Removal of the influence of plasma volume fluctuations for the athlete biological passport and stability of haematological variables in active women taking oral contraception

Basile, Moreillon; Equey, Tristan; Astolfi, Tiffany; Salamin, Olivier; Faiss, Raphaël

doi:10.1002/dta.3218

Cited by 11 publications

(10 citation statements)

References 68 publications

(166 reference statements)

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“…Despite, the larger relative decrease in blood volume in females the ABP biomarkers does not appear affected in a sex-specific way. Likewise, the menstrual cycle in females with and without hormonal contraception does not appear to affect interpretations of the ABP (23,24).…”

Section: Discussionmentioning

confidence: 96%

Hepcidin and Erythroferrone Complement the Athlete Biological Passport in the Detection of Autologous Blood Transfusion

Andersen

Bejder

Bonne

et al. 2022

Medicine &Amp; Science in Sports &Amp; Exercise

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Purpose: We investigated whether hepcidin and erythroferrone (ERFE) could complement the athlete biological passport (ABP) in indirectly detecting a 130-mL packed red blood cells (RBC) autologous blood transfusion. Endurance performance was evaluated. Methods: Forty-eight healthy men (n = 24) and women (n = 24) participated. Baseline samples were collected weekly followed by randomization to a blood transfusion (BT, n = 24) or control group (CON, n = 24). Only the BT group donated 450 mL whole blood from which 130 mL red blood cell was reinfused 4 wk later. Blood samples were collected 3, 7, 14, 21, and 28 d after donation, and 3, 6, and 24 h and 2, 3, and 6 d after reinfusion. In the CON group samples were collected with the same frequency. Endurance performance was evaluated by a 650-kCal time trial (n = 13) before and 1 and 6 d after reinfusion. Results: A time-treatment effect existed (P < 0.05) for hepcidin and ERFE. Hepcidin was increased (P < 0.01) ~110 and 89% 6 and 24 h after reinfusion. Using an individual approach (99% specificity, e.g., allowing 1:100 false-positive), sensitivities, i.e., true positives, of 30% and 61% was found for hepcidin and ERFE, respectively. For the ABP, the most sensitive marker was Off-hr score ([Hb] (gÁL À1 ) − 60 Â √RET%) (P < 0.05) with a maximal sensitivity of ~58% and ~9% after donation and reinfusion, respectively. Combining the findings for hepcidin, ERFE, and the ABP yielded a sensitivity across all time-points of 83% after reinfusion in BT. Endurance performance increased 24 h (+6.4%, P < 0.01) and 6 d after reinfusion (+5.8%, P < 0.01). Conclusions: Hepcidin and ERFE may serve as biomarkers in an antidoping context after an ergogenic, small-volume blood transfusion.

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Section: Discussionmentioning

confidence: 96%

Hepcidin and Erythroferrone Complement the Athlete Biological Passport in the Detection of Autologous Blood Transfusion

Andersen

Bejder

Bonne

et al. 2022

Medicine &Amp; Science in Sports &Amp; Exercise

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“…22 Subjects exercised for an average of 297 ± 100 min per week during the study whereas a minimum of 4 h of weekly physical activity was required to participate. All subjects had regular cycle length (28.5 ± 1.5 days) and were using oral contraceptive pill (more detailed anthropometric data are available eslewhere 23 ). Intake of medication was recorded.…”

Section: Methodsmentioning

confidence: 99%

Variability of the urinary and blood steroid profiles in healthy women

Basile

Salamin

Krumm

et al. 2022

Preprint

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The steroidal module of the Athlete Biological Passport (ABP) targets the use of exogenous androgenous anabolic steroids (EAAS) in elite sport by monitoring urinary steroid profiles. Urine and blood samples were collected weekly during two consecutive OCP cycles (8 weeks) in 15 physically active women to investigate the low urinary steroid concentrations and putative confounding effect of OCP. In urine, testosterone (T) and/or epitestosterone (E) were below the limit of quantification of 1 ng/mL in 62% of the samples. Biomarkers' variability ranged between 31% and 41%, with a significantly lesser variability for ratios (except for T/E (41%)): 20% for androsterone/etiocholanolone (p < 0.001) and 25% for 5alpha-androstane-3lapha,17beta-diol/5beta-androstane-3,17beta-diol (p < 0.001). In serum, markers variability (testosterone: 24%, androstenedione: 23%, dihydrotestosterone: 19% and T/A4: 16%) was significantly lower than in urine (p < 0.001). Urinary A/Etio increased by > 18% after the first two weeks (p < 0.05) following blood loss. In contrast, serum T (0.98 nmol/L during the first week), and T/A4 (0.34 the first week) decreased significantly by more than 25% and 17% (p < 0.05), respectively in the following weeks. Our results outline steroidal variations during the OCP cycle, highlighting exogenous hormonal preparations as confounder for steroid concentrations in blood. Low steroid levels in urine samples have a clear detrimental impact on the subsequent interpretation of steroidal variations for the ABP. With a greater analytical sensitivity and lesser variability for steroids in healthy active women, serum represents a complementary matrix to urine in the ABP steroidal module.

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“…This model was further validated in elite athletes, allowing them to discern hemoglobin concentration ([Hb]) changes caused by an alteration of erythropoiesis from those resulting from a transient hemodilution caused by physical exercise ( 20 ) or altitude exposure ( 21 ). The validity of these latter serum biomarkers in assessing PV variations was additionally shown in women monitored over 8 weeks ( 22 ). The model, therefore, seems particularly promising in encompassing all forms of natural variations in PV over time and could be considered useful in the toolbox for the interpretation of individual ABP profiles.…”

Section: Development Of Current Modulesmentioning

confidence: 98%

Future opportunities for the Athlete Biological Passport

Krumm

Botrè

Saugy

et al. 2022

Front. Sports Act. Living

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The Athlete Biological Passport (ABP) was introduced to complement the direct anti-doping approach by indirectly outlining the possible use of prohibited substances or methods in sports. The ABP proved its effectiveness, at least through a deterrent effect, even though the matrices used for longitudinal monitoring (urine and blood) are subject to many intrinsic (e.g., genetic) and extrinsic (e.g., environmental conditions) confounding factors. In that context, new and more specific biomarkers are currently under development to enhance both the sensitivity and the specificity of the ABP. Multiple strategies are presently being explored to improve this longitudinal monitoring, with the development of the current modules, the investigation of new strategies, or the screening of new types of doping. Nevertheless, due to the variability induced by indirect biomarkers, the consideration of confounding factors should continuously support this research. Beyond tremendous advances in analytical sensitivity, machine learning-based approaches seem inevitable to facilitate an expert interpretation of numerous biological profiles and promote anti-doping efforts. This perspective article highlights the current innovations of the Athlete Biological Passport that seem the most promising. Through different research axes, this short manuscript provides an opportunity to bring together approaches that are more widely exploited (e.g., omics strategies) and others in the early stages of investigation (e.g., artificial intelligence) seeking to develop the ABP.

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Removal of the influence of plasma volume fluctuations for the athlete biological passport and stability of haematological variables in active women taking oral contraception

Cited by 11 publications

References 68 publications

Hepcidin and Erythroferrone Complement the Athlete Biological Passport in the Detection of Autologous Blood Transfusion

Hepcidin and Erythroferrone Complement the Athlete Biological Passport in the Detection of Autologous Blood Transfusion

Variability of the urinary and blood steroid profiles in healthy women

Future opportunities for the Athlete Biological Passport

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