Projets de recherche

Code: 13D31PV

Although recent advances of steroid profiling have shown to substantially increase the detection sensitivity, still, the prevalent of misuse is larger than what doping control laboratories can detect. In particular the introduction of slow-release preparations such as T-gels and steroid patches poses anti-doping analysts for greater challenges as the metabolic footprint of misuse with these preparations is very small. 
In 2009, Bayer introduced a long-acting T undecanoate depot Nebido® for therapeutic treatment of hypogonadism in males. Nebido® should be administered only once in two or three months, which is a much longer release period compared to other long-term T-formulations (e.g. Sustanon®). A dose of 1000mg T undecanoate should be injected in the muscle. It is claimed that the insufficient T-levels are restored and do not exceed normal serum levels and likewise cause less unwanted side-effects. 
Also, it has been shown that such high T undecanoate doses can lead to elevated hematocrit levels. Moreover, sustained elevated T-levels can exert a beneficial anabolic effect on micro-damaged muscle tissue after long exercise to enhance recovery.  Interesting features for endurance athletes, for whom the biological passport is a well-established tool to screen and record their doping test results. In this light, it is assumed that described effects can be noticed in both the steroidal and blood module of the biological passport and help to find Nebido® misuse in this category of athletes.  This study aims to investigate the direct detectability of T-undecanoate as administered with Nebido® in blood as well as the influence on various blood and steroid parameters as recorded in the biological passport. 

Main Findings:

Today the steroid passport is a very performant tool to detect abnormal variations in steroid profile markers. Although recent advances of current methods for endogenous steroids have shown to substantially increase the detection sensitivity, the prevalent of misuse is far larger than what doping control laboratories can detect. Particularly, slow-release preparations pose anti-doping analysts for great challenges as the metabolic footprint of misuse with these preparations can be very small. Nebido (Bayer) is one of such long-acting slow release T preparations, containing T undecanoate, that is used for therapeutic treatment of hypogonadism in males. In sports, slow releasing T formulation are applied to rapid repair of micro damage to muscles after exercise for faster recovery. In addition, it has been shown that such high T doses can lead to elevated haematocrit levels. Moreover, sustained elevated T-levels can exert a beneficial anabolic effect on micro-damaged muscle tissue after long exercise to enhance recovery. Both features are interesting for endurance athletes, whereas T used to be related to cheating power athletes for its anabolic effects.  
The T/E ratio was clearly altered by the use of Nebido as slow release T formulation and remain detectable using longitudinal following during 3 months. Androstanediol  ratio and androsterone over etiocholanolone remain mostly unaltered, despite elevated concentrations. Minor steroid metabolites did not contribute to longer or better detection as likely the major pathways were not saturated. As a result the steroidomic model showed similar sensitivities as those observed for longitudinal evaluation of the T/E ratio.  
A very sensitive method for the detection of T in saliva was developed and applied to the oral fluid samples collected after Nebido. Although, salivary T concentrations increased to 7 fold and detectable using population based reference ranges, the basal values were restored after 14 days. Oral fluid analysis of T did not provide any added value for doping control. Hence, the pharmacokinetics of salivary T are much different compared with the observations for T-gel, also a slow-release formulation. 
Blood passports were created after the Nebido T supplementation and results demonstrated that the blood markers were significantly altered but did not results in atypical passport findings. The reticulocyte production was stimulated in the month after Nebido injection, after which a suppressive effect was observed in the second month. By this time haemoglobin was formed to give rise to an elevated plateau in the blood passport that remained below the upper individual limit. Also the off-score showed the alterations that was typical for bone marrow stimulation. 

