Yorck Olaf Schumacher

Detection of autologous blood doping with adaptively evaluated biomarkers of doping: a longitudinal blinded study.

BACKGROUND: Since no direct detection method for autologous blood transfusions exists, the most promising attempt is the Athlete Biological Passport (ABP) and its adaptive model that enables a longitudinal monitoring of hematologic measures to identify patterns of blood manipulations. The purpose therefore was to evaluate the performance of this adaptive model for the detection of autologous blood transfusions in a longitudinal blinded setting.

The contribution of haemoglobin mass to increases in cycling performance induced by simulated LHTL.

We sought to determine whether improved cycling performance following ‘Live High-Train Low’ (LHTL) occurs if increases in haemoglobin mass (Hbmass) are prevented via periodic phlebotomy during hypoxic exposure. Eleven, highly trained, female cyclists completed 26 nights of simulated LHTL (16xa0hxa0day−1, 3000xa0m). Hbmass was determined in quadruplicate before LHTL and in duplicate weekly thereafter. After 14 nights, cyclists were pair-matched, based on their Hbmass response (ΔHbmass) from baseline, to form a response group (Response, nxa0=xa05) in which Hbmass was free to adapt, and a Clamp group (Clamp, nxa0=xa06) in which ΔHbmass was negated via weekly phlebotomy. All cyclists were blinded to the blood volume removed. Cycling performance was assessed in duplicate before and after LHTL using a maximal 4-min effort (MMP4min) followed by a ride time to exhaustion test at peak power output (Tlim). VO2peak was established during the MMP4min. Following LHTL, Hbmass increased in Response (meanxa0±xa0SD, 5.5xa0±xa02.9%). Due to repeated phlebotomy, there was no ΔHbmass in Clamp (−0.4xa0±xa00.6%). VO2peak increased in Response (3.5xa0±xa02.3%) but not in Clamp (0.3xa0±xa02.6%). MMP4min improved in both the groups (Response 4.5xa0±xa01.1%, Clamp 3.6xa0±xa01.4%) and was not different between groups (pxa0=xa00.58). Tlim increased only in Response, with Clamp substantially worse than Response (−37.6%; 90% CL −58.9 to −5.0, pxa0=xa00.07). Our novel findings, showing an ~4% increase in MMP4min despite blocking an ~5% increase in Hbmass, suggest that accelerated erythropoiesis is not the sole mechanism by which LHTL improves performance. However, increases in Hbmass appear to influence the aerobic contribution to high-intensity exercise which may be important for subsequent high-intensity efforts.

Stability and robustness of blood variables in an antidoping context

Introduction:u2002 With the setting up of the newly Athlete’s Biological Passport antidoping programme, novel guidelines have been introduced to guarantee results beyond reproach. We investigated in this context, the effect of storage time on the variables commonly measured for the haematological passport. We also wanted to assess for these variables, the within and between analyzer variations.

Diurnal and Exercise-Related Variability of Haemoglobin and Reticulocytes in Athletes

Haemoglobin (Hb) and Reticulocytes (Ret) are measured as indirect markers of doping in athletes. We studied the diurnal variation, the impact of exercise, fluid intake and ambient temperature in athletes on these parameters. Hourly venous blood samples were obtained from 36 male athletes of different disciplines (endurance (END) and non-endurance (NON-END)) over 12 h during a typical training day. Seven inactive subjects served as controls (CON). Hb and Ret were determined. A mixed model procedure was used to analyse the data. At baseline, Hb was similar for all groups, END showed lower Ret than NON-END and CON. Exercise showed a significant impact on Hb (+0.46 g/dl, p<0.001), the effect disappeared approximately 2 h after exercise. Hb decreased over the day by approximately 0.55 g/dl (p<0.01). There was no relevant effect on Ret. Fluid intake and ambient temperature had no significant effect. Hb shows significant diurnal- and exercise related variations. In an anti-doping context, most of these variations are in favour of the athlete. Blood samples taken after exercise might therefore provide reliable results and thus be used for the longitudinal monitoring of athletes if a timeframe for the re-equilibration of vascular volumes is respected.

