Detection methods for autologous blood doping

Abstract

The use of blood doping is forbidden by the World Anti-Doping Agency. Several practices, such as blood transfusions are used to increase oxygen delivery to muscles and all of them are highly pursued. In this regard, the development of accurate methodologies for detecting these prohibited practices is one of the current aims of the anti-doping control laboratories. Flow cytometry methods are able to detect allogeneic blood transfusions but there is no official methodology available to detect autologous blood transfusions. This paper reviews protocols, including the Athlete Biological Passport, that use indirect markers to detect misuse of blood transfusions, especially autologous blood transfusions. The methods of total haemoglobin mass measurements and the detection of metabolites of blood bags plasticizers in urine are reviewed. The latter seems to be an important step forward because it is a fast screening method and it is based on urine, a fluid widely available for doping control. Other innovative approaches to blood transfusion detection are also mentioned. A combination of the reported methodologies and the implementation of the Athlete Biological Passport is becoming a promising approach.

Determination of five di-(2-ethylhexyl)phthalate metabolites in urine by UPLC–MS/MS, markers of blood transfusion misuse in sports

“…The use of blood transfusions produces a huge increase in the concentration of all DEHP metabolites in urine [30][31][32][33][34][35]. However, as DEHP is ubiquitously present, all population is exposed to some extent.…”

“…Instead, DEHP is released from blood bags [29] and urinary concentrations of DEHP metabolites have demonstrated to be higher in patients subjected to homologous blood transfusion and in moderately trained volunteers who were subjected to a protocol of autologous blood transfusion [30][31][32]. So, the detection of high concentrations of DEHP metabolites in urine has been proposed as a marker of the misuse of both homologous and autologous blood transfusions in sports [33]. The ubiquitous exposure to DEHP of the general population makes the definition of commonly exposed population concentrations necessary.…”

Blood doping: potential of blood and urine sampling to detect autologous transfusion

“…The potential of ABP to detect haematopioetic changes such as those induced by blood transfusion or erythropoietin (EPO) administration is discussed in another chapter of this volume12 and in several articles and reviews 4 13–16. Therefore, we will not elaborate on them here.…”

“…Flow cytometry can reveal double populations of surface antigens and thereby detect homologous (allogeneic) transfusions—those from a different person 2 3. However, it remains impossible to detect autologous transfusions, that is, transfusions with one's own blood, by this approach 4. The lack of a direct detection method for autologous transfusion remains a significant problem for endurance sports 5…”

Alterations in phospholipid profiles of erythrocytes deep‐frozen without cryoprotectants

“…[10][11][12] However, collecting complete data for all athletes is not possible; therefore, the ABP is not suitable for participants with no reference data. Numerous studies have been devoted to ABT detection 13 based on plasticizers leached from storage bags during blood storage 14,15 or differences between young and old RBCs, 16,17 but none of these methods has been certified without limitations.…”