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Requena-Tutusaus L, Anselmo I, Alechaga É, Bergés R, Ventura R. Achieving routine application of dried blood spots for erythropoietin receptor agonist analysis in doping control: low-volume single-spot detection at minimum required performance level. Bioanalysis 2023; 15:1235-1246. [PMID: 37676639 DOI: 10.4155/bio-2023-0118] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023] Open
Abstract
Background: Erythropoietin receptor agonists (ERAs) are substances prohibited in sports and currently monitored in urine and blood. There is a great interest in new matrices like dried blood spots (DBSs). Method: A direct method for the detection of ERAs in DBSs using one single spot of 25 μl has been optimized and validated. Results: Limits of detection close or equal to those required by the World Anti-Doping Agency for serum/plasma samples were achieved, using a volume 20-times lower. All analytes were stable for at least 90 days at room temperature. Conclusion: Method performance was comparable to the requirements established for blood samples and, thus, monitoring of ERAs is reliable in DBSs in the context of doping control.
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Affiliation(s)
- Lídia Requena-Tutusaus
- Catalonian Antidoping Laboratory, Doping Control Research Group, Fundació IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Experimental & Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Indira Anselmo
- Catalonian Antidoping Laboratory, Doping Control Research Group, Fundació IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Élida Alechaga
- Catalonian Antidoping Laboratory, Doping Control Research Group, Fundació IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Experimental & Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Rosa Bergés
- Catalonian Antidoping Laboratory, Doping Control Research Group, Fundació IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Rosa Ventura
- Catalonian Antidoping Laboratory, Doping Control Research Group, Fundació IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
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Lee SY, Park JH, Yoon J, Lee JY. A Validation Study of a Deep Learning-Based Doping Drug Text Recognition System to Ensure Safe Drug Use among Athletes. Healthcare (Basel) 2023; 11:1769. [PMID: 37372885 DOI: 10.3390/healthcare11121769] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
This study aimed to develop an English version of a doping drug-recognition system using deep learning-based optical character recognition (OCR) technology. A database of 336 banned substances was built based on the World Anti-Doping Agency's International Standard Prohibited List and the Korean Pharmaceutical Information Center's Drug Substance Information. For accuracy and validity analysis, 886 drug substance images, including 152 images of prescriptions and drug substance labels collected using data augmentation, were used. The developed hybrid system, based on the Tesseract OCR model, can be accessed by both a smartphone and website. A total of 5379 words were extracted, and the system showed character recognition errors regarding 91 words, showing high accuracy (98.3%). The system correctly classified all 624 images for acceptable substances, 218 images for banned substances, and incorrectly recognized 44 of the banned substances as acceptable. The validity analysis showed a high level of accuracy (0.95), sensitivity (1.00), and specificity (0.93), suggesting system validity. The system has the potential of allowing athletes who lack knowledge about doping to quickly and accurately check whether they are taking banned substances. It may also serve as an efficient option to support the development of a fair and healthy sports culture.
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Affiliation(s)
- Sang-Yong Lee
- Center for Sports and Performance Analysis, Korea National Sport University, Seoul 05541, Republic of Korea
| | - Jae-Hyeon Park
- Center for Sports and Performance Analysis, Korea National Sport University, Seoul 05541, Republic of Korea
| | - Jiwun Yoon
- Center for Sports and Performance Analysis, Korea National Sport University, Seoul 05541, Republic of Korea
| | - Ji-Yong Lee
- Center for Sports and Performance Analysis, Korea National Sport University, Seoul 05541, Republic of Korea
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Martin L, Martin JA, Collot D, Hoang O, Audran M, Ericsson M, Marchand A. Improved detection methods significantly increase the detection window for EPO microdoses. Drug Test Anal 2020; 13:101-112. [PMID: 32737925 DOI: 10.1002/dta.2904] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 07/24/2020] [Accepted: 07/24/2020] [Indexed: 12/11/2022]
Abstract
To reproduce a potential doping scenario, a 2 week administration of recombinant erythropoietin (rEPO) microdoses alone or in combination with growth hormone (GH) microdoses (three times a week) was performed on healthy and athletic male subjects. The aim of this study was to evaluate the identification capability of rEPO in samples obtained during and post treatment. Detection was tested in urine and blood using the antidoping techniques for rEPO detection (iso-electric focusing (IEF)-, sodium-dodecyl-sulfate (SDS)-polyacrylamide gel electrophoresis (PAGE) and for some urine samples the sarcosyl (SAR)-PAGE method) with some improvements: for blood samples, instead of a simple concentration step, immuno-extraction of EPO was performed for all urines to limit protein contamination that can affect migration. In addition, elution buffer modifications also improved the quality of migration. The use of a recently validated biotinylated anti-EPO antibody simplified the protocols, allowing a single transfer step instead of a double-blot even by IEF with a lowered background. The criteria for suspicious blood and urine samples by IEF were also re-evaluated. While endogenous EPO was not decreased over the course of the study, EPO microdoses were detectable in blood and urine between 24 h and 72 h after an administration. Detection in urine in combination with SDS-PAGE was the most sensitive combination for prolonged detection (100% identification after 48 h, 91% after 72 h), slightly better than IEF. Urine samples also tested by SAR-PAGE indicated a similar sensitivity of detection to SDS-PAGE. GH co-administration had no impact on rEPO elimination/detection.
