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Hassanpour M, Salybekov AA. Whispers in the Blood: Leveraging MicroRNAs for Unveiling Autologous Blood Doping in Athletes. Int J Mol Sci 2023; 25:249. [PMID: 38203416 PMCID: PMC10779309 DOI: 10.3390/ijms25010249] [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: 10/31/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 01/12/2024] Open
Abstract
The prevalence of autologous blood transfusions (ABTs) presents a formidable challenge in maintaining fair competition in sports, as it significantly enhances hemoglobin mass and oxygen capacity. In recognizing ABT as a prohibited form of doping, the World Anti-Doping Agency (WADA) mandates stringent detection methodologies. While current methods effectively identify homologous erythrocyte transfusions, a critical gap persists in detecting autologous transfusions. The gold standard practice of longitudinally monitoring hematological markers exhibits promise but is encumbered by limitations. Despite its potential, instances of blood doping often go undetected due to the absence of definitive verification processes. Moreover, some cases remain unpenalized due to conservative athlete-sanctioning approaches. This gap underscores the imperative need for a more reliable and comprehensive detection method capable of unequivocally differentiating autologous transfusions, addressing the challenges faced in accurately identifying such prohibited practices. The development of an advanced detection methodology is crucial to uphold the integrity of anti-doping measures, effectively identifying and penalizing instances of autologous blood transfusion. This, in turn, safeguards the fairness and equality essential to competitive sports. Our review tackles this critical gap by harnessing the potential of microRNAs in ABT doping detection. We aim to summarize alterations in the total microRNA profiles of erythrocyte concentrates during storage and explore the viability of observing these changes post-transfusion. This innovative approach opens avenues for anti-doping technologies and commercialization, positioning it as a cornerstone in the ongoing fight against doping in sports and beyond. The significance of developing a robust detection method cannot be overstated, as it ensures the credibility of anti-doping efforts and promotes a level playing field for all athletes.
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2
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Buisson C, Brooker L, Goebel C, Morrow R, Chakrabarty R, Speers N, Molina A, Ericsson M, Collomp K. Summer Olympic sports and female athletes: comparison of anti-doping collections and prohibited substances detected in Australia and New Zealand vs. France. Front Sports Act Living 2023; 5:1213735. [PMID: 37745202 PMCID: PMC10515209 DOI: 10.3389/fspor.2023.1213735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/31/2023] [Indexed: 09/26/2023] Open
Abstract
Like any athlete, female athletes may be tempted to use prohibited substances during competition or training to enhance their performance. Anti-doping tests performed on female athletes in summer Olympic sports from two geographical areas: Australia/ New Zealand, and France were compared. First, the distribution of sample collections across different sports disciplines, as well as the distribution of substances was investigated. Then the distribution of collections and substances detected in the five sports categories (Strength/Speed, Endurance, Mixed, Motor Skills with High Energy Expenditure, and Motor Skills with Low Energy Expenditure) were studied with consideration of therapeutic use exemptions obtained by the athlete. Australia/New Zealand and France were similar in their overall number of anti-doping collections performed. Likewise, both regions had the same sports disciplines (athletics, aquatics, cycling) and sport categories (Mixed and Endurance) as having the highest number of sample collections. The Motor Skills with High Energy Expenditure, and Motor Skills with Low Energy Expenditure categories had the lowest number of sample collections. However, the number of substances detected was significantly different (p < 0.05) with a greater number of substances found in the French data. There were a few substances in common between the two geographical areas, namely prednisone/prednisolone, carboxy-THC, terbutaline, vilanterol and methylphenidate, but most were different. In-competition tests were the category where most of the AAFs were found.
