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Moreillon B, Salamin O, Krumm B, Iannella L, Molaioni F, Kuuranne T, Nicoli R, Saugy JJ, Botrè F, Faiss R. Variability of the urinary and blood steroid profiles in healthy and physically active women with and without oral contraception. Drug Test Anal 2023; 15:324-333. [PMID: 36414566 DOI: 10.1002/dta.3412] [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: 10/13/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022]
Abstract
The steroidal module of the athlete biological passport (ABP) targets the use of pseudo-endogenous androgenous anabolic steroids in elite sport by monitoring urinary steroid profiles. Urine and blood samples were collected weekly during two consecutive oral contraceptive pill (OCP) cycles in 15 physically active women to investigate the low urinary steroid concentrations and putative confounding effect of OCP. In urine, testosterone (T) and epitestosterone (E) were below the limit of quantification of 1 ng/ml in 62% of the samples. Biomarkers' variability ranged between 31% and 41%, with a significantly lesser variability for ratios (except for T/E [41%]): 20% for androsterone/etiocholanolone (p < 0.001) and 25% for 5α-androstane-3α,17β-diol/5ß-androstane-3α,17β-diol (p < 0.001). In serum, markers' variability (testosterone: 24%, androstenedione: 23%, dihydrotestosterone: 19%, and T/A4: 16%) was significantly lower than in urine (p < 0.001). Urinary A/Etio increased by >18% after the first 2 weeks (p < 0.05) following withdrawal blood loss. In contrast, serum T (0.98 nmol/l during the first week) and T/A4 (0.34 the first week) decreased significantly by more than 25% and 17% (p < 0.05), respectively, in the following weeks. Our results outline steroidal variations during the OCP cycle, highlighting exogenous hormonal preparations as confounder for steroid concentrations in blood. Low steroid levels in urine samples have a clear negative impact on the subsequent interpretation of steroid profile of the ABP. With a greater analytical sensitivity and lesser variability for steroids in healthy active women, serum represents a complementary matrix to urine in the ABP steroidal module.
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Affiliation(s)
- Basile Moreillon
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Olivier Salamin
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Bastien Krumm
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Loredana Iannella
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Francesco Molaioni
- Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Tiia Kuuranne
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Raul Nicoli
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Lausanne and Geneva, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jonas J Saugy
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Francesco Botrè
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.,Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Rome, Italy
| | - Raphael Faiss
- Research and Expertise in anti-Doping Sciences (REDs), Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
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2
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Eklund E, Andersson A, Ekström L, Hirschberg AL. Urinary Steroid Profile in Elite Female Athletes in Relation to Serum Androgens and in Comparison With Untrained Controls. Front Physiol 2021; 12:702305. [PMID: 34526910 PMCID: PMC8435769 DOI: 10.3389/fphys.2021.702305] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/09/2021] [Indexed: 11/15/2022] Open
Abstract
Introduction In female athletes, the interpretation of doping tests is complex due to hormonal variations during the menstrual cycle and hormonal contraceptive use, both influencing the urinary steroid profile. Exercise is suggested to affect circulating steroid hormone levels, and in women, the urinary steroid profile differs between in competition testing and out of competition testing. No previous study has investigated the relationship between amount of exercise and the urinary steroid profile in female elite athletes. Purpose To compare the urinary steroid profile between female Olympic athletes and age- and BMI-matched untrained controls, and to study the urinary steroid profile in relation to serum hormones and amount of exercise. Methods In this cross-sectional study conducted at the Women’s Health Research Unit, Karolinska University Hospital, Stockholm, 94 female elite athletes and 86 untrained controls were included. Serum estrogens and testosterone and the urinary steroid profile were analyzed by liquid chromatography–tandem mass spectrometry and gas chromatography-tandem mass spectrometry, respectively. Exercise hours/week were evaluated by questionnaire. Results Although serum steroid hormones were comparable between groups, the athletes demonstrated approximately 30% lower urinary steroid metabolites of testosterone, epitestosterone, androsterone, etiocholanolone, 5α-androstan-3α, 17β-diol, and 5β-androstan-3α, 17β-diol compared to the controls. The urinary steroid metabolites correlated positively with serum steroid hormones. In the athletes, urinary steroid metabolites: androsterone (rs = −0.28, p = 0.007), epitestosterone (rs = −0.22, p = 0.034), 5αAdiol (rs = −0.31, p = 0.002) and testosterone (rs = −0.24, p = 0.026), were negatively correlated with amount of training (hours per week). Conclusion The urinary concentrations of steroid metabolites were lower in elite athletes than in sedentary controls, although serum steroids were comparable between groups. Moreover, exercise time was negatively associated with the urinary concentrations. Our findings suggest alternative excretion routes of androgens in the athletes related to training.
