There is a lot of confusion regarding the EPO tests available.
Currently there is the direct "pee test" that works only 3 to 4 days
out; IOW you need to be dumb and unlucky to get caught. The other
test is indirect and uses blood (its hard to get people to give this
up) and looks for specific blood characteristics. Below is one such
paper describing how they do this. Again, its hard to implement blood
tests in any sport due to its invasive nature. owever, blood tests
are very good for detecting drug use. I also included some work on
hGH testing.
Chris
Detection of recombinant human erythropoietin abuse in athletes
utilizing markers of altered erythropoiesis.
Parisotto R, Wu M, Ashenden MJ, Emslie KR, Gore CJ, Howe C, Kazlauskas
R, Sharpe K, Trout GJ, Xie M.
Department of Physiology, Australian Institute of Sport, P.O. Box 176,
Belconnen ACT 2616, Australia. [email hidden]
BACKGROUND AND OBJECTIVES: The detection of recombinant human
erythropoietin (r-HuEPO) abuse by athletes remains problematic. The
main aim of this study was to demonstrate that the five indirect
markers of altered erythropoiesis identified in our earlier work were
reliable evidence of current or recently discontinued r-HuEPO use. A
subsidiary aim was to refine weightings of the five markers in the
initial model using a much larger data set than in the pilot study. A
final aim was to verify that the hematologic response to r-HuEPO did
not differ between Caucasian and Asiatic subjects. DESIGN AND METHODS:
Recreational athletes resident in Sydney, Australia (Sydney, n = 49;
16 women, 33 men) or Beijing, China (Beijing, n=24; 12 women, 12 men)
were randomly assigned to r-HuEPO or placebo groups prior to a 25 day
administration phase. Injections of r-HuEPO (or saline) were
administered double-blind at a dose of 50 IU/kg three times per week,
with oral iron (105 mg) or placebo supplements taken daily by all
subjects. Blood profiles were monitored during and for 4 weeks after
drug administration for hematocrit (Hct), reticulocyte hematocrit
(RetHct), percent macrocytes (%Macro), serum erythropoietin (EPO) and
soluble transferrin receptor (sTfr), since we had previously shown
that these five variables were indicative of r-HuEPO use. RESULTS. The
changes in Hct, RetHct, %Macro, EPO and sTfr in the Sydney trial were
qualitatively very similar to the changes noted in our previous
administration trial involving recreational athletes of similar
genetic origin. Statistical models developed from Fisher's
discriminant analysis were able to categorize the user and placebo
groups correctly. The same hematologic response was demonstrated in
Beijing athletes also administered r-HuEPO. INTERPRETATION AND
CONCLUSIONS: This paper confirms that r-HuEPO administration causes a
predictable and reproducible hematologic response. These markers are
disturbed both during and for several weeks following r-HuEPO
administration. This work establishes an indirect blood test which
offers a useful means of detecting and deterring r-HuEPO abuse.
Ethnicity did not influence the markers identified as being able to
detect athletes who abuse r-HuEPO.
Indirect evidence of hormone abuse. Proof of doping?
Minuto F, Barreca A, Melioli G.
Chair of Endocrinology, DiSEM, University of Genova, Italy.
[email hidden]
Besides anabolic steroids, the most common performance-enhancing
hormones are erythropoietin (EPO), insulin, GH, and gonadotropins,
mostly indistinguishable from endogenous hormones and with very short
half-life. This makes virtually impossible to demonstrate their use by
measuring their concentration in the blood or urine. A possible
approach to the problem may lie in in-direct demonstration through
detection of the biological effects of these substances. The finding
of an increased hematocrit level is suspicious but not clearly
demonstrative of EPO abuse. Very high levels of circulating EPO could
be associated with a strong suspicion of doping, when associated to
other abnormal parameters, such as Ht, sTFRr, EPO, RDW. The presence
of antibodies against the polysaccharide fraction of lateral chains of
EPO has been observed only in patients treated with rhEPO. Owing to
the pulsatile pattern of GH, particularly during physical exercise,
pathologically high values may be found in normal subjects. Therefore,
as in the case of EPO, evidence of GH abuse can be gathered only
indirectly by detecting the biological effects of its administration.
In training subjects GH treatment increased GH, IGF-I, IGFBP-3 and
ALS, and decreased IGBP-2. After cessation of treatment IGF-I, IGFBP-3
and ALS approached basal values between 49 and 96 h. Also the bone
parameters PICP ICIP, PIUP and osteocalcin increased significantly.
Four days after cessation of treatment, levels of PIIIP and ICTP were
still abnormally elevated. In conclusion, increases in IGF-I, IGFBP-3,
ALS, PIIIP and ICTP are all indicative of recent GH abuse or of
acromegaly.
The name acromegaly comes from the Greek words for "extremities" and
"enlargement" and reflects one of its most common symptoms, the
abnormal growth of the hands and feet. Soft tissue swelling of the
hands and feet is often an early feature, with patients noticing a
change in ring or shoe size. Gradually, bony changes alter the
patient's facial features: the brow and lower jaw protrude, the nasal
bone enlarges, and spacing of the teeth increases.
Quoted message said:"Still, even the EPO test has loopholes: It can reach back and detect
the drug for only three or four days, according to Olivier Rabin,
science director at the World Anti-Doping Agency (WADA). But an
athlete could reap benefits for as long as two weeks, Rabin and other
experts said.
There is thus a lengthy period when users enjoy athletic advantage
without risking detection. Rabin suspects some cyclists take a high
dose of EPO and stop at least three days before the race begins, a
strategy mirrored in other sports and a prime illustration of how the
cheaters stay one step ahead of the testers. "
