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Innovative Anti Doping Tests
- Thread starter fmk_RoI
- Start date
Theranos did come to mind, yes. I think my bigger concern would be how much testing could actually be done, not just immediately, but in the future if we are to believe that storing samples is the way to let technology catch up with cheating methods. KingBoonen, you got any ideas?ClassicomanoLuigi said:
I have had only a precursory look at the article and haven't read it in too much detail yet, but here is a brand new article about a relatively new approach to detect autotransfusions:
https://cyclingtips.com/2018/08/game-changer-the-long-push-to-end-blood-transfusions-in-sport/
The research has been going on for a few years and while the approach has had some problems and there hasn't been (yet) a breakthrough, I know for sure that none-other-than Dr. Björn Ekblom (who "developed" blood doping in the late-1960's) is about 100 % certain that the method will eventually catch the blood dopers.
https://cyclingtips.com/2018/08/game-changer-the-long-push-to-end-blood-transfusions-in-sport/
The research has been going on for a few years and while the approach has had some problems and there hasn't been (yet) a breakthrough, I know for sure that none-other-than Dr. Björn Ekblom (who "developed" blood doping in the late-1960's) is about 100 % certain that the method will eventually catch the blood dopers.
That's quite interesting actually. Thanks.ClassicomanoLuigi said:
I see from the WADA research page that there's been several funded projects looking into it, all coming from Cologne university:
- Expanding the use of dried blood sports in doping controls to peptidic drugs of lower and higher molecular mass - Thevis
- Quantification of synthetic glucocorticoids in dried blood spot samples for in-competition sports drug testing - Thevis
- Dried Blood Spots (DBS) in Sports Drug Testing: Complementary Matrix Providing Unique Features and Utilities to Modern Anti-Doping Fights - Thevis
After the many journalists who fell in love with Yannis Pitsiladis I find it hard not to be somewhat sceptical of these projects, especially at such an early stage and with so many hurdles to overcome. That said, if it comes good, it's interesting. Will definitely be keeping an eye out for further developments.Aragon said:
However. A question: is there much in terms of evidence that this is a real problem, either in general or within cycling? Yes, at the lower levels we're still popping people for EPO and related substances, but at the top end of the sport, how much of an influence do we think this still is? Yes, the ABP is beatable, that's long been known but if it's being beaten on a large scale, why are so few cocking it all up or just getting unlucky with teh timing of a test?
The Kreuziger case as an explanation - as used by Stokes - sounds like a lot of typical anti-doping 'logic': they're not catching the people because they don't want to.
It is indeed difficult to evaluate how "game changer" the test would be without knowing how prevalent the use of autotransfusions are and whether cyclists would only be switching to some alternative blood doping strategy would the test be implemented.
And one should be super-skeptical whenever a scientist sees a huge problem and he is the chosen one who has the key to solve it, because despite Ekblom's enthusiasm, this might turn out to be yet still another false hope, and for the last 20-40 years the doping testers wanting more funding have regularly seen the paradise right around the corner with some new fancy method + lucrative funding + "a few years to finish the research".
One example of some over-the-top claims in the article is that the quoted 17 % increase in Vo2Max is just hyperbole, because it is the "overnight" increase that took place when the donated blood was reinfused. This doesn't mean that blood doping increases Vo2Max by 17 %, because if one actually reads the study, the Vo2Max increase was more modest when compared to the starting point and the transfused group only more-or-less recovered to the original figure:
It would be interesting to know the source for claim about autotransfusions that "it is likely that it was used by some in pro cycling during [the 1970's]", because just recently I found out that a professional cycling team contacted Ekblom in 1971 inquiring whether the doctor would be interested in providing his know-how + in order to blood dope their cyclists.
And one should be super-skeptical whenever a scientist sees a huge problem and he is the chosen one who has the key to solve it, because despite Ekblom's enthusiasm, this might turn out to be yet still another false hope, and for the last 20-40 years the doping testers wanting more funding have regularly seen the paradise right around the corner with some new fancy method + lucrative funding + "a few years to finish the research".
