1
|
Kintz P. Reply to the paper of Breuer et al.: complementary information concerning the suspected interindividual transmission of GW1516, a substance prohibited in sport, through intimate contact-a case report. Forensic Toxicol 2024:10.1007/s11419-024-00694-0. [PMID: 38935295 DOI: 10.1007/s11419-024-00694-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 06/22/2024] [Indexed: 06/28/2024]
Affiliation(s)
- Pascal Kintz
- X-Pertise Consulting, 42 Rue Principale, 67206, Mittelhausbergen, France.
- Institut de Médecine Légale, 11 Rue Humann, 67000, Strasbourg, France.
| |
Collapse
|
2
|
Kintz P, Gheddar L. Evidence of ostarine cross-contamination via sweat in 2 athletes sharing the same neoprene hamstring sleeves. An original situation of drug transfer where the anti-doping rule violation was suspended by the sport authorities. Clin Chim Acta 2024; 559:119688. [PMID: 38670521 DOI: 10.1016/j.cca.2024.119688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 04/23/2024] [Accepted: 04/24/2024] [Indexed: 04/28/2024]
Abstract
The presence of ostarine, a selective androgen receptor modulator (SARM) in an athlete's sample constitutes one of the most frequent anti-doping rules violation. It is possible to challenge this violation but it is the athlete who has to demonstrate he / she is innocent. The conditions to evidence no fault or negligence are mostly based on 2 points: 1. the athlete or his/her legal representative must present verified circumstances of contamination and the source of contamination must be identified; and 2. there must be verified claims by the athlete about the fact that he / she did not knowingly take the prohibited substance, i.e. that the violation was not intentional. During a 2-weeks period, a male athlete tested two times positive for ostarine in urine (<0.1 ng/ml) and he challenged these results. His hair and nail tests returned negative (LOQ at 0.5 pg/mg). He admitted using two neoprene hamstring sleeves of another athlete who confessed abusing ostarine. This was confirmed in his hair (190 pg/mg), his fingernail clippings (780 pg/mg) and his toenail clippings (45 pg/mg). To document the presence of ostarine in the hamstring sleeves and therefore possible drug transfer, the hamstring sleeves were analysed. Ostarine was identified in 12 different selected pieces (about 1 g) of the sleeves at concentrations ranging from 3 to 142 pg/g. Sport authorities (USADA) agreed that the most likely source of contamination was the hamstring sleeves, thus confirming the scenario of drug transfer and gave the athlete a no fault.
Collapse
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
| |
Collapse
|
3
|
Hung SH, Kan HL, Tung CW, Lin YC, Chen TT, Tian C, Chang WCW. Probing the hair detectability of prohibited substances in sports: an in vivo-in silico-clinical approach and analytical implications compared with plasma, urine, and faeces. Arch Toxicol 2024; 98:779-790. [PMID: 38224356 PMCID: PMC10861659 DOI: 10.1007/s00204-023-03667-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/14/2023] [Indexed: 01/16/2024]
Abstract
Hair analysis is a crucial method in forensic toxicology with potential applications in revealing doping histories in sports. Despite its widespread use, knowledge about detectable substances in hair is limited. This study systematically assessed the detectability of prohibited substances in sports using a multifaceted approach. Initially, an animal model received a subset of 17 model drugs to compare dose dependencies and detection windows across different matrices. Subsequently, hair incorporation data from the animal experiment were extrapolated to all substances on the World Anti-Doping Agency's List through in-silico prediction. The detectability of substances in hair was further validated in a proof-of-concept human study involving the consumption of diuretics and masking agents. Semi-quantitative analysis of substances in specimens was performed using ultra-performance liquid chromatography-tandem mass spectrometry. Results showed plasma had optimal dose dependencies with limited detection windows, while urine, faeces, and hair exhibited a reasonable relationship with the administered dose. Notably, hair displayed the highest detection probability (14 out of 17) for compounds, including anabolic agents, hormones, and diuretics, with beta-2 agonists undetected. Diuretics such as furosemide, canrenone, and hydrochlorothiazide showed the highest hair incorporation. Authentic human hair confirmed diuretic detectability, and their use duration was determined via segmental analysis. Noteworthy is the first-time reporting of canrenone in human hair. Anabolic agents were expected in hair, whereas undetectable compounds, such as peptide hormones and beta-2 agonists, were likely due to large molecular mass or high polarity. This study enhances understanding of hair analysis in doping investigations, providing insights into substance detectability.
Collapse
Affiliation(s)
- Shao-Hsin Hung
- Doctoral Degree Program in Toxicology, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
| | - Hung-Lin Kan
- Institute of Biotechnology and Pharmaceutical Research, National Health Research Institutes, Miaoli County, 350, Taiwan
| | - Chun-Wei Tung
- Institute of Biotechnology and Pharmaceutical Research, National Health Research Institutes, Miaoli County, 350, Taiwan
| | - Yi-Ching Lin
- Doctoral Degree Program in Toxicology, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
- Department of Laboratory Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
| | - Ting-Ting Chen
- Department of Leisure Industry and Health Promotion, College of Humanities and Management, National Ilan University, Yilan County, 260, Taiwan
| | - Ciao Tian
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
| | - William Chih-Wei Chang
- Doctoral Degree Program in Toxicology, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
| |
Collapse
|
4
|
Kintz P, Gheddar L. Interest of hair tests to discriminate a tail end of a doping regimen from a meat contamination in case of challenging an antidoping rule violation. III. Case report involving boldenone. Drug Test Anal 2024. [PMID: 38356252 DOI: 10.1002/dta.3656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 01/24/2024] [Accepted: 01/28/2024] [Indexed: 02/16/2024]
Affiliation(s)
- Pascal Kintz
- X-Pertise Consulting, Mittelhausbergen, France
- Institut de medecine légale, Strasbourg, France
| | | |
Collapse
|
5
|
Kintz P. Drug transfer during intimate moments: A key issue in doping control that can be documented by hair tests of the athlete and the partner. MEDICINE, SCIENCE, AND THE LAW 2024; 64:72-76. [PMID: 37161267 DOI: 10.1177/00258024231173346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
The presence of a prohibited substance or its metabolites or its markers in an athlete's sample constitutes the more frequent anti-doping rules violation. In the world anti-doping code, it is indicated (point 10.5) that if someone establishes in an individual case that the athlete bears no fault or negligence, then the otherwise applicable period of ineligibility shall be eliminated. The conditions that have to be met to fix the no fault or negligence evidence are described in several other points of the code. The following two points are of paramount importance: 1. the athlete or his/her legal representative must present verified circumstances of contamination and the source of contamination must be identified; and
2. there must be verified claims by the athlete about the fact that he/she did not knowingly take the prohibited substance, i.e., that the violation was not intentional.In recent years, several cases of contamination involving drug transfer during intimate moments have been reported. This later situation was first reported in 2009 with the Richard Gasquet case. Since that time, several athletes have been allowed to return to competition with no charge based on strong evidence that the source of contamination was drug transfer during intimate moments. As some of these cases are public and because the author performed hair tests for the majority of the international athletes involved in such procedures, the strategy of the defence and the scientific bases of discussion are reviewed in this article.