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Affiliation(s)
- Corinne Buisson
- LADF, French Anti-Doping Laboratory, Université Paris-Saclay, Orsay, France
| | - Lance Brooker
- ASDTL, Australian Sports Drug Testing Laboratory, National Measurement Institute, Sydney, NSW, Australia
| | - Catrin Goebel
- ASDTL, Australian Sports Drug Testing Laboratory, National Measurement Institute, Sydney, NSW, Australia
| | - Ryan Morrow
- DFSNZ, Drug Free Sport New Zealand, Auckland, New Zealand
| | | | - Naomi Speers
- SIA, Sport Integrity Australia, Fyshwick, ACT, Australia
| | | | - Magnus Ericsson
- LADF, French Anti-Doping Laboratory, Université Paris-Saclay, Orsay, France
| | - Katia Collomp
- LADF, French Anti-Doping Laboratory, Université Paris-Saclay, Orsay, France
- CIAMS, Université D'Orléans, Orléans, France
- CIAMS, Université Paris-Saclay, Orsay, France
- SAPRéM, Université d'Orleans, Orléans, France
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3
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Bianchi VE, von Haehling S. The treatment of chronic anemia in heart failure: a global approach. Clin Res Cardiol 2023:10.1007/s00392-023-02275-4. [PMID: 37660308 DOI: 10.1007/s00392-023-02275-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 07/24/2023] [Indexed: 09/05/2023]
Abstract
Chronic anemia is an independent risk factor for mortality in patients with heart failure (HF). Restoring physiological hemoglobin (Hb) levels is essential to increase oxygen transport capacity to tissues and improve cell metabolism as well as physical and cardiac performance. Nutritional deficits and iron deficiency are the major causes of chronic anemia, but other etiologies include chronic kidney disease, inflammatory processes, and unexplained anemia. Hormonal therapy, including erythropoietin (EPO) and anabolic treatment in chronic anemia HF patients, may contribute to improving Hb levels and clinical outcomes. Although preliminary studies showed a beneficial effect of EPO therapy on cardiac efficiency and in HF, more recent studies have not confirmed this positive impact of EPO, alluding to its side effect profile. Physical exercise significantly increases Hb levels and the response of anemia to treatment. In malnourished patients and chronic inflammatory processes, low levels of anabolic hormones, such as testosterone and insulin-like growth factor-1, contribute to the development of chronic anemia. This paper aims to review the effect of nutrition, EPO, anabolic hormones, standard HF treatments, and exercise as regulatory mechanisms of chronic anemia and their cardiovascular consequences in patients with HF.
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Affiliation(s)
- Vittorio Emanuele Bianchi
- Department of Endocrinology and Metabolism, Clinical Center Stella Maris, Strada Rovereta, 42, 47891, Falciano, San Marino.
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site, Göttingen, Germany
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4
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García-Arnés JA, García-Casares N. Doping and sports endocrinology: growth hormone, IGF-1, insulin, and erythropoietin. Rev Clin Esp 2023; 223:181-187. [PMID: 36736729 DOI: 10.1016/j.rceng.2023.01.005] [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] [Indexed: 02/04/2023]
Abstract
Among the substances prohibited by the World Anti-Doping Agency, "peptide hormones, growth factors, related substances, and mimetics" are classified as prohibited both in- and out-of-competition in section S2. This work reviews growth hormone and its releasing peptides, insulin-like growth factor 1 as the main growth factor, insulin, and erythropoietin and other agents that affect erythropoiesis. This review analyzes the prevalence of use among professional athletes and gym clients, the forms of use, dosing, ergogenic effects and effects on physical performance, as well as side effects and anti-doping detection methods.
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Affiliation(s)
- J A García-Arnés
- Departamento de Farmacología, Facultad de Medicina, Universidad de Málaga, Málaga, Spain.
| | - N García-Casares
- Departamento de Medicina, Facultad de Medicina, Universidad de Málaga, Málaga, Spain; Centro de Investigaciones Médico-Sanitarias (CIMES), Universidad de Málaga, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
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5
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Tonino RPB, Zwaginga LM, Schipperus MR, Zwaginga JJ. Hemoglobin modulation affects physiology and patient reported outcomes in anemic and non-anemic subjects: An umbrella review. Front Physiol 2023; 14:1086839. [PMID: 36875043 PMCID: PMC9975154 DOI: 10.3389/fphys.2023.1086839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
Background: An abnormal hemoglobin concentration has a substantial effect on a person's quality of life and physiology. Lack of tools that effectively evaluate hemoglobin-related outcomes leads to uncertainty regarding optimal hemoglobin levels, transfusion thresholds and treatment targets. We therefore aim to summarize reviews that assess the effects of hemoglobin modulation on the human physiology at various baseline hemoglobin levels, and identify gaps in existing evidence. Methods: We conducted an umbrella review of systematic reviews. PubMed, MEDLINE (OVID), Embase, Web of Science, Cochrane Library and Emcare were searched from inception to the 15th of April 2022 for studies that reported on physiological and patient reported outcomes following a hemoglobin change. Results: Thirty-three reviews were included of which 7 were scored as of high quality and 24 of critically low quality using the AMSTAR-2 tool. The reported data generally show that an increase in hemoglobin leads to improvement of patient reported and physical outcomes in anaemic and non-anaemic subjects. At lower hemoglobin levels, the effect of a hemoglobin modulation on quality of life measures appears more pronounced. Conclusion: This overview has revealed many knowledge gaps due to a lack of high-quality evidence. For chronic kidney disease patients, a clinically relevant benefit of increasing the hemoglobin levels up until 12 g/dL was found. However, a personalized approach remains necessary due to the many patient-specific factors that affect outcomes. We strongly encourage future trials to incorporate physiological outcomes as objective parameters together with subjective, but still very important, patient reported outcome measures.
