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Journal of Analytical Toxicology 2014;38:242 –248

doi:10.1093/jat/bku025 Advance Access publication March 28, 2014 Article

Applying Quantitative Structure–Activity Relationship (QSAR) Methodology for Modeling


Postmortem Redistribution of Benzodiazepines and Tricyclic Antidepressants
Constantinos Giaginis1*, Anna Tsantili-Kakoulidou2 and Stamatios Theocharis3
1
Department of Food Science and Nutrition, School of Environment, University of the Aegean, Mitropoliti Ioakeim 2 Street, Myrina,
Lemnos GR 81400, Greece, 2Department of Pharmaceutical Chemistry, School of Pharmacy, University of Athens, Panepistimiopolis,
Zografou, Athens 157 71, Greece, and 3First Department of Pathology, Medical School, University of Athens, Athens, Greece

*Author to whom correspondence should be addressed. Email: cgiaginis@aegean.gr

Postmortem redistribution (PMR) constitutes a multifaceted process, postmortem period (11). Consequently, PMR of drugs may com-
which complicates the interpretation of drug concentrations by foren- plicate the interpretation of the analytical results in forensic toxi-
sic toxicologists. The present study aimed to apply quantitative struc- cology and has emergently been considered as ‘a toxicological
ture –activity relationship (QSAR) analysis for modeling PMR data of nightmare’ (10, 12).
structurally related drugs, 10 benzodiazepines and 10 tricyclic antide- Quantitative structure – activity relationship (QSAR) method-
pressants. For benzodiazepines, an adequate QSAR model was ology is a useful tool for analyzing in a systematic way the infor-
obtained (R 2 5 0.98, Q 2 5 0.88, RMSEE 5 0.12), in which energy, mation incorporated in the chemical structure of compounds in
ionization and molecular size exerted significant impact. For tricyclic relation to the available biological data (13, 14). This method-
antidepressants, an adequate QSAR model with slightly inferior sta- ology has widely been accepted to evaluate and predict the activ-
tistics (R 2 5 0.95, Q 2 5 0.87, RMSEE 5 0.29) was established after ity of drugs against a therapeutic target, as well as the toxicity
exclusion of maprotiline, in which energy parameters, basicity char- risk assessment of drugs or chemicals, supporting the reduction,
acter and lipophilicity exerted significant contribution. Thus, QSAR refinement and/or replacement of experimental studies (15 –
analysis could be used as a complementary tool to provide an inform- 17). Currently, relevant software packages are available, which
ative illustration of the contributing molecular, physicochemical and permit the calculation of a large number of physicochemical, mo-
structural properties in PMR process. However, the complexity, non- lecular and structural descriptors, facilitating their elaboration in
static and time-dependent nature of PMR endpoints raises serious QSARs as an alternative strategy for the establishment of predict-
concerns whether QSAR methodology could predict the degree of ive models (14–16). In the last few years, multivariate data ana-
redistribution, highlighting the need for animal-derived PMR data. lysis (MVDA), a projection method to latent variables, the
principal components, which are linear combination of the ori-
ginal descriptors, has widely been applied to QSAR modeling
(18, 19). MVDA has been considered as a powerful statistical
Introduction tool, which can treat a large number of interrelated descriptors,
The interpretation of drug concentrations in postmortem period exploiting the maximum information encoded within them and
constitutes one of the most difficult aspects in the field of foren- separating regularities from noise (18, 19). Moreover, MVDA per-
sic toxicology. This is mainly ascribed to the fact that drug mits the elaboration of descriptors and response variables, in
concentrations obtained from postmortem samples do not ne- which the high accuracy of computational and experimental
cessarily reflect the blood concentration at the time of death values is not an emergent requisite in contrast to conventional
due to variations according to the sampling site and the interval statistical methods (18, 19).
between death and sampling (1 – 5). These site- and time- Physicochemical properties are considered to play a crucial
dependent variations have been attributed to a multifaceted pro- role in pharmacokinetics, mainly in absorption and distribution,
cess occurring after death, referred to as postmortem redistribu- as well as in the pharmacodynamic and toxicological profile of
tion (PMR) (6, 7). The high complexity of PMR process is drugs (20, 21). Among them, lipophilicity, ionization and
amplified by the fact that it does not exclusively refer to fatal poi- volume of distribution were reported to affect the ability of
soning, but it may also reflect antemortem physical or biochem- drugs to redistribute across the tissue barriers during post-
ical alterations. Many drugs are sequestered antemortem in mortem period (22 – 24). In a previous work by our group, we
organs qualified as drug reservoirs. Hollow organs with high con- effectively applied QSAR methodology to model PMR of struc-
centrating power, such as different parts of the gastrointestinal turally diverse drugs (25). The derived QSAR model provided an
tract or viscera, liver, lungs and heart, can function as drug reser- informative illustration of the contributing molecular, physico-
voirs (6 –8). Redistribution from these organs can occur by diffu- chemical and structural properties of drugs in the PMR process
sion through blood vessels and/or transparietal diffusion toward (25). However, this model presented moderate predictive
surrounding organs (6 –8). The competing processes of diffusion power and limited applicability, which was ascribed to the
from drug reservoirs, disruption of cellular membranes and high complexity of the PMR process and the structurally diver-
putrefaction may lead to alterations in drug concentrations be- sity of the data set (25). In view of above considerations, the
tween sites and sampling intervals (9, 10). Drugs biotransforma- present study aimed to develop more specific QSAR models
tion by metabolizing enzymes, such as cytochrome P450 using two structurally homogeneous data sets, benzodiazepines
monooxygenases and/or uridine diphosphate-glucuronosyl- and tricyclic antidepressants, which attract special attention in
transferases, could also be triggered at an early stage of the field of forensic toxicology.

