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. "
