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Gene Doping

Doping in Torino

I am writing from the Torino Media Centre within the City after having read and heard a lot more about Repoxygen. Over the last few days, there have been a number of journalists getting in touch wanting to find out about this. On Thursday, I interviewed for the Canadian Broadcast Corporation's evening news. I spoke with Tom Harrington, whom I first met in Toronto when Genetically Modified Athletes came out. It's so good to speak to Tom, as he is genuinely interested in the broader philosophical questions that the development in technology provokes. I am also interviewing for CBC's The Hour on Monday, which will take place at the Main Media Centre in Torino. From what I have seen, doping has been high on the news agenda for Torino. There still seems a lot of confusion about whether genetic doping is taking place and there are no confirmed cases. However, there does seem to be a lot of uncertainty about the circumstances here, which is quite different from Athens where nearly no discussions emerged during Games time about whether gene doping might be happening.

From what I have read, there is also less clarity about how best to deal with genetic doping. While WADA and others wish to treat it as just another form of doping, i believe that there is also a philosophical uncertainty about the future of doping and its bearing on humanity. This ambiguity relates to the broader changes within society through technology. In the end, we appear to live within a culture of enhancement and, in this environment, the relevance of prohibiting genetically modified athletes is weakened. All that remains is the medical interest to protect its integrity and the safety of athletes.

If any journalist would like to call me for interview while in Torino, I can be contacted on:

0034 6365 0302

Repoxygen

Last week, a new gene doping story broke just as I was preparing my final grades for the end of semester and desperately trying to finalise details for the the research trip to the Torino Olympics. Repoxygen has been billled as the first case of genetic doping. Naturally, the media has gone crazy trying to understand what this means and sports officials already claim that a test is already under development. Interestingly, the claim about this new method of doping using 'repoxygen' was discovered through heresay:

"The springboard for these dire pronouncements was an email German police found on the computer belonging to former east German coach to Katrin Krabbe, Thomas Springstein, who is on trial at the moment for doping under-age female athletes. The message complained how "difficult it is to get hold of Repoxygen. Please give me new instructions so that I can get hold of the product for Christmas". Michael Butcher, Scotland on Sunday [who, by the way, didnt bother to call me for an opinion!]

I'm off to Turin tomorrow and already have interviews lined up on this subject. On the approach to Athens, scientists were claiming that Beijing might be our first Gene Games, but it seems Turin might have that famous title.

Gene Doping Stockholm Declaration

After a fascinating series of presentations at the Stockholm meeting, we concluded proceednigs with a drafting of a declaration on gene doping. I think of particular interest was the stance taken on the use of genetic tests. This might raise a number of challenges for those who are already using them, though the declration does not forbid the use of such tests.

WADA's Second Gene Doping Symposium

From 4-5 December, the World Anti-Doping Agency hosts its second Gene Doping symposium in Stockholm Sweden. They have already issues a press release for this meeting and, like the NYC meeting in 2002, the proceedings are closed to the media and by invitation only. At the meeting, I will give a reply to Dr Thomas H. Murray, President of The Hastings Center as part of a session on the ethics and policy implications of gene doping for sport.

One of the greatest catalysts for media coverage at the first meeting was Lee Sweeney's statement that he had been contacted by coaches and athletes who wish to enrol in gene therapy trials, in order to boost their performances. For the media and many other interested parties, this made the issue real and present.

It is likely that this meeting will present some advance on whether detection will be possible and I will argue for a re-definition of the ethics of sport based on a couple of recent pieces I have written. The first - published in the journal Public Understanding of Science - will advance a critique on the way in which gene doping has been discussed in society; the second - published in the European Journal of Sport Science - will argue that anti-doping policy should be replaced with a 'performance policy'.

Together, my conclusion will state that a rejection of gene transfer on the basis of current arguments implied and explicit within anti-doping policy is not justified. The two references are as follows:

Miah, A. (2005). "Genetics, cyberspace and bioethics: why not a public engagement with ethics?" Public Understanding of Science 14(4): 409-421.

Miah, A. (2005). "From anti-doping to a 'performance policy': sport technology, being human, and doing ethics." European Journal of Sport Science 5(1): 51-57.

"Genetic Technologies Launches Sports Gene Test in Japan"

The launch of the SportsGeneTest in Japan was announced in the Washington Post in mid-September. Here is a quote from the press release: "GTG director, Professor Deon Venter, himself a former British Ironman Triathlon champion, attended the launch. Professor Venter commented, "Japan represents a significant market for the ACTN3 SportsGene Test(TM), with highly influential sporting and government bodies keen to explore the relationship between genetics and sporting performance. Japan is an extremely technologically-sophisticated country and is now taking a leadership position in the science of optimizing a person's sports potential according to their inherited genetic capabilities."