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Affiliation(s)
- R P B Tonino
- Research, TRIP, Leiden, Netherlands.,Hematology, Haga Teaching Hospital, The Hague, Netherlands.,Hematology, LUMC, Leiden, Netherlands
| | | | - M R Schipperus
- Research, TRIP, Leiden, Netherlands.,Hematology, Haga Teaching Hospital, The Hague, Netherlands.,Department of Clinical Affairs, Sanquin Bloodbank, Amsterdam, Netherlands
| | - J J Zwaginga
- Research, TRIP, Leiden, Netherlands.,Hematology, LUMC, Leiden, Netherlands
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6
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García-Arnés J, García-Casares N. Endocrinología del dopaje y los deportes: hormona de crecimiento, IGF-1, insulina y eritropoyetina. Rev Clin Esp 2023. [DOI: 10.1016/j.rce.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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7
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Arrebola-Moreno AL, Casuso RA, Bejder J, Bonne TC, Breenfeldt Andersen A, Aragón-Vela J, Nordsborg NB, Huertas JR. Does Hypoxia and Stress Erythropoiesis Compromise Cardiac Function in Healthy Adults? A Randomized Trial. SPORTS MEDICINE - OPEN 2022; 8:137. [PMID: 36334130 PMCID: PMC9637068 DOI: 10.1186/s40798-022-00531-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 10/20/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To investigate whether recombinant human erythropoietin (rHuEPO) injections during an altitude training camp impact heart function. METHODS Thirty (12 women) moderately trained subjects stayed at 2320 m altitude for 4 weeks while training. Subjects were randomized to placebo (isotonic saline) or rHuEPO (20 IU/kg body weight) i.v. injections. Transthoracic echocardiography imaging was acquired 3 days after arrival to altitude and prior to the first placebo or rHuEPO injection as well as one day after the last rHuEPO injection three weeks later. RESULTS rHuEPO did not alter cardiovascular morphology parameters, systolic or diastolic function. In the placebo group, altitude exposure improved left ventricle (LV) systolic function due to an increased twist angle but rHuEPO had no additional effects. Pulmonary arterial systolic pressure was unaffected in either group. Notably, rHuEPO hampered LV untwist rate without affecting LV early filling. CONCLUSION rHuEPO provided during mild altitude exposure does not cause any major effects on heart function. The observed alteration in LV untwist induced by rHuEPO is unlikely to have a meaningful clinical effect. Trial Registration Registered on www. CLINICALTRIALS gov (NCT04227665).
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Affiliation(s)
| | - Rafael A. Casuso
- grid.4489.10000000121678994Department of Physiology, Institute of Nutrition and Food Technology, University of Granada, Granada, Spain ,grid.449008.10000 0004 1795 4150Department of Health Sciences, Universidad Loyola Andalucía, Sevilla, Spain
| | - Jacob Bejder
- grid.5254.60000 0001 0674 042XDepartment of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Thomas Christian Bonne
- grid.5254.60000 0001 0674 042XDepartment of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Andreas Breenfeldt Andersen
- grid.5254.60000 0001 0674 042XDepartment of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Jerónimo Aragón-Vela
- grid.4489.10000000121678994Department of Physiology, Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - Nikolai B. Nordsborg
- grid.5254.60000 0001 0674 042XDepartment of Nutrition, Exercise and Sports (NEXS), University of Copenhagen, Copenhagen, Denmark
| | - Jesús R. Huertas
- grid.4489.10000000121678994Department of Physiology, Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
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8
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Gild ML, Stuart M, Clifton-Bligh RJ, Kinahan A, Handelsman DJ. Thyroid Hormone Abuse in Elite Sports: The Regulatory Challenge. J Clin Endocrinol Metab 2022; 107:e3562-e3573. [PMID: 35438767 PMCID: PMC9387720 DOI: 10.1210/clinem/dgac223] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Indexed: 11/19/2022]
Abstract
Abuse of androgens and erythropoietin has led to hormones being the most effective and frequent class of ergogenic substances prohibited in elite sports by the World Anti-Doping Agency (WADA). At present, thyroid hormone (TH) abuse is not prohibited, but its prevalence among elite athletes and nonprohibited status remains controversial. A corollary of prohibiting hormones for elite sports is that endocrinologists must be aware of a professional athlete's risk of disqualification for using prohibited hormones and/or to certify Therapeutic Use Exemptions, which allow individual athletes to use prohibited substances for valid medical indications. This narrative review considers the status of TH within the framework of the WADA Code criteria for prohibiting substances, which requires meeting 2 of 3 equally important criteria of potential performance enhancement, harmfulness to health, and violation of the spirit of sport. In considering the valid clinical uses of TH, the prevalence of TH use among young adults, the reason why some athletes seek to use TH, and the pathophysiology of sought-after and adverse effects of TH abuse, together with the challenges of detecting TH abuse, it can be concluded that, on the basis of present data, prohibition of TH in elite sport is neither justified nor feasible.
