Keeping Pace with ACE: Are ACE Inhibitors and Angiotensin II Type 1 Receptor Antagonists Potential Doping Agents? (2008, Dec 1)

Version:1.0 StartHTML:0000000149 EndHTML:0000000489 StartFragment:0000000199 EndFragment:0000000455 StartSelection:0000000199 EndSelection:0000000455 Keeping Pace with ACE: Are ACE Inhibitors and Angiotensin II Type 1 Receptor Antagonists Potential Doping Agents? Keeping Pace with ACE: Are ACE Inhibitors and Angi...[Sports Med. 2008] - PubMed Result <http://www.ncbi.nlm.nih.gov/pubmed/19026021?dopt=Abstract> Sports Med. 2008;38(12):1065-79. doi: 10.2165/00007256-200838120-00008. Related Articles <http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&DbFrom=pubmed&Cmd=Link&LinkName=pubmed_pubmed&LinkReadableName=Related%20Articles&IdsFromResult=19026021&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract> , Links

Keeping Pace with ACE: Are ACE Inhibitors and Angiotensin II Type 1 Receptor Antagonists Potential Doping Agents? Wang P <http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Wang%20P%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract> , Fedoruk MN <http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Fedoruk%20MN%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract> , Rupert JL <http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=Search&Term=%22Rupert%20JL%22%5BAuthor%5D&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVAbstract> .

School of Human Kinetics, University of British Columbia, Vancouver, British Columbia, Canada.

In the decade since the angiotensin-converting enzyme (ACE) gene was first proposed to be a 'human gene for physical performance', there have been numerous studies examining the effects of ACE genotype on physical performance phenotypes such as aerobic capacity, muscle function, trainability, and athletic status. While the results are variable and sometimes inconsistent, and corroborating phenotypic data limited, carriers of the ACE 'insertion' allele (the presence of an alu repeat element in intron 16 of the gene) have been reported to have higher maximum oxygen uptake (V (2max)), greater response to training, and increased muscle efficiency when compared with individuals carrying the 'deletion' allele (absence of the alu repeat). Furthermore, the insertion allele has been reported to be over-represented in elite athletes from a variety of populations representing a number of endurance sports. The mechanism by which the ACE insertion genotype could potentiate physical performance is unknown. The presence of the ACE insertion allele has been associated with lower ACE activity (ACE(plasma)) in number of studies, suggesting that individuals with an innate tendency to have lower ACE levels respond better to training and are at an advantage in endurance sporting events. This could be due to lower levels of angiotensin II (the vasoconstrictor converted to active form by ACE), higher levels of bradykinin (a vasodilator degraded by ACE) or some combination of the two phenotypes. Observations that individuals carrying the ACE insertion allele (and presumably lower ACE(plasma)) have an enhanced response to training or are over-represented amongst elite athletes raises the intriguing question: would individuals with artificially lowered ACE(plasma) have similar training or performance potential? As there are a number of drugs (i.e. ACE inhibitors and angiotensin II type 1 receptor antagonists [angiotensin receptor blockers - ARBs]) that have the ability to either reduce ACE(plasma) activity or block the action of angiotensin II, the question is relevant to the study of ergogenic agents and to the efforts to rid sports of 'doping'. This article discusses the possibility that ACE inhibitors and ARBs, by virtue of their effects on ACE or angiotensin II function, respectively, have performance-enhancing capabilities; it also reviews the data on the effects of these medications on V (2max), muscle composition and endurance capacity in patient and non-patient populations. We conclude that, while the direct evidence supporting the hypothesis that ACE-related medications are potential doping agents is not compelling, there are insufficient data on young, athletic populations to exclude the possibility, and there is ample, albeit indirect, support from genetic studies to suggest that they should be. Unfortunately, given the history of drug experimentation in athletes and the rapid appropriation of therapeutic agents into the doping arsenal, this indirect evidence, coupled with the availability of ACE-inhibiting and ACE-receptor blocking medications may be sufficiently tempting to unscrupulous competitors looking for a shortcut to the finish line.

