Anabolic androgenic steroids are synthetic derivatives of testosterone that mimic its actions in various tissues. Due to its strong anabolic activity, weak androgenic effects, and resistance to hepatic metabolism, oxandrolone is one of the most commonly used anabolic steroids among female athletes. This study aimed to evaluate the anabolic effects of oxandrolone and its toxicological profile in female rats subjected to a strength training protocol. A total of 24 female Wistar rats (60 days old) were randomly assigned to receive oxandrolone (1.77 mg/kg/day) or its vehicle (corn oil) (n = 12 per group) via daily gavage for 28 days. The exercise protocol consisted of six climbs on an inclined ladder, with two climbs per workload (50 %, 75 %, and 100 % of each animal's maximum load) performed three times per week. Investigators remained blinded throughout experimentation and data analysis. Oxandrolone did not significantly affect body weight gain, relative organ and muscle mass, or muscle strength. However, it altered mean corpuscular volume, eosinophil count, and urea levels. Additionally, liver TBARS levels increased, while no changes were observed in plasma lipid peroxidation, antioxidant enzyme activity, total non-protein thiol levels, or mitochondrial respiratory chain complex activity. Histopathological analysis revealed oxandrolone-induced damage to cardiac and skeletal muscle, along with structural alterations in the spleen and adrenal gland. Given its limited effect on muscle strength, along with histopathological changes and increased liver lipoperoxidation, these findings raise concerns about oxandrolone use in healthy individuals seeking aesthetic or athletic benefits.

Anabolic androgenic steroids (AAS) may exert effects through the insulin-like growth factor (IGF) system. We compared the IGF system in male and female recreational athletes who were current or former AAS users and non-users. The cross-sectional study included 80 active AAS users (19 women), 26 former users (8 women), and 58 age- and sex-matched non-users (16 women). Participants underwent clinical examination, echocardiography, and measurement of circulating IGF-1, IGF-2, IGF bioactivity, IGF-binding proteins (IGFBPs), pregnancy-associated plasma protein-A (PAPP-A) and -A2 (PAPP-A2), and stanniocalcin-1 (STC1) and -2 (STC2). In active AAS users, IGF-2 levels were reduced by 36.1% vs. former users and 38.4% vs. non-users (P < .001), and IGFBP-3 levels were 13.6% and 35.8% lower (P < .001). STC2 was increased in AAS-using men only, being 24.5% higher than former users (P = .029) and 45.7% higher than non-users (P < .001). PAPP-A was higher in non-using men than women, whereas levels were similar in active users. Differences remained after adjustment for age, sex, body fat, exercise and strength training, family history of coronary disease, smoking, alcohol, and drug use. No group differences were observed for IGF-1, bioactive IGF, IGFBP-2, or PAPP-A2. Cumulative lifetime AAS exposure was associated with IGF-2, IGFBP-3, and STC2 in multivariable models. Higher IGF-2 and IGFBP-3 associated with lower left ventricular mass, higher left ventricular ejection fraction, and better diastolic function, whereas higher STC2 associated with adverse outcomes (all P < .05). Illicit AAS use is associated with persistent, sex-specific alterations in the IGF-PAPP-A-STC2 axis, potentially contributing to cardiovascular risk in recreational athletes.

Most in vitro reporter gene bioassays for detecting biological activities in aquatic environments rely on mammalian receptors and may not accurately assess risk for aquatic organisms. This study explored species-specific differences in activation or inhibition of six human and zebrafish nuclear receptors by environmental water extracts from the Czech Republic. Active sampling was conducted at wastewater treatment plants (WWTP) influents and effluents, receiving waters, and ponds; passive sampling in rivers across the Czech Republic, spanning the Bohemian and Moravian regions. A battery of bioassays including human (h) and zebrafish (zf) estrogen receptor-alpha (ERα), androgen (AR), progesterone (PR), glucocorticoid (GR), mineralocorticoid (MR), and pregnane X (PXR) receptors were employed. hERα activity was detected more frequently than zfERα. Detection and responsiveness of AR activity were similar in both human and zebrafish bioassays. hPR activity appeared only in influent of WWTP Protivín, whereas zfPR activity was found in influents of both WWTP Protivín and Vodňany. zfMR activity was detected in both WWTP influents; no hMR activity was observed. zfPXR activity occurred in influents and surface waters, whereas hPXR activity was restricted to WWTP influents. No (anti-)glucocorticoid activity was detected. Our findings indicate that both human and zebrafish nuclear receptor-based bioassays are suitable for monitoring ERα and AR activities, while zebrafish bioassays are better for PR, MR, and PXR activities in fish habitats. These results may guide researchers in selecting the most appropriate bioassay for assessing endocrine activity in waters.