Collapse
Affiliation(s)
- Pascal Kintz
- X-Pertise Consulting, Mittelhausbergen, France
- Institut de médecine légale, Strasbourg, France
| |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Kintz P, Gheddar L. Does a hair test allow discriminating a tail end of a doping regimen from a contamination in case of challenging an anti-doping rule violation? II. Case report involving chlortalidone. Drug Test Anal 2023. [PMID: 38128574 DOI: 10.1002/dta.3634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Pascal Kintz
- X-Pertise Consulting, Mittelhausbergen, France
- Institut de médecine légale, Strasbourg, France
| | | |
Collapse
|
8
|
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.
Collapse
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
| | | |
Collapse
|
9
|
Ishii H, Shibuya M, Kusano K, Sone Y, Kamiya T, Wakuno A, Ito H, Miyata K, Yamada M, Leung GNW. First evidence of the incorporation of daprodustat and other hypoxia-inducible factor stabilizers into equine hair by passive transfer based on segmental quantitative analysis. J Pharm Biomed Anal 2023; 235:115600. [PMID: 37516063 DOI: 10.1016/j.jpba.2023.115600] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 07/31/2023]
Abstract
Daprodustat is a hypoxia-inducible factor prolyl hydroxylase domain (HIF-PHD) inhibitor and is used as an erythropoiesis stimulant for the treatment of anemia in humans. In general, administering daprodustat to horses will result in a lifetime ban from both equestrian sports and horseracing by the International Federation of Horseracing Authorities and the Fédération Équestre Internationale, respectively. To control the misuse/abuse of daprodustat, we conducted nasoesophageal administration of daprodustat (100 mg/day for 3 days) to three thoroughbred mares and the post-administration hair samples collected from the three horses over 6 months were analyzed to demonstrate the potential longer-term detection of daprodustat and its metabolites in hair compared with the detection times of daprodustat of 1 and 2 weeks in plasma and urine respectively. The results of the quantitative 2-cm segmental analysis showed that daprodustat was primarily localized in the proximal region (0-2 cm) at 0.375-0.463 pg/mg at 1 month post-administration. These drug bands were gradually spread out along the hair shaft at a rate consistent with the reported growth rate of horse mane hair (approximately 2.5 cm/month) over the following 6 months. In addition, to attain deeper insight into the mechanism of drug incorporation into hair, a total of 11 relevant parameters, including the actual PK parameters and simulated physicochemical and biopharmaceutical parameters for three HIF stabilizers (i.e., daprodustat, vadadustat, and IOX4), were investigated after normalization of the z-scores of all these parameters. Multiple regression analysis indicated that the major factors contributing to the incorporation of the three drugs into hair were their maximum plasma concentrations and lipophilicities, strongly suggesting that the three HIF stabilizers permeated from the bloodstream into the hair bulb via passive transfer with concentration gradients. This work is the first reported evidence showing the incorporation of HIF stabilizers into hair via passive transfer. In addition, cross-species comparison of drug incorporations into hair between daprodustat in horse and roxadustat in human was made in order to have a better understanding of the interactive interpretations about the analysis results obtained from different species. The above findings are not only useful and beneficial for the purpose of doping control but also provide a better understanding of the mechanism of drug incorporation into horse hair.
