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Slíž K, Mikuš P. Advances in SARMs anti-doping analysis. Drug Test Anal 2024. [PMID: 38706416 DOI: 10.1002/dta.3697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 04/02/2024] [Accepted: 04/02/2024] [Indexed: 05/07/2024]
Abstract
Selective androgen receptor modulators (SARMs) are performance-enhancing drugs (PEDs) that stimulate anabolism, increase muscle mass and strength and promote recovery from exercise. The use of SARMs in sports is considered doping and is strictly prohibited by the World Anti-Doping Agency (WADA) and the International Federation of Horseracing Authorities (IFHA). To monitor the abuse of SARMs in sports, it is essential to develop advanced, selective and sensitive analytical methods that provide reliable results. This review evaluates the advances in this area, with a focus on the identification of target analytes related to SARMs, such as SARMs, their metabolites or markers. The aim is to identify targets that could extend the detection windows of SARMs, provide scientific support for results management and/or offer an indirect biomarker-based approach to doping control. This review also aims to evaluate the current liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) methods developed for the monitoring of SARMs in different biological matrices, including traditional matrices such as urine and serum/plasma samples, as well as alternative matrices such as dried blood spots, hair and nail samples.
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Affiliation(s)
- Kristián Slíž
- Department of Pharmaceutical Analysis and Nuclear Pharmacy, Faculty of Pharmacy, Comenius University Bratislava, Bratislava, Slovakia
- Toxicologic and Antidoping Centre, Faculty of Pharmacy, Comenius University Bratislava, Bratislava, Slovakia
| | - Peter Mikuš
- Department of Pharmaceutical Analysis and Nuclear Pharmacy, Faculty of Pharmacy, Comenius University Bratislava, Bratislava, Slovakia
- Toxicologic and Antidoping Centre, Faculty of Pharmacy, Comenius University Bratislava, Bratislava, Slovakia
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2
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Angelis YS, Sakellariou P, Petrou M, Pitsinos EN. Targeted Metabolic Investigation of Ligandrol and Analytical Methods Validation for Its Main Long-term Metabolite. Chempluschem 2024; 89:e202300634. [PMID: 38183391 DOI: 10.1002/cplu.202300634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/18/2023] [Accepted: 01/05/2024] [Indexed: 01/08/2024]
Abstract
Prompted by the need for related analytical reference material in the frame of the fight against doping in sports, synthetic efforts towards the main long-term bishydroxylated metabolite (LGD-LTM1) of the nonsteroidal selective androgen receptor modulator (SARM) ligandrol have produced related derivatives that were exploited for a targeted metabolite analysis of urine samples obtained in the course of previous excretion studies of this SARM. Further clarifying ligandrol's metabolic profile, the availability of synthetic reference material permitted the structural elucidation of a previously reported pyrrolidinone-type metabolite and revealed its potential analytical utility as an additional long-term marker. Moreover, synthetic reference material enabled the comparison and validation of liquid chromatography coupled with mass spectrometry (LC-MS)-based and gas chromatography coupled with mass spectrometry (GC-MS)-based detection and identification methods focusing on the LGD-LTM1 marker.
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Affiliation(s)
- Yiannis S Angelis
- Institute of Biosciences & Applications, National Centre for Scientific Research "DEMOKRITOS", Doping Control Laboratory of Athens, Neratziotissis & Amaryssias Artemidos Str, GR 151 23, Athens, Greece
| | - Panagiotis Sakellariou
- Institute of Biosciences & Applications, National Centre for Scientific Research "DEMOKRITOS", Doping Control Laboratory of Athens, Neratziotissis & Amaryssias Artemidos Str, GR 151 23, Athens, Greece
| | - Michael Petrou
- Cyprus Anti-Doping Authority, Makarion Athletic Centre Avenue, Engomi, CY 2400, Nicosia, Cyprus
| | - Emmanuel N Pitsinos
- Institute of Nanoscience and Nanotechnology, National Centre for Scientific Research "DEMOKRITOS", P.O. Box 60037, Aghia Paraskevi, GR 153 10, Athens, Greece
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3
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Thevis M, Görgens C, Guddat S, Thomas A, Geyer H. Mass spectrometry in sports drug testing-Analytical approaches and the athletes' exposome. Scand J Med Sci Sports 2024; 34:e14228. [PMID: 36539355 DOI: 10.1111/sms.14228] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/02/2022] [Accepted: 08/12/2022] [Indexed: 01/26/2024]
Abstract
Test methods in anti-doping, most of which rely on the most modern mass spectrometric instrumentation, undergo continuous optimization in order to accommodate growing demands as to comprehensiveness, sensitivity, retrospectivity, cost-effectiveness, turnaround times, etc. While developing and improving analytical approaches is vital for appropriate sports drug testing programs, the combination of today's excellent analytical potential and the inevitable exposure of humans to complex environmental factors, specifically chemicals and drugs at the lowest levels, has necessitated dedicated research, particularly into the elite athlete's exposome. Being subjected to routine doping controls, athletes frequently undergo blood and/or urine tests for a plethora of drugs, chemicals, corresponding metabolic products, and various biomarkers. Due to the applicable anti-doping regulations, the presence of prohibited substances in an athlete's organism can constitute an anti-doping rule violation with severe consequences for the individual's career (in contrast to the general population), and frequently the question of whether the analytical data can assist in differentiating scenarios of 'doping' from 'contamination through inadvertent exposure' is raised. Hence, investigations into the athlete's exposome and how to distinguish between deliberate drug use and potential exposure scenarios have become a central topic of anti-doping research, aiming at supporting and consolidating the balance between essential analytical performance characteristics of doping control test methods and the mandate of protecting the clean athlete by exploiting new strategies in sampling and analyzing specimens for sports drug-testing purposes.
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Affiliation(s)
- Mario Thevis
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
- European Monitoring Center for Emerging Doping Agents, Cologne, Germany
| | - Christian Görgens
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
| | - Sven Guddat
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
| | - Andreas Thomas
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
| | - Hans Geyer
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Cologne, Germany
- European Monitoring Center for Emerging Doping Agents, Cologne, Germany
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4
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Ondern Komathu P, Padusha MKSA, Laya S, Nalakath J, Palathinkal AB, Nelliyott I. Investigation of in vitro generated metabolites of LGD-4033, a selective androgen receptor modulator, in homogenized camel liver for anti-doping applications. RAPID COMMUNICATIONS IN MASS SPECTROMETRY : RCM 2023; 37:e9633. [PMID: 37817338 DOI: 10.1002/rcm.9633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 10/12/2023]
Abstract
RATIONALE The use of selective androgen receptor modulators (SARM) in sports is prohibited by the World Anti-Doping Agency (WADA) due to their potential as performance-enhancing drugs, offering an unfair advantage. LGD-4033 is a SARM known for its similarities to anabolic steroids and can be easily purchased online, leading to increased availability and misuse. Adverse analytical findings have revealed the presence of SARMs in dietary supplements. Although LGD-4033 misuse has been reported in human sports over the years, concerns also arise regarding its illicit use in animal sports, including camel racing. Although various studies have investigated the metabolism of LGD-4033 in humans, horse, and other species, there is limited research specifically dedicated to racing camels. METHODS This study focuses on the in vitro metabolism of LGD-4033 in homogenized camel liver using liquid chromatography-high-resolution mass spectrometry (LC-HRMS) to identify and characterize the metabolites. RESULTS The findings indicated the presence of 12 phase I metabolites and 1 phase II metabolite. Hydroxylation was responsible for the formation of the main phase I metabolites that were identified. A glucuronic acid conjugate of the parent drug was observed in this study, but no sulfonic acid conjugate was found. The possible chemical structures of these metabolites, along with their fragmentation patterns, were identified using MS. CONCLUSIONS These findings provide valuable insights into the metabolism of LGD-4033 in camels and aid in the development of effective doping control methods for the detection of SARMs in camel racing.
