Is anti-doping analysis so far from clinical, legal or forensic targets?: The added value of close relationships between related disciplines

Chronicle of an unintentional MDMA intoxication of a field hockey team to prevent its qualification for the Beijing 2008 Olympics: A case report

Current doping trends overshadow the traditional interpretation of using prohibited performance-enhancing drugs to improve training and/or sports results. Its definition has evolved due to several recent cases of unconventional manipulation in sports. In this article, we present a case study of an intentional intoxication against the Spanish National Field Hockey team that resulted in its ineligibility for the 2008 Summer Olympics. The events occurred during the pre-qualifying Olympic tournament held in Azerbaijan. The Spanish team won the final match of the tournament against the hosting team and gained qualification for the Olympic Games. One month later, the International Hockey Federation (IHF) reported that two players of the Spanish National Hockey Team had tested positive for MDMA and would subsequently disqualify the Spanish National team from the tournament. The Spanish Hockey Federation then started an appeal process to demonstrate (1) contamination through team's hotel air ventilation and (2) tampering of a urine sample. This process ended with the IHF's final ruling that overturned the sanctions imposed on the Spanish National Team. This manuscript not only outlines a deliberate case to exclude a team from the Olympic Games, but also a federation's difficult efforts to prove an intentional intoxication that resulted in adverse findings.

Comprehensive steroid profiling by liquid chromatography coupled to high resolution mass spectrometry

A steroidomics workflow has been developed in the objective of monitoring a wide range (n >150) of steroids in urine. The proposed workflow relies on the optimization of an adequate SPE extraction step followed by an UHPLC-HRMS/MS simultaneous analysis of both free and conjugated forms of C18, C19 and C21 steroid hormones. On the basis of 44 selected steroids, representative of main classes of steroids constituting the steroidome, the performances of the developed workflow were evaluated in terms of selectivity, repeatability (< 13%) and linearity (R2> 0.985 in the concentration range [0.01-10 ng/mL]). As metabolites identification and characterization constitute the bottleneck of such profiling approaches, a homemade database was created encompassing a large number of characterized free and conjugated steroids (n> 150) for putative steroid-like biomarkers identification purposes. The efficiency of the workflow in highlighting fine modifications within the urinary steroidome was assessed in the frame of an anabolic treatment involving an intra-muscular administration of boldenone undecylenate (2 mg/kg) to veals (n=6) and the investigation of potential steroid biomarkers. Besides monitoring known phase II metabolites of boldenone in the bovine specie, namely, boldenone glucuronide and sulfate, the applied strategy also permitted to observe, upon boldenone administration, a modified profile of epiboldenone glucuronide. Furthermore, 31 signals corresponding to non-identified steroid species could also be highlighted as impacted upon the exogenous steroid treatment. This study is the first to simultaneously investigate both free and conjugated C18, C19 and C21 steroid hormones in their native form using UHPLC-HRMS/MS and allowing their comprehensive profiling. This strategy was probed in-vivo.

Expanding analytical options in sports drug testing: Mass spectrometric detection of prohibited substances in exhaled breath

RATIONALE

Continuously refining and advancing the strategies and methods employed in sports drug testing is critical for efficient doping controls. Besides improving and expanding the spectrum of target analytes, alternative test matrices have warranted in-depth evaluation as they commonly allow for minimal-/non-invasive and non-intrusive sample collection. In this study, the potential of exhaled breath (EB) as doping control specimen was assessed.

METHODS

EB collection devices employing a non-woven electret-based air filter unit were used to generate test specimens, simulating a potential future application in doping controls. A multi-analyte sports drug testing approach configured for a subset of 12 model compounds that represent specific classes of substances prohibited in sports (anabolic agents, hormone and metabolic modulators, stimulants, and beta-blockers) was established using unispray liquid chromatography/tandem mass spectrometry (LC/MS/MS) and applied to spiked and elimination study EB samples. The test method was characterized concerning specificity, assay imprecision, and limits of detection.