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Methods and materials van der Waals surface area (SASA and WASA), as well as refractiv-
Data set ity (Refr), polarizability (Pol) and dipole moment (Dipol 2X,
The data set consisted of two chemical classes of compounds, 10 2Y, 2Z matrix), were calculated in the lowest energetic con-
benzodiazepines and 10 tricyclic antidepressants. The extent of formation. Energy parameters, such as the energy of the highest
PMR expressed by the central : peripheral concentration ratio occupied molecular orbital (EHOMO) and the energy of the lowest
(C : P ratio) was taken from the literature (22). unoccupied molecular orbital (ELUMO), which reflect the nucleo-
philicity and electrophilicity of a compound, respectively, the
energy gap: ELUMO – EHOMO, reflecting reactivity, as well as total
energy (Etotal ), binding energy (Ebinding), electronic energy
Descriptors (Eelectr), nuclear energy (Enuclear) and heat of formation
Structural specific constitutional descriptors were derived manu- (Heat.Form), were calculated by Hyperchem (16, 25). In total,
ally. Structural specific constitutional descriptors include the 81 constitutional, 2D and 3D descriptors were calculated.
total number of rings (nRings), the number of aromatic rings
(nArC6), the number of heteroatoms into the rings, such as the
number of nitrogen (nNr), oxygen (nOr) and sulfur atoms (nSr), Multivariate data analysis
the sum of nitrogen and oxygen atoms (nNOr) and the sum of MVDA was performed using Simca-P 10.5 (Umetrics, CA, USA).
nitrogen, oxygen and sulfur atoms (nNOSr), the number of het- Prior to analysis, data were mean centered and scaled to unit
eroatoms out of the rings (nNnr, nOnr, nSnr, nNOnr and NOSnr), variance. Partial least squares (PLS) analysis was then applied to
as well as the total number of heteroatoms (nN, nO, nS, nF, nCl obtain regression models (18, 19). In PLS analysis, PMR data were
and nHal) and the number of double bonds (nC¼C). The treated as response variable Y. The derived models were validated
descriptors nRings and nArC6 constitute a measure of the size by different procedures: first, internal validation (cross-
of a molecule. The number of nitrogen (nN), oxygen (nO), sulfur validation) was performed using the default option of SIMCA-P,
(nS) and fluoride (nF) constitute a measure of the polarity of a namely by developing parallel models leaving out one group of
molecule, reflecting hydrogen-bonding capability. The number seven compounds each time. The omitted data are then consid-
of halogens (nHal) and chlorides (nCl) reflect the hydrophobi- ered as test set and the sum of squared differences between the
city of compounds (16, 25). measured response and the predicted value, defined as predict-
Physicochemical and molecular properties, such as lipophili- ing residuals sum of squares (PRESS), is used to calculate cross-
city (logarithm of octanol – water partition coefficient 2log P validated correlation coefficient Q 2: Q 2 ¼ 12 PRESS/SSY. SSY
for the neutral form, logarithm of octanol –water distribution co- represents the variation in Y after mean centering and scaling.
efficient 2log D5.5 and log D7.4 if ionized molecular species are This cross-validation procedure provides a more severe criterion
