Sports drug testing using complementary matrices: Advantages and limitations

https://doi.org/10.1016/j.jpba.2016.03.055Get rights and content

Highlights

  • Benefits and drawbacks of alternative matrices for doping controls are revisited.

  • Combined matrices provide best-possible testing scenario.

  • Advantages and limitations are predominantly found in retrospectivity and retrospective accuracy.

  • Suitability of alternative matrices not yet fully explored for most areas of doping controls.

Abstract

Today, routine doping controls largely rely on testing whole blood, serum, and urine samples. These matrices allow comprehensively covering inorganic as well as low and high molecular mass organic analytes relevant to doping controls and are collecting and transferring from sampling sites to accredited anti-doping laboratories under standardized conditions. Various aspects including time and cost-effectiveness as well as intrusiveness and invasiveness of the sampling procedure but also analyte stability and breadth of the contained information have been motivation to consider and assess values potentially provided and added to modern sports drug testing programs by alternative matrices. Such alternatives could be dried blood spots (DBS), dried plasma spots (DPS), oral fluid (OF), exhaled breath (EB), and hair. In this review, recent developments and test methods concerning these alternative matrices and expected or proven contributions as well as limitations of these specimens in the context of the international anti-doping fight are presented and discussed, guided by current regulations for prohibited substances and methods of doping as established by the World Anti-Doping Agency (WADA). Focusing on literature published between 2011 and 2015, examples for doping control analytical assays concerning non-approved substances, anabolic agents, peptide hormones/growth factors/related substances and mimetics, β2-agonists, hormone and metabolic modulators, diuretics and masking agents, stimulants, narcotics, cannabinoids, glucocorticoids, and beta-blockers were selected to outline the advantages and limitations of the aforementioned alternative matrices as compared to conventional doping control samples (i.e. urine and blood/serum).

Introduction

Doping controls have become an integral part of professional sport and, with the growing spectrum of drug candidates, approved therapeutics as well as obsolete medicines with purported or evident performance-enhancing properties, the demands and burdens for both athletes and sports drug testing laboratories continue to increase constantly [1]. Consequently, the desire for solutions providing the required analytical information under acceptable circumstances of controls is manifest. Options to complement and/or substitute conventional doping control strategies and corresponding test matrices (i.e. blood and urine) have therefore frequently been assessed [2], [3], [4], especially taking into account accepted strategies employed in diagnostics, forensics, and toxicology. Among the alternative biological matrices, particularly hair, oral fluid (OF), dried blood spots (DBS), and exhaled breath (EB) have received substantial attention, all of which offering advantages but also exhibiting limitations when compared to currently employed routine doping control samples consisting primarily of urine and blood (including whole blood and serum). The use of alternative specimens in sports drug testing is generally warranted as long as the results are not “used to counter Adverse Analytical Findings or Atypical Findings from urine” as specified in paragraph 5.2.4.4 of the World Anti-Doping Code [5]. Therefore, recent accomplishments in developing new analytical approaches using the aforementioned alternative matrices are summarized, and expectations, demonstrated added value, as well as caveats and undisputed downsides are discussed in this mini-review.

Section snippets

Aspects relevant for athletes, doping control laboratories, and anti-doping organizations

The classification of criteria characterizing a specific doping control sampling method is inevitably influenced and colored by the role of the participating party. Even under the assumption that the athlete as well as the anti-doping organization and laboratory pursue the same goal with comprehensive doping controls, i.e. providing evidence that the athlete’s performance was achieved without illicit means, aspects considered relevant for these parties might differ substantially given the

Established test methods in doping controls employing alternative matrices

Numerous doping control analytical methods have been established for urine and blood (including serum and plasma) in the past, which allow for covering the majority of compounds and methods of doping banned in sports according to WADA’s Prohibited List [25]. As summarized in Table 2, also complementary assays employing alternative matrices have been established for various classes of prohibited substances, and the potential as well as limitations of these specimens concerning specific

Conclusion

Doping controls are an integral part of today’s elite sport. They have been the subject of continuous improvements to enable utmost comprehensiveness, aiming at counteracting the fraudulent creativity of some individuals trying to gain the competitive edge via illicit means. Best-possible test methods are required especially in professional sport and, while the combined use of blood and urine does provide the majority of the desired information, alternative matrices have shown to possess the

Acknowledgments

The project was conducted with support of Antidoping Switzerland (Berne, Switzerland) and the Federal Ministry of the Interior of the Federal Republic of Germany (Bonn, Germany).

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