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Affiliation(s)
- Praseen Ondern Komathu
- Camel Forensic Laboratory, Central Veterinary Research Laboratory, Dubai, United Arab Emirates
- Post Graduate and Research Department of Chemistry, Jamal Mohamed College (Affiliated to Bharathidasan University), Tiruchirappalli, India
| | - Mohamed Khan Syed Ali Padusha
- Post Graduate and Research Department of Chemistry, Jamal Mohamed College (Affiliated to Bharathidasan University), Tiruchirappalli, India
| | - Saraswathy Laya
- Department of Chemistry, College of Science, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Jahfar Nalakath
- Camel Forensic Laboratory, Central Veterinary Research Laboratory, Dubai, United Arab Emirates
| | - Ansar Babu Palathinkal
- Camel Forensic Laboratory, Central Veterinary Research Laboratory, Dubai, United Arab Emirates
| | - Ibrahimwaseem Nelliyott
- Camel Forensic Laboratory, Central Veterinary Research Laboratory, Dubai, United Arab Emirates
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Kwiatkowska D, Wicka M, Grucza K, Konarski P, Drapała A, Kaliszewski P. Variation of Sequential Ligandrol (LGD-4033) Metabolite Levels in Routine Anti-Doping Urine Samples Detected with or without Other Xenobiotics. Molecules 2023; 28:6486. [PMID: 37764261 PMCID: PMC10535477 DOI: 10.3390/molecules28186486] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/24/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Ligandrol, also known as LGD-4033, belongs to the group of selective androgen receptor modulators (SARMs). Ligandrol was first included in the WADA Prohibited List in 2018. This work presents a method that allows for the detection and identification of ligandrol and its metabolite in athletes' urine and in dietary supplements by means of ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). Samples were prepared according to an approach involving acid hydrolysis and double liquid-liquid extraction (LLE). Furthermore, due to the lack of reference material for ligandrol metabolites, the urine collected from the control excretion study was analyzed. The presented method is appropriate to monitor ligandrol and its metabolites. The samples collected for doping control purpose contained multiple metabolites, which may potentially rule out the hypothesis of ingesting a single 1 µg or 10 µg dose only. Another aspect to take into account is that ligandrol can be applied together with SARMs, steroids, and GHSs. This will also affect the substances' metabolism and elimination. It is also worth noting that dietary supplements may contain ligandrol as an official ingredient or as a contaminant. The described method may be usefully applied by other anti-doping or toxicological laboratories.
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Affiliation(s)
- Dorota Kwiatkowska
- Polish Anti-Doping Laboratory, Ksiecia Ziemowita 53 Bud. 4, 03-885 Warsaw, Poland; (M.W.); (K.G.); (P.K.); (A.D.); (P.K.)
- Biological and Chemical Research Centre, University of Warsaw, Zwirki i Wigury 101, 02-093 Warsaw, Poland
| | - Mariola Wicka
- Polish Anti-Doping Laboratory, Ksiecia Ziemowita 53 Bud. 4, 03-885 Warsaw, Poland; (M.W.); (K.G.); (P.K.); (A.D.); (P.K.)
| | - Krzysztof Grucza
- Polish Anti-Doping Laboratory, Ksiecia Ziemowita 53 Bud. 4, 03-885 Warsaw, Poland; (M.W.); (K.G.); (P.K.); (A.D.); (P.K.)
| | - Patryk Konarski
- Polish Anti-Doping Laboratory, Ksiecia Ziemowita 53 Bud. 4, 03-885 Warsaw, Poland; (M.W.); (K.G.); (P.K.); (A.D.); (P.K.)
| | - Aleksandra Drapała
- Polish Anti-Doping Laboratory, Ksiecia Ziemowita 53 Bud. 4, 03-885 Warsaw, Poland; (M.W.); (K.G.); (P.K.); (A.D.); (P.K.)
| | - Paweł Kaliszewski
- Polish Anti-Doping Laboratory, Ksiecia Ziemowita 53 Bud. 4, 03-885 Warsaw, Poland; (M.W.); (K.G.); (P.K.); (A.D.); (P.K.)
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Vignali JD, Pak KC, Beverley HR, DeLuca JP, Downs JW, Kress AT, Sadowski BW, Selig DJ. Systematic Review of Safety of Selective Androgen Receptor Modulators in Healthy Adults: Implications for Recreational Users. J Xenobiot 2023; 13:218-236. [PMID: 37218811 DOI: 10.3390/jox13020017] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/05/2023] [Accepted: 05/08/2023] [Indexed: 05/24/2023] Open
Abstract
Selective Androgen Receptor Modulators (SARMs) are not FDA approved, and obtaining SARMs for personal use is illegal. Nevertheless, SARM use is increasingly popular amongst recreational athletes. Recent case reports of drug-induced liver injury (DILI) and tendon rupture raise serious concerns for the safety of recreational SARM users. On 10 November 2022 PubMed, Scopus, Web of Science, and ClinicalTrials.gov were searched for studies that reported safety data of SARMs. A multi-tiered screening approach was utilized, and any study or case report of generally healthy individuals exposed to any SARM was included. Thirty-three studies were included in the review with 15 case reports or case series and 18 clinical trials (total patients N = 2136 patients, exposed to SARM N = 1447). There were case reports of drug-induced liver injury (DILI) (N = 15), Achilles tendon rupture (N = 1), rhabdomyolysis (N = 1), and mild reversible liver enzyme elevation (N = 1). Elevated alanine aminotransferase (ALT) was commonly reported in clinical trials in patients exposed to SARM (mean 7.1% across trials). Two individuals exposed to GSK2881078 in a clinical trial were reported to have rhabdomyolysis. Recreational SARM use should be strongly discouraged, and the risks of DILI, rhabdomyolysis, and tendon rupture should be emphasized. However, despite warnings, if a patient refuses to discontinue SARM use, ALT monitoring or dose reduction may improve early detection and prevention of DILI.