present at pH 5.5 and 7.4, respectively), number of hydrogen than the so-called leave-one-out approach since by decreasing
bond acceptor and donor sites, number of rotatable bonds the size of CV groups the estimated Q 2 becomes very similar to
(nRB) that expresses the flexibility of a molecule, ionization con- R 2. As a second tool, permutation testing was applied based on
stant ( pKa), topological polar surface area and molecular weight, the randomization of the response data (Y scrambling). The de-
were calculated with ADME Boxes 3.0 (Pharma-Algorithms, fault option of SIMCA including 20 permutations was applied.
Toronto, Canada). The number of acidic (aIon) and basic The proposed model was considered robust if the new models
(bIon) ionizable groups was also deduced by ADME software. on the set with randomized responses presented significantly
The module Absolv implemented in the same software was lower R 2 and Q 2 than the original model. In addition, as a more
used to calculate Abraham’s solvatochromic parameters: hydro- critical test, randomized response data were used to run from the
gen bond acidity (A), hydrogen bond basicity (B), excessive beginning the model development procedure (26). Finally, exter-
molar refractivity (E), polarizability (S) and McGowan volume nal validation was performed in the final model by splitting the
(Vmc). For the calculation of lipophilicity corresponding to the data set into several training and test sets. The root mean square
neutral species, additional software was used: ClogP (Biobyte error of prediction (RMSEP) was considered for evaluating
4.0), ChemDraw Ultra 9.0—logP(chem), according to Crippen predictive power.
fragmentation (Cambridge Soft Corporation) and Pallas 3.3.2.4
(CompuDrug, International, Inc., Sedona, AZ, USA) and tried al-
ternatively in the analysis. ClogP (Biobyte 4.0) was selected as
the most appropriate to be incorporated in the final statistical Results
models. Boiling and melting points (BoilP and MeltP, respective- Benzodiazepines
ly), critical temperature (cTemp), pressure (cPres) and volume PLS analysis was initially performed for the whole data set of ben-
(cVol), Gibbs energy (EGibbs) and Henry’s law (LHenry) were zodiazepines (n ¼ 10), including all the descriptors. A two-
deduced by ChemDraw (16, 25). component PLS model with moderate statistics was derived
Threedimensional (3D) descriptors were calculated by (R 2 ¼ 0.75, Q 2 ¼ 0.66, RMSEE ¼ 0.51). Nonoutliers were identi-
Hyperchem, v.5.0/Chemplus v.1.6 software. Energy minimization fied. A PLS model was further refined by variable selection
was carried out by molecular mechanics using MMþ force field according to the variable influence to projection (VIP) criterion,
followed by the semi-empirical AM1 method. The molecular the weight (w) in the loadings plot and the size of the coeffi-
structures were constructed many times with different starting cients. Variables with VIP , 0.6 or low weight in the loading
points, and the robustness of the calculated parameters was eval- plot and low coefficient were excluded. Among the descriptors
uated. Molecular size parameters, such as solvent accessible and encoding the same information, those who performed better
van der Waals volume (SAVol and WAVol), solvent accessible and were chosen. Finally, a three-component PLS model based on

