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Walpurgis K, Thomas A, Sato M, Okano M, Geyer H, Thevis M. Detection of the GH analog somatrogon in sports drug testing: Immunological approaches and LC-HRMS/MS. Drug Test Anal 2024. [PMID: 38992930 DOI: 10.1002/dta.3766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 06/18/2024] [Accepted: 06/25/2024] [Indexed: 07/13/2024]
Abstract
Due to the presumed lipolytic and anabolic properties, the misuse of human growth hormone (hGH) and its synthetic analogs in sports is prohibited both in- and out-of-competition. Within this research project, the detectability of somatrogon, a recombinant fusion glycoprotein of 22 kDa hGH and the C-terminal peptide (CTP) of the human chorionic gonadotropin (hCG) β-subunit, with current WADA-approved doping control assays for hGH and hCG was investigated. For that purpose, cross-reactivity tests and a somatrogon administration study were conducted, and only "Kit 2" of the GH isoform differential immunoassays proved applicable to the detection of somatrogon administration in serum. In urine, the immunoassay specific for total hCG yielded presumptively positive findings for several post-administration samples, which can probably be attributed to the presence of an immunoreactive fragment of the hCG β-subunit. As the detectability of somatrogon with these approaches was found to be limited, a highly specific detection assay (LOD: 10 ng/mL) for the drug in serum samples was developed by using affinity purification with GH receptor (GHR)-conjugated magnetic beads, proteolytic digestion, and liquid chromatography high-resolution tandem mass spectrometry (LC-HRMS/MS). Following optimization, the approach was comprehensively characterized, and authentic post-administration serum samples were successfully analyzed as proof-of-concept, indicating a detection window of at least 96 h. Consequently, the presented method can be employed to confirm the presence of somatrogon in serum samples, where only "Kit 2" of the currently used immunoassay kits yielded an abnormally high Rec/Pit ratio.
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Affiliation(s)
- Katja Walpurgis
- Institute of Biochemistry/Center for Preventive Doping Research, German Sport University Cologne, Cologne, Germany
| | - Andreas Thomas
- Institute of Biochemistry/Center for Preventive Doping Research, German Sport University Cologne, Cologne, Germany
| | - Mitsuhiko Sato
- Anti-Doping Laboratory, LSI Medience Corporation, Tokyo, Japan
| | - Masato Okano
- Anti-Doping Laboratory, LSI Medience Corporation, Tokyo, Japan
| | - Hans Geyer
- Institute of Biochemistry/Center for Preventive Doping Research, German Sport University Cologne, Cologne, Germany
| | - Mario Thevis
- Institute of Biochemistry/Center for Preventive Doping Research, German Sport University Cologne, Cologne, Germany
- European Monitoring Center for Emerging Doping Agents (EuMoCEDA), Cologne/Bonn, Germany
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Thomas A, Thevis M. Recent advances in mass spectrometry for the detection of doping. Expert Rev Proteomics 2024; 21:27-39. [PMID: 38214680 DOI: 10.1080/14789450.2024.2305432] [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: 11/09/2023] [Accepted: 01/08/2024] [Indexed: 01/13/2024]
Abstract
INTRODUCTION The analysis of doping control samples is preferably performed by mass spectrometry, because obtained results meet the highest analytical standards and ensure an impressive degree of reliability. The advancement in mass spectrometry and all its associated technologies thus allow for continuous improvements in doping control analysis. AREAS COVERED Modern mass spectrometric systems have reached a status of increased sensitivity, robustness, and specificity within the last decade. The improved sensitivity in particular has, on the other hand, also led to the detection of drug residues that were attributable to scenarios where the prohibited substances were not administered consciously but rather by the unconscious ingestion of or exposure to contaminated products. These scenarios and their doubtless clarification represent a great challenge. Here, too, modern MS systems and their applications can provide good insights in the interpretation of dose-related metabolism of prohibited substances. In addition to the development of new instruments itself, software-assisted analysis of the sometimes highly complex data is playing an increasingly important role and facilitating the work of doping control laboratories. EXPERT OPINION The sensitive analysis and evaluation of a higher number of samples in a shorter time is made possible by the ongoing developments in mass spectrometry.
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Affiliation(s)
- Andreas Thomas
- Institute of Biochemistry/Center for Preventive Doping Research, German Sport University Cologne, Cologne, Germany
| | - Mario Thevis
- Institute of Biochemistry/Center for Preventive Doping Research, German Sport University Cologne, Cologne, Germany
- European Monitoring Center for Emerging Doping Agents (EuMoCEDA), Cologne/Bonn, Germany
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Krombholz S, Thomas A, Delahaut P, Bidlingmaier M, Schilbach K, Miller G, Thevis M. A combined top-down and bottom-up LC-HRMS/MS method for the quantification of human growth hormone in plasma and serum. Growth Horm IGF Res 2023; 72-73:101560. [PMID: 37995539 DOI: 10.1016/j.ghir.2023.101560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/03/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVE The precise and accurate quantification of human growth hormone (GH) in plasma/ serum is crucial for the diagnosis and treatment of diseases like GH deficiency or acromegaly. However, the ligand-binding assays (LBAs) currently used for routine testing show considerable methodological variability. Here, we present a complementary, combined top-down and bottom-up LC-MS-based method to quantify (intact) GH in plasma and serum, which concurrently provides a basis for a MS-based analysis of GH in doping controls. DESIGN Extraction of GH from plasma/ serum was accomplished by protein precipitation, followed by an immunocapture step using protein A-coupled magnetic beads and a polyclonal anti-GH antibody. The intact protein was subsequently analyzed top-down on a 2D-LC-HRMS/MS system. In addition, sample extracts were digested with trypsin and analyzed for signal peptides corresponding to 'total', 22 kDa and 20 kDa GH (bottom-up). Both assays were validated according to current guidelines and compared to the GH isoform differential immunoassay used in routine doping control analysis. GH concentrations in serum samples of healthy adults, patients with acromegaly, and in samples obtained after administration of recombinant GH were analyzed as proof-of-principle. RESULTS The intact monomeric 22 kDa isoform of GH was selectively quantified in a representative working range of 0.5 to 10 ng/ml by top-down LC-HRMS/MS. Subsequent bottom-up analysis provided additional data on 'total' and 20 kDa GH. Top-down and bottom-up assay results for the 22 kDa isoform correlated well with the corresponding immunoassay results (R2 > 0.95). For a possible application of the method in an anti-doping context, the ratio between 22 kDa and 'total' GH was evaluated, indicating differences between the various donor groups, but only with limited significance. CONCLUSION The top-down and bottom-up LC-HRMS/MS method developed here presents a valuable tool for the quantification of GH in plasma/ serum complementary to established LBAs used at present in clinical measurements. Albeit the examination of the GH isoform proportions by the LC-MS method does not yet allow for the assessment of GH abuse, the obtained findings provide an important basis to enable LC-MS-based GH analysis of doping control samples in the future.
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Affiliation(s)
- Sophia Krombholz
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Germany
| | - Andreas Thomas
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Germany
| | | | - Martin Bidlingmaier
- Endocrine Research Laboratories, Department of Medicine IV, LMU University Hospital, Munich, Germany
| | - Katharina Schilbach
- Endocrine Research Laboratories, Department of Medicine IV, LMU University Hospital, Munich, Germany
| | - Geoffrey Miller
- Sports Medicine Research and Testing Laboratory, Salt Lake City, UT, USA
| | - Mario Thevis
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Germany; European Monitoring Center for Emerging Doping Agents (EuMoCEDA), Cologne, Bonn, Germany.
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Thevis M, Walpurgis K, Thomas A. DropWise: current role and future perspectives of dried blood spots (DBS), blood microsampling, and their analysis in sports drug testing. Crit Rev Clin Lab Sci 2023; 60:41-62. [PMID: 35938300 DOI: 10.1080/10408363.2022.2103085] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
For decades, blood testing has been an integral part of routine doping controls. The breadth of information contained in blood samples has become considerably more accessible for anti-doping purposes over the last 10 years through technological advancements regarding analytical instrumentation as well as enhanced sample collection systems. Particularly, microsampling of whole blood and serum, for instance as dried blood spots (DBS), has opened new avenues in sports drug testing and substantially increased the availability and cost-effectiveness of doping control specimens. Thus, microvolume blood specimens possess the potential to improve monitoring of blood hormone and drug levels, support evaluation of circulating drug concentrations in competition, and enhance the stability of labile markers and target analytes in blood passport analyses as well as peptide hormone and steroid ester detection. Further, the availability of the fraction of lysed erythrocytes for anti-doping purposes warrants additional investigation, considering the sequestering capability of red blood cells (RBCs) for certain substances, as a complementary approach in support of the clean sport.
