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Krumm B, Saugy JJ, Botrè F, Donati F, Faiss R. Indirect biomarkers of blood doping: A systematic review. Drug Test Anal 2024; 16:49-64. [PMID: 37160638 DOI: 10.1002/dta.3514] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/13/2023] [Accepted: 05/02/2023] [Indexed: 05/11/2023]
Abstract
The detection of blood doping represents a current major issue in sports and an ongoing challenge for antidoping research. Initially focusing on direct detection methods to identify a banned substance or its metabolites, the antidoping effort has been progressively complemented by indirect approaches. The longitudinal and individual monitoring of specific biomarkers aims to identify nonphysiological variations that may be related to doping practices. From this perspective, the identification of markers sensitive to erythropoiesis alteration is key in the screening of blood doping. The current Athlete Biological Passport implemented since 2009 is composed of 14 variables (including two primary markers, i.e., hemoglobin concentration and OFF score) for the hematological module to be used for indirect detection of blood doping. Nevertheless, research has continually proposed and investigated new markers sensitive to an alteration of the erythropoietic cascade and specific to blood doping. If multiple early markers have been identified (at the transcriptomic level) or developed directly in a diagnostics' kit (at a proteomic level), other target variables at the end of the erythropoietic process (linked with the red blood cell functions) may strengthen the hematological module in the future. Therefore, this review aims to provide a global systematic overview of the biomarkers considered to date in the indirect investigation of blood doping.
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Affiliation(s)
- Bastien Krumm
- REDs, Research & Expertise in AntiDoping Sciences, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Jonas J Saugy
- REDs, Research & Expertise in AntiDoping Sciences, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Francesco Botrè
- REDs, Research & Expertise in AntiDoping Sciences, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Francesco Donati
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Raphael Faiss
- REDs, Research & Expertise in AntiDoping Sciences, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
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Marchand A, Roulland I, Semence F, Jaffredo F, Dehainault C, Le Guiner S, Le Pajolec MG, Donati F, Mekacher LR, Lamek K, Ericsson M. Evaluation of the detection of the homologous transfusion of a red blood cell concentrate in vivo for antidoping. Drug Test Anal 2023; 15:1417-1429. [PMID: 36709998 DOI: 10.1002/dta.3448] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
Two doping cases of homologous blood transfusion (HBT) during Tokyo 2020 Summer Olympics have shown that more controls are needed. The method of detection using flow cytometry to evaluate the expression of minor blood group antigens from red blood cells (RBCs) and identify different RBC populations is efficient but still complex to perform with multiple antigens detection. Recently, the interest of using forensic DNA analysis was also highlighted as a potential new method to detect HBT, with possibility to start from dried blood spots (DBS) instead of fresh blood. After a first phase of development, a protocol was validated for HBT detection using DNA analysis after extraction from DBS. Presence of a second DNA was clear down to 2% of donor blood in vitro. A flow cytometry protocol was also developed with preparation and analysis in 96-well plates and detection of two different antigens per well using two secondary antibodies with distinct fluorophores. The objective of the project was to evaluate the window of detection of an HBT performed in vivo with 150 mL of RBC concentrate. Blood samples obtained over 7 weeks post-transfusion were analyzed. DNA profiling from DBS was not sensitive enough to detect the presence of a second DNA even 1 day after transfusion. On the contrary, the flow cytometry protocol was very efficient and allowed identification of several double populations of RBC (expressing/non-expressing several antigens) until day 50 post-transfusion. This protocol can be fully validated for a future application to doping control samples.