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Affiliation(s)
- Matti L Gild
- Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
- Department of Diabetes and Endocrinology, Royal North Shore Hospital, Sydney 2065, Australia
- Cancer Genetics, Kolling Institute of Medical Research, St Leonards 2065, Australia
| | - Mark Stuart
- Division of Medicine, Centre for Metabolism and Inflammation, University College London, WC1E 6BT, UK
- International Testing Agency Lausanne, Lausanne 1007, Switzerland
| | - Roderick J Clifton-Bligh
- Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia
- Department of Diabetes and Endocrinology, Royal North Shore Hospital, Sydney 2065, Australia
- Cancer Genetics, Kolling Institute of Medical Research, St Leonards 2065, Australia
| | | | - David J Handelsman
- Correspondence: Professor David Handelsman, ANZAC Research Institute, Department of Andrology, Concord Hospital, Sydney, New South Wales, Australia.
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9
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Bækken LV, Holden G, Gjelstad A, Lauritzen F. Ten years of collecting hematological athlete biological passport samples—perspectives from a National Anti-doping Organization. Front Sports Act Living 2022; 4:954479. [PMID: 35928963 PMCID: PMC9343672 DOI: 10.3389/fspor.2022.954479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 06/27/2022] [Indexed: 11/26/2022] Open
Abstract
The hematological module of the Athlete Biological Passport (ABP) aims to reveal blood doping indirectly by looking at selected biomarkers of doping over time. For Anti-Doping Organizations (ADOs), the ABP is a vital tool in the fight against doping in sports through improved target testing and analysis, investigations, deterrence, and as indirect evidence for use of prohibited methods or substances. The physiological characteristics of sport disciplines is an important risk factor in the overall risk assessment and when implementing the hematological module. Sharing of experiences with implementing the hematological ABP between ADOs is key to further strengthen and extend its use. In this study, we present 10 years of experience with the hematological ABP program from the perspectives of a National ADO with special attention to sport disciplines' physiological characteristics as a potential risk factor for blood doping. Not surprisingly, most samples were collected in sport disciplines where the aerobic capacity is vital for performance. The study highlights strengths in Anti-Doping Norway's testing program but also areas that could be improved. For example, it was shown that samples were collected both in and out of season in a subset of the data material that included three popular sports in Norway (Cross-Country Skiing, Nordic Combined, and Biathlon), however, from the total data material it was clear that athletes were more likely to be tested out of competition and on certain days of the week and times of the day. The use of doping control officers with a flexible time schedule and testing outside an athlete's 60 min time-slot could help with a more even distribution during the week and day, and thus reduce the predictability of testing. In addition to promoting a discussion on testing strategies, the study can be used as a starting point for other ADOs on how to examine their own testing program.