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Affiliation(s)
- M Thevis
- Institute of Biochemistry/Center for Preventive Doping Research, German Sport University Cologne, Cologne, Germany.,European Monitoring Center for Emerging Doping Agents (EuMoCEDA), Bonn, Germany
| | - Katja Walpurgis
- Institute of Biochemistry/Center for Preventive Doping Research, German Sport University Cologne, Cologne, Germany
| | - A Thomas
- Institute of Biochemistry/Center for Preventive Doping Research, German Sport University Cologne, Cologne, Germany
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Wettersten N, Mital R, Cushman M, Howard G, Judd SE, Howard VJ, Safford MM, Hartmann O, Bergmann A, Struck J, Maisel A. Growth hormone concentration and risk of all-cause and cardiovascular mortality: The REasons for Geographic And Racial Disparities in Stroke (REGARDS) study. Atherosclerosis 2022; 359:20-26. [PMID: 36155327 DOI: 10.1016/j.atherosclerosis.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 08/23/2022] [Accepted: 09/09/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS Identifying individuals at elevated risk for mortality, especially from cardiovascular disease, may help guide testing and treatment. Risk factors for mortality differ by sex and race. We investigated the association of growth hormone (GH) with all-cause and cardiovascular mortality in a racially diverse cohort in the United States. METHODS Among an age, sex and race stratified subgroup of 1046 Black and White participants from the REasons for Geographic And Racial Disparities in Stroke (REGARDS) study, 881 had GH available; values were log2 transformed. Associations with all-cause and cardiovascular mortality were assessed in the whole subgroup, and by sex and race, using multivariable Cox-proportional hazard models and C-index. RESULTS The mean age was 67.4 years, 51.1% were women, and 50.2% were Black participants. The median GH was 280 (interquartile range 79-838) ng/L. There were 237 deaths and 74 cardiovascular deaths over a mean of 8.0 years. In multivariable Cox analysis, GH was associated with higher risk of all-cause mortality per doubling (hazard ratio [HR] 1.17, 95% confidence interval [CI] 1.09-1.25) and cardiovascular mortality (HR 1.21, 95% CI 1.06-1.37). The association did not differ by sex or race (interaction p > 0.05). The addition of GH to a model of clinical variables significantly improved the C-index compared to clinical model alone for all-cause and cardiovascular death. CONCLUSIONS Higher fasting GH was associated with higher risk of all-cause and cardiovascular mortality and improved risk prediction, regardless of sex or race.
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Affiliation(s)
- Nicholas Wettersten
- Division of Cardiovascular Medicine, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Division of Cardiovascular Medicine, University of California, San Diego, La Jolla, CA, USA.
| | - Rohit Mital
- Department of Cardiovascular Diseases, Mayo Clinic, Scottsdale, AZ, USA
| | - Mary Cushman
- Departments of Medicine and Pathology & Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - George Howard
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Suzanne E Judd
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Monika M Safford
- Division of General Internal Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Oliver Hartmann
- SphingoTec GmbH, Neuendorfstr. 15 A, 16761 Hennigsdorf, Germany
| | | | - Joachim Struck
- SphingoTec GmbH, Neuendorfstr. 15 A, 16761 Hennigsdorf, Germany
| | - Alan Maisel
- Division of Cardiovascular Medicine, University of California, San Diego, La Jolla, CA, USA
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Cawley A, Keen B, Tou K, Elbourne M, Keledjian J. Biomarker ratios. Drug Test Anal 2022; 14:983-990. [PMID: 35293161 DOI: 10.1002/dta.3250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/06/2022] [Accepted: 03/06/2022] [Indexed: 12/21/2022]
Affiliation(s)
- Adam Cawley
- Australian Racing Forensic Laboratory, Racing NSW, Sydney, NSW, Australia
| | - Bethany Keen
- Centre for Forensic Science, University of Technology Sydney, Broadway, NSW, Australia
| | - Kathy Tou
- Centre for Forensic Science, University of Technology Sydney, Broadway, NSW, Australia
| | - Madysen Elbourne
- Centre for Forensic Science, University of Technology Sydney, Broadway, NSW, Australia
| | - John Keledjian
- Australian Racing Forensic Laboratory, Racing NSW, Sydney, NSW, Australia
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Miller GD, Husk J, Crouch AK, Eichner D. Growth hormone isoform testing in capillary dried blood spots: results from single and multiple dose administration studies and large‐scale field collections. Drug Test Anal 2022; 14:1255-1263. [DOI: 10.1002/dta.3248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 11/06/2022]
Affiliation(s)
| | - Jacob Husk
- Sports Medicine Research and Testing Laboratory Salt Lake City UT USA
| | - Andre K. Crouch
- Sports Medicine Research and Testing Laboratory Salt Lake City UT USA
| | - Daniel Eichner
- Sports Medicine Research and Testing Laboratory Salt Lake City UT USA
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Investigations into the In Vitro Metabolism of hGH and IGF-I Employing Stable-Isotope-Labelled Drugs and Monitoring Diagnostic Immonium Ions by High-Resolution/High-Accuracy Mass Spectrometry. Metabolites 2022; 12:metabo12020146. [PMID: 35208220 PMCID: PMC8877552 DOI: 10.3390/metabo12020146] [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: 01/12/2022] [Revised: 01/28/2022] [Accepted: 01/30/2022] [Indexed: 12/04/2022] Open
Abstract
Studying the metabolism of prohibited substances is an essential element in anti-doping research in order to facilitate and improve detectability. Whilst pharmacokinetic studies on healthy volunteers are valuable, they are often difficult, not least due to safety reasons and ethical constraints, especially concerning peptidic substances, which must be administered parenterally. Hence, there is a growing need for suitable in vitro models and sophisticated analytical strategies to investigate the metabolism of protein- and peptide-derived drugs. These include human growth hormone (hGH) and its main mediator insulin-like growth factor-I (IGF-I), both prohibited in professional sports for their anabolic and lipolytic effects, while challenging in their detection, as they occur naturally in the human body.Within this study, the in vitro metabolism of hGH and IGF-I was investigated using a stable-isotope-labelled reporter ion screening strategy (IRIS). A combination of liquid chromatography, high-resolution mass spectrometry, and characteristic immonium ions generated by internal dissociation of the stable-isotope-labelled peptidic metabolites enabled the detection of specific fragments. Several degradation products for hGH and IGF-I were identified within this study. These metabolites, potentially even indicative for subcutaneous administration of the drugs, could serve as promising targets for the detection of hGH and IGF-I misuse in future anti-doping applications.
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Interest of HRMS systems in analytical toxicology: Focus on doping products. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2022. [DOI: 10.1016/j.toxac.2021.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Esefeld M, Pastor A, de la Torre R, Barroso O, Aikin R, Sarwath H, Engelke R, Schmidt F, Suhre K. The Proteomic Signature of Recombinant Growth Hormone in Recreational Athletes. J Endocr Soc 2021; 5:bvab156. [PMID: 34765854 PMCID: PMC8577606 DOI: 10.1210/jendso/bvab156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Administration of human growth hormone (hGH) is prohibited in competitive sport and its detection in an athlete's sample triggers an adverse analytical finding. However, the biological processes that are modulated by recombinant hGH are not well characterized and associated blood serum proteins may constitute new biomarkers for hGH misuse. METHODS Thirty-five recreational athletes were enrolled in a study to investigate the time- and dose-dependent response of serum protein levels to recombinant hGH administration. Participants were randomly assigned to 4 groups, receiving 1 of 3 different doses of recombinant hGH or a placebo. Bio samples were collected at 22 time points over a period of 13 weeks, starting 4 weeks before treatment, during 3 weeks of treatment, and at 6 weeks' follow-up. A total of 749 serum samples were analyzed for 1305 protein markers using the SOMAscan proteomics platform. RESULTS We identified 66 proteins that significantly associated with recombinant hGH administration and dosage, including well known hGH targets, such as IGF1, but also previously unknown hGH-related proteins (eg, protease inhibitors, WFIKKN1, and chemokines, CCL2). Network analysis revealed changes in specific biological pathways, mainly related to the immune system and glucose metabolism. CONCLUSION Our analysis suggests that hGH administration affects biological processes more strongly than previously acknowledged. Some of the proteins were dysregulated even after hGH treatment and could potentially be developed into biomarkers for hGH misuse. Moreover, our findings suggest new roles for hGH-associated proteins in the etiology of hGH-related diseases and may indicate new risks that may be associated with hGH misuse.
