>Purpose</h3><div>Following regulatory controls on etomidate (October 2023) and its first-generation analogs (July 2024), novel analogs are rapidly emerging in China. Our laboratory has, for the first time, detected a novel analog in police-seized electronic cigarette liquids and in the hair of associated abusers — a substance that has not been documented in any prior scientific literature. The aim of this study was to describe the analytical procedures used to identify such compounds and to develop an high performance liquid chromatography–tandem mass spectrometry (HPLC-MS/MS) assay for the simultaneous detection of eight analytes containing the novel analog and the metabolite etomidate acid in hair.</div></div><div><h3>Methods</h3><div>Identification of the substances of concern was carried out using various instruments, including gas chromatography-tandem mass spectrometry (GC-MS), headspace gas chromatography (HS-GC), liquid chromatography–high-resolution mass spectrometry (LC-HRMS) and HPLC-MS/MS.</div></div><div><h3>Results</h3><div>Analysis of the e-cigarette sample of concern using GC-MS and LC-HRMS yielded mass spectra, which allowed structural elucidation. HS-GC analysis of hydrolyzed alcohols provided further insights into the substituent groups linked to imidazole core, then the compound was identified as iso-butomidate through comparison with reference standards. The established HPLC-MS/MS method was validated and complied with international guidelines. Iso-butomidate was present in all five real hair samples (concentration range: 10.8–5,760<!--> <!-->pg/mg), whereas trifluoro-etomidate and etomidate were detected only in sample 5 (1,440 and 159<!--> <!-->pg/mg).</div></div><div><h3>Conclusion</h3><div>In this paper, a novel etomidate analog, iso-butomidate, was identified and an HPLC-MS/MS method was developed for the detection of eight imidazoles in hair and the method could be applied to authentic cases.</div></div>","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"38 1","pages":"Pages 101-119"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147417358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational exposure to hydrogen cyanamide in a young farmer: Case report of acute toxicity","authors":"Marwa Mohammed Fouad ,&nbsp;Nermin Hamdy Zawilla ,&nbsp;Ahmed Maher Ali","doi":"10.1016/j.toxac.2025.08.009","DOIUrl":"10.1016/j.toxac.2025.08.009","url":null,"abstract":"<div><h3>Background</h3><div>Hydrogen cyanamide, a widely used agricultural chemical, is primarily employed as a dormancy-breaking agent in fruit crops. Despite its benefits in enhancing bud break and synchronization, exposure to hydrogen cyanamide poses significant health risks, particularly through dermal contact or inhalation. Toxicity can result in a spectrum of adverse effects, ranging from mild irritation to severe systemic reactions.</div></div><div><h3>Case report</h3><div>We report a case of acute occupational hydrogen cyanamide toxicity in a previously healthy agricultural worker who presented with altered mental status and visual hallucinations associated with characteristic skin lesions shortly after exposure that responded successfully to supportive management.</div></div><div><h3>Conclusion</h3><div>By highlighting the clinical presentation, and treatment strategies, this report highlights the importance of recognizing the toxic profile of hydrogen cyanamide to enhance awareness among healthcare professionals and contribute to improved safety protocols and appropriate protective measures for individuals dealing with this chemical in agricultural practices.</div></div>","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"38 1","pages":"Pages 120-124"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147416503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Soumission chimique : entre urgence sociétale et rigueur scientifique – le rôle des sociétés savantes","authors":"Islam Amine Larabi ,&nbsp;Christine Tournoud ,&nbsp;Nicolas Fabresse ,&nbsp;Jean-Christophe Gallart ,&nbsp;Pascal Kintz ,&nbsp;Jean-Claude Alvarez ,&nbsp;Anne-Laure Pélissier","doi":"10.1016/j.toxac.2025.08.008","DOIUrl":"10.1016/j.toxac.2025.08.008","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;La soumission chimique constitue un enjeu croissant de santé publique. La prise en charge des victimes, de plus en plus nombreuses, reste complexe en raison du manque de lisibilité du parcours de soins – avec ou sans dépôt de plainte –, et des exigences analytiques élevées pour détecter les substances impliquées. Dans ce contexte, une expérimentation régionale pilotée par les autorités françaises portant sur le remboursement de kits de prélèvements, ainsi que des analyses toxicologiques associées, est actuellement à l’étude.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Méthode&lt;/h3&gt;&lt;div&gt;À la demande des autorités sanitaires, une expertise conjointe a été menée par la Société française de toxicologie analytique (SFTA) et la Société de toxicologie clinique (STC), chacune intervenant dans son périmètre de compétences. L’analyse repose sur un consensus scientifique publié, des avis d’experts, et une revue critique du cadre réglementaire, analytique, et organisationnel.