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Affiliation(s)
- Alexandre Marchand
- Laboratoire Antidopage Français (LADF), Université Paris-Saclay, Châtenay-Malabry, France
| | - Ingrid Roulland
- Laboratoire Antidopage Français (LADF), Université Paris-Saclay, Châtenay-Malabry, France
| | - Florian Semence
- Laboratoire Antidopage Français (LADF), Université Paris-Saclay, Châtenay-Malabry, France
| | - Franck Jaffredo
- Institut Génétique Nantes Atlantique (IGNA), Saint-Herblain, France
| | | | - Soizic Le Guiner
- Institut Génétique Nantes Atlantique (IGNA), Saint-Herblain, France
| | | | - Francesco Donati
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana (FMSI), Rome, Italy
| | | | - Kahina Lamek
- Laboratoire de Toxicologie, Centre Hospitalier Universitaire Tizi-Ouzou, Tizi-Ouzou, Algeria
| | - Magnus Ericsson
- Laboratoire Antidopage Français (LADF), Université Paris-Saclay, Châtenay-Malabry, France
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Untargeted Metabolomics Identifies a Novel Panel of Markers for Autologous Blood Transfusion. Metabolites 2022; 12:metabo12050425. [PMID: 35629929 PMCID: PMC9145416 DOI: 10.3390/metabo12050425] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/29/2022] [Accepted: 05/02/2022] [Indexed: 11/17/2022] Open
Abstract
Untargeted metabolomics was used to analyze serum and urine samples for biomarkers of autologous blood transfusion (ABT). Red blood cell concentrates from donated blood were stored for 35−36 days prior to reinfusion into the donors. Participants were sampled at different time points post-donation and up to 7 days post-transfusion. Metabolomic profiling was performed using ACQUITY ultra performance liquid chromatography (UPLC), Q-Exactive high resolution/accurate mass spectrometer interfaced with a heated electrospray ionization (HESI-II) source and Orbitrap mass analyzer operated at 35,000 mass resolution. The markers of ABT were determined by principal component analysis and metabolites that had p < 0.05 and met ≥ 2-fold change from baseline were selected. A total of 11 serum and eight urinary metabolites, including two urinary plasticizer metabolites, were altered during the study. By the seventh day post-transfusion, the plasticizers had returned to baseline, while changes in nine other metabolites (seven serum and two urinary) remained. Five of these metabolites (serum inosine, guanosine and sphinganine and urinary isocitrate and erythronate) were upregulated, while serum glycourdeoxycholate, S-allylcysteine, 17-alphahydroxypregnenalone 3 and Glutamine conjugate of C6H10O2 (2)* were downregulated. This is the first study to identify a panel of metabolites, from serum and urine, as markers of ABT. Once independently validated, it could be universally adopted to detect ABT.
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Grau M, Zollmann E, Bros J, Seeger B, Dietz T, Noriega Ureña JA, Grolle A, Zacher J, Notbohm HL, Suck G, Bloch W, Schumann M. Autologous Blood Doping Induced Changes in Red Blood Cell Rheologic Parameters, RBC Age Distribution, and Performance. BIOLOGY 2022; 11:biology11050647. [PMID: 35625375 PMCID: PMC9137932 DOI: 10.3390/biology11050647] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 12/03/2022]
Abstract
Simple Summary Autologous blood doping (ABD) refers to the artificial increase in circulating red blood cell (RBC) mass by sampling, storage, and transfusion of one’s own blood. It is assumed that some athletes apply this prohibited technique to improve oxygen transport capacity and thus exercise performance. The primary aim of this study was to test whether RBC rheological and associated parameters significantly change due to ABD with the consideration of whether this type of measurement might be suitable for detecting ABD. Further, it was assessed whether those changes are translated into indices of endurance performance. Eight males underwent an ABD protocol combined with several blood parameter measurements and two exercise tests (pre and post transfusion). Results of this investigation suggest a change in the distribution of age-related RBC sub-populations and altered deformability of total RBC as well as of the respective sub-populations. Further, the identified changes in RBC also appear to improve sports performance. In conclusion, these data demonstrate significant changes in hematological and hemorheological parameters, which could be of interest in the context of new methods for ABD detection. However, additional research is needed with larger and more diverse study groups to widen the knowledge gained by this study. Abstract Autologous blood doping (ABD) refers to the transfusion of one’s own blood after it has been stored. Although its application is prohibited in sports, it is assumed that ABD is applied by a variety of athletes because of its benefits on exercise performance and the fact that it is not detectable so far. Therefore, this study aims at identifying changes in hematological and hemorheological parameters during the whole course of ABD procedure and to relate those changes to exercise performance. Eight healthy men conducted a 31-week ABD protocol including two blood donations and the transfusion of their own stored RBC volume corresponding to 7.7% of total blood volume. Longitudinal blood and rheological parameter measurements and analyses of RBC membrane proteins and electrolyte levels were performed. Thereby, responses of RBC sub-populations—young to old RBC—were detected. Finally, exercise tests were carried out before and after transfusion. Results indicate a higher percentage of young RBC, altered RBC deformability and electrolyte concentration due to ABD. In contrast, RBC membrane proteins remained unaffected. Running economy improved after blood transfusion. Thus, close analysis of RBC variables related to ABD detection seems feasible but should be verified in further more-detailed studies.
