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Rocca A, Martin L, Kuuranne T, Ericsson M, Marchand A, Leuenberger N. A fast screening method for the detection of CERA in dried blood spots. Drug Test Anal 2021; 14:820-825. [PMID: 34380180 PMCID: PMC9540874 DOI: 10.1002/dta.3142] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 08/02/2021] [Accepted: 08/02/2021] [Indexed: 11/30/2022]
Abstract
Continuous erythropoietin receptor activator (CERA) is a third‐generation erythropoiesis‐stimulating agent that was developed for the treatment of anemia. However, misuse of CERA for doping in endurance sports has been reported. Previous studies have shown blood as the matrix of choice for the detection of CERA, due to its high molecular weight. The use of dried blood spots (DBSs) for anti‐doping purposes constitutes a complementary approach to the standard urine and venous blood matrices and could facilitate sample collection and increase the number of blood samples available for analysis due to reduced costs of sample collection and transport. Here, we investigated whether CERA could be indirectly detected in extracts of single DBSs using an erythropoietin‐specific immunoassay that is capable of providing results within approximately 2 h. Reconstituted DBS samples were prepared from mixtures of red blood cell pellets and serum samples. The samples were collected in a previous clinical study in which six healthy volunteers were injected with a single, 200 μg dose of CERA. Using a commercially available ELISA kit, CERA was detected in the DBSs with a detection window of up to 20 days post‐injection. Furthermore, in order to demonstrate the fitness‐for‐purpose, three authentic doping control serum samples, which were identified as containing CERA, were analyzed by the presented methodological approach on DBS. The testing procedure described here could be used as a fast and cost‐effective method for the detection of CERA abuse in sport.
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Affiliation(s)
- Angela Rocca
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne & Geneva, Lausanne University Hospital & University of Lausanne, Switzerland
| | - Laurent Martin
- Analysis Department, Agence Française de Lutte contre le Dopage (AFLD), Châtenay-Malabry, France
| | - Tiia Kuuranne
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne & Geneva, Lausanne University Hospital & University of Lausanne, Switzerland
| | - Magnus Ericsson
- Analysis Department, Agence Française de Lutte contre le Dopage (AFLD), Châtenay-Malabry, France
| | - Alexandre Marchand
- Analysis Department, Agence Française de Lutte contre le Dopage (AFLD), Châtenay-Malabry, France
| | - Nicolas Leuenberger
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne & Geneva, Lausanne University Hospital & University of Lausanne, Switzerland
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2
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Reverter-Branchat G, Ventura R, Ezzel Din M, Mateus J, Pedro C, Segura J. Detection of erythropoiesis-stimulating agents in a single dried blood spot. Drug Test Anal 2018; 10:1496-1507. [DOI: 10.1002/dta.2418] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/18/2018] [Accepted: 05/28/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Gemma Reverter-Branchat
- Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program; IMIM - Hospital del Mar Medical Research Institute; Barcelona Spain
| | - Rosa Ventura
- Catalonian Antidoping Laboratory, Doping Control Research Group, Neurosciences Research Programme; IMIM - Hospital del Mar Medical Research Institute; Barcelona Spain
| | - Mohammed Ezzel Din
- Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program; IMIM - Hospital del Mar Medical Research Institute; Barcelona Spain
| | - Julián Mateus
- Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program; IMIM - Hospital del Mar Medical Research Institute; Barcelona Spain
| | - Carme Pedro
- Department of Hematology; Hospital del Mar-IMIM; Barcelona Spain
| | - Jordi Segura
- Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program; IMIM - Hospital del Mar Medical Research Institute; Barcelona Spain
- Catalonian Antidoping Laboratory, Doping Control Research Group, Neurosciences Research Programme; IMIM - Hospital del Mar Medical Research Institute; Barcelona Spain
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3
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Salamin O, Kuuranne T, Saugy M, Leuenberger N. Erythropoietin as a performance-enhancing drug: Its mechanistic basis, detection, and potential adverse effects. Mol Cell Endocrinol 2018; 464:75-87. [PMID: 28119134 DOI: 10.1016/j.mce.2017.01.033] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 01/20/2017] [Accepted: 01/20/2017] [Indexed: 02/01/2023]
Abstract
Erythropoietin (EPO) is the main hormone regulating red blood cell (RBC) production. The large-scale production of a recombinant human erythropoietin (rHuEPO) by biotechnological methods has made possible its widespread therapeutic use as well as its misuse in sports. Since the marketing of the first epoetin in 1989, the development has progressed to the third-generation analogs. However, the production of rHuEPO is costly, and the frequent administration of an injectable formula is not optimal for compliance of therapeutic patients. Hence, pharmaceutical industries are currently developing alternative approaches to stimulate erythropoiesis, which might offer new candidates for doping purposes. The hypoxia inducible factors (HIF) pathway is of particular interest. The introduction of new erythropoiesis-stimulating agents (ESAs) for clinical use requires subsequent development of anti-doping methods for detecting the abuse of these substances. The detection of ESAs is based on two different approaches, namely, the direct detection of exogenous substances and the indirect detection, for which the effects of the substances on specific biomarkers are monitored. Omics technologies, such as ironomics or transcriptomics, are useful for the development of new promising biomarkers for the detection of ESAs. Finally, the illicit use of ESAs associates with multiple health risks that can be irreversible, and an essential facet of anti-doping work is to educate athletes of these risks. The aim of this review is to provide an overview of the evolution of ESAs, the research and implementation of the available detection methods, and the side effects associated with the misuse of ESAs.