Code: 13A08MT

The necessities generated by the high standards and quality requirements of modern sports drug testing entails numerous challenges for doping control authorities as well as accredited laboratories. Among these challenges, several prominent aspects can be approached and solved by collecting and, when indicated, testing an additional/ a complementary specimen referred to as dried blood spot (DBS). 1. An important element of efficient doping controls is the frequent and unpredictable sampling of athletes, especially out-of-competition and concerning e.g. anabolic agents, erythropoiesis-stimulating agents, etc. Here, costs associated with sample collection and analysis are particularly limiting factors.
2. With regard to in-competition controls, the differentiation whether a substance such as a stimulant or cannabinoid (i.e. not prohibited at all times) was present in the athlete's blood at pharmacologically relevant concentrations or not is required. From urine analyses, conclusions as to the blood concentration of a drug is a complex issue and has been subject of numerous studies and discussions in the past.2-5
3. The issue of instable compounds can be solved as e.g. in case of Synacthen, a substance that was confiscated in the Spanish Fuentes scandal and admittedly misused by several athletes. Due to its limited stability in blood and urine, its analysis was hampered despite the availability of analytical methods. DBS collection and analysis is considered as a valuable means to improve currently conducted doping control strategies as it addresses all of the above mentioned aspects. DBS are substantially cheaper than conventional doping control samples and thus larger collectives can be processed; drug concentrations at the time of competition can be determined; and instable analytes can be conserved. As a result, both relevant aspects of doping controls, i.e. deterrence from doping and protecion of honest athletes will be considerably strengthened. 

Main Findings: 

A drop of whole blood dried on filter paper (Dried Blood Spots, DBS) represents an aspiring technique for minimal-invasive sample collection in a multitude of analytical disciplines, e.g., therapeutic drug monitoring, preclinical drug development and diagnostic analysis of metabolic disorders in newborns. DBS sampling is characterized by cost-effectiveness, straightforwardness, robustness and facilitated storage and shipment conditions. 
The present investigation was conducted to highlight the opportunities arising from the implementation of DBS as complementary matrix in doping control programs. Being frequently abused, three model compounds were chosen to represent the classes of anabolic agents (stanozolol and dehydrochloromethyltestosterone) and stimulants (pseudoephedrine). A quantitative method was developed and validated for the detection of the target analytes from DBS using liquid chromatography coupled to high resolution/ high accuracy tandem mass spectrometry. The imprecision of the assay amounted to < 8% for intraday and < 18% for day-to-day measurements. Highly purified DBS sample extracts exhibited no ion suppression effects due to interfering matrix components and provided limits of detection of 20 pg/mL for stanozolol and 0.8 ng/mL for DHCMT and pseudoephedrine, respectively, notwithstanding an overall recovery of 26%. Deuterium-labeled internal standards were used to yield reliable quantitative results (accuracy 84-125%). Stability of the analytes was shown for at least 28 days at room temperature.  
Proof-of-principle for the method presented was substantiated by means of the analysis of authentic specimens obtained from administration studies with stanozolol, DHCMT and pseudoephedrine. The results provided, to our best knowledge, unprecedented detection windows for the tested anabolic agents accomplished by DBS sampling to support out-of-competition control efforts for the tested anabolic agents. Furthermore, the unambiguous proof of pharmacologically relevant blood concentrations at given urinary analyte levels are noteworthy for the improvement of in-competition controls, e.g., with regard to stimulant analysis.

Code: 13C35CC 

Stimulants are banned in competition by the World Anti-Doping Agency, except for nicotine. Psychoactive substance as nicotine is widely reported to increase alertness, improve coordination and enhance cognitive performance.
In healthy humans nicotine administration increases heart rate and blood pressure. Plasma nicotine concentrations improve anaerobic energy production and suggest a nicotine-induced sympathetic stimulation of the heart. Nicotine has been placed on WADA's 2013 Monitoring Program in order
to detect potential patterns of abuse. Smokeless tobacco is a blanket term that refers to a number of tobacco products that are used by means other than smoking. Snus is a smokeless tobacco consumed orally, which has a long tradition of use that, is widespread in North America and Scandinavian countries. It is typically placed between the upper lip and the gum, toward the front of the mouth, for approximately 30min before it is discarded. Recently, some studies on snus in competitive events showed a high use among athletes mostly in a winter sporting environment.  The aim of this study is to investigate the snus effects on sport performance. In the first year we will investigate the effects of snus in an aerobic performance by an exercise intensity nearly 80% VO2max until exhaustion correlated with the perception of effort and time to exhaustion along with a range of physiological parameters. In the second and third year the aim is to investigate the effect of snus on high-intensity exercise by on a, short-term high-intensity cycling test, (Wingate) using trained athletes. If results will show a snus effect of increasing time to exhaustion, reduced perception of effort and increase anaerobic performance, an informed decision on the potential doping of nicotine will be done. WADA could consider to include nicotine in Prohibited List of Substances and Methods, prohibited in-competition