Methyldienolone, a synthetic anabolic androgenic steroid (AAS), has been banned in sports by the World Anti-Doping Agency (WADA) because of its performance-enhancing properties. This study aimed to investigate the main metabolites using invitro incubation with human liver microsomes (HLM) and to detect them through liquid chromatography-high-resolution mass spectrometry (LC-HRMS) for doping control purposes. A total of six groups of Phase I metabolites, including 17-epimerization, hydroxylation, C3-keto reduction, 18-nor modifications, reduction, and demethylation, as well as five different Phase II metabolites, such as glucuronide conjugates, were characterized, indicating extensive metabolism by HLM. Structural characterization of these metabolites was improved through derivatization with methoxylamine and hydroxylamine, which enabled their detection with higher sensitivity by LC-HRMS. These novel metabolites provide new insights into the metabolism of methyldienolone and may contribute to antidoping analysis. The synthesis of reference materials is necessary to confirm the structure of the proposed metabolites in the future.

Fluoxymesterone (9α-fluoro-11β,17β-dihydroxy-17α-methyl-androst-4-en-3-one) is a prohibited anabolic androgenic steroid (AAS) under the regulations of the World Anti-Doping Agency (WADA). Comprehensive elucidation of its metabolic pathways and the identification of novel metabolites are essential for improving doping control. In this study, two healthy male volunteers were orally administered a single 10mg dose of fluoxymesterone, and urine samples were systematically collected over a 30-day period. An optimized three-step pretreatment procedure combined with gas chromatography-Orbitrap high-resolution mass spectrometry (GC-Orbitrap-HRMS) enabled the comprehensive detection of free, glucuronide-conjugated, and sulfate-conjugated metabolites. In total, the parent compound and ten metabolites were identified, including five novel structures reported for the first time. The primary metabolic transformations involved 4-ene reduction, 3-keto reduction, 6β-hydroxylation, 11β-hydroxy oxidation, and skeletal rearrangement. Excretion profiling demonstrated substantial interindividual variability in metabolite concentrations and clearance kinetics. Notably, the newly identified metabolite F-M7 (9α-fluoro-17α-methyl-3ξ,11β,17β-triol-5ξ-androstane) was detectable as a glucuronide conjugate for up to 5days post-administration, highlighting its potential as a reliable biomarker. These findings expand the understanding of fluoxymesterone metabolism in vivo and propose promising analytical targets for enhancing the sensitivity and reliability of anti-doping strategies.

Dehydroepiandrosterone (DHEA) is an important hormone precursor for androgen and oestrogen sex steroids, yet it is understudied in wildlife and has not been measured in rhinoceroses. The objective of this study was to examine serum DHEA concentrations in ex situ black (Diceros bicornis; n = 22 male, 18 female) and white (Ceratotherium simum; n = 25 male, 46 female) rhinoceroses. A commercially available DHEA immunoassay was validated for use with rhino serum, and monthly samples (n = 1029) were analysed. Analytical validation included demonstrating parallel displacement curves between serially diluted standards and pooled extracts, as well as 91% extraction efficiency in a spike and recovery test. Differences in DHEA concentrations relative to species, age, sex and pregnancy status were analysed using linear mixed models. Serum DHEA concentrations were higher (P < 0.001) in black (194 ± 14.2 pg/ml) versus white (123 ± 8.0 pg/ml) rhinoceroses and demonstrated a non-linear relationship with age in both species, with concentrations peaking around 15 years of age before declining thereafter. No sex differences between males and non-pregnant females were detected in either rhinoceros species. White rhinoceros DHEA concentrations were higher (P < 0.001) in pregnant (309 ± 31.9 pg/ml, n = 15) compared to non-pregnant (120 ± 10.4 pg/ml, n = 41) females; pregnant black rhinoceroses similarly produced elevated DHEA concentrations during pregnancy (1092 ± 90.3 pg/ml; n = 2) compared to non-pregnant (229 ± 8.1 pg/ml; n = 17) females. DHEA concentrations also increased throughout gestation particularly during mid- to late gestation in both species. These findings provide new insight into rhinoceros endocrinology and suggest potential utility of DHEA for monitoring pregnancy status.