RESULTS

The EB collection device allowed for retaining and extracting all selected model compounds from the EB aerosol. Following elution and concentration, LC/MS/MS analysis enabled detection limits between 5 and 100 pg/filter and imprecisions ranging from 3% to 20% for the 12 selected model compounds. By means of EB samples from patients and participants of administration studies, the elimination of relevant compounds and, thus, their traceability in EB for doping control purposes, was investigated. Besides stimulants such as methylhexaneamine and pseudoephedrine, also the anabolic-androgenic steroid dehydrochloromethyltestosterone, the metabolic modulator meldonium, and the beta-blocker bisoprolol was detected in exhaled breath.

CONCLUSIONS

The EB aerosol has provided a promising proof-of-concept suggesting the expansion of this testing strategy as a complement to currently utilized sports drug testing programs.

Surface plasmon resonance applications in clinical analysis

In the last 20 years, surface plasmon resonance (SPR) and its advancement with imaging (SPRi) emerged as a suitable and reliable platform in clinical analysis for label-free, sensitive, and real-time monitoring of biomolecular interactions. Thus, we report in this review the state of the art of clinical target detection with SPR-based biosensors in complex matrices (e.g., serum, saliva, blood, and urine) as well as in standard solution when innovative approaches or advanced instrumentations were employed for improved detection. The principles of SPR-based biosensors are summarized first, focusing on the physical properties of the transducer, on the assays design, on the immobilization chemistry, and on new trends for implementing system analytical performances (e.g., coupling with nanoparticles (NPs). Then we critically review the detection of analytes of interest in molecular diagnostics, such as hormones (relevant also for anti-doping control) and biomarkers of interest in inflammatory, cancer, and heart failure diseases. Antibody detection is reported in relation to immune disorder diagnostics. Subsequently, nucleic acid targets are considered for revealing genetic diseases (e.g., point mutation and single nucleotides polymorphism, SNPs) as well as new emerging clinical markers (microRNA) and for pathogen detection. Finally, examples of pathogen detection by immunosensing were also analyzed. A parallel comparison with the reference methods was duly made, indicating the progress brought about by SPR technologies in clinical routine analysis.

Anabolic agents: recent strategies for their detection and protection from inadvertent doping

According to the World Anti-Doping Agency (WADA) Prohibited List, anabolic agents consist of exogenous anabolic androgenic steroids (AAS), endogenous AAS and other anabolic agents such as clenbuterol and selective androgen receptor modulators (SARMs). Currently employed strategies for their improved detection include the prolongation of the detection windows for exogenous AAS, non-targeted and indirect analytical approaches for the detection of modified steroids (designer steroids), the athlete's biological passport and isotope ratio mass spectrometry for the detection of the misuse of endogenous AAS, as well as preventive doping research for the detection of SARMs. The recent use of these strategies led to 4-80-fold increases of adverse analytical findings for exogenous AAS, to the detection of the misuse of new designer steroids, to adverse analytical findings of different endogenous AAS and to the first adverse analytical findings of SARMs. The strategies of the antidoping research are not only focused on the development of methods to catch the cheating athlete but also to protect the clean athlete from inadvertent doping. Within the past few years several sources of inadvertent doping with anabolic agents have been identified. Among these are nutritional supplements adulterated with AAS, meat products contaminated with clenbuterol, mycotoxin (zearalenone) contamination leading to zeranol findings, and natural products containing endogenous AAS. The protection strategy consists of further investigations in case of reasonable suspicion of inadvertent doping, publication of the results, education of athletes and development of methods to differentiate between intentional and unintentional doping.

Potential and limitations of alternative specimens in doping control

Alternative specimens (e.g., hair and saliva) are well established in forensic toxicology and provide significant benefits as noninvasive, inexpensive alternatives to blood with access to improved long-term retrospection. Based on these experiences, the question of potential applications and limitations of alternative specimens in doping control arose. Compounds prohibited at all times (e.g., clenbuterol, β2 agonists, estrogen-receptor modulators) may be successfully tested and clearly interpreted in alternative specimens. In contrast, prohibition of certain compounds in sport are limited to time ranges (e.g., stimulants are only prohibited in-competition), dosages or administration routes (e.g., systemic uptake of glucocorticosteroids). This cannot be properly differentiated by semiquantitative tests (e.g., hair analyses), but may be distinguished in saliva. Similarly, proof of external administration of endogenous steroids (e.g., testosterone) only seems to be achievable by quantitative analysis of saliva. Moreover, the retrospective monitoring of the relevance of social drugs or upcoming (unapproved) substances represents promising applications of hair tests in doping control.