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Affiliation(s)
- Laurent Martin
- Analysis Department - Agence Française de Lutte contre le Dopage (AFLD), Châtenay-Malabry, France
| | - Jean-Antoine Martin
- Analysis Department - Agence Française de Lutte contre le Dopage (AFLD), Châtenay-Malabry, France
| | - David Collot
- Analysis Department - Agence Française de Lutte contre le Dopage (AFLD), Châtenay-Malabry, France
| | - Olivier Hoang
- Analysis Department - Agence Française de Lutte contre le Dopage (AFLD), Châtenay-Malabry, France
| | - Michel Audran
- Analysis Department - Agence Française de Lutte contre le Dopage (AFLD), Châtenay-Malabry, France
| | - 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
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Christensen B, Ludvigsen M, Nellemann B, Kopchick JJ, Honoré B, Jørgensen JOL. Serum proteomic changes after randomized prolonged erythropoietin treatment and/or endurance training: detection of novel biomarkers. PLoS One 2015; 10:e0117119. [PMID: 25679398 PMCID: PMC4332672 DOI: 10.1371/journal.pone.0117119] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2014] [Accepted: 12/12/2014] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Despite implementation of the biological passport to detect erythropoietin abuse, a need for additional biomarkers remains. We used a proteomic approach to identify novel serum biomarkers of prolonged erythropoiesis-stimulating agent (ESA) exposure (Darbepoietin-α) and/or aerobic training. TRIAL DESIGN Thirty-six healthy young males were randomly assigned to the following groups: Sedentary-placebo (n = 9), Sedentary-ESA (n = 9), Training-placebo (n = 10), or Training-ESA (n = 8). They were treated with placebo/Darbepoietin-α subcutaneously once/week for 10 weeks followed by a 3-week washout period. Training consisted of supervised biking 3/week for 13 weeks at the highest possible intensity. Serum was collected at baseline, week 3 (high dose Darbepoietin-α), week 10 (reduced dose Darbepoietin-α), and after a 3-week washout period. METHODS Serum proteins were separated according to charge and molecular mass (2D-gel electrophoresis). The identity of proteins from spots exhibiting altered intensity was determined by mass spectrometry. RESULTS Six protein spots changed in response to Darbepoietin-α treatment. Comparing all 4 experimental groups, two protein spots (serotransferrin and haptoglobin/haptoglobin related protein) showed a significant response to Darbepoietin-α treatment. The haptoglobin/haptoglobin related protein spot showed a significantly lower intensity in all subjects in the training-ESA group during the treatment period and increased during the washout period. CONCLUSION An isoform of haptoglobin/haptoglobin related protein could be a new anti-doping marker and merits further research. TRIAL REGISTRATION ClinicalTrials.gov NCT01320449.
