Blood doping: potential of blood and urine sampling to detect autologous transfusion

Abstract

The collection of blood, its storage as red blood cell (RBC) concentrates and its reinjection is prohibited; until now, the practice cannot be reliably detected. A recent innovation-the haematological module of the athlete's biological passport-can provide authorities with indications towards autologous blood transfusion. In situations where a given athlete has been exposed to altitude, heat stress, sickness, etc, additional evidence may be needed to establish beyond any reasonable doubt that a blood transfusion may actually have occurred. Additional evidence may be obtained from at least three different approaches using parameters related to blood and urine matrices.Genomics applied to mRNA or miRNA is one of the most promising analytical tools. Proteomics of changes associated with RBC membranes may reveal the presence of cells stored for some time, as can an abnormal pattern of size distribution of aged cells. In urine, high concentrations of metabolites of plasticisers originating from the blood storing bags strongly suggest a recent blood transfusion. We emphasise the usefulness of simultaneously obtaining and then analysing blood and urine for complementary evidence of autologous blood transfusion ('blood doping').

Altitude training causes haematological fluctuations with relevance for the Athlete Biological Passport

“…Likewise, detection of autologous blood transfusion remains a major challenge for a clean sport. For a complete review on the topic the reader is referred to recent reviews …”

“…For a complete review on the topic the reader is referred to recent reviews. [5,6] In order to detect illegal manipulation of blood and blood components, a mathematical model for detection of abnormal blood parameters, i.e., indirect evidence for blood manipulations, was introduced at the 2000 Olympic Games by Australian researchers [7] and has since then been further refined by a group from the Swiss Laboratory for Doping Analyses with inclusion of more parameters and factors accounting for heterogeneity. [8,9] Based on this initial work, the Athlete Biological Passport (ABP) was implemented in 2009 by WADA and the UCI and has proved its worth as the UCI has sanctioned more than 30 athletes based on abnormal blood profiles.…”

Hepcidin as a new biomarker for detecting autologous blood transfusion

“…The world anti-doping agency prohibits autologous blood transfusions (ABT) in sports [1,2]. The most common way to detect ABT in the blood matrix is the haematological module of the athlete biological passport (ABP).…”

Annual banned‐substance review: analytical approaches in human sports drug testing

“…The most frequently addressed questions relating to this class of prohibited methods have been autologous and homologous blood transfusion, which in particular have shown to represent complex tasks to doping control laboratories. Principles of underlying doping procedures, physiological reactions and potential health risks associated with these clandestine practices as well as current and potential future detection strategies have been revisited by several authors, [184][185][186][187][188] with specific focus on various different approaches using blood and urine as doping control matrices. Homologous (allogeneic) blood transfusion has been shown to be detectable by means of measuring arrays of minor blood group antigens, which allows illustrating the presence or absence of more than one population of erythrocytes.…”