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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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Filippa MG, Tektonidou MG, Mantzou A, Kaltsas GA, Chrousos GP, Sfikakis PP, Yavropoulou MP. Adrenocortical dysfunction in rheumatoid arthritis: Α narrative review and future directions. Eur J Clin Invest 2022; 52:e13635. [PMID: 34097322 DOI: 10.1111/eci.13635] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/01/2021] [Accepted: 06/03/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Iatrogenic adrenal insufficiency (AI) secondary to long-term treatment with exogenous glucocorticoids (GC) is common in patients with systematic rheumatic diseases, including rheumatoid arthritis (RA). Moreover, a proportion of these patients is always in need of even small doses of glucocorticoids to maintain clinical remission, despite concomitant treatment with conventional and biologic disease-modifying drugs. METHODS We conducted a literature review up to December 2020 on (a) the incidence of AI in both long-term GC-treated and GC-treatment naïve RA patients; (b) the potential effects of increased levels of circulating proinflammatory cytokines, as well as of chronic stress, in adrenocortical function in RA; (c) the circadian cortisol rhythm in RA; and (d) established and evolving methods of assessment of adrenocortical function. RESULTS Up to 48% of RA patients develop glucocorticoid-induced AI; however, predictors are not established, while adrenocortical dysfunction may also occur in GC-treatment naïve RA patients. Experimental and clinical data have suggested that inadequate production of endogenous cortisol relative to enhanced clinical needs associated with the systemic inflammatory response, coined as the 'disproportion principle', may operate in RA. Although the underlying mechanisms are unknown, both proinflammatory cytokines and chronic stress may contribute the most in the adrenals hyporesponsiveness and the target tissue glucocorticoid resistance that have been described, but not systematically studied. A precise longitudinal assessment of endogenous cortisol production may be needed for optimal RA management. CONCLUSION Apart from iatrogenic AI, an intrinsically compromised adrenal reserve in RA may have a pathogenetic role and interfere with effective management, thus deserving further research.
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Affiliation(s)
- Maria G Filippa
- 1st Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria G Tektonidou
- 1st Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Aimilia Mantzou
- University Research Institute of Maternal and Child Health and Precision Medicine and UNESCO Chair on Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Gregory A Kaltsas
- 1st Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George P Chrousos
- University Research Institute of Maternal and Child Health and Precision Medicine and UNESCO Chair on Adolescent Health Care, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Petros P Sfikakis
- 1st Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria P Yavropoulou
- 1st Department of Propaedeutic and Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Collomp K, Amiot V, Robin B, Ericsson M, Buisson C. Impact of short-term hydrocortisone intake on pituitary and adrenal function in healthy young male subjects. Endocrine 2020; 70:164-169. [PMID: 32785897 DOI: 10.1007/s12020-020-02450-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/30/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study was to evaluate the impact of short-term therapeutic hydrocortisone intake on pituitary and adrenal function in healthy young male subjects. METHODS Ten physically active men received 50 mg/per day of hydrocortisone at 8:00 a.m. for 5 days. Cortisol, DHEA, and ACTH concentrations in plasma, and cortisol and DHEA concentrations in saliva were determined the week before, just before (8:00 a.m.) and 2 h after (10:00 a.m.) drug ingestion on days 1, 3, and 5 of treatment and day 1 post treatment. RESULTS Hydrocortisone intake induced a significant increase in both plasma cortisol (×3) and saliva cortisol (×10) concentrations 2 h after administration. Plasma and saliva DHEA concentrations were significantly decreased, as were plasma ACTH concentrations, 2 h after administration, with an increase in the cortisol/DHEA and cortisol/ACTH ratios. However, no change in cortisol, DHEA, ACTH, cortisol/DHEA, or cortisol/ACTH was observed 24 h after the last intake during treatment or post treatment, except for a downward trend in saliva DHEA at days 3 and 5. The correlations between plasma and saliva cortisol, DHEA, and cortisol/DHEA were significant: respectively, r = 0.80, r = 0.80, and r = 0.88. CONCLUSIONS Once-daily oral therapeutic administration of hydrocortisone for 5 days altered adrenal DHEA secretion by inhibiting pituitary ACTH, but this effect seemed transient without significant impairment of basal adrenal or pituitary function 24 h after administration. Given the high correlations between plasma and saliva, saliva samples may be offered as a sensitive surrogate for blood sampling to estimate adrenal and pituitary function.