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Affiliation(s)
- Marijke Grau
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany; (E.Z.); (J.B.); (B.S.); (T.D.); (H.L.N.); (W.B.); (M.S.)
- Correspondence:
| | - Emily Zollmann
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany; (E.Z.); (J.B.); (B.S.); (T.D.); (H.L.N.); (W.B.); (M.S.)
| | - Janina Bros
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany; (E.Z.); (J.B.); (B.S.); (T.D.); (H.L.N.); (W.B.); (M.S.)
| | - Benedikt Seeger
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany; (E.Z.); (J.B.); (B.S.); (T.D.); (H.L.N.); (W.B.); (M.S.)
| | - Thomas Dietz
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany; (E.Z.); (J.B.); (B.S.); (T.D.); (H.L.N.); (W.B.); (M.S.)
| | - Javier Antonio Noriega Ureña
- German Red Cross Blood Donation Service West, Center for Transfusion Medicine Hagen, Feithstraße 184, 58097 Hagen, Germany; (J.A.N.U.); (A.G.); (G.S.)
| | - Andreas Grolle
- German Red Cross Blood Donation Service West, Center for Transfusion Medicine Hagen, Feithstraße 184, 58097 Hagen, Germany; (J.A.N.U.); (A.G.); (G.S.)
| | - Jonas Zacher
- Department of Preventive and Rehabilitative Sports and Performance Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany;
| | - Hannah L. Notbohm
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany; (E.Z.); (J.B.); (B.S.); (T.D.); (H.L.N.); (W.B.); (M.S.)
| | - Garnet Suck
- German Red Cross Blood Donation Service West, Center for Transfusion Medicine Hagen, Feithstraße 184, 58097 Hagen, Germany; (J.A.N.U.); (A.G.); (G.S.)
| | - Wilhelm Bloch
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany; (E.Z.); (J.B.); (B.S.); (T.D.); (H.L.N.); (W.B.); (M.S.)
| | - Moritz Schumann
- Department of Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany; (E.Z.); (J.B.); (B.S.); (T.D.); (H.L.N.); (W.B.); (M.S.)
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Tewabe H, Mitiku A, Worku H. Assessment of Blood Transfusion Utilization and Patient Outcomes at Yekatit-12 Hospital, Addis Ababa, Ethiopia. J Blood Med 2022; 13:171-180. [PMID: 35378868 PMCID: PMC8976520 DOI: 10.2147/jbm.s355178] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background The goal of blood transfusion is to provide a safe, sufficient, and timely supply of blood components to the recipients by ensuring that donation is safe and no harm to the recipient. So the current study was aimed to assess blood transfusion utilization and its outcome in patients at Yekatit-12 Hospital, Addis Ababa, Ethiopia. Methods A cross-sectional study was conducted from May 01 to July 30, 2021, on 616 individuals who have requested blood transfusion at Yekatit-12 Hospital, Addis Ababa, Ethiopia. Information on blood and blood component utilization was collected by using a checklist. Finally, data were analyzed using SPSS version 21.0, and those variables in which P-value is less than 0.05 were considered statistically clinically significant. Results A total of 1540 cross-match units were requested for 616 (53.2% male) patients with a mean age of 43 years. Out of 1540 cross-matched blood units, 1498 units of blood were transfused for 615 individuals with a mean of 2.43 units. The most widely used blood component was whole blood 694 (46.3%) and 1252 (83.6%) of the blood unit were “RH” positive. From a total of 68 (11.1%) none improved reported cases, 48 (10.5%) were those transfused with whole blood transfusion. The proportion of improvement after transfusion according to the service ranged from 83.3.0% to 100% and no post-transfusion reactions were reported. A significant improvement was seen in the hematological profile (hemoglobin, red blood cells, hematocrit, platelets, and white blood cells) findings of the transfused individuals after blood unit transfusion (P < 0.05). Conclusion The overall utilization rate and improvement status after transfusion were high even if the utilization rate has some limitations. The overall ratios of cross-match to transfusion ratio, transfusion probability, and transfusion index were 1.03, 99.8%, and 0.97, respectively.