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Affiliation(s)
- Emma Eklund
- Department of Women's and Children's Health, Division of Neonatology, Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden
| | - Alexander Andersson
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Lena Ekström
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Angelica Lindén Hirschberg
- Department of Women's and Children's Health, Division of Neonatology, Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden.,Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
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Nair VS, Sharpe K, Husk J, Miller GD, Van Eenoo P, Crouch A, Eichner D. Evaluation of blood parameters by linear discriminant models for the detection of testosterone administration. Drug Test Anal 2021; 13:1270-1281. [PMID: 33629499 DOI: 10.1002/dta.3017] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 11/09/2022]
Abstract
The steroidal module of the Athlete Biological Passport (ABP) has been used since 2014 for the longitudinal monitoring of urinary testosterone and its metabolites to identify samples suspicious for the use of synthetic forms of Endogenous Anabolic Androgenic Steroids (EAAS). Multiple recent studies have suggested that monitoring of blood parameters may provide enhanced detectability of exogenous testosterone administration. Transdermal and intramuscular testosterone administration studies were carried out in 15 subjects, and the effect on blood steroidal levels, hematological parameters, and gonadotropins was evaluated. Serum testosterone and dihydrotestosterone levels increased while gonadotropin levels were suppressed after administration. A modest increase in reticulocytes was also observed. The blood parameters that were responsive to the administrations were combined into several linear discriminant models targeting both administration (on) and washout (off) phases. The models were effective in detecting the large dose intramuscular administration but were less successful in the detection of the lower dose transdermal application. The blood profiling models may provide complementary value but do not appear to be substantially more advantageous than longitudinal urinary profiling.
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Affiliation(s)
- Vinod S Nair
- Sports Medicine Research and Testing Laboratory, South Jordan, Utah, USA.,DoCoLab, Department of Diagnostic Science, Ghent University, Ghent, Belgium
| | - Ken Sharpe
- Statistical Consulting Centre, School of Mathematics and Statistics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jacob Husk
- Sports Medicine Research and Testing Laboratory, South Jordan, Utah, USA
| | - Geoffrey D Miller
- Sports Medicine Research and Testing Laboratory, South Jordan, Utah, USA
| | - Peter Van Eenoo
- DoCoLab, Department of Diagnostic Science, Ghent University, Ghent, Belgium
| | - Andre Crouch
- Sports Medicine Research and Testing Laboratory, South Jordan, Utah, USA
| | - Daniel Eichner
- Sports Medicine Research and Testing Laboratory, South Jordan, Utah, USA
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Nair VS, Husk J, Miller GD, Eenoo P, Crouch A, Eichner D. Evaluation of longitudinal steroid profiling with the ADAMS adaptive model for detection of transdermal, intramuscular, and subcutaneous testosterone administration. Drug Test Anal 2020; 12:1419-1431. [DOI: 10.1002/dta.2885] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Vinod S. Nair
- Sports Medicine Research and Testing Laboratory South Jordan UT USA
- DoCoLab, Department of Diagnostic Science Ghent University Ghent Belgium
| | - Jacob Husk
- Sports Medicine Research and Testing Laboratory South Jordan UT USA
| | | | - Peter Eenoo
- DoCoLab, Department of Diagnostic Science Ghent University Ghent Belgium
| | - Andre Crouch
- Sports Medicine Research and Testing Laboratory South Jordan UT USA
| | - Daniel Eichner
- Sports Medicine Research and Testing Laboratory South Jordan UT USA