One example of some over-the-top claims in the article is that the quoted 17 % increase in Vo2Max is just hyperbole, because it is the "overnight" increase that took place when the donated blood was reinfused. This doesn't mean that blood doping increases Vo2Max by 17 %, because if one actually reads the study, the Vo2Max increase was more modest when compared to the starting point and the transfused group only more-or-less recovered to the original figure:
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0156157
It would be interesting to know the source for claim about autotransfusions that "it is likely that it was used by some in pro cycling during [the 1970's]", because just recently I found out that a professional cycling team contacted Ekblom in 1971 inquiring whether the doctor would be interested in providing his know-how + in order to blood dope their cyclists.
Given that that's Shane Stokes, I wouldn't hold your breath waiting for a reliable source to be produced, that's likely to be no more than the usual stories about Nencini and Anquetil, with maybe knowledge of Merckx and Zoetemelk added to it.Aragon said:
The professional cycling team was top tier or local to Ekblom? If the former, would you be thinking Italy-based?
WRT Malm's research, I do feel lousy being cynical about it, and it does offer new alternatives, but our experience on these things does lead us to question.
I don't know the team nor even the country, all I know is that when he discussed the matter in the media in 1971, Ekblom revealed that he was offered 100.000 krona had he assisted (some unspecified) athletic people with the method. By going through my research file, I noticed that when the issue emerged once again some ten years later, one journalist in friendly terms with him described that the method had its roots in September 1971 and mentioned in passing that Ekblom was offered "six figure amount" for his help by a professional cycling team.fmk_RoI said:
My reading is that they were describing the same incident, but to tell the truth, it isn't like 100 % certain that this actually is the case.
While I have a high opinion about Ekblom, it naturally would've been interesting if the team was Ferretti, because Gösta Pettersson from that team had became the only Swedish winner of Giro only a some months before the existence of blood doping was revealed and as an interesting detail, Pettersson was in familiar terms with Ekblom having visited the GIH-laboratory around 1966-1967 when Ekblom coauthored a paper about cardiovascular functions of athletes when it was revealed that Petterson's Vo2Max was 81.1 ml/kg/min and his stroke volume was enormous.
fmk_RoI said:
Late to the party on this one.
The problem with Theranos, as has been highlighted, was their claim that they had some new wonder machine that allowed tests for everything on less blood than you get from a pin-***. I seem to remember we discussed this at the time and most, if not all, were very dubious about their claims. DBS is different as it isn't a testing method in itself, it's just a way to store the sample.
DBS has a few issues over normal blood sample collection. The volume is small, it needs to be eluted from the media or analysed in situ and this all adds steps that can reduce the sensitivity of the test. It's not surprising that many of the tests discussed are for doping products that have no allowable limit, good limits of detection in normal samples and don't require much quantitation. For this I think it could work very well, DBS is already used as a sampling method in healthcare (most countries use it for disease screening in newborns covering cystic fibrosis, sickle cell disease, several metabolic disorders and hyperthyroidism) so it's mature enough that it should stand up to scrutiny provided the proper protocols are in place.
There are clear benefits to using DBS as collecting the samples does not require a trained phlebotomist and it should be easy to design a device that makes the chain of custody robust (I'm assuming this is what the TAP+ thingy described does). It should also be very easy to store the samples for future testing, I don't think you even require freezers, you just need what is basically a secure card catalogue. Add to that the testing is much, much less invasive. I've had cannulas inserted for a good few experiments in the past to the point I'm quite used to it and it can still induce slight hyperventilation in me, removing the need for these or needles is no bad thing at all. The small amount of material does mean any future testing will have to be sensitive enough to make use of the cards, which generally means several years/decades after a less sensitive test is developed and the instrumentation improves. With this in mind I hope there isn't a wholesale push towards DBS as a cheap option at the expense of normal blood samples.As for detecting more specialist methods of doping such as EPO, CERA, transfusions etc. it's highly unlikely it'll help at the moment or even i the foreseeable future.