Collapse
Affiliation(s)
- Hideaki Ishii
- Drug Analysis Department, Laboratory of Racing Chemistry, 1731-2 Tsuruta-machi, Utsunomiya, Tochigi 320-0851, Japan; Department of Pharmaceutical Sciences, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
| | - Mariko Shibuya
- Drug Analysis Department, Laboratory of Racing Chemistry, 1731-2 Tsuruta-machi, Utsunomiya, Tochigi 320-0851, Japan
| | - Kanichi Kusano
- Veterinarian Section, Equine Department, Japan Racing Association, 6-11-1 Roppongi, Minato-ku, Tokyo 105-0003, Japan
| | - Yu Sone
- Veterinarian Section, Equine Department, Japan Racing Association, 6-11-1 Roppongi, Minato-ku, Tokyo 105-0003, Japan
| | - Takahiro Kamiya
- Equine Veterinary Clinic, Horse Racing School, Japan Racing Association, 835-1 Ne, Shiroi, Chiba 270-1431, Japan
| | - Ai Wakuno
- Equine Veterinary Clinic, Horse Racing School, Japan Racing Association, 835-1 Ne, Shiroi, Chiba 270-1431, Japan
| | - Hideki Ito
- Equine Veterinary Clinic, Horse Racing School, Japan Racing Association, 835-1 Ne, Shiroi, Chiba 270-1431, Japan
| | - Kenji Miyata
- JRA Equestrian Park Utsunomiya Office, 321-4 Tokamicho, Utsunomiya, Tochigi 320-0856, Japan
| | - Masayuki Yamada
- Drug Analysis Department, Laboratory of Racing Chemistry, 1731-2 Tsuruta-machi, Utsunomiya, Tochigi 320-0851, Japan
| | - Gary Ngai-Wa Leung
- Drug Analysis Department, Laboratory of Racing Chemistry, 1731-2 Tsuruta-machi, Utsunomiya, Tochigi 320-0851, Japan
| |
Collapse
|
10
|
Chang WCW, Hsu MC, Liao PC. Detection of emerging patterns of drug misuse in sports via wastewater monitoring: A mini-review and potential strategies. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 333:122087. [PMID: 37348696 DOI: 10.1016/j.envpol.2023.122087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/16/2023] [Accepted: 06/19/2023] [Indexed: 06/24/2023]
Abstract
Biological testing is a key component of the current anti-doping programme implemented by the authorities to detect doping in sports. Strategies such as longitudinal individualised data analysis and sport-specific analysis have been developed to increase the comprehensiveness of the testing. However, the trends of drug misuse in sports might not be effectively captured through today's testing plan. Wastewater testing, assembling individual-level data of a designated group to produce population-level results in one single aggregated sample, can be employed to as a complementary strategy offering added value for doping control. This paper presents an updated summary of the status of anti-doping testing and analytical methodologies for wastewater. The available literature on wastewater-based analyses of drugs prohibited in sports is reviewed. Publications surrounding sporting activities or competitions and others relevant to sports doping are selected. We debate between potential strategies and major limitations of using wastewater monitoring in anti-doping. Knowledge gaps and research directions, specifically on metabolites, stability, sensitivity, and ethical and legal considerations, are discussed. Choosing different wastewater sampling sites allows target sub-population that involved competing athletes and potentially reveal sport-specific or athlete-level-specific behaviour. Sampling from on-board toilets or athlete villages could target international-level athletes, sampling from the dormitories of national training centres allows monitoring of national-level athletes on a daily basis, and sampling from sports stadiums provides a full picture of drug use in the general population during an event. Confounding occurs as (i) the presence of non-athlete composition and the difficulty of analyses to be completely selective to the athlete population; and (ii) the identification of compounds prescribed legitimately with Therapeutic Use Exemptions, only banned in-competition, and naturally occurring. The practicalities of the approach are contextualised in monitoring the non-threshold substances such as anabolic agents, selective androgen receptor modulators, metabolic modulators, and hypoxia-inducible factor activators.
Collapse
Affiliation(s)
- William Chih-Wei Chang
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, 807, Taiwan; College of Pharmacy, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
| | - Mei-Chich Hsu
- Department of Sports Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
| | - Pao-Chi Liao
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan.
| |
Collapse
|
11
|
Petróczi A, Cruyff M, de Hon O, Sagoe D, Saugy M. Hidden figures: Revisiting doping prevalence estimates previously reported for two major international sport events in the context of further empirical evidence and the extant literature. Front Sports Act Living 2022; 4:1017329. [PMID: 36544544 PMCID: PMC9760848 DOI: 10.3389/fspor.2022.1017329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/25/2022] [Indexed: 12/12/2022] Open
Abstract
Background High levels of admitted doping use (43.6% and 57.1%) were reported for two international sport events in 2011. Because these are frequently referenced in evaluating aspects of anti-doping, having high level of confidence in these estimates is paramount. Objectives In this study, we present new prevalence estimates from a concurrently administered method, the Single Sample Count (SSC), and critically review the two sets of estimates in the context of other doping prevalence estimates. Methods The survey featuring the SSC model was completed by 1,203 athletes at the 2011 World Championships in Athletics (WCA) (65.3% of all participating athletes) and 954 athletes at the 2011 Pan-Arab Games (PAG) (28.2% of all participating athletes). At WCA, athletes completed both UQM and SSC surveys in randomised order. At PAG, athletes were randomly allocated to one of the two surveys. Doping was defined as "having knowingly violated anti-doping regulations by using a prohibited substance or method." Results Estimates with the SSC model for 12-month doping prevalence were 21.2% (95% CI: 9.69-32.7) at WCA and 10.6% (95% CI: 1.76-19.4) at PAG. Estimated herbal, mineral, and/or vitamin supplements use was 8.57% (95% CI: 1.3-16.11) at PAG. Reliability of the estimates were confirmed with re-sampling method (n = 1,000, 80% of the sample). Survey non-compliance (31.90%, 95%CI: 26.28-37.52; p < 0.0001) was detected in the WCA data but occurred to a lesser degree at PAG (9.85%, 95% CI: 4.01-15.69, p = 0.0144 and 11.43%, 95% CI: 5.31-11.55, p = 0.0196, for doping and nutritional supplement use, respectively). A large discrepancy between those previously reported from the UQM and the prevalence rate estimated by the SSC model for the same population is evident. Conclusion Caution in interpreting these estimates as bona fide prevalence rates is warranted. Critical appraisal of the obtained prevalence rates and triangulation with other sources are recommended over "the higher rate must be closer to the truth" heuristics. Non-compliance appears to be the Achilles heel of the indirect estimation models thus it should be routinely tested for and minimised. Further research into cognitive and behaviour aspects, including motivation for honesty, is needed to improve the ecological validity of the estimated prevalence rates.
