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Erythropoietin (EPO) Erythropoietin’more commonly known as EPO’has long been the drug of choice for endurance athletes. Although used in a wide variety of sports, it is most commonly associated with cycling’particularly with the disgraced former champion of the Tour de France’Lance Armstrong. Produced naturally by the kidneys, EPO is also available as a pharmaceutical. EPO stimulates the production of red blood cells in bone marrow and regulates the concentration of red blood cells and haemoglobin in the blood. This is useful for athletes, since red blood cells shuttle oxygen to the cells, including muscle cells, enabling them to operate more effectively. EPO is a peptide GLOSSARY peptide A molecule consisting of a short chain of amino acids. Longer chains of amino acids are called proteins. By injecting EPO, athletes aim to increase their concentration of red blood cells and, consequently, their aerobic capacity. EPO can also work to increase the body’s ability to buffer lactic acid. If EPO levels are too high the body will produce too many red blood cells which can thicken the blood, leading to clotting, heart attack and stroke. In fact, EPO has been implicated in the deaths of numerous athletes, predominantly cyclists. Repeated doses of EPO can also stimulate the development of antibodies directed against EPO, which can result in anaemia. The long-term health risks of sustained EPO use are still unclear. The 1998 Tour de France hit controversy when the entire Festina team was disqualified after several hundred doses of EPO and other doping products were found in the team car. EPO has continued to be associated with the event ever since, as evidenced by Lance Armstrong’s admissions in 2012 of EPO use throughout his seven tour victories. Other sports associated with EPO use include boxing (Shane Mosley, 2003), 50km walk (Alex Schwazer, 2012) and athletics (Rashid Jacobs, 2008). An approved test for EPO was first introduced at the Sydney 2000 Olympic Games, cut stack 150 mg injectable steroids . The test used a combination of urine testing, which would identify the presence of EPO (direct test) and blood testing, which would show the residual ‘footprints’ of EPO drug use over time (indirect test). Methods such as isoelectric focusing, which is the separation of proteins based on their electrical charge, and sodium dodecyl sulfate polyacrylamide gel electrophoresis, which is the separation of proteins based on their size, are used to detect EPO. Since 2002, EPO tests in the United States were undertaken using only urine, however, in recent years the joint testing methods, such as direct EPO testing in urine and use of indirect blood tests as part of the Athlete Biological Passport (see below), have been used to help identify the use of newly-developed erythropoiesis stimulating agents. A new testing technique for EPO is also in the pipeline. Researchers are working on a detection method that will look for the effects of EPO in the body’s cellular anatomy as opposed to its presence in urine or blood. In essence the new test will look for genetic expressions which prove that EPO has been used. If the new test proves accurate and viable, it will be almost impossible to use EPO without detection. A molecular model of Erythropoietin (EPO).
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