The International Olympic Committee (IOC) banned blood doping in 1988 after the discovery that cyclists were transfusing homologous blood at the Los Angeles Olympic Games in 1984. Recombinant erythropoietin (EPO) was developed for the treatment of anaemia following the cloning of the human EPO gene in 1984. Unfortunately, sports competitors could then misuse EPO to increase circulating haemoglobin and its oxygen carrying capacity in order to gain an advantage in endurance events. The IOC added EPO to its list of prohibited substances in 1990, one year after adding peptide hormones as a new class. However, there was no internationally recognised test to detect administration until 2000 when direct and indirect tests were first conducted for EPO at the Sydney Olympic Games. The direct test, developed by Lasne and colleagues, requires a urine sample and uses isoelectric focussing and a Western double blotting technique with chemiluminescent detection. However, since the terminal half-life of EPO is only about 8.5 hours, this test has very little retrospectivity. Nevertheless, several athletes have been successfully prosecuted for administering EPO based on evidence from this test. The indirect test, which is less widely used, requires a blood sample and is based on a variety of markers stimulated by EPO administration.
Several forms of EPO are now on the market including Novel Erythrocyte Stimulating Protein (NESP), which has a modified amino acid backbone and greater glycosylation than EPO. This results in approximately three times the half-life of EPO while maintaining its biological activity. In 2002, despite media claims that it was undetectable, three long distance skiers were disqualified at the Winter Olympic Games in Salt Lake City for using NESP. This presentation will provide an update on the tests to detect EPO administration and highlight their strengths and weaknesses.