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Affiliation(s)
- Lasse V. Bækken
- Nordic Athlete Passport Management Unit, Norwegian Doping Control Laboratory, Department of Pharmacology, Oslo University Hospital, Oslo, Norway
- *Correspondence: Lasse V. Bækken
| | - Geir Holden
- Department of Testing, Investigations and Legal, Anti-doping Norway, Oslo, Norway
| | - Astrid Gjelstad
- Science and Medicine, Anti-doping Norway, Oslo, Norway
- Section of Pharmaceutical Chemistry, Department of Pharmacy, University of Oslo, Oslo, Norway
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10
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Collomp K, Ericsson M, Bernier N, Buisson C. Prevalence of Prohibited Substance Use and Methods by Female Athletes: Evidence of Gender-Related Differences. Front Sports Act Living 2022; 4:839976. [PMID: 35685685 PMCID: PMC9172204 DOI: 10.3389/fspor.2022.839976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/04/2022] [Indexed: 02/05/2023] Open
Abstract
To achieve optimal sports performances, women and men may show specific doping practices because of the physiological and psychological gender differences, but there are few data on this topic. Here, we report the apparent use of prohibited substances and methods by female athletes based on analyses of the doping tests collected by the French Anti-Doping Agency from 2013 to 2019. We compared the frequency of use and the ergogenic and side effects to those of their male counterparts. The results revealed lower use of prohibited substances in female vs. male athletes, with significantly fewer anabolic agents, hormone and metabolic modulators, and cannabinoids. Gender specificity in utilization of substance classes was also shown. Relatively lower use of hormone modulators and cannabinoids and higher use of beta-2 agonists, diuretics and glucocorticoids were found in the woman cohort compared with men cohort, combined with the different choice of substances, possibly because of the altered ergogenic and/or side effects. However, no impact due to gender regarding the sports disciplines was observed, with both women and men showing similar use of anabolic agents, mainly in the anaerobic sports, and EPO and corticoids, mainly in endurance or mixed sports. Further studies are needed to put these French data into a global perspective, comparing uses across countries and exploring possible new developments in the fight against doping in women.
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Affiliation(s)
- Katia Collomp
- CIAMS, Université d'Orléans, Pôle STAPS, Orléans, France
- CIAMS, Université Paris-Saclay, Faculté des Sciences du Sport, Orsay, France
- Laboratoire AntiDopage Français, LADF, Université Paris-Saclay, Chatenay-Malabry, France
- *Correspondence: Katia Collomp
| | - Magnus Ericsson
- Laboratoire AntiDopage Français, LADF, Université Paris-Saclay, Chatenay-Malabry, France
| | - Nathan Bernier
- CIAMS, Université d'Orléans, Pôle STAPS, Orléans, France
- CIAMS, Université Paris-Saclay, Faculté des Sciences du Sport, Orsay, France
| | - Corinne Buisson
- Laboratoire AntiDopage Français, LADF, Université Paris-Saclay, Chatenay-Malabry, France
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11
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Haider T, Diaz V, Albert J, Alvarez-Sanchez M, Thiersch M, Maggiorini M, Hilty MP, Spengler CM, Gassmann M. A Single 60.000 IU Dose of Erythropoietin Does Not Improve Short-Term Aerobic Exercise Performance in Healthy Subjects: A Randomized, Double-Blind, Placebo-Controlled Crossover Trial. Front Physiol 2020; 11:537389. [PMID: 33117187 PMCID: PMC7550763 DOI: 10.3389/fphys.2020.537389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 08/26/2020] [Indexed: 01/13/2023] Open
Abstract
Erythropoietin (EPO) boosts exercise performance through increase in oxygen transport capacity following regular administration of EPO but preclinical study results suggest that single high dose of EPO also may improve exercise capacity. Twenty-nine healthy subjects (14 males/15 females; age: 25 ± 3 years) were included in a randomized, double-blind, placebo-controlled crossover study to assess peak work load and cardiopulmonary variables during submaximal and maximal cycling tests following a single dose of 60.000 IU of recombinant erythropoietin (EPO) or placebo (PLA). Submaximal exercise at 40%/60% of peak work load revealed no main effect of EPO on oxygen uptake (27.9 ± 8.7 ml min–1⋅kg–1/ 37.1 ± 13.2 ml min–1⋅kg–1) versus PLA (25.2 ± 3.7 ml min–1⋅kg–1/ 33.1 ± 5.3 ml min–1⋅kg–1) condition (p = 0.447/p = 0.756). During maximal exercise peak work load (PLA: 3.5 ± 0.6 W⋅kg–1 vs. EPO: 3.5 ± 0.6 W kg–1, p = 0.892) and peak oxygen uptake (PLA: 45.1 ± 10.4 ml⋅min–1 kg–1 vs. EPO: 46.1 ± 14.2 ml⋅min–1 kg–1, p = 0.344) reached comparable values in the two treatment conditions. Other cardiopulmonary variables (ventilation, cardiac output, heart rate) also reached similar levels in the two treatment conditions. An interaction effect was found between treatment condition and sex resulting in higher peak oxygen consumption (p = 0.048) and ventilation (p = 0.044) in EPO-treated males. In conclusion, in a carefully conducted study using placebo-controlled design the present data failed to support the hypothesis that a single high dose of EPO has a measurable impact on work capacity in healthy subjects.
