Abellan, R., Ventura, R., Remacha, A. F., Rodriguez, F. A., Pascual, J. A., & Segura, J. (2007). Intermittent hypoxia exposure in a hypobaric chamber and erythropoietin abuse interpretation. Journal of Sports Science, 25, 1241-1250.

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This study assessed the effect of intermittent hypoxia exposure on direct and indirect methods used to evaluate recombinant human erythropoietin (rhEPO) misuse. Male triathletes (N = 16) were randomly assigned to either an intermittent hypoxia exposure group or a control normoxic group. Experimental Ss were exposed to simulated altitude (4,000-5,500 m) in a hypobaric chamber for three hours per day, five days a week, for four weeks. Blood and urine samples were collected before the first exposure, after the final exposure, and two weeks after that.

Serum erythropoietin significantly increased after the first and final exposures. Hemoglobin, percentage of reticulocytes, and soluble transferrin receptor were not elevated. Second-generation ON/OFF models (indirect recombinant human erythropoietin misuse detection) were insensitive to intermittent hypoxia exposure. The distribution of the urinary erythropoietin isoelectric profiles (direct recombinant human erythropoietin misuse detection) was altered after intermittent hypoxia exposure with a slight shift towards more basic isoforms. However, those shifts never resulted in any misinterpretation of results.

Implication. Twenty intermittent hypoxia exposures over four weeks does not produce any false-positive result for indirect or direct detection of recombinant human erythropoietin misuse despite changes in erythropoietin serum concentrations and urinary erythropoietin isoelectric profiles resulting from the experience.

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