Collapse
Affiliation(s)
- Andrea Petróczi
- School of Life Sciences, Pharmacy and Chemistry, Faculty of Health, Science, Social Care and Education, Kingston University, London, United Kingdom,Department of Movement Sciences, Faculty of Movement and Rehabilitation Sciences, Katholieke Universiteit (KU) Leuven, Leuven, Belgium,Willibald Gebhardt Research Institute, University of Münster, Münster, Germany,*Correspondence: Andrea Petróczi
| | - Maarten Cruyff
- Faculty of Social Sciences, Utrecht University, Utrecht, Netherlands
| | - Olivier de Hon
- Doping Authority Netherlands, Capelle aan den IJssel, Netherlands
| | - Dominic Sagoe
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Martial Saugy
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
12
|
Identification par LC-MS/MS de la testostérone acétate dans la crinière d’un cheval de course. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2022. [DOI: 10.1016/j.toxac.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
13
|
Wiedfeld C, Skopp G, Thieme D, Musshoff F. Application of single hair analysis in a doping case involving amphetamine. Drug Test Anal 2022; 14:781-784. [DOI: 10.1002/dta.3217] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/29/2021] [Accepted: 12/16/2021] [Indexed: 11/12/2022]
Affiliation(s)
| | - Gisela Skopp
- Forensic Toxicological Center (FTC) Munich Munich Germany
| | - Detlef Thieme
- Institute of Doping Analysis und Sports Biochemistry Dresden Kreischa Germany
| | - Frank Musshoff
- Forensic Toxicological Center (FTC) Munich Munich Germany
| |
Collapse
|
14
|
Kintz P. The forensic response after an adverse analytical finding (doping) involving a selective androgen receptor modulator (SARM) in human athlete. J Pharm Biomed Anal 2022; 207:114433. [PMID: 34715583 DOI: 10.1016/j.jpba.2021.114433] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/04/2021] [Accepted: 10/13/2021] [Indexed: 11/28/2022]
Abstract
Selective androgen receptor modulators (SARMs) are a class of drugs presenting identical anabolic properties to anabolic steroids in addition to marked reduced androgenic effects. These drugs have emerged in the doping area within the early 2000's. Ligandrol, ostarine, RAD-140 and andarine are the most popular agents belonging to this class. According to the world anti-doping agency (WADA) prohibited list, SARMs are prohibited at all times (i.e. in and out-of-competition) and are listed under the section S1.2 (other anabolic agents). The compilation of the WADA testing figures reports from 2015 to 2019 has indicated a regular increase of adverse analytical findings (AAF) due to SARMs, particularly with ostarine and ligandrol. The implementation of highly sensitive chromatographic anti-doping analyses has induced high-profile challenges of anti-doping rules violations as athletes have claimed in numerous occasions that contamination was the reason for their AAF. Since the early 2000's, it has been accepted by the Court of Arbitration for Sports (CAS) in Lausanne (Switzerland) that, under some specific circumstances, unusual explanations can be provided to the Panel to explain an AAF. This was the open door for forensic investigations, as it is done in criminal Courts. A forensic approach can include testing for SARMs in food, drinks, but mostly in dietary supplements. As most anti-doping rules violations are only known several weeks after urine collection, this biological matrix is seldom use for further tests, despite the fact that most SARMs can be detected for several weeks in urine. Luckily, hair or nail testing can be a complement to document the claim of the athlete but of course, it cannot be considered as an alternative to urinalysis. This is because a negative hair or nail result cannot exclude the use of the detected drug and cannot overrule the urine result. To date, all methods for SARMs identification in various matrices involve liquid chromatography coupled to tandem mass spectrometry or high-resolution mass spectrometry. The aim of this paper is to review the scientific literature on the analytical possibilities of testing SARMs in dietary supplements, urine and hair or nail clippings after an AAF to document the claims of an athlete or his/her legal team.
Collapse
Affiliation(s)
- Pascal Kintz
- X-Pertise Consulting, 42 rue principale, 67206 Mittelhausbergen, France; Institut de Médecine légale, 11 rue Humann, 67000 Strasbourg, France.
| |
Collapse
|
15
|
Interest of HRMS systems in analytical toxicology: Focus on doping products. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2022. [DOI: 10.1016/j.toxac.2021.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
16
|
Kintz P, Gheddar L, Ameline A, Raul JS. Human hair testing for selective androgen receptor modulators (SARMs): Current knowledge and limitations. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2022. [DOI: 10.1016/j.toxac.2021.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
17
|
Kintz P, Gheddar L, Raul JS. Liquid chromatography-tandem mass spectrometry and confirmation by liquid chromatography-high-resolution mass spectrometry hair tests to evidence use of tizanidine by racing cyclists. Drug Test Anal 2022; 14:154-161. [PMID: 34549540 DOI: 10.1002/dta.3164] [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: 08/13/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 01/26/2023]
Abstract
Tizanidine, an imidazoline derivative close to clonidine, is a central alpha-2 adrenergic receptor agonist. Therapeutically, the drug is used as a muscle relaxant under the trade names Sirdalud™ or Zanaflex™. The drug is not prohibited by the World Anti-Doping Agency but, for therapeutic purposes, can only be obtained via a nominative temporary use authorization. The French public health police requested the laboratory to test for tizanidine in head hair specimens collected from international racing cyclists. Using Liquid chromatography-tandem mass spectrometry (LC/MS-MS) and confirmation by liquid chromatography-high-resolution mass spectrometry (LC/HRMS), after pH 9.5 borate buffer overnight incubation of 20 mg and subsequent solvents extraction, tizanidine was identified in the hair of three athletes at 1.1, 3.7, and 11.1 pg/mg. This is the first evidence that tizanidine is incorporated in human hair. However, it was not possible to interpret the data in terms of doses and frequency of use due to a lack of controlled study.