Main Findings: 

Snus is a smokeless, orally consumed tobacco, traditionally produced and used in Sweden and in Scandinavian countries. Analytical chemistry studies showed an increase of nicotine use in athletes practicing different sports. Nicotine has also several physiological effects on heart and on the vascular system. This effect influence sport performances and exercise capacity.

The purpose of this study was to investigate the snus effects on aerobic performance (80% VO2max) during exercise until exhaustion and the perception of fatigue during abstinence (AC) and satiety condition (SC). We recruited 18 healthy male athletes daily snus users. The study was a double-blind cross-over design. Subjects were tested during three sessions on cycle-ergometer.  Experimental session 1 (EXP1) consisted in maximal incremental exercise test (MIT) to determine the VO2max. EXP2 and EXP3 consisted in exercise, after 25 min from snus administration, at 80% VO2max until exhaustion (TTE) under AC and SC conditions. During the tests, muscle and cerebral oxygenation was recorded by means of NIRS (near-infrared spectroscopy) and the global rating of perceived exertion (RPE). We measured, non-invasively the dynamic response of tissue O2 saturation (Ox%) on tight muscle by a vascular occlusion test (VOT).

Nicotine and cotinine analysis confirmed the different initial conditions (AC vs. SC). We found a significant increase (+13.1%) in TTE (24.1 ± 10.7 min; means ± SD during AC session; 20.9 ± 8.0 min during SC session; means ± SD, P = 0.0131). RPE values did not significantly change during exercise. We found significant differences in the oxygenation of the cerebral and muscular tissues at rest (T0) and over VOT. Interestingly, our data showed significant differences in metabolic responses (VO2; VCO2; HR; VO2/HR) and in cardiovascular responses (SV; EJT) at baseline (T0). Our sample of athletes consumed 8.1 ± 4.0 (means ± SD) daily snus portions with a value of 5.9 ± 1.9 (means ± SD) of the Fagerstrom Test for Nicotine Dependence-Smokeless Tobacco (FTNDST).

The results of this project research showed that the increase of performance (+13.1% TTE) due to snus administration could be associated to the nicotine effects in order to keep the allostatic state.  In conclusion, our study highlighted that athletes addicted to nicotine would use snus to maintain their nicotine level to “feel normal” in order to improve sport performance.

Code: 13C36AB 

Over the last decade, significant efforts by us and other researchers in the anti-doping community have led to the development of methodology for direct detection of gene doping, a new threat to the world of sport.  The methodology involves polymerase chain reaction (PCR) assays targeting intronless complementary DNA (cDNA) sequences that are present in doping genes but absent in intron-containing endogenous genes. To ensure the method for detection of erythropoietin (EPO) gene doping performs as intended when implemented in routine test laboratories, an EPO DNA reference material (RM) has been prepared and characterized in our laboratory for use as a control. This RM has been carefully designed to ensure that inadvertent cross-contamination of a tested sample with the RM will not lead to a false positive test result. We are currently optimizing and validating protocols for blood sample collection, processing and storage. This will then provide a complete protocol from sample collection through to PCR detection together with an appropriate RM for ongoing monitoring of the method performance. 
This project aims to translate the method for direct detection of gene doping into a routine test method which is implemented in three WADA-accredited laboratories. The method will be initially implemented in the Australian Sports Drug Testing Laboratory (ASDTL). The close association of the applicants' laboratory and ASDTL (both laboratories within the National Measurement Institute, Australia (NMI)) will allow efficient review of the method when conducted in a routine testing environment and enable rapid finalization of the routine test method protocol. The method will then be implemented in two additional WADA-accredited laboratories and the competency of the three laboratories demonstrated through interlaboratory analysis of test samples. 
The project is scheduled for completion early 2016 which is several months prior to the Rio de Janeiro 2016 Olympic Games.