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Affiliation(s)
- Britt Christensen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark; Medical Research Laboratories, Aarhus University, Aarhus, Denmark; Research Laboratory for Biochemical Pathology, Institute for Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Maja Ludvigsen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Birgitte Nellemann
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark; Medical Research Laboratories, Aarhus University, Aarhus, Denmark
| | - John J Kopchick
- Edison Biotechnology Institute Ohio University, Athens, Ohio, United States of America; Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Ohio University, Athens, Ohio, United States of America
| | - Bent Honoré
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Jens Otto L Jørgensen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
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Vogel M, Blobel M, Thomas A, Walpurgis K, Schänzer W, Reichel C, Thevis M. Isolation, Enrichment, and Analysis of Erythropoietins in Anti-Doping Analysis by Receptor-Coated Magnetic Beads and Liquid Chromatography–Mass Spectrometry. Anal Chem 2014; 86:12014-21. [DOI: 10.1021/ac5024765] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Matthias Vogel
- Center
for Preventive Doping Research/Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Mike Blobel
- Center
for Preventive Doping Research/Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Andreas Thomas
- Center
for Preventive Doping Research/Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Katja Walpurgis
- Center
for Preventive Doping Research/Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Wilhelm Schänzer
- Center
for Preventive Doping Research/Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Christian Reichel
- Doping
Control Laboratory, AIT Seibersdorf Laboratories, A-2444 Seibersdorf, Austria
| | - Mario Thevis
- Center
for Preventive Doping Research/Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
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From gene engineering to gene modulation and manipulation: can we prevent or detect gene doping in sports? Sports Med 2014; 43:965-77. [PMID: 23832852 DOI: 10.1007/s40279-013-0075-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
During the last 2 decades, progress in deciphering the human gene map as well as the discovery of specific defective genes encoding particular proteins in some serious human diseases have resulted in attempts to treat sick patients with gene therapy. There has been considerable focus on human recombinant proteins which were gene-engineered and produced in vitro (insulin, growth hormone, insulin-like growth factor-1, erythropoietin). Unfortunately, these substances and methods also became improper tools for unscrupulous athletes. Biomedical research has focused on the possible direct insertion of gene material into the body, in order to replace some defective genes in vivo and/or to promote long-lasting endogenous synthesis of deficient proteins. Theoretically, diabetes, anaemia, muscular dystrophies, immune deficiency, cardiovascular diseases and numerous other illnesses could benefit from such innovative biomedical research, though much work remains to be done. Considering recent findings linking specific genotypes and physical performance, it is tempting to submit the young athletic population to genetic screening or, alternatively, to artificial gene expression modulation. Much research is already being conducted in order to achieve a safe transfer of genetic material to humans. This is of critical importance since uncontrolled production of the specifically coded protein, with serious secondary adverse effects (polycythaemia, acute cardiovascular problems, cancer, etc.), could occur. Other unpredictable reactions (immunogenicity of vectors or DNA-vector complex, autoimmune anaemia, production of wild genetic material) also remain possible at the individual level. Some new substances (myostatin blockers or anti-myostatin antibodies), although not gene material, might represent a useful and well-tolerated treatment to prevent progression of muscular dystrophies. Similarly, other molecules, in the roles of gene or metabolic activators [5-aminoimidazole-4-carboxamide 1-β-D-ribofuranoside (AICAR), GW1516], might concomitantly improve endurance exercise capacity in ischaemic conditions but also in normal conditions. Undoubtedly, some athletes will attempt to take advantage of these new molecules to increase strength or endurance. Antidoping laboratories are improving detection methods. These are based both on direct identification of new substances or their metabolites and on indirect evaluation of changes in gene, protein or metabolite patterns (genomics, proteomics or metabolomics).
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Stanley SMR, Chua D. Improved Recovery of Erythropoietin and Darbepoetin from Equine Plasma by the Application of a Wheat Germ Agglutinin Mediated Pre-Extraction Prior to Immunoaffinity Chromatography. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/abb.2014.57077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Dehnes Y, Shalina A, Myrvold L. Detection of recombinant EPO in blood and urine samples with EPO WGA MAIIA, IEF and SAR-PAGE after microdose injections. Drug Test Anal 2013; 5:861-9. [DOI: 10.1002/dta.1579] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2013] [Revised: 10/02/2013] [Accepted: 10/02/2013] [Indexed: 11/06/2022]
Affiliation(s)
- Yvette Dehnes
- Norwegian Doping Control Laboratory; Oslo University Hospital; Trondheimsveien 235 0586 Oslo Norway
| | - Alexandra Shalina
- Norwegian Doping Control Laboratory; Oslo University Hospital; Trondheimsveien 235 0586 Oslo Norway
| | - Linda Myrvold
- Norwegian Doping Control Laboratory; Oslo University Hospital; Trondheimsveien 235 0586 Oslo Norway
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Okano M, Sato M, Kageyama S. Identification of the long-acting erythropoiesis-stimulating agent darbepoetin alfa in human urine by liquid chromatography–tandem mass spectrometry. Anal Bioanal Chem 2013; 406:1317-29. [DOI: 10.1007/s00216-013-6836-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 01/25/2013] [Accepted: 02/07/2013] [Indexed: 12/11/2022]
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Abuse of medicines for performance enhancement in sport: why is this a problem for the pharmaceutical industry? Bioanalysis 2012; 4:1681-90. [PMID: 22831483 DOI: 10.4155/bio.12.137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The misuse of medicines for performance enhancement in sport (doping) is not approved by regulatory agencies, and is illegal in many countries. In addition to the 'traditional' doping agents such as steroids, β-blockers and blood transfusions, the list of agents and techniques used in doping is increasing and now includes newer medicines such as erythropoiesis-stimulating agents and growth hormones. Innovative new medicines are of particular interest as would-be dopers may believe them to be undetectable by current methods. Close collaboration between the biopharmaceutical industry and anti-doping agencies such as the World Anti-Doping Agency is critical to a successful anti-doping strategy. Industry is ideally placed to identify the doping potential of new medicines at early stages and to support early development of detection assays. A strong, united front between the biopharmaceutical industry and anti-doping agencies is essential to counter the misuse of medicines for performance enhancement, as well as to promote fair play and clean sport.