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Affiliation(s)
- Haymanot Tewabe
- Department of Medical Laboratory Sciences, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
- Correspondence: Haymanot Tewabe, Email
| | - Asaye Mitiku
- Department of Medical Laboratory Sciences, College of Health Science, Dilla University, Dilla, Ethiopia
| | - Habtamu Worku
- Department of Medical Laboratory Sciences, ECUSTA Health Science College, Addis Ababa, Ethiopia
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Bennett-Guerrero E, Lockhart EL, Bandarenko N, Campbell ML, Natoli MJ, Jamnik VK, Carter TR, Moon RE. A randomized controlled pilot study of VO2max testing: a potential model for measuring relative in vivo efficacy of different red blood cell products. Transfusion 2016; 57:630-636. [DOI: 10.1111/trf.13918] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 10/01/2016] [Accepted: 10/02/2016] [Indexed: 11/29/2022]
Affiliation(s)
| | - Evelyn L. Lockhart
- University of New Mexico Health Science Center; Albuquerque New Mexico
- Duke University Medical Center; Durham North Carolina
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Salamin O, De Angelis S, Tissot JD, Saugy M, Leuenberger N. Autologous Blood Transfusion in Sports: Emerging Biomarkers. Transfus Med Rev 2016; 30:109-15. [DOI: 10.1016/j.tmrv.2016.05.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 05/19/2016] [Indexed: 12/12/2022]
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Abstract
Reticulocytes are young red blood cells which develop from erythroblasts and circulate in the bloodstream for about 1-4 days before maturing into erythrocytes. With the introduction of reticulocyte count in equations and statistical models for detecting suspected blood doping, its application to sports medicine has attracted growing interest in reticulocyte behavior during training and competition seasons in athletes and experimental blood doping treatment in healthy volunteers. An update on recent publications is therefore needed to improve the interpretation of reticulocyte analysis and its variability in sportsmen. Reticulocyte count constitutes a robust parameter during the preanalytical phase, but cell stability can be assured only if blood samples are kept at constantly cold temperatures (4 degrees C) and test results will differ depending on the blood analyzer system used. Marked intraindividual variability is the principal finding to be evaluated when exercise-induced changes are observed or illicit procedures suspected. Furthermore, reticulocyte variability is greater than that of other hematological parameters such as hemoglobin or hematocrit. Ideally, any variation should be interpreted against long-term time series for the individual athlete: values obtained from large athlete cohorts ought to be used only for extrapolating outliers that deserve further examination. Reticulocyte distribution in athletes is similar to that found in the general population, and a gender effect in some sports disciplines or selected athlete groups may be seen. Reticulocyte variability is strongly influenced by seasonal factors linked to training and competition schedules and by the type of sports discipline. Published experimental data have confirmed the high sensitivity of reticulocyte analysis in identifying abnormal bone marrow stimulation by either erythropoietin administration or blood withdrawal and reinfusion.
