Overview of Scientific Research funded by the World Anti-Doping Agency and Partnership for Clean Competition in the last 20 years : Scientific Research Report / Institute of National Anti-Doping Organisations (iNADO). - Bonn : iNADO, 2021

Contents:

1. Introduction
2. Evolution of Scientific Research on Doping
3. Funded Research Projects per Region and Country
4. Funded Research Projects per Research Area

• 4.1 Funded Research on Analytical Methods for the Detection of Prohibited Substances/ Methods
• 4.2 Funded Research on the Effect of Substances and Methods on Physical Performance
• 4.3 Funded Research on Social Sciences

5. Organizations that have conducted research projects funded by WADA and PCC
6. Conclusions

In this report and in this short video, we present you the results of a project we conducted to get an overview of social and scientific research on anti-doping in the last 20 years, focusing mainly on research projects funded by two of the major funding organizations: the World Anti-Doping Agency (WADA) and Partnership Competition Partnership (PCC), amounting each to over $83 million and $29 million in the last 20 years.

The report highlights how research evolved in terms of topics researched, the progressive increase of fundings and finally shed some light on trends: which countries and types of organizations concentrate most of the fundings, what are the new topics researchers focus on. The project also puts in perspective the trends observed with the funding organizations’ strategies, the current involvement of NADOs in Scientific and Social Sciences Research.

Oxandrolone Augmentation of Resistance Training in Older Women : A Randomized Trial / Yorgi Mavros, Evelyn O'Neill, Maureen Connerty, Jonathan F. Bean, Kerry Broe, Douglas P. Kiel, David Maclean, Ann Taylor, Roger A. Fielding, Maria A. Fiatarone Singh. - (Medicine & Science Sports & Exercise 47 (2015 11 (November); p. 2257-2267)

• PMID: 25899102
• DOI: 10.1249/MSS.0000000000000690

Abstract

Introduction: Sarcopenia is disproportionately present in older women with disability, and optimum treatment is not clear. We conducted a double-blind, randomized, placebo-controlled trial to determine whether oxandrolone administration in elderly women improves body composition or physical function beyond that which occurs in response to progressive resistance training (PRT).

Methods: Twenty-nine sedentary women (age 74.9 ± 6.8 yr; 5.9 ± 2.8 medications per day) were randomized to receive high-intensity PRT (three times a week for 12 wk) combined with either oxandrolone (10 mg·d(-1)) or an identical placebo. Peak strength was assessed for leg press, chest press, triceps, knee extension, and knee flexion. Power was assessed for leg press and chest press. Physical function measures included static and dynamic balance, chair rise, stair climb, gait speed, and 6-min walk test. Body composition was assessed using dual energy x-ray absorptiometry.

Results: Oxandrolone treatment augmented increases in lean tissue for the whole body (2.6 kg; 95% confidence interval (CI), 1.0-4.2 kg; P = 0.003), arms (0.3 kg; 95% CI, 0.1-0.5 kg; P = 0.001), legs (0.8 kg; 95% CI, 0.1-1.4 kg; P = 0.018), and trunk (1.4 kg; 95% CI, 0.4-2.3 kg; P = 0.004). Oxandrolone also augmented loss of fat tissue of the whole body (-1 kg; 95% CI, -1.6 to -0.4; P = 0.002), arms (-0.2 kg; 95% CI, -0.5 to -0.02 kg; P = 0.032), legs (-0.4 kg; 95% CI, -0.6 to -0.1; P = 0.009), and tended to reduce trunk fat (-0.4 kg; 95% CI, -0.9 to 0.04; P = 0.07). Improvements in muscle strength and power, chair stand, and dynamic balance were all significant over time (P < 0.05) but not different between groups (P > 0.05).

Conclusions: Oxandrolone improves body composition adaptations to PRT in older women over 12 wk without augmenting muscle function or functional performance beyond that of PRT alone.