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Affiliation(s)
- Max Esefeld
- Proteomics Core, Weill Cornell Medicine–Qatar, Qatar Foundation–Education City, Doha, Qatar
- Department of Transfusion Medicine, Institute for Immunology and Transfusion Medicine, University Medicine Greifswald, 17487 Greifswald, Germany
| | - Antoni Pastor
- Integrative Pharmacology and Systems Neuroscience Research Group. Hospital del Mar Medical Research Institute (IMIM), 08009 Barcelona, Spain
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBEROBN), 28029 Madrid, Spain
- University Pompeu Fabra (CEXS-UPF)
| | - Rafael de la Torre
- Integrative Pharmacology and Systems Neuroscience Research Group. Hospital del Mar Medical Research Institute (IMIM), 08009 Barcelona, Spain
- Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBEROBN), 28029 Madrid, Spain
- University Pompeu Fabra (CEXS-UPF)
| | - Osquel Barroso
- World Anti-Doping Agency, Montreal, Quebec H4Z 1B7, Canada
| | - Reid Aikin
- World Anti-Doping Agency, Montreal, Quebec H4Z 1B7, Canada
| | - Hina Sarwath
- Proteomics Core, Weill Cornell Medicine–Qatar, Qatar Foundation–Education City, Doha, Qatar
| | - Rudolf Engelke
- Proteomics Core, Weill Cornell Medicine–Qatar, Qatar Foundation–Education City, Doha, Qatar
| | - Frank Schmidt
- Proteomics Core, Weill Cornell Medicine–Qatar, Qatar Foundation–Education City, Doha, Qatar
| | - Karsten Suhre
- Bioinformatics Core, Weill Cornell Medicine-Qatar, Qatar Foundation–Education City, Doha, Qatar
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Marchand A, Roy D, Monsheimer SA, Lewis J, Ericsson M. Development of a microplate duplex immunoassay to simplify detection of growth hormone doping: Proof of concept. Drug Test Anal 2021; 14:724-732. [PMID: 34761559 DOI: 10.1002/dta.3197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 11/11/2022]
Abstract
The World Anti-Doping Agency (WADA) prohibits athletes from using recombinant growth hormone (GH). The validated method used in antidoping laboratories for the direct detection of exogenous GH in serum requires two immunoluminometric assays (ILMAs): The first mainly measures the concentration of the full-length (22 kDa) form of GH (recGH), and the second measures concentrations of multiple GH fragments produced by the pituitary gland (22 kDa, 20 kDa and other forms) (pitGH). The tube-by-tube analysis is laborious. A recent development opened new possibilities to simplify the detection of recGH in serum: multiplexed immunoassays that detect multiple targets in a single well of a 96-well plate using an ELISA-like procedure with high sensitivity. Our aim was to evaluate this technology by developing a customized assay for GH detection. One pair of antibodies with specificities similar to those of the recGH assay and one pair of antibodies compatible with pitGH detection were selected for a single duplex assay. Forty-eight serum samples (negative athlete samples and positive samples following GH administration) were analyzed using the two methods. The microplate duplex assay discriminated between the negative athlete samples and the positive controls, although the rec/pit ratios from the duplex assay were lower than those obtained with the ILMAs. This new assay would offer a modern alternative to ILMAs, with fewer analytical steps and a smaller sample volume. However, an adaptation of the decision limits seems mandatory.
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Affiliation(s)
- Alexandre Marchand
- Département des Analyses, Agence Française de Lutte contre le Dopage (AFLD), Châtenay-Malabry, France
| | - Daisy Roy
- Meso Scale Diagnostics LLC, Rockville, Maryland, USA
| | | | | | - Magnus Ericsson
- Département des Analyses, Agence Française de Lutte contre le Dopage (AFLD), Châtenay-Malabry, France
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Circulating levels of growth hormone in postural orthostatic tachycardia syndrome. Sci Rep 2021; 11:8575. [PMID: 33883597 PMCID: PMC8060383 DOI: 10.1038/s41598-021-87983-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 04/06/2021] [Indexed: 12/22/2022] Open
Abstract
Postural orthostatic tachycardia syndrome (POTS) is a cardiovascular autonomic disorder with poorly understood etiology and underlying pathophysiology. Since cardiovascular morbidity has been linked to growth hormone (GH), we studied GH levels in patients with POTS. We conducted an age-sex-matched case-control study in patients with POTS (age 31 ± 9 years; n = 42) and healthy controls (32 ± 9 years; n = 46). Plasma GH levels were measured using high-sensitivity chemiluminescence sandwich immunoassay. The burden of orthostatic intolerance symptoms was assessed by the Orthostatic Hypotension Questionnaire (OHQ), consisting of a symptom assessment scale (OHSA) and a daily activity scale (OHDAS). POTS patients had significantly higher composite OHQ score than controls, more symptoms and less activity. Supine heart rate and diastolic blood pressure (BP), but not systolic BP, were significantly higher in POTS. Median plasma GH levels were significantly lower in POTS (0.53 ng/mL) than controls (2.33 ng/mL, p = 0.04). GH levels were inversely related to OHDAS in POTS and supine systolic BP in POTS and controls, but not heart rate neither group. POTS is associated with lower GH levels. Impairment of daily life activities is inversely related with GH in POTS. A higher supine diastolic BP is inversely associated with GH levels in POTS and healthy individuals.
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A high-throughput assay for the quantification of intact Insulin-like Growth Factor I in human serum using online SPE-LC-HRMS. Clin Chim Acta 2020; 510:391-399. [DOI: 10.1016/j.cca.2020.07.054] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/27/2020] [Accepted: 07/27/2020] [Indexed: 02/04/2023]
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14
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Use of capillary dried blood for quantification of intact IGF-I by LC–HRMS for antidoping analysis. Bioanalysis 2020; 12:737-752. [DOI: 10.4155/bio-2020-0013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: IGF-I is used as a biomarker to detect Growth Hormone doping in athletes’ blood samples. Objective: Our aim was to develop and validate a fast, high-throughput and accurate quantification of intact IGF-I from volumetric absorptive microsampling (VAMS) dried blood using LC coupled to high resolution mass spectrometry (LC–HRMS). Methodology & results: IGF-I was extracted from the VAMS, released from its binding proteins, concentrated using microelution SPE and analyzed by LC–HRMS. The method was successfully validated in accordance with the World Anti-Doping Agency's requirements. Subsequently, IGF-I measurements from capillary dried blood and serum were compared. Conclusion: The combination of VAMS, microelution SPE and LC–HRMS is a promising strategy applicable to IGF-I quantification in athletes’ samples.
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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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Sieckmann T, Elmongy H, Ericsson M, Bhuiyan H, Lehtihet M, Ekström L. Longitudinal studies of putative growth hormone (GH) biomarkers and hematological and steroidal parameters in relation to 2 weeks administration of human recombinant GH. Drug Test Anal 2020; 12:711-719. [DOI: 10.1002/dta.2787] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Tobias Sieckmann
- Department of Laboratory Medicine, Division of Clinical PharmacologyKarolinska Institutet Stockholm Sweden
| | - Hatem Elmongy
- Department of Environmental Science and Analytical ChemistryStockholm University Stockholm Sweden
| | - Magnus Ericsson
- Department of Laboratory Medicine, Division of Clinical PharmacologyKarolinska Institutet Stockholm Sweden
- Doping Control Laboratory, Department of Clinical PharmacologyKarolinska University Hospital, Stockholm, Sweden
| | - Hasanuzzaman Bhuiyan
- Department of Environmental Science and Analytical ChemistryStockholm University Stockholm Sweden
| | - Mikael Lehtihet
- Department of MedicineKarolinska Institutet Stockholm Sweden
| | - Lena Ekström
- Department of Laboratory Medicine, Division of Clinical PharmacologyKarolinska Institutet Stockholm Sweden
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17
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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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18
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Marchand A, Martin J, Collot D, Hoang O, Roulland I, Semence F, Sottas P, Audran M, Varlet‐Marie E. Combined administration of microdoses of growth hormone and erythropoietin: Effects on performance and evaluation of GH detection capability using anti‐doping methods. Drug Test Anal 2019; 11:1698-1713. [DOI: 10.1002/dta.2674] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/01/2019] [Accepted: 07/04/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Alexandre Marchand
- Analyses Department ‐ Agence Française de Lutte contre le Dopage (AFLD) Châtenay‐Malabry France
| | - Jean‐Antoine Martin
- Analyses Department ‐ Agence Française de Lutte contre le Dopage (AFLD) Châtenay‐Malabry France
| | - David Collot
- Analyses Department ‐ Agence Française de Lutte contre le Dopage (AFLD) Châtenay‐Malabry France
| | - Olivier Hoang
- Analyses Department ‐ Agence Française de Lutte contre le Dopage (AFLD) Châtenay‐Malabry France
| | - Ingrid Roulland
- Analyses Department ‐ Agence Française de Lutte contre le Dopage (AFLD) Châtenay‐Malabry France
| | - Florian Semence
- Analyses Department ‐ Agence Française de Lutte contre le Dopage (AFLD) Châtenay‐Malabry France
| | | | - Michel Audran
- Analyses Department ‐ Agence Française de Lutte contre le Dopage (AFLD) Châtenay‐Malabry France
- Laboratoire de Biophysique et Bio‐Analyses, Institut des BiomoléculesMax Mousseron (IBMM), UMR 5247,CNRS‐ENSCM‐Université Montpellier France
| | - Emmanuelle Varlet‐Marie
- Laboratoire de Biophysique et Bio‐Analyses, Institut des BiomoléculesMax Mousseron (IBMM), UMR 5247,CNRS‐ENSCM‐Université Montpellier France
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19
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Holt RIG, Ho KKY. The Use and Abuse of Growth Hormone in Sports. Endocr Rev 2019; 40:1163-1185. [PMID: 31180479 DOI: 10.1210/er.2018-00265] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 02/27/2019] [Indexed: 12/18/2022]
Abstract
GH is banned by the World Anti-Doping Agency as a performance-enhancing anabolic agent. Doping with GH likely began in the early 1980s and became more prevalent with the advent of recombinant technology well before any scientific evidence of benefit. The expectation that GH improves physical function stems from its anabolic and lipolytic properties. Athletic performance depends on muscle strength and the energy required to power muscle function. In recreational athletes, GH selectively improves anaerobic sprint capacity but has not been proven to significantly enhance muscle strength, power, or maximum rate of oxygen consumption. GH is secreted as a family of isoform peptides in a pulsatile manner reflecting intermittent secretion and rapid clearance. Its anabolic actions are largely mediated by IGF-I, which stimulates whole-body protein synthesis, including skeletal muscle and collagen proteins. Two methods have been validated for detecting GH abuse in athletes. The first (the isoform method) is based on distinguishing pure recombinant 22-kDa GH from the heterogeneous isoforms secreted from the pituitary. The second (the marker method) is based on measuring blood levels of GH-responsive proteins, specifically IGF-I and the N-terminal propeptide of type III collagen (P-III-NP). Only a handful of athletes have been caught since the implementation of GH doping tests in 2004. The low rate likely reflects the limitation of in-competition testing using current methods. Improved detection rates may be achieved by more out-of-competition testing, introducing athletes' biological passports, and the development of novel methods. Governance, operational, technical, and political factors influence the effectiveness of an anti-doping program.
