Erythropoietin as a performance-enhancing drug: Its mechanistic basis, detection, and potential adverse effects
Cheating athletes now use microdoses of erythropoiesis-stimulating agents that are difficult to detect with current validated methods.
The development of new substances able to correct anemia in patients provide potential agents for doping purposes.
Markers originating from transcriptomics or ironomics could be introduced in the Athlete Biological Passport to ameliorate ESAs detection.
Erythropoietin (EPO) is the main hormone regulating red blood cell (RBC) production. The large-scale production of a recombinant human erythropoietin (rHuEPO) by biotechnological methods has made possible its widespread therapeutic use as well as its misuse in sports. Since the marketing of the first epoetin in 1989, the development has progressed to the third-generation analogs. However, the production of rHuEPO is costly, and the frequent administration of an injectable formula is not optimal for compliance of therapeutic patients. Hence, pharmaceutical industries are currently developing alternative approaches to stimulate erythropoiesis, which might offer new candidates for doping purposes. The hypoxia inducible factors (HIF) pathway is of particular interest. The introduction of new erythropoiesis-stimulating agents (ESAs) for clinical use requires subsequent development of anti-doping methods for detecting the abuse of these substances. The detection of ESAs is based on two different approaches, namely, the direct detection of exogenous substances and the indirect detection, for which the effects of the substances on specific biomarkers are monitored. Omics technologies, such as ironomics or transcriptomics, are useful for the development of new promising biomarkers for the detection of ESAs. Finally, the illicit use of ESAs associates with multiple health risks that can be irreversible, and an essential facet of anti-doping work is to educate athletes of these risks. The aim of this review is to provide an overview of the evolution of ESAs, the research and implementation of the available detection methods, and the side effects associated with the misuse of ESAs.
- Doping detection;
- Athlete biological passport;
- Omics technologies
Autor / Fonte:Olivier Salamin, Tiia Kuuranne, Martial Saugy, Nicolas Leuenberger Molecular and Cellular Endocrinology 2017 January 21