The International Cycling Union Unveils New Anti-Doping Program. How Much is Enough?

In March 2007, the International Cycling Union (ICU) unveiled the new anti-doping program, the main objective of which is to give cycling the best anti-doping programme worldwide. The so-called “100 % Against Doping” initiative complements the ICU's extensive existing anti-doping measures and is intended to represent a quantum leap forward for the cycling world in its efforts to fight doping [[2]]. The advisory board includes ICU Anti-Doping Authorities, the World Anti-Doping Agency (WADA), the International Olympic Committee (IOC), members of the scientific community and the political world. The provocative name of this initiative underlines that 100 % of the ProTour Teams cyclists will be subject to unannounced out-of-competition tests, especially in periods of preparation for their main targets. Riders not subject to such tests in their own countries will be particularly targeted. All of them will also undergo pre-race blood tests at least four times a year. A comprehensive haematological profile will be developed for all the ProTour Teams riders and a urinary steroid profile will be created for selected athletes to establish an international database in cooperation with the WADA and national anti-doping agencies. All the riders are also committed to sign an agreement to provide a sample of their DNA if necessary, in the respect of laws and ethical rules. Samples will hence be used only for identification purposes in the event of the discovery of suspect organic matter or doping substances. Finally, there will be a code of conduct for everyone as well and it will include high financial sanctions.

Basically, the innovative features contained in this thorough policy are expected to make it the most complete and pervasive anti-doping program developed so far by an international sport federation. The most notable aspect is the introduction of the so-called “haematological passport”. The continuous development of illicit means to boost erythropoiesis has led to much wasted efforts from anti-doping agencies in the spasmodic tentative to screen for all available blood doping methods, especially the most original ones such as the administration of novel analogues of erythropoietin, blood substitutes, homologous blood transfusions, allosteric modulators of haemoglobin, inorganic hypoxic ions and, last but not least, gene doping. Most of these methods are currently undetectable by the traditional laboratory testing. In fact, their identification relies on sophisticated and expensive analytical techniques, which can be delivered by reference anti-doping laboratories and are hence unsuitable to screen large numbers of athletes [[3]]. Owing to high individuality, the use of absolute reference ranges for haematological parameters is not useful. Therefore, repeated evaluation over a period of time of several of the haematological parameters, including haemoglobin, haematocrit, reticulocyte count and indexes, would define an individual, highly specific haematological profile, which is supposed to remain fairly stable over time. This approach allows a reliable longitudinal comparison of athletes' data and appears suitable to identify the use of illicit means to boost erythropoiesis that, regardless of their nature, are expected to modify the baseline profile [[4]].

The second and more controversial issue is the introduction of DNA testing. Although the final protocol has to be unveiled, genetic analysis should not be regarded an absolute novelty, since the IOC officially mandated gender verification for female athletes by laboratory-based genetic tests, beginning in 1968 [[1]]. According to the ICU, the DNA testing would not be used to identify cheaters, rather it may be useful to rule out erroneous sample identification, a sort of self-protective evidence for clean athletes suspected to undergo unfair practices, who would be primarily interested to demonstrate their innocence. Concerns and ethical issues raised by certain athletes and media on this approach appear unjustified, as DNA testing would be intently used to defend and not to accuse the athlete. Moreover, athletes entering a highly remunerative contract for their performances will be requested to deliver a verity of services on demand, including availability to be broadly tested for suspected cheating. This is a rather small price to pay for achieving fame and celebrity. Moreover, it should be considered that DNA analysis is a powerful tool that would enable a new approach for detecting sample substitution in sports drug testing. This is of particular relevance in those contexts where there is a tangible suspicion that the athlete's specimens provided for anti-doping controls have been collected from other unidentified individual(s) rather than from the nominal subject [[5]].

Since doping has become commonplace in competitive athletes who seek to enhance their aerobic performances through illicit techniques, the crucial issue is: how many resources should we invest in anti-doping testing? This innovative and pervasive initiative promoted by the ICU should be globally regarded as a valuable paradigm to be pursued by other sport federations. It represents an appropriate balance between resources (economical and organizational), and potential outcomes (limitation of false positive and negative results), since it has the potential to enable a safer approach to the fight against doping from both the sport federations and athletes sides.

References

• 1 Elsas L J, Ljungqvist A, Ferguson-Smith M A, Simpson J L, Genel M, Carlson A S, Ferris E, de la Chapelle A, Ehrhardt A A. Gender verification of female athletes.  Genet Med. 2000;  2 249-254
• 2 International Cycling Union .100 % Against Doping. Available at: http://www.uci.ch/Modules/BUILTIN/getObject.asp?MenuId=MTYxNw&. Last Accessed: 13 March 2007
• 3 Lippi G, Franchini M, Salvagno G L, Guidi G C. Biochemistry, physiology, and complications of blood doping: facts and speculation.  Crit Rev Clin Lab Sci. 2006;  43 349-391
• 4 Lippi G, Banfi G. Blood transfusions in athletes. Old dogmas, new tricks.  Clin Chem Lab Med. 2006;  44 1395-1402
• 5 Thevis M, Geyer H, Mareck U, Sigmund G, Henke J, Henke L, Schanzer W. Detection of manipulation in doping control urine sample collection: a multidisciplinary approach to determine identical urine samples.  Anal Bioanal Chem. 2007;