Oxygen delivery enhancers: past, present, and future.
In endurance sport the delivery of oxygen to muscles plays a critical role. Indeed, muscle performance declines during prolonged and intense activity as a consequence of the shift from the aerobic to the anaerobic metabolism with an increase of lactate. To enhance the aerobic capacity 2 alternatives may be used: increasing either the transport or the delivery of oxygen. In this setting, blood doping is the practice of illicitly using a drug or blood product to improve athletic performance. Based on this definition, blood doping techniques may include: 1) blood transfusion (autologous or omologous); 2) erythropoiesis-stimulating substances [recombinant human erythropoietin (alpha, beta, omega), darbepoietin-alpha, continuous erythropoiesis receptor activator, hematide]; 3) blood substitutes (hemoglobin-based oxygen carriers, perfluorocarbon emulsions); 4) allosteric modulators of hemoglobin (RSR-13 and RSR-4); 5) gene doping (human erythropoietin gene transfection); 6) gene regulation (hypoxia-inducible transcription factors pathway). In the present overview we will briefly describe the above-mentioned techniques with the aim of underlining potential hematological alternatives to gene doping for increasing aerobic capacity in sport.
Borrione
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Division of Internal Medicine, University of Turin, Orbassano (Turin), Italy. pborrione@libero.it
Mastrone
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Salvo
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Spaccamiglio
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Grasso
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Angeli
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D000818:Animals; D001692:Biological Transport / Q000502:physiology; D001803:Blood Transfusion / Q000379:methods; D004300:Doping in Sports / Q000639:trends*; D016503:Drug Delivery Systems / Q000379:methods / Q000639:trends*; D004921:Erythropoietin / Q000008:administration & dosage / Q000494:pharmacology; D005466:Fluorocarbons / Q000008:administration & dosage; D018014:Gene Transfer Techniques; D006454:Hemoglobins / Q000008:administration & dosage / Q000737:chemistry; D006801:Humans; D000860:Hypoxia / Q000628:therapy*; D051793:Hypoxia-Inducible Factor 1 / Q000378:metabolism; D008954:Models, Biological; D010100:Oxygen / Q000008:administration & dosage* / Q000378:metabolism; D010455:Peptides / Q000008:administration & dosage / Q000494:pharmacology; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000494:pharmacology; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000494:pharmacology; D015813:Substance Abuse Detection / Q000379:methods
D005466:Fluorocarbons; D006454:Hemoglobins; D051793:Hypoxia-Inducible Factor 1; D010455:Peptides; D011994:Recombinant Proteins; C508420:continuous erythropoietin receptor activator; C514771:hematide; D004921:Erythropoietin; D011092:Polyethylene Glycols; D010100:Oxygen