Sexual dimorphism in the incidence and mortality of hepatocellular carcinoma (HCC) has been observed worldwide. Sex hormones play an essential role in determining male predominance in hepatocarcinogenesis. Here we reveal significant sexual dimorphism in regulatory T cells (Tregs). Compared with HCC in female mice/patients, tumours in male mice/patients are more enriched in Tregs. The male sex hormone androgen is shown to activate the NFκB pathway and reinforce the binding of NFκB to Ccl2 promoter loci in HCC cells, thereby promoting Ccl2 production, which facilitates the intratumoral recruitment of Tregs via the Ccl2-Ccr2 axis. Additionally, Treg infiltration shapes the HCC microenvironment through the suppression of the antitumorigenic activity of γδ T cells rather than CD8+T cells. Moreover, intratumoral hypoxia induces the secretion of Treg-derived extracellular vesicle (EV)-S100a4, which serves as a transcriptional corepressor to impede γδ T cell activation in an epigenetic manner. Overall, these results demonstrate that sex-specific differences in Tregs from HCC are related to the ability of androgen-dependent Ccl2 secretion to enable immune evasion through the suppression of γδ T cell activity.

Cancer is a multifactorial disease influenced not only by genetic and epigenetic alterations but also by interactions with the surrounding microenvironment. Among the hallmarks of cancer, metabolic reprogramming enables tumor cells to adapt and survive under adverse conditions. These metabolic alterations also induce changes in stromal cells. In clear cell renal cell carcinoma (ccRCC), adipocytes are among the most abundant stromal components. We have previously shown that ccRCC progression depends on the bidirectional crosstalk between tumor epithelial cells and neighboring adipocytes. Here, we investigated the effects of ccRCC on naïve human adipose tissue (hRAN). Human retroperitoneal adipose tissue fragments from two distinct donors (n = 2) were incubated with conditioned media (CMs) derived from ccRCC tumors (T-CM) or renal epithelial cells (Tc-CM). We analyzed the expression of adipocytokines, differentiation and browning markers, metabolic parameters, and steroid hormone receptor profiles. The exposure of hRAN to T-CM or Tc-CM led to significant alterations in the expression of adiponectin and leptin, as well as markers associated with differentiation and browning, including PLIN1, HSL, PGC1α, PPARγ, and UCP1. Adipocytes from treated hRAN were smaller than those from controls, suggesting dedifferentiation. Moreover, expression of FABP4 and MCT1 was significantly increased in explants treated with T-CM compared to control media. Conditioned media from these treated hRAN samples showed elevated lactate secretion, indicating enhanced lactatogenesis. Given the role of sex hormones in metabolic regulation, we examined the expression of estrogen (ER), androgen (AR), and progesterone (PR) receptors. While AR and PR levels remained unchanged, both ERα and ERβ were significantly upregulated after T-CM treatment. Metabolic reprogramming in renal tumors induces profound adaptive changes in adjacent adipose tissue. The dedifferentiation and browning of adipocytes, altered adipocytokine expression, and increased lactate production observed in hRAN reflect the metabolic stress imposed by the tumor environment. Here, we provide evidence, using an ex vivo model, of a dynamic partnership between human adipose tissue and ccRCC tumors.

Postoperative acute kidney injury (AKI) worsens surgical outcomes. Previous studies have observed an age- and sex-dependent effect on postoperative AKI rates. The objective of our study was to determine whether preoperative exposure to male or female sex hormone therapies modified AKI risk after both noncardiac and cardiac surgery. We hypothesized that women older than 55 years on estrogen/progesterone replacement therapy and men on antiandrogen therapy would have lower odds of postoperative AKI compared to counterparts not receiving sex hormone therapies. We conducted a retrospective cohort study, using data from Duke University Medical Center from 2013 to 2023. The study included women older than 55 years and men older than 18 years undergoing surgery. Exclusions included patients with missing creatinine values, patients with chronic kidney disease stage 5 (CKD5), transplant cases, and minor cases. The primary exposure was preoperative utilization of exogenous sex hormones, and the primary outcome was the development of postoperative AKI, as defined by the Kidney Disease: Improving Global Outcomes (KDIGO) serum creatinine criteria. Multivariable logistic regression was used to examine the association of preoperative sex hormones with postoperative AKI. There were 82,557 patients in the cohort, with 68,471 undergoing noncardiac surgery and 14,086 undergoing cardiac surgery. Among men undergoing noncardiac surgery, exposure to antiandrogens was associated with lower odds of postoperative AKI (0.83, 95% confidence interval [CI], 0.72-0.96, P < .01). Among women undergoing noncardiac surgery, preoperative exposure to vaginal estrogen was associated with lower odds of postoperative AKI (adjusted odds ratio [OR], 0.61, 95% CI, 0.47-0.79, P < .001). Neither male nor female sex hormone exposures were associated with AKI risk after cardiac surgery. Preoperative antiandrogen therapy in men and vaginal estrogen therapy in women older than 55 years were associated with reduced odds of postoperative AKI after noncardiac surgery. Our findings provide correlative evidence that sex hormones might modify postoperative AKI outcomes, while revealing complexity in drug and patient selection.

