Interest of hair tests to discriminate a tail end of a doping regimen from a possible unpredictable source of a prohibited substance in case of challenging an anti-doping rule violation.

IF 3.8 2区 医学 Q1 MEDICAL LABORATORY TECHNOLOGY Clinical chemistry and laboratory medicine Pub Date : 2025-01-21 DOI:10.1515/cclm-2024-1407
Pascal Kintz
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Abstract

The presence of letrozole, an aromatase inhibitor, in an athlete's sample constitutes one of the more frequent anti-doping rules violation. It is possible to challenge this violation but it is the athletes who have to demonstrate their innocence. The conditions to evidence/establish the absence of fault or negligence hinge on two points: 1. the athletes or their legal representatives have to present verified circumstances of contamination and the source of contamination has to be identified; and 2. there have to be verified claims by the athlete about the fact that the intake of the prohibited substance was not known, i.e. that the violation was not intentional. This corresponds to the suggested shift terminology from "contaminated product" to "unpredictable source of a prohibited substance". In the recent years, several top athletes challenged their ADRV with a low urine letrozole concentration and requested a hair test. In three cases, letrozole concentration in segmented hair, particularly in the segment corresponding to the urine AAF was significantly lower than 1 pg/mg, which is the limit of quantification of the method. Considering that a ¼ of a 2.5 mg therapeutic dose of letrozole produces a hair concentration of approximately 30 pg/mg, it is easy to establish that the dose that entered in the body of these athletes was incidental. Nevertheless, all three athletes were sentenced a 2-years ban as the source of contamination was not identified. In that sense, the WADA dogma contradicts scientific evidence, and from a forensic perspective, this appears difficult to understand.

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在对违反反兴奋剂规则提出质疑的情况下,有兴趣进行毛发测试,以区分兴奋剂方案的末端与可能不可预测的禁用物质来源。
运动员样本中含有来曲唑(一种芳香酶抑制剂)是一种较为常见的违反反兴奋剂规则的行为。对这种违规行为提出质疑是可能的,但必须证明自己是清白的。证明不存在过失或过失的条件取决于两点:1。运动员或其法定代理人必须出示经核实的污染情况,并查明污染源;和2。必须核实运动员关于摄入违禁物质的事实的声明,即违规行为不是故意的。这对应于建议将术语从“受污染产品”转换为“不可预测的禁用物质来源”。近年来,几位顶级运动员以尿来曲唑浓度低来曲唑来挑战他们的ADRV,并要求进行头发测试。在三个病例中,来曲唑在分节毛发中的浓度,特别是在尿AAF对应的部分显著低于1 pg/mg,这是该方法的定量限。考虑到治疗剂量为2.5 mg的1 / 4的来曲唑产生的毛发浓度约为30 pg/mg,很容易确定进入这些运动员体内的剂量是偶然的。然而,由于没有确定污染源,这三名运动员都被判处两年禁赛。从这个意义上说,世界反兴奋剂机构的教条与科学证据相矛盾,从法医的角度来看,这似乎很难理解。
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来源期刊
Clinical chemistry and laboratory medicine
Clinical chemistry and laboratory medicine 医学-医学实验技术
CiteScore
11.30
自引率
16.20%
发文量
306
审稿时长
3 months
期刊介绍: Clinical Chemistry and Laboratory Medicine (CCLM) publishes articles on novel teaching and training methods applicable to laboratory medicine. CCLM welcomes contributions on the progress in fundamental and applied research and cutting-edge clinical laboratory medicine. It is one of the leading journals in the field, with an impact factor over 3. CCLM is issued monthly, and it is published in print and electronically. CCLM is the official journal of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and publishes regularly EFLM recommendations and news. CCLM is the official journal of the National Societies from Austria (ÖGLMKC); Belgium (RBSLM); Germany (DGKL); Hungary (MLDT); Ireland (ACBI); Italy (SIBioC); Portugal (SPML); and Slovenia (SZKK); and it is affiliated to AACB (Australia) and SFBC (France). Topics: - clinical biochemistry - clinical genomics and molecular biology - clinical haematology and coagulation - clinical immunology and autoimmunity - clinical microbiology - drug monitoring and analysis - evaluation of diagnostic biomarkers - disease-oriented topics (cardiovascular disease, cancer diagnostics, diabetes) - new reagents, instrumentation and technologies - new methodologies - reference materials and methods - reference values and decision limits - quality and safety in laboratory medicine - translational laboratory medicine - clinical metrology Follow @cclm_degruyter on Twitter!
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