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Ponzetto F, Baume N, Schweizer C, Saugy M, Kuuranne T. Steroidal module of the Athlete Biological Passport. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.coemr.2019.05.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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6
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Lv X, Zhang JB, Wang XX, Hu WZ, Shi YS, Liu SW, Hao DC, Zhang WD, Ge GB, Hou J, Yang L. Amentoflavone is a potent broad-spectrum inhibitor of human UDP-glucuronosyltransferases. Chem Biol Interact 2018; 284:48-55. [DOI: 10.1016/j.cbi.2018.02.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 02/03/2018] [Accepted: 02/12/2018] [Indexed: 11/25/2022]
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7
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Kotronoulas A, Gomez-Gómez À, Fabregat A, Segura J, Yang S, Xing Y, Moutian W, Marcos J, Joglar J, Ventura R, Pozo OJ. Evaluation of markers out of the steroid profile for the screening of testosterone misuse. Part I: Transdermal administration. Drug Test Anal 2017; 10:821-831. [PMID: 29148228 DOI: 10.1002/dta.2338] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 10/17/2017] [Accepted: 11/05/2017] [Indexed: 11/05/2022]
Abstract
Although the introduction by the World Anti-Doping Agency (WADA) of the steroid module of the athlete biological passport (ABP) marked an important step forward in the screening of testosterone (T) misuse, it still remains one of the most difficult challenges in doping control analysis. The urinary determination of alternative markers has been recently reported as a promising tool for improving the screening of T oral administration. However, their evaluation for other, commonly used, administration routes is still required. The main goal of this study is the evaluation of the potential of 2 groups of metabolites (cysteinyl conjugated and glucuronoconjugated) after transdermal and intramuscular administration of T. Their suitability was evaluated in individuals with both low basal (L-T/E) and medium basal (M-T/E) values of T/E. In this Part I, we evaluated the urinary excretion profile of these 2 groups of T metabolites after the administration of 3 doses of T gel to 12 volunteers (6 L-T/E and 6 M-T/E) for 3 consecutive days. For this purpose, 9 different concentration ratios (5 cysteinyl conjugated and 4 glucuronoconjugated markers) were studied. Both, the intra-individual variability and the detection windows (DW) obtained by each ratio were evaluated. Cysteinyl conjugates showed a general low intra-individual variability and DWs that were shorter than any other tested marker. Despite the relatively large intra-individual variability, the DWs reached by glucuronoconjugates (2-3 days) were similar to those obtained by markers currently included in the ABP. Overall; this evaluation advises for the introduction of additional glucuronoconjugated markers in the screening of transdermal T administration.
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Affiliation(s)
- Aristotelis Kotronoulas
- Bioanalysis Research Group. IMIM, Hospital del Mar, Barcelona, Spain.,Department of Biological Chemistry and Molecular Modelling, Institute of Advanced Chemistry of Catalonia, Spanish Council for Scientific Research (IQAC-CSIC), Barcelona, Spain
| | - Àlex Gomez-Gómez
- Bioanalysis Research Group. IMIM, Hospital del Mar, Barcelona, Spain.,Integrative Pharmacology and Systems Neuroscience Group, IMIM, Hospital del Mar, Barcelona, Spain.,Programa De Recerca En Epidemiologia I Salut Pública, ISGlobal, Campus Mar, Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Andreu Fabregat
- Bioanalysis Research Group. IMIM, Hospital del Mar, Barcelona, Spain.,Waters Cromatografia SA, MS Applicat Lab, Barcelona, Spain
| | - Jordi Segura
