Erythropoietin (EPO) is a hormone that stimulates red blood cell production. It has legitimate medical uses but some athletes abuse it to enhance performance by injecting it and artificially increasing their red blood cell count and oxygen-carrying capacity. However, EPO abuse poses health risks like increased blood pressure and stroke risk. While difficult to detect, tests can identify abnormal EPO levels. Its use is banned by anti-doping regulations due to its performance enhancing effects and health risks.

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References: http://biology.kenyon.edu/BMB/Chime2/2004/eryth/FRAMES/start.htm
Liv Hayward (HaywardO@cardiff.ac.uk)

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 The hormone itself
 Clinical Uses of EPO
 Side Effects of Clinical Use
 Misuse of EPO in sport
 Risks of Misuse
 Detection
 Summary
‘Describe how Erthyropoietin (EPO) may be ‘abused’ by
athletes seeking to enhance their performances.’

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 Increases the O2 carrying capacity of blood
 Stimulates the production of O2 carrying erythrocytes
 Naturally synthesised in the kidney and in macrophages
 Has a short half life
References: www.fi.edu/learn/heart/blood/red.html, (Rang et al., (2007)

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 2 recombined human forms – Epoetin α and β
 Can be given intravenously or subcutaneously
 Darbopoietin is a hyperglycosylated form and can be
administered less frequently due to a longer t½
References: www.pharmaceutical-technology.com/contractor_images/one2one/3-injection.jpg, Rang et al. (2007)

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1. Treatment of Anaemia Related to:
 Chronic renal failure
 Chemotherapy for cancer
 AIDS
 Chronic inflammatory conditions (e.g. rheumatoid
arthritis)
 Premature infants
2. Increase yield of autologous blood before blood
donation
References: Rang et al. (2007)

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 Passing flu-like symptoms
 Increased blood viscosity
 Hypertension leading to encephalopathy
 Iron deficiency
References: Rang et al. (2007)

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 Reduces fatigue (by increasing O2 levels in blood)
 Used mainly by athletes in endurance sports
 Recombinant human form most used
 Difficult to detect
References: Rang et al. (2007), Big Blade Photography (2009)
Cardiff Uni Rowing Club Women's Senior VIII
This picture
demonstrates the
toughness of some
sports – making sport
easier is a tempting
option for some athletes
However, I don’t use
EPO!

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 Taken over from another form of ‘blood doping’ –
removal of 1-2 litres of blood followed by retransfusion
 Injection of EPO provides an instant effect
 Officially prohibited by the World Anti-Doping Agency
References: Rang et al. (2007), The World Anti-Doping Code (2009)
EPO increases the
haematocrit (which
is normally around
40%)

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 Increased blood viscosity
 Hypertension
 Increased risk of stroke
 Increased risk of coronary attacks
 Risk of disqualification from competition
References: Rang et al. (2007)

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 The drug has a short plasma half life so detection is
difficult
 Lab-synthesised form similar to naturally occurring form
 Urine test directly detects normal EPO levels versus
synthetic EPO levels
 Use of blood plasma markers for indirect detection
o Athletes banned if found to have haematocrit above
50%
References: Robinson et al. (2006), Rang et al. (2007)

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 Blood doping using EPO has become more common
 Ways to ensure a negative EPO test have increased
 Further research into better detection methods is ongoing
 Future - should EPO use be allowed in sport?
... Probably not but the debate continues!
References: Rang et al. (2007), sportsanddrugs.procon.org/viewanswers.asp?questionID=001212

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Images:
 biology.kenyon.edu/BMB/Chime2/2004/eryth/FRAMES/start.htm
 www.fi.edu/learn/heart/blood/red.html
 www.pharmaceutical-technology.com/contractor_images/one2one/3-injection.jpg
 Big Blade Photography (2009) www.bigblade.net
Info:
• The World Anti-Doping Code (2009) Prohibited List
• www.rice.edu/~jenky/sports/epo.html
• Rang, HP., Dale, MM., Ritter, JM., Flower, RJ., (2009) Rang and Dale’s Pharmacology,
p768-769
• Robinson N, Giraud S, Saudan C, Baume N, Avois L, Mangin P, Saugy M, (2006)
Erythropoietin and Blood Doping, British Journal of Sports Medicine 2006, 40 (1), p30-34
• Kumar, P and Clark, M. (2004) Clinical Medicine, p525, 356
• sportsanddrugs.procon.org/