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Moreno-Parro I, Diaz-Garzon J, Aarsand AK, Sandberg S, Aikin R, Equey T, Ríos-Blanco JJ, Buño Soto A, Fernandez-Calle P. Biological Variation Data in Triathletes for Metabolism and Growth-Related Biomarkers Included in the Athlete Biological Passport. Clin Chem 2024; 70:987-996. [PMID: 38781424 DOI: 10.1093/clinchem/hvae072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/08/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND When using biological variation (BV) data, BV estimates need to be robust and representative. High-endurance athletes represent a population under special physiological conditions, which could influence BV estimates. Our study aimed to estimate BV in athletes for metabolism and growth-related biomarkers involved in the Athlete Biological Passport (ABP), by 2 different statistical models. METHODS Thirty triathletes were sampled monthly for 11 months. The samples were analyzed for human growth hormone (hGH), insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein 3 (IGFBP-3), insulin, and N-terminal propeptide of type III procollagen (P-III-NP) by immunoassay. Bayesian and ANOVA methods were applied to estimate within-subject (CVI) and between-subject BV. RESULTS CVI estimates ranged from 7.8% for IGFBP-3 to 27.0% for insulin, when derived by the Bayesian method. The 2 models gave similar results, except for P-III-NP. Data were heterogeneously distributed for P-III-NP for the overall population and in females for IGF-1 and IGFBP-3. BV components were not estimated for hGH due to lack of steady state. The index of individuality was below 0.6 for all measurands, except for insulin. CONCLUSIONS In an athlete population, to apply a common CVI for insulin would be appropriate, but for IGF-1 and IGFBP-3 gender-specific estimates should be applied. P-III-NP data were heterogeneously distributed and using a mean CVI may not be representative for the population. The high degree of individuality for IGF-1, IGFBP-3, and P-III-NP makes them good candidates to be interpreted through reference change values and the ABP.
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Affiliation(s)
- Isabel Moreno-Parro
- Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain
- IdiPaz-Hospital La Paz Institute for Health Research, Madrid, Spain
| | - Jorge Diaz-Garzon
- Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain
- IdiPaz-Hospital La Paz Institute for Health Research, Madrid, Spain
| | - Aasne K Aarsand
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Sverre Sandberg
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Reid Aikin
- World Anti-Doping Agency (WADA), Montreal, Quebec, Canada
| | - Tristan Equey
- World Anti-Doping Agency (WADA), Montreal, Quebec, Canada
| | - Juan José Ríos-Blanco
- IdiPaz-Hospital La Paz Institute for Health Research, Madrid, Spain
- Department of Internal Medicine, La Paz University Hospital, Madrid, Spain
| | - Antonio Buño Soto
- Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain
- IdiPaz-Hospital La Paz Institute for Health Research, Madrid, Spain
| | - Pilar Fernandez-Calle
- Department of Laboratory Medicine, La Paz University Hospital, Madrid, Spain
- IdiPaz-Hospital La Paz Institute for Health Research, Madrid, Spain
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Ryoo H, Cho S, Oh T, Kim Y, Suh SH. Identification of doping suspicions through artificial intelligence-powered analysis on athlete's performance passport in female weightlifting. Front Physiol 2024; 15:1344340. [PMID: 38938745 PMCID: PMC11208455 DOI: 10.3389/fphys.2024.1344340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 05/13/2024] [Indexed: 06/29/2024] Open
Abstract
Introduction Doping remains a persistent concern in sports, compromising fair competition. The Athlete Biological Passport (ABP) has been a standard anti-doping measure, but confounding factors challenge its effectiveness. Our study introduces an artificial intelligence-driven approach for identifying potential doping suspicious, utilizing the Athlete's Performance Passport (APP), which integrates both demographic profiles and performance data, among elite female weightlifters. Methods Analyzing publicly available performance data in female weightlifting from 1998 to 2020, along with demographic information, encompassing 17,058 entities, we categorized weightlifters by age, body weight (BW) class, and performance levels. Documented anti-doping rule violations (ADRVs) cases were also retained. We employed AI-powered algorithms, including XGBoost, Multilayer Perceptron (MLP), and an Ensemble model, which integrates XGBoost and MLP, to identify doping suspicions based on the dataset we obtained. Results Our findings suggest a potential doping inclination in female weightlifters in their mid-twenties, and the sanctioned prevalence was the highest in the top 1% performance level and then decreased thereafter. Performance profiles and sanction trends across age groups and BW classes reveal consistently superior performances in sanctioned cases. The Ensemble model showcased impressive predictive performance, achieving a 53.8% prediction rate among the weightlifters sanctioned in the 2008, 2012, and 2016 Olympics. This demonstrated the practical application of the Athlete's Performance Passport (APP) in identifying potential doping suspicions. Discussion Our study pioneers an AI-driven APP approach in anti-doping, offering a proactive and efficient methodology. The APP, coupled with advanced AI algorithms, holds promise in revolutionizing the efficiency and objectivity of doping tests, providing a novel avenue for enhancing anti-doping measures in elite female weightlifting and potentially extending to diverse sports. We also address the limitation of a constrained set of APPs, advocating for the development of a more accessible and enriched APP system for robust anti-doping practices.
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Affiliation(s)
- Hyunji Ryoo
- Department of Physical Education, Yonsei University Graduate School, Seoul, Republic of Korea
| | - Samuel Cho
- Independent Researcher, Seoul, Republic of Korea
| | - Taehan Oh
- Department of Physical Education, Yonsei University Graduate School, Seoul, Republic of Korea
| | - YuSik Kim
- Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sang-Hoon Suh
- Department of Physical Education, College of Educational Sciences, Yonsei University, Seoul, Republic of Korea
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3
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Diaz-Garzon J, Itkonen O, Aarsand AK, Sandberg S, Coskun A, Carobene A, Jonker N, Bartlett WA, Buño A, Fernandez-Calle P. Biological variation of inflammatory and iron metabolism markers in high-endurance recreational athletes; are these markers useful for athlete monitoring? Clin Chem Lab Med 2024; 62:844-852. [PMID: 38062926 DOI: 10.1515/cclm-2023-1071] [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] [Received: 09/25/2023] [Accepted: 11/21/2023] [Indexed: 04/05/2024]
Abstract
OBJECTIVES To deliver biological variation (BV) data for serum hepcidin, soluble transferrin receptor (sTfR), erythropoietin (EPO) and interleukin 6 (IL-6) in a population of well-characterized high-endurance athletes, and to evaluate the potential influence of exercise and health-related factors on the BV. METHODS Thirty triathletes (15 females) were sampled monthly (11 months). All samples were analyzed in duplicate and BV estimates were delivered by Bayesian and ANOVA methods. A linear mixed model was applied to study the effect of factors related to exercise, health, and sampling intervals on the BV estimates. RESULTS Within-subject BV estimates (CVI) were for hepcidin 51.9 % (95 % credibility interval 46.9-58.1), sTfR 10.3 % (8.8-12) and EPO 27.3 % (24.8-30.3). The mean concentrations were significantly different between sex, but CVI estimates were similar and not influenced by exercise, health-related factors, or sampling intervals. The data were homogeneously distributed for EPO but not for hepcidin or sTfR. IL-6 results were mostly below the limit of detection. Factors related to exercise, health, and sampling intervals did not influence the BV estimates. CONCLUSIONS This study provides, for the first time, BV data for EPO, derived from a cohort of well-characterized endurance athletes and indicates that EPO is a good candidate for athlete follow-up. The application of the Bayesian method to deliver BV data illustrates that for hepcidin and sTfR, BV data are heterogeneously distributed and using a mean BV estimate may not be appropriate when using BV data for laboratory and clinical applications.
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Affiliation(s)
- Jorge Diaz-Garzon
- Laboratory Medicine Department, La Paz University Hospital, Madrid, Spain
| | - Outi Itkonen
- Endocrinology and Metabolism Laboratory, Helsinki University Hospital, Helsinki, Finland
| | - Aasne K Aarsand
- Department of Medical Biochemistry and Pharmacology, Norwegian Porphyria Centre, Haukeland University Hospital, Bergen, Norway
- Norwegian Organization for Quality Improvement of Laboratory Examinations (NOKLUS), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Sverre Sandberg
- Department of Medical Biochemistry and Pharmacology, Norwegian Porphyria Centre, Haukeland University Hospital, Bergen, Norway
- Norwegian Organization for Quality Improvement of Laboratory Examinations (NOKLUS), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Abdurrahman Coskun
- Department of Medical Biochemistry Atasehir, School of Medicine, Acibadem Mehmet Ali Aydınlar University, Istanbul, Türkiye
| | - Anna Carobene
- Laboratory Medicine, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Niels Jonker
- Certe, Wilhelmina Ziekenhuis Assen, Assen, The Netherlands
| | - William A Bartlett
- Undergraduate Teaching, School of Medicine, University of Dundee, Dundee, Scotland
| | - Antonio Buño
- Laboratory Medicine Department, La Paz University Hospital, Madrid, Spain
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Dragčević D, Pandžić Jakšić V, Jakšić O. Athlete biological passport: longitudinal biomarkers and statistics in the fight against doping. Arh Hig Rada Toksikol 2024; 75:24-31. [PMID: 38548376 PMCID: PMC10978099 DOI: 10.2478/aiht-2024-75-3793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 10/01/2023] [Accepted: 02/01/2024] [Indexed: 04/01/2024] Open
Abstract
As novel substances, short time windows, and limits of detection increasingly challenge direct methods of doping detection in sports, indirect tools inevitably take a greater role in the fight against it. One such tool is the athlete biological passport (ABP) - a longitudinal profiling of the measured haematological and biochemical biomarkers, combined with calculated scores, against the background of epidemiological data crucial for doping detection. In both of its modules, haematological and steroidal, ABP parameters are analysed with the Bayesian adaptive model, which individualises reference and cut-off values to improve its sensitivity. It takes into account the confounding factors with proven and potential influence on the biomarkers, such as race and altitude exposure. The ABP has already changed the fight against doping, but its importance will further grow with the new modules (e.g., endocrinological), parameters (e.g., plasma volume-independent parameters), and complementing indirect methods (e.g., transcriptomic).
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Affiliation(s)
- Dora Dragčević
- University Hospital Merkur, Department of Haematology, Zagreb, Croatia
| | - Vlatka Pandžić Jakšić
- University Hospital Dubrava, Department of Endocrinology, Zagreb, Croatia
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Ozren Jakšić
- University of Zagreb School of Medicine, Zagreb, Croatia
- University Hospital Dubrava, Department of Haematology, Zagreb, Croatia
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Bezuglov E, Malyakin G, Telyshev D, Morgans R, Lazarev A, Kapralova E, Sadkovaya O, Talibov O. The effects of anti-doping measures on sports performance in weightlifting. J Sports Sci 2024; 42:373-380. [PMID: 38531055 DOI: 10.1080/02640414.2024.2334483] [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] [Received: 07/10/2023] [Accepted: 03/18/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Evaluating anti-doping measures is essential to optimise their effectiveness. Comparing sporting results that have a higher doping prevalence, such as weightlifting, before and after the implementation of anti-doping measures may serve as an effectiveness indicator. METHODS The results of the most successful weightlifters of both sexes in two time periods, 2009-2015 and 2016-2022 were analysed. The Sinclair Total (ST) to compare the relative strength of weightlifters from different weight categories was calculated. RESULTS A significant decrease in the ST during 2016-2022 (p < 0.001) in athletes of all ages and both sexes overall was reported. When analysed by age, there was a decrease in ST in juniors and seniors of both sexes (p = 0.010 and p < 0.001, respectively), but not in youth. There was a decrease in the ST in senior men (p < 0.001), junior women (p < 0.001) and senior women (p < 0.001). CONCLUSION In elite weightlifting, adult athletic results declined during 2016-2022, which may partly be explained by the implementation of new methods to detect long-term anabolic androgenic steroid metabolites as well as other policies. This may highlight the effectiveness of these methods both in the prevention and detection of anti-doping rule violations.