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Résultats&lt;/h3&gt;&lt;div&gt;Le circuit de prise en charge des victimes demeure hétérogène et insuffisamment structuré. Une coordination renforcée entre les acteurs de terrain (médecins généralistes, urgences, SAMU, unités médico-judiciaires, Centre de référence sur les agressions facilitées par les substances [CRAFS], maisons des femmes…) est indispensable. Concernant l’aspect analytique, les dispositifs médicaux de diagnostic in vitro (DMDIV), appelé communément tests rapides de dépistage de drogues, sont inadaptés, en raison de leur faible fiabilité, et la spectrométrie de masse s’impose comme méthode de référence. Le développement d’un maillage territorial des laboratoires spécialisés est un objectif prioritaire. L’absence de tarification harmonisée hors procédure judiciaire engendre des inégalités d’accès aux analyses pour les victimes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;La réussite de l’expérimentation repose sur la clarification des circuits, la formation des professionnels, et le référencement des laboratoires répondant à des critères de qualité stricts.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Drug facilitated crimes (DFC) including Drugs Facilitated Sexual Assault (DFSA) represents a growing public health concern. The management of an increasing number of victims remains challenging due to the lack of clarity in care pathways, whether or not legal action is pursued, and the high analytical requirements needed to detect the substances involved. In this context, a regional pilot initiative led by the French authorities, focusing on the reimbursement of sampling kits and the associated toxicological analyses, is currently under consideration.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;At the request of public health authorities, a joint expert review was conducted by the French Society of Analytical Toxicology (SFTA) and the Society of Clinical Toxicology (STC), each contributing within their respective field. The analysis was based on a published scientific consen","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"38 1","pages":"Pages 93-100"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147416506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond traditional antivenoms: Exploring human proteins and plant-based ligands for viper venom neutralisation through molecular interaction studies","authors":"Sana S. Hussain,&nbsp;Danie Kingsley J","doi":"10.1016/j.toxac.2025.09.081","DOIUrl":"10.1016/j.toxac.2025.09.081","url":null,"abstract":"<div><div>Viper envenomation remains a pressing global health challenge, particularly in tropical and subtropical regions, where access to effective and affordable antivenom therapies is limited. Conventional antivenoms, predominantly derived from animal immunoglobulins, often suffer from limited efficacy, high production costs, cold-chain dependency, and the risk of severe hypersensitivity reactions. This review presents a comprehensive, interdisciplinary analysis of alternative venom neutralisation strategies, focusing on endogenous human proteins and phytochemical inhibitors as novel therapeutic avenues. We explore the mechanistic roles of key endogenous proteins—such as serum albumin, α2-macroglobulin, tissue inhibitors of metalloproteinases (TIMPs), C-reactive protein (CRP), and antithrombin III—in neutralizing viper venom components, particularly phospholipase A2 (PLA2) and snake venom metalloproteinases (SVMPs). These proteins exhibit diverse inhibitory mechanisms, including direct enzymatic blockade, modulation of inflammation, and regulation of coagulation pathways. In parallel, we highlight plant-derived bioactive compounds (phytoligands) such as flavonoids, tannins, alkaloids, and saponins, which demonstrate broad-spectrum inhibition of venom enzymes through antioxidant, anti-inflammatory, and direct enzyme-binding activities. Importantly, this review integrates recent advances in computational biology—molecular docking, molecular dynamics simulations, and AI-driven drug discovery—to elucidate and optimize the molecular interactions between venom components and inhibitors. We emphasize the synergistic potential of combining endogenous proteins with phytoligands to create next-generation, multi-target antivenom therapies that are safer, more accessible, and cost-effective. By bridging biochemistry, ethnopharmacology, and in silico modelling, this review provides a forward-looking framework for developing innovative, non-immunoglobulin-based antivenoms. The insights presented here pave the way for rational drug design and a paradigm shift in snakebite management.</div></div>","PeriodicalId":23170,"journal":{"name":"Toxicologie Analytique et Clinique","volume":"38 1","pages":"Pages 18-39"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147416499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}