A fast screening method for the detection of CERA in dried blood spots.

Angela Rocca,Tiia Kuuranne,Alexandre Marchand,Laurent Martin,Magnus Ericsson,Nicolas Leuenberger

doi:10.1002/dta.3142

Abstract

Continuous erythropoietin receptor activator (CERA) is a third‐generation erythropoiesis‐stimulating agent that was developed for the treatment of anemia. However, misuse of CERA for doping in endurance sports has been reported. Previous studies have shown blood as the matrix of choice for the detection of CERA, due to its high molecular weight. The use of dried blood spots (DBSs) for anti‐doping purposes constitutes a complementary approach to the standard urine and venous blood matrices and could facilitate sample collection and increase the number of blood samples available for analysis due to reduced costs of sample collection and transport. Here, we investigated whether CERA could be indirectly detected in extracts of single DBSs using an erythropoietin‐specific immunoassay that is capable of providing results within approximately 2 h. Reconstituted DBS samples were prepared from mixtures of red blood cell pellets and serum samples. The samples were collected in a previous clinical study in which six healthy volunteers were injected with a single, 200 μg dose of CERA. Using a commercially available ELISA kit, CERA was detected in the DBSs with a detection window of up to 20 days post‐injection. Furthermore, in order to demonstrate the fitness‐for‐purpose, three authentic doping control serum samples, which were identified as containing CERA, were analyzed by the presented methodological approach on DBS. The testing procedure described here could be used as a fast and cost‐effective method for the detection of CERA abuse in sport.

Highlights

Use of erythropoietin receptor agonists (ERAs)) for performanceenhancing purposes can be detected via direct and indirect methods.[1]
There was a significant correlation (R = 0.9301, p < 0.05) between the EPO levels in the dried blood spots (DBSs) and the Continuous erythropoietin receptor activator (CERA) levels in the serum samples. These findings suggest that DBSs could represent a potential alternative matrix for the initial testing of CERA for anti-doping purposes
Our findings suggest that the detection of CERA in DBSs can be achieved using a specific EPO immunoassay

Summary

Introduction

Use of erythropoietin receptor agonists (ERAs)) for performanceenhancing purposes can be detected via direct and indirect methods.[1]. Attain therapeutic effects.[4] For doping, the short elimination time is advantageous, because the detection window is narrowed, whereas the effect is sustained For this reason, the first generation rhEPO is the most used by cheated athletes. Recent anti-doping operations have demonstrated that doping practices with CERA is still relevant scenario in endurance sport.[8,9] These findings indicate that doping is widespread in athletes competing regionally and that CERA is still a popular drug for endurance sports They underline the need to facilitate blood sampling during nonmajor competitions

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Discussion

Conclusion