title: Detection of erythropoietin misuse by the Athlete Biological Passport combined with reticulocyte percentage.
abstract: The sensitivity of the adaptive model of the Athlete Biological Passport (ABP) and reticulocyte percentage (ret%) in detection of recombinant human erythropoietin (rHuEPO) misuse was evaluated using both a long-term normal dose and a brief high dose treatment regime. Sixteen subjects received either 65 IU rHuEPO × kg-1every second day for two weeks (normal-dose), 390 IU rHuEPO × kg-1on three consecutive days (high-dose), or frequent placebo treatment for 13 days in a randomized, placebo-controlled, double-blind crossover design. Blood variables were measured 4, 11, and 25 days following treatment initiation. The ABP based on haemoglobin concentration ([Hb]) and OFF-hr score ([Hb] - 60 × √ret%) yielded atypical profiles following both normal-dose and high-dose treatment (0 %, 31 %, 13 % vs. 21 %, 33 %, 20 % at days 4, 11, and 25 after normal and high dose, respectively). Including ret% as a stand-alone marker for atypical blood profiles increased (P < 0.05) the sensitivity of the adaptive model at day 11 to 63 % and 67 % for normal-dose and high-dose rHuEPO administration, respectively. In conclusion, ~30 % of subjects injecting a normal-dose rHuEPO for two weeks or a high-dose rHuEPO for three days will present an atypical ABP profile. Including ret% as a stand-alone parameter improves the sensitivity two-fold. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Department of Nutrition, Exercise and Sport Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Jacob
authors.initials: J
authors.lastname: Bejder
authors.affiliation: Department of Neuroscience and Pharmacology, University of Copenhagen.
authors.forename: Niels Jacob
authors.initials: NJ
authors.lastname: Aachmann-Andersen
authors.affiliation: Department of Nutrition, Exercise and Sport Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Thomas Christian
authors.initials: TC
authors.lastname: Bonne
authors.affiliation: Department of Neuroscience and Pharmacology, University of Copenhagen.|Department of Neuroanesthesia, The Neuroscience Center, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark.
authors.forename: Niels Vidiendal
authors.initials: NV
authors.lastname: Olsen
authors.affiliation: Department of Nutrition, Exercise and Sport Sciences, University of Copenhagen, Copenhagen, Denmark. nbn@nexs.ku.dk.
authors.forename: Nikolai Baastrup
authors.initials: NB
authors.lastname: Nordsborg
mesh_terms: D056352:Athletes; D004300:Doping in Sports; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D000068817:Epoetin Alfa / Q000737:chemistry / Q000378:metabolism*; D004921:Erythropoietin / Q000008:administration & dosage / Q000097:blood* / Q000737:chemistry / Q000378:metabolism*; D006801:Humans; D011994:Recombinant Proteins / Q000737:chemistry* / Q000378:metabolism*; D017701:Reticulocyte Count / Q000379:methods*
chemical_list: C554270:EPO protein, human; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa
keywords: blood manipulation; doping control; recombinant human erythropoietin