Doping yesterday, today, tomorrow: A challenge for the clinical laboratory

This work highlights the role of the clinical laboratory, in the early detection of the use of substances prohibited for doping. This is because most people who practice sports today are non-professional athletes and amateurs, in particular young kids. These persons are not subjected to anti-doping controls but are at risk for their health. Endocrinologists and laboratory tests, by detecting evidence of such usage can help protect their health. Anti-doping testing require specific instruments for qualitative and quantitative chemistry, to meet regulations of official competitions but are impossible to be used in every person because of high cost. A particular role the clinical laboratory can acquire in the future is through its molecular biology sections, when genetic doping will probably be a reality and quantitative chemistry will be unable to detect it. A brief history of doping is provided to understand the reasons of its spread. Although doping has great resonance nowadays, it is not a recent problem. It was common among ancient Greek wrestlers and Romans, who used mixtures of herbs and stimulants. Ancient Greece started the Olympic Games and winners assumed great esteem, akin to demi-god status. Therefore, any attempt to improve athletic performance was a norm, also because the damage caused by the substances used was not known at that time. The use became so widespread that soldiers also used drugs to better combat during recent wars, and doping was practiced by athletes, actors and musicians in attempts to obtain better performance results. Today, doping has been refined so as not to be discovered and there is a continuous race between those who promote new substances and those who, like the World Anti-Doping Agency (WADA), were created to defend the health of athletes and comply with regulations of competitions. The clinical laboratory plays a fundamental role in identifying the use of prohibited substances, especially in competitions not classified as official, which are the majority and involve thousands of amateurs. In this paper a series of laboratory tests are proposed in this perspective, at low cost without the need of qualitative/quantitative chemical analyses required by the sport jurisdictions. Finally, a glance into genetic doping illustrates a likely future and imminent practice.