- Bioanalysis Research Group. IMIM, Hospital del Mar, Barcelona, Spain.,Integrative Pharmacology and Systems Neuroscience Group, IMIM, Hospital del Mar, Barcelona, Spain.,Doping Control Research Group, IMIM, Hospital del Mar, Barcelona, Spain
| | - Sheng Yang
- National Anti-Doping Laboratory, China Anti-Doping Agency, Beijing, China
| | - Yanyi Xing
- National Anti-Doping Laboratory, China Anti-Doping Agency, Beijing, China
| | - Wu Moutian
- National Anti-Doping Laboratory, China Anti-Doping Agency, Beijing, China
| | - Josep Marcos
- Bioanalysis Research Group. IMIM, Hospital del Mar, Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.,Cerba Internacional, Sabadell, Spain
| | - Jesús Joglar
- Department of Biological Chemistry and Molecular Modelling, Institute of Advanced Chemistry of Catalonia, Spanish Council for Scientific Research (IQAC-CSIC), Barcelona, Spain
| | - Rosa Ventura
- Bioanalysis Research Group. IMIM, Hospital del Mar, Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain.,Doping Control Research Group, IMIM, Hospital del Mar, Barcelona, Spain
| | - Oscar J Pozo
- Bioanalysis Research Group. IMIM, Hospital del Mar, Barcelona, Spain.,Integrative Pharmacology and Systems Neuroscience Group, IMIM, Hospital del Mar, Barcelona, Spain
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8
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Choong E, Schulze JJ, Ericsson M, Rane A, Ekström L. Discordant genotyping results using DNA isolated from anti-doping control urine samples. Drug Test Anal 2016; 9:994-1000. [DOI: 10.1002/dta.2103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 09/21/2016] [Accepted: 10/01/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Eva Choong
- Department Laboratory Medicine; Division of Clinical Pharmacology, Karolinska Institutet; Stockholm Sweden
| | - Jenny J Schulze
- Department Laboratory Medicine; Division of Clinical Pharmacology, Karolinska Institutet; Stockholm Sweden
| | - Magnus Ericsson
- Department Laboratory Medicine; Division of Clinical Pharmacology, Karolinska Institutet; Stockholm Sweden
| | - Anders Rane
- Department Laboratory Medicine; Division of Clinical Pharmacology, Karolinska Institutet; Stockholm Sweden
| | - Lena Ekström
- Department Laboratory Medicine; Division of Clinical Pharmacology, Karolinska Institutet; Stockholm Sweden
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9
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Baume N, Jan N, Emery C, Mandanis B, Schweizer C, Giraud S, Leuenberger N, Marclay F, Nicoli R, Perrenoud L, Robinson N, Dvorak J, Saugy M. Antidoping programme and biological monitoring before and during the 2014 FIFA World Cup Brazil. Br J Sports Med 2016; 49:614-22. [PMID: 25878079 PMCID: PMC4413745 DOI: 10.1136/bjsports-2015-094762] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background The FIFA has implemented an important antidoping programme for the 2014 FIFA World Cup. Aim To perform the analyses before and during the World Cup with biological monitoring of blood and urine samples. Methods All qualified players from the 32 teams participating in the World Cup were tested out-of-competition. During the World Cup, 2–8 players per match were tested. Over 1000 samples were collected in total and analysed in the WADA accredited Laboratory of Lausanne. Results The quality of the analyses was at the required level as described in the WADA technical documents. The urinary steroid profiles of the players were stable and consistent with previously published papers on football players. During the competition, amphetamine was detected in a sample collected on a player who had a therapeutic use exemption for attention deficit hyperactivity disorder. The blood passport data showed no significant difference in haemoglobin values between out-of-competition and postmatch samples. Conclusions Logistical issues linked to biological samples collection, and the overseas shipment during the World Cup did not impair the quality of the analyses, especially when used as the biological passport of football players.