Gene Doping: Human Genetic Technologies and the Future of Sports

Information about an event: Please join us Oct. 11 for the inaugural talk in our new Genetics Perspectives on Policy Seminars (GenePOPS) series, designed to explore and illuminate some of the critical issues at the intersection of human genetics and public policy. Hosted by the Genetics and Public Policy Center, a partnership between Johns Hopkins University and The Pew Charitable Trusts, GenePOPS will feature some of the nations leading scientists, medical practitioners, policymakers, patient advocates, and ethicists as they discuss issues as wide ranging as genetic privacy, reproductive genetics, gene doping in sports, and safety and efficacy of commercial genetic tests.

Our first program features a panel discussion of the science, ethics, and regulation of genetically enhanced athletic prowess. Are the scientific tools available today to use gene therapy or germline modification to boost athletic performance, and if so, should they be used? Would the procedure be detectable through existing tests?

What kinds of pressures would athletes feel to use gene doping if it were available? Would parents be likely to choose genetic athletic enhancement for their children?

Tuesday, Oct. 11, 2005 Kenney Auditorium, Johns Hopkins University 1740 Massachusetts Ave., N.W. 4:00 p.m., reception to follow

PANEL: Dr. Kathy Hudson, Director, Genetics & Public Policy Center (moderator) Ms. Melissa Dalio Mierke, Exercise Physiologist and USA Triathlon National Champion Dr. Tom Murray, Director, The Hastings Center (Chair, Ethical Issues Review Panel, World Anti-Doping Agency) Dr. Bengt Saltin, Director, Center for Muscle Research, Copenhagen University (Member, Scientific Board, World Anti-Doping Agency) Dr. H. Lee Sweeney, Chair and Professor of Physiology, Department of Physiology, University of Pennsylvania

Contact: Rick Borchelt (202.663.5978); rborche1@jhu.edu ) Audrey Huang (202.663.5979); ahuang18@jhu.edu

Please RSVP to Rick or Audrey at the contact information above.

Gene Doping

Yesterday, I interviewed for The Kojo Nnamdi Show (Washington, USA) on the subject of gene doping. It was one of the more interesting, on-air debates I have had on this subject and we covered a lot of ground. Other guests included: Dr. Gary Wadler, Sports physician, clinical associate professor of medicine at New York University and expert on sports doping

Richard Pound, Chairman, World Anti-Doping Agency

Jose Canseco, Former all-star baseball player and author of the book “Juiced: Wild Times, Rampant 'Roids, Smash Hits, and How Baseball Got Big”

Osagie Obasogie, Project Director on Race, Disability, and Eugenics, Center for Genetics and Society.

It was particularly nice to debate with Gary Wadler and Richard Pound whom I have not met in person. It appeared to me that the gene doping debate is a rich subject for society, in part for the reasons i have argued elsewhere. It does seem to provoke alarm bells which suggest that more is at stake than the usual concerns surrounding doping. Genetic science and technology does not have the same connotations for people as drug use.

This is quite useful from my perspective because it could yield a new kind of debate about doping and even transform the way in which anti-doping takes place.

Is 'Gene Doping' Wrong?

This is the title of an article I recently published with Project Syndicate. Rather than repeat the entire article here, I will just paste links to its various translations: Is 'Gene Doping' Wrong? (English, by Andy Miah)

¿Es inaceptable el “dopaje genético”? (Spanish, Translated by Carlos Manzano)

Что плохого в «генетическом допинге»? (Russian, Translated by Николай Жданович)

Faut-il condamner le dopage génétique ? (French, Translated by Bérengère Viennot)

Ist „Gendoping“ verwerflich? (German, Translated by Anke Püttmann)

Je „genetický doping“ nesprávný? (Czech, Translated by Jiří Kobělka)

“基因兴奋剂”错了吗? (Chinese, Translated by 许彬彬)

هل "تنشيط الجينات" خطأ؟ (Arabic, Translated by Ibrahim M. Ali

SportsGeneTest.com and ACTN3

I have just returned from Belgrade, where I presented a paper in an invited symposium at the 10th European College of Sport Science meeting. The title of the paper was 'Ban Drugs, Permit Gene Transfer'. Upon my return, I was updating the GMathletes website and discovered the SportsGeneTest website. To my knowledge, this is the first site to indicate commercial tests for athletic performance. I noticed they have a policy statement, but it is only in German. If anyone can read German, perhaps you would tell me if it is an interesting statement or not!