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Affiliation(s)
- Thomas Haider
- Institute for Veterinary Physiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.,Zurich Center for Integrative Human Physiology (ZIHP), Zurich, Switzerland.,Department of Cardiology, University Hospital Zürich, Zurich, Switzerland
| | - Victor Diaz
- Institute for Veterinary Physiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Jamie Albert
- Institute of Human Movement Science and Sport, ETH Zürich, Zurich, Switzerland
| | - Maria Alvarez-Sanchez
- Institute for Veterinary Physiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Markus Thiersch
- Institute for Veterinary Physiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Marco Maggiorini
- Institute of Intensive Care Medicine, University Hospital of Zürich, Zurich, Switzerland
| | - Matthias P Hilty
- Institute of Intensive Care Medicine, University Hospital of Zürich, Zurich, Switzerland
| | - Christina M Spengler
- Zurich Center for Integrative Human Physiology (ZIHP), Zurich, Switzerland.,Institute of Human Movement Science and Sport, ETH Zürich, Zurich, Switzerland
| | - Max Gassmann
- Institute for Veterinary Physiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.,Zurich Center for Integrative Human Physiology (ZIHP), Zurich, Switzerland
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12
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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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Trinh KV, Diep D, Chen KJQ, Huang L, Gulenko O. Effect of erythropoietin on athletic performance: a systematic review and meta-analysis. BMJ Open Sport Exerc Med 2020; 6:e000716. [PMID: 32411382 PMCID: PMC7213874 DOI: 10.1136/bmjsem-2019-000716] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2020] [Indexed: 12/15/2022] Open
Abstract
Introduction Athletes have attempted to glean the ergogenic benefits of recombinant human erythropoietin (rHuEPO) since it became available in the 1980s. However, there is limited consensus in the literature regarding its true performance-enhancing effects. In fact, some studies suggest there is no conclusive evidence; therefore, it is necessary to evaluate and quantify the strength of the evidence. Objective To determine the effects of erythropoietin on enhancing athletic performance. Design At least two independent reviewers conducted citation identification through abstract and full-text screening, and study selection, and extracted raw data on demographics, descriptions of interventions and all outcomes to predesigned abstraction forms. Outcomes were stratified by treatment periods and dosages. Study quality was assessed using the Cochrane Risk of Bias Tool and Cochrane Grading of Recommendations Assessment Development and Education (GRADE) scale. Where appropriate, quantitative analysis was performed. Data sources EMBASE, MEDLINE and SPORTDiscus were searched from their inception to January 2020. Eligibility criteria Trials that examined any enhancement in sport in healthy participants aged 18-65 using rHuEPO compared with placebo were included. Results Overall, there is low-to-moderate quality evidence suggesting rHuEPO may be more beneficial than placebo in enhancing haematological parameters, pulmonary measures, maximal power output and time to exhaustion independent of dosage. However, these improvements are almost exclusively seen during maximal exercise intensities, which may be less relevant to athletic competition conditions. Conclusion Due to heterogeneity among trials, more high-quality randomised controlled trials with larger sample sizes in conditions that mirror actual competition are needed to further elucidate these effects.
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Affiliation(s)
- Kien Vinh Trinh
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Dion Diep
- MD Program, University of Toronto, Toronto, Ontario, Canada
| | | | - Le Huang
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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14
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Gewehr MCF, Silverio R, Rosa-Neto JC, Lira FS, Reckziegel P, Ferro ES. Peptides from Natural or Rationally Designed Sources Can Be Used in Overweight, Obesity, and Type 2 Diabetes Therapies. Molecules 2020; 25:E1093. [PMID: 32121443 PMCID: PMC7179135 DOI: 10.3390/molecules25051093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/20/2020] [Accepted: 02/25/2020] [Indexed: 12/18/2022] Open
Abstract
Overweight and obesity are among the most prominent health problems in the modern world, mostly because they are either associated with or increase the risk of other diseases such as type 2 diabetes, hypertension, and/or cancer. Most professional organizations define overweight and obesity according to individual body-mass index (BMI, weight in kilograms divided by height squared in meters). Overweight is defined as individuals with BMI from 25 to 29, and obesity as individuals with BMI ≥30. Obesity is the result of genetic, behavioral, environmental, physiological, social, and cultural factors that result in energy imbalance and promote excessive fat deposition. Despite all the knowledge concerning the pathophysiology of obesity, which is considered a disease, none of the existing treatments alone or in combination can normalize blood glucose concentration and prevent debilitating complications from obesity. This review discusses some new perspectives for overweight and obesity treatments, including the use of the new orally active cannabinoid peptide Pep19, the advantage of which is the absence of undesired central nervous system effects usually experienced with other cannabinoids.
