Blood doping

Blood doping

Blood doping is the practice of boosting the number of red blood cells (RBCs) in the circulation in order to enhance athletic performance. Because they carry oxygen from the lungs to the muscles, more RBCs in the blood can improve an athlete’s aerobic capacity (VO2 max) and endurance.

Methods

The term blood doping originally meant doping with blood, i.e. the transfusion of RBCs. RBCs are uniquely suited to this process because they can be concentrated, frozen and later thawed with little loss of viability or activity. There are two possible types of transfusion: homologous and autologous. In a homologous transfusion, RBCs from a compatible donor are harvested, concentrated and then transfused into the athlete’s circulation prior to endurance competitions. In an autologous transfusion, the athlete's own RBCs are harvested well in advance of competition and then re-introduced before a critical event. For some time after the harvesting the athlete may be anemic.

Both types of transfusion can be dangerous because of the risk of infection and the potential toxicity of improperly stored blood. Homologous transfusions present the additional risks of communication of infectious diseases and the possibility of a transfusion reaction. From a logistical standpoint, either type of transfusion requires the athlete to surreptitiously transport frozen RBCs, thaw and re-infuse them in a non-clinical setting and then dispose of the medical paraphernalia.

In the late 1980s an advance in medicine led to an entirely new form of blood doping involving the hormone erythropoietin (EPO). EPO is a naturally-occurring growth factor that stimulates the formation of RBCs. Recombinant DNA technology made it possible to produce EPO economically on a large scale and it was approved in US and Europe as a pharmaceutical product for the treatment of anemia resulting from renal failure or cancer chemotherapy. Easily injected under the skin, pharmaceutical EPO can boost hematocrit for six weeks or longer. The use of EPO is now believed by many to be widespread in endurance sports. ]

Vinokourov's teammate Andrej Kashechkin also tested positive for homologous blood doping [cite web | url = http://www.cyclingnews.com/news.php?id=news/2007/aug07/aug09news | title = Kashechkin tests positive for blood doping | publisher = Cyclingnews.com | accessdate = 2007-08-09] on August 1st, 2007, just a few days after the conclusion of the 2007 Tour de France (a race that had been dominated by doping scandals). His team withdrew after the revelation that Vinokourov had doped.

Preventative measures

It was revealed in autumn 2007, following another troubled year for professional cycling, that the sport's governing body (UCI) would introduce mandatory "blood passports" for all professional riders. The scheme, thought to be the the first of its type in any sport, involves using blood and urine samples to create a medical profile that could be compared to results of subsequent doping tests. Blood doping can be very effective but also very dangerous.

Former World Anti-Doping Agency (WADA) President Dick Pound has stated a belief that anti-doping passports will be in widespread use within three years, although not in time for the 2008 Olympic Games. [cite web | url = http://news.bbc.co.uk/sport1/hi/other_sports/cycling/7048972.stm | title = Cyclists face rise in drugs tests | publisher = BBC Sport| accessdate = 2007-10-24]

Negative effects

There are many side effects to blood doping. The simple act of increasing the number of RBCs in the blood stream makes blood thicker. This can also make it clot more readily. This has shown an increase in the chances of heart attack, stroke and pulmonary embolism. This has been seen in cases where there is too much blood reintroduced into the blood stream. Blood contamination during preparation or storage is another issue. This was seen in 1 in every 500,000 transfusions of RBC in 2002. [Blajchman M. "Incidence and significance of the bacterial contamination of blood components.". Dev Biol (Basel) 108: 59-67.] This contamination can lead to sepsis or an infection that affects the whole body. This may seem like a small number but as blood doping becomes more popular among athletes, infections due to the procedure may increase. Also certain medications used to increase RBCs can reduce liver function and lead to liver failure, pituitary and increase cholesterol levels. [Urhausen,Axel , Albers Torsten and Kindermann Wilfried. Reversibility of the effects on blood cells, lipids, liver function and hormones in former anabolic–androgenic steroid abusers. The Journal of Steroid Biochemistry and Molecular Biology. Volume 84, Issues 2-3, February 2003, Pages 369-375]

In popular culture

*In an episode of House M.D., a patient who is a professional cyclist was found to be blood-doped.

ee also

* List of doping cases in cycling

References

*cite journal | first=Wolfgang | last=Jelkmann | year=2007 | title=Novel Erythropoietic Agents: A Threat To Sportsmanship | publisher=Polish Society of Sports Medicine | journal=Medicina Sportiva | volume = 11 | issue = 2 | pages = 32–42 | url=http://www.medicinasportiva.pl/new/pliki/ms2007_02_01_jelkmann.pdf | format=PDF | accessdate=2007-07-31 | doi=10.2478/v10036-007-0007-1


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