QSAR Analysis in Forensic Toxicology 243

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10 original descriptors was obtained with N ¼ 10, R 2 ¼ 0.98, number of basic ionizable groups (bIon), as well as the number
Q 2 ¼ 0.88, RMSEE ¼ 0.12. In Table I, the observed and predicted of halogen (nHal) exerted considerable positive influence on the
PMR values, as well as the matching residuals, are included. model. Lipophilicity at pH 7.4 (log D7.4) and hydrogen-bonding
The VIPs and coefficients of the original descriptors are pre- donor capability contributed at a lower extent to the model.
sented as histograms in Figures 1A and B, respectively. Among The model was validated using a permutation test through ran-
the energy parameters, ELUMO – HOMO exerted the most important domly reordering response data. R 2 and Q 2 were plotted against
contribution to the model with a negative sign. Molecular size the correlation coefficient of the Y vector itself (Ry) yielding
descriptors, such as MR, Pol, SAVol and SASA, were found to be intercepts close (0.0, 0.401) and below (0.0, 20.219) zero,
important, exerting also negative impact on the model. On the respectively, indicating robustness of the model. Moreover, no
other hand, the ionization state of the drugs expressed by the significant model was obtained (R 2 , 0.2, Q 2 , 0.1), when the
entire model development procedure for the 10 compounds
was repeated with randomized response data (26). For external
Table I
validation, the same three-component PLS model was obtained
Observed PMR Data Taken from the Literature (22), Predicted PMR Data by QSAR Modeling and the
Matching Residuals for the Chemical Class of Benzodiazepines (RMSEE ¼ 0.12) for the training (n ¼ 8) set each time and successful PMR predic-
tions (0.08 , RMSEP , 0.28) were provided for the correspond-
Compounds PMRobs PMRpred PMRobs 2 PMRpred ing test set (N ¼ 2).
Alprazolam 1.5 1.6 20.1
Clonazepam 2.0 2.2 20.2
Clozapine 2.8 2.8 0.0
Diazepam 1.6 1.7 20.1
Flunitrazepam 3.0 3.0 0.0 Tricyclic antidepressants
Flurazepam 3.0 3.0 0.0
Midazolam 4.0 3.9 0.1
PLS analysis was initially performed for the whole data set (n ¼
Oxazepam 1.3 1.2 0.1 10), including all the descriptors. A two-component PLS model
Temazepam 1.6 1.5 0.1 with poor statistics was derived (R 2 ¼ 0.63, Q 2 ¼ 0.41,
Triazolam 2.8 2.8 0.0
RMSEE ¼ 0.88). Maprotiline was identified as extreme outlier

Figure 1. Histograms of (A) VIPs and (B) coefficients of the original descriptors used in the final PLS models for benzodiazepines. ELUMO – HOMO, energy of the lowest unoccupied
molecular orbital– energy of the highest occupied molecular orbital; Refr, refractivity; bIon, number of basic (bIon) ionizable groups; Etotal, total energy; Pol, polarizability; nHal, number
of halogens; SAVol, solvent accessible volume; SASA, solvent accessible surface area; log D7.4, logarithm of octanol– water distribution coefficient at pH 7.4; HBD, number of hydrogen
bond donor sites.

