Detection of growth hormone abuse in sport

Growth Horm IGF Res. 2007 Jun;17(3):220-6. Epub 2007 Mar 6.
Powrie JK, Bassett EE, Rosen T, Jorgensen JO, Napoli R, Sacca L, Christiansen JS, Bengtsson BA, Sonksen PH; On behalf of the GH-2000 Project Study Group.
Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Foundation Trust, 3rd Floor, Thomas Guy house, Guy's Hospital, London SE1 9RT, UK
PubMed ID & Record: 17339122

OBJECTIVE: To develop a test for GH abuse in sport. DESIGN: A double blind placebo controlled study of one month's GH administration to 102 healthy non-competing but trained subjects. Blood levels of nine markers of GH action were measured throughout the study and for 56 days after cessation of GH administration. Blood samples were also taken from 813 elite athletes both in and out of competition. RESULTS: GH caused a significant change in the nine measured blood markers. Men were more sensitive to the effects of GH than women. IGF-I and N-terminal extension peptide of procollagen type III were selected to construct formulae which gave optimal discrimination between the GH and placebo groups. Adjustments were made to account for the fall in IGF-I and P-III-P with age and the altered distribution seen in elite athletes. Using a cut-off specificity of 1:10,000 these formulae would allow the detection of up to 86% of men and 60% of women abusing GH at the doses used in this study. CONCLUSIONS: We report a methodology that will allow the detection of GH abuse. This will provide the basis of a robust and enforceable test identifying those who are already cheating and provide a deterrent to those who may be tempted to do so.

Detection of growth hormone abuse in sport

Growth Horm IGF Res. 2007 Jun;17(3):220-6. Epub 2007 Mar 6
Powrie JK, Bassett EE, Rosen T, Jorgensen JO, Napoli R, Sacca L, Christiansen JS, Bengtsson BA, Sonksen PH; On behalf of the GH-2000 Project Study Group.
Department of Diabetes and Endocrinology, Guy's and St Thomas' NHS Foundation Trust, 3rd Floor, Thomas Guy house, Guy's Hospital, London SE1 9RT, UK
PubMed ID & Record: 17339122

OBJECTIVE: To develop a test for GH abuse in sport. DESIGN: A double blind placebo controlled study of one month's GH administration to 102 healthy non-competing but trained subjects. Blood levels of nine markers of GH action were measured throughout the study and for 56 days after cessation of GH administration. Blood samples were also taken from 813 elite athletes both in and out of competition. RESULTS: GH caused a significant change in the nine measured blood markers. Men were more sensitive to the effects of GH than women. IGF-I and N-terminal extension peptide of procollagen type III were selected to construct formulae which gave optimal discrimination between the GH and placebo groups. Adjustments were made to account for the fall in IGF-I and P-III-P with age and the altered distribution seen in elite athletes. Using a cut-off specificity of 1:10,000 these formulae would allow the detection of up to 86% of men and 60% of women abusing GH at the doses used in this study. CONCLUSIONS: We report a methodology that will allow the detection of GH abuse. This will provide the basis of a robust and enforceable test identifying those who are already cheating and provide a deterrent to those who may be tempted to do so.

Germany may tighten its laws on sports medicine after doping incidents

British Medical Journal (BMJ). 2007 Jun 9;334(7605):1184-5.
Tuffs A.
PubMed ID & Record: 17556450

Leading Text: Doctors and politicians in Germany are demanding stricter laws for sports medicine after three doctors were discovered to have given performance enhancing drugs to professional cyclists. Two of the three doctors, from Freiburg University Hospital, were suspended last week by the university when they admitted doping professional cyclists. In separate statements, Lothar Heinrich and Andreas Schmid said that they gave the blood cell stimulating hormone erythropoietin to the cycling team of the German telephone company Deutsche Telekom, now T-Mobile. The confessions were made after several cyclists had recently publicly admitted to taking drugs for performance and accused the doctors of involvement. "I admit that I supported doping individual cycling professionals from the mid-1990s," Dr Schmid said in a statement released by his attorney. Previously, he and his colleague had denied any wrongdoing. Freiburg prosecutors are investigating and the university has also promised a full independent investigation into the past 20...