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Affiliation(s)
- Norbert Baume
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Geneva & Lausanne, Epalinges, Switzerland
| | - Nicolas Jan
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Geneva & Lausanne, Epalinges, Switzerland
| | - Caroline Emery
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Geneva & Lausanne, Epalinges, Switzerland
| | - Béatrice Mandanis
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Geneva & Lausanne, Epalinges, Switzerland
| | - Carine Schweizer
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Geneva & Lausanne, Epalinges, Switzerland
| | - Sylvain Giraud
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Geneva & Lausanne, Epalinges, Switzerland
| | - Nicolas Leuenberger
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Geneva & Lausanne, Epalinges, Switzerland
| | - François Marclay
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Geneva & Lausanne, Epalinges, Switzerland
| | - Raul Nicoli
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Geneva & Lausanne, Epalinges, Switzerland
| | - Laurent Perrenoud
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Geneva & Lausanne, Epalinges, Switzerland
| | - Neil Robinson
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Geneva & Lausanne, Epalinges, Switzerland
| | - Jiri Dvorak
- FIFA, Zürich, Switzerland FIFA Medical Assessment and Research Centre (F-MARC) and Schulthess Clinic, Zürich, Switzerland
| | - Martial Saugy
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Geneva & Lausanne, Epalinges, Switzerland
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10
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Genetic and phenotypic variation in UGT2B17, a testosterone-metabolizing enzyme, is associated with BMI in males. Pharmacogenet Genomics 2015; 25:263-9. [PMID: 25794161 DOI: 10.1097/fpc.0000000000000135] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE A number of candidate gene and genome-wide association studies have identified significant associations between single nucleotide polymorphisms, particularly in FTO and MC4R, and body weight. However, the association between copy number variation and body weight is less understood. Anabolic androgenic steroids, such as testosterone, can regulate body weight. In humans, UDP-glucuronosyltransferase 2B17 (UGT2B17) metabolizes testosterone to a metabolite, which is readily excreted in urine. We investigate the association between genetic and phenotypic variation in UGT2B17 and body weight. MATERIALS AND METHODS UGT2B17 deletion was genotyped and in-vivo UGT2B17 enzymatic activity (as measured by the 3-hydroxycotinine glucuronide to free 3-hydroxycotinine ratio) was measured in 400 Alaska Native individuals and 540 African Americans. RESULTS In Alaska Native people, UGT2B17 deletion was strongly associated with lower BMI in male individuals (P<0.001), but not in female individuals, consistent with testosterone being a male dominant steroid. The sex-specific association between UGT2B17 deletion and lower BMI was also observed in African Americans (P=0.01 in male individuals). In both populations, UGT2B17 deletion was significantly associated with lower measured in-vivo UGT2B17 activity. In male individuals, lower in-vivo UGT2B17 activity was associated with lower BMI, as observed in the sex-specific genotypic association. CONCLUSION These data suggest that UGT2B17 deletion leads to reduced UGT2B17 activity, and lower BMI in male individuals. This is consistent with the hypothesis that reduced UGT2B17-mediated testosterone excretion results in higher testosterone levels. Future studies could confirm this hypothesis by directly measuring serum testosterone levels.
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11
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Strahm E, Mullen JE, Gårevik N, Ericsson M, Schulze JJ, Rane A, Ekström L. Dose-dependent testosterone sensitivity of the steroidal passport and GC-C-IRMS analysis in relation to the UGT2B17 deletion polymorphism. Drug Test Anal 2015. [DOI: 10.1002/dta.1841] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Emmanuel Strahm
- Department of Laboratory Medicine, Division of Clinical Pharmacology; Karolinska Institutet; SE-141 86 Stockholm Sweden
| | - Jenny E. Mullen
- Department of Laboratory Medicine, Division of Clinical Pharmacology; Karolinska Institutet; SE-141 86 Stockholm Sweden
| | - Nina Gårevik
- Department of Laboratory Medicine, Division of Clinical Pharmacology; Karolinska Institutet; SE-141 86 Stockholm Sweden
| | - Magnus Ericsson