Detecting testosterone (T) doping remains a significant challenge, driving the search for novel biomarkers and advancements in the steroidal Athlete's Biological Passport (ABP). Phase II metabolites of endogenous anabolic androgenic steroids (EAAS) have emerged as promising biomarkers, demonstrating prolonged detection times (DTs) and greater sensitivity compared to conventional biomarkers. Studies involving male participants investigated the effect of intramuscular, oral, and transdermal administration of T on these biomarkers and proposed their integration in future urinary steroid profiling. However, before the inclusion of phase II EAAS metabolites, it is crucial to address a range of possible doping scenarios and the influence of known confounding factors, like ethnicity or sex, on the steroid profile. This study addresses this gap by investigating the impact of oral and transdermal T administration on phase II EAAS metabolites in both men and women. This second part of the study presents the results for female participants, which have not been included in prior research on this topic. Results partially confirm the trends observed in men, with sulfate ratios exhibiting prolonged detection times and higher sensitivity compared to conventional steroid profile biomarkers following multiple oral and transdermal T administration. However, the evaluation in women showed greater variability due to lower steroid concentrations and greater fluctuations influenced by the menstrual cycle. This study provides additional evidence supporting the inclusion of phase II EAAS metabolites for enhanced detection of T doping. Further, it underscores the need for further research to address the unique challenges of female steroid profiling.

Erectile dysfunction and related variables due to anabolic steroid use. A review of reviews.

Profiling medicines containing anabolic steroids by electronic circular dichroism and infrared spectroscopies.

Proteinuria is a common laboratory finding in adolescents. It is often benign and due to transient causes or orthostatic proteinuria. However, it can also be an early sign of underlying conditions that may lead to long-term kidney damage. Early recognition and appropriate diagnostic evaluation are crucial to preventing or slowing disease progression. In this age group, proteinuria may result from newly diagnosed diseases, pre-existing conditions that become clinically evident during adolescence, or previously undiagnosed disorders. Additionally, several proteinuric conditions are specific to this age group, including those related to obesity, recreational drug use, and anabolic androgenic steroids, all of which have increased significantly in recent decades. Adolescence is a transitional phase between childhood and adulthood that presents unique diagnostic challenges due to reduced parental involvement, frequent underreporting of symptoms, and non-compliance with pharmacological treatment or diet. Furthermore, adolescents may receive care in either pediatric or adult settings, where clinical approaches and guidelines often differ. This educational review addresses the diagnostic approach to proteinuria in adolescents and aims to propose a unified algorithm for this age group.

One of the most common endocrine disorders that impacts reproductive-aged women is Polycystic Ovary Syndrome (PCOS). There are various pharmacological agents used to manage the condition, such as antiandrogens, aromatase inhibitors, metformin, thiazolidinediones, and ovulation-inducing medications. Such medications focus on increasing insulin sensitivity and restoring ovulatory function. The clinical characterizations of polycystic ovary syndrome include hyperandrogenism, menstrual irregularities, and polycystic ovarian morphology. The objective of this research is to estimate the effectiveness of different medications on the signs and symptoms of polycystic ovary syndrome. Methods: From October to December 2024, a cross-sectional study was performed on 204 women in Iraq aged between 15 and 45 years to assess the therapeutic practices for PCOS. To acquire the relevant data, private gynecological consultations were held, including laboratory measurements and a questionnaire, which were analyzed using Microsoft Excel 2021. Results: The findings showed that the commonly-prescribed medications are Metformin (35.2%) and Diane 35 (34.8%). Furthermore, menstrual interruptions, hirsutism, and acne were the most commonly-reported symptoms. Hormonal evaluations show that there was heterogeneity between participants, especially regarding the levels of androgen and reproductive hormones. The findings are reflective of typical polycystic ovary syndrome clinical manifestations and the personalized pharmacological approaches used to manage symptoms and regulate hormones. Conclusion: Polycystic ovary syndrome is an intricate condition that can have different manifestations, including menstrual irregularities, obesity, acne, and hirsutism. Moreover, it can have significant metabolic and psychological implications. Despite being the most commonly administered drugs for the condition, Diane-35 and Metformin were found to impact quality of life. In turn, this highlights the need to develop treatment approaches that integrate pharmacological management with lifestyle changes in order to achieve the best possible outcomes.