Oxygen delivery enhancers: past, present, and future / P. Borrione, A. Mastrone, R.A. Salvo, A. Spaccamiglio, L. Grasso, A. Angeli. - (Journal of Endocrinological Investigation 31 ( (2008) 2 (February); p. 185-192)

• PMID: 18362513
• DOI: 10.1007/BF03345588

Abstract

In endurance sport the delivery of oxygen to muscles plays a critical role. Indeed, muscle performance declines during prolonged and intense activity as a consequence of the shift from the aerobic to the anaerobic metabolism with an increase of lactate. To enhance the aerobic capacity 2 alternatives may be used: increasing either the transport or the delivery of oxygen. In this setting, blood doping is the practice of illicitly using a drug or blood product to improve athletic performance. Based on this definition, blood doping techniques may include: 1) blood transfusion (autologous or omologous); 2) erythropoiesis-stimulating substances [recombinant human erythropoietin (alpha, beta, omega), darbepoietin-alpha, continuous erythropoiesis receptor activator, hematide]; 3) blood substitutes (hemoglobin-based oxygen carriers, perfluorocarbon emulsions); 4) allosteric modulators of hemoglobin (RSR-13 and RSR-4); 5) gene doping (human erythropoietin gene transfection); 6) gene regulation (hypoxia-inducible transcription factors pathway). In the present overview we will briefly describe the above-mentioned techniques with the aim of underlining potential hematological alternatives to gene doping for increasing aerobic capacity in sport.

Oxygen gas-filled microparticles provide intravenous oxygen delivery / J.N. Kheir, L.A. Scharp, M.A. Borden, E.J. Swanson, A. Loxley, J.H. Reese, K.J. Black, L.A. Velazquez, L.M. Thomson, Brian K. Walsh, Kathryn E. Mullen, Dionne A. Graham, Michael W. Lawlor, Carlo Brugnara, David C. Bell, FX McGowan Jr. – (Science translational medicine 4 (2012) 140 (27 June) : p. 1-10) doi: 10.1126/scitranslmed.3003679.

We have developed an injectable foam suspension containing self-assembling, lipid-based microparticles encapsulating a core of pure oxygen gas for intravenous injection. Prototype suspensions were manufactured to contain between 50 and 90 ml of oxygen gas per deciliter of suspension. Particle size was polydisperse, with a mean particle diameter between 2 and 4 μm. When mixed with human blood ex vivo, oxygen transfer from 70 volume % microparticles was complete within 4 s. When the microparticles were infused by intravenous injection into hypoxemic rabbits, arterial saturations increased within seconds to near-normal levels; this was followed by a decrease in oxygen tensions after stopping the infusions. The particles were also infused into rabbits undergoing 15 min of complete tracheal occlusion. Oxygen microparticles significantly decreased the degree of hypoxemia in these rabbits, and the incidence of cardiac arrest and organ injury was reduced compared to controls. The ability to administer oxygen and other gases directly to the bloodstream may represent a technique for short-term rescue of profoundly hypoxemic patients, to selectively augment oxygen delivery to at-risk organs, or for novel diagnostic techniques. Furthermore, the ability to titrate gas infusions rapidly may minimize oxygen-related toxicity.

VA Bocci, I Zanardi & V Travagli. Ozone acting on human blood yields a hormetic dose-response relationship. Journal of Translational Medicine 2011, 9:66.

Ghandourah S, Hofer MJ, Kießling A, El-Zayat B, Schofer, DM.
J Med Case Rep. 2012 Aug 20;6(1):248.

Abstract

Introduction
Synthol is a site enhancement oil used by bodybuilders to boost the cosmetic appearance of muscles. Here, we describe the case of a patient with severe side effects following repeated intramuscular injections of synthol in his right biceps muscle.

Case presentation
A 29-year-old Middle Eastern male bodybuilder, following intramuscular injections of synthol five years ago, presented with painful pressure in his right upper arm. On presentation to our clinic, his muscle appeared disfigured. Magnetic resonance imaging revealed scattered cystic fatty lesions in the muscle. The affected part was surgically removed and histopathology showed inflammatory changes with fibrosis and a so-called Swiss cheese pattern.

Conclusion
Synthol injections that are used for the short-term enhancement of muscle appearance by bodybuilders bear the danger of long-term painful muscle fibrosis and disfigurement.

Pancreatic Islet Hyperplasia : A Potential Marker for Anabolic-Androgenic Steroid Use / Jared Weinand, Walter L. Kemp. - (Academic Forensic Pathology 8 (2018) 3 (31 August); p. 777-785).
- PMID: 31240072.
- PMCID: PMC6490586.
- DOI: 10.1177/1925362118797755

Abstract

It has been estimated that up to four million Americans have used anabolic-androgenic steroids (AAS) to increase muscle mass - either for improved athletic performance, enhanced personal appearance, or both. While the pathologic effects of supra-physiologic doses of AAS have been well-described for some organ systems, such as the cardiovascular system, the effects on other organ systems are less well-described; for example, there is a dearth of knowledge in the medical literature regarding the effects of recreational use of AAS on the islet cells of the endocrine pancreas. As pancreatic islet hyperplasia has previously been described in the literature in a group of patients receiving long-term AAS treatment for Fanconi anemia, it is reasonable to suggest that the use of AAS by bodybuilders could produce the same (or similar) histologic changes. We present a case that offers support for the association of anabolic-androgenic steroid use and pancreatic islet hyperplasia.