Collapse
Affiliation(s)
- Pascal Kintz
- X-Pertise Consulting, Mittelhausbergen, France.,Institut de medecine légale, Strasbourg, France
| | | | | |
Collapse
|
18
|
Piacentino D, Sani G, Kotzalidis GD, Cappelletti S, Longo L, Rizzato S, Fabi F, Frati P, Fineschi V, Leggio L. Anabolic androgenic steroids used as performance and image enhancing drugs in professional and amateur athletes: Toxicological and psychopathological findings. Hum Psychopharmacol 2022; 37:e2815. [PMID: 34528289 PMCID: PMC8727496 DOI: 10.1002/hup.2815] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/31/2021] [Accepted: 08/24/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The use of anabolic androgenic steroids (AASs) as performance and image enhancing drugs (PIEDs), once restricted to professional athletes, now includes amateurs and regular gym visitors. AAS use is associated with psychopathology, yet this relationship is complex and not fully understood. We aimed to assess the presence of AASs and other misused substances in athletes' biological samples and link toxicological to psychopathological findings. METHODS A multicentre, cross-sectional study in fitness centres in Italy recruited 122 professional and amateur athletes training in several sports (84 men; age range = 18-45 years). Athletes completed questionnaires, interviews, and toxicology testing for AASs, other PIEDs, illicit drugs, and non-prescribed psychotropics. Toxicology was conducted in blood, urine, and hair. RESULTS Self-reported and toxicologically detected use rates of AASs and other misused substances showed slight-to-fair agreement (Fleiss' κ = 0.104-0.375). There was slight-to-moderate agreement among the three biological samples used for AAS testing (κ = 0.112-0.436). Thirty-one athletes (25.4%) tested positive for AASs. More sport hours/week, narcissistic or antisocial personality disorders, and higher nonplanning impulsiveness scores predicted AAS use (pseudo-R2 = 0.665). AAS users did not differ significantly from non-users in major psychopathology, but their Hypomania Checklist-32 score, which also predicted AAS use, was significantly higher (p < 0.001), suggesting increased odds for cyclothymic disorder or subthreshold hypomania. CONCLUSIONS Our results have implications for studying AAS users, as they identify a cluster of variables that may be relevant in future understanding of AAS use risks (e.g., personality disorders). Possible disagreements between AAS assessment methods should be considered when implementing harm reduction interventions, such as needle and syringe distribution, health education, and counselling, as well as surveillance programmes.
Collapse
Affiliation(s)
- Daria Piacentino
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD, USA,Center on Compulsive Behaviors, National Institutes of Health, Bethesda, MD, USA,Neurosciences, Mental Health, and Sensory Organs (NESMOS) Department, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy,Correspondence: Daria Piacentino, M.D., Ph.D., M.S., Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, NIDA IRP and NIAAA DICBR, National Institutes of Health, 251 Bayview Blvd, Room 02A406, Baltimore, MD 21224, Phone: 443-740-2793,
| | - Gabriele Sani
- Department of Neuroscience, Psychiatry Section, Catholic University of Rome, Rome, Italy
| | - Georgios D. Kotzalidis
- Neurosciences, Mental Health, and Sensory Organs (NESMOS) Department, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Simone Cappelletti
- Anatomical, Histological, Forensic Medicine, and Orthopedic Sciences (SAIMLAL) Department, Sapienza University of Rome, Rome, Italy
| | - Livia Longo
- Neurosciences, Mental Health, and Sensory Organs (NESMOS) Department, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Salvatore Rizzato
- Neurosciences, Mental Health, and Sensory Organs (NESMOS) Department, School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Francesco Fabi
- Centre for Statistical and Social Studies (CE3S), Rome, Italy
| | - Paola Frati
- Anatomical, Histological, Forensic Medicine, and Orthopedic Sciences (SAIMLAL) Department, Sapienza University of Rome, Rome, Italy
| | - Vittorio Fineschi
- Anatomical, Histological, Forensic Medicine, and Orthopedic Sciences (SAIMLAL) Department, Sapienza University of Rome, Rome, Italy
| | - Lorenzo Leggio
- Clinical Psychoneuroendocrinology and Neuropsychopharmacology Section, Translational Addiction Medicine Branch, National Institute on Drug Abuse Intramural Research Program and National Institute on Alcohol Abuse and Alcoholism Division of Intramural Clinical and Biological Research, National Institutes of Health, Baltimore and Bethesda, MD, USA,Center on Compulsive Behaviors, National Institutes of Health, Bethesda, MD, USA,Medication Development Program, National Institute on Drug Abuse Intramural Research Program, National Institutes of Health, Baltimore, MD, USA,Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA,Division of Addiction Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Department of Neuroscience, Georgetown University Medical Center, Washington, DC, USA
| |
Collapse
|
19
|
Moeller BC, Flores L, Clifford A, Alarcio G, Mosburg M, Arthur RM. Detection of Methylphenidate in Equine Hair Using Liquid Chromatography-High-Resolution Mass Spectrometry. Molecules 2021; 26:molecules26195798. [PMID: 34641342 PMCID: PMC8510229 DOI: 10.3390/molecules26195798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/13/2021] [Accepted: 09/15/2021] [Indexed: 11/16/2022] Open
Abstract
Methylphenidate is a powerful central nervous system stimulant with a high potential for abuse in horse racing. The detection of methylphenidate use is of interest to horse racing authorities for both prior to and during competition. The use of hair as an alternative sampling matrix for equine anti-doping has increased as the number of detectable compounds has expanded. Our laboratory developed a liquid chromatography–high-resolution mass spectrometry method to detect the presence of methylphenidate in submitted samples. Briefly, hair was decontaminated, cut, and pulverized prior to liquid–liquid extraction in basic conditions before introduction to the LC-MS system. Instrumental analysis was conducted using a Thermo Q Exactive mass spectrometer using parallel reaction monitoring using a stepped collision energy to obtain sufficient product ions for qualitative identification. The method was validated and limits of quantitation, linearity, matrix effects, recovery, accuracy, and precision were determined. The method has been applied to confirm the presence of methylphenidate in official samples submitted by racing authorities.
Collapse
Affiliation(s)
- Benjamin C. Moeller
- KL Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California, Davis, CA 95616, USA; (L.F.); (A.C.); (G.A.); (M.M.)
- Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
- Correspondence: ; Tel.: +1-530-752-8700
| | - Luis Flores
- KL Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California, Davis, CA 95616, USA; (L.F.); (A.C.); (G.A.); (M.M.)
| | - Amel Clifford
- KL Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California, Davis, CA 95616, USA; (L.F.); (A.C.); (G.A.); (M.M.)
| | - Gwendolyne Alarcio
- KL Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California, Davis, CA 95616, USA; (L.F.); (A.C.); (G.A.); (M.M.)
| | - Mary Mosburg
- KL Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California, Davis, CA 95616, USA; (L.F.); (A.C.); (G.A.); (M.M.)
| | - Rick M. Arthur
- School of Veterinary Medicine, University of California, Davis, CA 95616, USA;
| |
Collapse
|
20
|
Moeller BC, Clifford A, Emery RT, Alarcio G, Favro G, Arthur RM. Detection and Confirmation of Zilpaterol in Equine Hair Using Liquid Chromatography - Mass Spectrometry. Drug Test Anal 2021; 14:31-38. [PMID: 34355536 DOI: 10.1002/dta.3138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/24/2021] [Accepted: 07/31/2021] [Indexed: 11/06/2022]
Abstract
Zilpaterol is a β2 -adrenergic agonist and a repartitioning agent that has a high potential for abuse in equine performance athletes. Analysis of zilpaterol in hair is an alternative sampling matrix that extends detection time periods beyond those found in urine or blood samples. Our laboratory has been screening for zilpaterol in hair for many years and recently detected and confirmed its presence in official samples. Accordingly, a liquid chromatography - mass spectrometry method was developed and validated to detect and confirm zilpaterol in equine hair. Briefly, equine hair was decontaminated, cut, and pulverized prior to disruption and liquid-liquid extraction in basic conditions. Following extraction, the sample was introduced to an Agilent 1260 HPLC and zilpaterol was separated using a reverse phase gradient with a total run time of 12.5 minutes. Following chromatographic separation, zilpaterol and its corresponding stable isotope labeled internal standard were introduced via positive mode electrospray ionization to a Thermo Q-Exactive Plus mass spectrometer and spectra collected using parallel reaction monitoring. The methodology was validated using in-house criteria including characterization of accuracy, precision, recovery, linear range, matrix effects, limit of detection and limit of quantitation and the method was found to be fit-for-purpose to confirm the presence of zilpaterol in equine hair. This methodology has been used to detect and confirm the presence of zilpaterol from out-of-competition hair samples submitted by regional racing authorities.
Collapse
Affiliation(s)
- Benjamin C Moeller
- KL Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California, Davis, Davis, CA.,Department of Molecular Biosciences, School of Veterinary Medicine, University of California, Davis, Davis, CA
| | - Amel Clifford
- KL Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California, Davis, Davis, CA
| | - Richard T Emery
- KL Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California, Davis, Davis, CA
| | - Gwen Alarcio
- KL Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California, Davis, Davis, CA
| | - Gianna Favro
- KL Maddy Equine Analytical Chemistry Laboratory, School of Veterinary Medicine, University of California, Davis, Davis, CA
| | - Rick M Arthur
- School of Veterinary Medicine, University of California, Davis, Davis, CA
| |
Collapse
|
21
|
Kintz P. What Are the Prerequisites to Account for "No Fault" in Doping Control after an Adverse Analytical Finding Possibly due to Drug Contamination? Perspective from a Hair Testing Analyst. J Anal Toxicol 2021; 45:e3-e5. [PMID: 33150948 DOI: 10.1093/jat/bkaa171] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/31/2020] [Accepted: 11/03/2020] [Indexed: 11/12/2022] Open
Affiliation(s)
- Pascal Kintz
- X-Pertise Consulting, Mittelhausbergen 67206, France.,Institut de medecine légale, Strasbourg 67000, France
| |
Collapse
|
22
|
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.
Collapse
Affiliation(s)
- Pascal Kintz
- Institut de médecine légale, Strasbourg, France.,X-Pertise Consulting, Mittelhausbergen, France
| | | | | |
Collapse
|
23
|
Kintz P, Gheddar L, Ameline A, Raul JS. Perspectives in Evaluating Selective Androgen Receptor Modulators in Human Hair: A Short Communication. Ther Drug Monit 2021; 43:298-300. [PMID: 33337588 DOI: 10.1097/ftd.0000000000000859] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/01/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND As hair testing increases the window of drug detection and permits the differentiation of long-term use from a single exposure when performing segmental analyses (which also allows establishing the pattern of use), this matrix should be considered as a suitable complement to standard investigations in clinical, forensic, and sport toxicology. The authors were recently involved in 3 cases where hair analysis was used to demonstrate the use of selective androgen receptor modulators (SARMs), including ligandrol (LGD-4033), andarine (S-4), and ostarine (S-22). SARMs are increasingly being abused as "safe" alternatives to steroids. METHODS After decontamination using dichloromethane, hair specimens were segmented, cut into very small segments (<1 mm), incubated overnight in a buffer, and extracted using a mixture of organic solvents. Drugs were tested using liquid chromatography-tandem mass spectrometry and confirmed using liquid chromatography/HRMS. RESULTS The determined concentrations were as follows: ligandrol, 14-42 pg/mg; andarine, 0.1-0.7 pg/mg; and ostarine, 3-21 pg/mg. CONCLUSIONS To enhance performance, SARMs must be used on a long-term basis, which can have serious clinical consequences, including liver damage, myocardial infarction, and blood clots. Hair testing for SARMs has additional benefits versus urine analysis as it can detect the parent compound and numerous metabolites.
Collapse
Affiliation(s)
- Pascal Kintz
- X-Pertise Consulting, University of Strasbourg, Strasbourg, France ; and
- Institut de Médecine Légale, University of Strasbourg, Strasbourg, France
| | - Laurie Gheddar
- Institut de Médecine Légale, University of Strasbourg, Strasbourg, France
| | - Alice Ameline
- Institut de Médecine Légale, University of Strasbourg, Strasbourg, France
| | | |
Collapse
|
24
|
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: 20] [Impact Index Per Article: 6.7] [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.
