The Use of Erythropoietin by Athletes

The Use of Erythropoietin by Athletes

Erythropoietin is a glycoprotein that is produced primarily in the kidneys in adults and, to a lesser extent, in the liver. It behaves like a hormone, regulating the level of erythropoiesis, and keeping the RBC count within a narrow range

It is used widely in medicine as a treatment for a number of serious illnesses, ranging from types of anaemia, to the treatment of certain types of cancer, and also in the battle against AIDS. Unfortunately certain athletes, who will do anything to win, have realised its ergogenic benefits, and also the severity of its misuse.

Regulation of Erythropoietin Production.

In the kidneys, erythropoietin is produced in fibroblastoid interstitial cells in the inner renal cortex, while in the liver, the hormone is produced by both hepatocytes and interstitial fibroblastoid cells. Although a variety of growth factors influence erythroid progenitor cell proliferation, erythropoietin is the most important, and erythropoiesis cannot continue in its absence.

Among the haematopoietic growth factors, erythropoietin is one of few that behaves like a hormone. It is unique because its production, under normal circumstances, is controlled solely at the level of its gene, by tissue hypoxia and not by the absolute number of circulating erythrocytes.

Hypoxia is the sole physiologic stimulus for erythropoietin production, and an excess of oxygen suppresses its production but never completely.

Some facts about EPO. (Birchard K, Lancet 1998; 352: 42.)

· Neither age nor gender influences the plasma erythropoietin level,

· Plasma erythropoietin is constant in a given individual,

· Erythropoietin production is regulated at the level of its gene,

· Hypoxia is t...

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It was suspected, but not proven, that the deaths of 18 Belgium and Dutch world-class cyclists may have been linked to erythropoietin-induced RBC growth.

Clearly EPO use can boost performance but the risk to the user is just too great. Any method that can safely dissuade athletes away from this hazardous avenue of performance enhancement should be considered.

Bibliography:

M, Larkin. The Lancet, Issue: June 10, 2000

J. J. M. Marx. The Lancet, Issue: August 8, 1998

Audran, M., et all., Effects of Erythropoietin Administration in Training Athletes and Possible Indirect Detection in Doping Control. 1999 Medicine and Science in Sports and Exercise, 195: 639-645

Birchard K. Why doctors should worry about doping in sport. Lancet 1998; 352: 42.

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