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Thevis M, Görgens C, Guddat S, Thomas A, Geyer H. Mass spectrometry in sports drug testing-Analytical approaches and the athletes' exposome. Scand J Med Sci Sports 2024; 34:e14228. [PMID: 36539355 DOI: 10.1111/sms.14228] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/02/2022] [Accepted: 08/12/2022] [Indexed: 01/26/2024]
Abstract
Test methods in anti-doping, most of which rely on the most modern mass spectrometric instrumentation, undergo continuous optimization in order to accommodate growing demands as to comprehensiveness, sensitivity, retrospectivity, cost-effectiveness, turnaround times, etc. While developing and improving analytical approaches is vital for appropriate sports drug testing programs, the combination of today's excellent analytical potential and the inevitable exposure of humans to complex environmental factors, specifically chemicals and drugs at the lowest levels, has necessitated dedicated research, particularly into the elite athlete's exposome. Being subjected to routine doping controls, athletes frequently undergo blood and/or urine tests for a plethora of drugs, chemicals, corresponding metabolic products, and various biomarkers. Due to the applicable anti-doping regulations, the presence of prohibited substances in an athlete's organism can constitute an anti-doping rule violation with severe consequences for the individual's career (in contrast to the general population), and frequently the question of whether the analytical data can assist in differentiating scenarios of 'doping' from 'contamination through inadvertent exposure' is raised. Hence, investigations into the athlete's exposome and how to distinguish between deliberate drug use and potential exposure scenarios have become a central topic of anti-doping research, aiming at supporting and consolidating the balance between essential analytical performance characteristics of doping control test methods and the mandate of protecting the clean athlete by exploiting new strategies in sampling and analyzing specimens for sports drug-testing purposes.
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Affiliation(s)
- Mario Thevis
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
- European Monitoring Center for Emerging Doping Agents, Cologne, Germany
| | - Christian Görgens
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
| | - Sven Guddat
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
| | - Andreas Thomas
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
| | - Hans Geyer
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
- European Monitoring Center for Emerging Doping Agents, Cologne, Germany
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2
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Kintz P, Gheddar L, Blanchot A, Ameline A, Raul JS. Testing for clomiphene in keratinous matrices (hair and nail). J Anal Toxicol 2023; 47:703-708. [PMID: 37522606 DOI: 10.1093/jat/bkad050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/06/2023] [Accepted: 07/27/2023] [Indexed: 08/01/2023] Open
Abstract
Clomiphene or clomifene is a selective estrogen receptor modulator used to treat female fertility in case of ovulatory dysfunction. In sport, clomiphene is prohibited at all times for use by athletes and is listed in the section S4.2 (hormone and metabolic modulators) by the World Anti-Doping Agency. Indeed, clomiphene can indirectly increase testosterone levels in the body and can mitigate some side effects of synthetic steroid abuse. Despite its prescription to millions of subjects, its detection in human hair or nail clippings has never been reported. The aim of this study was to develop a specific method to identify clomiphene in hair and nail clippings by liquid chromatography-quadrupole tandem mass spectrometry. The procedure was then applied in a case of challenged doping results. The method involves sonication/incubation for 1 h of 30 mg of pulverized material in 1 mL of methanol in the presence of 2 ng diazepam-d5 used as internal standard. The chromatographic separation was performed using a HSS C18 column with a 15 min gradient elution. After spiking blank hair and nail with the corresponding amounts of clomiphene, linearity was verified from 1 to 500 pg/mg (r2 = 0.9994 and 0.9995 for hair and nail, respectively). The limit of detection was estimated at 0.3 pg/mg for both matrices. No interference was noted from endogenous compounds, particularly steroids. Clomiphene was identified at 85 and 20 pg/mg in the pubic hair and the fingernail clippings, respectively, of a male athlete challenging an adverse analytical finding.