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Affiliation(s)
- Eduard Bezuglov
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University, Moscow, Russia
- High Performance Sports Laboratory, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Georgiy Malyakin
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University, Moscow, Russia
- High Performance Sports Laboratory, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Danila Telyshev
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Ryland Morgans
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Artemii Lazarev
- Department of Internal Medicine, Mount Sinai Hospital, Chicago, IL, USA
| | - Elizaveta Kapralova
- Department of Sports Medicine and Medical Rehabilitation, Sechenov First Moscow State Medical University, Moscow, Russia
- High Performance Sports Laboratory, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Olga Sadkovaya
- N.A. Semashko Public Health and Healthcare Department, F.F. Erisman Institute of Public Health, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Oleg Talibov
- Department of Therapy, Clinical Pharmacology and Ambulance Care, Moscow Medical University of Medicine and Dentistry, Moscow, Russia
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Lee HJ, Jeon M, Seo Y, Kang I, Jeong W, Son J, Yi EC, Min H. Application of Skyline software for detecting prohibited substances in doping control analysis. PLoS One 2023; 18:e0295065. [PMID: 38051722 DOI: 10.1371/journal.pone.0295065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 11/14/2023] [Indexed: 12/07/2023] Open
Abstract
As the number of prohibited drugs has been progressively increasing and analytical methods for detecting such substances are renewed continuously for doping control, the need for more sensitive and accurate doping analysis has increased. To address the urgent need for high throughput and accurate analysis, liquid chromatography with tandem mass spectrometry is actively utilized in case of most of the newly designated prohibited substances. However, because all mass spectrometer vendors provide data processing software that is incapable of handling other instrumental data, it is difficult to cover all doping analysis procedures, from method development to result reporting, on one platform. Skyline is an open-source and vendor-neutral software program invented for the method development and data processing of targeted proteomics. Recently, the utilization of Skyline has been expanding for the quantitative analysis of small molecules and lipids. Herein, we demonstrated Skyline as a simple platform for unifying overall doping control, including the optimization of analytical methods, monitoring of data quality, discovery of suspected doping samples, and validation of analytical methods for detecting newly prohibited substances. For method optimization, we selected the optimal collision energies for 339 prohibited substances. Notably, 195 substances exhibited a signal intensity increase of >110% compared with the signal intensity of the original collision energy. All data related to method validation and quantitative analysis were efficiently visualized, extracted, or calculated using Skyline. Moreover, a comparison of the time consumed and the number of suspicious samples screened in the initial test procedure highlighted the advantages of using Skyline over the commercially available software TraceFinder in doping control.
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Affiliation(s)
- Hyeon-Jeong Lee
- Doping Control Center, Korea Institute of Science and Technology, Seongbuk-gu, Seoul, Republic of Korea
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Yeongeon-dong, Jongno-gu, Seoul, Republic of Korea
| | - Mijin Jeon
- Doping Control Center, Korea Institute of Science and Technology, Seongbuk-gu, Seoul, Republic of Korea
| | - Yoondam Seo
- Doping Control Center, Korea Institute of Science and Technology, Seongbuk-gu, Seoul, Republic of Korea
| | - Inseon Kang
- Doping Control Center, Korea Institute of Science and Technology, Seongbuk-gu, Seoul, Republic of Korea
| | - Wooyeon Jeong
- Doping Control Center, Korea Institute of Science and Technology, Seongbuk-gu, Seoul, Republic of Korea
| | - Junghyun Son
- Doping Control Center, Korea Institute of Science and Technology, Seongbuk-gu, Seoul, Republic of Korea
| | - Eugene C Yi
- Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Yeongeon-dong, Jongno-gu, Seoul, Republic of Korea
| | - Hophil Min
- Doping Control Center, Korea Institute of Science and Technology, Seongbuk-gu, Seoul, Republic of Korea
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de Figueiredo M, Saugy J, Saugy M, Faiss R, Salamin O, Nicoli R, Kuuranne T, Rudaz S, Botrè F, Boccard J. A new multimodal paradigm for biomarkers longitudinal monitoring: a clinical application to women steroid profiles in urine and blood. Anal Chim Acta 2023; 1267:341389. [PMID: 37257979 DOI: 10.1016/j.aca.2023.341389] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/12/2023] [Accepted: 05/16/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Most current state-of-the-art strategies to generate individual adaptive reference ranges are designed to monitor one clinical parameter at a time. An innovative methodology is proposed for the simultaneous longitudinal monitoring of multiple biomarkers. The estimation of individual thresholds is performed by applying a Bayesian modeling strategy to a multivariate score integrating several biomarkers (compound concentration and/or ratio). This multimodal monitoring was applied to data from a clinical study involving 14 female volunteers with normal menstrual cycles receiving testosterone via transdermal route, as to test its ability to detect testosterone administration. The study samples consisted of urine and blood collected during 4 weeks of a control phase and 4 weeks with a daily testosterone gel application. RESULTS Integrating multiple biomarkers improved the detection of testosterone gel administration with substantially higher sensitivity compared with the distinct follow-up of each biomarker, when applied to selected urine and serum steroid biomarkers, as well as the combination of both. Among the 175 known positive samples, 38% were identified by the multimodal approach using urine biomarkers, 79% using serum biomarkers and 83% by combining biomarkers from both biological matrices, whereas 10%, 67% and 64% were respectively detected using standard unimodal monitoring. SIGNIFICANCE AND NOVELTY The detection of abnormal patterns can be improved using multimodal approaches. The combination of urine and serum biomarkers reduced the overall number of false-negatives, thus evidencing promising complementarity between urine and blood sampling for doping control, as highlighted in the case of the use of transdermal testosterone preparations. The generation in a multimodal setting of adaptive and personalized reference ranges opens up new opportunities in clinical and anti-doping profiling. The integration of multiple parameters in a longitudinal monitoring is expected to provide a more complete evaluation of individual profiles generating actionable intelligence to further guide sample collection, analysis protocols and decision-making in clinics and anti-doping.
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Affiliation(s)
- Miguel de Figueiredo
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland; Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| | - Jonas Saugy
- Center of Research and Expertise in Anti-Doping Sciences, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Martial Saugy
- Center of Research and Expertise in Anti-Doping Sciences, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Raphaël Faiss
- Center of Research and Expertise in Anti-Doping Sciences, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Olivier Salamin
- Center of Research and Expertise in Anti-Doping Sciences, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland; Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Lausanne University, Hospital and University of Lausanne, Switzerland
| | - Raul Nicoli
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Lausanne University, Hospital and University of Lausanne, Switzerland
| | - Tiia Kuuranne
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Lausanne University, Hospital and University of Lausanne, Switzerland
| | - Serge Rudaz
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland; Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| | - Francesco Botrè
- Center of Research and Expertise in Anti-Doping Sciences, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Julien Boccard
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland; Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland.
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Equey T, Salamin O, Ponzetto F, Nicoli R, Kuuranne T, Saugy J, Saugy M, Aikin R, Baume N. Longitudinal Profiling of Endogenous Steroids in Blood Using the Athlete Biological Passport Approach. J Clin Endocrinol Metab 2023; 108:1937-1946. [PMID: 36794909 DOI: 10.1210/clinem/dgad085] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/02/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023]
Abstract
CONTEXT Detection of endogenous anabolic androgenic steroids (EAAS), like testosterone (T), as doping agents has been improved with the launch of the Steroidal Module of the Athlete Biological Passport (ABP) in urine samples. OBJECTIVE To target doping practices with EAAS, particularly in individuals with low level of biomarkers excreted in urine, by including new target compounds measured in blood. DESIGN T and T/androstenedione (T/A4) distributions were obtained from 4 years of anti-doping data and applied as priors to analyze individual profiles from 2 T administration studies in female and male subjects. SETTING Anti-doping laboratory. Elite athletes (n = 823) and male and female clinical trials subjects (n = 19 and 14, respectively). INTERVENTION(S) Two open-label administration studies were carried out. One involved a control phase period followed by patch and then oral T administration in male volunteers and the other followed female volunteers during 3 menstrual cycles with 28 days of daily transdermal T application during the second month. MAIN OUTCOME MEASURE(S) Serum samples were analyzed for T and A4 and the performance of a longitudinal ABP-based approach was evaluated for T and T/A4. RESULTS An ABP-based approach set at a 99% specificity flagged all female subjects during the transdermal T application period and 44% of subjects 3 days after the treatment. T showed the best sensitivity (74%) in response to transdermal T application in males. CONCLUSIONS Inclusion of T and T/A4 as markers in the Steroidal Module can improve the performance of the ABP to identify T transdermal application, particularly in females.
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Affiliation(s)
- Tristan Equey
- World Anti-Doping Agency (WADA), Montreal, Quebec H4Z 1B7, Canada
| | - Olivier Salamin
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Genève and Lausanne, Centre Hospitalier Universitaire Vaudois and University of Lausanne, 1066 Epalinges, Switzerland
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, 1015 Lausanne, Switzerland
| | - Federico Ponzetto
- Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, City of Health and Science University Hospital, University of Turin, 10126 Turin, Italy
| | - Raul Nicoli
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Genève and Lausanne, Centre Hospitalier Universitaire Vaudois and University of Lausanne, 1066 Epalinges, Switzerland
| | - Tiia Kuuranne
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Genève and Lausanne, Centre Hospitalier Universitaire Vaudois and University of Lausanne, 1066 Epalinges, Switzerland
| | - Jonas Saugy
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, 1015 Lausanne, Switzerland
| | - Martial Saugy
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, 1015 Lausanne, Switzerland
| | - Reid Aikin
- World Anti-Doping Agency (WADA), Montreal, Quebec H4Z 1B7, Canada
| | - Norbert Baume
- World Anti-Doping Agency (WADA), Montreal, Quebec H4Z 1B7, Canada
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Kolliari-Turner A, Lima G, Wang G, Malinsky FR, Karanikolou A, Eichhorn G, Tanisawa K, Ospina-Betancurt J, Hamilton B, Kumi PY, Shurlock J, Skiadas V, Twycross-Lewis R, Kilduff L, Martin RP, Ash GI, Potter C, Guppy FM, Seto JT, Fossati C, Pigozzi F, Borrione P, Pitsiladis Y. An observational human study investigating the effect of anabolic androgenic steroid use on the transcriptome of skeletal muscle and whole blood using RNA-Seq. BMC Med Genomics 2023; 16:94. [PMID: 37138349 PMCID: PMC10157927 DOI: 10.1186/s12920-023-01512-z] [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: 12/14/2022] [Accepted: 04/08/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND The effects of Anabolic Androgenic Steroids (AAS) are largely illustrated through Androgen Receptor induced gene transcription, yet RNA-Seq has yet to be conducted on human whole blood and skeletal muscle. Investigating the transcriptional signature of AAS in blood may aid AAS detection and in muscle further understanding of AAS induced hypertrophy. METHODS Males aged 20-42 were recruited and sampled once: sedentary controls (C), resistance trained lifters (RT) and resistance trained current AAS users (RT-AS) who ceased exposure ≤ 2 or ≥ 10 weeks prior to sampling. RT-AS were sampled twice as Returning Participants (RP) if AAS usage ceased for ≥ 18 weeks. RNA was extracted from whole blood and trapezius muscle samples. RNA libraries were sequenced twice, for validation purposes, on the DNBSEQ-G400RS with either standard or CoolMPS PE100 reagents following MGI protocols. Genes were considered differentially expressed with FDR < 0.05 and a 1.2- fold change. RESULTS Cross-comparison of both standard reagent whole blood (N = 55: C = 7, RT = 20, RT-AS ≤ 2 = 14, RT-AS ≥ 10 = 10, RP = 4; N = 46: C = 6, RT = 17, RT-AS ≤ 2 = 12, RT-AS ≥ 10 = 8, RP = 3) sequencing datasets, showed that no genes or gene sets/pathways were differentially expressed between time points for RP or between group comparisons of RT-AS ≤ 2 vs. C, RT, or RT-AS ≥ 10. Cross-comparison of both muscle (N = 51, C = 5, RT = 17, RT-AS ≤ 2 = 15, RT-AS ≥ 10 = 11, RP = 3) sequencing (one standard & one CoolMPS reagent) datasets, showed one gene, CHRDL1, which has atrophying potential, was upregulated in RP visit two. In both muscle sequencing datasets, nine differentially expressed genes, overlapped with RT-AS ≤ 2 vs. RT and RT-AS ≤ 2 vs. C, but were not differentially expressed with RT vs. C, possibly suggesting they are from acute doping alone. No genes seemed to be differentially expressed in muscle after the long-term cessation of AAS, whereas a previous study found long term proteomic changes. CONCLUSION A whole blood transcriptional signature of AAS doping was not identified. However, RNA-Seq of muscle has identified numerous differentially expressed genes with known impacts on hypertrophic processes that may further our understanding on AAS induced hypertrophy. Differences in training regimens in participant groupings may have influenced results. Future studies should focus on longitudinal sampling pre, during and post-AAS exposure to better control for confounding variables.
