Tuesday, 1 April 2014

The doping crystal ball: A sporting performance future.

Not too long ago I was having a conversation with someone while we were doing some weightlifting. I was snatching that day and somehow we had come to the topic of drugs in sport. The person I was lifting with is an ironman and in the past I have worked with him to improve his nutrition and overall performance. As you may be aware performance enhancing substances are often linked with weightlifting and also since the outing of Lance (you know who I am talking about) the public is becoming aware of drugs in endurance based events. To be frank I don`t know of many sports where someone hasn`t tried something to get an advantage, golfers have had laser procedures to improve vision after all. During this conversation I told this person about the possible future of performance enhancement in sports and he seemed shocked. I told him I thought the future in performance enhancement is gene doping and about what potential things gene therapy could do. I thought it was worth sharing this information with all of you as well.

So first off what is gene doping? Gene doping is defined by the World Anti-Doping Agency as "the non-therapeutic use of cells, genes, genetic elements, or of the modulation of gene expression, having the capacity to improve athletic performance". Seems simple right? We also have to ask ourselves is it ethical and is it safe. I`ll leave these questions up to you to answer for yourself. 

So how do we detect and stop gene doping? Well I want to be clear about this the World Anti Doping Agency (WADA) and other agencies are trying to get ahead of the game here. It is well known that they had to play catch up with steroids and some other performance enhancing substances. Often I have heard through the sport grapevine that detecting for substances is done via changes in blood and urine and even now some drugs are hard to detect with current methods. Gene doping is introduced differently than these other enhancing methods.  Gene doping can be done in a number of ways these include direct injection of DNA into the muscle, insertion of genetically modified cells or utilising a virus to introduce the information. Right now you may be thinking that it sounds really far out. Gene therapy was created to help those with life threatening disease and I believe the future of medicine lies in stems cells and gene therapy. The problem exists for sporting agencies because these genes are from our genetic codes. In other words the changes that would appear seem like natural mutations in the body. For testing to be successful agencies will have to take a long term approach. Reference values may have to be established from the time an athlete starts competing. The reference values would have to take a far more comprehensive range of values and see if overall homeostasis is disturbed or altered in some shape or form.  That would include even lower levels of competition to track changes over time. This type of testing would also require tissue samples to test DNA which may have to be site specific.

It has been outlined in a basic fashion what gene doping is and how it can be administered, but how could it actually be used? Well gene doping started out in medicine to help save lives. The doping method is the same in both instances with only the outcome being different. The difference being that therapy is used for those that are very sick e.g. someone with severe anaemia requires more haemoglobin or red blood cells (RBC`s) to get oxygen around the body. In comparison a healthy athlete doesn`t require further RBC so when they dope they gain benefits which equates to an advantage i.e. getting extra capacity to carry more oxygen to muscles. There are drugs already in existence that can do something similar but they can easily be detected through testing. Another case that was brought to my attention was those born without the myostatin gene or receptors. Myostatin helps to regulate muscle growth. This happens in a number of species including humans resulting in large and powerful muscles. This is a natural mutation but since gene therapy came along for muscular dystrophy, people have turned their attention to using this for improving sporting performance.  Gene doping has even been hypothesised to be used in concert with these other changes to increase endorphins of the doping athlete to further the effects of the enhanced “abilities”.

Sounds great doesn`t it? How great would it be too be able to run all day and then lift a car and look like the Hulk. Well I want you to think about this saying  “there is no such thing as a free biological lunch” (I am not sure who said that version and if you do please tell me). Those that dope already have to weigh up the risk reward equation. Those that want to increase erythropoietin may be faced with thickening blood that may clot leading to a number of adverse outcomes. It may even come to a point that the heart may stop due to excess load. Athletes don`t seem to stop and think “what are some bigger muscle going to do to me?” There are repercussions for all doping, connective tissues such as tendons and ligaments face extra strain which may lead to sprains, strains and tearing of tendon insertions from the bone. There is also an increased metabolic cost the body having so much muscle.  These are by no means an extensive list but provide food for thought. The ultimate risk is not knowing what could happen to the rest of the body. Will those new genes affect other genes leading to a more complex adverse outcome? No one really knows the long term effects because all of this is relatively new. To me it seems crazy to even think of doing anything like this but in saying that I have always been against drugs in sport. 

So what does the future look like? Will there be hulking twelve year olds breaking weightlifting records or humans making ultra-marathons look like a walk on the beach? I can`t say. What I can say is the future is here and now. I am sure this is not the last of the discussion on gene doping and this will begin to be seen more in the public eye. Who knows maybe the future of sports will be dominated by the genetically doped and manufactured battling it out for our attention and money.  What do you think the future will look like? Post comments.

                     Filipp, F. (2007). Is science killing sport? Gene therapy and its possible abuse in doping.                                             NEMBO reports, 8(5), 433.

             Scherling, P. (2001, November). Gene doping, ISM. In UCL Conference on Genes in     Sport.

          Unal, M., & Unal, D. O. (2004). Gene doping in sports. Sports Medicine, 34(6), 357-362.

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