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Affiliation(s)
- Richard I G Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Ken K Y Ho
- Garvan Institute of Medical Research, St. Vincent's Hospital, University of New South Wales, Sydney, New South Wales, Australia
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20
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Lehtihet M, Bhuiyan H, Dalby A, Ericsson M, Ekström L. Longitudinally monitoring of P-III-NP, IGF-I, and GH-2000 score increases the probability of detecting two weeks' administration of low-dose recombinant growth hormone compared to GH-2000 decision limit and GH isoform test and micro RNA markers. Drug Test Anal 2018; 11:411-421. [PMID: 30223291 DOI: 10.1002/dta.2506] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 09/01/2018] [Accepted: 09/12/2018] [Indexed: 12/20/2022]
Abstract
To detect doping with growth hormone (GH), GH isoform and biomarkers tests are available. Both methods use population-based decision limits. Future testing in anti-doping is progressing toward individual-based reference ranges, and it is possible that with such an approach the sensitivity to detect GH doping may increase. In addition to monitoring different proteins, the use of miRNAs as future GH biomarkers has been discussed. Here we have longitudinally studied the serum concentrations of IGF-I, P-III-NP and the different GH isoforms in nine healthy men prior to, during and after two weeks' administration with low doses (1 and 4 IU/day) of recGH. Moreover, three putative miRNAs were analyzed. The results show that 80% of the participants were identified as atypical findings using the GH isoform test. However, the participants were only positive 1.5-3 hours directly after an injection. Only one of the participants reached a GH-2000 score indicative of doping when a population-based decision limit was applied. When IGF-I and P-III-NP were longitudinally monitored, 88% of the participants were identified above an individual upper threshold arbitrarily calculated as three standard deviations above the mean values of four baseline samples. The miRNA levels displayed large intra-subject variations that did not change in relation to recGH administration. Our results show that the GH isoform test is very sensitive in detecting low doses of recGH but with a short detection window. Moreover, longitudinally monitoring of IGF-I and P-III-NP may be a promising future approach to detect GH doping.
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Affiliation(s)
- Mikael Lehtihet
- Department of Medicine, Karolinska Institutet, Stockholm and S:t Görans Hospital, Stockholm, Sweden
| | | | - Abigayle Dalby
- Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Magnus Ericsson
- Anti-Doping Laboratory, Karolinska University Hospital, Stockholm, Sweden.,Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Lena Ekström
- Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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21
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Ribeiro de Oliveira Longo Schweizer J, Ribeiro-Oliveira A, Bidlingmaier M. Growth hormone: isoforms, clinical aspects and assays interference. Clin Diabetes Endocrinol 2018; 4:18. [PMID: 30181896 PMCID: PMC6114276 DOI: 10.1186/s40842-018-0068-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 08/19/2018] [Indexed: 11/11/2022] Open
Abstract
The measurement of circulating concentrations of growth hormone (GH) is an indispensable tool in the diagnosis of both GH deficiency and GH excess. GH is a heterogeneous protein composed of several molecular isoforms, but the physiological role of these different isoforms has not yet been fully understood. The 22KD GH (22 K-GH) is the main isoform in circulation, followed by 20KD GH (20 K-GH) and other rare isoforms. Studies have been performed to better understand the biological actions of the different isoforms as well as their importance in pathological conditions. Generally, the non-22 K- and 20 K-GH isoforms are secreted in parallel to 22 K-GH, and only very moderate changes in the ratio between isoforms have been described in some pituitary tumors or during exercise. Therefore, in a diagnostic approach, concentrations of 22 K-GH accurately reflect total GH secretion. On the other hand, the differential recognition of GH isoforms by different GH immunoassays used in clinical routine contributes to the known discrepancy in results from different GH assays. This makes the application of uniform decision limits problematic. Therefore, the worldwide efforts to standardize GH assays include the recommendation to use 22 K-GH specific GH assays calibrated against the pure 22 K-GH reference preparation 98/574. Adoption of this recommendation might lead to improvement in diagnosis and follow-up of pathological conditions, and facilitate the comparison of results from different laboratories.
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Affiliation(s)
| | - Antônio Ribeiro-Oliveira
- 1Endocrinology Laboratory of Federal University of Minas Gerais. Alfredo Balena, 190, Santa Efigênia, Belo Horizonte, 30130-100 Brazil
| | - Martin Bidlingmaier
- 2Endocrine Laboratory, Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ziemssenstraße 1, 80336 Munich, Germany
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22
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Krug O, Thomas A, Malerød-Fjeld H, Dehnes Y, Laussmann T, Feldmann I, Sickmann A, Thevis M. Analysis of new growth promoting black market products. Growth Horm IGF Res 2018; 41:1-6. [PMID: 29864719 DOI: 10.1016/j.ghir.2018.05.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/11/2018] [Accepted: 05/16/2018] [Indexed: 01/29/2023]
Abstract
Detecting agents allegedly or evidently promoting growth such as human growth hormone (GH) or growth hormone releasing peptides (GHRP) in doping controls has represented a pressing issue for sports drug testing laboratories. While GH is a recombinant protein with a molecular weight of 22 kDa, the GHRPs are short (3-6 amino acids long) peptides with GH releasing properties. The endogenously produced GH (22 kDa isoform) consists of 191 amino acids and has a monoisotopic molecular mass of 22,124 Da. Within this study, a slightly modified form of GH was discovered consisting of 192 amino acids carrying an additional alanine at the N-terminus, leading to a monoisotopic mass of 22,195 Da. This was confirmed by top-down and bottom-up experiments using liquid chromatography coupled to high resolution/high accuracy mass spectrometry. Additionally, three analogues of GHRPs were identified as Gly-GHRP-6, Gly-GHRP-2 and Gly-Ipamorelin, representing the corresponding GHRP extended by a N-terminal glycine residue. The structure of these peptides was characterised by means of high resolution (tandem) mass spectrometry, and for Gly-Ipamorelin and Gly-GHRP-2 their identity was additionally confirmed by custom synthesis. Further, established in-vitro experiments provided preliminary information considering the potential metabolism after administration.
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Affiliation(s)
- Oliver Krug
- Institute of Biochemistry/Center for Preventive Doping Research, German Sport University Cologne, Am Sportpark Müngersdorf, 50933 Cologne, Germany; European Monitoring Center for Emerging Doping Agents (EuMoCEDA), Cologne/Bonn, Germany
| | - Andreas Thomas
- Institute of Biochemistry/Center for Preventive Doping Research, German Sport University Cologne, Am Sportpark Müngersdorf, 50933 Cologne, Germany.
| | - Helle Malerød-Fjeld
- Norwegian Doping Control Laboratory, Department of Pharmacology, Oslo University Hospital, 0424 Oslo, Norway
| | - Yvette Dehnes
- Norwegian Doping Control Laboratory, Department of Pharmacology, Oslo University Hospital, 0424 Oslo, Norway
| | - Tim Laussmann
- Centre of Education and Science of the Federal Revenue Administration, Cologne, Germany
| | - Ingo Feldmann
- Leibniz-Institut für Analytische Wissenschaften-ISAS e.V., Bunsen-Kirchhoff-Str. 11, 44139 Dortmund, Germany
| | - Albert Sickmann
- Leibniz-Institut für Analytische Wissenschaften-ISAS e.V., Bunsen-Kirchhoff-Str. 11, 44139 Dortmund, Germany
| | - Mario Thevis
- Institute of Biochemistry/Center for Preventive Doping Research, German Sport University Cologne, Am Sportpark Müngersdorf, 50933 Cologne, Germany; European Monitoring Center for Emerging Doping Agents (EuMoCEDA), Cologne/Bonn, Germany
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23
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Schilbach K, Olsson DS, Boguszewski MCS, Bidlingmaier M, Johannsson G, Jørgensen JOL. Biomarkers of GH action in children and adults. Growth Horm IGF Res 2018; 40:1-8. [PMID: 29601998 DOI: 10.1016/j.ghir.2018.03.005] [Citation(s) in RCA: 6] [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: 01/26/2018] [Revised: 03/02/2018] [Accepted: 03/17/2018] [Indexed: 12/12/2022]
Abstract
Growth hormone (GH) and IGF-I levels in serum are used as biomarkers in the diagnosis and management of GH-related disorders but have not been subject to structured validation. Auxological parameters in children and changes in body composition in adults, as well as metabolic parameters and patient related outcomes are used as clinical and surrogate endpoints. New treatment options, such as long acting GH and GH antagonists, require reevaluation of the currently used biochemical biomarkers. This article will review biomarkers, surrogate endpoints and clinical endpoints related to GH treatment in children and adults as well as in acromegaly.