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Abstract
AbstractHemoglobin mass is a key factor for maximal exercise capacity. Some athletes apply prohibited techniques and substances with intent to increase hemoglobin mass and physical performance, and this is often difficult to prove directly. Autologous red blood cell transfusion cannot be traced on reinfusion, and also recombinant erythropoietic proteins are detectable only within a certain timeframe. Novel erythropoietic substances, such as mimetics of erythropoietin (Epo) and activators of the Epo gene, may soon enter the sports scene. In addition, Epo gene transfer maneuvers are imaginable. Effective since December 2009, the World Anti-Doping Agency has therefore implemented “Athlete Biologic Passport Operating Guidelines,” which are based on the monitoring of several parameters for mature red blood cells and reticulocytes. Blood doping may be assumed, when these parameters change in a nonphysiologic way. Hematologists should be familiar with blood doping practices as they may play an important role in evaluating blood profiles of athletes with respect to manipulations, as contrasted with the established diagnosis of clinical disorders and genetic variations.
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Dehnes Y, Hemmersbach P. Effect of single doses of methoxypolyethylene glycol-epoetin beta (CERA, Mircera™) and epoetin delta (Dynepo™) on isoelectric erythropoietin profiles and haematological parameters. Drug Test Anal 2011; 3:291-9. [DOI: 10.1002/dta.270] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2010] [Revised: 01/06/2011] [Accepted: 01/06/2011] [Indexed: 11/11/2022]
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Applications and Biomonitoring Issues of Recombinant Erythropoietins for Doping Control. Ther Drug Monit 2011; 33:3-13. [DOI: 10.1097/ftd.0b013e31820032c4] [Citation(s) in RCA: 12] [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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Erythropoietin (EPO) immunoaffinity columns—A powerful tool for purifying EPO and its recombinant analogues. J Pharm Biomed Anal 2010; 53:1028-32. [DOI: 10.1016/j.jpba.2010.06.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Revised: 06/17/2010] [Accepted: 06/18/2010] [Indexed: 11/21/2022]
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Lamon S, Boccard J, Sottas PE, Glatz N, Wuerzner G, Robinson N, Saugy M. IEF pattern classification-derived criteria for the identification of epoetin-δ in urine. Electrophoresis 2010; 31:1918-24. [DOI: 10.1002/elps.200900645] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
Erythropoietin (EPO), a glycoprotein hormone, stimulates the growth of red blood cells and as a consequence it increases tissue oxygenation. This performance enhancing effect is responsible for the ban of erythropioetin in sports since 1990. Especially its recombinant synthesis led to the abuse of this hormone, predominatly in endurance sports. The analytical differentiation of endogenously produced erythropoietin from its recombinant counterpart by using isoelectric focusing and double blotting is a milestone in the detection of doping with recombinant erythropoietin. However, various analogous of the initial recombinant products, not always easily detectable by the standard IEF-method, necessitate the development of analytical alternatives for the detection of EPO doping. The following chapter summarizes its mode of action, the various forms of recombinant erythropoietin, the main analytical procedures and strategies for the detection of EPO doping as well as a typical case report.
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Affiliation(s)
- Christian Reichel
- Austrian Research Centers GmbH - ARC, Doping Control Laboratory, A-2444, Seibersdorf, Austria.
