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Blood dopping, defination, methods, detection, pros/cons

Jul 13, 2015



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Hiba Nasir1248129Endocrinology Presentation Blood dopingHave you ever heard???

The injury-prone Pakistani fast bowlers, Shoaib Akhtar and Mohammad Asif both failed tests for nandrolone in 2006 and were handed bans which were later overturned on appeal. Asif claimed his was due to a faulty nutritional supplement. He later failed a test in the IPL for steroids in 2008 and also was detained at Dubai airport that same year for possessing illegal substances all apparently linked to injury recovery.

Nandrolone(19-nortestosterone) is ananabolic steroid. The positive effects of the drug include muscle growth, appetite stimulation and increasedred blood cellproduction andbone density.3Doping?Adding impurities to something.

Blood Doping

Dopingis generally the practice of adding impurities to something.Doping in sport, a term for theuse of performance-enhancing drugs in sportoften to improve athletic performanceBlood doping, another means of improving athletic performance

4Blood DopingIncreased red blood cellsRBCs carry O2Higher RBC higher aerobic capacityAerobic capacity (VO2 max)

Blood dopingis the practice of boosting the number ofred blood cellsin the bloodstream in order to enhance athletic performance. Because such blood cells carryoxygenfrom thelungsto themuscles, a higher concentration in the blood can improve an athletesaerobic capacity(VO2max) andendurance.VO2 max (also maximal oxygen consumption, maximal oxygen uptake, peak oxygen uptake or maximal aerobic capacity) is the maximum rate of oxygen consumption as measured during incremental exercise, most typically on a motorized treadmill.5

6Increment in hemoglobin mass

The body undergoes aerobic respiration in order to provide sufficient delivery of O2to the exercising skeletal muscles and the main determining factors is shown in figure 1. The rate maximum O2uptake (O2max) depends on cardiac output, O2extraction and hemoglobin mass. The cardiac output of an athlete is difficult to manipulate during a competitions and the distributions of cardiac output is at the maximum rate (i.e. 80%) during competitions. In addition, the O2extraction is approximately 90% at maximal exercise.[2]Therefore, the only method to enhance the physical performance left to increase the O2content in the artery is by enhancing the hemoglobin mass. In other words, hemoglobin concentration and blood volume contributes to hemoglobin mass.

Hemoglobin is an oxygen-carrying protein in the blood. So increasing hemoglobin allows higher amounts of oxygen to reach and fuel an athlete's muscles. This can improve stamina and performance, particularly in long-distance events, such asrunningand cycling.

7 methodsBlood Transfusion1-4 unitscentrifugedplasma components reinfused(RBCs), refrigerated at 4C frozen at 80C

Blood transfusion begins by the withdrawal of 1 to 4 units of blood (1 unit = 450 ml of blood) several weeks before competition. The blood is centrifuged, the plasma components are immediately reinfused, and the corpuscular elements, principally red blood cells (RBCs), are stored refrigerated at 4C or frozen at 80C.[3]As blood stored by refrigeration displays a steady decline in the number of RBCs, a substantial percentage, up to 40%, of the stored RBCs may not be viable.[4]The freezing process, conversely, limits the aging of the cells, allowing the storage of the blood for up to 10 years with a 10% to 15% loss of RBCs.[5]Stored RBCs are then reinfused, usually 1 to 7 days before a high-endurance event. As a signicant amount of iron is removed by each autologous transfusion, an adequate time for recovery of not less than 3 days from the last donation, and appropriate iron supplements, are usually required for patients undergoing autologous donations.9Blood TransfusionDue to storage, 40% RBCs non- viable.Stored RBCs are then reinfused, iron supplements for autologous donations.

Blood Transfusion TypesAutologous transfusionOwn bloodHomologous transfusionSomeone else blood

.This involves a transfusion of the athlete's own blood, which is drawn and then stored for future use.. In this type of transfusion, athletes use the blood of someone else with the sameblood type.

11Blood SubstitutesSynthetic oxygen carriershuman blood unavailableblood infectionthere isn't enough time to match of blood typeExampleHBOCsPFCs

Synthetic oxygen carriers. These are chemicals that have the ability to carry oxygen. Two examples are:HBOCs (hemoglobin-based oxygen carriers)PFCs (perfluorocarbons)Synthetic oxygen carriers have a legitimate medical use as emergency therapy. It is Athletes use synthetic oxygen carriers to achieve the same performance-enhancing effects of other types of blood doping: increased oxygen in the blood that helps fuel muscles.