More information is available through the Australian site 'Genetic Technologies'. In fact, at this page, the 'ethical tell' is a little clearer from their advice for coaches. I quote:

"It is important to note:

  • this test is primarily aimed at elite athletes, serious competitors and teenagers already involved in sport and considering the next steps in terms of professional sports development;
  • this test provides a complementary insight into a person's natural sport gearing and should only be considered as one aspect of a range of elements that go into being a champion, such as determination and the desire to win, enjoyment of the sport, coaching, nutrition, ability and level of fitness;
  • the test may only be beneficial for those children already involved in and enjoying their sport who desire some direction as to their optimum sport or event if considering sport as a career or serious hobby;
  • Genetic Technologies does not recommend or condone using the results of this test to pressure children into any sport or event. Children should only participate in sports that they enjoy for the purpose of fun and exercise."

So, it would seem they are concerned about:

1. These tests being used too early in a competitors life. Perhaps parents might wish to try them on their kids first, as a means of deciding whether it is worthwhile for them to play sport. 2. Genetic determinism - coaches/parents might conclude that the test result is the dominant predictor of performance capacity. 3. Tests might be imposed upon (young) athletes - though notably, they do not demonstrate a concern for adults being tested.

Well, I cover some of these issues in GMA, so perhaps no need to go over old ground. Still, genetic testing has yet to really hit home in the world of sport. It seems to be seen as merely an extension of talent identification, though I am not convinced that the principles are the same.

More on Genetic Tests for Performance

A few months ago, I posted on the use of genetic tests in the AFL. Since my very first talk about genomics and sport in 1999 at the First International Conference on Human Rights and Sport, I have been arguing on this subject. In 2003, the Australian Law Reforms Commission wrote about the potential for discrimination arising from genetic tests in sport. This issue has arisen again in the context of the Australian Football League. Reports indicate that Port Adelaide and Essendon are considering the use of genetic tests to 'predict' the capacity of 'natural physical attributes'. The Age (Sydney) reported that each test would cost around AU$750 and AFL Players' Association president, Brendon Gale, has argued that such tests would be contrary to privacy laws in Australia. This issues seems about to, ahem, 'kick off' in Australia and few other countries have yet to really think it through.

Certainly, employment law might be a reasonable avenue for action within the UK, though where this takes place with young athletes, it seems likely to fall within the realm of parental consent.

Some of this relates to a piece I published a few years ago on this subject:

Miah, A. (2001) Genetics, Law & Athletes' Rights, Sports Law Bulletin 4(5), pp.10-12 Available here: http://www.media.paisley.ac.uk/andymiah/Miah2001GeneTest.pdf

Marathon Mice and PPARd

Press release from The Salk Institute. It is intriguing that any connection is made between this work and athletic performance. Clearly, the scientist's work is aimed at medical intervention and yet the prospects for athletes are implied through the communication. It is a further indication of how the application of pharmaceuticals to sports is sexy enough to spice up scientific research, but that most scientists are not really alarmed by how their work might be used for non-therapeutic purposes. Equally, perhaps Dr Evans is working with WADA to ensure they have tests for any future product that might arrive on the market. While I don't think that this would be enough to deal with the use of dangerous substances in sport, it would be an important development. Altering steroid receptor genes creates fat burning muscles, resistance to weight gain, and lowered inflammation.

April 04, 2005 La Jalla, CA — The Salk Institute scientist who earlier discovered that enhancing the function of a single protein produced a mouse with an innate resistance to weight gain and the ability to run a mile without stopping, has found new evidence that this protein and a related protein play central roles in the body's complex journey to obesity and offer a new and specific metabolic approach to the treatment of obesity related disease such as Syndrome X (insulin resistance, hyperlipidemia and atherosclerosis).

Dr. Ronald M. Evans, a Howard Hughes Medical Investigator at Salk Institute's Gene Expression Laboratory, presented two new studies Monday, April 4, at Experimental Biology 2005 in the scientific sessions of the American Society for Biochemistry and Molecular Biology.

The studies focus on genes for two of the nuclear hormone receptors that control broad aspects of body physiology, including serving as molecular sensors for numerous fat soluble hormones, Vitamins A and D, and dietary lipids.

The first study focuses on the gene for PPARd, a master regulator that controls the ability of cells to burn fat. When the "delta switch" is turned on in adipose tissue, local metabolism is activated resulting in increased calorie burning. Increasing PPARd activity in muscle produces the "marathon mouse," characterized by super-ability for long distance running.