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Affiliation(s)
- Jonathan D Vignali
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - Kevin C Pak
- Department of Gastroenterology, Naval Medical Center San Diego, San Diego, CA 92134, USA
| | - Holly R Beverley
- Gorgas Memorial Library, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - Jesse P DeLuca
- Clinical Pharmacology Fellowship, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - John W Downs
- Department of Toxicology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Adrian T Kress
- Clinical Pharmacology Fellowship, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - Brett W Sadowski
- Department of Gastroenterology, Naval Medical Center San Diego, San Diego, CA 92134, USA
| | - Daniel J Selig
- Clinical Pharmacology Fellowship, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
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Investigations into the concentration and metabolite profiles of stanozolol and LGD-4033 in blood plasma and seminal fluid using liquid chromatography high-resolution mass spectrometry. Anal Bioanal Chem 2023; 415:669-681. [PMID: 36441233 PMCID: PMC9839828 DOI: 10.1007/s00216-022-04456-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/27/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2022]
Abstract
Potential scenarios as to the origin of minute amounts of banned substances detected in doping control samples have been a much-discussed problem in anti-doping analysis in recent years. One such debated scenario has been the contamination of female athletes' urine with ejaculate containing doping agents and/or their metabolites. The aim of this work was to obtain complementary information on whether relevant concentration ranges of doping substances are excreted into the ejaculate and which metabolites can be detected in the seminal fluid (sf) and corresponding blood plasma (bp) samples. A method was established to study the concentration and metabolite profiles of stanozolol and LGD-4033-substances listed under anabolic substances (S1) on the World Anti-Doping Agency's Prohibited List-in bp and sf using liquid chromatography high-resolution mass spectrometry (LC-HRMS). For sf and bp, methods for detecting minute amounts of these substances were developed and tested for specificity, recovery, linearity, precision, and reliability. Subsequently, sf and bp samples from an animal administration study, where a boar orally received stanozolol at 0.33 mg/kg and LGD-4033 at 0.11 mg/kg, were measured. The developed assays proved appropriate for the detection of the target substances in both matrices with detection limits between 10 and 40 pg/mL for the unmetabolized drugs in sf and bp, allowing to estimate the concentration of stanozolol in bp (0.02-0.40 ng/mL) and in sf (0.01-0.25 ng/mL) as well as of LGD-4033 in bp (0.21-2.00 ng/mL) and in sf (0.03-0.68 ng/mL) post-administration. In addition, metabolites resulting from different metabolic pathways were identified in sf and bp, with sf resembling a composite of the metabolic profile of bp and urine.
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Cardaci TD, Machek SB, Wilburn DT, Heileson JL, Harris DR, Cintineo HP, Willoughby DS. LGD-4033 and MK-677 use impacts body composition, circulating biomarkers, and skeletal muscle androgenic hormone and receptor content: A case report. Exp Physiol 2022; 107:1467-1476. [PMID: 36303408 DOI: 10.1113/ep090741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/06/2022] [Indexed: 12/14/2022]
Abstract
NEW FINDINGS What is the main observation in this case? Co-administration of LGD-4033 and MK-677 increased body mass, lean mass and fat mass, while negatively impacting bone, serum lipids, liver enzymes, testosterone (total and free) and, probably, follicle-stimulating hormone. What insights does it reveal? Our cross-sectional data imply that these compounds might alter intramuscular androgenic hormone and receptor concentrations along with promoting muscular strength, when compared with previously published data from trained males. ABSTRACT LGD-4033, a selective androgen receptor modulator, and MK-677, a growth hormone secretagogue, are being used increasingly amongst recreationally active demographics. However, limited data exist describing their effects on health- and androgen-related biomarkers. The purpose of this case study was to determine changes in body composition and biomarkers during and after continued co-administration of LGD-4033 and MK-677. We also aimed to examine muscular strength and intramuscular androgen-associated biomarkers relative to non-users. A 25-year-old male ingested LGD-4033 (10 mg) and MK-677 (15 mg) daily for 5 weeks. Blood and body composition metrics were obtained pre-, on- and post-cycle. One-repetition maximum leg and bench press, in addition to intramuscular androgens and androgen receptor content, were analysed on-cycle. We observed pre- to on-cycle changes in body composition (body mass, +6.0%; total lean body mass, +3.1%; trunk lean body mass, +6.6%; appendicular lean body mass, +4.3%; total fat mass, +15.4%; trunk fat mass, +2.8%; and appendicular fat mass, +14.8%), bone (bone mineral content, -3.60%; area, -1.1%; and bone mineral density, -2.1%), serum lipid-associated biomarkers (cholesterol, +14.8%; triglycerides, +39.2%; low-density lipoprotein-cholesterol, +40.0%; and high-density lipoprotein-cholesterol, -36.4%), liver-associated biomarkers (aspartate aminotransferase, +95.8%; and alanine aminotransferase, +205.0%) and androgen-associated biomarkers (free testosterone, -85.7%; total testosterone, -62.3%; and sex hormone-binding globulin, -79.6%); however, all variables returned to pre-cycle values post-cycle, apart from total fat mass, appendicular fat mass, bone area, total cholesterol and low-density lipoprotein-cholesterol. Follicle-stimulating hormone was below clinical reference values on- (1.2 IU/L) and post-cycle (1.3 IU/L). Intramuscular androgen receptor (-44.6%), testosterone (+47.8%) and dihydrotestosterone (+34.4%), in addition to one-repetition maximum leg press and bench press (+39.2 and +32.0%, respectively), were different in the case subject compared with non-users. These data demonstrate that LGD-4033 and MK-677 increase several body composition parameters, whilst negatively impacting bone and several serum biomarkers. Given the sparsity of data in recreationally using demographics, further research is warranted to elucidate the acute and chronic physiological effects of these anabolic agents.
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Affiliation(s)
- Thomas D Cardaci
- Department of Pathology, Microbiology, and Immunology, School of Medicine, University of South Carolina, Columbia, South Carolina, USA
| | - Steven B Machek
- Kinesiology Department, College of Health Sciences and Human Services, California State University, Monterey Bay, California, USA
| | - Dylan T Wilburn
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
| | - Jeffery L Heileson
- Nutrition Services Division, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Dillon R Harris
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
| | - Harry P Cintineo
- Department of Kinesiology, Lindenwood University, St. Charles, Missouri, USA
| | - Darryn S Willoughby
- School of Exercise and Sport Science, University of Mary Harden-Baylor, Belton, Texas, USA
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Pitsinos EN, Angelis YS, Petrou M. Structure revision and chemical synthesis of ligandrol's main bishydroxylated long-term metabolic marker. Org Biomol Chem 2022; 20:9112-9116. [PMID: 36354052 DOI: 10.1039/d2ob01907h] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Although the main bishydroxylated long-term metabolite of the WADA-banned anabolic agent ligandrol (LGD-4033) is an important metabolic marker, it is not readily available in sufficient quantities to facilitate the development and validation of related analytical protocols or sensors. A chemically more robust structure was postulated as an alternative to the one previously established. The NMR spectra of the synthesized material and its LC-HRMS comparison with a relevant metabolic sample support the proposed structural revision.
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Affiliation(s)
- Emmanuel N Pitsinos
- National Centre for Scientific Research "DEMOKRITOS", Institute of Nanoscience and Nanotechnology, "Natural Products Synthesis and Bioorganic Chemistry" Laboratory, P.O. Box 60037, GR 153 10 Aghia Paraskevi, Athens, Greece.
| | - Yiannis S Angelis
- National Centre for Scientific Research "DEMOKRITOS", Institute of Biosciences & Applications, Doping Control Laboratory of Athens, Neratziotissis & Amaryssias Artemidos Str, GR 151 23 Athens, Greece.
| | - Michael Petrou
- Cyprus Anti-Doping Authority, Makarion Athletic Centre Avenue, Engomi, CY 2400 Nicosia, Cyprus
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10
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Pascali JP, Piva E, Ioime P, Forcato M, Boscolo-Berto R, Rondinelli R, Fais P. Multiple prohibited ingredients detected in nutritional supplements in a case of adverse analytical finding (AAF). Drug Test Anal 2022; 14:1791-1794. [PMID: 35867601 DOI: 10.1002/dta.3345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/07/2022] [Accepted: 07/08/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Jennifer P Pascali
- Unit of Legal Medicine and Toxicology, University of Padova, Padova, Italy
| | | | | | - Mattia Forcato
- Unit of Legal Medicine and Toxicology, University of Padova, Padova, Italy
| | - Rafael Boscolo-Berto
- Section of Anatomy, Department of Neuroscience, University of Padova, Padova, Italy
| | | | - Paolo Fais
- Unit of Legal Medicine, University of Bologna, Bologna, Italy
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Abstract
Cachexia is a complex wasting syndrome, accompanying a variety of end-stage chronic diseases, such as cancer, heart failure and human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS). It significantly affects patients' quality of life and survival. Multiple therapeutic approaches have been studied over time. However, despite promising results, no drug has been approved to date. In this review, we examine and discuss the available data on the therapeutic effects of androgens and selective androgen receptor modulators (SARMs) for cachexia.