Purpose: Prenatal androgen exposure, particularly testosterone, may play a pivotal role in shaping brain development and is hypothesised to affect intelligence and learning skills.The second-to-fourth digit ratio (2D:4D) is widely recognized as a biomarker for prenatal exposure to the androgenic hormone testosterone. The present study seeks to examine 2D:4D ratios in children diagnosed with specific learning disorder (SLD) and to assess comparatively these values with those of typically developing peers. Methods: Participants in the study were 94 children diagnosed with SLD and 57 healthy controls. Sociodemographic data were collected, and 2D:4D ratios for each hand were determined and differences between groups were examined. Results: Children diagnosed with SLD exhibited notably reduced 2D:4D digit ratios in both hands relative to typically developing peers. In the SLD group, lower 2D:4D ratios were observed in both sexes, with the difference reaching statistical significance for females’ left hand measurements. Conclusion: This evidence suggests that elevated testosterone exposure during the prenatal period may be implicated in the pathogenesis of SLD. By employing the non-invasive 2D:4D ratio, this study contributes to the growing body of evidence on biological markers associated with neurodevelopmental disorders.

The non-medical use of anabolic androgenic steroid (AAS) has significantly increased among athletes, bodybuilders, and individuals who focus on physical performance as well as body aesthetics. Although AAS has certain therapeutic benefits, use outside of medical supervision can lead to AAS withdrawal syndrome. This condition is characterized by physical and psychological symptoms, such as fatigue, decreased libido, anxiety, depression, and sleep disturbances. Its primary mechanism is the suppression of the hypothalamic–pituitary–gonadal (HPG) axis, which reduces endogenous testosterone production after discontinuation of AAS. Disruption of this axis not only decreases endogenous testosterone production but also alters gonadotropin hormone dynamics and androgen receptor responsiveness. Several risk factors, such as high doses, prolonged duration of use, specific usage patterns (cycling, stacking, pyramiding), and a history of psychological disorders, may exacerbate withdrawal symptoms. Management of AAS withdrawal syndrome includes short-term hormonal therapy, agents that stimulate endogenous testosterone production, psychological interventions, and physical rehabilitation. A multidisciplinary approach and close medical monitoring are required to restore endocrine function, prevent complications, and improve the patient’s psychological well-being. This paper provides a comprehensive overview to assist healthcare practitioners in recognizing, diagnosing, and appropriately managing AAS withdrawal syndrome.

Testosterone, an androgenic steroid hormone, regulates primary sexual characteristics and influences mood, cognition, social behavior, and sexual function. Deficiency, caused by factors such as aging and genetics, is linked to multiple disease conditions. However, current testosterone therapies are limited by extensive metabolism, poor solubility, and undesirable side effects. To address these limitations, we synthesized a four-armed star PEG-OH-linked testosterone (PEG-T). The in vitro release of testosterone from PEG-T was evaluated in buffer (pH 7.4) and mouse plasma. PEG-T was stable in the buffer, but released testosterone in plasma via esterase-mediated hydrolysis. Pharmacokinetics of testosterone and PEG-T were compared following intraperitoneal (IP) and subcutaneous (SC) administration. Following IP dosing, PEG-T exhibited a ~6-fold improvement in half-life compared to testosterone (1.18 h vs. 0.21 h), and a 54-fold increase in exposure (AUC0-t = 36.0 μM·h vs. 0.67 μM·h) at equimolar doses; furthermore, following SC dosing, PEG-T showed a 4-fold improvement in both half-life (3.57 h vs. 0.91 h) and plasma exposure (11.5 μM·h vs. 3.1 μM·h). Additionally, PEG-T showed lower liver and kidney to plasma ratios, which could potentially result in reduced hepatotoxicity and nephrotoxicity. Overall, PEG-T provides sustained release pharmacokinetics, representing a promising candidate for safer testosterone replacement therapy.

