The Performance Effects of Microdose Recombinant Human Erythropoietin Administration and Carbon Monoxide Rebreathing

Abstract

Frequent, low doses of recombinant human erythropoietin (rHuEpo) have been shown to increase the oxygen carrying capacity of an athlete and enhance endurance performance, although its effect on repeated sprint ability (RSA) remains unknown. If the mechanisms behind improved RSA performance reside within the augmented O 2 carrying capacity, then carbon monoxide (CO) inhalation should inhibit RSA. Purpose: The aim of this study was to assess the effects on maximal oxygen uptake (VO 2max ) and RSA of two interventions known to differentially influence blood oxygen carrying capacity. Methods: Fourteen endurance-trained individuals were administered microdoses of rHuEpo (20Y40 IU . kg j1 ) or placebo twice per week for 7 wk using a randomized, crossover design. VO 2max and RSA were measured at baseline and after rHuEpo administration. Total hemoglobin mass (tHb-mass) was measured twice at baseline (14 and 7 d before the first injection), three times during rHuEpo administration (10, 24, and 38 d after the first rHuEpo injection) and twice after the cessation of rHuEpo administration (7 and 21 d after the final injection) using the optimized CO rebreathing method. VO 2max and RSA also were assessed in a separate cohort of 11 Black lines represent the mean for all subjects. (A) Changes in VO 2max following rHuEpo administration, (B) VO 2max following placebo and CO rebreathing, (C) Changes in VT following rHuEpo administration and (D) Changes in VT following placebo or CO rebreathing.

Impairment in maximal lactate steady state after carbon monoxide inhalation is related to training status

“…In agreement with previous studies (Ekblom & Huot, 1972;Ekblom et al, 1975;Schmidt & Prommer, 2005), CO inhalation significantly decreased VO 2 peak and PPO, further indicating that both variables are generally limited by O 2 -carrying capacity (Skattebo et al, 2020). Previous research has mostly produced comparable results regarding the general effect of CO on VO 2 max : changes of −9.0% with 7% COHb (Ekblom & Huot, 1972), −6.3% with 4.3% COHb (Klausen et al, 1983), −4.8% with 4.7% COHb (Sutehall et al, 2018) and −3.0% with 4.9% COHb (Schmidt & Prommer, 2005) were reported in groups of individuals with similar average VO 2 peak (45-55 ml kg BM −1 min −1 ).…”

“…In agreement with previous studies (Ekblom & Huot, 1972; Ekblom et al., 1975; Schmidt & Prommer, 2005), CO inhalation significantly decreased $${\dot{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{peak}}}$$ and PPO, further indicating that both variables are generally limited by O 2 ‐carrying capacity (Skattebo et al., 2020). Previous research has mostly produced comparable results regarding the general effect of CO on $${\dot{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{max}}}$$: changes of −9.0% with 7% COHb (Ekblom & Huot, 1972), −6.3% with 4.3% COHb (Klausen et al., 1983), −4.8% with 4.7% COHb (Sutehall et al., 2018) and −3.0% with 4.9% COHb (Schmidt & Prommer, 2005) were reported in groups of individuals with similar average $${\dot{V}}_{{{\rm{O}}}_{\rm{2}}{\rm{peak}}}$$ (45–55 ml kg BM −1 min −1 ). The reduced O 2 ‐carrying capacity did not impair other peak physiological responses to exercise, except for O 2 pulse and $${\dot{V}}_{\rm{E}}$$/$${\dot{V}}_{{{\rm{O}}}_{\rm{2}}}$$, which were lower and higher in CO, respectively.…”

Microdoses of Recombinant Human Erythropoietin Enhance Time Trial Performance in Trained Males and Females

“…When taking into account a 5% attrition rate, 24 participants were enrolled in both groups. Considering the MPO in a comparable population during a similar exercise protocol (26), it is expected to enable a detection of changes in MPO by ~9 W. For tHb, the inclusion of 48 participants allows a detection of differences of more than 2% based on previous findings (29).…”

Factors Confounding the Athlete Biological Passport: A Systematic Narrative Review

“…Following blood withdrawal there should be a decrease in [Hb] and increase in Ret%, with the opposite effect occurring after re-infusion [20,21]. In addition, chronic exposure to low doses of carbon monoxide was recently shown to positively influence erythropoiesis and alter markers sensitive to PV variations [23,94]. Conversely, repeated intake of desmopressin or chronic xenon inhalation induced haemodilution and decreased concentration-based biomarkers sensitive to PV shift [24,25,95].…”