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Affiliation(s)
- Olivier Salamin
- Center for Research and Expertise in Anti-Doping Sciences - REDs, University of Lausanne, Switzerland
| | - Tiia Kuuranne
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland
| | - Martial Saugy
- Center for Research and Expertise in Anti-Doping Sciences - REDs, University of Lausanne, Switzerland
| | - Nicolas Leuenberger
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
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4
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Sgrò P, Sansone M, Sansone A, Romanelli F, Di Luigi L. Effects of erythropoietin abuse on exercise performance. PHYSICIAN SPORTSMED 2018; 46:105-115. [PMID: 29113535 DOI: 10.1080/00913847.2018.1402663] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The present review provides a comprehensive overview on the erythropoietic and non-erythropoietic effects of rHuEpo on human sport performance, paying attention to quantifying numerically how rHuEpo affects exercise performance and describing physiological changes regarding the most important exercise variables. Much attention has been paid to treatment schedules, in particular, to assess the effects of microdoses of rHuEpo and the prolonged effects on sport performance following withdrawal. Moreover, the review takes into account non-erythropoietic ergogenic effects of rHuEpo, including cognitive benefits of rHuEpo. A significant increase in both Vo2max and maximal cycling power was evidenced in studies taken into account for this review. rHuEpo, administered at clinical dosage, may have significant effects on haematological values, maximal and submaximal physiological variables, whereas few reports show positive effects on exercise perfomance. However, the influence of micro-dose rHuEpo on endurance performance in athletes is still unclear and further studies are warranted.
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Affiliation(s)
- Paolo Sgrò
- a Department of Movement, Human and Health Sciences, Unit of Endocrinology , Università degli Studi di Roma "Foro Italico" Piazza Lauro de Bosis , Rome , Italy
| | - Massimiliano Sansone
- b Department of Experimental Medicine , "Sapienza" Università di Roma , Rome , Italy
| | - Andrea Sansone
- b Department of Experimental Medicine , "Sapienza" Università di Roma , Rome , Italy
| | - Francesco Romanelli
- b Department of Experimental Medicine , "Sapienza" Università di Roma , Rome , Italy
| | - Luigi Di Luigi
- a Department of Movement, Human and Health Sciences, Unit of Endocrinology , Università degli Studi di Roma "Foro Italico" Piazza Lauro de Bosis , Rome , Italy
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Mobasheri A, Proudman CJ. Cobalt chloride doping in racehorses: Concerns over a potentially lethal practice. Vet J 2015; 205:335-8. [PMID: 26093914 DOI: 10.1016/j.tvjl.2015.04.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 04/01/2015] [Accepted: 04/02/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Ali Mobasheri
- King Abdulaziz University, Jeddah 21589, Saudi Arabia; School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Duke of Kent Building, Guildford, Surrey, GU2 7XH, UK.
