Erythropoiesis related biomarkers to detect autologous blood micro-transfusion in antidoping field

Abstract

Indirect detection of autologous blood transfusion (ABT) abuse in Anti-Doping world is done by hematological module of athlete biological passport (ABP). Actual markers (reticulocytes (%RET) and hemoglobin (HGB)) of this module are enough sensitive to detect ABT. However, a new way uses by athlete to improve their performance is micro ABT and in this case %RET and HGB have some lack of sensitivity to detect this new way of doping. Previous studies have demonstrated that erythropoiesis-related RNAs, genes 5’-aminolevulinate synthase 2 ( ALAS2) and carbonic anhydrase 1 ( CA1) in capillary dried blood spots (DBS) could be potential biomarkers to increased sensitivity of the ABP in case of micro-ABT. In the present study, we monitored ALAS2 and CA1 expression in DBS after a donation of 450ml of blood and after a micro reinfusion (130ml) of this blood. DBSs samples collected from 48 volunteers’ males and females were analyzed. Participants were divided in two groups (micro ABT and placebo). Before the beginning of the study, randomized volunteers from transfused and non-transfused cohort were monitored 2 or 8 times weekly to get baseline points. 5 samples were collected after the blood withdrawal and 6 samples after the micro-ABT. The purpose was to evaluate the performance of RNAs biomarkers for the detection of micro-ABT in a longitudinal blinded setting. Our results illustrated a clear significant increase of ALAS2 until to 300 % after withdrawal. Regarding CA1 the increase is up to 250%. Looking at micro-ABT ALAS2 and CA1 will decrease under the baseline value. Regarding actual ABP markers, %RET slightly increase after the withdrawal up to 140%. In contrast, micro-ABT seem to have any effect with value that came back to baseline value without decreasing under baseline value. Finally, HGB slightly decrease after withdrawal follow by any increase after micro-ABT. Oppositely, regarding placebo group RNA markers and actual ABP markers stay stable all along the study. Erythropoiesis-related RNAs in capillary DBS such as ALAS2 and CA1 were sensitive biomarkers for blood withdrawal detection followed by micro-ABT. Furthermore, this investigation provide evidence that micro ABT can be detected in a longitudinal blinded setting with RNA biomarkers in DBS. World Anti Doping Agency. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.