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1References: http://biology.kenyon.edu/BMB/Chime2/2004/eryth/FRAMES/start.htm

Liv Hayward ([email protected])

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The hormone itself

Clinical Uses of EPO

Side Effects of Clinical Use

Misuse of EPO in sport

Risks of Misuse

Detection

Summary

‘Describe how Erthyropoietin (EPO) may be ‘abused’ by athletes seeking to enhance their performances.’

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Increases the O2 carrying capacity of blood

Stimulates the production of O2 carrying erythrocytes

Naturally synthesised in the kidney and in macrophages

Has a short half life

References: www.fi.edu/learn/heart/blood/red.html, (Rang et al., (2007)

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2 recombined human forms – Epoetin α and β

Can be given intravenously or subcutaneously

Darbopoietin is a hyperglycosylated form and can be administered less frequently due to a longer t½

References: www.pharmaceutical-technology.com/contractor_images/one2one/3-injection.jpg, Rang et al. (2007)

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1. Treatment of Anaemia Related to: Chronic renal failure Chemotherapy for cancer AIDS Chronic inflammatory conditions (e.g. rheumatoid

arthritis) Premature infants

2. Increase yield of autologous blood before blood donation

References: Rang et al. (2007)

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Passing flu-like symptoms

Increased blood viscosity

Hypertension leading to encephalopathy

Iron deficiency


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Reduces fatigue (by increasing O2 levels in blood)

Used mainly by athletes in endurance sports

Recombinant human form most used

Difficult to detect

References: Rang et al. (2007), Big Blade Photography (2009)

Cardiff Uni Rowing Club Women's Senior VIII

This picture demonstrates the toughness of some sports – making sport easier is a tempting option for some athletes However, I don’t use EPO!

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Taken over from another form of ‘blood doping’ – removal of 1-2 litres of blood followed by retransfusion

Injection of EPO provides an instant effect

Officially prohibited by the World Anti-Doping Agency

References: Rang et al. (2007), The World Anti-Doping Code (2009)

EPO increases the haematocrit (which is normally around 40%)

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Increased blood viscosity

Hypertension

Increased risk of stroke

Increased risk of coronary attacks

Risk of disqualification from competition


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The drug has a short plasma half life so detection is difficult

Lab-synthesised form similar to naturally occurring form

Urine test directly detects normal EPO levels versus synthetic EPO levels

Use of blood plasma markers for indirect detection

o Athletes banned if found to have haematocrit above 50%

References: Robinson et al. (2006), Rang et al. (2007)

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Blood doping using EPO has become more common

Ways to ensure a negative EPO test have increased

Further research into better detection methods is ongoing

Future - should EPO use be allowed in sport? ... Probably not but the debate continues!

References: Rang et al. (2007), sportsanddrugs.procon.org/viewanswers.asp?questionID=001212

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Images: biology.kenyon.edu/BMB/Chime2/2004/eryth/FRAMES/start.htm www.fi.edu/learn/heart/blood/red.html www.pharmaceutical-technology.com/contractor_images/one2one/3-injection.jpg Big Blade Photography (2009) www.bigblade.net

Info:• The World Anti-Doping Code (2009) Prohibited List• www.rice.edu/~jenky/sports/epo.html• Rang, HP., Dale, MM., Ritter, JM., Flower, RJ., (2009) Rang and Dale’s Pharmacology, p768-769• Robinson N, Giraud S, Saudan C, Baume N, Avois L, Mangin P, Saugy M, (2006) Erythropoietin and Blood Doping, British Journal of Sports Medicine 2006, 40 (1), p30-34• Kumar, P and Clark, M. (2004) Clinical Medicine, p525, 356• sportsanddrugs.procon.org/

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