Marathon mice contain altered muscle composition, which doubles its physical endurance, enabling it to run an hour longer than a normal mouse. Marathon mice contain increased levels of slow twitch (type I) muscle fiber, which confers innate resistance to weight gain, even in the absence of exercise.

Additional work to be reported at Experimental Biology looks at another characteristic of PPARd: its role as a major regulator of inflammation. Coronary artery lesions or atherosclerosis are thought to be sites of inflammation.

Dr. Evans found that activation of PPARd suppresses the inflammatory response in the artery, dramatically slowing down lesion progression. Combining the results of this new study with the original "marathon mouse" findings suggests that PPARd drugs could be effective in controlling atherosclerosis by limiting inflammation and at the same time promoting improved physical performance.

Dr. Evans says he is very excited about the therapeutic possibilities related to activation of the PPARd gene. He believes athletes, especially marathon runners, naturally change their muscle fibers in the same way as seen in the genetically engineered mice, increasing levels of fat-burning muscle fibers and thus building a type of metabolic 'shield" that keeps them from gaining weight even when they are not exercising.

But athletes do it through long periods of intensive training, an approach unavailable to patients whose weight or medical problems prevent them from exercise. Dr. Evans believes activating the PPARd pathway with drugs (one such experimental drug already is in development to treat people with lipid metabolism) or genetic engineering would help enhance muscle strength, combat obesity, and protect against diabetes in these patients.

Link to site

WADA's Play True - Gene Doping

The first 2005 issue of WADA's magazine 'Play True' is all about Gene Doping. WADA President Richard Pound leads the publication, identifying that 'gene therapy represents an exciting and promising step forward in medical research, but its use to enhnace athletic ability is as wrong as any type of traditional doping'. It is not the first time that the magazine has discussed gene doping, but the profile in this issue is significant. WADA have set-up a gene doping panel, which includes H. Lee Sweeney, Olivier Rabin (WADA Science Director) and Theodore Freidmann, among others.

Pound emphasises the need for regulatory frameworks in gene transfer technology and Thomas H. Murray (The Hastings Center and WADA Ethics and Education) provides an ethical analysis of the issue.

On Detection: The issue includes a couple of main points about detection. It first identifies that many athletes have a 'false sense of security about wheher gene doping can be detected'. It goes on to state that 'It might be difficult to see that a particular gene has been added to the body, but there will be consequences to that addition that can be seen and measured'. They conclude 'Bottom line? Detection is possible and probable', but there are no tests yet.

Superhumans, mutants and monsters

Superhumans, Mutants and Monsters: Gene Doping, Bioethics and the Posthuman GameUniversity of Toronto, Canada.

I just got back from UoT, where i gave a presentation on this topic. I wanted to talk a bit about how posthumanism is evolving as a body of literature and how it relates to competing ideas on transhumanism and cyborgology.

It always suprises me (pleasantly) at how different people approach this subject. The cover of GMA has written the content for many of my talks on this subject. This week conversations got into the subject of 'feline' modifications and the possible colonial interpretations of enhancement. For example, could we think about the discourse of posthumanism as similar to how people of certain races might have been characterised as savage or other. Alternatively, does the morphed human with cheetah tell us anything about the gendered nature of enhancement? What kind of animal would we like to look more like and what does thi reveal about our values and assumptions about beauty?

Interesting lines i think. If you would like to view the presentation click here (microsoft powerpoint needed, best on Mac OSX and office 2004)

Genetic tests for Rugby team

Dennis, C. (2005). "Rugby team converts to give gene tests a try." Nature 34: 260. Carina Dennis writes in Nature about an Australian rugby league team which aims to use genetic tests to stream-line training methods. The article quotes someone from the Australian Law Reforms Commission, whose report 'Essentially Yours' deals with this subject at some length. Australia seems to be taking a leading role in thinking through these issues. Ron Trent's work at the University of Sydney is central to this research and he claims that we still do not know enough about genes for this purpose. Issues of privacy and discrimination are central to this topic. Will genetically risky athletes be prevented from participation? Will young children who dont fit the profile be excluded? Will sports authorities have the legal power to demand genetic info from athletes?

HFL to lead gene doping research

Quote from UK Sport link "The World Anti-Doping Agency (WADA) has announced a major research award of $400,000 (£212,000) to HFL – one of the UK’s WADA-accredited laboratories. The funding will support a three-year programme managed by HFL which aims to develop suitable detection methods for gene doping.

WADA defines gene doping as "the non-therapeutic use of genes, genetic elements and/or cells that have the capacity to enhance athletic performance". The practice is banned under the WADA list of prohibited substances or methods, although there is currently no way in which it can be detected.