Increased serum concentration of IGFBP-4 and IGFBP-5 in healthy adults during one month's treatment with supraphysiological doses of growth hormone

Growth Horm IGF Res. 2007 Jun;17(3):234-41. Epub 2007 Mar 8
Ehrnborg C, Ohlsson C, Mohan S, Bengtsson BK, Rosen T.
Research Centre for Endocrinology and Metabolism (RCEM), Endocrine Division, Department of Internal Medicine, Grona Straket 8, Sahlgrenska University Hospital, SE-413 45 Goteborg, Sweden.
PubMed ID & Record: 17347011

OBJECTIVES: To study the effects on insulin-like growth factor binding proteins (IGFBP)-4 and -5 after one month's treatment with supraphysiological doses of growth hormone (GH) in healthy, active young adults with a normal GH-IGF-I axis. Furthermore, the possible use of IGFBP-4 and IGFBP-5 as markers of GH doping is discussed. DESIGN: Thirty healthy, physically active volunteers (15 men and 15 women), mean age 25.9 years (range 18-35), participated in this randomized, double-blind, placebo-controlled, parallel study with three groups (n=10; 5 men and 5 women in each group). The groups comprised the following: placebo, GH 0.1IU/kg/day [0.033mg/kg/day] and GH 0.2IU/kg/day [0.067mg/kg/day]. RESULTS: Baseline levels of IGFBP-4 were higher (+20%), while IGFBP-5 levels were lower (-37%) in women than in men. IGFBP-5 levels were positively correlated to age, but no significant correlation was found for IGFBP-4. In the pooled group with active GH treatment (n=20), both IGFBP-4 and IGFBP-5 levels were increased vs. the placebo group from day 14 until end of treatment [day 28, IGFBP-4 (+40%, p<0.01) and IGFBP-5 (+61%, p <0.001)]. After inclusion of serum IGF-I as a covariate in the linear regression analysis, the associations between GH treatment and the IGFBP-4 and IGFBP-5 levels were not significant. CONCLUSIONS: This study shows that the levels of IGFBP-4 and IGFBP-5 are affected by supraphysiological GH treatment given to young, healthy, physically active adults of both genders. The present study, including relatively few subjects, does not support that IGFBP-4 and IGFBP-5 can be used as IGF-I independent markers in a forthcoming method for detecting GH doping, although, further studies are needed to investigate the potential use of IGFBP-4 and IGFBP-5 as markers of GH doping.

Tour de chaos

Br J Sports Med. 2007 Jun 11; [Epub ahead of print]
Lippi G, Franchini M, Guidi GC.
Sez. Chimica e Microscopia Clinica, Dip. Scienze Morfologico-Biomediche, Verona University, Italy.
PubMed ID & Record: 17562744

Competition is connatural to the human nature and it has substantially contributed to evolution and survival, often revealing as an unconditional inclination to dominance. Although success in competition can be traditionally achieved through intensive training and categorical mental attitude, celebrity and economical benefits ensued from success in competitive sports have always persuaded the athletes to use alternative, occasionally unfair and dangerous means to enhance their athletic performances. There is rather a long history of fraud in sport competitions, which founds its origin in remote times. However, revolutionary advances in biology and biochemistry have profoundly distorted this scenario, providing the unfair athletes with sophisticated performance enhancing substances and techniques (1). On the evidence of a widespread use of illicit and potentially harmful manoeuvres, several sport federations, in teamwork with the medical community, have adopted increasingly complicated and comprehensive systems of control to overcome the gory problem of doping in sports. Despite the full commitment of the World Anti-Doping Agency (WADA) and the International Cycling Union (ICU), there is evidence that athletes are testing positive at antidoping controls on a regular basis. The very recent Tour de France 2006 saga is disappointing. The cycling fans have always thought that the greatest cycling competition in the world, next in term of audience and media involvement to the Olympics and the football Word Championships, was an endurance race where cycling performance and some sort of racing ability would have represented the main requisites to wear the yellow jersey in Paris. However, the recent developments are profoundly altering this scenario, transforming the Tour in an elimination race. Just 24 hours ahead of the prologue start in Strasbourg, nine riders from five teams were ruled out of the race, suspected to be implicated in an international doping probe based on blood transfusions and involving more than 200 athletes of different sport disciplines. This huge doping scandal, conventionally known as the "affair Fuentes", set out in an unadorned apartment in Madrid, where the Spanish police discovered a clandestine structures of the international performance enhancement business, seizing more than two hundreds blood bags, along with doping records and several other doping substances. Apparently, the investigators were able to match code names of athletes with their highly detailed doping records (2). In the prosecution, the American rider Floyd Landis, who worn the 2006 yellow jersey in Paris, tested positive for unusual levels of testosterone after winning stage 17 and is now set to lose his title. This was not enough. Runner-up Oscar Pereiro of Spain, the athlete who would have been probably awarded of the yellow jersey, is under investigation for testing positive at the banned substance salbutamol. Metabolites of this drug, often prescribed for asthma, were discovered by the French anti-doping body (AFLD) in Pereiro's urine sample after the stages 14 and 16. Although the authority of the AFLD is limited to French soil only, Pereiro will risk not taking part in the 2007 Tour and could be stripped of second place in the 2006 race. These disappointing events deserve some profound considerations...