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Affiliation(s)
- Luca Giovanelli
- Department of Medical Biotechnology and Translational Medicine, University of Milan, 20100, Milan, Italy; Department of Endocrine and Metabolic Medicine, IRCCS Istituto Auxologico Italiano, 20100, Milan, Italy; Department of Endocrinology, Diabetes & Metabolism, Newcastle-upon-Tyne Hospitals, NE1 4LP, UK.
| | - Richard Quinton
- Department of Endocrinology, Diabetes & Metabolism, Newcastle-upon-Tyne Hospitals, NE1 4LP, UK; Translational & Clinical Research Institute, University of Newcastle-upon-Tyne, NE1 3BZ, UK.
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12
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Walpurgis K, Piper T, Thevis M. Androgens, sports, and detection strategies for anabolic drug use. Best Pract Res Clin Endocrinol Metab 2022; 36:101609. [PMID: 35120801 DOI: 10.1016/j.beem.2021.101609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
For decades, anabolic androgenic agents have represented the substance class most frequently observed in doping control samples. They comprise synthetic and pseudoendogenous anabolic androgenic steroids and other, mostly non-steroidal compounds with (presumed) positive effects on muscle mass and function. While exogenous substances can easily be detected by gas/liquid chromatography and mass spectrometry, significantly more complex methodologies including the longitudinal monitoring of individual urinary steroid concentrations/ratios and isotope ratio mass spectrometry are required to provide evidence for the exogenous administration of endogenous compounds. This narrative review summarizes the efforts made within the last 5 years to further improve the detection of anabolic agents in doping control samples. Different approaches such as the identification of novel metabolites and biomarkers, the acquisition of complementary mass spectrometric data, and the development of new analytical strategies were employed to increase method sensitivity and retrospectivity while simultaneously reducing method complexity to facilitate a higher and faster sample throughput.
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Affiliation(s)
- Katja Walpurgis
- Center for Preventive Doping Research/Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany.
| | - Thomas Piper
- Center for Preventive Doping Research/Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany.
| | - Mario Thevis
- Center for Preventive Doping Research/Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany.
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13
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Cutler C, Viljanto M, Taylor P, Habershon-Butcher J, Van Eenoo P. Equine metabolism of the growth hormone secretagogue MK-0677 in vitro and in urine and plasma following oral administration. Drug Test Anal 2022; 14:1273-1290. [PMID: 35302297 DOI: 10.1002/dta.3252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/26/2022] [Accepted: 03/14/2022] [Indexed: 11/07/2022]
Abstract
Ibutamoren mesylate, or MK-0677, is an orally active, non-peptide growth hormone secretagogue that has been developed to stimulate excretion of endogenous growth hormone. It has been evaluated for the treatment of a range of clinical conditions but is not available therapeutically. Nonetheless, MK-0677 is widely available to purchase online, sold as 'supplement' products. The mode of action and relative ease of purchase make MK-0677 a potential threat with regard to sports doping. The aim of this study was to investigate the metabolism of MK0677 in the horse following in vitro incubation and oral administration to two Thoroughbred racehorses, in order to identify the most appropriate analytical targets for doping control laboratories. Liquid chromatographyhigh resolution mass spectrometry was used for metabolite identification, and subsequently liquid chromatography-tandem mass spectrometry was used to generate full metabolite profiles for post-administration urine and plasma samples. Fourteen phase I metabolites were identified in vitro; thirteen of these were subsequently detected in urine and nine in plasma collected post-administration, alongside the parent compound in both matrices. In both urine and plasma, the longest duration of detection was observed for an O-dealkylated metabolite of MK-0677 and, therefore, this would be the best target for the detection of MK-0677 administration. MK-0677 and the O-dealkylated metabolite were found to be excreted largely unconjugated in urine and plasma.
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Affiliation(s)
- Charlotte Cutler
- LGC Ltd, Fordham, Cambridgeshire, UK.,Ghent University (Ugent) Doping Control Laboratory, Ghent, Belgium
| | | | | | | | - Peter Van Eenoo
- Ghent University (Ugent) Doping Control Laboratory, Ghent, Belgium
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14
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Ameline A, Gheddar L, Raul JS, Kintz P. In vitro characterization of S-23 metabolites produced by human liver microsomes, and subsequent application to urine after a controlled oral administration. J Pharm Biomed Anal 2022; 212:114660. [PMID: 35182830 DOI: 10.1016/j.jpba.2022.114660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/20/2022] [Accepted: 02/10/2022] [Indexed: 10/19/2022]
Abstract
The selective androgen receptor modulators are a recent class of anabolic agents, used to improve athletic performance. Among these molecules, there is (2 S)-N-(4-cyano-3-trifluoromethylphenyl)- 3-(3-fluoro-4-chlorophenoxyl)2-hydroxy-2-methyl-propanamide, commonly known as S-23. This molecule appeared very recently on the doping market. As a result, very few data are available in the literature, and nothing has been published about long-term effects of S-23. The authors focused on the detection of S-23 and its metabolites in human urine, following a single oral administration of approx. 8 mg to a volunteer, using standard ultra-performance liquid chromatography-triple quadrupole-mass spectrometry (UPLC-MS/MS), and ultra-performance liquid chromatography-quadrupole time of flight-mass spectrometry (UPLC-Q-TOF-MS). To the best of the authors knowledge, this seems to be the first study ever achieved on S-23. In vitro experiment was performed, using human liver microsomes, in order to investigate the potential CYP- and UGT-dependent S-23 metabolites. Four metabolites were produced, which were identified as hydroxy-S-23 (C18H12O4N2ClF4: m/z [M-H-] 431.0423); O-dephenylate-S-23 (C12H10O3N2F3: m/z [M-H-] 287.0647); S-23-glucuronide (C24H20O9N2ClF4: m/z [M-H-] 591.0794) and hydroxy-S-23-glucuronide (C24H20O10N2ClF4: m/z [M-H-] 607.0743). After consumption of S-23, the parent drug was detectable in hydrolyzed urine from 2 h post administration up to 28 days, with concentrations ranging between 0.5 and 93 ng/mL. In the urine, only one of the four metabolites identified in vitro was detected, hydroxy-S-23. This metabolite was detected up to 28 days. It does not seem to increase the window of detection of S-23 as the ratio between hydroxy-S-23 and the parent drug was always lower than 1. Another metabolite, dihydroxy-S-23, not identified in vitro, was identified in the urine of the volunteer. Hair sample, collected one month after the consumption of a single tablet, was negative for S-23 and hydroxy-S-23, with a LOQ at 0.1 pg/mg.