Main Findings: 

Over the last decade, significant efforts have led to the development and validation of methodology for detecting erythropoietin gene doping together with preparation of a DNA reference material to monitor test method performance. This project aimed to translate the method into a routine test and to implement it in one WADA-accredited laboratory, the Australian Sports Drug Testing Laboratory, which is part of the National Measurement Institute of Australia. We documented the complete test for detecting erythropoietin gene doping, provided staff training and assisted the laboratory during method implementation. Following test implementation in a routine laboratory environment, we assessed staff competence in analyzing blind samples and validated the test using blood samples which were prepared to model positive and negative gene doping samples from athletes

Code: 13D18GF 

Synthetic cannabinoids mimic the psychoactive effects of tetrahydrocannabinol (THC) and are found in herbal smoking mixtures, commonly sold as "spice".  Like THC, these compounds are cannabinoid receptor agonists. Today, there is an immense variety of synthetic cannabinoids and spice blends available on the market and new substances constantly appear. Slight chemical modifications of existing compounds make many new cannabimimetics possible. For doping analysis, a fast elucidation of the metabolic pathways of new synthetic cannabinoids is of high importance in order to be able to implement them in doping control procedures. Due to a lack of a toxicological profile, in vivo excretion studies are however difficult to perform. Hence, the current study will employ in vitro metabolism studies on selected cannabimimetics using human cryopreserved hepatocytes. Human cryopreserved hepatocytes are recognized to be a close model to the human liver, showing excellent metabolizing and transporting activities. After hepatocyte incubation and a clean-up procedure, analysis will be performed with liquid chromatography and gas chromatography, combined with mass spectrometry. The selection of the target substances for the in vitro experiments will be based on the frequency of their detection in forensic samples. This is due to a rapidly changing market. The proposed metabolism is verified through the analysis of samples from traffic controls.

Main Findings: 

For doping analysis, the elucidation of the metabolic pathways of new synthetic cannabinoids is of high importance in order to be able to implement them in doping control procedures. Because of the high variability of synthetic cannabinoids and new herbal mixtures in a rapidly changing marked, a fast characterisation of metabolites is required. In terms of non-approved substances like this, though, human excretion studies are difficult to perform due to ethical considerations. In vitro studies, however, can identify human metabolites, and human primary hepatocytes are recognized to be a very close model to the human liver. Furthermore, the improvement of cryopreservation techniques has facilitated the use of cryopreserved hepatocytes which are now commercial available. 
The aim of the current project was to use human cryopreserved hepatocytes to study the metabolism and characterize metabolites of selected synthetic cannabinoids predominating on the marked today. Two frequently reported cannabinoids in herbal smoking mixtures are JWH-307 and AM-694. Thus, these two compounds were selected for the study. 
The incubation mixtures were analysed for substrate and metabolites using liquid chromatography-mass spectrometry (LC/MS/MS) with electrospray ionisation (ESI). Free, glucuronide and sulphate products were separated during sample preparation. Although varied conjugation rates were observed, the majority of the main metabolites were to a high extent excreted as glucuronide conjugates. For all metabolites, the structures are proposed, not confirmed. 
After incubation of AM-694 with human hepatocytes, 10 metabolites were recovered in the extracted culture medium. The most abundant generated products were a defluoroniated monohydroxylated metabolite and a carboxylated metabolite. Furthermore, the results from the hepatocyte assay were compared to analytical results from a forensic AM-694 urine sample. The in vitro data correlated well with observed metabolites in the urine sample. 
After incubation of JWH-307 with human hepatocytes, 22 metabolites were identified. A monohydroxylated compound, a dihydroxylated compound, and three dihydrodiol metabolites were the prevailing metabolites generated in the incubation mixture. 
In conclusion, incubations with human hepatocytes seems to represent a useful model for identifying and predicting major urinary metabolites. 