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Affiliation(s)
- Katia Collomp
- CIAMS, Université d'Orléans, Orléans, France.
- Université Paris-Saclay CIAMS, Orsay, France.
- Département des Analyses, AFLD, Chatenay-Malabry, France.
| | - Virgile Amiot
- Service de Médecine du Sport, CHR Orléans, Orléans, France
| | - Barbara Robin
- Département des Analyses, AFLD, Chatenay-Malabry, France
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Collomp K, Arlettaz A, Buisson C, Lecoq AM, Mongongu C. Glucocorticoid administration in athletes: Performance, metabolism and detection. Steroids 2016; 115:193-202. [PMID: 27643452 DOI: 10.1016/j.steroids.2016.09.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 09/13/2016] [Indexed: 12/12/2022]
Abstract
It is generally acknowledged in the sporting world that glucocorticoid (GC) use enhances physical performance. This pharmacological class is therefore banned by the World Anti-Doping Agency (WADA) in in-competition samples after systemic but not local (defined as any route other than oral, intravenous, intramuscular or rectal) administration, which thus allows athletes to use GCs for therapeutic purposes. According to the 2016 WADA list, the urine reporting level for all GCs is set at 30ng/ml to distinguish between the authorized and banned routes of administration. The actual data on the ergogenic effects of GC intake are nevertheless fairly recent, with the first study showing improved physical performance with systemic GC administration dating back only to 2007. Moreover, the studies over the last decade coupling ergogenic and metabolic investigations in humans during and after GC intake have shown discrepant results. Similarly, urine discrimination between banned and authorized GC use remains complex, but it seems likely to be improved thanks to new analytical studies and the inclusion of the authorized GC uses (local routes of administration and out-of-competition samples) in the WADA monitoring program. In this review, we first summarize the current knowledge on the ergogenic and metabolic GC effects in humans during various types of exercise. We then present the antidoping legislation and methods of analysis currently used to detect GC abuse and conclude with some practical considerations and perspectives.
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Affiliation(s)
- Katia Collomp
- CIAMS, Université Paris-Sud, Université Paris-Saclay, 91405 Orsay Cedex, France; CIAMS, Université Orléans, 45067 Orléans, France; Département des Analyses, Agence Française de Lutte contre le Dopage, 92290 Chatenay-Malabry, France.
| | - Alexandre Arlettaz
- CIAMS, Université Paris-Sud, Université Paris-Saclay, 91405 Orsay Cedex, France; CIAMS, Université Orléans, 45067 Orléans, France
| | - Corinne Buisson
- Département des Analyses, Agence Française de Lutte contre le Dopage, 92290 Chatenay-Malabry, France
| | - Anne-Marie Lecoq
- CIAMS, Université Paris-Sud, Université Paris-Saclay, 91405 Orsay Cedex, France; CIAMS, Université Orléans, 45067 Orléans, France
| | - Cynthia Mongongu
- Département des Analyses, Agence Française de Lutte contre le Dopage, 92290 Chatenay-Malabry, France
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Hair cortisol as a novel biomarker of HPA suppression by inhaled corticosteroids in children. Pediatr Res 2015; 78:44-7. [PMID: 25790275 DOI: 10.1038/pr.2015.60] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 12/18/2014] [Indexed: 12/15/2022]
Abstract
BACKGROUND Asthma is the most common chronic condition in childhood, and the recommended pharmacotherapy for long-term control includes the use of inhaled corticosteroids (ICS). ICS were designed to act at the site of inflammation in the lung, thus decreasing systemic absorption and reducing the risk of adverse effects associated with corticosteroid use (e.g., HPA suppression and its consequent effects). Available data show that measurement of hair cortisol successfully reflects endogenous cortisol levels. We sought to examine whether hair cortisol measurements can be used to identify HPA suppression surrounding ICS therapy in children with asthma. METHODS Hair samples were collected from the vertex posterior region of the head of 18 asthmatic children. We compared their hair cortisol concentration during ICS use with the concentration prior to ICS use. RESULTS During ICS therapy, median hair cortisol levels were twofold lower compared with the period of no ICS use (median 89.8 ng/g vs. 198.2 ng/g, P = 0.0015). CONCLUSION Hair cortisol is an effective biomarker of the HPA suppression associated with ICS therapy and can be a sensitive tool for determining systemic effects of ICS use and monitoring adherence. Future research is needed to characterize the effect of untreated asthma on hair cortisol concentrations, if any.