Gene doping - the battleground (2008, Nov 15)

I interviewed for Simon, got him to Florence for the gene doping meet, gave him a copy of my book and he didnt even bother to quote me. Bad form Simon! Gene doping - the battleground Telegraph Sport take a look at the front-line of drug-enhanced sport.

By Simon Hart Last Updated: 5:47PM GMT 15 Nov 2008 Myostatin What is it? A protein that inhibits muscle growth in animals and humans. How can it benefit athletes? If the gene responsible for myostatin is switched off, muscles will increase in size. Does gene modification work? Successful in trials on mice and dogs and set to go into commercial use as a veterinary treatment next year. Untested on humans but known to produce an immune reaction, so risky. Can it be detected? No, but researchers hope to find ways of testing for the virus used to deliver the gene. IGF-1 What is it? Insulin-like growth factor 1, a natural protein that promotes muscle- growth and repair but declines with age. How can it benefit athletes? Over-production of IGF-1 will cause an increase in muscle mass and strength. Does gene modification work? Successful in animal trials but human application still being tested. Has to be injected locally into muscle because high levels in the bloodstream cause problems with other tissues. Can it be detected? Not without a muscle biopsy. EPO What is it? A naturally occurring protein that produces red blood cells. How can it benefit athletes? A richer supply of oxygen-carrying blood cells reduces fatigue in muscles, which makes EPO so beloved of endurance athletes such as road cyclists and cross-country skiers. Does gene modification work? Offers prospect of permanent source of extra EPO rather than short-term burst. Trials on monkeys have had mixed results, with some producing dangerously high amounts of EPO and others developing immune responses. Very risky for humans at present. Can it be detected? Preliminary research suggests it will be detectable to drug-testers. What if... ...genetically modified animals were allowed into sport? By Andrew Baker · Lewis Hamilton dedicates second world motor racing title to the artificially enhanced hamsters who turn the wheels of his McLaren. “I’d have been nowhere without Nibbles, Whiflet, Coco and Mr Muscles,” the driver acknowledges. · Ranks of matadors decimated by giant, four-horned bulls. · Scientifically improved chimpanzee wins Tour de France. “The team pay me peanuts,” the muscular ape tells reporters on the Champs Elysees.’’What could be better?” · Air-breathing octopus with eight rackets wins Wimbledon singles title.Defeated finalist Andy Murray vows to clone himself and enter next year’s men’s doubles. · Greyhound Derby won by Tiny, a powerful Chihuahua who runs between his opponents’ legs. · Dee Caffari towed to victory in Vendee Globe round-the-world yacht race by killer whale fitted with genetic SatNav. “To be honest, I read my book most of the way”, the skipper confesses.

Drug cheats may benefit from animal test Lee Sweeney, professor of physiology at the University of Pennsylvania, is a popular man in the world of sport.