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Affiliation(s)
- Katharina Schilbach
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany.
| | - Daniel S Olsson
- Department of Internal medicine and clinical nutrition, Sahlgrenska academy, University of Gothenburg, Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Margaret C S Boguszewski
- Department of Pediatrics, Endocrine Division (SEMPR), Federal University of Paraná, Curitiba, Brazil
| | - Martin Bidlingmaier
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
| | - Gudmundur Johannsson
- Department of Internal medicine and clinical nutrition, Sahlgrenska academy, University of Gothenburg, Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
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24
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Arsene C, Schulze D, Röthke A, Thevis M, Henrion A. Growth hormone isoform-differential mass spectrometry for doping control purposes. Drug Test Anal 2018; 10:938-946. [DOI: 10.1002/dta.2350] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 11/20/2017] [Accepted: 12/05/2017] [Indexed: 12/27/2022]
Affiliation(s)
- Cristian Arsene
- Physikalisch-Technische Bundesanstalt (PTB); Braunschweig Germany
| | - Dirk Schulze
- Physikalisch-Technische Bundesanstalt (PTB); Braunschweig Germany
| | - Anita Röthke
- Physikalisch-Technische Bundesanstalt (PTB); Braunschweig Germany
| | - Mario Thevis
- Zentrum für Präventive Dopingforschung - Institut für Biochemie; Deutsche Sporthochschule Köln; Germany
| | - André Henrion
- Physikalisch-Technische Bundesanstalt (PTB); Braunschweig Germany
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25
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Pereira HMG, Sardela VF, Padilha MC, Mirotti L, Casilli A, de Oliveira FA, de Albuquerque Cavalcanti G, Rodrigues LML, de Araujo ALD, Levy RS, Teixeira PAC, de Oliveira FAG, Duarte ACG, Carneiro ACD, Evaristo JAM, Dos Santos GRC, da Costa GCV, de Lima Castro F, Nogueira FCS, Scalco FB, Pizzatti L, de Aquino Neto FR. Doping control analysis at the Rio 2016 Olympic and Paralympic Games. Drug Test Anal 2017; 9:1658-1672. [PMID: 29078043 DOI: 10.1002/dta.2329] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/10/2017] [Accepted: 10/11/2017] [Indexed: 01/13/2023]
Abstract
This paper summarises the results obtained from the doping control analyses performed during the Summer XXXI Olympic Games (August 3-21, 2016) and the XV Paralympic Games (September 7-18, 2016). The analyses of all doping control samples were performed at the Brazilian Doping Control Laboratory (LBCD), a World Anti-Doping Agency (WADA)-accredited laboratory located in Rio de Janeiro, Brazil. A new facility at Rio de Janeiro Federal University (UFRJ) was built and fully operated by over 700 professionals, including Brazilian and international scientists, administrative staff, and volunteers. For the Olympic Games, 4913 samples were analysed. In 29 specimens, the presence of a prohibited substance was confirmed, resulting in adverse analytical findings (AAFs). For the Paralympic Games, 1687 samples were analysed, 12 of which were reported as AAFs. For both events, 82.8% of the samples were urine, and 17.2% were blood samples. In total, more than 31 000 analytical procedures were conducted. New WADA technical documents were fully implemented; consequently, state-of-the-art analytical toxicology instrumentation and strategies were applied during the Games, including different types of mass spectrometry (MS) analysers, peptide, and protein detection strategies, endogenous steroid profile measurements, and blood analysis. This enormous investment yielded one of the largest Olympic legacies in Brazil and South America. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Henrique Marcelo Gualberto Pereira
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Vinicius Figueiredo Sardela
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Monica Costa Padilha
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Luciana Mirotti
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Alessandro Casilli
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Fabio Azamor de Oliveira
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Gustavo de Albuquerque Cavalcanti
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Lucas Martins Lisandro Rodrigues
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Amanda Lessa Dutra de Araujo
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Rachel Santos Levy
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Pedro Antonio Castelo Teixeira
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Felipe Alves Gomes de Oliveira
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Ana Carolina Giordani Duarte
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Ana Carolina Dudenhoeffer Carneiro
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Joseph Albert Medeiros Evaristo
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Gustavo Ramalho Cardoso Dos Santos
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Giovanni Carlo Verissimo da Costa
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Fernando de Lima Castro
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Fabio Cesar Sousa Nogueira
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Fernanda Bertão Scalco
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Luciana Pizzatti
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil.,Federal University of Rio de Janeiro - UFRJ, Laboratório de Biologia Molecular e Proteômica do Sangue - LABMOPS, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
| | - Francisco Radler de Aquino Neto
- Federal University of Rio de Janeiro - UFRJ, Brazilian Doping Control Laboratory - LBCD, LADETEC, Av. Horácio Macedo, 1281 - Polo de Química - Bloco C - Cidade Universitária - Ιlha do Fundão - Rio de Janeiro, Brazil
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26
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27
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González-Guerrero AB, Maldonado J, Dante S, Grajales D, Lechuga LM. Direct and label-free detection of the human growth hormone in urine by an ultrasensitive bimodal waveguide biosensor. JOURNAL OF BIOPHOTONICS 2017; 10:61-67. [PMID: 27669684 DOI: 10.1002/jbio.201600154] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 08/19/2016] [Accepted: 09/01/2016] [Indexed: 06/06/2023]
Abstract
A label-free interferometric transducer showing a theoretical detection limit for homogeneous sensing of 5 × 10-8 RIU, being equivalent to a protein mass coverage resolution of 2.8 fg mm-2 , is used to develop a high sensitive biosensor for protein detection. The extreme sensitivity of this transducer combined with a selective bioreceptor layer enables the direct evaluation of the human growth hormone (hGH) in undiluted urine matrix in the 10 pg mL-1 range.
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Affiliation(s)
- Ana Belén González-Guerrero
- Nanobiosensors and Bioanalytical Applications Group, Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC, CIBER-BBN and The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra, 08193, Barcelona, Spain
| | - Jesús Maldonado
- Nanobiosensors and Bioanalytical Applications Group, Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC, CIBER-BBN and The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra, 08193, Barcelona, Spain
| | - Stefania Dante
- Nanobiosensors and Bioanalytical Applications Group, Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC, CIBER-BBN and The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra, 08193, Barcelona, Spain
| | - Daniel Grajales
- Nanobiosensors and Bioanalytical Applications Group, Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC, CIBER-BBN and The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra, 08193, Barcelona, Spain
| | - Laura M Lechuga
- Nanobiosensors and Bioanalytical Applications Group, Catalan Institute of Nanoscience and Nanotechnology (ICN2), CSIC, CIBER-BBN and The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra, 08193, Barcelona, Spain
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28
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Affiliation(s)
- Martin Bidlingmaier
- Endocrine Laboratory, Medizinische Klinik und Polklinik IV, Klinikum der Universität München, Munich, Germany
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29
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Reverter-Branchat G, Bosch J, Vall J, Farré M, Papaseit E, Pichini S, Segura J. Determination of Recent Growth Hormone Abuse Using a Single Dried Blood Spot. Clin Chem 2016; 62:1353-60. [DOI: 10.1373/clinchem.2016.257592] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 06/23/2016] [Indexed: 12/28/2022]
Abstract
Abstract
BACKGROUND
Although it is being increasingly applied, blood collection for drug testing in sport presents some logistic issues that complicate full applicability on a large scale. The use of dried blood spots (DBS) could benefit compliant blood testing considerably owing to its simplicity, minimal invasiveness, analyte stability, and reduced costs. The aim of this study was to evaluate the applicability of DBS to the methodology approved by the World Anti-Doping Agency (WADA) for detection of doping by recombinant human growth hormone (rhGH) in serum.
METHODS
A protocol for a single DBS analysis using the hGH isoforms differential immunoassays (kit 1 and kit 2) was developed and validated. A clinical study with healthy volunteers injected for 3 consecutive days with a low subcutaneous dose (0.027 mg · kg−1 · day−1 · person−1) of rhGH was conducted. Finger prick DBS and paired-time serum samples from arm venipuncture were compared.
