title: Applications and biomonitoring issues of recombinant erythropoietins for doping control.
abstract: The biochemical actions and side effects of recombinant erythropoietins (rhEPOs), their analogs and mimetics, their misuse as doping agents, and the principal analytical strategies developed to identify them in athletes' biologic fluids are reviewed. Patients who experience a range of pathologies have benefited from the administration of rhEPOs to correct severe anemia. Currently, monitoring the biologic effect of rhEPO in patients under treatment is by measuring the hemoglobin concentration. However, it may be valuable to directly monitor the actual levels of the administered drug and determine a dose-dependent correlation with any clinical adverse effect observed. This may permit the adoption of a patient-specific administration regime. Currently, the method of detecting EPO approved for doping control is an isoelectric-focusing, double-blotting, chemiluminescence assay based on charge differences between isoforms of rhEPOs and endogenous EPO in urine. The advantages and limitations of this method are presented. A new approach using sodium dodecyl sulfate-polyacrylamide gel electrophoresis as a complementary tool to the established method is discussed. The application of matrix-assisted laser desorption/ionization mass spectrometry and liquid chromatography combined with tandem mass spectrometry for the direct detection of the rhEPO molecules may prove to be promising. Indirect evidence of rhEPO abuse by athletes is based on the analysis of blood parameters (hemoglobin hematocrit, reticulocytes, macrocytes, etc) and serum markers (concentration of EPO and serum transferrin receptors, etc). Enrichment of the screened parameters with gene or biochemical markers revealing altered erythropoiesis and adoption of longitudinal monitoring of athletes' hematologic and biochemical parameters could also be a complementary approach in the fight against doping.
authors.affiliation: Department of Drugs and Narcotics, 3rd Chemical Service of Athens, General Chemical State Laboratory of Greece, 16 An. Tsoha Street, 11521, Athens, Greece. chtsitsi@yahoo.com
authors.forename: Christina
authors.initials: C
authors.lastname: Tsitsimpikou
authors.forename: Demetrios
authors.initials: D
authors.lastname: Kouretas
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tsarouhas
authors.forename: Kenneth
authors.initials: K
authors.lastname: Fitch
authors.forename: Demetrios A
authors.initials: DA
authors.lastname: Spandidos
authors.forename: Aristides
authors.initials: A
authors.lastname: Tsatsakis
mesh_terms: D015415:Biomarkers / Q000032:analysis; D001774:Blood Chemical Analysis / Q000379:methods*; D004300:Doping in Sports; D004591:Electrophoresis, Polyacrylamide Gel / Q000379:methods*; D004921:Erythropoietin / Q000097:blood* / Q000494:pharmacology; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007525:Isoelectric Focusing; D008297:Male; D011994:Recombinant Proteins; D012156:Reticulocytes / Q000187:drug effects; D019032:Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization / Q000379:methods*; D015813:Substance Abuse Detection / Q000379:methods*
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin