The Athlete Biological Passport: An Effective Tool in the Fight against Doping

Abstract

Athletes dope to trigger physiological changes that provide advantages in competition. Doping leaves a biological fingerprint in the athlete's body. The Athlete Biological Passport (ABP)3 is the paradigm in testing that aims to detect this biological fingerprint (1, 2). Biomarkers of doping measured or inferred from blood and urine samples are used for that purpose, in the same way that biomarkers of disease are used in medicine as indicators of the presence or severity of a disease. Although both types of biomarkers aim to distinguish a biological fingerprint induced by a specific cause from the usual biological profile expected for a natural physiological condition, biomarkers of doping are collated and evaluated according to standards specific to forensic sciences. Several aspects of the ABP have been developed and validated in recent years. They include strict protocols for the collection, transport, and analysis of samples; a scrupulous chain of custody; an adaptive Bayesian method to evaluate longitudinal biological profiles; and application of forensic standards for the evaluation of doping evidence—with the anonymity of the athlete guaranteed at all steps of the process. The blood passport aims to detect any modification of erythropoiesis, whether by blood transfusion or the use of erythropoiesis-stimulating agents, such as recombinant erythropoietin (rEPO) (1, 3). The ABP can be used for intelligence, for sanctioning, for health protection, and, in turn, for deterrence. It can be used for intelligence because antidoping organizations (ADOs) can use data from the passport to define suspicious biological profiles and identify athletes who have them. It can be used for sanctioning because the weight of ABP evidence can be sufficiently high in some cases to prove beyond reasonable doubt that an athlete doped. The ABP can be used for health protection because it provides a direct view of the impact …