RESULTS
The analysis of the DBS-based protocol indicated that with only a single blood spot it was possible to detect positivity for growth hormone abuse. In spite of the low rhGH dose administered and independently of the kit used, the window of detection for DBS was confirmed in all analyzed samples up to 8 h after rhGH administration and extended up to 12 h in 50% of the cases. Serum positivity was detected in all studied samples for 12 h after administration.
CONCLUSIONS
These results support the usefulness of DBS as a biological matrix for testing recent growth hormone abuse.
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Affiliation(s)
- Gemma Reverter-Branchat
- Bioanalysis Research Group, Neurosciences Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Jaume Bosch
- Bioanalysis Research Group, Neurosciences Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Jessica Vall
- Bioanalysis Research Group, Neurosciences Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Magí Farré
- Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès (Bellaterra), Spain
- Clinical Pharmacology Unit. Hospital Universitari Germans Trias i Pujol-IGTP, Badalona, Spain
| | - Esther Papaseit
- Integrative Pharmacology and Systems Neuroscience Research Group, Neurosciences Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès (Bellaterra), Spain
- Clinical Pharmacology Unit. Hospital Universitari Germans Trias i Pujol-IGTP, Badalona, Spain
| | | | - Jordi Segura
- Bioanalysis Research Group, Neurosciences Research Program, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain
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30
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Genetic and protein biomarkers in blood for the improved detection of GH abuse. J Pharm Biomed Anal 2016; 128:111-118. [DOI: 10.1016/j.jpba.2016.05.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 04/29/2016] [Accepted: 05/15/2016] [Indexed: 11/20/2022]
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Bhandari SS, Narayan H, Jones DJ, Suzuki T, Struck J, Bergmann A, Squire IB, Ng LL. Plasma growth hormone is a strong predictor of risk at 1 year in acute heart failure. Eur J Heart Fail 2015; 18:281-9. [DOI: 10.1002/ejhf.459] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 10/08/2015] [Accepted: 10/22/2015] [Indexed: 11/08/2022] Open
Affiliation(s)
- Sanjay S. Bhandari
- Department of Cardiovascular Sciences; University of Leicester; Leicester UK
- NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital; University of Leicester; Leicester UK
| | - Hafid Narayan
- Department of Cardiovascular Sciences; University of Leicester; Leicester UK
- NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital; University of Leicester; Leicester UK
| | - Donald J.L. Jones
- Department of Cardiovascular Sciences; University of Leicester; Leicester UK
- NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital; University of Leicester; Leicester UK
- Department of Cancer Studies, Leicester Royal Infirmary; University of Leicester; Leicester UK
| | - Toru Suzuki
- Department of Cardiovascular Sciences; University of Leicester; Leicester UK
- NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital; University of Leicester; Leicester UK
| | | | | | - Iain B. Squire
- Department of Cardiovascular Sciences; University of Leicester; Leicester UK
- NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital; University of Leicester; Leicester UK
| | - Leong L. Ng
- Department of Cardiovascular Sciences; University of Leicester; Leicester UK
- NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital; University of Leicester; Leicester UK
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Hullstein IR, Malerod-Fjeld H, Dehnes Y, Hemmersbach P. Black market products confiscated in Norway 2011-2014 compared to analytical findings in urine samples. Drug Test Anal 2015; 7:1025-9. [DOI: 10.1002/dta.1900] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 09/17/2015] [Accepted: 09/17/2015] [Indexed: 11/08/2022]
Affiliation(s)
- Ingunn R. Hullstein
- Norwegian Doping Control Laboratory; Oslo University Hospital; Aker Hospital, P.O. Box 4959 Nydalen 0424 Oslo Norway
| | - Helle Malerod-Fjeld
- Norwegian Doping Control Laboratory; Oslo University Hospital; Aker Hospital, P.O. Box 4959 Nydalen 0424 Oslo Norway
| | - Yvette Dehnes
- Norwegian Doping Control Laboratory; Oslo University Hospital; Aker Hospital, P.O. Box 4959 Nydalen 0424 Oslo Norway
| | - Peter Hemmersbach
- Norwegian Doping Control Laboratory; Oslo University Hospital; Aker Hospital, P.O. Box 4959 Nydalen 0424 Oslo Norway
- School of Pharmacy; University of Oslo; P.O. Box 1068 Blindern 0316 Oslo Norway
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Ng LL, Bhandari SS, Sandhu JK, Quinn PA, Squire IB, Davies JE, Struck J, Bergmann A, Jones DJL. Growth hormone for risk stratification and effects of therapy in acute myocardial infarction. Biomarkers 2015; 20:371-5. [PMID: 26525661 DOI: 10.3109/1354750x.2015.1093031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Excess growth hormone (GH) is associated with early mortality. OBJECTIVES We assessed the association of GH with prognosis after acute myocardial infarction (AMI), and the effects of secondary prevention therapies. METHODS GH was measured using a high-sensitivity assay in 953 AMI patients (687 males, mean age 66.1 ± 12.8 years). RESULTS During 2 years follow-up, there were 281 major adverse cardiac events (MACE). Patients with MACE had higher GH levels (median [range], 0.91 [0.04-26.28] μg/L) compared to event-free survivors (0.59 [0.02-21.6], p < 0.0005). In multivariate Cox survival analysis, GH was a significant predictor of MACE (hazard ratios 1.43, p = 0.026 and 1.49, p = 0.01, respectively) with significant interactions with beta blocker therapy (p = 0.047) and angiotensin converting enzyme inhibitor or angiotensin receptor blocker (ACE/ARB) therapy (p = 0.016). CONCLUSIONS GH levels post-AMI are prognostic for MACE and may indicate those patients who benefit from beta blocker and ACE/ARB therapy.
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Affiliation(s)
- Leong L Ng
- a Department of Cardiovascular Sciences , NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester , Leicester , UK
| | - Sanjay S Bhandari
- a Department of Cardiovascular Sciences , NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester , Leicester , UK
| | - Jatinderpal K Sandhu
- a Department of Cardiovascular Sciences , NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester , Leicester , UK
| | - Paulene A Quinn
- a Department of Cardiovascular Sciences , NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester , Leicester , UK
| | - Iain B Squire
- a Department of Cardiovascular Sciences , NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester , Leicester , UK
| | - Joan E Davies
- a Department of Cardiovascular Sciences , NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester , Leicester , UK
| | | | | | - Donald J L Jones
- c Department of Cancer Studies and Molecular Medicine , Leicester Royal Infirmary, University of Leicester , Leicester , UK
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Abstract
Growth hormone (GH) constitutes a set of closely related protein isoforms. In clinical practice, the disagreement of test results between commercially available ligand-binding assays is still an ongoing issue, and incomplete knowledge about the particular function of the different forms leaves an uncertainty of what should be the appropriate measurand. Mass spectrometry is promising to be a way forward. Not only is it capable of providing SI-traceable reference values for the calibration of current GH-tests, but it also offers an independent approach to highly reliable mass-selective quantification of individual GH-isoforms. This capability may add to reliability in doping control too. The article points out why and how.
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Kojima A, Nishitani Y, Sato M, Kageyama S, Dohi M, Okano M. Comparison of urine analysis and dried blood spot analysis for the detection of ephedrine and methylephedrine in doping control. Drug Test Anal 2015; 8:189-98. [DOI: 10.1002/dta.1803] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 03/13/2015] [Accepted: 03/14/2015] [Indexed: 11/05/2022]
Affiliation(s)
- Asami Kojima
- Anti-Doping Laboratory; LSI Medience Corporation; Tokyo Japan
| | | | - Mitsuhiko Sato
- Anti-Doping Laboratory; LSI Medience Corporation; Tokyo Japan
| | - Shinji Kageyama
- Anti-Doping Laboratory; LSI Medience Corporation; Tokyo Japan
| | - Michiko Dohi
- Medical Centre; Japan Institute of Sports Sciences; Tokyo Japan
| | - Masato Okano
- Anti-Doping Laboratory; LSI Medience Corporation; Tokyo Japan
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Junnila RK, Strasburger CJ, Bidlingmaier M. Pitfalls of insulin-like growth factor-i and growth hormone assays. Endocrinol Metab Clin North Am 2015; 44:27-34. [PMID: 25732639 DOI: 10.1016/j.ecl.2014.10.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Accurate measurement of growth hormone (GH) and insulin-like growth factor-I (IGF-I) are the key to correct diagnosis of acromegaly and GH deficiency. Unfortunately, there is much variation involved when these hormones are measured at different sites and using different assay methods. There is an ongoing global effort to standardize the measurement process to obtain more comparable results in the future. This review discusses common pitfalls in the measurement of GH and IGF-I and guides laboratories in their analyses of these hormones.
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Affiliation(s)
- Riia K Junnila
- Endocrine Research Unit, Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität (LMU), Ziemssenstr. 1, Munich 80336, Germany
| | - Christian J Strasburger
- Department of Endocrinology and Metabolic Diseases, Campus Charité Mitte, Charité Universitaetsmedizin, Charitéplatz 1, Berlin 10117, Germany
| | - Martin Bidlingmaier
- Endocrine Research Unit, Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität (LMU), Ziemssenstr. 1, Munich 80336, Germany.