By Simon Hart Last Updated: 5:48PM GMT 15 Nov 2008 He gets between five and 10 emails a week from athletes, some from Britain, and so many phone calls that his secretary has stopped putting them through. And that is in a quiet week. If he publishes an academic paper or does a media interview, a flurry of 50 or more calls and emails usually follows, as it did 10 years ago when he first revealed his 'mighty mice' to the world at a meeting of the American Society for Cell Biology – laboratory mice with enormous muscles that retained their strength and regenerative ability even when the animals reached old age. Sweeney's super-strong rodents were the product of his pioneering research into gene transfer technology and the implications were clearly not lost on the athletes and coaches who got in touch, one of whom offered $100,000 for what the mice were getting. Shockingly, Sweeney also received a request from a high school American football coach for his entire team to be genetically modified. Sweeney told him what he is still telling everyone a decade later, that bulking up on gene therapy is not yet safe enough for humans and would require heavy-duty immune suppression. He always gets the same response. "Even if I explain to them that to make it work might require all sorts of heroic measures, they basically say, 'Fine. I'll do it'. And if it's a matter of money, they'll get the money." Sweeney has never been contacted by a name he recognises – "I don't get Barry Bonds calling me up" – and says most of the would-be guinea pigs appear to be young athletes trying to make the big time. "Some of them are from Europe," he says. "I get quite a few from the UK and Germany." He says he would feel uneasy about passing on their names to the anti-doping authorities but is sufficiently concerned to have accepted a seat on the gene-doping panel of the World Anti-Doping Agency (Wada), who are funding eight research projects on gene-doping detection in a desperate attempt to stay ahead of the cheats. Sweeney is bracing himself for another surge of calls and emails next year when his work moves from the laboratory to the commercial world with a muscle-building gene therapy for dogs. It will be available not only for dogs with muscular diseases but dogs that are just old and immobile who, after an injection in their liver, could soon be running around like puppies again. "We are now in the final stages of getting all the approvals to offer this through the veterinary hospital as a treatment to try to improve strength in pet dogs," he says. "As the dogs get weak their owners get upset that they can't walk around any more. So we're hoping that within the next year we will begin the era of genetic enhancement in dogs." Sweeney hopes his new canine anti-aging treatment will be just the start. Humans have the same gene that Sweeney is manipulating in dogs and the next step will be to treat people with serious genetic diseases such as muscular dystrophy. Ultimately, he hopes to give the elderly, like the pampered pooches of Pennsylvania, greater muscle strength and mobility in their final years. But any breakthrough will inevitably be seized upon by dope cheats in the same way that clinical drugs such as steroids, human growth hormone and the red blood cell-boosting EPO soon found their way into kit bags. With the prospect of as yet undetectable, lifelong enhancement, how could any drug cheat resist? As gene transfer technology enters the medical mainstream as a treatment for numerous diseases from blindness to cancer, scientists are agreed it is only a matter of time before it crosses over into sport. Some predict that London 2012 could be the first genetically modified Olympic Games. Others say the Beijing Games may already have that dubious honour. "We do not have any proof that gene doping has been practised yet but we have had signs that people are interested and they are looking at it," says Arne Ljungqvist, chairman of the International Olympic Committee's medical commission. Evidence that sport is closing in on the science came two years ago when German police discovered an email sent by Thomas Springstein, the disgraced former coach of sprinter Katrin Krabbe, complaining about how difficult it was to get hold of Repoxygen, a sophisticated agent for delivering EPO by means of gene transfer. Springstein was later convicted of giving doping substances to children. Cyclists are also beating at the door. A French gene expert, Professor Philippe Moullier, had his eyes opened when a couple of former Tour de France cyclists paid a visit to his laboratory in Nantes, where he is experimenting on EPO genes in monkeys as a treatment for anaemia. The pair were working for an anti-doping organisation – or at least that is what they told Moullier – and said they wanted to learn about his research. "The thing that really surprised me was that when I told them it was just the start of the technology, they told me that the riders would not care," says Moullier. "They would go for it if they had a chance to be undetectable. "They said there were kids in the Tour de France who would do anything just to have the most advanced technology. It's a concern because there are still severe adverse side-effects. We are taking such care before it comes to patients so we are scared to see guys who are ready to use it. It's terrible." If the risks are no deterrent, cheats still have to overcome the complexity of gene modification, though if the BALCO conspirators were able to find a biochemist capable of altering a molecule and synthesising a new designer steroid, engaging the services of gene expert should not be beyond the wit and wealth of an athlete determined enough to cheat. "I think the real threat is from scientists and clinicians who decide they want to make money off the athletes to make this available," says Sweeney. "There are people in India and China who will do stem cell transplantation in anyone who'll pay them. There is no evidence anything they are doing has any effect on the patients but they'll do it for money. At some point someone will say, 'I'll do immune suppression if you want me to and I'll put in any gene you want'." Sweeney admits that day could not be far away. "The bottom line is that we're going to be able to do genetic enhancement for serious diseases," he says. "It's not beyond the realm of possibility that over the next few years, if someone has sufficient help and sufficient motivation, it could be done outside that arena."