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Affiliation(s)
- Mayara C. F. Gewehr
- Department of Pharmacology, Biomedical Sciences Institute, University of São Paulo (USP), São Paulo 05508-000, Brazil;
| | - Renata Silverio
- Department of Pharmacology, Center of Biological Sciences, Federal University of Santa Catarina (UFSC), Florianópolis 88040-900, Brazil;
| | - José Cesar Rosa-Neto
- Department of Cell and Developmental Biology, Biomedical Sciences Institute, University of São Paulo (USP), São Paulo 05508-000, Brazil;
| | - Fabio S. Lira
- Department of Physical Education, São Paulo State University (UNESP), Presidente Prudente 19060-900, Brazil;
| | - Patrícia Reckziegel
- Department of Pharmacology, National Institute of Pharmacology and Molecular Biology (INFAR), Federal University of São Paulo (UNIFESP), São Paulo 05508-000, Brazil;
| | - Emer S. Ferro
- Department of Pharmacology, Biomedical Sciences Institute, University of São Paulo (USP), São Paulo 05508-000, Brazil;
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15
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Atkinson TS, Kahn MJ. Blood doping: Then and now. A narrative review of the history, science and efficacy of blood doping in elite sport. Blood Rev 2020; 39:100632. [DOI: 10.1016/j.blre.2019.100632] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 09/16/2019] [Accepted: 09/18/2019] [Indexed: 12/20/2022]
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16
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Marchand A, Martin J, Collot D, Hoang O, Roulland I, Semence F, Sottas P, Audran M, Varlet‐Marie E. Combined administration of microdoses of growth hormone and erythropoietin: Effects on performance and evaluation of GH detection capability using anti‐doping methods. Drug Test Anal 2019; 11:1698-1713. [DOI: 10.1002/dta.2674] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/01/2019] [Accepted: 07/04/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Alexandre Marchand
- Analyses Department ‐ Agence Française de Lutte contre le Dopage (AFLD) Châtenay‐Malabry France
| | - Jean‐Antoine Martin
- Analyses Department ‐ Agence Française de Lutte contre le Dopage (AFLD) Châtenay‐Malabry France
| | - David Collot
- Analyses Department ‐ Agence Française de Lutte contre le Dopage (AFLD) Châtenay‐Malabry France
| | - Olivier Hoang
- Analyses Department ‐ Agence Française de Lutte contre le Dopage (AFLD) Châtenay‐Malabry France
| | - Ingrid Roulland
- Analyses Department ‐ Agence Française de Lutte contre le Dopage (AFLD) Châtenay‐Malabry France
| | - Florian Semence
- Analyses Department ‐ Agence Française de Lutte contre le Dopage (AFLD) Châtenay‐Malabry France
| | | | - Michel Audran
- Analyses Department ‐ Agence Française de Lutte contre le Dopage (AFLD) Châtenay‐Malabry France
- Laboratoire de Biophysique et Bio‐Analyses, Institut des BiomoléculesMax Mousseron (IBMM), UMR 5247,CNRS‐ENSCM‐Université Montpellier France
| | - Emmanuelle Varlet‐Marie
- Laboratoire de Biophysique et Bio‐Analyses, Institut des BiomoléculesMax Mousseron (IBMM), UMR 5247,CNRS‐ENSCM‐Université Montpellier France
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17
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Thevis M, Kuuranne T, Geyer H. Annual banned-substance review: Analytical approaches in human sports drug testing. Drug Test Anal 2019; 11:8-26. [DOI: 10.1002/dta.2549] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 11/18/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Mario Thevis
- Center for Preventive Doping Research - Institute of Biochemistry; German Sport University Cologne; Cologne Germany
- European Monitoring Center for Emerging Doping Agents; Cologne Germany
| | - Tiia Kuuranne
- Swiss Laboratory for Doping Analyses; University Center of Legal Medicine, Genève and Lausanne, Centre Hospitalier Universitaire Vaudois and University of Lausanne; Epalinges Switzerland
| | - Hans Geyer
- Center for Preventive Doping Research - Institute of Biochemistry; German Sport University Cologne; Cologne Germany
- European Monitoring Center for Emerging Doping Agents; Cologne Germany
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18
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Yap KN, Dick MF, Guglielmo CG, Williams TD. Effects of experimental manipulation of hematocrit on avian flight performance in high- and low-altitude conditions. ACTA ACUST UNITED AC 2018; 221:jeb.191056. [PMID: 30266786 DOI: 10.1242/jeb.191056] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 09/21/2018] [Indexed: 12/13/2022]
Abstract