- Department of Laboratory Medicine, Division of Clinical Pharmacology; Karolinska Institutet; SE-141 86 Stockholm Sweden
| | - Jenny J. Schulze
- Department of Laboratory Medicine, Division of Clinical Pharmacology; Karolinska Institutet; SE-141 86 Stockholm Sweden
| | - Anders Rane
- Department of Laboratory Medicine, Division of Clinical Pharmacology; Karolinska Institutet; SE-141 86 Stockholm Sweden
| | - Lena Ekström
- Department of Laboratory Medicine, Division of Clinical Pharmacology; Karolinska Institutet; SE-141 86 Stockholm Sweden
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12
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Fabregat A, Marcos J, Segura J, Ventura R, Pozo OJ. Factors affecting urinary excretion of testosterone metabolites conjugated with cysteine. Drug Test Anal 2015; 8:110-9. [DOI: 10.1002/dta.1801] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 03/09/2015] [Accepted: 03/11/2015] [Indexed: 11/08/2022]
Affiliation(s)
- Andreu Fabregat
- Bioanalysis Research Group, IMIM; Hospital del Mar; Doctor Aiguader 88 08003 Barcelona Spain
| | - Josep Marcos
- Bioanalysis Research Group, IMIM; Hospital del Mar; Doctor Aiguader 88 08003 Barcelona Spain
- Department of Experimental and Health Sciencies; Universitat Pompeu Fabra; Doctor Aiguader 88 08003 Barcelona Spain
| | - Jordi Segura
- Bioanalysis Research Group, IMIM; Hospital del Mar; Doctor Aiguader 88 08003 Barcelona Spain
- Department of Experimental and Health Sciencies; Universitat Pompeu Fabra; Doctor Aiguader 88 08003 Barcelona Spain
| | - Rosa Ventura
- Bioanalysis Research Group, IMIM; Hospital del Mar; Doctor Aiguader 88 08003 Barcelona Spain
- Department of Experimental and Health Sciencies; Universitat Pompeu Fabra; Doctor Aiguader 88 08003 Barcelona Spain
| | - Oscar J. Pozo
- Bioanalysis Research Group, IMIM; Hospital del Mar; Doctor Aiguader 88 08003 Barcelona Spain
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13
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Kuuranne T, Saugy M, Baume N. Confounding factors and genetic polymorphism in the evaluation of individual steroid profiling. Br J Sports Med 2015; 48:848-55. [PMID: 24764553 PMCID: PMC4033181 DOI: 10.1136/bjsports-2014-093510] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In the fight against doping, steroid profiling is a powerful tool to detect drug misuse with endogenous anabolic androgenic steroids. To establish sensitive and reliable models, the factors influencing profiling should be recognised. We performed an extensive literature review of the multiple factors that could influence the quantitative levels and ratios of endogenous steroids in urine matrix. For a comprehensive and scientific evaluation of the urinary steroid profile, it is necessary to define the target analytes as well as testosterone metabolism. The two main confounding factors, that is, endogenous and exogenous factors, are detailed to show the complex process of quantifying the steroid profile within WADA-accredited laboratories. Technical aspects are also discussed as they could have a significant impact on the steroid profile, and thus the steroid module of the athlete biological passport (ABP). The different factors impacting the major components of the steroid profile must be understood to ensure scientifically sound interpretation through the Bayesian model of the ABP. Not only should the statistical data be considered but also the experts in the field must be consulted for successful implementation of the steroidal module.
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Affiliation(s)
- Tiia Kuuranne
- Doping Control Laboratory, United Medix Laboratories Ltd., , Helsinki, Finland
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14
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Pharmacogenomics of human uridine diphospho-glucuronosyltransferases and clinical implications. Clin Pharmacol Ther 2014; 96:324-39. [PMID: 24922307 DOI: 10.1038/clpt.2014.126] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 06/07/2014] [Indexed: 12/12/2022]
Abstract
Glucuronidation by uridine diphospho-glucuronosyltransferase enzymes (UGTs) is a major phase II biotransformation pathway and, complementary to phase I metabolism and membrane transport, one of the most important cellular defense mechanisms responsible for the inactivation of therapeutic drugs, other xenobiotics, and endogenous molecules. Interindividual variability in UGT pathways is significant and may have profound pharmacological and toxicological implications. Several genetic and genomic processes underlie this variability and are discussed in relation to drug metabolism and diseases such as cancer.