12HBOCsResistance to dissociate when dissolved in mediagreater benets than hemoglobinhighly effective O2donors in terms of tissue oxygenation

A common feature of all HBOCs is their, which contrasts hemoglobin of natural dissociation under non-physiological conditions. HBOCs may hypothetically supply greater benets to athletes than those provided by the equivalent hemoglobin in traditional RBC infusion. Recent developments have shown that HBOCs are not only simple RBC substitutes, but highly effective O2donors in terms of tissue oxygenation.13PFCsdissolve 100 times more oxygen than plasma.

Small size = flow in tiny capillaries.

Some of these molecules can dissolve 100 times more oxygen than plasma.

Due to their small size, PFCs are able to permeate circulation where erythrocytes may not ow. In tiny capillaries, PFCs produce the greatest benet,14EPO InjectionsHormone, produced by kidney.

Regulates production of RBCs by acting on bone marrow.

EPO injections are given to stimulate the production of RBCs to treat patients with anemia.

EPO injections.EPO is a hormone produced by the kidney. It regulates the body's production of red blood cells.In medical practice, EPO injections are given to stimulate the production of red blood cells. For example, a synthetic EPO can be used to treat patients with anemia related to chronic or end-stage kidney disease.Athletes using EPO do so to encourage their bodies to produce higher than normal amounts of red blood cells to enhance performance.

EPO is already present in the human body. The kidneys release this peptide hormone and it stimulates the production of red blood cells by acting on the bone marrow. This may help in increasing the buffering of lactic acid. It is also known to increase how much oxygen is sent to the muscles by increasing red blood cell counts.15Athletes using EPO to produce higher than normal amounts of red blood cells


Detection for Homologous Blood Doping

Fluorescent-activated cell sorting

Examining markers on the surface of rbcs

Determine whether blood from more than one person is present

The test method is based on a technique known as fluorescent-activated cell sorting. By examining markers on the surface of blood cells, the method can determine whether blood from more than one person is present in an athletes circulation. The test utilizes 12 antisera directed against the blood group antigens, obtained from donor plasma. The antigens are labeled with secondary antibodies, which are conjugated with fluorescein to label IgG-coated RBCs and enhance the detection by flow cytometry 18

Detection for Autologous Blood doping

CO rebreathing technique

To measure the nonphysiologic increases in hb mass

O2-CO gas mixture inhalation for about 10-15mins

By measuring the difference in carboxyhemoglobin concentration (hbco) before and after rebreathing total hb mass can be calculated.

Autologous blood doping detection is done indirectly via CO rebreathing technique to measure the nonphysiologic increases in Hb mass. The principle of CO rebreathing method used currently requires an O2-CO gas mixture inhalation for about 10-15mins.[21] By measuring the difference in carboxyhemoglobin concentration (HbCO) before and after rebreathing, the volume of CO and the binding capacity of Hb for CO ( 1.39ml g-1), total Hb mass can be calculated.19

Pros Of Blood Doping

Affects the brain of the athlete, Athletes exercise endurance levelImprove the health of athletesBenefits the athlete's long exerciseNo oxygen depletion and lactic acid formation.

Blood doping affects the brain of the athlete. It can cause an increase in motivation level. The way that this is done is by the brain sends signals to the nerves, which in turn sends signals to the body, to secrete the hormones and enzymes that play a role in how the person is feelingincrease the athletes exercise endurance levelEndurance refers to the power or capability of doing a certain activity for long periods without getting tired. Such a trait is important for any athlete or individual in body building workouts. Blood doping is said to enhance endurance levels by about 5%improve the health of athletesthat have low haematocrit for genetic or dietary reasonblood doping also benefits the athlete's long exercise; people who take part in long exercises such as marathon running and cross country skating and skiing, can increase their effectivenessand helps the athlete avoid oxygen depletion. During exercises of high intensity, such as weight training, oxygen usually becomes depleted. The body therefore cannot get sufficient amounts of oxygen for it to optimally perform. This state is known as oxygen debt, which may lead to formation of lactic acid. Blood doping prevents both oxygen depletion and also lactic acid formation.20Cons of blood dopingIncreased viscosity of the blood

Risk of heart diseases

Cerebral or pulmonary embol