Abstract
Haemoglobin concentration ([Hb]), reticulocyte percentage (retic%) and OFFhr score are well-implemented screening tools to determine potential recombinant human erythropoietin (rHuEpo) abuse in athletes. Recently, the International Cycling Union implemented the OFFz score and the Hbz score in their anti-doping testing programme. The aim of this study is to evaluate the sensitivity of these indirect screening methods. Twenty-four human subjects divided into three groups with eight subjects each (G1; G2 and G3) were injected with rHuEpo. G1 and G2 received rHuEpo for a 4-week period with 2 weeks of “boosting” followed by 2 weeks of “maintenance” and a wash-out period of 3 weeks. G3 received rHuEpo for a 10-week period (boost = 3 weeks; maintenance = 7 weeks; wash out = 1 week). Three, seven and eight of the 24 volunteers exceeded the cut-off limits for OFFhr score, [Hb] and retic%, respectively. One subject from G1, nobody from G2, and seven subjects from G3 exceeded the cut-off limit for Hbz score. In total, ten subjects exceeded the cut-off limit for the OFFz score; two subjects from G1, two subjects from G2 and six subjects from G3. In total, indirect screening methods were able to indicate rHuEpo injections in 58% of subjects. However, 42% of our rHuEpo-injected subjects were not detected. It should be emphasised that the test frequency in real world anti-doping is far less than the present study, and hence the detection rate will be lower.
References
Ashenden M, Varlet-Marie E, Lasne F, Audran M (2006) The effects of microdose recombinant human erythropoietin regimens in athletes. Haematologica 91:1143–1144
Banfi G (2008) Reticulocytes in sports medicine. Sports Med 38:187–211
Beullens M, Delanghe JR, Bollen M (2006) False-positive detection of recombinant human erythropoietin in urine following strenuous physical exercise. Blood 107:4711–4713
Calbet JAL, Lundby C, Koskolou M, Boushel R (2006) Importance of hemoglobin concentration to exercise: acute manipulations. Respir Physiol Neurobiol 151:132–140
Cazzola M (2000) A global strategy for prevention and detection of blood doping with erythropoietin and related drugs. Haematologica 85:561–563
Eastwood A, Hopkins WG, Bourdon PC, Withers RT, Gore CJ (2008) Stability of hemoglobin mass over 100 days in active men. J Appl Physiol 104:982–985
Gore C, Parisotto R, Ashenden M, Stray-Gundersen J, Sharpe K, Hopkins W, Emslie K, Howe C, Trout G, Kazlauskas R, Hahn A (2003) Second-generation blood tests to detect erythropoietin abuse by athletes. Haematologica 88:333–344
Lamon S, Martin L, Robinson N, Saugy M, Jd Ceaurriz, Lasne F (2009) Effects of exercise on the isoelectric patterns of erythropoietin. Clin J Sport Med 19:311–315
Lasne F, de Ceaurriz J (2000) Recombinant erythropoietin in urine. Nature 405:635
Lundby C, Robach P (2009) Assessment of total haemoglobin mass: can it detect erythropoietin-induced blood manipulations? Eur J Appl Physiol. doi:10.1007/s00421-009-1259-3
Lundby C, Thomsen JJ, Boushel R, Koskolou M, Warberg J, Calbet JAL, Robach P (2007) Erythropoietin treatment elevates haemoglobin concentration by increasing red cell volume and depressing plasma volume. J Physiol 578:309–314
Lundby C, Achman-Andersen NJ, Thomsen JJ, Norgaard AM, Robach P (2008a) Testing for recombinant human erythropoietin in urine: problems associated with current anti-doping testing. J Appl Physiol 105:417–419
Lundby C, Robach P, Boushel R, Thomsen JJ, Rasmussen P, Koskolou M, Calbet JAL (2008b) Does recombinant human Epo increase exercise capacity by means other than augmenting oxygen transport? J Appl Physiol 105:581–587
Mørkeberg JS, Belhage B, Damsgaard R (2009) Changes in blood values in elite cyclist. Int J Sports Med 30:130–138
Ninot G, Connes P, Caillaud C (2006) Effects of recombinant human erythropoietin injections on physical self in endurance athletes. J Sports Sci 24:383–391
Robinson N, Giraud S, Saudan C, Baume N, Avois L, Mangin P, Saugy M (2006) Erythropoietin and blood doping. Br J Sports Med 40:30–34
Sharpe K, Ashenden M, Schumacher Y (2006) A third generation approach to detect erythropoietin abuse in athletes. Haematologica 91:356–363
Thomsen J, Rentsch R, Robach P, Calbet J, Boushel R, Rasmussen P, Juel C, Lundby C (2007) Prolonged administration of recombinant human erythropoietin increases submaximal performance more than maximal aerobic capacity. Eur J Appl Physiol 101:481–486
Acknowledgments
We wish to thank the subjects who volunteered for this study. The studies were made possible through research Grants from anti-doping Denmark.
Author information
Authors and Affiliations
Corresponding author
Additional information
Communicated by Susan Ward.
A. Bornø and N. J. Aachmann-Andersen contributed equally to the work.
Rights and permissions
About this article
Cite this article
Bornø, A., Aachmann-Andersen, N.J., Munch-Andersen, T. et al. Screening for recombinant human erythropoietin using [Hb], reticulocytes, the OFFhr score, OFFz score and Hbz score: status of the Blood Passport. Eur J Appl Physiol 109, 537–543 (2010). https://doi.org/10.1007/s00421-010-1370-5
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00421-010-1370-5