Audran, M., Gareau, R., Matecki, S., Durand, F., Cheard, C., Sicart, M., Marion, B., & Bressolle, F. (1999). Effects of erythropoietin administration in training athletes and possible indirect detection in doping control. Medicine and Science in Sports and Exercise, 31, 639-645.

Repeated subcutaneous injections of rHuEpo (50 IU/kg) were given daily for 26 days to training athletes (M = 7; N = 2). To determine a reference baseline value for serum soluble transferrin receptors to serum protein ratio, training mountain bikers (M = 146; F =30), internationally ranked wrestlers (N = 15), and individuals living at or above 3,000 m (N = 33) were measured. Blood samples were taken on days 0, 10, 14, 1, 21, and 24 during the injection period and days 1, 3, 7, 14, and 25 posttreatment.

At days 18, 19, and 21 of the treatment, three athletes had a hematocrit above 50% and did not receive the final does of rHuEpo. No adverse effects of the treatment were reported.

After day 10 of the treatment, a significant increase in reticulocytes was observed. For the first seven days after treatment, reticulocytes remained significantly higher than at baseline (day 0). From day 14 through 25 after treatment, reticulocytes were significantly lower than day 0. Hematocrit was increased for the first 14 days after treatment and hemoglobin concentration was increased for the first 7 days. Serum erythropoietin increased above the Day 0 value throughout the treatment, however, after treatment, the values returned to Day 0 levels on days 2 and 4, but for days 7, 1, and 21 posttreatment were significantly lower. During treatment and for the first 14 days posttreatment the serum soluble transferrin receptors to serum protein ratio was significantly higher than Day 0 values.

VO2max and power output at VO2max were significantly higher after the 26-day treatment. Maximal ventilation at VO2max and RER did not change throughout treatment. Maximal heart rate was lowered (177-168 bpm) over the treatment period.

Ratio values of serum soluble transferrin receptors to serum protein above 153 indicate probably rHuEpo intake with less than 1% error. To confirm this finding, it is recommended that a second blood sample be obtained one week later to quantify changes in serum soluble transferrin receptor levels. An increased hematocrit, with serum soluble transferrin receptor levels above 10ug/ml, and a serum soluble transferrin receptor level to serum protein ratio above 153 indicates probably intake of erythropoietin.

Implication. This form of testing could serve as a quick and simple first step in doping control during competitions that would indicate use of erythropoietin for performance enhancement in endurance events.

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