Code: 13A17MT

Most substances relevant to doping controls undergo considerable metabolism following administration. The generated metabolites are commonly less toxic and more polar which allows for renal clearance. Consequently, in urine the analysis of metabolites is more promising than attempts to detect the ingested or injected compound, particularly when these metabolites are excreted for a longer period of time than the drug. These so-called long-term metabolites are of great interest especially for those doping agents that are predominantly used during out-of-competition periods as for instance in case of anabolic androgenic steroids. 
In order to identify drug metabolites in biological matrices, stable isotope labeling of compounds has proven to be a helpful means within the last 3 decades. Usually, hydrogen is replaced by its heavier isotope deuterium at 3 to 5 locations within the steroid nucleus and the resulting mass shift was detected by means of conventional mass spectrometers. The sensitivity of this approach has recently been considerably improved by using hydrogen isotope ratio (HIR) mass spectrometry instead of conventional mass spectrometers as these HIR-dedicated systems are built to determine the deuterium/hydrogen ratio at natural abundance, i.e. with approximately 1 out of 10000 hydrogen atoms representing a deuterium atom. For deuterium-labeled compounds commonly up to 10 % of hydrogen is substituted and thus enables a highly sensitive detection of any metabolite of the administered compound as long as it carries the deuterium-label.  This feature will be exploited in a novel approach to investigate the metabolism of clenbuterol and nandrolone. Both substances are in the scope of sports drug testing since several years and the systematic study of their metabolism will be conducted to support their long-term detection and determination of respective sources (i.e. endogenous/natural or artificial/contamination). 

Main Findings: 

Employing stable isotope-labeled drugs and GC/IRMS for metabolism studies significantly facilitates the detection of relevant analytes also at lowest abundance in complex matrices such as human urine. In the present research project, the metabolism of two critical anabolic agents, 19-nortestosterone and clenbuterol, was revisited utilizing the recently established approach. Triply deuterated 19-nortestosterone and nine-fold deuterated clenbuterol was used to characterize the drugs’ metabolic profile and to complement and/or corroborate the picture of long-term metabolites as well as the possibilities to differentiate the origin of analytes. In case of 19-nortestosterone, metabolites supporting the classification of low abundant 19-norandrosterone findings as of natural or xenobiotic nature is desirable; in case of clenbuterol, information facilitating the differentiation of contaminated food ingestion from deliberate drug misuse is needed.
The results obtained for both drugs were manifold and a substantial number of known and several yet unknown metabolites as well as sample preparation-derived artefacts were identified. A new 19-nortestosterone metabolite was observed, which was traceable as long as 19-norandrosterone in human urine in the conducted elimination study. The structure of this compound is not entirely clarified yet, and since it appeared to exhibit significant interindividual variability (as suggested by means of routine doping control samples and confirmed adverse analytical findings), its utility for sports drug testing purposes might unfortunately be rather limited. Also for clenbuterol, metabolites were detected and attributed to oxygenation products of the drug. As these are expected to possess different elimination kinetics than clenbuterol itself, a means to differentiate the recent intake of a minute amount (i.e. via food contamination) from remnants of clenbuterol being eliminated from drug abuse weeks ago could be obtained. Here, urinary clenbuterol / metabolite ratios need to be determined in future studies.

Code: 13B10MU 

Prohibited glycoprotein hormones such as ESA, hCG, FSH etc. are currently tested by immunological methods, and the decision is made by immuno-blotting electrophoresis or by comparing concentration with the applicable threshold. However, heterogeneity of the markers or multiple sources of the target compound, e.g. pregnancy, hormone producing tumor, doping etc. can sometime cause in difficulty of decision making. We confirmed that all recombinant glycoproteins from CHO cell line studied were lacking certain human type glycanes, which are not always identifiable by mass spectrometry. Our first year results represented that recombinant and human glycoprotein hormone can be isolated by stereo specific lectin-glycane interactions, and the recombinant fraction does not show any human type glycane specific lectin interactions. Thus, findings of our 1st year project supported the possibility of origin specific detection of glycoproteins by lectin specific extraction coupled to a normal immunoassay instruments that commonly used by all WADA laboratories.