Elderly dogs to be offered genetic enhancement to make them young again Frail elderly dogs could be injected with genes which allow them to run around like puppies, with technology which could be approved by next year.

Simon Hart and Laura Donnelly Last Updated: 12:09AM GMT 16 Nov 2008 An American professor is preparing to market a form of canine gene therapy, which would see dogs injected with substances which switch off the genes that regulate their muscle growth. Prof Lee Sweeney, from the University of Pennsylvania, has pioneered research into gene transfer technology, a field in which poorly functioning and abnormal genes are manipulated, switched off or replaced. Ten years ago he created "mighty mice" in the lab with enormous muscles and strength in old age. Now he says experiments on dogs have been so successful that he is preparing to market the treatments to owners of ageing pets across the United States. He said: "We are now in the final stages of getting all the approvals to offer this through the veterinary hospital as a treatment to try to improve strength in pet dogs. "As the dogs get weak their owners get upset that they can't walk around any more. So we're hoping that within the next year we will begin the era of genetic enhancement in dogs." Under the therapy, dogs would be given an injection into the liver of an inhibitor which switches off the gene which produces myostatin, a protein which inhibits muscle growth in animals and humans. The treatment has passed laboratory trials, but regulatory authorities are now discussing whether the dogs would have to be held in quarantine after treatment, because of possible risks if humans came into contact with their waste after the procedure, Prof Sweeney said. Scientists hope the same technology could be used in humans, to treat serious genetic diseases such as muscular dystrophy. Human trials of gene therapy have faced difficulties due to the risks of introducing new genes into cells or unintentionally interfering with genes other than those being targeted, which can include inducing cancers. In some cases the immune system may also have to be suppressed, which can also have increase the risk of infection and other diseases. Despite the dangers attached to the use of genetic transfer in humans, the professor of physiology is regularly contacted by athletes desperate to use the technology to enhance their performance. Gene doping is one of the greatest fears of sports regulators, because injections of genes directly into muscle would be almost impossible to detect. Prof Sweeney says every week he refuses approaches from athletes who will do anything to get their hands on genetic material, including one from a high-school football coach who wanted his entire team to be genetically modified. He tells them that bulking up on gene therapy is not yet safe enough for humans, and would require heavy-duty immune suppression, even if it were legal. Prof Sweeney said he always gets the same response: "Even if I explain to them that to make it work might require all sorts of heroic measures, they basically say 'Fine, I'll do it'.

Enhanced Olympians

How "Gene Doping" Could Create Enhanced OlympiansRick Lovett for National Geographic News August 14, 2008 Although China has aggressively tested athletes at the Beijing Olympics for performance-enhancing drugs, no case of so-called gene doping has yet been detected.

But experts say Oympic athletes may soon be able to genetically enhance their muscles to be faster, stronger, and better able to recover after workouts—if they aren't already.

Gene doping uses techniques similar to gene therapies developed to treat muscle-wasting diseases, such as muscular dystrophy.

Injected into an athlete, a harmless virus could carry a performance-enhancing gene and splice it into a muscle cell, said Theodore Friedmann, a gene therapy researcher at the University of California, San Diego (quick genetics overview ).

A synthetic virus called Repoxygen, for example, has been used this way in animal tests to insert a gene for erythropoietin (EPO), a hormone that tells the body to make more red blood cells, which carry oxygen to muscles.

EPO is important in the treatment of anemia, and it's also a favorite doping agent for cyclists, runners, and cross-country skiers.

Athletes are well aware of Repoxygen's potential: A German coach was accused of trying to obtain it before the 2006 Winter Olympics.

Gene-doping may also work by modifying genes that are already in an athlete's cells but whose functioning he or she might want to control.

It's not a new concept. Many ordinary drugs can have this effect, as can daily activities.

