Autologous Blood Doping Induced Changes in Red Blood Cell Rheologic Parameters, RBC Age Distribution, and Performance

Abstract

Autologous blood doping (ABD) refers to the transfusion of one’s own blood after it has been stored. Although its application is prohibited in sports, it is assumed that ABD is applied by a variety of athletes because of its benefits on exercise performance and the fact that it is not detectable so far. Therefore, this study aims at identifying changes in hematological and hemorheological parameters during the whole course of ABD procedure and to relate those changes to exercise performance. Eight healthy men conducted a 31-week ABD protocol including two blood donations and the transfusion of their own stored RBC volume corresponding to 7.7% of total blood volume. Longitudinal blood and rheological parameter measurements and analyses of RBC membrane proteins and electrolyte levels were performed. Thereby, responses of RBC sub-populations—young to old RBC—were detected. Finally, exercise tests were carried out before and after transfusion. Results indicate a higher percentage of young RBC, altered RBC deformability and electrolyte concentration due to ABD. In contrast, RBC membrane proteins remained unaffected. Running economy improved after blood transfusion. Thus, close analysis of RBC variables related to ABD detection seems feasible but should be verified in further more-detailed studies.

Annual banned‐substance review—Analytical approaches in human sports drug testing 2021/2022–

“…Alterations in erythrocyte rheology and age distribution in ABT processes were further confirmed by Grau et al in the context of a transfusion intervention study with eight male volunteers that donated and received two units of 500 ml of blood (and corresponding red blood cell fractions) 94 . Deformability and age distributions were found to be considerably affected by the withdrawal/infusion procedures, but the authors also critically discussed the facts that observed changes in hematological parameters remained within reference ranges for males and/or the result of the physiological response to the first blood draw, hence requiring intraindividual continuous monitoring if considered for anti‐doping purposes.…”

“…Nevertheless, the additional data are valuable and warrant further investigations, especially because the stability and applicability of long-term stored whole-blood samples also to RNA analyses (even in the absence of RNA preservatives) was demonstrated by Lima et al 93 Alterations in erythrocyte rheology and age distribution in ABT processes were further confirmed by Grau et al in the context of a transfusion intervention study with eight male volunteers that donated and received two units of 500 ml of blood (and corresponding red blood cell fractions). 94 Deformability and age distributions were found to be considerably affected by the withdrawal/infusion procedures, but the authors also critically discussed the facts that observed changes in hematological parameters remained within reference ranges for males and/or the result of the physiological response to the first blood draw, hence requiring intraindividual continuous monitoring if considered for anti-doping purposes. Such longitudinal monitoring is provided for a variety of markers by the hematological module of the ABP, whose effectiveness, advantages, and limitations were reviewed by Saugy et al, 95 unaffected by static apnea training, 96 and put into an anti-doping organization's perspective by Baekken et al 97 Being referred to as a particularly valuable tool in anti-doping,…”

Indirect biomarkers of blood doping: A systematic review

“…In addition, RBC rheological parameters were monitored after blood reinfusion to understand the in vivo impact of RBC cryopreservation (storage at À80 C): Despite no significant influences with low volumes ($4% of total blood volume), 85 results highlighted a shift in the age distribution of RBC subpopulations as well as a deformability alteration after a reinfusion representing 7.7% of the total blood volume. 86 Nevertheless, the clearance of these markers once the blood is reinjected has not always been investigated. 40,42,84,87 Crucial in an antidoping context, further studies are needed to determine the detection window of such markers and thus evaluate their suitability for ABT detection.…”

Future opportunities for the Athlete Biological Passport

“…It is known that some properties of RBCs will be altered during storage ( 44 ), especially to membrane modification inducing a reduction of the deformability ( 45 ). Based on a recent study, it seems besides that deformability alteration is observed generally but also in the different subpopulations of RBC maturation ( 46 ). In this way, changes in the expression of CD 55 and CD 59 surface RBC proteins and variation in cell size have been observed ( 47 ), demonstrating the relevance of biomarkers related to blood aging and storage.…”