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Affiliation(s)
- Alexander Kolliari-Turner
- School of Sport and Heath Sciences, University of Brighton Welkin House, 30 Carlisle Road, Eastbourne, BN20 7SN UK
- Centre for Stress and Age-Related Disease, University of Brighton, Brighton, UK
| | - Giscard Lima
- School of Sport and Heath Sciences, University of Brighton Welkin House, 30 Carlisle Road, Eastbourne, BN20 7SN UK
- Muscle Research, Murdoch Children’s Research Institute, Parkville, VIC Australia
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Guan Wang
- School of Sport and Heath Sciences, University of Brighton Welkin House, 30 Carlisle Road, Eastbourne, BN20 7SN UK
- Centre for Regenerative Medicine and Devices, University of Brighton, Brighton, UK
| | - Fernanda Rossell Malinsky
- School of Sport and Heath Sciences, University of Brighton Welkin House, 30 Carlisle Road, Eastbourne, BN20 7SN UK
| | - Antonia Karanikolou
- School of Sport and Heath Sciences, University of Brighton Welkin House, 30 Carlisle Road, Eastbourne, BN20 7SN UK
| | - Gregor Eichhorn
- School of Sport and Heath Sciences, University of Brighton Welkin House, 30 Carlisle Road, Eastbourne, BN20 7SN UK
- Environmental Extremes Laboratory, University of Brighton, Eastbourne, UK
| | - Kumpei Tanisawa
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | | | - Blair Hamilton
- School of Sport and Heath Sciences, University of Brighton Welkin House, 30 Carlisle Road, Eastbourne, BN20 7SN UK
- Centre for Stress and Age-Related Disease, University of Brighton, Brighton, UK
- The Gender Identity Clinic, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Paulette Y.O. Kumi
- Centre for Sports and Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, London, UK
| | | | - Vasileios Skiadas
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Richard Twycross-Lewis
- School of Engineering and Materials Science, Queen Mary University of London, London, UK
- St Mary’s University, Twickenham, London, UK
| | - Liam Kilduff
- Applied Sports, Technology, Exercise, and Medicine Research Centre (A-STEM), Faculty of Science and Engineering, Swansea University, Swansea, Wales
| | - Renan Paulo Martin
- Department of Biophysics, Federal University of Sao Paulo, Sao Paulo, Brazil
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Garrett I. Ash
- Veterans Affairs Connecticut Healthcare System, West Haven, CT USA
- Center for Medical Informatics, Yale University, New Haven, CT USA
| | | | - Fergus M. Guppy
- Centre for Stress and Age-Related Disease, University of Brighton, Brighton, UK
- Institute for Life and Earth Sciences, School of Energy, Geoscience, Infrastructure and Society, Heriot-Watt University, Edinburgh, UK
| | - Jane T. Seto
- Muscle Research, Murdoch Children’s Research Institute, Parkville, VIC Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC Australia
| | - Chiara Fossati
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Fabio Pigozzi
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Paolo Borrione
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Yannis Pitsiladis
- School of Sport and Heath Sciences, University of Brighton Welkin House, 30 Carlisle Road, Eastbourne, BN20 7SN UK
- Centre for Stress and Age-Related Disease, University of Brighton, Brighton, UK
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10
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McLean S, Naughton M, Kerhervé H, Salmon PM. From Anti-doping-I to Anti-doping-II: Toward a paradigm shift for doping prevention in sport. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 115:104019. [PMID: 37028132 DOI: 10.1016/j.drugpo.2023.104019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 03/23/2023] [Accepted: 03/25/2023] [Indexed: 04/08/2023]
Abstract
Doping remains an intractable issue in sport and occurs in a complex and dynamic environment comprising interactions between individual, situational, and environmental factors. Anti-doping efforts have previously predominantly focused on athlete behaviours and sophisticated detection methods, however, doping issues remain. As such, there is merit in exploring an alternative approach. The aim of this study was to apply a systems thinking approach to model the current anti-doping system for four football codes in Australia, using the Systems Theoretic Accident Model and Processes (STAMP). The STAMP control structure was developed and validated by eighteen subject matter experts across a five-phase validation process. Within the developed model, education was identified as a prominent approach anti-doping authorities use to combat doping. Further, the model suggests that a majority of existing controls are reactive, and hence that there is potential to employ leading indicators to proactively prevent doping and that new incident reporting systems could be developed to capture such information. It is our contention that anti-doping research and practice should consider a shift away from the current reactive and reductionist approach of detection and enforcement to a proactive and systemic approach focused on leading indicators. This will provide anti-doping agencies a new lens to look at doping in sport.
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11
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Diaz-Garzon J, Fernandez-Calle P, Aarsand AK, Sandberg S, Coskun A, Equey T, Aikin R, Soto AB. Long-Term Within- and Between-Subject Biological Variation Data of Hematological Parameters in Recreational Endurance Athletes. Clin Chem 2023; 69:500-509. [PMID: 36786725 DOI: 10.1093/clinchem/hvad006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/28/2022] [Indexed: 02/15/2023]
Abstract
BACKGROUND Hematological parameters have many applications in athletes, from monitoring health to uncovering blood doping. This study aimed to deliver biological variation (BV) estimates for 9 hematological parameters by a Biological Variation Data Critical Appraisal Checklist (BIVAC) design in a population of recreational endurance athletes and to assess the effect of self-reported exercise and health-related variables on BV. METHODS Samples were drawn from 30 triathletes monthly for 11 months and measured in duplicate for hematological measurands on an Advia 2120 analyzer (Siemens Healthineers). After outlier and homogeneity analysis, within-subject (CVI) and between-subject (CVG) BV estimates were delivered (CV-ANOVA and log-ANOVA, respectively) and a linear mixed model was applied to analyze the effect of exercise and other related variables on the BV estimates. RESULTS CVI estimates ranged from 1.3% (95%CI, 1.2-1.4) for mean corpuscular volume to 23.8% (95%CI, 21.6-26.3) for reticulocytes. Sex differences were observed for platelets and OFF-score. The CVI estimates were higher than those reported for the general population based on meta-analysis of eligible studies in the European Biological Variation Database, but 95%CI overlapped, except for reticulocytes, 23.9% (95%CI, 21.6-26.5) and 9.7% (95%CI, 6.4-11.0), respectively. Factors related to exercise and athletes' state of health did not appear to influence the BV estimates. CONCLUSIONS This is the first BIVAC-compliant study delivering BV estimates that can be applied to athlete populations performing high-level aerobic exercise. CVI estimates of most parameters were similar to the general population and were not influenced by exercise or athletes' state of health.
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Affiliation(s)
- Jorge Diaz-Garzon
- Laboratory Medicine Department, La Paz University Hospital, Madrid, Spain
| | | | - Aasne K Aarsand
- Norwegian Porphyria Centre, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway.,Norwegian Organization for Quality Improvement of Laboratory Examinations (NOKLUS), Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Sverre Sandberg
- Norwegian Porphyria Centre, Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway.,Norwegian Organization for Quality Improvement of Laboratory Examinations (NOKLUS), Haraldsplass Deaconess Hospital, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Abdurrahman Coskun
- School of Medicine, Acibadem Mehmet Ali Aydınlar University, Istanbul, Turkey
| | - Tristan Equey
- Athlete Biological Passport, World Anti-Doping Agency (WADA), Montréal, Canada
| | - Reid Aikin
- Athlete Biological Passport, World Anti-Doping Agency (WADA), Montréal, Canada
| | - Antonio Buno Soto
- Laboratory Medicine Department, La Paz University Hospital, Madrid, Spain
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12
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Krumm B, Botrè F, Saugy JJ, Faiss R. Future opportunities for the Athlete Biological Passport. Front Sports Act Living 2022; 4:986875. [PMID: 36406774 PMCID: PMC9666424 DOI: 10.3389/fspor.2022.986875] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/18/2022] [Indexed: 01/25/2023] Open
Abstract
The Athlete Biological Passport (ABP) was introduced to complement the direct anti-doping approach by indirectly outlining the possible use of prohibited substances or methods in sports. The ABP proved its effectiveness, at least through a deterrent effect, even though the matrices used for longitudinal monitoring (urine and blood) are subject to many intrinsic (e.g., genetic) and extrinsic (e.g., environmental conditions) confounding factors. In that context, new and more specific biomarkers are currently under development to enhance both the sensitivity and the specificity of the ABP. Multiple strategies are presently being explored to improve this longitudinal monitoring, with the development of the current modules, the investigation of new strategies, or the screening of new types of doping. Nevertheless, due to the variability induced by indirect biomarkers, the consideration of confounding factors should continuously support this research. Beyond tremendous advances in analytical sensitivity, machine learning-based approaches seem inevitable to facilitate an expert interpretation of numerous biological profiles and promote anti-doping efforts. This perspective article highlights the current innovations of the Athlete Biological Passport that seem the most promising. Through different research axes, this short manuscript provides an opportunity to bring together approaches that are more widely exploited (e.g., omics strategies) and others in the early stages of investigation (e.g., artificial intelligence) seeking to develop the ABP.
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Affiliation(s)
- Bastien Krumm
- Research and Expertise in Anti-Doping Sciences, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Francesco Botrè
- Research and Expertise in Anti-Doping Sciences, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland,Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Jonas J. Saugy
- Research and Expertise in Anti-Doping Sciences, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Raphael Faiss
- Research and Expertise in Anti-Doping Sciences, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland,*Correspondence: Raphael Faiss
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13
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Psychosocial aspects of sports medicine in pediatric athletes: Current concepts in the 21 st century. Dis Mon 2022:101482. [PMID: 36100481 DOI: 10.1016/j.disamonth.2022.101482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Behavioral aspects of organized sports activity for pediatric athletes are considered in a world consumed with winning at all costs. In the first part of this treatise, we deal with a number of themes faced by our children in their sports play. These concepts include the lure of sports, sports attrition, the mental health of pediatric athletes (i.e., effects of stress, anxiety, depression, suicide in athletes, ADHD and stimulants, coping with injuries, drug use, and eating disorders), violence in sports (i.e., concepts of the abused athlete including sexual abuse), dealing with supervisors (i.e., coaches, parents), peers, the talented athlete, early sports specialization and sports clubs. In the second part of this discussion, we cover ergolytic agents consumed by young athletes in attempts to win at all costs. Sports doping agents covered include anabolic steroids (anabolic-androgenic steroids or AAS), androstenedione, dehydroepiandrostenedione (DHEA), human growth hormone (hGH; also its human recombinant homologue: rhGH), clenbuterol, creatine, gamma hydroxybutyrate (GHB), amphetamines, caffeine and ephedrine. Also considered are blood doping that includes erythropoietin (EPO) and concepts of gene doping. In the last section of this discussion, we look at disabled pediatric athletes that include such concepts as athletes with spinal cord injuries (SCIs), myelomeningocele, cerebral palsy, wheelchair athletes, and amputee athletes; also covered are pediatric athletes with visual impairment, deafness, and those with intellectual disability including Down syndrome. In addition, concepts of autonomic dysreflexia, boosting and atlantoaxial instability are emphasized. We conclude that clinicians and society should protect our precious pediatric athletes who face many challenges in their involvement with organized sports in a world obsessed with winning. There is much we can do to help our young athletes find benefit from sports play while avoiding or blunting negative consequences of organized sport activities.