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Affiliation(s)
- Alice Ameline
- Institut de Médecine Légale, 11 Rue Humann, 67000 Strasbourg, France.
| | - Laurie Gheddar
- Institut de Médecine Légale, 11 Rue Humann, 67000 Strasbourg, France
| | | | - Pascal Kintz
- Institut de Médecine Légale, 11 Rue Humann, 67000 Strasbourg, France
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15
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Kintz P. The forensic response after an adverse analytical finding (doping) involving a selective androgen receptor modulator (SARM) in human athlete. J Pharm Biomed Anal 2022; 207:114433. [PMID: 34715583 DOI: 10.1016/j.jpba.2021.114433] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/04/2021] [Accepted: 10/13/2021] [Indexed: 11/28/2022]
Abstract
Selective androgen receptor modulators (SARMs) are a class of drugs presenting identical anabolic properties to anabolic steroids in addition to marked reduced androgenic effects. These drugs have emerged in the doping area within the early 2000's. Ligandrol, ostarine, RAD-140 and andarine are the most popular agents belonging to this class. According to the world anti-doping agency (WADA) prohibited list, SARMs are prohibited at all times (i.e. in and out-of-competition) and are listed under the section S1.2 (other anabolic agents). The compilation of the WADA testing figures reports from 2015 to 2019 has indicated a regular increase of adverse analytical findings (AAF) due to SARMs, particularly with ostarine and ligandrol. The implementation of highly sensitive chromatographic anti-doping analyses has induced high-profile challenges of anti-doping rules violations as athletes have claimed in numerous occasions that contamination was the reason for their AAF. Since the early 2000's, it has been accepted by the Court of Arbitration for Sports (CAS) in Lausanne (Switzerland) that, under some specific circumstances, unusual explanations can be provided to the Panel to explain an AAF. This was the open door for forensic investigations, as it is done in criminal Courts. A forensic approach can include testing for SARMs in food, drinks, but mostly in dietary supplements. As most anti-doping rules violations are only known several weeks after urine collection, this biological matrix is seldom use for further tests, despite the fact that most SARMs can be detected for several weeks in urine. Luckily, hair or nail testing can be a complement to document the claim of the athlete but of course, it cannot be considered as an alternative to urinalysis. This is because a negative hair or nail result cannot exclude the use of the detected drug and cannot overrule the urine result. To date, all methods for SARMs identification in various matrices involve liquid chromatography coupled to tandem mass spectrometry or high-resolution mass spectrometry. The aim of this paper is to review the scientific literature on the analytical possibilities of testing SARMs in dietary supplements, urine and hair or nail clippings after an AAF to document the claims of an athlete or his/her legal team.
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Affiliation(s)
- Pascal Kintz
- X-Pertise Consulting, 42 rue principale, 67206 Mittelhausbergen, France; Institut de Médecine légale, 11 rue Humann, 67000 Strasbourg, France.
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16
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Interest of HRMS systems in analytical toxicology: Focus on doping products. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2022. [DOI: 10.1016/j.toxac.2021.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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17
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Wagener F, Guddat S, Görgens C, Angelis YS, Petrou M, Lagojda A, Kühne D, Thevis M. Investigations into the elimination profiles and metabolite ratios of micro-dosed selective androgen receptor modulator LGD-4033 for doping control purposes. Anal Bioanal Chem 2021; 414:1151-1162. [PMID: 34734312 PMCID: PMC8724150 DOI: 10.1007/s00216-021-03740-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/07/2021] [Accepted: 10/18/2021] [Indexed: 11/29/2022]
Abstract
LGD-4033 (ligandrol) is a selective androgen receptor modulator (SARM), which is prohibited in sports by the World Anti-Doping Agency (WADA) and led to 62 adverse analytical findings (AAFs) in 2019. But not only deliberate doping with LGD-4033 constitutes a problem. In the past years, some AAFs that concerned SARMs can be attributed to contaminated dietary supplements (DS). Thus, the urgency to develop methods to differentiate between inadvertent doping and abuse of SARMs to benefit from the performance-enhancing effect of the compound in sports is growing. To gain a better understanding of the metabolism and excretion patterns of LGD-4033, human micro-dose excretion studies at 1, 10, and 50 µg LGD-4033 were conducted. Collected urine samples were prepared for analysis using enzymatic hydrolysis followed by solid-phase extraction and analyzed via LC-HRMS/MS. Including isomers, a total of 15 phase I metabolites were detected in the urine samples. The LC-HRMS/MS method was validated for qualitative detection of LGD-4033, allowing for a limit of detection (LOD) of 8 pg/mL. The metabolite M1, representing the epimer of LGD-4033, was synthesized and the structure elucidated by NMR spectroscopy. As the M1/LGD-4033 ratio changes over time, the ratio and the approximate LGD-4033 concentration can contribute to estimating the time point of drug intake and dose of LGD-4033 in doping control urine samples, which is particularly relevant in anti-doping result management.
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Affiliation(s)
- Felicitas Wagener
- Center for Preventive Doping Research/Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Sven Guddat
- Center for Preventive Doping Research/Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Christian Görgens
- Center for Preventive Doping Research/Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Yiannis S Angelis
- Doping Control Laboratory of Athens, Institute of Biosciences & Applications, National Center for Scientific Research "Demokritos", Neratziotissis & Amaryssias Artemidos Str, 15123, Athens, Greece
| | - Michael Petrou
- Cyprus Anti-Doping Authority, Makarion Athletic Centre Avenue, Engomi, CY 2400, Nicosia, Cyprus
| | - Andreas Lagojda
- BayerCropScience AG, Alfred-Nobel-Str. 50, 40789, Monheim, Germany
| | - Dirk Kühne
- BayerCropScience AG, Alfred-Nobel-Str. 50, 40789, Monheim, Germany
| | - Mario Thevis
- Center for Preventive Doping Research/Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany. .,European Monitoring Center for Emerging Doping Agents (EuMoCEDA), Cologne/Bonn, Germany.
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18
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Cutler C, Viljanto M, Taylor P, Hincks P, Biddle S, Van Eenoo P. Identification of equine in vitro metabolites of seven non-steroidal selective androgen receptor modulators for doping control purposes. Drug Test Anal 2021; 14:349-370. [PMID: 34714606 DOI: 10.1002/dta.3189] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 08/20/2021] [Accepted: 09/10/2021] [Indexed: 11/09/2022]
Abstract
Selective androgen receptor modulators, SARMs, are a large class of compounds developed to provide therapeutic anabolic effects with minimal androgenic side effects. A wide range of these compounds are available to purchase online and thus provide the potential for abuse in sports. Knowledge of the metabolism of these compounds is essential to aid their detection in doping control samples. In vitro models allow a quick, cost-effective response where administration studies are yet to be carried out. In this study, the equine phase I metabolism of the non-steroidal SARMs GSK2881078, LGD-2226, LGD-3303, PF-06260414, ACP-105, RAD-140 and S-23 was investigated using equine liver microsomes. Liquid chromatography coupled to a QExactive Orbitrap mass spectrometer allowed identification of metabolites with high resolution and mass accuracy. Three metabolites were identified for both GSK2881078 and LGD-2226, four for LGD-3303 and RAD-140, five for PF-06260414, twelve for ACP-105 and ten for S-23. The equine metabolism of GSK-2881078, LGD-2226, LGD-3303 and PF-06260414 is reported for the first time. Although the equine metabolism of ACP-105, RAD-140 and S-23 has previously been reported, the results obtained in this study have been compared with published data.