244 Giaginis et al.

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presenting residuals for its predictive PMR value of .2 RMSEE. The VIPs and coefficients of the original descriptors included
After exclusion of maprotiline, refinement of the PLS model was in the final model are presented as histograms in Figure 2A and B,
performed, as previously described for benzodiazepines. Finally, respectively. Among energy parameters, heat of formation
a two-component PLS model based on 10 original descriptors (Heat.Form) exerted the most important contribution to the
was obtained with N ¼ 9, R 2 ¼ 0.95, Q 2 ¼ 0.87, RMSEE ¼ 0.29. model with a negative sign, while electronic, nuclear and binding
In Table II, the observed and predicted PMR values, as well as energy (Eelectr, Enuclear and Ebinding) showed moderate influence.
the matching residuals, are included. The basicity character (B) of compounds contributed consider-
ably to the model with a positive sign, followed by lipophilicity
expressed as ClogP, which exerted negative influence. Among
Table II the structural descriptors, nNr and nN were the most important
Observed PMR Data Taken from the Literature (22), Predicted PMR Data by QSAR Modeling and the
with a negative sign, following nC¼C that exerted positive influ-
Matching Residuals for the Chemical Class of Tricyclic Antidepressants (RMSEE ¼ 0.29)
ence to the model. Flexibility expressed by nRB also contributed
Compounds PMRobs PMRpred PMRobs 2 PMRpred to the model with negative impact.
Amitriptyline 3.1 2.7 0.4 Validation procedure using the permutation test showed that
Clomipramine 1.9 1.9 0.0 R 2 and Q 2 presented intercepts close (0.0, 0.422) and below (0.0,
Cyclobenzaprine 2.2 2.2 0.0
Desipramine 2.4 2.0 0.4 20.222) zero, respectively, indicating robustness of the model.
Dothiepin 3.0 2.7 0.3 Moreover, no significant model was obtained (R2 , 0.2, Q2 , 0.1),
Doxepin 5.5 5.3 0.2 when the entire model development procedure for the nine
Imipramine 1.9 2.1 20.2
Maprotiline 4.7 (2.3) (2.4) compounds was repeated with randomized response data (26).
Nortriptyline 2.4 2.6 20.2 For external validation, the same three-component PLS model
Trimipramine 1.6 1.5 0.1
was obtained for the training (n ¼ 7) set each time and success-
Predicted PMR data and the matching residual for maprotiline, which was identified as an outlier, are ful PMR predictions (0.21 , RMSEP , 0.40) were provided for
depicted into brackets. the corresponding test set (N ¼ 2).

Figure 2. Histograms of (A) VIPs and (B) coefficients of the original descriptors used in the final PLS models for tricyclic antidepressants. Heat.Form, heat of formation; B, hydrogen
bond basicity; ClogP, calculated octanol–water partition coefficient by Biobyte 4.0; nN, total number of nitrogen; nNr, number of nitrogen into rings; nC¼C, number of double bonds;
nRB, number of rotatable bonds; Eelectr, electronic energy; Enuclear, nuclear energy; Ebinding, binding energy.