With the support of WADA funding, HFL will manage a consortium of scientific experts on gene doping from Nottingham Trent University and the Royal Free Hospital in London. "As soon as new technology becomes available, it is subject to abuse by those who have no interest in fair competition," said David Hall, Chief Executive Officer of HFL. "This funding will help us to develop methods of detecting gene manipulation."

The potential threat of gene doping has been long recognised by WADA, which has devoted a significant share of its research funds finding a solution to the problem. This concentrated effort is back by John Scott, Director of Drug-Free Sport at UK Sport. "Gene therapy is a major medical breakthrough which could transform the lives of many people who suffer from muscle wasting diseases," he said. "However, it is also a dream come true for an athlete wishing to cheat, particularly while it remains undetectable.

"The development of such a detection method is key in protecting the integrity of sport, and it is testimony to the expertise at our disposal that British scientists are at the forefront on this research."

In addition, HFL has been awarded up to £800,000 by the Horserace Betting Levy Board (HBLB) to investigate gene doping specifically for the horseracing industry"

It is great that the UK is moving on this. I met Ian Gibson MP in July 2004 to discuss the state of anti-doping in the UK. He agreed that this issue needs to be placed on the political agenda. This is one indication that some wheels are turning but where's the ethical framework for the strategy? Detect-test is only part of the system.

Gene Doping Public Forum (USA)

This week, Portland State University hosted a public forum on gene doping. To my knowledge, this is the first 'public engagement' event on this subject. It was titled: Super Athletes: A Public Dialogue about Genetic Enhancement and Sports.

Of particular concern seems to be clarification about the scientific basis of gene doping - what is really possible? To me, this is only one element of what public dialogue should entail. I have recently argued for a 'Public Engagement with Ethics' particularly in the context of science.

I am doubtful that public debates can really function in any satisfactory way without first consideration what are the salient aspects of public debate. While discussion abuot the technical aspects of science certainly can help to allay unsubstantiated fears about technology, it does not necessarily offer an empowering platform for the public to articulate their moral concerns.

Gene Doping May Not Elude Testing

Quoting from WebMD: "In a letter published in the August issue of Molecular Therapy, French researchers say they found good reason to believe gene doping may be detectable.

In their study, monkeys were genetically doped with erythropoieten (EPO), a hormone that stimulates red blood cell formation and is often used to increase endurance in sports. Treatment with the hormone currently requires repeated injections and is detectable by antidoping urine tests.

But in this case, the EPO gene was injected directly into the monkey's muscle tissue. Researchers say muscle is a likely target for gene dopers, because it's easily accessible and plentiful.

Contrary to what had been predicted, the results of the experiment showed that the EPO protein produced by the genetically doped monkeys was different than the EPO protein produced naturally by nonenhanced animals and the injected gene produced was detectable by DNA screening. They say further tests are needed to determine if EPO gene doping would be detectable in urine tests.

"Although other methods of gene transfer exist and may be exploited for gene doping, and such methods are yet to be investigated, our results provide encouraging evidence that doping by gene transfer will likely not go undetected at least when skeletal muscle is the target," write researcher Françoise Lasne of thetNational Anti-Doping Laboratory in Chatenay-Malabry, France, and colleagues."

SOURCES: Lasne, F. Molecular Therapy, August 2004; vol 10. News release, American Society of Gene Therapy.

Netherlands and GMathletes

Today, the Netherlands Centre for Doping Affairs and the World Anti-Doping Agency hosted a symposium about gene doping. the intention of this meeting was to develop collaboration with scientists, with a view to finding ways of understanding what might next be used by athletes. WADA Science Director Dr Oliver Rabin was attending and I certainly can't imagine a more helpful scientist to be leading the policy on this matter. He is open to recognising the limitations of WADA as a social institution and interested to develop a wide-ranging debate on the value of enhancement in sport.

Gene technology in elite sports, Sweden

International Conference on Gene Technology in Elite Sports,22/23 May, 2003 University of Sports at Stockholm,

The Department of Philosophy at the University of Gothenburg organises an international conference on gene technology in Elite Sports, in collaboration with the University of Sports at Stockholm, and the Center for Sport Studies in Gothenburg. The conference is supported by the Swedish Council of Medicine, section for Medicine.

The following persons have already confirmed their participation: Ruth Chadwick, Julian Savulescu, Torbjörn Tännsjö, Christian Munthe, Sigmund Loland (Norwegian University of Sports), Arne Ljungqvist (Wada and IOC), Bengt Saltin, Lincoln Alison.

For information about the conference, please contact Claudio Tamburrini