The endocrine regulation of testicular and ovarian development during early life in chelonians remains poorly understood, despite major morphophysiological changes occurring in this period. This study investigated the immunolocalization of estrogen (ER1 and ER2), androgen (AR), and aromatase (AROM) in the gonads and mesonephros of Podocnemis expansa during the first year after hatching (n = 5; males: 1, 3, 12 months; females: 2, 4 months). After euthanasia, gonads and mesonephros were collected, fixed in 10% buffered formaldehyde, and processed for immunohistochemistry. The intensity of immunoreactions varied according to age and sex, but not with tissue distribution. AROM, AR, ER1, and ER2 were detected in both gonads and mesonephros, confirming the persistence of steroidogenic and steroid-responsive activity after hatching. In males, AROM showed weak to moderate labeling in germ and interstitial cells of seminiferous tubules, whereas ER2 expression predominated in spermatogonia and interstitial endocrine cells. In females, AROM and AR were moderately expressed in the germinal epithelium and oogonia at two months, decreasing at four months, while ER2 persisted in follicles and oogonia. These findings suggest a dynamic endocrine environment influencing posthatch gonadal maturation, with the mesonephros acting as a transient extragonadal source of steroids. Despite the small, sex-unbalanced sample (due to lack of dimorphism), the results provide valuable baseline information and support future quantitative and functional studies on the reproductive endocrinology of P. expansa and other chelonians with temperature-dependent sex determination.

The illicit use of androgenic anabolic steroids, such as 17β-testosterone, in food-producing animals poses significant risks to animal welfare and consumer safety. Detecting exogenous administration of endogenous hormones like testosterone is particularly challenging, as the administered compound is chemically identical to naturally occurring hormones. In this study, we developed a metabolomics-based workflow using ultra-high-performance liquid chromatography coupled to quadrupole-Orbitrap high-resolution mass spectrometry to enhance detection of testosterone misuse in cattle. Serum samples from treated steers were analyzed using an untargeted metabolomics workflow combined with multivariate supervised modeling (OPLS-DA). Data processing with an optimized IPO-XCMS pipeline provided peak picking and alignment. OPLS-DA modeling provided robust class separation, correctly predicting the hold-out samples. Cross-validation and permutation testing further confirmed the model's stability and predictive reliability. Untargeted analysis identified three molecular features with high discriminatory power and positive correlation with the treatment, and a significant suppression of endogenous hormones (androstenedione, corticosterone, and progesterone) as part of a negative feedback response. Notably, these suppression effects persisted beyond the period of elevated testosterone responses. The proposed workflow offers a sensitive tool to strengthen regulatory surveillance by identifying both novel candidate markers and endocrine disruptions in suspected samples.

The integrity of competitive athletics is increasingly compromised by sophisticated pharmacologies, rendering traditional sporadic testing of urine and blood insufficient for comprehensive oversight. This critical review examines the emergence of wearable electrochemical biosensors as a non-invasive alternative capable of bridging the gap between laboratory precision and real-time field monitoring. We propose a dual biofluid framework wherein sweat functions as a cumulative reservoir for lipophilic anabolic androgenic steroids due to ion trapping mechanisms, while saliva serves as a dynamic plasma ultrafiltrate suitable for tracking the pharmacokinetics of stimulants and psychotropic substances. The text provides a detailed analysis of biorecognition engineering, emphasizing the shift from labile enzymatic systems to robust synthetic receptors, including structure-switching aptamers and molecularly imprinted polymers, which offer superior stability under harsh environmental conditions. Furthermore, we evaluate the integration of functional nanomaterials such as metal-organic frameworks and MXenes that amplify signal transduction to meet the stringent Minimum Required Performance Levels established by the World Anti-Doping Agency. Technical challenges regarding biological interface fouling and sample handling are addressed through the discussion of zwitterionic antifouling coatings and active microfluidic routing. The review concludes by conceptualizing the Internet of Anti-Doping Bodies, a framework leveraging encrypted wireless data transmission and artificial intelligence pattern recognition to transform anti-doping into a continuous and preventive data-driven discipline.