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Affiliation(s)
- Charlotte Cutler
- LGC Ltd, Fordham, UK.,Doping Control Laboratory, Ghent University (UGent), Ghent, Belgium
| | | | | | | | | | - Peter Van Eenoo
- Doping Control Laboratory, Ghent University (UGent), Ghent, Belgium
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19
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Thevis M, Piper T, Thomas A. Recent advances in identifying and utilizing metabolites of selected doping agents in human sports drug testing. J Pharm Biomed Anal 2021; 205:114312. [PMID: 34391136 DOI: 10.1016/j.jpba.2021.114312] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/03/2021] [Accepted: 08/05/2021] [Indexed: 12/29/2022]
Abstract
Probing for evidence of the administration of prohibited therapeutics, drugs and/or drug candidates as well as the use of methods of doping in doping control samples is a central assignment of anti-doping laboratories. In order to accomplish the desired analytical sensitivity, retrospectivity, and comprehensiveness, a considerable portion of anti-doping research has been invested into studying metabolic biotransformation and elimination profiles of doping agents. As these doping agents include lower molecular mass drugs such as e.g. stimulants and anabolic androgenic steroids, some of which further necessitate the differentiation of their natural/endogenous or xenobiotic origin, but also higher molecular mass substances such as e.g. insulins, growth hormone, or siRNA/anti-sense oligonucleotides, a variety of different strategies towards the identification of employable and informative metabolites have been developed. In this review, approaches supporting the identification, characterization, and implementation of metabolites exemplified by means of selected doping agents into routine doping controls are presented, and challenges as well as solutions reported and published between 2010 and 2020 are discussed.
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Affiliation(s)
- Mario Thevis
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany; European Monitoring Center for Emerging Doping Agents (EuMoCEDA), Cologne, Bonn, Germany.
| | - Thomas Piper
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
| | - Andreas Thomas
- Center for Preventive Doping Research - Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany
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20
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Koller T, Vrbova P, Meciarova I, Molcan P, Smitka M, Adamcova Selcanova S, Skladany L. Liver injury associated with the use of selective androgen receptor modulators and post-cycle therapy: Two case reports and literature review. World J Clin Cases 2021; 9:4062-4071. [PMID: 34141767 PMCID: PMC8180234 DOI: 10.12998/wjcc.v9.i16.4062] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/28/2021] [Accepted: 03/25/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Muscle growth promoters are being developed for the treatment of disease-induced loss of muscle mass. Ligandrol and ostarine are selective androgen receptor modulators (SARMs) with a non-steroidal structure and a presumably more favorable side effect profile. In recent years, these substances with or without “post-cycle therapy” (PCT) are often misused by amateur athletes aiming to promote muscle growth. At the same time, reports on their toxic effects on organ systems are emerging.
CASE SUMMARY We report two cases of liver injury in young men who used ligandrol and/or ostarine for a few weeks followed by the use of substances for PCT. Acute liver injury occurred in both cases after stopping SARMs while on PCT. The clinical picture was dominated by jaundice and fatigue. The biochemical pattern showed a mixed type of injury with normal alkaline phosphatase and high concentrations of bilirubin and serum bile acids. Histological evidence showed predominantly cholestatic injury with canalicular bile plugs, ductopenia, and mild hepatocellular damage without significant fibrosis. The patients recovered from the condition after 3 mo. The off target effects of SARMs were likely idiosyncratic, but our report highlights the yet unrecognized effects of other toxic substances used for PCT, supra-therapeutic doses, and the complete absence of monitoring for adverse effects.
CONCLUSION Among muscle-building amateur athletes, SARMs (ligandrol or ostarine) and/or substances in PCT may cause cholestatic liver injury with prolonged recovery.
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Affiliation(s)
- Tomas Koller
- Gastroenterology and Hepatology Subdiv. 5th Department of Internal Medicine, Comenius University Faculty of Medicine, University Hospital Bratislava, 82606, Slovakia
| | - Petra Vrbova
- Gastroenterology and Hepatology Subdiv. 5th Department of Internal Medicine, Comenius University Faculty of Medicine, University Hospital Bratislava, 82606, Slovakia
| | - Iveta Meciarova
- Department of Pathology, Alpha medical Patológia s.r.o., Bratislava 82606, Slovakia
| | - Pavol Molcan
- HEGITO (Division of Hepatology, Gastroenterology and Liver Transplantation), Department of Internal Medicine II of Slovak Medical University, F.D. Roosevelt University Hospital, Banska Bystrica 97517, Slovakia
| | - Michal Smitka
- Department of Pathology, FD Roosevelt Hospital, Banska Bystrica 97517, Slovakia
| | - Svetlana Adamcova Selcanova
- HEGITO (Division of Hepatology, Gastroenterology and Liver Transplantation), Department of Internal Medicine II of Slovak Medical University, F.D. Roosevelt University Hospital, Banska Bystrica 97517, Slovakia
| | - Lubomir Skladany
- HEGITO (Division of Hepatology, Gastroenterology and Liver Transplantation), Department of Internal Medicine II of Slovak Medical University, F.D. Roosevelt University Hospital, Banska Bystrica 97517, Slovakia
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21
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Medicinal Use of Testosterone and Related Steroids Revisited. Molecules 2021; 26:molecules26041032. [PMID: 33672087 PMCID: PMC7919692 DOI: 10.3390/molecules26041032] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/11/2021] [Accepted: 02/11/2021] [Indexed: 12/31/2022] Open
Abstract
Testosterone derivatives and related compounds (such as anabolic-androgenic steroids—AAS) are frequently misused by athletes (both professional and amateur) wishing to promote muscle development and strength or to cover AAS misuse. Even though these agents are vastly regarded as abusive material, they have important pharmacological activities that cannot be easily replaced by other drugs and have therapeutic potential in a range of conditions (e.g., wasting syndromes, severe burns, muscle and bone injuries, anemia, hereditary angioedema). Testosterone and related steroids have been in some countries treated as controlled substances, which may affect the availability of these agents for patients who need them for therapeutic reasons in a given country. Although these agents are currently regarded as rather older generation drugs and their use may lead to serious side-effects, they still have medicinal value as androgenic, anabolic, and even anti-androgenic agents. This review summarizes and revisits the medicinal use of compounds based on the structure and biological activity of testosterone, with examples of specific compounds. Additionally, some of the newer androgenic-anabolic compounds are discussed such as selective androgen receptor modulators, the efficacy/adverse-effect profiles of which have not been sufficiently established and which may pose a greater risk than conventional androgenic-anabolic agents.
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22
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Stacchini C, Botrè F, Comunità F, de la Torre X, Dima AP, Ricci M, Mazzarino M. Simultaneous detection of different chemical classes of selective androgen receptor modulators in urine by liquid chromatography-mass spectrometry-based techniques. J Pharm Biomed Anal 2020; 195:113849. [PMID: 33383501 DOI: 10.1016/j.jpba.2020.113849] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
Analytical procedures to detect the misuse of selective androgen receptor modulators in human urine, targeting either the parent drugs and/or their main metabolites, were developed and validated. In detail, 19 target compounds belonging to 9 different chemical classes were considered: arylpropionamide (i.e., andarine (S4), ostarine (S22), S1, S6, S9 and S23), diarylhydantoin (i.e., GLPG0492), indole (i.e., LY2452473, GSK2881078), isoquinoline-carbonyle (i.e., PF-02620414), phenyl-oxadiazole (i.e., RAD140), pyrrolidinyl-benzonitrile (i.e., LGD4033), quinolinone (i.e., LGD2226, LGD3303), steroidal (i.e., Cl-4AS-1, MK0773 and TFM-4AS-1), and tropanol (i.e., AC-262536 and ACP105) derivatives. The metabolites of the target compounds considered were enzymatically synthesized by using human liver microsomes. Sample pre-treatment included enzymatic hydrolysis followed by liquid-liquid extraction at neutral pH. The instrumental analysis was performed by ultra-high-performance liquid chromatography coupled to either high- or low-resolution mass spectrometry. Validation was performed according to the ISO 17025 and the World Anti-Doping Agency guidelines. The analyses carried out on negative samples confirmed the method's selectivity, not showing any significant interferences at the retention times of the analytes of interest. Detection capability was determined in the range of 0.1-1.0 ng/mL for the screening procedure and 0.2-1.0 ng/mL for the confirmation procedure (except for GLPG0492 and GSK2881078). The recovery was greater than 80 % for all analytes, and the matrix effect was smaller than 35 %. The method also matched the criteria of the World Anti-Doping Agency in terms of repeatability of the relative retention times (CV% < 1.0) and of the relative abundances of the selected ion transitions (performed only in the case of triple quadrupole, CV% < 15), ensuring the correct identification of all the analytes considered. Urine samples containing andarine, ostarine, or LGD4033 were used to confirm the actual applicability of the selected analytical strategies. All target compounds (parent drugs and their main metabolites) were detected and correctly identified.