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Red blood cell populations and membrane levels of peroxiredoxin 2 as candidate biomarkers to reveal blood doping. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2012; 10 Suppl 2:s71-7. [PMID: 22890272 DOI: 10.2450/2012.011s] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Blood doping represents one main trend in doping strategies. Blood doping refers to the practice of boosting the number of red blood cells (RBCs) in the bloodstream in order to enhance athletic performance, by means of blood transfusions, administration of erythropoiesis-stimulating substances, blood substitutes, natural or artificial altitude facilities, and innovative gene therapies. While detection of recombinant EPO and homologous transfusion is already feasible through electrophoretic, mass spectrometry or flow cytometry-based approaches, no method is currently available to tackle doping strategies relying on autologous transfusions. MATERIALS AND METHODS We exploited an in vitro model of autologous transfusion through a 1:10 dilution of concentrated RBCs after 30 days of storage upon appropriate dilution in freshly withdrawn RBCs from the same donor. Western blot towards membrane Prdx2 and Percoll density gradients were exploited to assess their suitability as biomarkers of transfusion. RESULTS Membrane Prdx2 was visible in day 30 samples albeit not in day 0, while it was still visible in the 1:10 dilution of day 30 in day 0 RBCs. Cell gradients also highlighted changes in the profile of the RBC subpopulations upon dilution of stored RBCs in the fresh ones. DISCUSSION From this preliminary in vitro investigation it emerges that Prdx2 and RBC populations might be further tested as candidate biomarkers of blood doping through autologous transfusion, though it is yet to be assessed whether the kinetics in vivo of Prdx2 exposure in the membrane of transfused RBCs will endow a sufficient time-window to allow reliable anti-doping testing.
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Ex vivo erythrocyte generation and blood doping. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2012; 11:161-3. [PMID: 23114519 DOI: 10.2450/2012.0028-12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Accepted: 03/28/2012] [Indexed: 11/21/2022]
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Abuse of medicines for performance enhancement in sport: why is this a problem for the pharmaceutical industry? Bioanalysis 2012; 4:1681-90. [PMID: 22831483 DOI: 10.4155/bio.12.137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The misuse of medicines for performance enhancement in sport (doping) is not approved by regulatory agencies, and is illegal in many countries. In addition to the 'traditional' doping agents such as steroids, β-blockers and blood transfusions, the list of agents and techniques used in doping is increasing and now includes newer medicines such as erythropoiesis-stimulating agents and growth hormones. Innovative new medicines are of particular interest as would-be dopers may believe them to be undetectable by current methods. Close collaboration between the biopharmaceutical industry and anti-doping agencies such as the World Anti-Doping Agency is critical to a successful anti-doping strategy. Industry is ideally placed to identify the doping potential of new medicines at early stages and to support early development of detection assays. A strong, united front between the biopharmaceutical industry and anti-doping agencies is essential to counter the misuse of medicines for performance enhancement, as well as to promote fair play and clean sport.
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Mørkeberg J. Detection of Autologous Blood Transfusions in Athletes: A Historical Perspective. Transfus Med Rev 2012; 26:199-208. [DOI: 10.1016/j.tmrv.2011.09.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Schneider AJ, Fedoruk MN, Rupert JL. Human genetic variation: new challenges and opportunities for doping control. J Sports Sci 2012; 30:1117-29. [PMID: 22681541 DOI: 10.1080/02640414.2012.692480] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Sport celebrates differences in competitors that lead to the often razor-thin margins between victory and defeat. The source of this variation is the interaction between the environment in which the athletes develop and compete and their genetic make-up. However, a darker side of sports may also be genetically influenced: some anti-doping tests are affected by the athlete's genotype. Genetic variation is an issue that anti-doping authorities must address as more is learned about the interaction between genotype and the responses to prohibited practices. To differentiate between naturally occurring deviations in indirect blood and urine markers from those potentially caused by doping, the "biological-passport" program uses intra-individual variability rather than population values to establish an athlete's expected physiological range. The next step in "personalized" doping control may be the inclusion of genetic data, both for the purposes of documenting an athlete's responses to doping agents and doping-control assays as well facilitating athlete and sample identification. Such applications could benefit "clean" athletes but will come at the expense of risks to privacy. This article reviews the instances where genetics has intersected with doping control, and briefly discusses the potential role, and ethical implications, of genotyping in the struggle to eliminate illicit ergogenic practices.
