PREVENTION OF BLOOD DOPING ABUSE
A global strategy for prevention and detection of blood doping with erythropoietin and related drugs
Blood doping’s definition was introduced by the media in the 1970s to describe the use of blood transfusion to increase red cell mass artificially, and in turn to enhance both maximal oxygen uptake and performance in endurance sports. Since the late 1980s blood doping is no longer achieved by autologous transfusion but instead through administration of ecombinant human erythropoietin (rHuEpo).
Prospects for the next years and magnitude of blood doping
Of course, when considering this question, we cannot simply adopt evidence-based medical principles. Because there is no traditional data source. The information available is from newspapers and more recently police investigations. According to data provided by CONI (Comitato limpico
Nazionale Italiano), [Italian National Olympics Committee]. Blood doping with rHuEpo is especially common in professional cycling and cross-ountry skiing. This is mainly expected as these are typically endurance sports. evertheless, some observations Reports from CONI show that abuse of rHuEpo is widespread in other areas. People even believe that blood doping helps reduce physiological stress during exercise and accelerates post-exercise recovery. It should also be noted that blood doping is no longer available. Problems limited to career athletes as they are now also includes amateurs and young athletes. The outlook for the next few years is isappointing. In fact, major pharmaceutical companies are currently developing modified long-acting Epo molecules.
Medical risks of blood doping with rHuEpo and vital importance of this drug for thousands of patients
There is speculation that blood doping with rHuEpo may have contributed to death of a cyclist from the Netherlands in the early 1990s. At that time, the abuse of rHuEpo was largely uncontrolled, Hct values above 60% were probably achieved. These erythrocytosis, exacerbated by dehydration during exercise, tend to predispose athletes for thromboembolic complications. Today, the abuse of rHuEpo is arguably more fine-tuned. However, there are medical risks associated with blood doping
that are still important. Erythropoietin significantly enhances human and their endothelial activation and platelet reactivity. It may also significantly increase the risk of thromboembolism, especially hereditary individual complications. Another problem associated with it its that a small number of athletes who abuse 4rHuEpo eventually develop a thrombophilia. Professional cyclist whose data was examined by an Italian judge in a recent investigation shows a comparable level of iron overload. These individuals were clearly co-administered with intravenous iron rHuEpo. Therefore, this type of iron overload ultimately results in organ damage comparable to that found in genetic hemochromatosis, including the risk of developing liver cancer. Finally, preliminary observation Abuse of rHuEpo may carry the risk of decreased endogenous erythropoietin production after treatment. In particular, these individuals will not be able to develop an appropriate erythropoiesis response to stressful conditions. In general, we still don’t know the long-term implications, however the risk of developing myeloproliferative disorders is known. Over 500,000 patients worldwide are currently receiving rHuEpo to treat anemia. Interestingly, the potential drawback effects on normal hemostasis help the kidneys patients to prevent bleeding complications.
What is currently being done to prevent blood doping
The use of rHuEpo is prohibited by International Olympic Committee (IOC) and other major Sports organization. The Commission has introduced a new doping class of peptide hormones and analogs, including rHuEpo, human chorionic gonadotropin and related compounds, adrenocorticotropic hormone, and humans. However, there is no reliable way to do the routine. Since now, detection of doping by rHuEpo recombinant molecules cannot be easily distinguished from endogenous
hormones. To dissuade the abuse of rHuEpo, some sports have imposed upper limits on hematocrit and hemoglobin [50% and 17 g/dL, respectively, in males, International Cycling Union [UCI]) or hemoglobin [18.5 g/dL in males, International Ski Federation (FIS)]. This strategy has many pitfalls,
which have been extensively discussed elsewhere and include: large natural variation between individuals, postural effects on hematocrit, risk of false positivity and ease of manipulation through interventions such as saline infusion. In particular the upper limit of 18.5 g/dL adopted by the FIS is difficult to understand: in a prospective study that we are conducting on elite soccer players in Italy, no Hb level greater than 17 g/dL has so far been observed.
Indirect methods for detecting erythropoietin abuse in athletes
In recent years, many studies have investigated indirect methods of detecting rHuEpo abuse. Being able to define individual hematology profile: Physiological individual range of hematocrit values Hemoglobin can be defined as mean ± 10% of the average. Optimal variation size is (5%, 7.5%, 10%).
What can be done to prevent steroid misuse?
Studies suggest that high school athletes are less likely to use steroids when their peers and parents are disapproved. However, according to a study, high school students simply do not discourage young people from taking steroids in the future, as the side effects of steroids are adversely affected
by teenagers. Showing both the risks and benefits of using anabolic steroid hormones is more effective in convincing adolescents of the adverse effects of steroids, as students clearly find the balanced approach more reliable. High-risk behavior such as drinking or driving, carrying a gun, riding a motorcycle without a helmet, or using other illegal drugs. This suggests that preventive programs should focus on comprehensive screening and counseling of teenage high-risk behaviors using anabolic steroids.
The ATHENA program, which targets healthy exercise and nutrition options, is modeled after the ATLAS program, but is designed for adolescent girls on the athletic team. Early tests of girls enrolled in the ATHENA program showed that dangerous behaviors, such as drunk driving and sexual activity with new partners, were significantly reduced compared to controls. ATHENA participants also reduced the number of diet pills, amphetamines, anabolic steroids, and muscle-building supplements used during the sports season. The program had no direct impact on tobacco, alcohol, or marijuana use in a survey of 1-3 years after graduating from high school, but ATHENA-trained athletes used these substances in their lifetimes. As a result of this 1-3 years of follow-up, diet pills and steroid consumption have decreased in both ATHENA-trained athletes and control group athletes, so there is no difference in consumption between these groups, material.