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Thevis M, Thomas A, Schänzer W. Detecting peptidic drugs, drug candidates and analogs in sports doping: current status and future directions. Expert Rev Proteomics 2014; 11:663-73. [DOI: 10.1586/14789450.2014.965159] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Hallengren E, Almgren P, Engström G, Hedblad B, Persson M, Suhr J, Bergmann A, Melander O. Fasting levels of high-sensitivity growth hormone predict cardiovascular morbidity and mortality: the Malmö Diet and Cancer study. J Am Coll Cardiol 2014; 64:1452-60. [PMID: 25277616 PMCID: PMC4180127 DOI: 10.1016/j.jacc.2014.03.063] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 03/26/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Both pathological excess and deficiency of growth hormone (GH) are associated with cardiovascular mortality. OBJECTIVES The goal of this study was to test whether fasting levels of growth hormone measured with a high-sensitivity assay (hs-GH) predict cardiovascular morbidity and mortality at the population level. METHODS We studied 4,323 participants (age 46 to 68 years; mean age 58 years; 59% women) of the Swedish, population-based Malmö Diet and Cancer study examined in 1991 to 1994. Using multivariate-adjusted Cox proportional hazards models, we related baseline levels of fasting hs-GH to incidence of coronary artery disease, stroke, congestive heart failure, all-cause mortality, and cardiovascular mortality. RESULTS During a median follow-up of 16.2 years, hs-GH (hazard ratio [HR]/SD increment of natural logarithm of fasting hs-GH) was independently associated with increased risk of coronary artery disease (397 events; HR: 1.11; 95% confidence interval [CI]: 1.01 to 1.23; p = 0.04), stroke (251 events; HR: 1.18; 95% CI: 1.04 to 1.34; p = 0.01), congestive heart failure (107 events; HR: 1.25; 95% CI: 1.03 to 1.52; p = 0.02), all-cause mortality (645 events; HR: 1.17; 95% CI: 1.08 to 1.26; p < 0.001) and cardiovascular mortality (186 events; HR: 1.43; 95% CI: 1.24 to 1.66; p < 0.001). The addition of hs-GH to a model with conventional cardiovascular risk factors significantly reclassified risk, with a category-free net reclassification improvement (>0) of 0.542 (95% CI: 0.205 to 0.840) in cardiovascular mortality. CONCLUSIONS Higher values of hs-GH were associated with an increased risk of cardiovascular morbidity and mortality.
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Affiliation(s)
- Erik Hallengren
- Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Peter Almgren
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Bo Hedblad
- Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Margaretha Persson
- Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Jennifer Suhr
- ICI Immunochemical Intelligence GmbH, Berlin, Germany
| | - Andreas Bergmann
- SphingoTec GmbH, Hohen Neuendorf, Germany; Waltraut Bergmann Foundation, Hohen Neuendorf, Germany
| | - Olle Melander
- Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden.
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Hanley JA, Saarela O, Stephens DA, Thalabard JC. hGH isoform differential immunoassays applied to blood samples from athletes: decision limits for anti-doping testing. Growth Horm IGF Res 2014; 24:205-215. [PMID: 24973245 DOI: 10.1016/j.ghir.2014.06.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 06/02/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To detect hGH doping in sport, the World Anti-Doping Agency (WADA)-accredited laboratories use the ratio of the concentrations of recombinant hGH ('rec') versus other 'natural' pituitary-derived isoforms of hGH ('pit'), measured with two different kits developed specifically to detect the administration of exogenous hGH. The current joint compliance decision limits (DLs) for ratios derived from these kits, designed so that they would both be exceeded in fewer than 1 in 10,000 samples from non-doping athletes, are based on data accrued in anti-doping labs up to March 2010, and later confirmed with data up to February-March 2011. In April 2013, WADA asked the authors to analyze the now much larger set of ratios collected in routine hGH testing of athletes, and to document in the peer-reviewed literature a statistical procedure for establishing DLs, so that it be re-applied as more data become available. DESIGN We examined the variation in the rec/pit ratios obtained for 21,943 screened blood (serum) samples submitted to the WADA accredited laboratories over the period 2009-2013. To fit the relevant sex- and kit-specific centiles of the logs of the ratios, we classified 'rec/pit' ratios based on low 'rec' and 'pit' values as 'negative' and fitted statistical distributions to the remaining log-ratios. The flexible data-driven quantile regression approach allowed us to deal with the fact that the location, scale and shape of the distribution of the modeled 'rec/pit' ratios varied with the concentrations of the 'rec' and 'pit' values. The between-kit correlation of the ratios was included in the fitting of the DLs, and bootstrap samples were used to quantify the estimation error in these limits. We examined the performance of these limits by applying them to the data obtained from investigator-initiated hGH administration studies, and in athletes in a simulated cycling stage race. RESULTS The mean and spread of the distribution of the modeled log-ratios depended in different ways on the magnitude of the rec and pit concentrations. Ultimately, however, the estimated limits were almost invariant to the concentrations, and similar to those obtained by fitting simpler (marginal) log-normal and Box-Cox transformed distributions. The estimated limits were similar to the (currently-used) limits fitted to the smaller datasets analyzed previously. In investigator-initiated instances, the limits distinguished recent use of rec-hGH from non-use. CONCLUSIONS The distributions of the rec/pit ratios varied as a function of the rec and pit concentrations, but the patterns in their medians and spreads largely canceled each other. Thus, ultimately, the kit- and sex-specific ratio DL obtained from the simpler model was very close to the 'curve of DLs' obtained from the more complex one. Both were close to previously established limits.
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Affiliation(s)
- James A Hanley
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada; Department of Mathematics and Statistics, McGill University, Montreal, Canada.
| | - Olli Saarela
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - David A Stephens
- Department of Mathematics and Statistics, McGill University, Montreal, Canada
| | - Jean-Christophe Thalabard
- Paris Descartes University, MAP5, UMR CNRS 8145, Paris, France; Endocrine Gynaecology Unit, Hôpital Cochin, Paris, France
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Fischer K, Berry DA. Statisticians Introduce Science to International Doping Agency: The Andrus Veerpalu Case. ACTA ACUST UNITED AC 2014. [DOI: 10.1080/09332480.2014.965625] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Pope HG, Wood RI, Rogol A, Nyberg F, Bowers L, Bhasin S. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocr Rev 2014; 35:341-75. [PMID: 24423981 PMCID: PMC4026349 DOI: 10.1210/er.2013-1058] [Citation(s) in RCA: 339] [Impact Index Per Article: 33.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Despite the high prevalence of performance-enhancing drug (PED) use, media attention has focused almost entirely on PED use by elite athletes to illicitly gain a competitive advantage in sports, and not on the health risks of PEDs. There is a widespread misperception that PED use is safe or that adverse effects are manageable. In reality, the vast majority of PED users are not athletes but rather nonathlete weightlifters, and the adverse health effects of PED use are greatly underappreciated. This scientific statement synthesizes available information on the medical consequences of PED use, identifies gaps in knowledge, and aims to focus the attention of the medical community and policymakers on PED use as an important public health problem. PED users frequently consume highly supraphysiologic doses of PEDs, combine them with other PEDs and/or other classical drugs of abuse, and display additional associated risk factors. PED use has been linked to an increased risk of death and a wide variety of cardiovascular, psychiatric, metabolic, endocrine, neurologic, infectious, hepatic, renal, and musculoskeletal disorders. Because randomized trials cannot ethically duplicate the large doses of PEDs and the many factors associated with PED use, we need observational studies to collect valid outcome data on the health risks associated with PEDs. In addition, we need studies regarding the prevalence of PED use, the mechanisms by which PEDs exert their adverse health effects, and the interactive effects of PEDs with sports injuries and other high-risk behaviors. We also need randomized trials to assess therapeutic interventions for treating the adverse effects of PEDs, such as the anabolic-androgen steroid withdrawal syndrome. Finally, we need to raise public awareness of the serious health consequences of PEDs.
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Affiliation(s)
- Harrison G Pope
- McLean Hospital (H.G.P.), Harvard Medical School, Belmont, Massachusetts 02478; University of Southern California (R.I.W.), Los Angeles, California 90089; University of Virginia (A.R.), Charlottesville, Virginia 22904; Department of Pharmaceutical Biosciences, (F.N.), Upsala University, SE-751 24, Upsala, Sweden; United States Anti-Doping Agency (L.B.), Colorado Springs, Colorado 80919; and Brigham and Women's Hospital (S.B.), Harvard Medical School, Boston, Massachusetts 02115
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Ge L, Yu J, Ge S, Yan M. Lab-on-paper-based devices using chemiluminescence and electrogenerated chemiluminescence detection. Anal Bioanal Chem 2014; 406:5613-30. [DOI: 10.1007/s00216-014-7756-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 03/03/2014] [Accepted: 03/07/2014] [Indexed: 02/07/2023]
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Abstract
Standardization of hormone determinations is important because it simplifies interpretation of results and facilitates the use of common reference values for different assays. Progress in standardization has been achieved through the introduction of more homogeneous hormone standards for peptide and protein hormones. However, many automated methods for determinations of steroid hormones do not provide satisfactory result. Isotope dilution-mass spectrometry (ID-MS) has been used to establish reference methods for steroid hormone determinations and is now increasingly used for routine determinations of steroids and other low molecular weight compounds. Reference methods for protein hormones based on MS are being developed and these promise to improve standardization.