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Discussion by binding at a higher extent to the myocardium, rendering the
Currently, QSAR methodology has widely been accepted to determination of C : P ratio more sensitive to experimental
evaluate and predict Absorption, Distribution, Metabolism, errors.
Excretion/Toxicity (ADME/Tox) processes, such as passive bio- The derived QSAR models presented considerable differences
membrane permeation (27). Since PMR process includes passive concerning the other contributing molecular, physicochemical
diffusion through biomembranes as an essential step among and structural properties of drugs in the PMR process. For
others, it could be considered as an ADME endpoint with benzodiazepine chemical class, energy parameters, and espe-
enhanced chance to effectively be predicted by QSAR method- cially the reactivity (ELUMO – EHOMO) of compounds, as well as
ology. In this context, we previously applied QSAR methodology molecular size parameters (Refr, Pol, SAVol and SASA) exerted
for modeling PMR data using a data set of structurally heteroge- considerable influence on PMR process with a negative sign.
neous drugs (25). The derived QSAR model provided an inform- For tricyclic antidepressants, heat of formation (Heat.Form),
ative illustration of the contributing molecular, physicochemical lipophilicity (ClogP), structural characteristics (nN and nNr)
and structural properties of drugs in the PMR process. However, and flexibility (nRB) exerted the most important influence on
it presented low predictability (R 2 ¼ 0.65, Q 2 ¼ 0.56, RMSEE ¼ PMR process with negative impact. Notably, flunitrazepam,
0.34) and limited applicability, since for a significant number of midazolam and triazolam that were identified as outliers in the
drugs (N ¼ 18, 23%) no accurate predictions were obtained (25). previously reported ‘global’ QSAR model were successfully pre-
In view of above consideration, the present study aimed to de- dicted in the structural specific model for benzodiazepines
velop more specific QSAR models using structurally homoge- (25). Accordingly, three outliers of the ‘global’ QSAR model, clo-
neous data sets, highlighting to the contribution of specific mipramine, doxepin and trimipramine were effectively treated
structural characteristics of distinct chemical classes in the in the structurally specific model for tricyclic antidepressants
PMR process. (25). On the other hand, maprotiline was identified as an ex-
We selected two major chemical classes of drugs, benzodiaze- treme outlier in both global and structurally specific QSAR mod-
pines and tricyclic antidepressants, for which a sufficient num- els, with predicted C : P values 2.5 and 2.3, respectively, which
ber of PMR data exist in the literature compared with other strongly deviate from that referred to the literature (25). The
chemicals classes. These highly prescribed drugs are frequently underestimated predicted C : P value may be ascribed to ill-
used together with legal or illegal drugs and can result in synergy defined literature experimental measurements or to other pro-
of symptoms and intoxication (5, 7, 8, 28, 29). Thus, the estima- cess occurring during postmortem period beyond passive diffu-
tion of their PMR is of great interest in the field of forensic toxi- sion; e.g., biotransformation of maprotiline by metabolizing
cology in order to avoid potential complications concerning the enzymes. In the later case, the currently applied QSAR method-
interpretation of their analytical results determined in a toxico- ology does not generally account explicitly since it cannot take
logical laboratory (30, 31). into consideration potential drug metabolism process.
In the present study, QSAR methodology was efficiently Collectively, the above-mentioned comparisons amplify that
applied for modeling PMR data of both data sets. The derived QSAR analysis could be considered as a potential complemen-
QSAR models were characterized by a reasonable improved tary tool to validate experimental data with certain, however,
statistical fit compared with the previously reported model on serious limitations.
structurally diverse drugs (25). For both chemical classes, the Alarmingly enough, the complexity, subtlety and sometimes
basic functionalities of compounds exerted positive influence ill-defined nature of PMR endpoints combined with the lack of
on PMR. Thus, the positive contribution of the basicity charac- reliable available data constitute major drawbacks for the devel-
ter in the PMR process seems to be a common feature inde- opment of computational classification and prediction models in
pendently of the specific structural domain of each chemical the area of forensic toxicology. PMR data are currently being
class, as we previously identified descriptors related to the derived by case reports, which undoubtedly are characterized
basic functionalities of compounds as the most important in by low accuracy and reproducibility (30, 31). It should also be
the ‘global’ QSAR model (25). In this context, several studies taken into consideration the fact that although there is good evi-
have documented that when bodies are in a supine position; dence that C : P ratio is related to PMR, it cannot be assumed that
drugs with basic functionalities rapidly diffuse from lungs the peripheral blood drug concentration is equal to the ante-
into the left heart compartments through the pulmonary mortem concentration (24). Moreover, it should be kept on
venous blood rather than simply diffuse across concentration mind that C : P ratio is expected to be higher in case of acute poi-
gradients (32 – 34). It was also shown that basic drugs, including soning compared with cases of chronic exposure. The collec-
tricyclic antidepressants, can bind selectively to the myo- tion of autopsy samples from either a heart chamber or the
cardium and that drug diffusion from the myocardium into pericardial sac may also result in drug concentration measure-
heart blood may, in turn, result in enhanced heart blood ments that are significantly higher than the peripheral concen-
concentrations (22). In this aspect, it should be noted that, trations, leading to inaccurate interpretation of the analytical
for tricyclic antidepressants, the derived model was character- results (2). In this respect, MVDA seems to be advantageous
ized by slightly inferior statistics compared with that for benzo- compared with conventional statistical methods, as it permits
diazepines. This may be attributed to the fact that the tricyclic the use of biological data of lower accuracy and reproducibility
antidepressants under study exert stronger basic functionalities (18, 19). However, well-defined PMR data derived by animal
( pKabasic  9.1) compared with benzodiazepines ( pKabasic  studies, where experimental conditions are more reproducible,
7.4), which may increase the complexity of their PMR process constitute an emergent demand in order for QSAR models of

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Conflict of interest Experimental and computational approaches to estimate solubility
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