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A high-throughput test to detect C.E.R.A. doping in blood. J Pharm Biomed Anal 2009; 50:954-8. [DOI: 10.1016/j.jpba.2009.06.038] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2009] [Revised: 06/16/2009] [Accepted: 06/20/2009] [Indexed: 12/31/2022]
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Bowers LD. The analytical chemistry of drug monitoring in athletes. ANNUAL REVIEW OF ANALYTICAL CHEMISTRY (PALO ALTO, CALIF.) 2009; 2:485-507. [PMID: 20636072 DOI: 10.1146/annurev-anchem-060908-155159] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The detection and deterrence of the abuse of performance-enhancing drugs in sport are important to maintaining a level playing field among athletes and to decreasing the risk to athletes' health. The World Anti-Doping Program consists of six documents, three of which play a role in analytical development: The World Anti-Doping Code, The List of Prohibited Substances and Methods, and The International Standard for Laboratories. Among the classes of prohibited substances, three have given rise to the most recent analytical developments in the field: anabolic agents; peptide and protein hormones; and methods to increase oxygen delivery to the tissues, including recombinant erythropoietin. Methods for anabolic agents, including designer steroids, have been enhanced through the use of liquid chromatography/tandem mass spectrometry and gas chromatography/combustion/isotope-ratio mass spectrometry. Protein and peptide identification and quantification have benefited from advances in liquid chromatography/tandem mass spectrometry. Incorporation of techniques such as flow cytometry and isoelectric focusing have supported the detection of blood doping.
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Affiliation(s)
- Larry D Bowers
- United States Anti-Doping Agency, Colorado Springs, Colorado 80906, USA.
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20
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Erythropoiesis-stimulating agents and other methods to enhance oxygen transport. Br J Pharmacol 2008; 154:529-41. [PMID: 18362898 DOI: 10.1038/bjp.2008.89] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Oxygen is essential for life, and the body has developed an exquisite method to collect oxygen in the lungs and transport it to the tissues. Hb contained within red blood cells (RBCs), is the key oxygen-carrying component in blood, and levels of RBCs are tightly controlled according to demand for oxygen. The availability of oxygen plays a critical role in athletic performance, and agents that enhance oxygen delivery to tissues increase aerobic power. Early methods to increase oxygen delivery included training at altitude, and later, transfusion of packed RBCs. A breakthrough in understanding how RBC formation is controlled included the discovery of erythropoietin (Epo) and cloning of the EPO gene. Cloning of the EPO gene was followed by commercial development of recombinant human Epo (rHuEpo). Legitimate use of this and other agents that affect oxygen delivery is important in the treatment of anaemia (low Hb levels) in patients with chronic kidney disease or in cancer patients with chemotherapy-induced anaemia. However, competitive sports was affected by illicit use of rHuEpo to enhance performance. Testing methods for these agents resulted in a cat-and-mouse game, with testing labs attempting to detect the use of a drug or blood product to improve athletic performance (doping) and certain athletes developing methods to use the agents without being detected. This article examines the current methods to enhance aerobic performance and the methods to detect illicit use.
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21
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Abstract
Erythropoietin (Epo) is a glycoprotein hormone that promotes the production of red blood cells. Recombinant human Epo (rhEpo) is illicitly used to improve performance in endurance sports. Doping in sports is discouraged by the screening of athletes for rhEpo. Both direct tests (indicating the presence of exogeneous Epo isoforms) and indirect tests (indicating hematological changes induced by exogenous Epo administration) can be used for Epo detection. At present, the test adopted by the World Anti Doping Agency is based on a combination of isoelectric focusing and double immunoblotting, and distinguishes between endogenous and rhEpo. However, the adopted monoclonal anti-Epo antibodies are not monospecific. Therefore, the test can occasionally lead to the false-positive detection of rhEpo (epoetin-beta) in post-exercise, protein-rich urine, or in case of contamination of the sample with microorganisms. An improved preanalytical care may counteract a lot of these problems. Adaptation of the criteria may be helpful to further refine direct Epo testing. Indirect tests have the disadvantage that they require blood instead of urine samples, but they can be applied to detect a broader range of performance improving techniques which are illicitly used in sports.
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Affiliation(s)
- Joris R Delanghe
- Department of Clinical Chemistry, University Hospital, Ghent, Belgium.
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