"Training and athletic workouts probably do their work at least partly by modifying the expression of genes," Friedmann said.

Cheating Delayed?

A few years ago it was believed that wholesale gene doping was just around the corner. But clinical trials of legitimate gene-therapy methods have run into hitches.

"There have been deaths," Friedmann said.

And an otherwise successful attempt to cure severe combined immunodeficiency disorder—the so-called bubble-baby syndrome—was halted when some of the children developed leukemia.

Also the gene-therapy viruses that might lend themselves to cheating don't work as easily as had been hoped.

The problem is that the human immune system tries to fight them off, said H. Lee Sweeney, a physiology professor at the University of Pennsylvania.

"That's caused most of the trials to stop," Sweeney said.

In future tests patients may have to be hospitalized during treatment, with their immune systems suppressed.

"I'm not sure an athlete is going to be willing to be put in the hospital for six weeks right in the middle of their training," Sweeney said.

"Naked" DNA

Less ambitious forms of gene doping may be right around the corner, though.

Dispensing with the troublesome virus-based delivery system, this type of doping would inject "naked" DNA directly into a muscle.

Nearby cells would take up some of the DNA, and if that DNA controls an important hormone, like EPO or human growth hormone (HGH), it might be enough to do the job.

It's not so different from injecting EPO or HGH directly, but it would save money, because it would only have to be done once.

"You could probably get a molecular-biology major to make it for you for a couple hundred dollars," Sweeney said.

Testing for this type of doping would be easy, though, since the athlete's body would still carry too much of the hormone.

Testing for full-blown gene doping will be more difficult. Just be safe, the International Olympic Committee is hanging on to Olympians' genetic samples for eight years, in case testing methods catch up with currently indetectable doping methods.

For its part, the World Anti-Doping Authority is working on a test to determine the expression of all 25,000 of the human body's genes, looking for abnormal patterns, said the University of California's Friedmann, who chairs the agency's genetics panel.

But sports authorities may eventually have to accept gene doping as a fact of life, scientists say.

The same techniques that could create superathletes will likely also help ordinary people stay fitter and healthier.

"I think [gene therapy] will change the way we all live and how health care treats the average person," the University of Pennsylvania's Sweeney said.

"You can't legislate it out of sport, because you'd be depriving people of a standard of care."

Finding the golden genes (2008, Aug 13)

Finding the golden genesBy Patrick Barry Web edition : Wednesday, August 13th, 2008

