shutterstock_392800570The 103rd Tour de France 21 stage grueling cycling race begins in early July. While professional cycling season runs from January to October across all continents, 80% of TV coverage is spent on this event alone. The dark cloud of cheating has plagued the sport for years, from alcohol, to amphetamines, to blood doping and now motorized doping.

What’s next and do we really care?

The History of Anti-doping Testing at the Tour de France

Leading up to France declaring the use of performance enhancing drugs as illegal, followed by the first anti-doping testing at the Tour de France as a result of the 1960 death of a Danish rider, Knud Enemark Jensen. He collapsed during the 100 km team time trial at the 1960 Olympic Games in Rome and later died. The autopsy showed he had taken amphetamines and Ronicol, a drug known to dilate the blood vessels.

1990s: The Era of EPO and Blood Doping

When other performance enhancing drugs became detectable and added to the World Anti Doping Agency’s (WADAs) prohibited list, cyclists looked for new ways to get an edge. Enter the era of manipulating blood through transfusions, drugs or hormones. While blood transfusions offered improved performance, it was discovered that the same effects could be achieved more effectively by using erythropoietin, also known as EPO. Erythropoietin was intended for use to increase red-cell production for those suffering from anemia. There are additional pharmaceutical drug treatments misused for blood doping which were created for clinical use to increase the oxygen delivery when the human body is not able to do so naturally.

Like testing for anabolic steroid-use and identifying endogenous versus exogenous testosterone, it isn’t easy to distinguish EPO from what the body produces naturally. Prior to 2005, accredited testing laboratories couldn’t meaningfully detect for EPO. Today, depending on the type of blood doping (homologous, autologous, or hemoglobin-based oxygen carriers), a variety of laboratory instrument techniques may be used including flow cytometry, UV/VIS, capillary electrophoresis and high resolution mass spectrometry.

Why It’s So Difficult to Confirm Cheating

Make no mistake; cheating is high tech. Athletes use fine-tuned formulations of compounds and masking agents such as diuretics, dextran, epitestosterone and even saline to improve performance while hiding their secret. WADA annually updates their prohibited compounds list which includes a sub-section on diuretics and masking agents based on new findings within the sport testing community.

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Athletes have reportedly taken narcotics to suppress pain, beta blockers to slow their heart rate and improve fine motor control and stimulants to add pep. In the report, “Hacking your body: Lance Armstrong and the science of doping Athletes use drugs, transfusions, and science to perform better. But how do they do it, and how are they caught?”,Tim Carmody highlights the extent to which cheating has occurred. Using slow-release skin patches, infused olive oil and direct injections to bypass vital organs or avoid metabolization in urine are just a few tricks of the trade.

One of the most common banned masking agents cyclists use to confound blood testing is saline injections which dilute detection of extra hemoglobin and hematocrit cells within a short time window prior to a blood draw.

Anti-motorized Doping: A New Frontier

Amidst decades of doping scandals involving some of the biggest names and winners in cycling, there’s a new buzz in cheating this year. For more than six years, it’s been rumored that cyclists are housing tiny motors in their bicycles. Unlike biological doping where plausible excuses arise, hopefully a motor in your bike framework will be conclusive. The Union Cycliste Internationale (UCI) and the Tour’s organizers are teaming with the French Atomic Energy Commission to deploy portable thermal cameras for use by racing officials.

What’s Next?

Cobalt chloride has been known to be useful in treating anemic patients. [1][2] Today, it’s (mis)use in human, as well as animal, sport as an erythropoiesis-stimulating agent has been discussed frequently. A recent pilot study[3]  was completed to assess possible analytical options to test for prevalence and concentration of cobalt use/misuse in athlete’s urine using inductively coupled plasma-mass spectrometry (ICP-MS). While results look promising, the researchers concluded additional studies are required.

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  1. Lippi, G.; Franchini, M.; Guidi, G. (2005). “Cobalt chloride administration in athletes: a new perspective in blood doping?”. Br J Sports Med 39 (11): 872–873. doi:1136/bjsm.2005.019232. PMC1725077. PMID 16244201.
  2. Jelkmann, W (2007). “Novel Erythropoietic Agents: A Threat to Sportsmanship”. Medician Sportiva 11 (2): 32–34. doi:2478/v10036-007-0007-1.
  3. Krug O, Kutscher D, Piper T, Geyer H, Schänzer W, Thevis M. (2014). “Quantifying cobalt in doping control urine samples–a pilot study”. Drug Test Anal,Nov-Dec;6(11-12):1186-90.