Post Mortem Molecular Biomarkers of Asphyxia: A Literature Review

Asphyxia is a critical condition characterized by inadequate oxygen supply to the body. Post mortem diagnostics of asphyxia present significant challenges in forensic pathology, particularly when there are equivocal signs during autopsy or uncertain circumstantial data. The identification of biochemical biomarkers that indicate asphyxia has emerged as a promising area of research, as these markers can provide vital insights into the physiological changes occurring at the cellular level during asphyxiation. We performed a review of the scientific literature on the search engines Pubmed and Scopus in order to assess the state of the art on this topic. The aim of this study is to analyze which are the most promising markers and methods in the post mortem diagnosis of asphyxia. The literature review highlighted the great potential that molecular investigations can have in the analysis of this type of death, especially considering that hypoxia determines strong biochemical alterations in response to cellular stress. These changes are marked by specific biochemical alterations, which can be detected through various advanced technologies and methodologies, including mass spectrometry, immunohistochemistry, and metabolomic profiling. The review evidenced a combination of markers that can be used for diagnostic purposes in various cases, including mechanical asphyxia, carbon monoxide (CO) poisoning, perinatal asphyxia, and drowning analysis. However, we highlight that, to date, there are still no standard protocols for forensic biochemistry in asphyxia. By scrutinizing the reliability of identified biomarkers and their potential to reshape forensic investigative practices, this research aims to elucidate the critical role that post mortem biochemical analysis can play in diagnosing asphyxia, ultimately contributing to a more nuanced understanding of death-related scenarios and the development of standardized protocols in forensic examinations.