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Affiliation(s)
- Pascal Kintz
- Institut de médecine légale, 11 rue Humann, Strasbourg 67000, France
- X-Pertise Consulting, 42 rue Principale, Mittelhausbergen 67206, France
| | - Laurie Gheddar
- Institut de médecine légale, 11 rue Humann, Strasbourg 67000, France
| | - Adeline Blanchot
- Institut de médecine légale, 11 rue Humann, Strasbourg 67000, France
| | - Alice Ameline
- Institut de médecine légale, 11 rue Humann, Strasbourg 67000, France
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3
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Gessner L, Thevis M, Rothschild MA, Juebner M. Detectability of oxandrolone, metandienone, clostebol and dehydrochloromethyltestosterone in urine after transdermal application. Drug Test Anal 2022; 14:1744-1761. [PMID: 35947101 DOI: 10.1002/dta.3355] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 07/29/2022] [Accepted: 08/07/2022] [Indexed: 11/11/2022]
Abstract
Situations of both, intentional as well as inadvertent or accidental doping, necessitate consideration in today's doping controls, especially in the light of the substantial consequences that athletes are facing in case of so-called adverse analytical findings. The aim of this study was to investigate, whether a transdermal uptake of doping substances would be possible. In addition to the period of detectability of the particular substances or respective characteristic metabolites, the possibility of deducing the route of administration by metabolite patterns was also assessed. Twelve male subjects were included in the study. Four common anabolic androgenic steroids (AAS) were dissolved in dimethylsulfoxide (DMSO) to facilitate transdermal administration on different skin regions. One half of the test persons received only oxandrolone (17α-methyl-2-oxa-4,5α-dihydrotestosterone), the other half was applied a mixture of oxandrolone, metandienone (17β-hydroxy-17-methylandrosta-1,4-dien-3-one), clostebol (4-chlorotestosterone-17β-acetate) and dehydrochloromethyltestosterone (DHCMT). Urine samples were collected 1 hour, 6 hours and one sample per day for the next 14 consecutive days. Measurements were conducted on a GC-MS/MS or LC-MS/MS system. Substance findings were obtained at least 1 day after application on nearly all skin locations. The results indicated inter-individual variability in detection windows, also varying between the different analytes and possible impact of skin location and skin thickness, respectively. Nevertheless, a rapid and rather long detectability of all substances (or respective metabolites) was given, in some cases within hours after administration and for up to 10-14 days. Hence, the transdermal application or exposure to the investigated AAS is a plausible scenario that warrants consideration in anti-doping.
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Affiliation(s)
- L Gessner
- Department of Toxicology, Institute of Legal Medicine, University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany
| | - M Thevis
- German Sport University Cologne, Center for Preventive Doping Research/Institute of Biochemistry
| | - M A Rothschild
- Department of Toxicology, Institute of Legal Medicine, University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany
| | - M Juebner
- Department of Toxicology, Institute of Legal Medicine, University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany
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Kintz P, Gheddar L, Raul JS. Testing for anabolic steroids in human nail clippings. J Forensic Sci 2021; 66:1577-1582. [PMID: 33885144 DOI: 10.1111/1556-4029.14729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 12/29/2022]
Abstract
Anabolic steroids are synthetic derivatives of testosterone, and their abuse can have numerous health consequences. Identification of this group of drugs has found applications in forensic toxicology, clinical situations, psychiatric disorders, and of course, anti-doping violations. Although anabolic steroids are generally tested in urine and very occasionally in head hair, collectors can face the lack of standard specimens, and therefore, nail clippings can be the unique alternative choice. Although there is no possibility to perform segmental analyses using nail clippings, the window of drug detection is generally much longer in nail when compared to head hair (particularly in male subjects), that is, 3-8 months and 4-12 months for finger and toenail clippings, respectively. A new method was developed, including nail pulverization in a ball mill, sonication for 90 min in methanol, and a combination of liquid-liquid and solid-phase extractions, followed by gas and liquid chromatography coupled to tandem mass spectrometry. To document the application of steroid testing in nail clippings, the authors present 6 authentic cases of abuse, involving stanozolol (7 and 24 pg/mg), nandrolone (6 pg/mg), trenbolone (26, 67, 81, and 89 pg/mg), drostanolone (8 and 11 pg/mg), and testosterone enanthate (14 pg/mg). Given concentrations were always in the low pg/mg range, the use of tandem mass spectrometry appears as a prerequisite.
