title: Evaluation of the reporting level to detect triamcinolone acetonide misuse in sports.
abstract: Triamcinolone acetonide (TA) is prohibited in sport competitions using systemic administrations (e.g., intramuscular, IM), and it is allowed by other routes (e.g., intranasal, IN, or topical, TOP). A reporting level of 30 ng/mL is used to discriminate between forbidden and allowed administrations. We examined urinary profiles of TA metabolites after TOP, IN and IM administrations to evaluate the suitability of the current reporting level and to define the best criteria to discriminate between these administrations. TA was administered to healthy volunteers by different routes: a single IM dose (n=2), IN doses for three days (n=6), and TOP doses for five days followed by a single IM dose (n=8). Urine samples were collected at different time intervals and they were analyzed by liquid chromatography-tandem mass spectrometry to measure TA and eight metabolites. After TOP and IN administrations, concentrations of the metabolites were significantly lower (p<0.05) than after IM administrations. Concentrations of TA after IM administration were lower than 30 ng/mL for all volunteers (range 0.7-29.7 ng/mL), and they were lower than 5 ng/mL after multiple IN or TOP doses (0.1-3.6 ng/mL and 0-1.7 ng/mL, respectively). For 6β-hydroxy-TA, the main TA metabolite, greater concentrations were obtained: 10.7-469.1 ng/mL, 2.2-90.6 ng/mL and 0-57.2 ng/mL after IM, IN and TOP administrations, respectively. These results suggest that the current reporting level is not suitable to detect forbidden IM administration of TA. A lower concentration of the parent drug or the use of specific metabolites could discriminate IM from TOP or IN administrations.
authors.affiliation: Bioanalysis Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Doctor Aiguader 88, 08003 Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Matabosch
authors.affiliation: Bioanalysis Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Doctor Aiguader 88, 08003 Barcelona, Spain.
authors.forename: Oscar J
authors.initials: OJ
authors.lastname: Pozo
authors.affiliation: Human Pharmacology and Neurosciences Research Group, IMIM, Doctor Aiguader 88, 08003 Barcelona, Spain; Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain.
authors.forename: Clara
authors.initials: C
authors.lastname: Pérez-Mañá
authors.affiliation: Human Pharmacology and Neurosciences Research Group, IMIM, Doctor Aiguader 88, 08003 Barcelona, Spain; Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), 08193 Barcelona, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Papaseit
authors.affiliation: Bioanalysis Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Doctor Aiguader 88, 08003 Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Marcos
authors.affiliation: Bioanalysis Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Doctor Aiguader 88, 08003 Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Segura
authors.affiliation: Bioanalysis Research Group, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Doctor Aiguader 88, 08003 Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain. Electronic address: rventura@imim.es.
authors.forename: Rosa
authors.initials: R
authors.lastname: Ventura
mesh_terms: D000281:Administration, Intranasal; D000287:Administration, Topical; D000328:Adult; D002138:Calibration; D002853:Chromatography, Liquid; D004300:Doping in Sports; D005189:False Positive Reactions; D064368:Healthy Volunteers; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D011786:Quality Control; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013177:Sports; D053719:Tandem Mass Spectrometry; D014222:Triamcinolone Acetonide / Q000652:urine*; D016482:Urinalysis; D055815:Young Adult
chemical_list: D014222:Triamcinolone Acetonide
keywords: Administration routes; Doping; LC–MS/MS; Metabolites; Triamcinolone acetonide