Are 10 min of seating enough to guarantee stable haemoglobin and haematocrit readings for the athlete's biological passport?

Haemoglobin (Hb) and haematocrit (Hct) are measured as indirect markers of doping in athletes. We studied the effect of posture on these parameters in a typical antidoping setting. Venous blood samples were obtained from nine endurance athletes (six males, three females) and nine control subjects (six males, three females) immediately and after 5, 10, 15, 20 and 30u2003min after having adopted a seated position from normal daily activity. Hb (CV 0.72%) and Hct (CV 0.87%) were determined using an automated cell counter, plasma volume changes were calculated. Differences between the time points, gender and groups were calculated using a mixed‐model procedure. Significant changes were observed in the first 10u2003min after sitting down but no further changes were noted between 10 and 30u2003min. Mean directional change for Hb and Hct between 0u2003min and the average of the period from 10 to 30u2003min was −2.4% (−0.35u2003g/dl) for Hb and −2.7% (−1.2%) for Hct. Plasma volume increased accordingly. Neither group nor gender had significant effects. Under typical conditions encountered during blood testing in doping control, a period of 10u2003min in a seated position is sufficient for the vascular volumes to re‐equilibrate and to adapt to the new posture.

Doping with Artificial Oxygen Carriers An Update

There is a long history of science seeking to develop artificial substitutes for body parts damaged by disease or trauma. While defective teeth and limbs are commonly replaced by imitations without major loss of functionality, the development of a substitute for red blood cells has proved elusive.There is a permanent shortage of donor blood in western societies. Nevertheless, despite whole blood transfusions carrying measurable risks due to immunogenicity and the transmission of blood-borne infectious diseases, red blood cells are still relatively inexpensive, well tolerated and widely available. Researchers seeking to develop products that are able to meet and perhaps exceed these criteria have responded to this difficult challenge by adopting many different approaches. Work has focussed on two classes of substances: modified haemoglobin solutions and perfluorocarbon emulsions. Other approaches include the creation of artificial red cells, where haemoglobin and supporting enzyme systems are encapsulated into liposomes.Haemoglobin is ideally suited to oxygen transport when encased by the red cell membrane; however, once removed, it rapidly dissociates into dimers and is cleared by the kidney. Therefore, it must be stabilised before it can be safely re-infused into humans. Modifications concomitantly alter the vascular half-life, oxygen affinity and hypertensive characteristics of raw haemoglobin, which can be sourced from outdated blood stores, genetically-engineered Escherichia coli or even bovine herds. In contrast, perfluorocarbons are entirely synthetic molecules that are capable of dissolving oxygen but biologically inert. Since they dissolve rather than bind oxygen, their capacity to serve as a blood substitute is determined principally by the oxygen pressure gradients in the lung and at the target tissue.Blood substitutes have important potential areas of clinical application including red cell replacement during surgery, emergency resuscitation of traumatic blood loss, oxygen therapeutic applications in radiography (oxygenation of tumour cells is beneficial to the effect of certain chemotherapeutic agents), other medical applications such as organ preservation, and finally to meet the requirements of patients who cannot receive donor blood because of religious beliefs.Given the elite athlete’s historical propensity to experiment with novel doping strategies, it is likely that the burgeoning field of artificial oxygen carriers has already attracted their attention. Scientific data concerning the performance benefits associated with blood substitutes are virtually nonexistent; however, international sporting federations have been commendably proactive in adding this category to their banned substance lists. The current situation is vulnerable to exploitation by immoral athletes since there is still no accepted methodology to test for the presence of artificial oxygen carriers.

ORIGINAL ARTICLE: Are 10 min of seating enough to guarantee stable haemoglobin and haematocrit readings for the athlete’s biological passport?