Main Findings: 

Genetically manufactured glycoprotein has the unique isoform profile and the heterogeneity can sometimes cause in interpretation difficulties. Prohibited glycoprotein hormones are currently tested by immunological methods with the result evaluation using the applicable threshold or by comparing the isoform profile with that of the reference standard as no procedure yet available to identify their origins. Glycoproteins from human show a strong lectin-glycan interaction with certain lectins whereas those expressed in CHO-cell lines do not show any interaction with the selected lectins. Immobilized SSA lectin was suspended with a sample aliquot and non-reactive glycoprotein was collected by an exclusion chromatography.  Rest of captured hormone was then eluted with Lactose solution and each fraction was measured by immunoassays. SSA captures LH and FSH from human, and Lutropin (rLH) and Follitropin (rFSH) are collected in the Filtrate. IEF gel electrophoresis western blotting analysis and well-evaluated immunoassays confirmed that FSH in the Filtrate and the Eluate were identical to those of rFSH and uFSH respectively. Pre-analysis lectin fractionation coupled with immunoassay has enabled an origin identification of LH and FSH. Some other possible markers to indicate origin of glycoprotein were evaluated.

Code: 13D13JD 

This research project will contribute to the understanding of inhaling high therapeutic doses of asthma medication (long acting Beta-2-agonists) over a sustained period of time on athletic performance. The majority of research undertaken with inhaled Beta-2-agonists involves acute doses of short acting Beta-2-agonists in male athletes. Investigating acute doses of Beta-2-agonists does not necessarily replicate real life situations, where athletes prescribed Beta-2-agonists will use them on a daily basis for a prolonged period of the time.

The potential performance enhancement from inhaled Beta-2-agonists focuses on increases in skeletal muscle protein, leading to increased muscle mass.  Increased muscle mass is associated with increased muscle force production.  In addition the long term use of Beta-2-agonists may also decrease body fat.  No study has investigated the potential for these performance gains to occur when athletes inhale long acting Beta-2-agonists over a prolonged period of time.

There is limited ecologically valid data available that demonstrates whether long acting Beta-2-agonists, taken over a prolonged period of time is performance enhancing. Further to this there is no data available that details the movement of Beta-2-agonists through the body following long-term use of high therapeutic doses of inhaled long-acting Beta-2-agonists.

This research project will investigate the impact of inhaling the long acting Beta-2-agonists Salmeterol or Formoterol twice daily over a 12 week period on sprint performance, strength, power, recovery and body composition in male and female athletes. In addition the movement of the inhaled long acting Beta-2-agonists through the body will be analysed at 6 weeks and 12 weeks.  The results of this study will provide data to inform the use of inhaled Beta-2-agonists by elite athletes. In particular they will provide data to assist in the implementation of regulations on the use of inhaled Salmeterol and Formoterol and assist in the resolution of contested doping violations.
 

Main Findings: 

The purpose of this study was to contribute to the understanding of inhaling high therapeutic doses of long acting β2-agonists over a sustained period of time on athletic performance. In particular this study investigated the impact of inhaling Salmeterol or Formoterol twice daily over a ten week period on strength, power, recovery and body composition in male and female athletes.
To carry out the investigation into the potential ergogenic effect of long term use of long acting β2-agonists we recruited 38 participants (23 male and 15 female) who had no history of asthma. All participants underwent a eucapnic voluntary hyperpnoea challenge to confirm absence of asthma. Participants completed baseline assessments which included measuring strength and power performance as well as assessing body composition. Participants were randomly assigned to one of three groups: placebo inhaler, salmeterol inhaler (100 µg twice daily) or formoterol inhaler (12 µg twice daily). The participants undertook a 10 week training protocol with a repeat of the baseline assessments taking place at five and ten weeks. Over the course of the training periods participants took their assigned inhaled dose of β2-agonists twice daily.  During the training weeks participants attended three training sessions a week that focused specifically on developing strength, power and sprint performance. Assessments of recovery and mood were recorded via questionnaires during the training period. 
All 38 participants completed all data collection between weeks 0 and 5, however only the male participants completed all 10 weeks. Between week zero and week five 30 m sprint time improved in both the formoterol (–0.29 ± 0.11 s; P<0.049) and salmeterol (– 0.35 ± 0.05 s; P<0.04) groups when compared to the placebo group (+0.01 ± 0.11 s).  However, there were no changes in other strength and power measurements, recovery, mood or sum of 4 skin folds between groups over the course of the 5 weeks between groups. Between weeks 5 and 10 decreases in sprint time in salmeterol and formoterol groups were similar to placebo group in the male participants. 
Our results suggest that large daily doses of salmeterol and formoterol may lead to improvements in sprint performance over a 5 week period. However the improvements in sprint performance are not sustained over a longer period of time.  Future work investigating the mechanisms will provide an understanding how daily use of long acting β2-agonists may influence sprint performance over a sustained period of time.