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15
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Pope HG, Wood RI, Rogol A, Nyberg F, Bowers L, Bhasin S. Adverse health consequences of performance-enhancing drugs: an Endocrine Society scientific statement. Endocr Rev 2014; 35:341-75. [PMID: 24423981 PMCID: PMC4026349 DOI: 10.1210/er.2013-1058] [Citation(s) in RCA: 319] [Impact Index Per Article: 31.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Despite the high prevalence of performance-enhancing drug (PED) use, media attention has focused almost entirely on PED use by elite athletes to illicitly gain a competitive advantage in sports, and not on the health risks of PEDs. There is a widespread misperception that PED use is safe or that adverse effects are manageable. In reality, the vast majority of PED users are not athletes but rather nonathlete weightlifters, and the adverse health effects of PED use are greatly underappreciated. This scientific statement synthesizes available information on the medical consequences of PED use, identifies gaps in knowledge, and aims to focus the attention of the medical community and policymakers on PED use as an important public health problem. PED users frequently consume highly supraphysiologic doses of PEDs, combine them with other PEDs and/or other classical drugs of abuse, and display additional associated risk factors. PED use has been linked to an increased risk of death and a wide variety of cardiovascular, psychiatric, metabolic, endocrine, neurologic, infectious, hepatic, renal, and musculoskeletal disorders. Because randomized trials cannot ethically duplicate the large doses of PEDs and the many factors associated with PED use, we need observational studies to collect valid outcome data on the health risks associated with PEDs. In addition, we need studies regarding the prevalence of PED use, the mechanisms by which PEDs exert their adverse health effects, and the interactive effects of PEDs with sports injuries and other high-risk behaviors. We also need randomized trials to assess therapeutic interventions for treating the adverse effects of PEDs, such as the anabolic-androgen steroid withdrawal syndrome. Finally, we need to raise public awareness of the serious health consequences of PEDs.
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Affiliation(s)
- Harrison G Pope
- McLean Hospital (H.G.P.), Harvard Medical School, Belmont, Massachusetts 02478; University of Southern California (R.I.W.), Los Angeles, California 90089; University of Virginia (A.R.), Charlottesville, Virginia 22904; Department of Pharmaceutical Biosciences, (F.N.), Upsala University, SE-751 24, Upsala, Sweden; United States Anti-Doping Agency (L.B.), Colorado Springs, Colorado 80919; and Brigham and Women's Hospital (S.B.), Harvard Medical School, Boston, Massachusetts 02115
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16
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Badoud F, Boccard J, Schweizer C, Pralong F, Saugy M, Baume N. Profiling of steroid metabolites after transdermal and oral administration of testosterone by ultra-high pressure liquid chromatography coupled to quadrupole time-of-flight mass spectrometry. J Steroid Biochem Mol Biol 2013; 138:222-35. [PMID: 23796409 DOI: 10.1016/j.jsbmb.2013.05.018] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 05/16/2013] [Accepted: 05/18/2013] [Indexed: 11/23/2022]
Abstract
The screening of testosterone (T) misuse for doping control is based on the urinary steroid profile, including T, its precursors and metabolites. Modifications of individual levels and ratio between those metabolites are indicators of T misuse. In the context of screening analysis, the most discriminant criterion known to date is based on the T glucuronide (TG) to epitestosterone glucuronide (EG) ratio (TG/EG). Following the World Anti-Doping Agency (WADA) recommendations, there is suspicion of T misuse when the ratio reaches 4 or beyond. While this marker remains very sensitive and specific, it suffers from large inter-individual variability, with important influence of enzyme polymorphisms. Moreover, use of low dose or topical administration forms makes the screening of endogenous steroids difficult while the detection window no longer suits the doping habit. As reference limits are estimated on the basis of population studies, which encompass inter-individual and inter-ethnic variability, new strategies including individual threshold monitoring and alternative biomarkers were proposed to detect T misuse. The purpose of this study was to evaluate the potential of ultra-high pressure liquid chromatography (UHPLC) coupled with a new generation high resolution quadrupole time-of-flight mass spectrometer (QTOF-MS) to investigate the steroid metabolism after transdermal and oral T administration. An approach was developed to quantify 12 targeted urinary steroids as direct glucuro- and sulfo-conjugated metabolites, allowing the conservation of the phase II metabolism information, reflecting genetic and environmental influences. The UHPLC-QTOF-MS(E) platform was applied to clinical study samples from 19 healthy male volunteers, having different genotypes for the UGT2B17 enzyme responsible for the glucuroconjugation of T. Based on reference population ranges, none of the traditional markers of T misuse could detect doping after topical administration of T, while the detection window was short after oral TU ingestion. The detection ability of the 12 targeted steroids was thus evaluated by using individual thresholds following both transdermal and oral administration. Other relevant biomarkers and minor metabolites were studied for complementary information to the steroid profile, including sulfoconjugated analytes and hydroxy forms of glucuroconjugated metabolites. While sulfoconjugated steroids may provide helpful screening information for individuals with homozygotous UGT2B17 deletion, hydroxy-glucuroconjugated analytes could enhance the detection window of oral T undecanoate (TU) doping.