Despite widely held assumptions that hematocrit (Hct) is a key determinant of aerobic capacity and exercise performance, this relationship has not often been tested rigorously in birds and results to date are mixed. Migration in birds involves high-intensity exercise for long durations at various altitudes. Therefore, it provides a good model system to examine the effect of Hct on flight performance and physiological responses of exercise at high altitude. We treated yellow-rumped warblers (Setophaga coronata) with avian erythropoietin (EPO) and anti-EPO to experimentally manipulate Hct and assessed flight performance at low and high altitudes using a hypobaric wind tunnel. We showed that anti-EPO-treated birds had lower Hct than vehicle- and EPO--treated birds post-treatment. Anti-EPO-treated birds also had marginally lower exercise performance at low altitude, committing a higher number of strikes (mistakes) in the first 30 min of flight. However, anti-EPO-treated birds performed significantly better at high altitude, attaining a higher altitude in a ramped altitude challenge to 3000 m equivalent altitude, and with a longer duration of flight at high altitude. Birds exercising at high altitude showed decreased Hct, increased glucose mobilization and decreased antioxidant capacity, regardless of treatment. In summary, we provide experimental evidence that the relationship between Hct and exercise performance is dependent on altitude. Future studies should investigate whether free-living birds adaptively modulate their Hct, potentially through a combination of erythropoiesis and plasma volume regulation (i.e. hemodilution), based on the altitude they fly at during migratory flight.
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Affiliation(s)
- Kang Nian Yap
- Department of Biological Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Morag F Dick
- Department of Biology, Advanced Facility for Avian Research, University of Western Ontario, 1393 Western Road, London, ON, N6G 1G9, Canada
| | - Christopher G Guglielmo
- Department of Biology, Advanced Facility for Avian Research, University of Western Ontario, 1393 Western Road, London, ON, N6G 1G9, Canada
| | - Tony D Williams
- Department of Biological Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
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Lauretta R, Sansone M, Sansone A, Romanelli F, Appetecchia M. Gender in Endocrine Diseases: Role of Sex Gonadal Hormones. Int J Endocrinol 2018; 2018:4847376. [PMID: 30420884 PMCID: PMC6215564 DOI: 10.1155/2018/4847376] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 09/08/2018] [Accepted: 10/03/2018] [Indexed: 12/15/2022] Open
Abstract
Gender- and sex- related differences represent a new frontier towards patient-tailored medicine, taking into account that theoretically every medical specialty can be influenced by both of them. Sex hormones define the differences between males and females, and the different endocrine environment promoted by estrogens, progesterone, testosterone, and their precursors might influence both human physiology and pathophysiology. With the term Gender we refer, instead, to behaviors, roles, expectations, and activities carried out by the individual in society. In other words, "gender" refers to a sociocultural sphere of the individual, whereas "sex" only defines the biological sex. In the last decade, increasing attention has been paid to understand the influence that gender can have on both the human physiology and pathogenesis of diseases. Even the clinical response to therapy may be influenced by sex hormones and gender, but further research is needed to investigate and clarify how they can affect the human pathophysiology. The path to a tailored medicine in which every patient is able to receive early diagnosis, risk assessments, and optimal treatments cannot exclude the importance of gender. In this review, we have focused our attention on the involvement of sex hormones and gender on different endocrine diseases.
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Affiliation(s)
- R. Lauretta
- IRCCS Regina Elena National Cancer Institute, Endocrinology Unit, Rome, Italy
| | - M. Sansone
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza Università di Roma, Rome, Italy
| | - A. Sansone
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza Università di Roma, Rome, Italy
| | - F. Romanelli
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza Università di Roma, Rome, Italy
| | - M. Appetecchia
- IRCCS Regina Elena National Cancer Institute, Endocrinology Unit, Rome, Italy
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