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14
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Saugy JJ, Schmoutz T, Botrè F. Altitude and Erythropoietin: Comparative Evaluation of Their Impact on Key Parameters of the Athlete Biological Passport: A Review. Front Sports Act Living 2022; 4:864532. [PMID: 35847455 PMCID: PMC9282833 DOI: 10.3389/fspor.2022.864532] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
The hematological module of the Athlete's Biological Passport (ABP) identifies doping methods and/or substances used to increase the blood's capacity to transport or deliver oxygen to the tissues. Recombinant human erythropoietin (rhEPOs) are doping substances known to boost the production of red blood cells and might have an effect on the blood biomarkers of the ABP. However, hypoxic exposure influences these biomarkers similarly to rhEPOs. This analogous impact complicates the ABP profiles' interpretation by antidoping experts. The present study aimed to collect and identify, through a literature search, the physiological effects on ABP blood biomarkers induced by these external factors. A total of 43 studies were selected for this review. A positive correlation (R2 = 0.605, r = 0.778, p < 0.001) was identified between the hypoxic dose and the increase in hemoglobin concentration (HGB) percentage. In addition, the change in the reticulocyte percentage (RET%) has been identified as one of the most sensitive parameters to rhEPO use. The mean effects of rhEPO on blood parameters were greater than those induced by hypoxic exposure (1.7 times higher for HGB and RET% and 4 times higher for hemoglobin mass). However, rhEPO micro-doses have shown effects that are hardly distinguishable from those identified after hypoxic exposure. The results of the literature search allowed to identify temporal and quantitative evolution of blood parameters in connection with different hypoxic exposure doses, as well as different rhEPOs doses. This might be considered to provide justified and well-documented interpretations of physiological changes in blood parameters of the Athlete Biological Passport.
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Affiliation(s)
- Jonas J. Saugy
- Institute of Sport Sciences, University of Lausanne (ISSUL), Lausanne, Switzerland
- Research and Expertise in anti-Doping Sciences (REDs), University of Lausanne, Lausanne, Switzerland
- *Correspondence: Jonas J. Saugy
| | - Tania Schmoutz
- Institute of Sport Sciences, University of Lausanne (ISSUL), Lausanne, Switzerland
| | - Francesco Botrè
- Institute of Sport Sciences, University of Lausanne (ISSUL), Lausanne, Switzerland
- Research and Expertise in anti-Doping Sciences (REDs), University of Lausanne, Lausanne, Switzerland
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15
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Donati F, de la Torre X, Pagliarosi S, Pirri D, Prevete G, Botrè F. Detection of Homologous Blood Transfusion in Sport Doping by Flow Cytofluorimetry: State of the Art and New Approaches to Reduce the Risk of False-Negative Results. Front Sports Act Living 2022; 4:808449. [PMID: 35224486 PMCID: PMC8866641 DOI: 10.3389/fspor.2022.808449] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 01/12/2022] [Indexed: 12/04/2022] Open
Abstract
This article presents the results of a study aimed to give new suggestions and strategies for improving the implementation of the flow cytofluorimetry-based method for the detection of homologous blood transfusions in doping control. The method is based on the recognition of the phenotypic mismatch between minority blood group antigens possessed by the donor and the recipient. Two strategies have been followed to reduce the risk of false-negative results: (i) the monitoring of a broader range of erythrocytes surface antigens; and (ii) the application of different surface erythrocyte staining protocols, tailored on the different antigens and the type of antigenic mismatch that had to be detected (whether it is the donor or the recipient who expresses or not the antigen to be detected). Special attention has also been focused on the time factor, to avoid prolonged sample storage, since hemolysis may have a significant impact on the reliability and quality of the results. Our experimental evidence suggests that the risk of false-negative results can be minimized by (i) the expansion of the antigen panel, with the inclusion of four additional targets; (ii) a more accurate selection of the gating area of the red blood cells; (iii) the choice of a better fluorochrome (alexa fluor 488) to be conjugated to the secondary antibody; and (iv) the implementation of different staining protocols depending on the nature of the double population to be detected (donor expressing vs. recipient non-expressing and vice versa). The combination of the above approaches allowed a significant reduction of false-negative results, assessed on samples simulating a homologous blood transfusion between two compatible subjects.
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Affiliation(s)
- Francesco Donati
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
- *Correspondence: Francesco Donati
| | - Xavier de la Torre
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | | | - Daniela Pirri
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Giuliana Prevete
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Francesco Botrè
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
- REDs–Research and Expertise in AntiDoping Sciences, Synathlon, Quartier Centre, ISSUL–Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
- Francesco Botrè
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16
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Importance of weightlifting performance analysis in anti-doping. PLoS One 2022; 17:e0263398. [PMID: 35120152 PMCID: PMC8815941 DOI: 10.1371/journal.pone.0263398] [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: 06/03/2021] [Accepted: 01/18/2022] [Indexed: 12/02/2022] Open
Abstract
We examined the potential roles of the athlete’s performance passport (APP) for doping detection by analyzing the relationship between weightlifting performance and sanction status. For the present study, performance data of ‘not-sanctioned’ (26740 datasets) and ‘sanctioned’ (289 datasets) male athletes were acquired from the website of the International Weightlifting Federation (www.iwf.net). One-way ANOVA, correlation analysis, and t-tests were used to analyze the relationship between athletes’ use of doping and their performances across age and body weight. Athletic performance was significantly greater for athletes in the sanctioned group than those of the same age group who were not sanctioned, and this performance difference between the two groups was the greatest in their late thirties at 20.6% (not-sanctioned 292.0kg vs. sanctioned 352.3kg) (p < 0.05). From the age group analysis, out of 289 sanctioned cases, 84 cases, which was the largest proportion, were found within the top 10–25% of their performances. When stratified by body weight, athletic performance was significantly greater for the sanctioned group than the not-sanctioned group, and this performance gap was the greatest in the bodyweight category of 96 at 18.6% (not-sanctioned 310.1kg vs. sanctioned 367.8kg) (p < 0.05). From the body weight category analysis, out of 289 sanctioned cases, 75 cases, which was the largest proportion, were found within the top 10–25% of their performances. Additionally, the mean difference in performance between not-sanctioned and sanctioned groups was the largest in the body weight category of 67kg in the ages of 15–19 at 20% (not-sanctioned 234.6kg vs. sanctioned 281.5kg). These results are interpreted to mean that in male weightlifters 1) sanctioned athletes were detected in all ranges of performances regardless of age and body weight, 2) there were even higher rates of sanctioned athletes who performed within the top 10–25% of each age group and body weight category, 3) there were significant differences in performance between not-sanctioned and sanctioned group for all body weight categories, excluding +109, in the ages of 15–19 and 20–24, 4) therefore, performance data can be effectively used to better target suspected athletes for doping testing.
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17
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Moreillon B, Equey T, Astolfi T, Salamin O, Faiss R. Removal of the influence of plasma volume fluctuations for the athlete biological passport and stability of haematological variables in active women taking oral contraception. Drug Test Anal 2022; 14:1004-1016. [PMID: 34994063 PMCID: PMC9306693 DOI: 10.1002/dta.3218] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 12/20/2021] [Accepted: 12/21/2021] [Indexed: 01/06/2023]
Abstract
The haematological module of the athlete biological passport (ABP) monitors longitudinal haematological variations that could be indicative of blood manipulation. This study applied a multi‐parametric model previously validated in elite cyclists to compare inferred and actual PV variations, whereas the potential influence of the oral contraceptive pill (OCP) cycle on the ABP blood biomarkers and plasma volume (PV) in 14 physically active women taking OCPs was also investigated. Blood and serum samples were collected each week for 8 weeks, and the ABP haematological variables were determined according to the World Anti‐Doping Agency guidelines. Transferrin (sTFN), ferritin (FERR), albumin (ALB), calcium (Ca), creatinine (CRE), total protein (TP) and low‐density lipoprotein (LDL) were additionally computed as ‘volume‐sensitive’ variables in a multivariate analysis to determine individual estimations of PV variations. Actual PV variations were indirectly measured using a validated carbon monoxide rebreathing method. We hypothesised ABP markers to be stable during a standard OCP cycle and estimated PV variations similar to measured PV variations. Measured PV variations were in good agreement with the predictions and allowed to explain an atypical passport finding (ATPF). The ABP biomarkers, Hbmass and PV were stable over 8 weeks. Significant differences occurred only between Week 7 and Week 1, with lower levels of haemoglobin concentration ([Hb]), haematocrit (HCT) and red blood cell count (RBC)(−4.4%, p < 0.01; −5.1%, p < 0.01; −5.2%, p < 0.01) and higher levels of PV at week 7 (+9%, p = 0.05). We thus concluded that estimating PV variations may help interpret individual ABP haematological profiles in women.
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Affiliation(s)
- Basile Moreillon
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | | | - Tiffany Astolfi
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,Research and Expertise in anti-Doping sciences (REDs), University of Lausanne, Lausanne, Switzerland
| | - Olivier Salamin
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,Research and Expertise in anti-Doping sciences (REDs), University of Lausanne, Lausanne, Switzerland
| | - Raphael Faiss
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,Research and Expertise in anti-Doping sciences (REDs), University of Lausanne, Lausanne, Switzerland
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18
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Iron Status and Homeostasis Across 2 Competitive Seasons in NCAA Division I Collegiate Cross-Country Runners Residing at Low Altitude. Int J Sports Physiol Perform 2022; 17:1716-1724. [DOI: 10.1123/ijspp.2021-0546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 07/13/2022] [Accepted: 08/25/2022] [Indexed: 11/09/2022]
Abstract
Purpose: Inflammatory cytokines including interleukin-6 can upregulate hepcidin and decrease iron absorption. Endurance exercise is associated with transient increases in cytokines, which may alter the risk of iron deficiency (ID). This study examined whether chronic elevations in basal levels of cytokines and hepcidin were associated with ID in highly trained runners. Methods: Fifty-four collegiate runners (26 males and 28 females) living at ∼1625 m were recruited from an NCAA Division I cross-country team for this prospective cohort study. Over 2 seasons, fasted, preexercise blood draws were performed in the morning 4 times per season and were analyzed for hemoglobin concentration, ferritin, soluble transferrin receptor (sTfR), hepcidin, and 10 cytokines. Stages of ID were defined using ferritin, sTfR, and hemoglobin concentration. During the study, a registered dietician provided all runners with iron supplements using athletic department–created guidelines. Results: Fifty-seven percent of females and 35% of males exhibited stage 2 ID (ferritin <20 ng/mL or sTfR >29.5 nmol/L) at least once. Cytokines, ferritin, and sTfR exhibited changes through the 2 years, but changes in cytokines were not associated with alterations in hepcidin, ferritin, or sTfR. In males and females, lower ferritin was associated with lower hepcidin (both P < .0001). One female exhibited higher hepcidin and lower iron stores compared with other individuals, suggesting a different etiology of ID. Conclusion: ID is common in highly trained collegiate runners. In general, the high prevalence of ID in this population is not associated with alterations in basal hepcidin or cytokine levels.