Collapse
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
| | | |
Collapse
|
25
|
Kintz P, Ameline A, Gheddar L, Escudero P, Ferrari L, Raul JS. Cocaine External Contamination Can Be Documented by a Hair Test. J Anal Toxicol 2021; 44:e4-e5. [PMID: 32507873 DOI: 10.1093/jat/bkaa061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/17/2020] [Accepted: 04/28/2020] [Indexed: 12/13/2022] Open
Affiliation(s)
- Pascal Kintz
- X-Pertise Consulting, 42 rue principale, Mittelhausbergen F-67206, France.,Institut de medecine légale, 11 rue Humann, Strasbourg F-67000, France
| | - Alice Ameline
- Institut de medecine légale, 11 rue Humann, Strasbourg F-67000, France
| | - Laurie Gheddar
- Institut de medecine légale, 11 rue Humann, Strasbourg F-67000, France
| | - Pablo Escudero
- Cátedra Toxicología y Química Forense, U.M, Cabildo 134, 1708 Morón, Buenos Aires, Argentina
| | - Luis Ferrari
- Cátedra Toxicología y Química Forense, U.M, Cabildo 134, 1708 Morón, Buenos Aires, Argentina
| | | |
Collapse
|
26
|
Characterization of letrozole in human hair using LC-MS/MS and confirmation by LC-HRMS: Application to a doping case. J Chromatogr B Analyt Technol Biomed Life Sci 2021; 1162:122495. [PMID: 33360417 DOI: 10.1016/j.jchromb.2020.122495] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/04/2020] [Accepted: 12/06/2020] [Indexed: 12/26/2022]
Abstract
Letrozole is a reversible aromatase inhibitor, used in the treatment of hormone-dependent woman cancer. No indication for medical use is available for men. In recent years, several cases of doping with letrozole have been observed, especially among high level athletes. Aromatase inhibitors reverse the harmful effects (feminizing) of the abuse of anabolic androgenic steroids. Letrozole is included on the list of products prohibited in- and out-competition by the World Anti-Doping Agency, under section S4.1. The aim of the present work was to develop a specific method to identify letrozole in human hair of a male amateur athlete by LC-MS/MS and confirmation by LC-HRMS, after incubation of 20 mg of matrix in 1 mL of methanol. The chromatographic separation was performed using a reverse phase column HSS C18 with a gradient elution of 15 min (from 87% to 5% of formate buffer adjusted to pH 3). Linearity was observed from 1 to 1000 pg/mg (r2 = 0.9999), after spiking blank hair with the corresponding amounts of letrozole. The limit of detection was estimated at 0.5 pg/mg and the lower limit of quantification was the first point of the calibration curve, i.e. 1 pg/mg. The precision was lower than 20% and there was no interference with the analytes by chemicals or any extractable endogenous materials present in hair. Letrozole was identified in the male amateur athlete hair at 310 pg/mg (segment 0-2 cm) and 245 pg/mg (segment 2-4 cm).
Collapse
|
27
|
Feisthauer E, Ameline A, Gheddar L, Arbouche N, Raul JS, Kintz P. Analysis of Cocaine and its Metabolites in Urine After Consummation of Coca Tea by Five Subjects and Subsequent Hair Testing. J Anal Toxicol 2020; 46:108-113. [PMID: 33277893 DOI: 10.1093/jat/bkaa190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 11/20/2020] [Accepted: 12/04/2020] [Indexed: 11/14/2022] Open
Abstract
Coca tea is a popular drink in some South American countries where it is reputed to have medicinal properties. This preparation is composed of natural cocaine alkaloids and therefore can be banned in some countries. During an anti-doping control in Peru, the urine of an athlete tested positive for benzoylecgonine, ecgonine methyl ester and cocaine (400 ng/mL, 180 ng/mL and 0.5 ng/mL, respectively). The athlete indicated that she had consumed a coca tea in the morning before the competition. As her lawyer contacted us to assess the scientific aspects of possible involvement of coca tea to explain the adverse analytical finding, a study was implemented with the same tea bags. Five volunteers from the laboratory consumed 250 mL of coca tea containing approximately 3.8 mg of cocaine. Urine (11 specimens for each subject) was collected over 3 days to follow the elimination of cocaine and metabolites (benzoylecgonine and ecgonine methyl ester). All samples were analyzed by UHPLC-MS/MS after alkaline extraction. Cocaine was identified for 20 hours, with concentrations ranging from 6 to 91 ng/mL. Benzoylecgonine and ecgonine methyl ester were identified for 70 hours and for 60 hours, respectively, with concentrations ranging from 6 to 3730 ng/mL and from 6 to 1738 ng/mL. The concentration profiles were identical for the five volunteers. This study supports the athlete's claims. In addition, the hair of the five subjects was collected a month later and all the hair tests were negative for cocaine using a limit of decision at 10 pg/mg. Although it is accepted that a 4 mg dose of cocaine has no significant pharmacological effect, the consummation of coca tea can lead to significant legal consequences since the measured urine concentrations sometimes cannot be considered incidental. Therefore, discrimination between coca tea consummation and recreational cocaine abuse relies primarily on hair analysis.
Collapse
Affiliation(s)
| | | | | | | | | | - Pascal Kintz
- Institut de Médecine Légale, Strasbourg, France.,X-Pertise Consulting, Mittelhausbergen, France
| |
Collapse
|
28
|
Thevis M, Kuuranne T, Geyer H. Annual banned-substance review: Analytical approaches in human sports drug testing 2019/2020. Drug Test Anal 2020; 13:8-35. [PMID: 33185038 DOI: 10.1002/dta.2969] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/08/2020] [Indexed: 12/18/2022]
Abstract
Analytical chemistry-based research in sports drug testing has been a dynamic endeavor for several decades, with technology-driven innovations continuously contributing to significant improvements in various regards including analytical sensitivity, comprehensiveness of target analytes, differentiation of natural/endogenous substances from structurally identical but synthetically derived compounds, assessment of alternative matrices for doping control purposes, and so forth. The resulting breadth of tools being investigated and developed by anti-doping researchers has allowed to substantially improve anti-doping programs and data interpretation in general. Additionally, these outcomes have been an extremely valuable pledge for routine doping controls during the unprecedented global health crisis that severely affected established sports drug testing strategies. In this edition of the annual banned-substance review, literature on recent developments in anti-doping published between October 2019 and September 2020 is summarized and discussed, particularly focusing on human doping controls and potential applications of new testing strategies to substances and methods of doping specified the World Anti-Doping Agency's 2020 Prohibited List.
