The Potential Role of Oral Fluid in Antidoping Testing

Abstract

BACKGROUND Currently, urine and blood are the only matrices authorized for antidoping testing by the World Anti-Doping Agency (WADA). Although the usefulness of urine and blood is proven, issues remain for monitoring some drug classes and for drugs prohibited only in competition. The alternative matrix oral fluid (OF) may offer solutions to some of these issues. OF collection is easy, noninvasive, and sex neutral and is directly observed, limiting potential adulteration, a major problem for urine testing. OF is used to monitor drug intake in workplace, clinical toxicology, criminal justice, and driving under the influence of drugs programs and potentially could complement urine and blood for antidoping testing in sports. CONTENT This review outlines the present state of knowledge and the advantages and limitations of OF testing for each of the WADA drug classes and the research needed to advance OF testing as a viable alternative for antidoping testing. SUMMARY Doping agents are either prohibited at all times or prohibited in competition only. Few OF data from controlled drug administration studies are available for substances banned at all times, whereas for some agents prohibited only in competition, sufficient data may be available to suggest appropriate analytes and cutoffs (analytical threshold concentrations) to identify recent drug use. Additional research is needed to characterize the disposition of many banned substances into OF; OF collection methods and doping agent stability in OF also require investigation to allow the accurate interpretation of OF tests for antidoping monitoring.

Direct drug analysis from oral fluid using medical swab touch spray mass spectrometry

“…, not in a clinical–laboratory setting). Examples include therapeutic drug monitoring, pain management programs [1,5,6], anti-doping controls [2], and roadside or workplace drug testing [4,5,7,8]. Major advantages of oral fluid analysis include these features: (i) non-invasive, (ii) sex-neutral ( i.e.…”

“…Major advantages of oral fluid analysis include these features: (i) non-invasive, (ii) sex-neutral ( i.e. , common to male and females), (iii) directly observable sample collection (unlike urine testing), and (iv) reduced biohazard risks [2,6]. On the other hand, drawbacks are the limited fluid volume that can be collected rapidly [4,5] and the instability of some drugs in oral fluid.…”

Potential detection of low‐dose transdermal testosterone administration in blood, urine, and saliva

“…[50][51][52] The authors also describe the advantage of LC-MS/ MS compared to immunoassay in relation to sensitivity. [53] In this context Keevil et al have shown that testosterone is almost stable for several days at room temperature as well as stable after several freeze-thaw cycles, supporting the focus on saliva in doping analysis. [52] In sum, there are many arguments for focusing on salivary analysis in the fight against doping.…”

Metabolic and isotopic signature of short‐term DHEA administration in women: Comparison with findings in men

“…21 In case of administration of DHEA, which is considered as a prohormone of T, the analysis of T and its metabolites leads to positive results in the same way as direct analysis of DHEA. [25][26][27] Ponzetto et al 28 Saliva samples were collected after T gel application and the concentration of T was clearly above the intra-individual reference threshold, enabling the detection of T application for 76 hours. [25][26][27] Ponzetto et al 28 Saliva samples were collected after T gel application and the concentration of T was clearly above the intra-individual reference threshold, enabling the detection of T application for 76 hours.…”