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Iannone M, Alberti F, Braganò MC, de la Torre X, Molaioni F, Botrè F. Influence of synthetic isoflavones on selected urinary steroid biomarkers: Relevance to doping control. Steroids 2021; 174:108900. [PMID: 34391799 DOI: 10.1016/j.steroids.2021.108900] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 07/25/2021] [Accepted: 08/01/2021] [Indexed: 11/27/2022]
Abstract
In this work we have investigated the influence of the intake of two synthetic isoflavones, methoxyisoflavone and ipriflavone, on the urinary concentration of endogenous steroids, and on their relative ratios, of doping relevance. Specifically, the concentrations of testosterone (T), epitestosterone (E), androsterone (A), etiocholanolone (Etio), 5α-androstan-3α,17α-diol (5αAdiol), 5β-androstan-3α,17α-diol (5βAdiol), and the ratios T/E, A/T, A/Etio, 5αAdiol/5βAdiol, 5αAdiol/E, were considered, in the framework of the Steroidal Module of the Athlete Biological Passport (ABP). The above set of parameters were complemented by the urinary levels of luteinizing hormone (total LH) and the ratio between T and LH (T/total LH), to assess the possible effects on the biosynthesis of the mentioned steroids. Five healthy Caucasian male volunteers were selected for the study. Urine samples were collected before and during the administration of (i) methoxyisoflavone (Methoxyisoflavone, MyProtein) and (ii) ipriflavone (Osteofix ®, Chiesi Farmaceutici). For the analysis of the urinary steroid profile, after enzymatic hydrolysis with β-glucuronidase from Escherichia Coli (E. Coli) and liquid-liquid extraction with tert-buthylmethyl ether, all samples were analyzed by gas chromatography coupled to tandem mass spectrometry (GC-MS/MS), while for the determination of total LH all urine samples were directly analyzed by a chemiluminescent immunometric assay technique (Siemens Immulite 2000 LH). Our results show that the administration of either methoxyisoflavone or ipriflavone causes an alteration of the urinary concentrations and concentration ratios of the investigated steroids, in the range 55-80% from the baseline values. Furthermore, an oversecretion of LH after the daily intake of methoxyisoflavone or ipriflavone was also recorded in all volunteers, corresponding to an increase in the biosynthesis and excretion of T and some of its metabolites. These changes trigger a disregulation in the pattern of urinary excretion of the steroids included in the Steroidal Module of the ABP, which makes more difficult the interpretation of the longitudinal steroid profile based on the definition of individual normality ranges for each athlete. Our data are also consistent with previous evidence regarding the in vitro effects of natural and synthetic isoflavones, suggesting that their monitoring in doping control routine analysis would be very beneficial for the result management activities.
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Affiliation(s)
- Michele Iannone
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Onesti 1, 00197 Rome, Italy
| | - Francesca Alberti
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Onesti 1, 00197 Rome, Italy
| | - Maria Cristina Braganò
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Onesti 1, 00197 Rome, Italy
| | - Xavier de la Torre
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Onesti 1, 00197 Rome, Italy
| | - Francesco Molaioni
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Onesti 1, 00197 Rome, Italy
| | - Francesco Botrè
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Onesti 1, 00197 Rome, Italy; REDs - Research and Expertise in antiDoping Sciences, ISSUL - Institute of Sport Sciences, University of Lausanne, Synathlon, Quartier Centre, 1015 Lausanne, Switzerland.
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20
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De Wilde L, Van Renterghem P, Van Eenoo P. Long-term stability study and evaluation of intact steroid conjugate ratios after the administration of endogenous steroids. Drug Test Anal 2021; 14:851-863. [PMID: 33982451 DOI: 10.1002/dta.3096] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 12/26/2022]
Abstract
The most frequently detected substances prohibited by the World Anti-Doping Agency (WADA) belong to the anabolic steroids class. The most challenging compounds among this class are the endogenous anabolic steroids, which are detected by quantitative measurement of testosterone (T) and its metabolites with a so-called "steroid profiling" method. The current steroid profile is based on the concentrations and ratios of the sum of free and glucuronidated steroids. Recently, our group developed a steroid profiling method for the detection of three free steroids and 14 intact steroid conjugates, including both the glucuronic acid conjugated and sulfated fraction. The study aimed at evaluating the long-term stability of steroid conjugate concentrations and ratios, and the influence of different endogenous steroids on this extended steroid profile. A single dose of oral T undecanoate (TU), topical T gel, topical dihydrotestosterone (DHT) gel, and oral dehydroepiandrosterone (DHEA) was administered to six healthy male volunteers. One additional volunteer with a homozygote deletion of the UGT2B17 gene (del/del genotype) received a single topical dose of T gel. An intramuscular dose of TU was administered to another volunteer. To avoid fluctuation of steroid concentrations caused by variations in urinary flow rates, steroid ratios were calculated and evaluated as possible biomarkers for the detection of endogenous steroid abuse with low doses. Overall, sulfates do not have substantial additional value in prolonging detection times for the investigated endogenous steroids and administration doses. The already monitored glucuronides were overall the best markers and were sufficient to detect the administered steroids.
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Affiliation(s)
- Laurie De Wilde
- Department Diagnostic Sciences, Doping Control Laboratory (DoCoLab), Ghent University (UGent), Ghent, Belgium
| | - Pieter Van Renterghem
- Department Diagnostic Sciences, Doping Control Laboratory (DoCoLab), Ghent University (UGent), Ghent, Belgium
| | - Peter Van Eenoo
- Department Diagnostic Sciences, Doping Control Laboratory (DoCoLab), Ghent University (UGent), Ghent, Belgium
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21
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Bermon S, Garrandes F, Szabo A, Berkovics I, Adami PE. Effect of Advanced Shoe Technology on the Evolution of Road Race Times in Male and Female Elite Runners. Front Sports Act Living 2021; 3:653173. [PMID: 33969296 PMCID: PMC8100054 DOI: 10.3389/fspor.2021.653173] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 02/10/2021] [Indexed: 12/15/2022] Open
Abstract
The influence of advanced footwear technology (thickness of light midsole foam and rigid plate) on distance running performances was analyzed during an 8-year period. Analysis of variance was used to measure effects of time, gender, shoe technology, and East African origin on male and female top 20 or top 100 seasonal best times in 10-kilometer races, half-marathons, and marathons. In both genders and three distance-running events, seasonal best times significantly decreased from 2017, which coincided with the introduction of the advanced footwear technology in distance running. This performance improvement was of similar magnitude in both East African and non-East African elite runners. In female elite athletes, the magnitudes (from 1.7 to 2.3%) of the decrease in seasonal best times between 2016 and 2019 were significantly higher than in their male counterparts (from 0.6 to 1.5%). Analyses of variance confirmed that the adoption of the advanced footwear technology significantly improved the top 20 seasonal best times in female half marathons and marathons and male marathons, with the improvements being more pronounced in females and in long-distance running events. The adoption of this new shoe technology improved female marathon time by ~2 min and 10 s, which represents a significant increase in performance (1.7%).
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Affiliation(s)
- Stéphane Bermon
- Health and Science Department, World Athletics, Manoco City, Monaco.,Laboratoire Motricité Humaine Expertise Sport Santé, Université Côte d'Azur, Nice, France
| | | | | | | | - Paolo Emilio Adami
- Health and Science Department, World Athletics, Manoco City, Monaco.,Department of Movement, Human and Health Sciences, University of Rome "Foro Italico," Rome, Italy
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22
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Badrick T. Biological variation: Understanding why it is so important? Pract Lab Med 2021; 23:e00199. [PMID: 33490349 PMCID: PMC7809190 DOI: 10.1016/j.plabm.2020.e00199] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 12/23/2020] [Indexed: 12/19/2022] Open
Abstract
This Review will describe the increasing importance of the concepts of biological variation to clinical chemists. The idea of comparison to 'reference' is fundamental in measurement. For the biological measurands, that reference is the relevant patient population, a clinical decision point based on a trial or an individual patient's previous results. The idea of using biological variation to set quality goals was then realised for setting Quality Control (QC) and External Quality Assurance (EQA) limits. The current phase of BV integration into practice is using Patient-Based Real-Time Quality Control (PBRTQC) and Patient Based Quality Assurance (PBQA) to detect a change in assay performance. The challenge of personalised medicine is to determine an individual reference interval. The Athletes Biological Passport may provide the solution.
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Affiliation(s)
- Tony Badrick
- Royal College of Pathologists of Australasia Quality Assurance Programs, St Leonards Sydney, NSW, 2065, Australia
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23
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The Influence of Floorball on Hematological Parameters: Consequences in Health Assessment and Antidoping Testing. JOURNAL OF SPORTS MEDICINE 2020; 2020:6109308. [PMID: 32802889 PMCID: PMC7403938 DOI: 10.1155/2020/6109308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 07/06/2020] [Indexed: 02/04/2023]
Abstract
Assessment of hematological parameters is common in sports medicine. Although physical exercise is an important preanalytical variable, data about acute hematological changes after high-intensity intermittent exercise are scarce. This study aimed to examine floorball as a potential preanalytical variable for hematological parameters used in health assessment and antidoping testing. Twenty-three professional male floorball players participated in a floorball game. Hematological parameters including hemoglobin, erythrocyte count and erythrocyte indices, reticulocytes, white blood cells (WBC), platelets, reticulocytes, and OFF-hr score were assessed at baseline, immediately postgame, and at 2 h postgame. Median hemoglobin concentration decreased significantly from 146 g/L pregame to 141 g/L immediately postgame (p < 0.001). WBC count increased from 7.2 × 109/L pregame to 10.1 × 109/L 2 h postgame (p < 0.001). The median OFF-hr score decreased from 99.5 to 94.2 immediately postgame and remained significantly lower than baseline at 2 h postgame (94.4, p=0.030). Looking at individual results, the highest OFF-hr score increased from 120 at baseline to 124 at 2 h postgame. Our findings suggest that participation in a floorball game affects several hematological parameters and consequently can affect health assessment and antidoping testing.