The testing for autologous blood transfusions is interesting. Without throughly reading the literature it's hard to know what they are looking for to create their screen. It is possible they are looking at levels of specific proteins, or they may be looking at levels of post-translational-modifications (PTMs). PTMs might be interesting, because if you can find proteins that exhibit specific, reproducible patterns for different PTMs under certain conditions, you may then be able to look for those PTMs that shouldn't be present but are due to an autologous transfusion. The issue would be finding a robust pattern influenced by a transfusion and that PTMs can be short-lived. Looking purely at the levels of specific proteins may be hard, you need a baseline that can be applied across a population and this isn't always possible. Based on the report and making some assumptions due to who they word things, I think they have found a difference in their proteomic data between their treatment and controls, but they don't know what that difference is. They're working on finding out what component/s are causing it and limiting down the test to reproducible signal/s. This is usually the hardest part and without seeing the models they built to assess the data it's hard to have any handle on how successful it might be.
I don't want to sound cynical either, especially as I've not seen any of the data, but I will point out that once you've looked at genomic and transcriptomic data and that hasn't worked, the next logical step is proteomic data, so it's possible this research is more following a general trend, rather than being guided by a biological hypothesis. It's also very possible they have a good idea what they are looking for, they know it's very likely to work and they are spending the time refining it to ensure robust results. We can all hope for the later.
As to how much of an effect such a test will have on the pro peloton, I'd guess very little at WT, increasing down the ranks. The no needles policy and increased testing must make it harder to transfuse and the process is longer than injecting mircera or whatever the current product of choice is. I would think that transfusions are fairly low down the pecking order. That's just supposition though.
Another quick point/question. I don't see mention of positive controls in the article (and I didn't really expect it, hence why this is a question). A brief scanning of the paper I see Aragon posted (thanks!), and I mean brief, literally 5 seconds, and I only see control Vs. transfusion. I'm not sure what the positive control would be without knowing what they are looking at, but this is where things like this have a high probability of falling over. It's possible they don't need one, can anyone think of one? (reading more, altitude would be an obvious one). It's something to be aware of.
Honestly, my first reaction when reading this was "SURPRISE TEST!" Though, I guess if the collection process takes up to five minutes the athlete might notice.
And there might also be rules against testing people without their knowledge, though, when you become a professional athlete you kinda agree that you will accept being tested.
Re:
Tap Blood Collection System
350 microns puts it somewhere between a 28 and 29 gauge hypodermic needle in diameter. The 31-gauge needle commonly used by diabetics for insulin injections is thinner still by about a fourth, so one wonders how these qualify as "microneedles." However, the typical insulin needle is quite longer, 8mm.
According to one article I found, the TAP device already has been approved by the USA Food and Drug Admin for HbA1c blood sugar testing.
The pivotal question, from my perspective, is how immune is it to adulterants, masking agents and other contaminants when applied to the skin (deliberately or otherwise). We know for instance that cyclists were thwarting some urine testing for PEDs by secreting a contaminant under their foreskin, which they dipped into the specimen as they were relieving themselves. Because I question the usefulness of a "new" test that the dopers already have devised a method to defeat.
Tap Blood Collection System
350 microns puts it somewhere between a 28 and 29 gauge hypodermic needle in diameter. The 31-gauge needle commonly used by diabetics for insulin injections is thinner still by about a fourth, so one wonders how these qualify as "microneedles." However, the typical insulin needle is quite longer, 8mm.
According to one article I found, the TAP device already has been approved by the USA Food and Drug Admin for HbA1c blood sugar testing.
The pivotal question, from my perspective, is how immune is it to adulterants, masking agents and other contaminants when applied to the skin (deliberately or otherwise). We know for instance that cyclists were thwarting some urine testing for PEDs by secreting a contaminant under their foreskin, which they dipped into the specimen as they were relieving themselves. Because I question the usefulness of a "new" test that the dopers already have devised a method to defeat.