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Affiliation(s)
- Carlotta Stacchini
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti, 1, 00197, Rome, Italy; Dipartimento Chimica e Tecnologia del farmaco, "Sapienza" Università di Roma, Piazzale Aldo Moro 5, 00161, Rome, Italy
| | - Francesco Botrè
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti, 1, 00197, Rome, Italy; ISSUL - Institute of Sport Sciences, University of Lausanne, Synathlon - Quartier Centre, 1015, Lausanne, Switzerland.
| | - Fabio Comunità
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti, 1, 00197, Rome, Italy
| | - Xavier de la Torre
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti, 1, 00197, Rome, Italy
| | - Anna Pia Dima
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti, 1, 00197, Rome, Italy
| | - Matteo Ricci
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti, 1, 00197, Rome, Italy
| | - Monica Mazzarino
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti, 1, 00197, Rome, Italy
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23
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Machek SB, Cardaci TD, Wilburn DT, Willoughby DS. Considerations, possible contraindications, and potential mechanisms for deleterious effect in recreational and athletic use of selective androgen receptor modulators (SARMs) in lieu of anabolic androgenic steroids: A narrative review. Steroids 2020; 164:108753. [PMID: 33148520 DOI: 10.1016/j.steroids.2020.108753] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/07/2020] [Accepted: 10/17/2020] [Indexed: 12/12/2022]
Abstract
Anabolic androgenic steroids (AAS) are testosterone and testosterone-derivative compounds sporadically employed by athletes and increasingly used recreationally to acquire a competitive edge or improve body composition. Nevertheless, users are subject to undesired side effects majorly associated with tissue-specific androgen receptor (AR) binding-mediated actions. More recently, selective AR modulators (SARMs) have gained popularity towards delivering androgen-associated anabolic actions with hopes of minimal androgenic effects. While several SARMs are in preclinical and clinical phases intended for demographics subject to hypogonadism, muscle wasting, and osteoporosis, several athletic organizations and drug testing affiliates have realized the increasingly widespread use of SARMs amongst competitors and have subsequently banned their use. Furthermore, recreational users are haphazardly acquiring these compounds from the internet and consuming doses several times greater than empirically reported. Unfortunately, online sources are rife with potential contamination, despite a prevailing public opinion suggesting SARMs are innocuous AAS alternatives. Considering each agent has a broad range of supporting evidence in both human and non-human models, it is important to comprehensively evaluate the current literature on commercially available SARMs to gain better understanding of their efficacy and if they can truly be considered a safer AAS alternative. Therefore, the purpose of this review is to discuss the current evidence regarding AAS and SARM mechanisms of action, demonstrate the efficacy of several prominent SARMs in a variety of scientific trials, and theorize on the wide-ranging contraindications and potential deleterious effects, as well as potential future directions regarding acute and chronic SARM use across a broad range of demographics.
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Affiliation(s)
- Steven B Machek
- Exercise & Biochemical Nutrition Laboratory, Department of Health, Human Performance, and Recreation. Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Thomas D Cardaci
- Exercise & Biochemical Nutrition Laboratory, Department of Health, Human Performance, and Recreation. Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA; Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Dylan T Wilburn
- Exercise & Biochemical Nutrition Laboratory, Department of Health, Human Performance, and Recreation. Robbins College of Health and Human Sciences, Baylor University, Waco, TX, USA
| | - Darryn S Willoughby
- Mayborn College of Health Sciences, School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, TX, USA.
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24
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Rading A, Anielski P, Thieme D, Keiler AM. Detection of the selective androgen receptor modulator GSK2881078 and metabolites in urine and hair after single oral administration. Drug Test Anal 2020; 13:217-222. [PMID: 33037775 DOI: 10.1002/dta.2943] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/01/2020] [Accepted: 10/01/2020] [Indexed: 01/22/2023]
Abstract
Hair and urine concentrations of the nonsteroidal selective androgen receptor modulator GSK2881078 were examined following single oral administration to investigate its hair incorporation and estimate the general suitability of hair testing for selected androgen receptor modulators. Hair segments were collected following a single dose of 1.5 mg GSK2881078 by repeated shaving of scalp hair at Week 0 (blank), Week 1 (representing the pre-application period), Week 3 (ideally focusing the time of incorporation), and Weeks 5 and 9 (post-administration period). The intact compound and various (at least 4) hydroxy-metabolites exhibited similar elimination profiles. The peak urinary concentration (approximately 920 pg/ml) was observed after 8 h and is reduced to the detection limit (2 pg/ml) on Day 42 following administration of 760 μg GSK2881078. Correspondingly, hair concentrations of GSK2881078 (intact compound only) following a single oral dose of 1.5 mg GSK2881078 reached a peak concentration of 1.7 pg/mg in the segments collected 3 weeks post administration, representing the time of ingestion. The concentration rapidly declined to trace amounts of 0.7 (Week 5) and 0.2 pg/mg (Week 9), respectively. In conclusion, measurement of the intact compound GSK2881078 is feasible for both urine and hair analysis. However, concentrations in hair after single oral administration are in the low pg/mg range and can only be detected, if the segments cover the administration period.
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Affiliation(s)
- Alina Rading
- Institute of Doping Analysis and Sports Biochemistry Dresden, Kreischa, Germany
| | - Patricia Anielski
- Institute of Doping Analysis and Sports Biochemistry Dresden, Kreischa, Germany
| | - Detlef Thieme
- Institute of Doping Analysis and Sports Biochemistry Dresden, Kreischa, Germany
| | - Annekathrin Martina Keiler
- Institute of Doping Analysis and Sports Biochemistry Dresden, Kreischa, Germany.,Institute of Zoology, Technical University Dresden, Dresden, Germany
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Sobolevsky T, Ahrens B. High-throughput liquid chromatography tandem mass spectrometry assay as initial testing procedure for analysis of total urinary fraction. Drug Test Anal 2020; 13:283-298. [PMID: 32852861 DOI: 10.1002/dta.2917] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/16/2020] [Accepted: 08/17/2020] [Indexed: 12/14/2022]
Abstract
In the recent years, a lot of effort was put into the development of multiclass initial testing procedures (ITP) to streamline analytical workflow in antidoping laboratories. Here, a high-throughput assay based on liquid chromatography-triple quadrupole mass spectrometry suitable for use as initial testing procedure covering multiple classes of compounds prohibited in sports is described. Employing a 96-well plate packed with 10 mg of weak cation exchange polymeric sorbent, up to 94 urine samples and their associated positive and negative controls can be processed in less than 3 h with minimal labor. The assay requires a 0.5-ml urine aliquot, which is subjected to enzymatic hydrolysis followed by solid phase extraction, evaporation, and reconstitution in a 96-well collection plate. With a 10-min run time, more than 100 analytes can be detected using electrospray ionization with polarity switching. The assay can be run nearly 24/7 with minimal downtime for instrument maintenance while detecting picogram amounts for the majority of analytes. Having analyzed approximately 28,000 samples, nearly 400 adverse analytical findings were found of which only one tenth were at or above 50% of the minimum required performance level established by the World Anti-Doping Agency. Compounds most often identified were stanozolol, GW1516, ostarine, LGD4033, and clomiphene, with median estimated concentrations in the range of 0.02-0.09 ng/ml (either as parent drug or a metabolite). Our data demonstrate the importance of using a highly sensitive ITP to ensure efficient antidoping testing.