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24
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25
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Coffman KE, Mitchell KM, Salgado RM, Miller GD, Kenefick RW, Cheuvront SN. Potential for dehydration to impact the athlete biological passport. Drug Test Anal 2020; 12:1206-1211. [DOI: 10.1002/dta.2811] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/16/2020] [Accepted: 04/17/2020] [Indexed: 01/06/2023]
Affiliation(s)
- Kirsten E. Coffman
- Thermal and Mountain Medicine Division U.S. Army Research Institute of Environmental Medicine Natick MA 01760 US
| | - Katherine M. Mitchell
- Thermal and Mountain Medicine Division U.S. Army Research Institute of Environmental Medicine Natick MA 01760 US
| | - Roy M. Salgado
- Thermal and Mountain Medicine Division U.S. Army Research Institute of Environmental Medicine Natick MA 01760 US
| | - Geoffrey D. Miller
- Sports Medicine Research and Testing Laboratory Salt Lake City UT 84095 US
| | - Robert W. Kenefick
- Thermal and Mountain Medicine Division U.S. Army Research Institute of Environmental Medicine Natick MA 01760 US
| | - Samuel N. Cheuvront
- Biophysics and Biomedical Modeling Division U.S. Army Research Institute of Environmental Medicine Natick MA 01760 US
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26
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Narduzzi L, Dervilly G, Marchand A, Audran M, Le Bizec B, Buisson C. Applying metabolomics to detect growth hormone administration in athletes: Proof of concept. Drug Test Anal 2020; 12:887-899. [DOI: 10.1002/dta.2798] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 03/29/2020] [Accepted: 03/29/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Luca Narduzzi
- Laboratoire d’Etude des Résidus et Contaminants dans les Aliments (LABERCA), Oniris INRAE Nantes F‐44307 France
| | - Gaud Dervilly
- Laboratoire d’Etude des Résidus et Contaminants dans les Aliments (LABERCA), Oniris INRAE Nantes F‐44307 France
| | - Alexandre Marchand
- Département des analyses Agence Française de Lutte contre le Dopage (AFLD) Châtenay‐Malabry France
| | - Michel Audran
- Département des analyses Agence Française de Lutte contre le Dopage (AFLD) Châtenay‐Malabry France
| | - Bruno Le Bizec
- Laboratoire d’Etude des Résidus et Contaminants dans les Aliments (LABERCA), Oniris INRAE Nantes F‐44307 France
| | - Corinne Buisson
- Département des analyses Agence Française de Lutte contre le Dopage (AFLD) Châtenay‐Malabry France
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27
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Narduzzi L, Dervilly G, Audran M, Le Bizec B, Buisson C. A role for metabolomics in the antidoping toolbox? Drug Test Anal 2020; 12:677-690. [DOI: 10.1002/dta.2788] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/30/2020] [Accepted: 03/05/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Luca Narduzzi
- Laboratoire d’Etude des Résidus et Contaminants dans les Aliments (LABERCA)Oniris, INRAE Nantes France
| | - Gaud Dervilly
- Laboratoire d’Etude des Résidus et Contaminants dans les Aliments (LABERCA)Oniris, INRAE Nantes France
| | - Michel Audran
- Département des analysesAgence Française de Lutte contre le Dopage (AFLD) Châtenay‐Malabry France
| | - Bruno Le Bizec
- Laboratoire d’Etude des Résidus et Contaminants dans les Aliments (LABERCA)Oniris, INRAE Nantes France
| | - Corinne Buisson
- Département des analysesAgence Française de Lutte contre le Dopage (AFLD) Châtenay‐Malabry France
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28
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SCHMIDT WALTERFJ, HOFFMEISTER TORBEN, HAUPT SANDRA, SCHWENKE DIRK, WACHSMUTH NADINEB, BYRNES WILLIAMC. Chronic Exposure to Low-Dose Carbon Monoxide Alters Hemoglobin Mass and V˙O2max. Med Sci Sports Exerc 2020; 52:1879-1887. [DOI: 10.1249/mss.0000000000002330] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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29
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Mullen J, Bækken LV, Törmäkangas T, Ekström L, Ericsson M, Hullstein IR, Schulze JJ. Inter‐individual variation of the urinary steroid profiles in Swedish and Norwegian athletes. Drug Test Anal 2020; 12:720-730. [DOI: 10.1002/dta.2778] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/05/2020] [Accepted: 02/05/2020] [Indexed: 11/07/2022]
Affiliation(s)
- Jenny Mullen
- Department of Laboratory Medicine, Division of Clinical PharmacologyKarolinska Institutet Sweden
| | | | - Timo Törmäkangas
- Health Sciences, Faculty of Sport and Health SciencesUniversity of Jyväskylä Finland
| | - Lena Ekström
- Department of Laboratory Medicine, Division of Clinical PharmacologyKarolinska Institutet Sweden
| | - Magnus Ericsson
- Department of Laboratory Medicine, Division of Clinical PharmacologyKarolinska Institutet Sweden
- French Doping Control LaboratoryAgence Française de lutte contre le dopage (AFLD) Département des Analyses France
| | | | - Jenny J. Schulze
- Department of Laboratory Medicine, Division of Clinical PharmacologyKarolinska Institutet Sweden
- The Swedish National Anti‐Doping OrganisationSwedish Sports Confederation Sweden
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30
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Faiss R, Saugy J, Zollinger A, Robinson N, Schuetz F, Saugy M, Garnier PY. Prevalence Estimate of Blood Doping in Elite Track and Field Athletes During Two Major International Events. Front Physiol 2020; 11:160. [PMID: 32161553 PMCID: PMC7052379 DOI: 10.3389/fphys.2020.00160] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 02/12/2020] [Indexed: 12/20/2022] Open
Abstract
In elite sport, the Athlete Biological Passport (ABP) was invented to tackle cheaters by monitoring closely changes in biological parameters, flagging atypical variations. The hematological module of the ABP was indeed adopted in 2011 by World Athletics (WA). This study estimates the prevalence of blood doping based on hematological parameters in a large cohort of track and field athletes measured at two international major events (2011 and 2013 WA World Championships) with a hypothesized decrease in prevalence due to the ABP introduction. A total of 3683 blood samples were collected and analyzed from all participating athletes originating from 209 countries. The estimate of doping prevalence was obtained by using a Bayesian network with seven variables, as well as "blood doping" as a variable mimicking doping with low-doses of recombinant human erythropoietin (rhEPO), to generate reference cumulative distribution functions (CDFs) for the Abnormal Blood Profile Score (ABPS) from the ABP. Our results from robust hematological parameters indicate an estimation of an overall blood doping prevalence of 18% in 2011 and 15% in 2013 (non-significant difference) in average in endurance athletes [95% Confidence Interval (CI) 14-22 and 12-19% for 2011 and 2013, respectively]. A higher prevalence was observed in female athletes (22%, CI 16-28%) than in male athletes (15%, CI 9-20%) in 2011. In conclusion, this study presents the first comparison of blood doping prevalence in elite athletes based on biological measurements from major international events that may help scientists and experts to use the ABP in a more efficient and deterrent way.
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Affiliation(s)
- Raphael Faiss
- Research and Expertise in Anti-Doping Sciences, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Jonas Saugy
- Research and Expertise in Anti-Doping Sciences, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Alix Zollinger
- Bioinformatics Core Facility, SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Neil Robinson
- Swiss Laboratory for Doping Analyses, University Centre of Legal Medicine, Lausanne and Geneva, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Frederic Schuetz
- Bioinformatics Core Facility, SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
- Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland
| | - Martial Saugy
- Research and Expertise in Anti-Doping Sciences, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
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31
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Abstract
The Athlete Biological Passport programme was initiated in 2009 by the World Anti-Doping Agency for making the anti-doping programme more effective and stronger. There are three modules in this ABP programme: haematological, steroidal and endocrinological. Currently, the first two modules have been implemented. The newer products such as recombinant human erythropoietin, recombinant proteins, and peptides are similar to those produced naturally. Hence, detection of these substances even with advanced techniques is difficult. Therefore, the concept of ABP came into existence which is based on longitudinal monitoring of biological markers and their variations over a period of time. The ABP does not rely upon the detection of a particular prohibited substance but it reflects the changes in biological markers collated over an athlete's career. Hence, athletes can be monitored through constant interpretation of the passport data. There are many advantages with the implementation of this programme; however, there are various issues which may lead to false interpretation of passport data that must be taken into consideration.
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32
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Faiss R, Saugy J, Saugy M. Fighting Doping in Elite Sports: Blood for All Tests! Front Sports Act Living 2019; 1:30. [PMID: 33344954 PMCID: PMC7739585 DOI: 10.3389/fspor.2019.00030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Accepted: 09/03/2019] [Indexed: 12/19/2022] Open
Abstract
In the fight against doping, detection of doping substances in biological matrices is paramount. Analytical possibilities have evolved and sanctioning a doping scenario by detecting forbidden bioactive compounds circulating unmodified in blood is nowadays very attractive. In addition, the World Anti-Doping Agency (WADA) introduced the Athlete Biological Passport (ABP) a decade ago as a new paradigm inferring the use of prohibited substances or methods through longitudinal profiling, or serial analyses of indirect biomarkers of doping, to be both scientifically and legally robust. After the introduction in 2008 of an hematological module (i.e., based on variations of blood variables) aiming to identify enhancement of oxygen transport and any form of blood transfusion or manipulation, a urinary steroidal module was additionally introduced in 2014 composed of concentrations and ratios of various endogenously produced steroidal hormones. Some evidence tends to discredit steroid profiles obtained from urine analyses to detect the use of endogenous androgenic anabolic steroids (EAAS), when administered exogenously, due to high rates of false negatives with short half-life and topical formulations rendering profile alteration only minimal or equivocal. On the other hand, steroid hormones quantification in blood showed a promising ability to detect testosterone doping and interesting complementarities to the ABP thanks to the most recent analytical techniques (UHPLC-HRMS or/and MS/MS). This perspective article explores the opportunities of blood samples to monitor not only hematological but also steroid profiles in elite athletes.
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Affiliation(s)
- Raphael Faiss
- REDs, Research and Expertise in Antidoping Sciences, University of Lausanne, Lausanne, Switzerland
| | - Jonas Saugy
- REDs, Research and Expertise in Antidoping Sciences, University of Lausanne, Lausanne, Switzerland
| | - Martial Saugy
- REDs, Research and Expertise in Antidoping Sciences, University of Lausanne, Lausanne, Switzerland
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33
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Saulière G, Dedecker J, Marquet LA, Rochcongar P, Toussaint JF, Berthelot G. Z-scores-based methods and their application to biological monitoring: an example in professional soccer players. Biostatistics 2019; 20:48-64. [PMID: 29149240 DOI: 10.1093/biostatistics/kxx044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 08/21/2017] [Indexed: 11/14/2022] Open
Abstract
The clinical and biological follow-up of individuals, such as the biological passport for athletes, is typically based on the individual and longitudinal monitoring of hematological or urine markers. These follow-ups aim to identify abnormal behavior by comparing the individual's biological samples to an established baseline. These comparisons may be done via different ways, but each of them requires an appropriate extra population to compute the significance levels, which is a non-trivial issue. Moreover, it is not necessarily relevant to compare the measures of a biomarker of a professional athlete to that of a reference population (even restricted to other athletes), and a reasonable alternative is to detect the abnormal values by considering only the other measurements of the same athlete. Here we propose a simple adaptive statistic based on maxima of Z-scores that does not rely on the use of an extra population. We show that, in the Gaussian framework, it is a practical and relevant method for detecting abnormal values in a series of observations from the same individual. The distribution of this statistic does not depend on the individual parameters under the null hypothesis, and its quantiles can be computed using Monte Carlo simulations. The proposed method is tested on the 3-year follow-up of ferritin, serum iron, erythrocytes, hemoglobin, and hematocrit markers in 2577 elite male soccer players. For instance, if we consider the abnormal values for the hematocrit at a 5% level, we found that 5.57% of the selected cohort had at least one abnormal value (which is not significantly different from the expected false-discovery rate). The approach is a starting point for more elaborate models that would produce a refined individual baseline. The method can be extended to the Gaussian linear model, in order to include additional variables such as the age or exposure to altitude. The method could also be applied to other domains, such as the clinical patient follow-up in monitoring abnormal values of biological markers.
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Affiliation(s)
- Guillaume Saulière
- Institut National du Sport de l'Expertise et de la Performance, Institut de Recherche bioMédicale et d'Épidémilogie du Sport (IRMES), France.,Université Paris-Sud Orsay, France and Université Paris Descartes, Paris, France
| | - Jérôme Dedecker
- Université Paris Descartes, Sorbonne Paris Cité, Laboratoire MAP5 (UMR 8145), Paris, France
| | - Laurie-Anne Marquet
- Institut National du Sport de l'Expertise et de la Performance, Institut de Recherche bioMédicale et d'Épidémilogie du Sport (IRMES), France and Université Paris Descartes, Paris, France
| | - Pierre Rochcongar
- Fédération Française de Football, Ligue de Football Professionnel (LFP) Paris, France
| | - Jean-Francois Toussaint
- Institut National du Sport de l'Expertise et de la Performance, Institut de Recherche bioMédicale et d'Épidémiologie du Sport (IRMES), France, Université Paris Descartes, Paris, France and Assistance Publique-Hôpitaux de Paris, Centre d'Investigation en Médecine du Sport, Hôtel-Dieu (CIMS), Paris, France
| | - Geoffroy Berthelot
- Institut National du Sport de l'Expertise et de la Performance, Institut de Recherche bioMédicale et d'Épidémiologie du Sport (IRMES), France, Université Paris Descartes, Paris, France and REsearch LAboratory for Interdisciplinary Studies (RELAI), Paris, France
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34
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Sutehall S, Muniz-Pardos B, Lima G, Wang G, Malinsky FR, Bosch A, Zelenkova I, Tanisawa K, Pigozzi F, Borrione P, Pitsiladis Y. Altitude Training and Recombinant Human Erythropoietin: Considerations for Doping Detection. Curr Sports Med Rep 2019; 18:97-104. [PMID: 30969231 DOI: 10.1249/jsr.0000000000000577] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The benefit of training at altitude to enhance exercise performance remains equivocal although the most widely accepted approach is one where the athletes live and perform lower-intensity running at approximately 2300 m with high-intensity training at approximately 1250 m. The idea is that this method maintains maximal augmentations in total hemoglobin mass while reducing the performance impairment of high-intensity sessions performed at moderate altitude and thus preventing any detraining that can occur when athletes live and train at moderate altitude. This training regimen, however, is not universally accepted and some argue that the performance enhancement is due to placebo and training camp effects. Altitude training may affect an athlete's hematological parameters in ways similar to those observed following blood doping. Current methods of detection appear insufficient to differentiate between altitude training and blood doping making the interpretation of an athlete's biological passport difficult. Further research is required to determine the optimal method for altitude training and to enhance current detection methods to be able to differentiate better blood doping and altitude exposure.
