EPO drugs threaten testing regime/Drug tester calls for development of smarter EPO tests

Hormone use and abuse in sport and development conference

Many of the performance-enhancing drugs used in sport are analogues of natural hormones found in the body. What do these hormones do? How do they affect athletes, and how can you detect them? How do they affect normal young adults? What happens to a young adult when the balance of hormones goes wrong? How does nutrition affect physical performance?

Some of the world’s top researchers will meet to discuss these topics just before the Turin Olympics. The Hormones, Nutrition and Physical Performance conference, will take place in Turin, from the 28-31 January 2006.

The Hormones, Nutrition and Physical Performance conference takes place in Torino from 28-31 Jan, immediately before the Winter Olympics. The conference has two main strands, how children develop into healthy young adults, and how hormones affect sport and performance (including drug abuse).

1 New EPO drugs threaten testing regime

EPO, the drug which scandalised the Tour de France, may be about to appear in new variants. EPO (erythropoietin) is used as a performance-enhancing drug in endurance sports. It controls the amount of oxygen in the body by regulating blood haemoglobin and red cell mass. The World Anti-Doping Agency (WADA) regards the test for EPO as ‘Valid and reliable’ (). Now, however, the possibility of new, longer-lasting EPOs will make the job of the drug testers even harder.

Professor Wolfgang Jelkmann (University of Lübeck) has warned delegates attending the Hormones, Nutrition and Physical Performance Conference in Turin about new, long-lasting EPO variant which will soon be available to patients – and the drug-cheats will be watching these developments closely.

At present, EPO has a half-life in the body of around 6-8 hours. Darbepoetin alfa, a genetically modified EPO analogue with a half-life of around 24 hours, became available a few years ago, and almost immediately reports of abuse appeared in the press. Now Professor Jelkmann warns of even more forms of EPO in development. Professor Jelkmann says:

‘At this moment there are new EPOs in development, which will present real challenges to those who want to clean up drug use in sport. Some of these drugs are long-lasting analogues, which could be great for patients, but it will also present alternatives to athletes who want to boost their stamina illegally. For example, we know of a new form of Epoetin beta (with a half-life of around 130 hours), being developed by a major pharmaceutical company. But these are just the drugs we know about, it’s almost inevitable that athletes will be experimenting with other EPOs, and we will be catching up. When athletes are presented with alternatives, testing becomes harder. We need to prepare for this’.

NOTE: EPO is an peptide hormone. It is used clinically to treat anaemia, or low red blood cell count, mainly in people with cancer, AIDS or kidney problems. Athletes inject the drug illegally, to help increase endurance. As it causes a thickening of the blood, it can lead to heart and circulation problems. EPO is normally broken down in the body rapidly, but its stimulating effect can last for up to two weeks after use.

Biography and background: Wolfgang Jelkmann is Professor of Physiology and the Dean of the Medical Faculty, at the University of Lübeck. He is a member of the advisory boards of the Federal Institute of Sport Science, and has edited three books on erythropoietin. Note Jelkmann article on EPO:

Contact: jelkmann@physio.uni-luebeck.de

2 Drug tester calls for development of smarter EPO tests.

Drugs testers will have to develop smarter tests to stay ahead of athletes illegally taking the illegal endurance-enhancing drug erythropoetin (EPO). That’s the verdict of Giovanni Melioli, of the Giannina Gaslini Paediatric Institute in Genoa.

Since the Sydney Olympics in 2000, drug testers have been using the WADA (Word Anti-Doping Agency) approved isoelectric focusing test. In that test, samples of the EPO polypeptide hormone are separated by an electric current, and then identified immunologically. The test was suspected of giving some false negatives, and WADA revised the protocol early in 2005.

Now Professor Melioli believes that testers need to extend the testing regime in controversial cases. Professor Melioli has been the expert witness in several high-profile doping cases in Italy in recent years. He now believes that testers need to begin to develop a combination of tests to specifically identify the EPO drug.

Speaking at the Hormones, Nutrition and Physical Performance conference in Turin, Professor Melioli said:

‘The current EPO test is a very good test, but we may need to begin to move towards combining the existing test with other very high specificity tests. For example, in HPLC/MS testing the urine sample is separated into individual components, and then each component can be accurately identified according the weight of the individual component. This is very specific indeed, and combining the high specificity of the isoelectric focusing test, with the high specificity of the HPLC/MS test, means that the chance of a false positive drops dramatically. There are some techniques which those designing the drugs can use to mask drug use. So far, we have not seen them in use, but it’s only a matter of time. We need to stay ahead of the drug designers’.

Please mention the Hormones, Nutrition and Physical Performance conference in any story.

e-mail: giovannimelioli@ospedale-gaslini.ge , telephone +39 010 5636557 (Laboratorio Generale di Analisi)