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Affiliation(s)
- Tim Sobolevsky
- UCLA Olympic Analytical Laboratory, Department of Pathology & Laboratory Medicine, David Geffen School of Medicine, Los Angeles, California, USA
| | - Brian Ahrens
- UCLA Olympic Analytical Laboratory, Department of Pathology & Laboratory Medicine, David Geffen School of Medicine, Los Angeles, California, USA
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26
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Fragkaki AG, Petropoulou G, Athanasiadou I, Kiousi P, Kioukia‐Fougia N, Archontaki H, Bakeas E, Angelis YS. Determination of anabolic androgenic steroids as imidazole carbamate derivatives in human urine using liquid chromatography–tandem mass spectrometry. J Sep Sci 2020; 43:2154-2161. [DOI: 10.1002/jssc.202000036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Argyro G. Fragkaki
- Doping Control Laboratory of AthensInstitute of Biosciences & ApplicationsNational Center for Scientific Research “Demokritos” Athens Greece
| | - Georgia Petropoulou
- Doping Control Laboratory of AthensInstitute of Biosciences & ApplicationsNational Center for Scientific Research “Demokritos” Athens Greece
- Laboratory of Analytical ChemistryDepartment of ChemistryNational & Kapodistrian University of Athens Athens Greece
| | | | - Polyxeni Kiousi
- Doping Control Laboratory of AthensInstitute of Biosciences & ApplicationsNational Center for Scientific Research “Demokritos” Athens Greece
| | - Nassia Kioukia‐Fougia
- Doping Control Laboratory of AthensInstitute of Biosciences & ApplicationsNational Center for Scientific Research “Demokritos” Athens Greece
| | - Helen Archontaki
- Laboratory of Analytical ChemistryDepartment of ChemistryNational & Kapodistrian University of Athens Athens Greece
| | - Evangelos Bakeas
- Laboratory of Analytical ChemistryDepartment of ChemistryNational & Kapodistrian University of Athens Athens Greece
| | - Yiannis S. Angelis
- Doping Control Laboratory of AthensInstitute of Biosciences & ApplicationsNational Center for Scientific Research “Demokritos” Athens Greece
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27
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Christiansen AR, Lipshultz LI, Hotaling JM, Pastuszak AW. Selective androgen receptor modulators: the future of androgen therapy? Transl Androl Urol 2020; 9:S135-S148. [PMID: 32257854 PMCID: PMC7108998 DOI: 10.21037/tau.2019.11.02] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Selective androgen receptor modulators (SARMs) are small molecule drugs that function as either androgen receptor (AR) agonists or antagonists. Variability in AR regulatory proteins in target tissues permits SARMs to selectively elicit anabolic benefits while eschewing the pitfalls of traditional androgen therapy. SARMs have few side effects and excellent oral and transdermal bioavailability and may, therefore, represent viable alternatives to current androgen therapies. SARMs have been studied as possible therapies for many conditions, including osteoporosis, Alzheimer’s disease, breast cancer, stress urinary incontinence (SUI), prostate cancer (PCa), benign prostatic hyperplasia (BPH), male contraception, hypogonadism, Duchenne muscular dystrophy (DMD), and sarcopenia/muscle wasting/cancer cachexia. While there are no indications for SARMs currently approved by the Food and Drug Administration (FDA), many potential applications are still being explored, and results are promising. In this review, we examine the literature assessing the use of SARMS for a number of indications.
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Affiliation(s)
| | - Larry I Lipshultz
- Scott Department of Urology.,Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX, USA
| | - James M Hotaling
- Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Alexander W Pastuszak
- Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
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28
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Thevis M, Kuuranne T, Geyer H. Annual banned‐substance review – Analytical approaches in human sports drug testing. Drug Test Anal 2020; 12:7-26. [DOI: 10.1002/dta.2735] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 11/09/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Mario Thevis
- Center for Preventive Doping Research ‐ Institute of Biochemistry German Sport University Cologne Cologne Germany
- European Monitoring Center for Emerging Doping Agents Cologne Germany
| | - Tiia Kuuranne
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Genève and Lausanne Centre Hospitalier Universitaire Vaudois and University of Lausanne Epalinges Switzerland
| | - Hans Geyer
- Center for Preventive Doping Research ‐ Institute of Biochemistry German Sport University Cologne Cologne Germany
- European Monitoring Center for Emerging Doping Agents Cologne Germany
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29
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Cutler C, Viljanto M, Hincks P, Habershon‐Butcher J, Muir T, Biddle S. Investigation of the metabolism of the selective androgen receptor modulator LGD‐4033 in equine urine, plasma and hair following oral administration. Drug Test Anal 2020; 12:247-260. [DOI: 10.1002/dta.2719] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 09/02/2019] [Accepted: 10/14/2019] [Indexed: 12/13/2022]
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30
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Thevis M, Walpurgis K, Thomas A. Analytical Approaches in Human Sports Drug Testing: Recent Advances, Challenges, and Solutions. Anal Chem 2019; 92:506-523. [DOI: 10.1021/acs.analchem.9b04639] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Mario Thevis
- Center for Preventive Doping Research, Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, Cologne 50933, Germany
- European Monitoring Center for Emerging Doping Agents (EuMoCEDA), Cologne 50933, Germany
| | - Katja Walpurgis
- Center for Preventive Doping Research, Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, Cologne 50933, Germany
| | - Andreas Thomas
- Center for Preventive Doping Research, Institute of Biochemistry, German Sport University Cologne, Am Sportpark Müngersdorf 6, Cologne 50933, Germany
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31
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Ventura E, Gadaj A, Monteith G, Ripoche A, Healy J, Botrè F, Sterk SS, Buckley T, Mooney MH. Development and validation of a semi-quantitative ultra-high performance liquid chromatography-tandem mass spectrometry method for screening of selective androgen receptor modulators in urine. J Chromatogr A 2019; 1600:183-196. [DOI: 10.1016/j.chroma.2019.04.050] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 04/16/2019] [Accepted: 04/17/2019] [Indexed: 12/13/2022]
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32
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Thevis M. The 36 th Manfred Donike workshop on doping analysis. Drug Test Anal 2018; 10:1633-1634. [PMID: 30394671 DOI: 10.1002/dta.2536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 10/25/2018] [Indexed: 12/26/2022]
Affiliation(s)
- Mario Thevis
- Institute of Biochemistry, German Sport University Cologne, Am Sportpark Muengersdorf 6, 50933, Cologne, Germany
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