Advances in gene therapy could tempt some athletes to enhance their genetic makeup, leading some researchers to work on detection methods just in case. Click here to see an animation of how one gene therapy can enhance endurance. This month — 8/8/08, to be precise — the curtain rose on what many experts believe could prove to be the first genetically modified Olympics. For the unscrupulous or overdriven Olympic athlete, the banned practice of “doping” by taking hormones or other drugs to enhance athletic prowess may seem so last century. The next thing in doping is more profound and more dangerous. It’s called gene doping: permanently inserting strength- or endurance-boosting genes into DNA. “Once you put that gene in, it’s there for the rest of that person’s life,” says Larry Bowers, a clinical chemist at the U.S. Anti-Doping Agency in Colorado Springs, Colo. “You can’t go back and fish it out.” Scientists developed the technology behind gene doping as a promising way to treat genetic diseases such as sickle-cell anemia and the “bubble boy” immune deficiency syndrome. This experimental medical technology — called gene therapy — has begun to emerge from the pall of early failures and fatalities in clinical trials. As gene therapy begins to enjoy some preliminary successes, scientists at the World Anti-Doping Agency, which oversees drug testing for the Olympics, have started to worry that dopers might now see abuse of gene therapy in sport as a viable option, though the practice was banned by WADA in 2003. “Gene therapy has now broken out from what seemed to be too little progress and has now shown real therapies for a couple diseases, and more coming,” says Theodore Friedmann, a gene therapy expert at the University of California, San Diego and chairman of WADA’s panel on gene doping. While gene therapy research has begun making great strides, the science of detecting illicit use of gene therapy in sport is only now finding its legs. To confront the perceived inevitability of gene doping, Friedmann and other scientists have started in recent years to explore the problem of detecting whether an athlete has inserted a foreign gene — an extra copy that may be indistinguishable from the natural genes — into his or her DNA. It’s proving to be a formidable challenge. Genetic makeup varies from person to person, and world-class athletes are bound to have some natural genetic endowments that other people lack. Somehow, gene-doping tests must distinguish between natural genetic variation among individuals and genes inserted artificially — and the distinction must stand up in court. Scientists are fighting genetics with genetics, so to speak, enlisting the latest technologies for gene sequencing or for profiling the activity of proteins to find the telltale signs of gene doping. Some techniques attempt the daunting search for the foreign gene itself, like looking for a strand of hay in an enormous haystack. But new research could also lead to an easier and more foolproof approach: detecting the characteristic ways that an inserted gene affects an athlete’s body as a whole. Resurgence of gene therapy In 1999, 18-year-old Jesse Gelsinger died during a gene therapy trial for a rare liver disease. Investigators later attributed his death to a violent immune reaction to the delivery virus rather than to the therapeutic gene. His death was a major setback for the field. It also may have scared away early would-be gene dopers. In recent years, safety and efficacy of gene therapy have shown signs of progress in numerous clinical trials for conditions ranging from early-onset vision loss to erectile dysfunction. As scientists develop ways to use safer, weaker viruses for delivery, and as gene therapies wind their way through clinical trials, athletes and coaches might start to see gene doping as even more viable than they already do. In the courtroom during the 2006 trial of Thomas Springstein, a German track coach accused of giving performance-enhancing drugs to high-school–age female runners, prosecutors read aloud an e-mail Springstein had written that would shock the sports world. “The new Repoxygen is hard to get,” the e-mail read, according to press reports. “Please give me new instructions soon so that I can order the product before Christmas.” Repoxygen isn’t merely another doping drug such as a hormone or the latest designer steroid — it’s an experimental virus designed to deliver a therapeutic gene and insert it into a person’s DNA. British pharmaceutical company Oxford BioMedica developed Repoxygen in 2002 as a treatment for severe anemia. The therapy “infects” patients with a harmless virus carrying a modified gene that encodes erythropoietin, a protein that boosts red blood cell production. This protein, often called EPO, is itself a favorite among dopers seeking to increase their oxygen capacity, and hence their endurance. Viruses have the natural ability to inject genetic material into their host’s DNA. The host’s cells can translate that gene into active proteins as if the foreign gene were the cells’ own. So by delivering the gene for EPO within a virus, Repoxygen could potentially increase the amounts of EPO protein — and the change would be permanent. Athletes might also be tempted by perhaps the most tantalizing gene therapy experiment of all: the “mighty mouse.” In 1998, H. Lee Sweeney and his colleagues at the University of Pennsylvania School of Medicine injected mice with a virus carrying a gene that boosted production of insulin-like growth factor 1, or IGF-1, a protein that regulates muscle growth. As a result, the mice had 15 percent more muscle mass and were 14 