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Affiliation(s)
- Shaun Sutehall
- Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, SOUTH AFRICA
| | - Borja Muniz-Pardos
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, SPAIN
| | - Giscard Lima
- Collaborating Centre of Sports Medicine, University of Brighton, Eastbourne, UNITED KINGDOM.,Centre for Exercise Science and Sports Medicine, University of Rome "Foro Italico", Rome, ITALY
| | - Guan Wang
- Collaborating Centre of Sports Medicine, University of Brighton, Eastbourne, UNITED KINGDOM
| | | | - Andrew Bosch
- Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, SOUTH AFRICA
| | | | - Kumpei Tanisawa
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, JAPAN
| | - Fabio Pigozzi
- Centre for Exercise Science and Sports Medicine, University of Rome "Foro Italico", Rome, ITALY
| | - Paolo Borrione
- Centre for Exercise Science and Sports Medicine, University of Rome "Foro Italico", Rome, ITALY
| | - Yannis Pitsiladis
- Collaborating Centre of Sports Medicine, University of Brighton, Eastbourne, UNITED KINGDOM
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35
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Faiss R, Saugy M, Passfield L, Hopker J. Editorial: Performance Modeling and Anti-doping. Front Physiol 2019; 10:169. [PMID: 30881313 PMCID: PMC6405518 DOI: 10.3389/fphys.2019.00169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/12/2019] [Indexed: 11/23/2022] Open
Affiliation(s)
- Raphael Faiss
- REDs - Research & Expertise in Antidoping Sciences, University of Lausanne, Lausanne, Switzerland
| | - Martial Saugy
- REDs - Research & Expertise in Antidoping Sciences, University of Lausanne, Lausanne, Switzerland
| | - Louis Passfield
- School of Sport and Exercise Sciences, University of Kent, Chatham, United Kingdom.,Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - James Hopker
- School of Sport and Exercise Sciences, University of Kent, Chatham, United Kingdom
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36
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Christou GA, Christou MA, Žiberna L, Christou KA. Indirect clinical markers for the detection of anabolic steroid abuse beyond the conventional doping control in athletes. Eur J Sport Sci 2019; 19:1276-1286. [DOI: 10.1080/17461391.2019.1587522] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Georgios A. Christou
- Laboratory of Sports Medicine, Sports Medicine Division, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria A. Christou
- Department of Endocrinology, Medical School, University of Ioannina, Ioannina, Greece
| | - Lovro Žiberna
- Faculty of Medicine, Institute of Pharmacology and Experimental Toxicology, University of Ljubljana, Ljubljana, Slovenia
- Slovenian Anti-Doping Organization (SLOADO), Ljubljana, Slovenia
| | - Konstantinos A. Christou
- Laboratory of Sports Medicine, Sports Medicine Division, Aristotle University of Thessaloniki, Thessaloniki, Greece
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37
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Miller GD, Teramoto M, Smeal SJ, Cushman D, Eichner D. Assessing serum albumin concentration following exercise-induced fluid shifts in the context of the athlete biological passport. Drug Test Anal 2019; 11:782-791. [PMID: 30690899 DOI: 10.1002/dta.2571] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 01/18/2019] [Accepted: 01/21/2019] [Indexed: 11/09/2022]
Abstract
PURPOSE The hydration status of an athlete at the time of a doping control sample collection is an important factor to consider when reviewing athlete biological passports (ABPs). Dehydration results in a reduction of the circulating plasma volume (PV), which may lead to artificially high values of some blood parameters. This study aimed to identify whether serum albumin could serve as a single marker of fluid shifts, which are not currently accounted for in the hematological passport. An additional marker could be used to assist experts when interpreting irregularities in the ABP. METHODS Twelve subjects underwent multiple controlled exercise trials designed to induce varying levels of PV shifts. Pre-exercise blood samples were collected to establish baseline values for individual passports. During exercise interventions, blood samples were collected before the start of exercise and at 10 minute, 1 hour, 2 hours, and 24 hours following exercise. RESULTS Significant increases in hematological parameters - hemoglobin [Hb], hematocrit (HCT), albumin (ALB), and calculated OFF-score - were identified at varying time points following fluid shift-inducing exercise. Changes in ALB correlated strongly with changes in [Hb] (r = 0.753) and with estimated PV shifts (r = -0.764). In analyzing ABPs, the resulting increases in Hb did not trigger any atypical findings at 99% specificity. PERSPECTIVE Monitoring changes in ALB longitudinally may assist experts when reviewing PV shifts in the biological passport.
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Affiliation(s)
- Geoffrey D Miller
- Sports Medicine Research and Testing Laboratory, University of Utah School of Medicine, Utah, USA.,Division of Physical medicine and Rehabilitation, University of Utah School of Medicine, Utah, USA
| | - Masaru Teramoto
- Division of Physical medicine and Rehabilitation, University of Utah School of Medicine, Utah, USA
| | - Stacy J Smeal
- Sports Medicine Research and Testing Laboratory, University of Utah School of Medicine, Utah, USA
| | - Dan Cushman
- Division of Physical medicine and Rehabilitation, University of Utah School of Medicine, Utah, USA
| | - Daniel Eichner
- Sports Medicine Research and Testing Laboratory, University of Utah School of Medicine, Utah, USA.,Division of Physical medicine and Rehabilitation, University of Utah School of Medicine, Utah, USA
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38
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Buisson C, Frelat C, Privat K, Martinat N, Audran M, Collomp K. Metabolic and isotopic signature of short-term DHEA administration in women: Comparison with findings in men. Drug Test Anal 2018; 10:1744-1754. [PMID: 30315670 DOI: 10.1002/dta.2519] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/09/2018] [Accepted: 10/10/2018] [Indexed: 12/31/2022]
Abstract
The impact of dehydroepiandrosterone (DHEA) administration has been widely studied for anti-doping purposes in men, whereas only a few studies have been performed in women. In the present study, the impact of DHEA on the steroid profile parameters and their carbon isotopic ratios was explored. Eleven healthy young women and 10 healthy young men received two treatments: One with 100 mg/day of DHEA for 28 days and one with a placebo according to a double-blind crossover protocol. Urine and saliva (only in females) samples were collected before and for 72 hours after each short-term treatment. In all female subjects, concentrations of the urinary parameters of the steroid profile were highly impacted by short-term DHEA administration including epitestosterone (E). Gas chromatography-combustion-isotope ratio mass spectrometry (GC-C-IRMS) analysis was performed and positive results were observed for E in the four female subjects where E concentration was adequate for such analysis, whereas men results remained negative for E. Last, the ability of the Anti-Doping Administration and Management System (ADAMS) software used for the athlete biological passport to identify such doping was assessed. Of the 11 passports generated for female subjects, 10 were automatically classified as an atypical passport finding (ATPF). For the remaining passport with normal status in one woman, the variability of the concentrations prevented the ADAMS software from adjusting individual limits. The most impacted markers in women were T/E and 5αAdiol/E, with a detection window of 36 hours for 5αAdiol/E. In addition, good correlations were observed for DHEA and T concentrations in urine and saliva in females.
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Affiliation(s)
| | - Claire Frelat
- AFLD - Département des Analyses, Chatenay-Malabry, France
| | - Kévin Privat
- AFLD - Département des Analyses, Chatenay-Malabry, France
| | | | - Michel Audran
- AFLD - Département des Analyses, Chatenay-Malabry, France
| | - Katia Collomp
- AFLD - Département des Analyses, Chatenay-Malabry, France
- CIAMS - Université Paris Sud, Université Paris Saclay, Orsay, France
- CIAMS - Université d'Orléans, Orléans, France
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39
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Han B, Min H, Jeon M, Kang B, Son J. A rapid non‐target screening method for determining prohibited substances in human urine using liquid chromatography/high‐resolution tandem mass spectrometry. Drug Test Anal 2018; 11:382-391. [DOI: 10.1002/dta.2495] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 08/27/2018] [Accepted: 09/01/2018] [Indexed: 12/23/2022]
Affiliation(s)
- Boyoung Han
- Doping Control CenterKorea Institute of Science and Technology Seoul South Korea
| | - Hophil Min
- Doping Control CenterKorea Institute of Science and Technology Seoul South Korea
| | - Mijin Jeon
- Doping Control CenterKorea Institute of Science and Technology Seoul South Korea
| | - Byeori Kang
- Doping Control CenterKorea Institute of Science and Technology Seoul South Korea
| | - Junghyun Son
- Doping Control CenterKorea Institute of Science and Technology Seoul South Korea
- Department of Biological ChemistryKorea University of Science and Technology (UST) Daejeon Republic of Korea
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40
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41
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Hoffmeister T, Schwenke D, Wachsmuth N, Krug O, Thevis M, Byrnes WC, Schmidt WF. Erythropoietic effects of low-dose cobalt application. Drug Test Anal 2018; 11:200-207. [DOI: 10.1002/dta.2478] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 06/04/2018] [Accepted: 08/01/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Torben Hoffmeister
- Department of Sports Medicine/Sports Physiology; University of Bayreuth; Germany
| | - Dirk Schwenke
- Institute of Doping Analysis and Sports Biochemistry; University of Dresden; Germany
| | - Nadine Wachsmuth
- Department of Sports Medicine/Sports Physiology; University of Bayreuth; Germany
| | - Oliver Krug
- Institute of Biochemistry; German Sports University; Cologne Germany
| | - Mario Thevis
- Institute of Biochemistry; German Sports University; Cologne Germany
| | - William C. Byrnes
- Department of Integrative Physiology; University of Colorado; Boulder Colorado USA
| | - Walter F.J. Schmidt
- Department of Sports Medicine/Sports Physiology; University of Bayreuth; Germany
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42
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Calleja-González J, Mielgo-Ayuso J, Sampaio J, Delextrat A, Ostojic SM, Marques-Jiménez D, Arratibel I, Sánchez-Ureña B, Dupont G, Schelling X, Terrados N. Brief ideas about evidence-based recovery in team sports. J Exerc Rehabil 2018; 14:545-550. [PMID: 30276172 PMCID: PMC6165975 DOI: 10.12965/jer.1836244.122] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 06/25/2018] [Indexed: 01/08/2023] Open
Abstract
Performance in team sports is the expression of complex, dynamic, interactive, and multidimensional processes. It is now well-established that optimum recovery after practice or match is a key factor of team sport performance. During season and tournaments, improving recovery could offer an advantage for following performance. As a consequence of the professionalization of different roles in staffs, new particular roles have been developed within the team sports physician core in order to improve recovery protocols. Presently, scientific literature presents a big amount of methods used to enhance recovery based on the type of practice, time between session or competitions and equipment and/or staff accessible. These practices, usually used by teams are related to: ergonutritional, water therapy, massages techniques, stretching compression garments, sleep strategies and psychological implements. Besides, travel fatigue has been recognized by athletes and coaches as a challenging problem that could benefit from practical solutions. Nowadays, players have to play a lot of matches without enough time to recover among them, therefore the use of well-managed recovery can lead to a competitive advantage. Although the main purpose of applied sport sciences investigation is to categorize the protocols as well as providing approaches for individual recovery, the stages to recognize the most appropriate recovery plans in the field of team sports come from the analysis of the individual parameters.