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Affiliation(s)
- Angela J Schneider
- The International Centre for Olympic Studies, The University of Western Ontario, London, Ontario, Canada
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Banfi G, Franchini M, Lippi G. Letter to the editor regarding "Rapid determination of urinary di(2-ethylhexyl) phthalate metabolites based on liquid chromatography/tandem mass spectrometry as a marker for blood transfusion in sports drug testing". Anal Bioanal Chem 2011; 401:577-8; author reply 579-80. [PMID: 21424775 DOI: 10.1007/s00216-011-4839-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mørkeberg J, Sharpe K, Belhage B, Damsgaard R, Schmidt W, Prommer N, Gore CJ, Ashenden MJ. Detecting autologous blood transfusions: a comparison of three passport approaches and four blood markers. Scand J Med Sci Sports 2011; 21:235-43. [DOI: 10.1111/j.1600-0838.2009.01033.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Blood transfusion is an effective and unmediated means of increasing the number of red blood cells in the circulation in order to enhance athletic performance. Blood transfusion became popular in the 1970s among elite endurance athletes and declined at the end of the 1980s with the introduction of recombinant erythropoietin. The successive implementation in 2001 of a direct test to detect exogenous erythropoietin and in 2004 of a test to detect allogeneic blood transfusion forced cheating athletes to reinfuse fully immunologically compatible blood. The implementation of indirect markers of blood doping stored in an Athlete's Biological Passport provides a powerful means to deter any form of blood transfusion.
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Affiliation(s)
- Sylvain Giraud
- Swiss Laboratory for Doping Analyses, Chemin des Croisettes 22, 1066, Epalinges, Switzerland.
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Arndt PA, Kumpel BM. Blood doping in athletes--detection of allogeneic blood transfusions by flow cytofluorometry. Am J Hematol 2008; 83:657-67. [PMID: 18508326 DOI: 10.1002/ajh.21196] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Athletes may undergo blood transfusion to increase their red cell mass and the oxygen carrying capacity of their blood in order to confer a competitive advantage. Allogeneic transfusions are normally mismatched at one or more minor blood group antigens. The most sensitive and accurate method known to detect this form of blood doping is flow cytometry. Low percentages of antigen-positive and antigen-negative red blood cells (RBCs) can be quantitated using suitable specific alloantibodies and careful analysis. By testing blood samples taken at various times, a reduction in the percentage of a minor population of RBCs will indicate transfusion has occurred.
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Affiliation(s)
- Patricia A Arndt
- American Red Cross Blood Services, Southern California Region, Pomona, California 91768, USA.
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Abstract
Doping in sports is commonplace. The prevention of harm to the athlete, the guarantee of fair play, and a level playing field for all competitors are the basis of the current anti-doping strategies. As healthcare systems are forced to allocate increasing resources to prevent and treat the prevailing pathologies worldwide, funding for anti-doping campaigns will necessarily be restricted. Ideally, additional resources should be devoted to increasing the number of athletes tested, the panels of tests used, and the frequency of out-of-competition controls. Since doping prevention cannot be considered a priority for most healthcare systems, such an approach is unaffordable and an alternative framework should be devised, focused primarily on harm reduction rather than fair play. The identification of abnormal deviations from reference values, regardless of pathological or artificial causes, would allow the athlete to be followed and tested using conventional laboratory tests, which are affordable to governments and healthcare systems and available to clinical laboratories. Although this strategy would not detect cheating, it would safeguard athletes' health.
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Affiliation(s)
- Giuseppe Lippi
- Istituto di Chimica e Microscopia Clinica, Università di Verona, Verona, Italy.
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Lippi G, Banfi G, Luca Salvagno G, Montagnana M, Franchini M, Cesare Guidi G. Comparison of creatinine-based estimations of glomerular filtration rate in endurance athletes at rest. ACTA ACUST UNITED AC 2008; 46:235-9. [DOI: 10.1515/cclm.2008.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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