Current Insights into the Potential Misuse of Platelet-based Applications for Doping in Sports

Abstract

Platelet-based applications are currently used for the delivery of growth factors and other biomolecules as autologous biomaterials in regenerative medicine and cosmetic therapies. Many studies have revealed that platelet-based applications such as platelet-rich plasma and platelet releasate exhibit beneficial biological effects after a sports injury or trauma when administered locally by intramuscular injections. At present, treatment of the public, patients and athletes with platelet-based applications is permitted and regulated by the Food and Drug Administration and the World Anti-Doping Agency. Since 2011 the use of autologous platelet-rich plasma is permitted in competitive sports by the World Anti-Doping Agency, due to the lack of evidence in performance enhancement and anabolic effects. However, accumulating research has recently shed light on the role of platelet-derived growth factors in wound healing, skeletal myogenesis, muscle stem cell function and tissue regeneration. Although any ergogenic potential of platelet-rich plasma and platelet releasate on intact skeletal muscle and human sports performance remain to be established, novel evidence suggests that platelet-derived growth factors can modulate muscle, tendon, ligament, protein synthesis/degradation, vascularization, energy utilization and regenerative capacity in various experimental settings. Since platelet-based applications are currently not prohibited, they constitute a tool for potential abuse and doping in sports. The aim of this review is to critically discuss and assimilate current insights and biological evidence that set the ground for exploitation and misuse in competitive sports, and develop strategies to combat these activities.

Platelet-derived chemokines promote skeletal muscle regeneration by guiding neutrophil recruitment to injured muscles

“…Interestingly, several studies have explored the therapeutic use of the platelet-rich plasma (PRP), i.e., the component of the blood devoid of white and red blood cells but rich in platelets and platelet-secreted factors (releasate). In particular, injection of the PRP has been proposed to boost wound healing and regeneration in a number of tissues [50][51][52][53][54][55][56][57][58] , including skeletal muscle [59][60][61][62][63][64] . However, it remains largely undetermined whether platelets are necessary for skeletal muscle regeneration beyond their role in hemostasis, and whether platelet-secreted factors are required for any step of muscle repair.…”

Platelet releasate normalises the compromised muscle regeneration in a mouse model of hyperlipidaemia

“…Recently we and others have refined platelet‐based therapies by developed secretomes that are produced in a cell‐regulated manner (rather than lysis of platelets) using specific mediators of degranulation. Platelet releasate is rich in numerous growth factors, cytokines and myokines, constituting a powerful biomaterial for regenerative medicine (Sassoli et al., 2018; Scully et al., 2018a, b, 2020; Scully & Matsakas, 2019; Tsai et al., 2018). Given that, platelet releasate increases the myogenic potential and promotes differentiation of myoblasts in vitro and ex vivo (Scully et al., 2018a, 2020), we sought to determine whether platelet releasate mitigates the impaired skeletal muscle regeneration of the ApoE –/– mice in vivo .…”

Optimising platelet secretomes to deliver robust tissue‐specific regeneration

“…To date, platelet‐based applications have gained a lot of attention for regenerative purposes in a variety of applications such as musculoskeletal injuries, skin, bone, nerve, and liver conditions (Scully & Matsakas, ; Scully, Naseem, et al, 2018). However, with regard to the use of autologous platelets for the regeneration of skeletal and heart muscle, the literature has been more stringent in accepting its potential benefits.…”