Hypoxia-inducible factor (HIF) stabilizers are listed
in the World
Anti-Doping Agency’s prohibited list as they can increase aerobic
exercise capacity. The rapid pace of emergence of highly structurally
diverse HIF stabilizers could pose a risk to conventional structure-based
methods in doping control to detect new investigational drugs. Therefore,
we developed a strategy that is capable of detecting the presence
of any HIF stabilizer, irrespective of its structure, by detecting
biological activity. Previously developed cell-based HIF1/2 assays
were optimized to a stable format and evaluated for their screening
potential toward HIF stabilizers. Improved pharmacological characterization
was established by the stable cell-based formats, and broad specificity
was demonstrated by pharmacologically characterizing a diverse set
of HIF stabilizers (including enarodustat, IOX2, IOX4, MK-8617, JNJ-42041935).
The methodological (in solvent) limit of detection of the optimal
HIF1 stable bioassay toward detecting the reference compound roxadustat
was 100 nM, increasing to 50–100 ng/mL (corresponding to 617–1233
nM in-well) in matching urine samples, owing to strong matrix effects.
In a practical context, a urinary limit of detection of 1.15 μg/mL
(95% detection rate) was determined, confirming the matrix-dependent
detectability of roxadustat in urine. Pending optimization of a universal
sample preparation strategy and/or a methodology to correct for the
matrix effects, this untargeted approach may serve as a complementing
method in antidoping control, as theoretically, it would be capable
of detecting any unknown substance with HIF stabilizing activity.