CERA Detection and Stability in Blood Versus Urine

Area of Science:

• Sports Science
• Biochemistry
• Analytical Chemistry

Background:

• Erythropoietin receptor agonists (ERAs), including continuous erythropoietin receptor activators (CERAs), are performance-enhancing drugs used in sports.
• Traditional detection methods in urine are becoming less effective for newer generations of ERAs due to their slow urinary elimination.
• Serum-based detection and hematological profiling are emerging as crucial anti-doping strategies.

Purpose of the Study:

• To compare the detectability and stability of CERA in urine, serum, and dried blood spot (DBS) matrices.
• To evaluate the effectiveness of combining direct CERA detection with hematological profiling via the Athlete Biological Passport (ABP).
• To assess the potential of DBS as a minimally invasive alternative for CERA detection.

Main Methods:

• Analysis of CERA in serum, urine, and simulated DBS (Tasso-M20) samples from controlled administration and authentic doping cases.
• Stability experiments involving incubation of spiked matrices at 37°C for up to 72 hours.
• Hematological profiling, including reticulocyte counts, to support the Athlete Biological Passport (ABP).

Main Results:

• CERA demonstrated superior stability and consistent detectability in serum and DBS compared to urine.
• Hematological alterations, such as increased reticulocyte percentage, flagged by the ABP, aided in targeted serum testing and CERA detection.
• DBS samples exhibited promising analytical performance and thermal stability, indicating their suitability for anti-doping applications.

Conclusions:

• Blood matrices (serum and DBS) are more effective than urine for detecting CERA due to enhanced stability and detectability.
• Integrating direct detection with indirect methods like ABP analysis significantly improves the detection of CERA doping.
• Dried blood spots (DBS) represent a viable, minimally invasive alternative for anti-doping programs targeting ERA use.