Panelists discuss about the challenges facing the World Anti-Doping Agency. Speakers include UK Anti-Doping CEO Andy Parkinson, British Olympic Association Director of Elite Performance Sir Clive Woodward, three-time London Marathon winner Paula Radcliffe, and 2012 Olympic and Paralympic Games Ambassador Steve Cram.

100% me is UK Anti-Doping's education programme which aims to prevent doping in sport. 100% me is about being a true athlete. It's about being able to say my performance is 100% me. There is no secret to my success - just hard work, determination and talent.

UK Anti-Doping is responsible for protecting sport from the threat of doping in the UK. This involves planning, implementing and monitoring the UK’s anti-doping policy and implementing effective anti-doping programmes.

Related case:
CAS 2006/A/1190 WADA vs Pakistan Cricket Board & Shoaib Akhtar & Muhammed Asif
June 28, 2006

In October 2006 the Pakistan Cricket Board (PCB) has reported an anti-doping rule violation against the cricket players Shoaib Akhtar and Muhammed Asif after their samples tested positive for the prohibited substance 19-norandrosteron (Nandrolone).
On 1 November 2006 the PCB Anti-Doping Commission decided to impose a 2 year period of ineligibility on the Athlete Akhtar and a 1 year period on the Athlete Asif.

Hereafter in November 2006 both Athlete’s appealed the PCB decision with the PCB Anti-Doping Appeals Committee.

Akhtar’s arguments in his defence was as follows:
(i) that his high protein intake and rigorous workout schedule over the years had caused endogenous production of 19-Norandrosterone in his system well over the prescribed limit of 2 ng/ml;
(ii) that the nutritional supplements taken by him - including Blaze Xtreme, Nitron 5, Size On, T-Bomb II, Promax 50 and Viper - were not banned items;
(iii) that contamination in the aforesaid supplements taken by him could have been the reason for the elevated level of 19-Norandrosterone; and
(iv) that he was never warned by the PCB about the PCB Regulations.

Asif’s defence to the charge of doping was more circumscribed. He pleaded:
(i) that he had not knowingly taken any medicine or substance which could explain the test result;
(ii) that he had started using supplements, including Promax, when he was in the U.K. three years ago;
(iii) that he honestly did not know the effects of the supplements he was taking; and
(iv) that when recently the team physiotherapist Mr. Darryn Lipson advised him to discontinue the use of supplements, he immediately stopped ingesting them.

The Appeals Committee accepts the Athlete's arguments and rules that the Athletes had “successfully established that they held an honest and reasonable belief that the supplement ingested by them did not contain any prohibited substances”, and the Athletes had therefore “met the test of ‘exceptional circumstances’ as laid down under clause 4.5 of the PCB Anti Doping Regulations.”

Therefore the PCB Anti-Doping Appeals Committee decides on 5 december 2006 to set aside the decision of 1 November 2006 and to annul the imposed sanction.

Hereafter in December 2006 the World Anti-Doping Agency (WADA) appeals the decision of the PCB Appeals Committee with the Court of Arbitration for Sport (CAS). However the CAS rules on 28 June 2007 that the WADA appeal is inadmissible due to CAS has no jurisdiction to rule under the PCB and ICC Rules.

In January 2014 the Pakistan Cricket Board (PCB) has reported an anti-doping rule violation against the cricket player Kashif Siddique after his sample tested positive for the prohibited substances 19-norandrostenedione, 19-norandrosterone (Nandrolone) and Stanozolol. After notification a provisional suspension was ordered.
The Athlete filed a statement in his defence and he was heard for the PCB Anti-Doping Tribunal.

The Athlete admitted the violation and stated that he had used the presctribed medication Wingstole and Deca Durabilin, without a TUE, as treatment for his shoulder injury as possible source of the positive test. The Athlete asserted that the violation was not intentional and that he acted with No Fault or Negligence.

The Tribunal did not accept the Athlete's statement and finds that he failed to produce evidence that the medication he used was the source of the positive test, neither that he underwent medical treatment.

The PCB Anti-Doping Tribunal concludes that the Athlete acted with negligence and without grounds for a reduced sanction it decides on 26 April 2014 to impose a 2 year period of ineligbility on the Athlete starting on the date of the provisional suspension, i.e. on 8 January 2014.