Screening for recombinant human erythropoietin using [Hb], reticulocytes, the OFFhrscore, OFF z score and Hb z score: status of the Blood Passport
Bornø, Andreas ; Aachmann-Andersen, Niels ; Munch-Andersen, Thor ; Hulston, Carl ; Lundby, Carsten
In: European Journal of Applied Physiology, 2010, vol. 109, no. 3, p. 537-543
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- Haemoglobin concentration ([Hb]), reticulocyte percentage (retic%) and OFFhrscore are well-implemented screening tools to determine potential recombinant human erythropoietin (rHuEpo) abuse in athletes. Recently, the International Cycling Union implemented the OFFzscore and the Hbzscore in their anti-doping testing programme. The aim of this study is to evaluate the sensitivity of these indirect screening methods. Twenty-four human subjects divided into three groups with eight subjects each (G1; G2 and G3) were injected with rHuEpo. G1 and G2 received rHuEpo for a 4-week period with 2weeks of "boosting” followed by 2weeks of "maintenance” and a wash-out period of 3weeks. G3 received rHuEpo for a 10-week period (boost=3weeks; maintenance=7weeks; wash out=1week). Three, seven and eight of the 24 volunteers exceeded the cut-off limits for OFFhrscore, [Hb] and retic%, respectively. One subject from G1, nobody from G2, and seven subjects from G3 exceeded the cut-off limit for Hbzscore. In total, ten subjects exceeded the cut-off limit for the OFFzscore; two subjects from G1, two subjects from G2 and six subjects from G3. In total, indirect screening methods were able to indicate rHuEpo injections in 58% of subjects. However, 42% of our rHuEpo-injected subjects were not detected. It should be emphasised that the test frequency in real world anti-doping is far less than the present study, and hence the detection rate will be lower