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Collomp K, Buisson C, Lasne F, Collomp R. DHEA, physical exercise and doping. J Steroid Biochem Mol Biol 2015; 145:206-12. [PMID: 24704255 DOI: 10.1016/j.jsbmb.2014.03.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 03/03/2014] [Accepted: 03/16/2014] [Indexed: 12/21/2022]
Abstract
The dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEA-S) concentrations during acute and chronic exercise (training) have been investigated only fairly recently. DHEA is generally preferred to DHEA-S for exploring the acute exercise repercussions in laboratory or field tests because of its shorter elimination half-life. Conversely, DHEA-S is preferred to estimate chronic adaptations. Both can be measured noninvasively in saliva, and it is therefore possible to follow these hormone responses in elite athletes during competitive events and in healthy and pathological populations, without imposing additional stress. Indeed, the correlation between saliva and serum concentrations is high for steroid hormones, both at rest and during exercise. In this review, we will first summarize the current knowledge on the DHEA/DHEA-S responses to exercise and examine the potential modulating factors: exercise intensity, gender, age, and training. We will then discuss the ergogenic effects that athletes expect from the exogenous administration of DHEA and the antidoping methods of analysis currently used to detect this abuse.
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Affiliation(s)
- K Collomp
- Laboratoire CIAMS, EA 4532, Université Paris Sud - Université Orléans, France; Département des Analyses, Agence Française de Lutte contre le Dopage, Chatenay-Malabry, France.
| | - C Buisson
- Département des Analyses, Agence Française de Lutte contre le Dopage, Chatenay-Malabry, France
| | - F Lasne
- Département des Analyses, Agence Française de Lutte contre le Dopage, Chatenay-Malabry, France
| | - R Collomp
- Laboratoire de Soins Pharmaceutiques et de Santé Publique, Pôle Pharmacie, CHU Nice, France
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Vibarel-Rebot N, Rieth N, Lasne F, Jaffré C, Collomp K. Oral contraceptive use and saliva diurnal pattern of metabolic steroid hormones in young healthy women. Contraception 2014; 91:245-7. [PMID: 25592051 DOI: 10.1016/j.contraception.2014.11.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 11/13/2014] [Accepted: 11/18/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND The impact of oral contraceptives (OCs) on the saliva diurnal pattern of metabolic steroid hormones remained unknown. STUDY DESIGN Saliva samples were taken from young healthy women (11 OC users, 10 non-OC users) to analyze cortisol, dehydroepiandrosterone (DHEA) and testosterone 4 times (days 1, 8, 15 and 22) over one menstrual cycle. RESULTS OC use decreased saliva testosterone concentrations (p<.01) under all conditions of day and time, but not saliva cortisol. OC also decreased saliva DHEA concentrations during the first part of the day (p<.05), with a dampened amplitude in its diurnal pattern. CONCLUSION The clinical relevance requires further study.
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Affiliation(s)
- N Vibarel-Rebot
- Laboratoire CIAMS, Université Paris Sud-Université Orléans, France
| | - N Rieth
- Laboratoire CIAMS, Université Paris Sud-Université Orléans, France
| | - F Lasne
- Département des Analyses, AFLD, France
| | - C Jaffré
- Laboratoire M2S, Université Rennes 2, France
| | - K Collomp
- Laboratoire CIAMS, Université Paris Sud-Université Orléans, France; Département des Analyses, AFLD, France.