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Affiliation(s)
- F Badoud
- Swiss Laboratory for Doping Analyses, University Center of Legal Medicine, Geneva and Lausanne, Chemin des Croisettes 22, 1066 Epalinges, Switzerland
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17
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Fallon JK, Neubert H, Hyland R, Goosen TC, Smith PC. Targeted quantitative proteomics for the analysis of 14 UGT1As and -2Bs in human liver using NanoUPLC-MS/MS with selected reaction monitoring. J Proteome Res 2013; 12:4402-13. [PMID: 23977844 DOI: 10.1021/pr4004213] [Citation(s) in RCA: 105] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Targeted quantitative proteomics using heavy isotope dilution techniques is increasingly being utilized to quantify proteins, including UGT enzymes, in biological matrices. Here we present a multiplexed method using nanoLC-MS/MS and multiple reaction monitoring (MRM) to quantify 14 UGT1As and UGT2Bs in liver matrices. Where feasible, we employ two or more proteotypic peptides per protein, with only four proteins quantified with only one proteotypic peptide. We apply the method to analysis of a library of 60 human liver microsome (HLM) and matching S9 samples. Ten of the UGT isoforms could be detected in liver, and the expression of each was consistent with mRNA expression reported in the literature. UGT2B17 was unusual in that ∼30% of liver microsomes had no or little (<0.5 pmol/mg protein) content, consistent with a known common polymorphism. Liver S9 UGT concentrations were approximately 10-15% those of microsomes. The method was robust, precise, and reproducible and provides novel UGT expression data in human liver that will benefit rational approaches to evaluate metabolism in drug development.
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Affiliation(s)
- John K Fallon
- Division of Molecular Pharmaceutics, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina 27599, United States
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18
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Pokrywka A, Kaliszewski P, Majorczyk E, Zembroń-Łacny A. Genes in sport and doping. Biol Sport 2013; 30:155-61. [PMID: 24744482 PMCID: PMC3944571 DOI: 10.5604/20831862.1059606] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2013] [Indexed: 11/19/2022] Open
Abstract
Genes control biological processes such as muscle production of energy, mitochondria biogenesis, bone formation, erythropoiesis, angiogenesis, vasodilation, neurogenesis, etc. DNA profiling for athletes reveals genetic variations that may be associated with endurance ability, muscle performance and power exercise, tendon susceptibility to injuries and psychological aptitude. Already, over 200 genes relating to physical performance have been identified by several research groups. Athletes’ genotyping is developing as a tool for the formulation of personalized training and nutritional programmes to optimize sport training as well as for the prediction of exercise-related injuries. On the other hand, development of molecular technology and gene therapy creates a risk of non-therapeutic use of cells, genes and genetic elements to improve athletic performance. Therefore, the World Anti-Doping Agency decided to include prohibition of gene doping within their World Anti-Doping Code in 2003. In this review article, we will provide a current overview of genes for use in athletes’ genotyping and gene doping possibilities, including their development and detection techniques.
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19
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Thevis M, Kuuranne T, Geyer H, Schänzer W. Annual banned-substance review: analytical approaches in human sports drug testing. Drug Test Anal 2012; 5:1-19. [DOI: 10.1002/dta.1441] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 11/02/2012] [Indexed: 12/12/2022]
Affiliation(s)
| | - Tiia Kuuranne
- Doping Control Laboratory, United Medix Laboratories; Höyläämötie 14; 00380; Helsinki; Finland
| | - Hans Geyer
- Center for Preventive Doping Research - Institute of Biochemistry; German Sport University Cologne; Am Sportpark Müngersdorf 6; 50933; Cologne; Germany
| | - Wilhelm Schänzer
- 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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Müller-Platz C. Misuse potential of molecular biology and biotechnology in sport. Drug Test Anal 2011; 3:643-4. [PMID: 22031501 DOI: 10.1002/dta.353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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