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Affiliation(s)
- Pascal Kintz
- Institut de médecine légale, Strasbourg, France.,X-Pertise Consulting, Mittelhausbergen, France
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Aknouche F, Gheddar L, Kernalléguen A, Maruejouls C, Kintz P. Anabolic steroids and extreme violence: a case of murder after chronic intake and under acute influence of metandienone and trenbolone. Int J Legal Med 2021; 135:1449-1453. [PMID: 33813613 DOI: 10.1007/s00414-021-02587-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/25/2021] [Indexed: 12/11/2022]
Abstract
A 32-year-old male went to the police to claim he just killed his girlfriend by inflicting several stabs with a kitchen knife. He was very nervous and particularly aggressive. About 90 min after the assault, a blood specimen was collected with natrium fluoride as preservative. The blood was free of alcohol, pharmaceuticals and drugs of abuse, but tested positive by LC-MS/MS for metandienone (32 ng/mL) and trenbolone (9 ng/mL). The perpetrator admitted regular consumption of anabolic steroids to enhance his muscular mass, as he was a professional security agent. To document long-term steroid abuse, a hair specimen was collected 3 weeks after the assault, which tested positive for both drugs. Segmental analyses revealed in the proximal 1.5 cm segment, corresponding to the period of the assault, the simultaneous presence of metandienone (11 pg/mg) and trenbolone (14 pg/mg), while only metandienone (3 pg/mg) was identified in the distal 1.5 cm segment. As aggressiveness and violence can be associated with abuse of anabolic steroids, the aetiology of this domestic crime was listed to be due impulsive behaviour in a context of antisocial lifestyle.
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Affiliation(s)
| | - Laurie Gheddar
- Institut de Médecine Légale, 11 rue Humann, F-67000, Strasbourg, France
| | | | | | - Pascal Kintz
- Institut de Médecine Légale, 11 rue Humann, F-67000, Strasbourg, France. .,X-Pertise Consulting, 42 rue principale, F-67206, Mittelhausbergen, France.
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Kintz P, Gheddar L, Raul JS. Simultaneous testing for anabolic steroids in human hair specimens collected from various anatomic locations has several advantages when compared with the standard head hair analysis. Drug Test Anal 2021; 13:1445-1451. [PMID: 33634609 DOI: 10.1002/dta.3020] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/23/2021] [Accepted: 02/23/2021] [Indexed: 12/14/2022]
Abstract
Since the late 90s, hair testing for anabolic steroids in humans has found numerous forensic, clinical, and anti-doping applications. In most cases, analyses were performed on head hair, collected in the vertex regions. However, for various reasons (shaved subject, bald subject, religious belief, cosmetic treatment and aesthetic reason), hair collectors can face the lack of head hair, and therefore, body hair can be the unique alternative choice. Although there is no possibility to perform segmental analyses with body hair, their use has two major advantages: (1) In most cases, anabolic steroids are more concentrated in body hair when compared with head hair, which allows detecting abuse at lower frequency and for lower dosages; and (2) the window of drug detection is generally much longer in body hair when compared with head hair, particularly in male athlete presenting short head hair. To document the relevance of simultaneous collection of head and body hair, the authors present eight authentic cases of anabolic steroids abuse, including clostebol (one case), drostanolone (one case), metandienone (one case), 19-norandrostenedione (one case), stanozolol (two cases) and trenbolone (three cases). In all cases, body hair concentrations were higher than head hair concentrations. Even in three cases, no steroid was identified in head hair, although present in body hair.
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Affiliation(s)
- Pascal Kintz
- X-Pertise Consulting, Mittelhausbergen, France.,Laboratory of Toxicology, Institut de medecine légale, Strasbourg, France
| | - Laurie Gheddar
- Laboratory of Toxicology, Institut de medecine légale, Strasbourg, France
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de la Torre X, Colamonici C, Iannone M, Jardines D, Molaioni F, Botrè F. Detection of clostebol in sports: Accidental doping? Drug Test Anal 2020; 12:1561-1569. [PMID: 33119965 DOI: 10.1002/dta.2951] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 09/25/2020] [Accepted: 09/25/2020] [Indexed: 12/23/2022]
Abstract
The detection of clostebol misuse in sports has been growing recently, especially in Italy, due to the ample availability of pharmaceutical formulations containing clostebol acetate (Trofodermin®) and the use of more sensitive instrumentation by the antidoping laboratories. Most of these cases have been claimed to be related to a nonconscious use of the drug or through contact with relatives or teammates using it. We have investigated, through the application of the well-known and currently used gas chromatographic mass spectrometric procedures, the likelihood of these allegations and have demonstrated that after a single transdermal administration of 5 mg of clostebol acetate and a transient contact with the application area, it is possible to generate adverse analytical findings in antidoping controls. We have reviewed the Phase I and Phase II clostebol metabolism in order to generate evidences that may help the sport authorities reviewing these cases. The main clostebol metabolite (4-chloro-androst-4-en-3α-ol-17-one, M1) generally used at the screening level as well as other three metabolites (M2-M4) are mainly excreted as glucuronides, whereas M5 (4ζ-chloro-5ζ-androstan-3β-ol-17-one) is predominantly excreted as sulfate. Neither the 5α-reductases activity (impaired by the presence of the chlorine in C4) nor specific sulfotransferases present in the skin allowed a clear distinction of the administration route. Studies with a larger number of volunteers and probably investigating another physiological fluid allowed in antidoping such as blood are needed for a deeper investigation. It is not unreasonable to establish a reporting level for M1, maybe creating some false negatives but excluding nonintentional doping scenarios.