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Affiliation(s)
- Julio Calleja-González
- Department of Physical Activity and Sports, University of the Basque Country, Vitoria, Spain
| | | | - Jaime Sampaio
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), CreativeLab Research Community, Vila Real, Portugal
| | - Anne Delextrat
- Sport and Health Sciences Department, Oxford Brookes University, Oxford, UK
| | | | - Diego Marques-Jiménez
- Department of Physical Activity and Sports, University of the Basque Country, Vitoria, Spain
| | - Iñaki Arratibel
- Department of Physical Activity and Sports, University of the Basque Country, Vitoria, Spain
| | - Braulio Sánchez-Ureña
- Human Movement and Quality Life School, Universidad Nacional de Costa Rica, Heredia, Costa Rica
| | - Gregory Dupont
- Université de Lille, EA 7369 - URePSSS - Unité de Recherche Pluridisciplinaires Sport Santé Société, Research Department, Lille Olympique Sporting Club (LOSC), Lille, France
| | - Xavi Schelling
- Complex Systems in Sport Research Group SGR, National Institute of Physical Education of Catalonia (INEFC), University of Lleida, Lleida, Spain
| | - Nicolás Terrados
- Department of Functional Biology, University of Oviedo, Oviedo, Spain
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43
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Puchowicz MJ, Mizelman E, Yogev A, Koehle MS, Townsend NE, Clarke DC. The Critical Power Model as a Potential Tool for Anti-doping. Front Physiol 2018; 9:643. [PMID: 29928234 PMCID: PMC5997808 DOI: 10.3389/fphys.2018.00643] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 05/11/2018] [Indexed: 11/13/2022] Open
Abstract
Existing doping detection strategies rely on direct and indirect biochemical measurement methods focused on detecting banned substances, their metabolites, or biomarkers related to their use. However, the goal of doping is to improve performance, and yet evidence from performance data is not considered by these strategies. The emergence of portable sensors for measuring exercise intensities and of player tracking technologies may enable the widespread collection of performance data. How these data should be used for doping detection is an open question. Herein, we review the basis by which performance models could be used for doping detection, followed by critically reviewing the potential of the critical power (CP) model as a prototypical performance model that could be used in this regard. Performance models are mathematical representations of performance data specific to the athlete. Some models feature parameters with physiological interpretations, changes to which may provide clues regarding the specific doping method. The CP model is a simple model of the power-duration curve and features two physiologically interpretable parameters, CP and W′. We argue that the CP model could be useful for doping detection mainly based on the predictable sensitivities of its parameters to ergogenic aids and other performance-enhancing interventions. However, our argument is counterbalanced by the existence of important limitations and unresolved questions that need to be addressed before the model is used for doping detection. We conclude by providing a simple worked example showing how it could be used and propose recommendations for its implementation.
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Affiliation(s)
- Michael J Puchowicz
- Department of Health Services, Arizona State University, Tempe, AZ, United States
| | - Eliran Mizelman
- Department of Biomedical Physiology and Kinesiology and Sports Analytics Group, Simon Fraser University, Burnaby, BC, Canada
| | - Assaf Yogev
- School of Kinesiology, The University of British Columbia, Vancouver, BC, Canada
| | - Michael S Koehle
- School of Kinesiology, The University of British Columbia, Vancouver, BC, Canada.,Division of Sport and Exercise Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Nathan E Townsend
- Athlete Health and Performance Research Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - David C Clarke
- Department of Biomedical Physiology and Kinesiology and Sports Analytics Group, Simon Fraser University, Burnaby, BC, Canada.,Canadian Sport Institute Pacific, Victoria, BC, Canada
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44
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Devriendt T, Chokoshvili D, Favaretto M, Borry P. Do athletes have a right to access data in their Athlete Biological Passport? Drug Test Anal 2018. [PMID: 29524351 DOI: 10.1002/dta.2380] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The Athlete Biological Passport (ABP) refers to the collection of data related to an individual athlete. The ABP contains the Haematological Module and the Steroidal Module, which are used for the longitudinal monitoring of variables in blood and urine, respectively. Based on changes in these variables, a statistical model detects outliers which indicate doping use and guide further targeted testing of the athlete. Presently, athletes can access their data of the Haematological Module in the Anti-Doping Administration and Management System (ADAMS). However, granting athletes access to this data has been a matter of debate within the anti-doping community. This article investigates whether an athlete has a right to access the contents of their ABP profile. We approached this discussion by comparing the nature of ABP data with that of forensic and medical data and touched on important concerns with ABP data disclosure to athletes such as potentially allowing for the development of alternative doping techniques to circumvent detection; and making athletes vulnerable to pressure by the media to publicly release their data. Furthermore, given that ABP data may contain medically relevant information that can be used to diagnose disease, athletes may over-interpret its medical significance and wrongly see it as a free health check. We argue that safeguarding the integrity of the ABP system must be seen as the most essential element and thus a departure from immediate data disclosure is necessary. Two different strategies for delayed data disclosure are proposed which diminish the chances of ABP data being misused to refine doping techniques.
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Affiliation(s)
- Thijs Devriendt
- Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, University of Leuven, Belgium
| | - Davit Chokoshvili
- Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, University of Leuven, Belgium
| | - Maddalena Favaretto
- Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, University of Leuven, Belgium
| | - Pascal Borry
- Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, University of Leuven, Belgium
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45
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Salamin O, Kuuranne T, Saugy M, Leuenberger N. Erythropoietin as a performance-enhancing drug: Its mechanistic basis, detection, and potential adverse effects. Mol Cell Endocrinol 2018; 464:75-87. [PMID: 28119134 DOI: 10.1016/j.mce.2017.01.033] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 01/20/2017] [Accepted: 01/20/2017] [Indexed: 02/01/2023]
Abstract
Erythropoietin (EPO) is the main hormone regulating red blood cell (RBC) production. The large-scale production of a recombinant human erythropoietin (rHuEPO) by biotechnological methods has made possible its widespread therapeutic use as well as its misuse in sports. Since the marketing of the first epoetin in 1989, the development has progressed to the third-generation analogs. However, the production of rHuEPO is costly, and the frequent administration of an injectable formula is not optimal for compliance of therapeutic patients. Hence, pharmaceutical industries are currently developing alternative approaches to stimulate erythropoiesis, which might offer new candidates for doping purposes. The hypoxia inducible factors (HIF) pathway is of particular interest. The introduction of new erythropoiesis-stimulating agents (ESAs) for clinical use requires subsequent development of anti-doping methods for detecting the abuse of these substances. The detection of ESAs is based on two different approaches, namely, the direct detection of exogenous substances and the indirect detection, for which the effects of the substances on specific biomarkers are monitored. Omics technologies, such as ironomics or transcriptomics, are useful for the development of new promising biomarkers for the detection of ESAs. Finally, the illicit use of ESAs associates with multiple health risks that can be irreversible, and an essential facet of anti-doping work is to educate athletes of these risks. The aim of this review is to provide an overview of the evolution of ESAs, the research and implementation of the available detection methods, and the side effects associated with the misuse of ESAs.
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Affiliation(s)
- Olivier Salamin
- Center for Research and Expertise in Anti-Doping Sciences - REDs, University of Lausanne, Switzerland
| | - Tiia Kuuranne
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland
| | - Martial Saugy
- Center for Research and Expertise in Anti-Doping Sciences - REDs, University of Lausanne, Switzerland
| | - Nicolas Leuenberger
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland.
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46
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Anneleen D, Anita VL, Lynn V. Mass Spectrometry for the Detection of Endogenous Steroids and Steroid Abuse in (Race) Horses and Human Athletes. Mass Spectrom (Tokyo) 2017. [DOI: 10.5772/intechopen.68593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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47
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Cawley AT, Keledjian J. Intelligence-based anti-doping from an equine biological passport. Drug Test Anal 2017; 9:1441-1447. [DOI: 10.1002/dta.2180] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 01/30/2017] [Accepted: 02/26/2017] [Indexed: 12/23/2022]
Affiliation(s)
- Adam T. Cawley
- Australian Racing Forensic Laboratory; Racing NSW; Sydney New South Wales Australia
| | - John Keledjian
- Australian Racing Forensic Laboratory; Racing NSW; Sydney New South Wales Australia
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48
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Clark B, Woolford SM, Eastwood A, Sharpe K, Barnes PG, Gore CJ. Temporal changes in physiology and haematology in response to high- and micro-doses of recombinant human erythropoietin. Drug Test Anal 2017; 9:1561-1571. [DOI: 10.1002/dta.2176] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 02/14/2017] [Accepted: 02/16/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Brad Clark
- University of Canberra Research Institute for Sport and Exercise, University of Canberra; University Drive North Bruce 2617 ACT Australia
| | - Sarah M. Woolford
- South Australian Sports Institute; Valetta Road Kidman Park 5025 SA Australia
| | - Annette Eastwood
- Department of Physiology; Australian Institute of Sport; Leverrier Crescent Bruce 2617 ACT Australia
- Bond Institute of Health and Sport; Bond University; Laver Drive Robina 4226 Queensland Australia
| | - Ken Sharpe
- Statistical Consulting Centre, School of Mathematics and Statistics; The University of Melbourne; Peter Hall Building Parkville 3010 Victoria Australia
| | - Peter G. Barnes
- South Australian Sports Institute; Valetta Road Kidman Park 5025 SA Australia
| | - Christopher J. Gore
- Department of Physiology; Australian Institute of Sport; Leverrier Crescent Bruce 2617 ACT Australia
- School of Education, Bedford Park Campus; Flinders University; Bedford Park 5042 SA Australia
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49
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Aguilar M, Muñoz-Guerra J, Plata MDM, Del Coso J. Thirteen years of the fight against doping in figures. Drug Test Anal 2017; 9:866-869. [DOI: 10.1002/dta.2168] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 01/16/2017] [Accepted: 01/17/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Millán Aguilar
- Exercise Physiology Laboratory; Camilo José Cela University; Madrid Spain
| | - Jesús Muñoz-Guerra
- Department for Doping Control; Spanish Agency for Health Protection in Sport; Madrid Spain
| | - María del Mar Plata
- Department of Education; Spanish Agency for Health Protection in Sport; Madrid Spain
| | - Juan Del Coso
- Exercise Physiology Laboratory; Camilo José Cela University; Madrid Spain
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50
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Palermo A, Botrè F, de la Torre X, Zamboni N. Non-targeted LC-MS based metabolomics analysis of the urinary steroidal profile. Anal Chim Acta 2017; 964:112-122. [PMID: 28351627 DOI: 10.1016/j.aca.2017.01.055] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 01/23/2017] [Accepted: 01/24/2017] [Indexed: 01/28/2023]
Abstract
The urinary steroidal fraction has been extensively explored as non-invasive alternative to monitor pathological conditions as well as to unveil the illicit intake of pseudo-endogenous anabolic steroids in sport. However, the majority of previous approaches involved the a priori selection of potentially relevant target analytes. Here we describe the non-targeted analysis of the urinary steroidal profiles. The workflow includes minimal sample pretreatment and normalization according to the specific gravity of urine, a 20 min reverse phase ultra-performance liquid chromatographic separation hyphenated to electrospray time-of-flight mass spectrometry. As initial validation, we analyzed a set of quality control urines spiked with glucurono- and sulfo-conjugated steroids at physiological ranges. We then applied the method for the analysis of samples collected after single transdermal administration of testosterone in hypogonadal men. The method allowed profiling of approximately three thousand metabolic features, including steroids of clinical and forensic relevance. It successfully identified metabolic pathways mostly responsible for groups clustering even in the context of high inter-individual variability and allowed the detection of currently unknown metabolic features correlating with testosterone administration. These outcomes set the stage for future studies aimed at implementing currently monitored urinary steroidal markers both in clinical and forensic analysis.
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Affiliation(s)
- Amelia Palermo
- Institute of Molecular Systems Biology, ETH Zurich, Switzerland; Department of Chemistry and Pharmaceutical Technologies, Sapienza University of Rome, Italy; Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Italy
| | - Francesco Botrè
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Italy; Department of Experimental Medicine, Sapienza University of Rome, Italy
| | | | - Nicola Zamboni
- Institute of Molecular Systems Biology, ETH Zurich, Switzerland.
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