Some substances prohibited by WADA may have potential medical applications -
While the world awaits the start of the 2016 Summer Olympics, doping in athletes remains a hot topic.
doping, or the use of a compound or a procedure that was banned by the sports governing body, since it provides an unfair competitive advantage, is governed by the WADA. WADA sets guidelines that most international sports associations follow.
Christopher Mendias, Ph.D., ATC, assistant professor of orthopedic surgery and of molecular and integrative physiology at the University of Michigan, why WADA regulates certain substances, how things change and how some these drugs can help rehabilitate injuries every day and elite athletes alike.
What are some drugs or athletes use drugs to improve performance?
Mendias: In general, you can break down the compounds and technical athletes use into three categories :. medicines that increase endurance athletes, drugs that make them faster and stronger athletes and drugs that help athletes recover after competition
for endurance, compounds typically work for doping increase the amount of oxygen you can carry in your blood. These range from drugs such as erythropoietin or EPO, which increases the production of red blood cells that carry oxygen circulating in the body athletes, transfusion, where you inject more physically red blood directly into veins 'an athlete. This type of doping is more often seen in sports where athletes must run or cycle long distances with little or no breaks during the competition.
When it comes to making stronger athletes, many drugs fall into the category of anabolic agents, working as the hormone testosterone and trigger the production of new proteins in the muscle. These proteins are the "engine" of the largest muscle cells and can generate more force. You see this type of doping use in sports that involve a lot of sprinting, or in collision sports such as football or rugby.
The third class of drugs, those for recovery, can accelerate the normal process of recovery of athletes' injured cells and help load faster fuel stores. Most drugs of this class are growth factors and compounds which are similar to hormones in the body that aid in tissue repair.
They are increasingly used in all different types of sports. Take swimming or athletics, where athletes must perform in the qualifying rounds of rounds before making it to the final. The ability to recover quickly can allow athletes to perform at a higher level in the qualifying rounds so they make it to the finals, and then do their best in the final too. For collision sports such as football or rugby, the faster you repair the damage caused by damaged muscle cells faster you can compete at a high level again.
Elite athletes who use these substances are breaking the rules of their sports. But there are times when these substances can be helpful
Mendias: While certain medications and substances on the prohibited list of WADA have no medical use legitimate, many do. Drugs that increase the red blood cells are often used in patients with kidney disease or recovering from certain types of cancer. The compounds that make muscle cells bigger and stronger approved the use in the fight against diseases of the severe muscle atrophy, as is observed in some types of myopathies and in men with exceptionally low rates androgenic hormones.
Sometimes these drugs have effects on the body that are different from their normal medical use. Take, for example, beta-blockers, which are drugs that are used to treat high blood pressure. Beta blockers may calm nervous nerves and increase accuracy for sports where accuracy is important, such as golf and archery.
Can you talk more about your research in this area?
Mendias :. My lab conducts research on both the biochemical and genetic side muscle weakness and providing therapies to patients in the clinic suffering from injuries that have profound muscle atrophy
the vast majority of patients we treat in sports medicine, almost all, in fact, are not elite athletes and professionals. We are talking about patients who are physically active supporters injury while playing recreational sports. Sports medicine clinicians and researchers are increasingly attentive to the long-term effects of sports injuries. If an injury is sufficiently serious to prevent a patient for a month or two, there's a good chance that there will be long-term consequences of that damage which will extend many years, sometimes decades, in their lives later.
In patients with ACL tears, for example, even after surgery and rehabilitation of the injured leg muscles are often around 30 percent lower than they were before the injury . Over time, this weakness slowly eroding the cartilage in the knee. My laboratory is studying the possibility that growth hormone - a banned substance by WADA - could help address this weakness in a clinical trial approved by the FDA. We chose growth hormone based on numerous laboratory and clinical studies that have shown it can help protect muscles from injury, although it has not been studied in patients with tears ACL.
This is just a potential medical application of WADA -banned substances. WADA and made offers exemptions for legitimate medical use of certain drugs. Before it can approve the use of the drug, WADA considers the benefits of improved performance potential and weighs this against medical use.
We do not know yet whether growth hormone can help restore the strength closer to normal levels in patients with ACL tears, but if our study and others are successful and the growth hormone is approved by the FDA for the treatment of this condition, WADA should assess in each case whether an athlete would be allowed to take growth hormones if they suffered a major knee injury. For growth hormone, most data show that in adults, it has little or no performance enhancing effects on healthy muscle, so we do not anticipate "doping" effect in our current study . But other drugs as anabolic agents that increase muscle strength in healthy could give athletes a long-term benefit in improving performance, even after they have recovered from their injuries.
Are there other drugs with legitimate medical uses in sick patients but no medical benefit in healthy athletes
Mendias: one of the most high profile doping cases involved a new drug recently banned meldonium. The drug, which has been around for decades, is used in some countries in Eastern Europe to treat patients with heart disease, in which low levels of oxygen to the heart causes tissue damage. But for athletes, meldonium seems to favor the recovery and delivery of oxygen to muscles and improve endurance performance.
Maria Sharapova, a famous tennis player, received a two-year suspension for testing positive for the drug. A recent documentary reported that nearly a fifth of Russian athletics athletes meldonium taking. It is a difficult stretch to justify the use of a heart failure drug in people who have some of the best cardiovascular systems of anyone in the world.
How do you think that this research will impact on professional sport in the future
of Mendias :? We are at a very exciting time in the field of sports medicine. There have been many advances in our understanding of how the biochemical and genetic factors control the function of muscle cells, bone, cartilage and tendon. Now we can use our knowledge of these processes to improve the treatment of injuries to these tissues. Unfortunately, some of the technologies that show great promise in regenerative medicine may also be used for doping purposes. WADA continues to develop new technologies and tests to detect doping, but the list of potential doping compounds and technologies seems beyond our ability to detect it in athletes.
Anti-Doping policies are in place not only to help ensure fairness in competition but also for the health and safety of athletes. Although there have been unscrupulous doctors and scientists involved in numerous doping scandals in recent times, the vast majority of clinical sports medicine and researchers are interested in finding ways to help restore injured athletes back to their pre-injury and not to engage in therapies that give athletes benefits that go beyond what they could achieve through technical and accredited training practices.
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