| | - Christopher J Proudman
- School of Veterinary Medicine, Faculty of Health and Medical Sciences, University of Surrey, Duke of Kent Building, Guildford, Surrey, GU2 7XH, UK
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6
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Oliveira CDRD, Bairros AVD, Yonamine M. Blood doping: risks to athletes' health and strategies for detection. Subst Use Misuse 2014; 49:1168-81. [PMID: 24766400 DOI: 10.3109/10826084.2014.903754] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Blood doping has been defined as the misuse of substances or certain techniques to optimize oxygen delivery to muscles with the aim to increase performance in sports activities. It includes blood transfusion, administration of erythropoiesis-stimulating agents or blood substitutes, and gene manipulations. The main reasons for the widespread use of blood doping include: its availability for athletes (erythropoiesis-stimulating agents and blood transfusions), its efficiency in improving performance, and its difficult detection. This article reviews and discusses the blood doping substances and methods used for in sports, the adverse effects related to this practice, and current strategies for its detection.
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7
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Detection of EPO injections using a rapid lateral flow isoform test. Anal Bioanal Chem 2013; 405:9685-91. [DOI: 10.1007/s00216-013-6997-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 04/08/2013] [Accepted: 04/17/2013] [Indexed: 10/26/2022]
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8
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Detection of recombinant human EPO administered to horses using MAIIA lateral flow isoform test. Anal Bioanal Chem 2012; 403:1619-28. [DOI: 10.1007/s00216-012-5972-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2011] [Revised: 03/09/2012] [Accepted: 03/22/2012] [Indexed: 10/28/2022]
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Schumacher YO, Saugy M, Pottgiesser T, Robinson N. Detection of EPO doping and blood doping: the haematological module of the Athlete Biological Passport. Drug Test Anal 2012; 4:846-53. [PMID: 22374784 DOI: 10.1002/dta.406] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Revised: 11/03/2011] [Accepted: 11/21/2011] [Indexed: 11/07/2022]
Abstract
The increase of the body's capacity to transport oxygen is a prime target for doping athletes in all endurance sports. For this pupose, blood transfusions or erythropoiesis stimulating agents (ESA), such as erythropoietin, NESP, and CERA are used. As direct detection of such manipulations is difficult, biomarkers that are connected to the haematopoietic system (haemoglobin concentration, reticulocytes) are monitored over time (Athlete Biological Passport (ABP)) and analyzed using mathematical models to identify patterns suspicious of doping. With this information, athletes can either be sanctioned directly based on their profile or targeted with conventional doping tests. Key issues for the appropriate use of the ABP are correct targeting and use of all available information (e.g. whereabouts, cross sectional population data) in a forensic manner. Future developments of the passport include the correction of all concentration-based variables for shifts in plasma volume, which might considerably increase sensitivity. New passport markers from the genomic, proteomic, and metabolomic level might add further information, but need to be validated before integration into the passport procedure. A first assessment of blood data of federations that have implemented the passport show encouraging signs of a decreased blood-doping prevalence in their athletes, which adds scientific credibility to this innovative concept in the fight against ESA- and blood doping.
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Lönnberg M, Andrén M, Birgegård G, Drevin M, Garle M, Carlsson J. Rapid detection of erythropoiesis-stimulating agents in urine and serum. Anal Biochem 2012; 420:101-14. [DOI: 10.1016/j.ab.2011.09.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Revised: 08/24/2011] [Accepted: 09/17/2011] [Indexed: 11/27/2022]
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Okano M, Sato M, Kaneko E, Kageyama S. Doping control of biosimilar epoetin kappa and other recombinant erythropoietins after intravenous application. Drug Test Anal 2011; 3:798-805. [DOI: 10.1002/dta.369] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 09/09/2011] [Accepted: 09/10/2011] [Indexed: 11/09/2022]
Affiliation(s)
- Masato Okano
- Anti-Doping Laboratory; Mitsubishi Chemical Medience Corporation; Tokyo; Japan
| | - Mitsuhiko Sato
- Anti-Doping Laboratory; Mitsubishi Chemical Medience Corporation; Tokyo; Japan
| | - Emi Kaneko
- Anti-Doping Laboratory; Mitsubishi Chemical Medience Corporation; Tokyo; Japan
| | - Shinji Kageyama
- Anti-Doping Laboratory; Mitsubishi Chemical Medience Corporation; Tokyo; Japan
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12
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Annual banned-substance review: analytical approaches in human sports drug testing. Drug Test Anal 2010; 2:149-61. [DOI: 10.1002/dta.128] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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