Haemoglobin (Hb) and haematocrit (Hct) are measured as indirect markers of doping in athletes. We studied the effect of posture on these parameters in a typical antidoping setting. Venous blood samples were obtained from nine endurance athletes (six males, three females) and nine control subjects (six males, three females) immediately and after 5, 10, 15, 20 and 30u2003min after having adopted a seated position from normal daily activity. Hb (CV 0.72%) and Hct (CV 0.87%) were determined using an automated cell counter, plasma volume changes were calculated. Differences between the time points, gender and groups were calculated using a mixed‐model procedure. Significant changes were observed in the first 10u2003min after sitting down but no further changes were noted between 10 and 30u2003min. Mean directional change for Hb and Hct between 0u2003min and the average of the period from 10 to 30u2003min was −2.4% (−0.35u2003g/dl) for Hb and −2.7% (−1.2%) for Hct. Plasma volume increased accordingly. Neither group nor gender had significant effects. Under typical conditions encountered during blood testing in doping control, a period of 10u2003min in a seated position is sufficient for the vascular volumes to re‐equilibrate and to adapt to the new posture.

Cycling power output produced during flat and mountain stages in the Giro d'Italia: A case study

Abstract Until recently, the physiological demands of cycling competitions were mostly reflected by the measurement of heart rate and the indirect estimation of exercise intensity. The purpose of this case study was to illustrate the varying power output of a professional cyclist during flat and mountain stages of a Grand Tour (Giro dItalia). Nine stage recordings of a cyclist of the 2005 Giro dItalia were monitored using a mobile power measurement device (SRM Trainingssystem, Julich, Germany), which recorded direct power output and heart rate. Stages were categorized into flat (n = 5) and mountain stages (n = 4). Data were processed electronically, and the overall mean power in flat and mountain stages and maximal mean power for various durations were calculated. Mean power output was 132 W ± 26 (2.0 W · kg−1 ± 0.4) for the flat and 235 W ± 10 (3.5 W · kg−1 ± 0.1) for the mountain stages. Mountain stages showed higher maximal mean power (367 W) for longer durations (1800 s) than flat stages (239 W). Flat stages are characterized by a large variability of power output with short bursts of high power and long periods with reduced intensity of exercise, whereas mountain stages mostly require submaximal, constant power output over longer periods.

Reticulocytes in athletes: Longitudinal aspects and the influence of long- and short-term exercise

Reticulocytes (Ret) are a key variable in the emerging concept of the athletes biological passport and the longitudinal monitoring of biological parameters in the field of anti-doping. In this context, knowledge on the variability of Ret in athletes and the influence of exercise is necessary. The aim of the present study was to evaluate longitudinal variation in Ret and the influence of short- and long-term exercise.Ret% in 793 samples of 238 athletes were determined and analyzed in different study parts for inter- and intra-individual variation and the impact of long- (competitive season) and short-term (all out) exercise.Median Ret% was 0.9 (CI(0.5-99.5%) 0.4-2.7). Intra-individual variation for Ret% was 0.0118; inter-individual variation 0.0124. During periods of intensive exercise Ret% was slightly lower (mean - 0.1%, p = 0.048). After a short, all-out exercise bout, Ret% was increased (+0.5%, p = 0.0028).Athletes mostly display similar Ret% than the normal population; however, intra-individual variation in athletes is higher. During the competitive season of endurance athletes, Ret% is slightly decreased. After short bouts of intense exercise Ret% is increased. These data can be used for the interpretation of blood profiles in athletes.

The impact of long‐haul air travel on variables of the athlete's biological passport

Dehydration, fluid shifts or changes in coagulation occurring during air travel can trigger distinct reactions in the haematological system. Athletes are concerned that these effects might impair sporting performance, increase the risk of thrombosis or cause abnormalities in blood values that might be mistaken for doping in the ‘Athlete′s biological passport’ (ABP) a longitudinal monitoring of haematological variables in antidoping. The aim of the study was to investigate key variables of the ABP before and after a long‐haul flight in athletes.