Collapse
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
| |
Collapse
|
29
|
Kintz P, Ameline A, Raul JS. Human hair tests to document drug environmental contamination: Application in a family law case involving N,N-dimethyltryptamine. Drug Test Anal 2020; 13:447-450. [PMID: 33095975 DOI: 10.1002/dta.2948] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/13/2020] [Accepted: 10/13/2020] [Indexed: 02/06/2023]
Abstract
For 40 years, hair tests have been presented as the best approach to document long-term consumption of a drug. This unique property has found numerous applications in clinical, forensic, and occupational toxicology. However, since the beginning of its implementation in biology, external contamination, with an associated risk of false positive result, has been presented as the key in the final interpretation. Evidence of environmental contamination and subsequent health issues can be the task of any toxicologist. Because of recent progress of analytical equipment, it is now possible to quantify drugs in hair with high level of accuracy and specificity at the pg/mg range. Therefore, segmental hair tests can be used to document environmental contamination and are the objective of this publication. In a family law case, N,N-dimethyltryptamine (DMT), a powerful hallucinogen, has been found in the hair of the partner of a repetitive DMT smoker at 4 to 13 pg/mg in 6 × 1 cm segments, with a regular increase of concentrations from the proximal to the distal hair end. The low measured concentrations and the particular pattern of DMT distribution along the hair shaft seem to be typical of environmental contamination, the older hair (those of the distal part) being for a longer time in contact with the drug. Despite strong decontamination, drugs from the environment can remain bound to the hair matrix and therefore be able to be used to document environmental contamination.
Collapse
Affiliation(s)
- Pascal Kintz
- X-Pertise Consulting, Mittelhausbergen, France.,Institut de Medecine Légale, Université de Strasbourg, Strasbourg, France
| | - Alice Ameline
- Institut de Medecine Légale, Université de Strasbourg, Strasbourg, France
| | | |
Collapse
|
30
|
Kintz P. Contrôles anti-dopage : trop, pas assez, autrement ? TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2020. [PMCID: PMC7313516 DOI: 10.1016/j.toxac.2020.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Pascal Kintz
- X-Pertise consulting, 42, rue Principale, 67206 Mittelhausbergen, France
- Institut de médecine légale, 11, rue Humann, 67000 Strasbourg, France
- Correspondance.
| |
Collapse
|
31
|
Kintz P, Gheddar L, Ameline A, Raul J. Identification of S22 (ostarine) in human nails and hair using LC‐HRMS. Application to two authentic cases. Drug Test Anal 2020; 12:1508-1513. [DOI: 10.1002/dta.2902] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/13/2020] [Accepted: 07/13/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Pascal Kintz
- X‐Pertise Consulting 42 rue principale Mittelhausbergen F‐67206 France
- Institut de médecine légale 11 rue Humann Strasbourg F‐67000 France
| | - Laurie Gheddar
- Institut de médecine légale 11 rue Humann Strasbourg F‐67000 France
| | - Alice Ameline
- Institut de médecine légale 11 rue Humann Strasbourg F‐67000 France
| | | |
Collapse
|
32
|
Kintz P. Negative hair test result after long-term drug use. About a case involving morphine and literature review. Clin Chem Lab Med 2020; 59:267-273. [PMID: 32692696 DOI: 10.1515/cclm-2020-0950] [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: 06/19/2020] [Accepted: 07/10/2020] [Indexed: 01/03/2023]
Abstract
Although it has been accepted by most scientists that drugs circulating in blood are eligible to hair incorporation, this cannot be considered as a general statement. A 42-year old man was found dead in his swimming pool. He was living alone, and seen alive 2 days before by a neighbour. Femoral blood, cardiac blood and hair were collected during body examination. Free morphine was identified in femoral blood at 28 ng/mL, corresponding to his treatment for chronic pain (3 × 5 mg daily for 4 months). However, with a limit of quantitation (LOQ) at 10 pg/mg, segmental hair testing (3 × 1 cm) for morphine was negative. In this paper, the author has reviewed the different factors which can be responsible of this discrepancy. Several variables can influence the detection of a drug in hair and the author has listed reasons that can account for the absence of analytical response in hair after drug administration. The drug may not be incorporated in hair. That is the case for large bio-molecules, such as hormones, which cannot be transferred from the blood capillaries to growing cells of hair. Cosmetic treatments (perming, colouring, bleaching) or environmental aggressions (ultraviolet radiation, thermal application) will always reduce the concentrations. In this case, the lack of morphine detection was attributed to the effects of chlorinated water from the swimming pool. A negative hair result is also a result. However, this can be interpreted in three different ways: 1. the owner of the hair did not take or was not exposed to the specific drug, 2. the procedure is not sensitive enough to detect the drug, or 3. something happened after drug incorporation (cosmetic treatment, environmental influence).
Collapse
Affiliation(s)
- Pascal Kintz
- X-Pertise Consulting, 42 rue principale, 67206, Mittelhausbergen, France.,Institut de médecine légale, 11 rue Humann, 67000, Strasbourg, France
| |
Collapse
|
33
|
Kintz P, Ameline A, Gheddar L, Raul J. Testing for GW501516 (cardarine) in human hair using LC/MS–MS and confirmation by LC/HRMS. Drug Test Anal 2020; 12:980-986. [DOI: 10.1002/dta.2802] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Pascal Kintz
- X‐Pertise Consulting Mittelhausbergen France
- Institut de medecine légale Strasbourg France
| | | | | | | |
Collapse
|