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Affiliation(s)
- Xavier de la Torre
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | | | - Michele Iannone
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Daniel Jardines
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Francesco Molaioni
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Francesco Botrè
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy.,Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
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Chan WS, Wong GF, Hung CW, Wong YN, Fung KM, Lee WK, Dao KL, Leung CW, Lo KM, Lee WM, Cheung BKK. Interpol review of toxicology 2016-2019. Forensic Sci Int Synerg 2020; 2:563-607. [PMID: 33385147 PMCID: PMC7770452 DOI: 10.1016/j.fsisyn.2020.01.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 01/23/2020] [Indexed: 12/13/2022]
Abstract
This review paper covers the forensic-relevant literature in toxicology from 2016 to 2019 as a part of the 19th Interpol International Forensic Science Managers Symposium. The review papers are also available at the Interpol website at: https://www.interpol.int/content/download/14458/file/Interpol%20Review%20.Papers%202019.pdf.
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Kintz P, Gheddar L, Ameline A, Arbouche N, Raul J. Hair testing for doping agents. What is known and what remains to do. Drug Test Anal 2020; 12:316-322. [DOI: 10.1002/dta.2766] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Pascal Kintz
- X‐Pertise Consulting 42 rue principale F‐67206 Mittelhausbergen France
- Institut de médecine légale 11 rue Humann F‐67000 Strasbourg France
| | - Laurie Gheddar
- Institut de médecine légale 11 rue Humann F‐67000 Strasbourg France
| | - Alice Ameline
- Institut de médecine légale 11 rue Humann F‐67000 Strasbourg France
| | - Nadia Arbouche
- Institut de médecine légale 11 rue Humann F‐67000 Strasbourg France
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10
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Thevis M, Kuuranne T, Geyer H. Annual banned‐substance review – Analytical approaches in human sports drug testing. Drug Test Anal 2020; 12:7-26. [DOI: 10.1002/dta.2735] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 11/09/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Mario Thevis
- Center for Preventive Doping Research ‐ Institute of Biochemistry German Sport University Cologne Cologne Germany
- European Monitoring Center for Emerging Doping Agents Cologne Germany
| | - Tiia Kuuranne
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Genève and Lausanne Centre Hospitalier Universitaire Vaudois and University of Lausanne Epalinges Switzerland
| | - Hans Geyer
- Center for Preventive Doping Research ‐ Institute of Biochemistry German Sport University Cologne Cologne Germany
- European Monitoring Center for Emerging Doping Agents Cologne Germany
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Usman M, Naseer A, Baig Y, Jamshaid T, Shahwar M, Khurshuid S. Forensic toxicological analysis of hair: a review. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2019. [DOI: 10.1186/s41935-019-0119-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Favretto D, Snenghi R, Pertile R, El Mazloum R, Tucci M, Visentin S, Vogliardi S. Hair analysis to discriminate voluntary doping vs inadvertent ingestion of the aromatase inhibitor letrozole. Drug Test Anal 2018; 11:762-771. [DOI: 10.1002/dta.2555] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 11/26/2018] [Accepted: 11/27/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Donata Favretto
- University Hospital of Padova Padova Italy
- Department of Cardiac Thoracic and Vascular Sciences and Public HealthUniversity of Padova Padova Italy
| | | | | | - Rafi El Mazloum
- Department of Cardiac Thoracic and Vascular Sciences and Public HealthUniversity of Padova Padova Italy
| | - Marianna Tucci
- Department of Cardiac Thoracic and Vascular Sciences and Public HealthUniversity of Padova Padova Italy
| | - Sindi Visentin
- University Hospital of Padova Padova Italy
- Department of Cardiac Thoracic and Vascular Sciences and Public HealthUniversity of Padova Padova Italy
| | - Susanna Vogliardi
- Department of Cardiac Thoracic and Vascular Sciences and Public HealthUniversity of Padova Padova Italy
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