Code: 13A04JW 

Traditional Chinese Medicine (TCM) has been used in China for thousands of years. Some drugs of TCM contain endogenous steroids such as musk, penis and testes of ox, and oviductus ranae, which make it possible to abuse TCM as doping. In the 2011 FIFA Women's World Cup, adverse analytical findings about the exogenous source of etiocholanolone and other steroids were reported , and musk was regarded as the source of the steroidal preparation. Isotope ratio mass spectrum is applied in doping test to confirm the endogenous steroids abuse by determining the isotopic ratio of 13C/12C, whereas the carbon isotope ratios of steroids in animal materials used in TCM were seldom reported in literature. In view of the fact that TCM materials would be abused as doping, their influences on doping test should be further studied. 
In this project, musk, penis and testes of ox, and oviductus ranae will be collected for the detection of concentrations and carbon isotope ratios of endogenous steroids by GC-MSD and GC/C/IRMS. Excretion study will also be executed to demonstrate the influences of musk intake on the doping test. 
Based on those studies, the possibility of those TCMs abuse as doping will be estimated.

Main Findings: 

Traditional Chinese Medicine (TCM) has been used for a long time. Some TCMs contain prohibited steroids, which make it possible to abuse TCMs as doping. In this study, steroid contents and δ13C-values were analyzed in musk, penis-testes of ox, and forest frog’s oviduct. Excretion study was executed to demonstrate the influences of musk ingestion on doping control.  
  The analysis on 20 batches of musk illustrated that the contents of androgen were greater than that of estrogen and progestin in musk. Etio, 5α-3β17α-diol, 5β-diol, and An were main androgen in musk. IRMS analysis demonstrated that the androgen in wild deer musk possessed δ13C-values in the range of exogenous steroid values, while the steroid δ13C-values in domestic deer musk samples were within the normal range of human body.  
  In penis-testes of ox, An, Etio, DHEA, DHT, 4-AD, T, EpiA, and Preg were detected; Chol had average δ13C-value of -22.6 ‰. In forest frog’s oviduct, Preg and 5β-diol could be identified; Chol bore the average δ13C-value of -27.8 ‰.  
  In musk excretion study, 200 and 100 mg of wild and domestic deer musk samples were administrated by 29 subjects. The urinary profile showed changes, but the changes were inconsistent among subjects. The fluctuations might be proportional to the musk quality. In the IRMS test, the δ13C-values of Etio and 5β-diol were more sensitive than other markers, and AAFs were obtained. It is the first report about the AAFs in the musk administration study. 

Code: 12D14MP

In accordance with the 2012 Prohibited List all 2-agonists are prohibited in sport, in- and out of-competition, except salbutamol, formoterol and salmeterol when administered by inhalation in accordance with the manufacturers recommended therapeutic regime. Whereas for salbutamol and formoterol thresholds differentiating the therapeutic use from misuse are indicated in the List, such threshold for salmeterol has not yet been established and existing data seem inconclusive.

