Current strategies of blood doping detection
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REVIEW
Current strategies of blood doping detection Torben Pottgiesser & Yorck Olaf Schumacher
Received: 29 April 2013 / Revised: 14 July 2013 / Accepted: 23 July 2013 / Published online: 10 August 2013 # Springer-Verlag Berlin Heidelberg 2013
Abstract During the last 30 years, the artificial increase of red blood cell volume (“blood doping”) has changed the level of performance in all endurance sports. Many doping scandals have shown the extent of the problem. The detection of blood doping relies on two different approaches: the direct detection of exogenous manipulating substances (erythropoietic stimulants) or red cells (homologous transfusion) and the indirect detection, where not the doping substance or technique itself, but its effect on certain biomarkers is measured. Whereas direct detection using standard laboratory procedures such as isoelectric focusing can identify erythropoietic stimulants, homologous blood transfusion is identified through mismatches in minor blood group antigens by flow cytometry. Indirect methods such as the athlete biological passport are the only means to detect autologous transfusion and may also be used for the detection of erythropoietic stimulants or homologous transfusion. New techniques to unmask blood doping include the use of high-throughput ‘omics’ technologies (proteomics/metabolomics) and the combination of different biomarkers with the help of mathematical approaches. Future strategies should aim at improving the use of the available data and resources by applying pattern recognition algorithms to recognize suspicious athletes and, on the basis of these Published in the topical collection Anti-doping Analysis with guest editor Christopher Harrison. T. Pottgiesser (*) Department of Sports Medicine, University Hospital of Freiburg, 79106 Freiburg, Germany e-mail: [email protected] Y. O. Schumacher Aspetar Orthopedic and Sports Medicine Hospital, P.O. Box 29222, Doha, Qatar Present Address: T. Pottgiesser Department of Cardiology and Angiology I, University Heart Center Freiburg, 79106 Freiburg, Germany
findings, use the appropriate testing method. Different types of information should be combined in the quest for a forensic approach to anti-doping. Keywords Blood doping . Erythropoietin . Blood transfusion . Athlete biological passport . Doping detection
Introduction The oxygen carrying capacity of the organism has been addressed as performance limiting in most endurance sport disciplines. From basic physiology, it is known that the oxygen transport of the body is mediated through cardiac output and hemoglobin, both entities being key factors in the Fick principle, which defines oxygen uptake. One of the prime training targets for endurance athletes is therefore to increase their oxygen uptake and thereby increase their cardiac output and the oxygen carrying capacity of the blood. It is well known that regular endurance training leads to enlargement of the cardiac cavities and thus cardiac output and, on the other hand, induces an increase in re
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