Erythropoietin: novelties in antidoping research

This review focuses on discoveries regarding doping with recombinant human erythropoietin and other erythropoiesis-stimulating agents (ESAs), reported since 2017. While ESAs are known to increase the total mass of hemoglobin (Hb_mass), V˙O_2max and maximal power output unresolved questions have remained with respect to their effects on endurance performance. ESAs are detectable by electrophoresis or isoelectric focusing and immunoblotting of urine (or blood) samples. The methods have undergone some improvements. Novel erythropoietic substances will become available in the near future. Analytical methods are already available for the detection of Epo mimetic peptides, hypoxia-inducible factor stabilizers, and activin type II receptor ligand traps. The ‘athlete biological passport’ is an indirect instrument in antidoping efforts. Additional hematologic parameters such as hepcidin and erythroferrone may strengthen the athlete biological passport approach.