Cytochrome P450 3A4 (CYP3A4) is an enzyme that plays a central role in the metabolism of a wide variety of drugs. P-glycoprotein 1 (P-gp), a protein encoded by the ABCB1 gene, is responsible for the regulation of the distribution of drugs. The activity of CYP3A4 and the expression of P-gp may be responsible for the inter-individual variability of pharmacokinetics (PK) of drugs using these substrates for their metabolic pathway and distribution, respectively. This can be explained due to the genetic polymorphisms of both CYP3A4 and P-gp among individuals and/or drug-drug interactions in the case of co-administration of drugs using CYP3A4. Salmeterol and fluticasone are using the same enzyme isoform CYP3A4 and corticosteroids appear to induce the activity of this enzyme.

This study aims to establish the PK profiles of inhaled salmeterol administered alone or in combination with fluticasone proprionate to healthy volunteers and type the genetic variations of the genes encoding for CYP3A4 enzyme and P-gp transporter protein in the participants of the study. This will allow determining the threshold level of the maximum therapeutic dose of inhaled salmeterol administered alone or in combination with fluticasone and to investigate the role of inhaled corticosteroids as potential masking agents when co-administered with salmeterol. Finally, the study will provide preliminary data on the possible association between genetic polymorphisms of the CYP3A4 and the ABCB1 genes with the PK and excretion profiles of inhaled salmeterol in healthy volunteers.

Main Findings

Results:

As part of the study, liquid chromatography – mass spectrometry (LC-MS) methods for the determination of salmeterol, its metabolite α-hydroxysalmeterol and fluticasone in human urine and plasma were developed and validated. In urine, the Limit of Detection (LOD) was 0.05 ng/mL for salmeterol and fluticasone, and 0.50 ng/ml for α-hydroxysalmeterol, while the Limit of Quantification (LOQ) was 0.10 ng/mL for salmeterol and fluticasone and 1.00 ng/mL for α-hydroxysalmeterol.

At Phase A, the highest observed individual urine concentration of salmeterol when not normalised for specific gravity was 0.56 ng/mL. When all urine concentrations were normalised, the highest concentration observed was 0.61 ng/mL and when only those samples with a specific gravity higher than 1.020 g/mL were normalised the highest concentration observed was 0.53 ng/mL. At Phase B, the highest observed individual urine concentration of salmeterol was 0.91 ng/mL when not normalised for specific gravity, 1.06 ng/mL when all urine concentrations were normalised for specific gravity and 0.79 ng/mL when only those samples with a specific gravity higher than 1.020 g/mL were normalised. No statistically significant differences were found between the concentration of salmeterol at Phase A and Phase B. The reported urinary concentrations of salmeterol represent the free parent compound, only.

At Phase A, the highest observed individual urine concentration of α-hydroxysalmeterol when not normalised for specific gravity was 5.55 ng/mL. When all urine concentrations were normalised, the highest concentration of α-hydroxysalmeterol observed was 6.94 ng/mL and when only those samples with a specific gravity higher than 1.020 g/mL were normalised to a urine specific gravity of 1.020 g/mL, the highest concentration of α-hydroxysalmeterol observed was 5.55 ng/mL. At phase B, the highest observed individual urine concentration of α-hydroxysalmeterol when not normalised for specific gravity was 3.42 ng/mL. When all urine concentrations were normalised, the highest concentration of α-hydroxysalmeterol observed was 11.4 ng/mL and when only those samples with a specific gravity higher than 1.020 g/mL were normalised the highest observed individual urine concentration of α-hydroxysalmeterol was 3.42 ng/mL. No statistically significant differences were found between the concentration of α-hydroxysalmeterol at Phase A and Phase B.

Conclusions:

We propose establishing a threshold for salmeterol and α-hydroxysalmeterol high enough to prevent any adverse analytical findings from the administration of salmeterol up to the maximum therapeutic dose yet able to detect those athletes who use salmeterol in excess doses. Based on the findings of the present study, the data that are available in the literature from other excretion studies and the analysis of routine doping control samples and a possible accumulation rate of 1.3, a urinary threshold concentration of 2.0 ng/mL for salmeterol can be supported.