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Zorgati H, Prieur F, Vergniaud T, Cottin F, Do MC, Labsy Z, Amarantini D, Gagey O, Lasne F, Collomp K. Ergogenic and metabolic effects of oral glucocorticoid intake during repeated bouts of high-intensity exercise. Steroids 2014; 86:10-5. [PMID: 24793567 DOI: 10.1016/j.steroids.2014.04.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 02/04/2014] [Accepted: 04/16/2014] [Indexed: 10/25/2022]
Abstract
All systemically administered glucocorticoids (GC) are prohibited in-competition, because of the potential ergogenic effects. Although short-term GC intake has been shown to improve performance during submaximal exercise, literature on its impact during brief intense exercise appears to be very scant. The purpose of this study was to examine the ergogenic and metabolic effects of prednisone during repeated bouts of high-intensity exercise. In a double-blind randomized protocol, ten recreational male athletes followed two 1-week treatments (Cor: prednisone, 60mg/day or Pla: placebo). At the end of each treatment, they hopped on their dominant leg for 30s three times consecutively and then hopped until exhaustion, with intervals of 5min of passive recovery. Blood and saliva samples were collected at rest and 3min after each exercise bout to determine the lactate, interleukin-6, interleukin-10, TNF-alpha, DHEA and testosterone values. The absolute peak force of the dominant leg was significantly increased by Cor but only during the first 30-s hopping bout (p<0.05), whereas time to exhaustion was not significantly changed after Cor treatment vs Pla (Pla: 119.9±24.7; Cor: 123.1±29.5s). Cor intake lowered basal and end-exercise plasma interleukin-6 and saliva DHEA (p<0.01) and increased interleukin-10 (p<0.01), whereas no significant change was found in blood lactate and TNF-alpha or saliva testosterone between Pla and Cor. According to these data, short-term glucocorticoid intake did not improve endurance performance during repeated bouts of high-intensity exercise, despite the significant initial increase in absolute peak force and anti-inflammatory effect.
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Affiliation(s)
- Houssem Zorgati
- Laboratoire CIAMS, EA 4532, Université Paris Sud - Université Orléans, France
| | - Fabrice Prieur
- Laboratoire CIAMS, EA 4532, Université Paris Sud - Université Orléans, France
| | - Thomas Vergniaud
- Laboratoire CIAMS, EA 4532, Université Paris Sud - Université Orléans, France
| | - François Cottin
- Laboratoire CIAMS, EA 4532, Université Paris Sud - Université Orléans, France
| | - Manh-Cuong Do
- Laboratoire CIAMS, EA 4532, Université Paris Sud - Université Orléans, France
| | - Zakaria Labsy
- Laboratoire CIAMS, EA 4532, Université Paris Sud - Université Orléans, France
| | | | - Olivier Gagey
- Laboratoire CIAMS, EA 4532, Université Paris Sud - Université Orléans, France
| | | | - Katia Collomp
- Laboratoire CIAMS, EA 4532, Université Paris Sud - Université Orléans, France; Département des Analyses, AFLD, France.
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Collomp R, Labsy Z, Zorgati H, Prieur F, Cottin F, Do MC, Gagey O, Lasne F, Collomp K. Therapeutic glucocorticoid administration alters the diurnal pattern of dehydroepiandrosterone. Endocrine 2014; 46:668-71. [PMID: 24347241 DOI: 10.1007/s12020-013-0122-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 11/09/2013] [Indexed: 10/25/2022]
Abstract
Significant alteration in hypothalamic-pituitary-adrenal function has been demonstrated in patients after short-term glucocorticoid therapy, but its impact on the circadian rhythm of steroid hormones has never been investigated. This study examined the effects of short-term prednisone administration on the diurnal patterns of dehydroepiandrosterone (DHEA) and testosterone. Saliva samples were collected from 11 healthy, physically active, male volunteers for DHEA and testosterone analysis, as follows: every 4 h from 0800 to 2000 h on 2 control days without medication, and after 1 week of oral therapeutic prednisone treatment (60 mg daily) (days 0-3). Overall, a diurnal decline in the two steroid hormones was observed on the control days. After short-term glucocorticoid administration, DHEA concentrations were significantly decreased with a complete disappearance of the DHEA diurnal pattern, which lasted 2 days post-treatment. No glucocorticoid effect was observed for testosterone. The results indicate that short-term prednisone treatment affects the circadian pattern of saliva DHEA but not testosterone in healthy active volunteers. Further studies are necessary to determine whether this alteration in DHEA circadian pattern has clinical consequences in patients with chronic glucocorticoid therapy.
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Affiliation(s)
- R Collomp
- Laboratoire de Soins Pharmaceutiques et de Santé Publique, Pôle Pharmacie, CHU, Nice, France
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Martin HJ, Riazanskaia S, Thomas CLP. Sampling and characterisation of volatile organic compound profiles in human saliva using a polydimethylsiloxane coupon placed within the oral cavity. Analyst 2012; 137:3627-34. [DOI: 10.1039/c2an35432b] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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