Much of the time probably is in documentation, establishing chain of custody, rather than the drawing of the sample.RedheadDane said:
Re: Re:
But it was mentioned under the explanation of how this particular testing method works. Surely establishing a chain of custody works the same way for every testing method.
But are you suggesting they actually should start performing surprise tests?
StyrbjornSterki said:
But it was mentioned under the explanation of how this particular testing method works. Surely establishing a chain of custody works the same way for every testing method.
But are you suggesting they actually should start performing surprise tests?
According to one athlete who participated in the blood doping research in 1970 and who was regularly in contact with Björn Ekblom that time period, they were "a couple of French professional cyclists". The participant mentioned this in 2009 in an interview, but it isn't necessarily the only source on the matter.Aragon said:
Purely for sport, since speculation is pointless, but there would - IIRC - have been three main French teams in 71: Fagor/Mercer, Peugeot and Bic. I've love it have have been Bic and one of the riders to have been Jean-Marie Leblanc, cause, you know, that'd be poetry. (Bic did have Luis Ocaña, and Ocaña was alike to Anquetil in so many ways, on and off the bike, and Anquetil did play with his blood, even if it wasn't fully blood doping as we know it, and in later life, after retiring, Ocaña tried to recruit Pedro Celaya as Fagor's team doctor.) Peugeot, they of course, went on to work with François Bellocq, the expert at hormone rebalancing. And Fagor/Mercer at that time, they had Cyrille Guimard, a man who liked the cutting edge of science. As I say, purely sepeculation for sport, almost any team can be made to fit the frame.Aragon said:
Thanks for the update on this one.
It is also interesting that in 1976 the Le Monde journalist was quite convinced that blood doping was going on in the pro cycling when the issue wasn't discussed that much in the media.
If I shall have the opportunity, I will ask some information from the people themselves because I have been working on an essay/article series on the origins of blood doping that might see the light of the day in a few months in which I have incorporated some new material from Sweden sources.
If I shall have the opportunity, I will ask some information from the people themselves because I have been working on an essay/article series on the origins of blood doping that might see the light of the day in a few months in which I have incorporated some new material from Sweden sources.
Re:
I think the paper is open access, it's here:
https://onlinelibrary.wiley.com/doi/full/10.1111/bjh.15605
fmk_RoI said:
I think the paper is open access, it's here:
https://onlinelibrary.wiley.com/doi/full/10.1111/bjh.15605
Re: Re:
Thanks. I only went as far as looking at the 'British Journal of Haematology' site and that didn't seem to have the article up yet so I gave up early...King Boonen said:
I'd be even slightly skeptical even if these researches would produce breakthroughs, because one problem with the blood doping research is always that even when they succeed in making the use of certain method more difficult, usually there is an alternative method available. While there could be less blood doping going on it isn't that certain if it is progress if certain participants can proceed with blood doping whereas others can't and if athletes are pushed to use very expensive and more hazardous methods.fmk_RoI said:
Even if the blood doping methods would be eliminated one-by-one, there are always some undetectable methods, for instance no present or imaginable direct approach to autotransfusions can' detect direct infusion from an identical twin because there are no storage components in the blood nor blood deterioration, it is just identical red fluid flowing from person A to person B.
ABP program is an interesting approach because it at least seemingly makes it more difficult for everyone to blood dope despite all of its insensitivity issues etc. I think it is valid question how much focus there should be from the testers on what takes place within the Z-score limits and how much PED use should be allowed there. It could be that the present system is the best one even with its flaws, but I have started to have some doubts.
One fair but utopistic method to curtail blood doping use would be to take a suspicion index based on Hct, OFFscores and variations and for the UCI to add an extra brake into the bikes in order to slow down the cyclists with suspicious scores corresponding the level of suspiciousness. Even wih its flaws, a rare blood doper could go totally unpunished and if someone had high figures by a bad luck, his career wouldn't be ruined by a doping case.
Remember when it was said that certain teams were signing riders based on their blood type? Maybe the current 'vogue' for twins - Yates, Oliveira - will spark a new rumour if either of these two blood tests gets off the ground.Aragon said:
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