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Affiliation(s)
- Ulf-Håkan Stenman
- Department of Clinical Chemistry, Biomedicum, Helsinki University, PB 63, FIN-00014 Helsinki, Finland.
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Abstract
Athletes have been misusing growth hormone (GH) for its anabolic and metabolic effects since the early 1980s, at least a decade before endocrinologists began to treat adults with GH deficiency. Although there is an ongoing debate about whether GH is performance enhancing, recent studies suggest that GH improves strength and sprint capacity, particularly when combined with anabolic steroids. The detection of GH misuse is challenging because it is an endogenous hormone. Two approaches have been developed to detect GH misuse; the first is based on the measurement of pituitary GH isoforms and the ratio of 22-kDa isoform to total GH. The second is based on the measurement of insulin like growth factor-I (IGF-I) and N-terminal propeptide of type III procollagen (P-III-NP) which increase in a dose-dependent manner in response to GH administration. Both methodologies have been approved by the World Anti-Doping Agency (WADA) and have led to the detection of a number of athletes misusing GH.
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Affiliation(s)
- Richard I. G. Holt
- Human Development and Health Academic Unit, Faculty of Medicine, University of Southampton, UK
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45
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Kniess A, Ziegler E, Thieme D, Müller RK. Intra-individual variation of GH-dependent markers in athletes: Comparison of population based and individual thresholds for detection of GH abuse in sports. J Pharm Biomed Anal 2013; 84:201-8. [DOI: 10.1016/j.jpba.2013.06.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 06/10/2013] [Accepted: 06/12/2013] [Indexed: 11/25/2022]
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Orlovius AK, Thomas A, Schänzer W, Thevis M. AOD-9604 does not influence the WADA hGH isoform immunoassay. Drug Test Anal 2013; 5:850-2. [DOI: 10.1002/dta.1557] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 08/16/2013] [Accepted: 08/29/2013] [Indexed: 11/11/2022]
Affiliation(s)
- A. K. Orlovius
- Institute of Biochemistry, Centre for Preventive Doping Research; German Sport University Cologne; Am Sportpark Müngersdorf 6 50933 Cologne Germany
| | - A. Thomas
- Institute of Biochemistry, Centre for Preventive Doping Research; German Sport University Cologne; Am Sportpark Müngersdorf 6 50933 Cologne Germany
| | - W. Schänzer
- Institute of Biochemistry, Centre for Preventive Doping Research; German Sport University Cologne; Am Sportpark Müngersdorf 6 50933 Cologne Germany
| | - M. Thevis
- Institute of Biochemistry, Centre for Preventive Doping Research; German Sport University Cologne; Am Sportpark Müngersdorf 6 50933 Cologne Germany
- European Monitoring Centre for Emerging Doping Agents; Cologne/Bonn Germany
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Voss SC, Giraud S, Alsayrafi M, Bourdon PC, Schumacher YO, Saugy M, Robinson N. The effect of a period of intensive exercise on the isoform test to detect growth hormone doping in sports. Growth Horm IGF Res 2013; 23:105-108. [PMID: 23608056 DOI: 10.1016/j.ghir.2013.03.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 02/13/2013] [Accepted: 03/26/2013] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The major objective of this study was to investigate the effects of several days of intense exercise on growth hormone (hGH) testing using the World Anti-Doping Agencies hGH isoform differential immunoassays. Additionally the effects of circadian variation and exercise type on the isoform ratios were also investigated. STUDY DESIGN 15 male athletes performed a simulated nine day cycling stage race. Blood samples were collected twice daily over a period of 15 days (stage race+three days before and after). hGH isoforms were analysed by the official WADA immunoassays (CMZ Assay GmbH). RESULTS All measured isoform ratios were far below the WADA decision limits for an adverse analytical finding. Changes in the isoform ratios could not be clearly connected to circadian variation, exercise duration or intensity. CONCLUSIONS The present study demonstrates that the hGH isoform ratios are not significantly affected by exercise or circadian variation. We demonstrated that heavy, long term exercise does not interfere with the decision limits for an adverse analytical finding.
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Affiliation(s)
- S C Voss
- Anti Doping Lab Qatar, PO Box 27775, Doha, Qatar.
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Bosch J, Luchini A, Pichini S, Tamburro D, Fredolini C, Liotta L, Petricoin E, Pacifici R, Facchiano F, Segura J, Garaci E, Gutiérrez-Gallego R. Analysis of urinary human growth hormone (hGH) using hydrogel nanoparticles and isoform differential immunoassays after short recombinant hGH treatment: preliminary results. J Pharm Biomed Anal 2013; 85:194-7. [PMID: 23954438 DOI: 10.1016/j.jpba.2013.07.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 07/15/2013] [Accepted: 07/19/2013] [Indexed: 11/28/2022]
Abstract
Successful application clinical-grade human growth hormone (hGH) immunoassays to the discovery of illegal doping cases has been rare. Indeed, the preferred biological matrix in doping control is urine, where the estimated baseline concentration of hGH falls well below the linear range and sensitivity threshold of all commercially available immunoassays, including hGH isoform differential immunoassays which can discriminate pituitary endogenous hGH from recombinant hGH. We employed hydrogel nanoparticles as a pre-processing step that concentrate urinary hGH into the linear range of isoform differential immunoassays. We explored the characteristics of immunoassays in urine spiked with both phGH or rhGH, after pre-treatment with the nanoparticles. Subsequently, pre-treatment was applied to urine obtained from 3 healthy volunteers administered during three days with daily subcutaneous injections of 0.026 mg/kg/day rhGH, Genotonorm(®). Linearity between both rhGH and phGH concentrations in urine measured by a chemoluminescent assay (Immulite) and in the particle eluate was evident for differential immunoassays (R square higher than 0.999). In case of treated individuals the recombinant/pituitary concentration ratios remained above the established World Anti-Doping Agency (WADA) criterion for hGH misuse up to 24h after the last administration dose, using both assays for volunteer 1 and 2 while in case of volunteer 3 results were inconclusive. The use of nanoparticles appears to open the possibility of assessing rhGH misuse in urine.
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Affiliation(s)
- Jaume Bosch
- Bioanalysis Group IMIM-Parc Salut Mar and Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona Biomedical Research Park (PRBB), Barcelona, Spain
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de Juan-Franco E, Rodríguez-Frade JM, Mellado M, Lechuga LM. Implementation of a SPR immunosensor for the simultaneous detection of the 22K and 20K hGH isoforms in human serum samples. Talanta 2013; 114:268-75. [PMID: 23953470 DOI: 10.1016/j.talanta.2013.04.042] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 04/10/2013] [Accepted: 04/21/2013] [Indexed: 10/26/2022]
Abstract
We have implemented a Surface Plasmon Resonance (SPR) immunosensor based on a sandwich assay for the simultaneous detection of the two main hGH isoforms, of 22 kDa (22K) and 20 kDa (20K). An oriented-antibody sensor surface specific for both hormone isoforms was assembled by using the biotin-streptavidin system. The immunosensor functionality was checked for the direct detection of the 22K hGH isoform in buffer, which gave high specificity and reproducibility (intra and inter-assay mean coefficients of variation of 8.23% and 9% respectively). The selective determination of the 22K and 20K hGH isoforms in human serum samples in a single assay was possible by using two specific anti-hGH monoclonal antibodies. The detection limit for both hormone isoforms was 0.9 ng mL(-1) and the mean coefficient of variation was below 7.2%. The excellent reproducibility and sensitivity obtained indicate the high performance of this immunosensor for implementing an anti-doping test.
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Affiliation(s)
- Elena de Juan-Franco
- Nanobiosensors and Bioanalytical Applications Group, Research Center on Nanoscience and Nanotechnology (CSIC) and CIBER-BBN, 08193 Bellaterra, Barcelona, Spain.
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50
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Kelly BN, Haverstick DM, Lee JK, Thorner MO, Vance ML, Xin W, Bruns DE. Circulating microRNA as a biomarker of human growth hormone administration to patients. Drug Test Anal 2013; 6:234-8. [DOI: 10.1002/dta.1469] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 02/04/2013] [Accepted: 02/05/2013] [Indexed: 11/11/2022]
Affiliation(s)
- Brian N. Kelly
- University of Virginia School of Medicine; Charlottesville VA USA
| | | | - Jae K. Lee
- University of Virginia School of Medicine; Charlottesville VA USA
| | | | - Mary Lee Vance
- University of Virginia School of Medicine; Charlottesville VA USA
| | - Wenjun Xin
- University of Virginia School of Medicine; Charlottesville VA USA
| | - David E. Bruns
- University of Virginia School of Medicine; Charlottesville VA USA
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