percent stronger than untreated mice — without ever having exercised. The treatment also prevented the decline of muscle mass as the mice grew older. Other genetic paths to increase muscle strength and volume could include the gene for human growth hormone or segments of DNA that block a protein called myostatin, which normally limits muscle growth. Endurance might also be boosted by the gene encoding a protein called peroxisome proliferator-activated receptor delta, or PPAR-delta. Mice engineered to have extra copies of this gene hopped onto a treadmill and, without ever having trained, ran about twice as far as unaltered mice. The extra PPAR-delta improved the ability of the mice’s muscles to use fat molecules for energy, and it shifted the animals’ ratio of muscle fiber types from fast-twitch toward slow-twitch fibers — a change that would improve muscle endurance in people as well. Ronald Evans and his colleagues at the Salk Institute for Biological Studies in La Jolla, Calif., published the research in 2004. Since then, Evans says, he has been routinely approached by curious coaches and athletes. “I’ve had athletes come to my lectures and go to the microphone and say, ‘If I took this drug, would it work with EPO and growth hormone?’ I mean, they would ask this publicly,” Evans says. “Based on athletes I’ve talked with, I’d say that it’s a reasonable possibility that gene doping will be used in this Olympics, and I think there’s a very high probability that it will be used in the next Olympics,” he says. Elusive signs Around the time that Evans was announcing his “marathon mouse” results, WADA kicked off a funding program to focus scientific research on strategies for detecting gene doping. “A key part of our project is to try to define what we call signatures of doping,” says Olivier Rabin, a biomedical engineer and director of science for WADA. “We are looking at the impact of those kinds of genetic manipulations at different levels.” The first and most obvious approach is simply to look for the inserted gene among the roughly 6 billion “letters” of genetic code in both sets of a person’s chromosomes. For clinical gene therapy trials, finding the inserted gene is fairly easy. Scientists know the exact sequence of the gene they inserted, and often they know where on the person’s chromosomes the gene should have ended up. Standard DNA sequencing techniques can reveal the genetic code for that region on the chromosomes, and the unique sequence of the inserted gene will be in plain view. With gene doping, the situation is much trickier. “In sport, you don’t know where that gene will be put, what virus was used or even what particular variety of gene was used,” Friedmann says. “You don’t have the advantage of knowing where to look and for what, so the argument is to look everywhere.” Another difficulty is that copies of the foreign gene wouldn’t be in all of a person’s cells. The gene-carrying viruses selectively target certain tissues such as muscle or liver (the liver helps to regulate muscle metabolism). Some blood cells might also take in the viruses’ genetic payloads, but it’s questionable whether a standard blood sample from an athlete would contain the gene. Instead, anti-doping officials would have to sample muscle tissue directly using punch biopsies, a procedure that is mildly painful. “No one’s expecting that an athlete will agree to a muscle biopsy,” Friedmann says. “That’s a nonstarter.” Still, direct detection of inserted genes could work in some cases. Evans points out that an artificially inserted gene for PPAR-delta would be much smaller than the natural gene. That’s because the natural gene is far too big to hitch a ride on the carrier virus. Fitting the gene onto a virus means only a trimmed down version of the gene can be used. This distinctive genetic pattern would only exist in a person who had undergone gene doping. In other cases, genes would end up in tissues where they’re not normally active, making detection more straightforward. For example, the liver and kidneys normally produce the protein EPO, which makes red blood cells, but gene doping could deliver the EPO-coding gene directly to muscle tissues. The trick, then, is to find a noninvasive way to detect where EPO production is occurring inside the body. One solution is to use medical imaging techniques such as PET scans. In research funded by WADA, Jordi Segura and his colleagues at the Municipal Institute for Medical Research in Barcelona, Spain, attached slightly radioactive “flags” to molecules made during EPO production. A standard PET scan can spot this radioactivity, revealing where EPO was being made in the bodies of mice injected with gene-doping viruses, the team reported in the October 2007 Therapeutic Drug Monitoring. The researchers showed that production of EPO in muscle tissue was a telltale sign of gene doping. With radioactivity that is relatively mild, the labels are routinely used in medical imaging to diagnose diseases and don’t pose a significant hazard. But Friedmann notes that asking athletes to undergo such a procedure could be controversial. Detection by proxy Another approach is to look for signs of the viral “infection,” rather than for the gene itself. Even a weakened virus could trigger a mild, and specific, immune reaction that might show up in a blood test. Perhaps the greatest challenge facing this method is that viruses aren’t the only way to deliver a gene into a doper’s body. “The reality is that you can just inject naked DNA directly into tissues” with a syringe, Evans says. “Direct injection could be more local and harder to detect.” This relatively crude way to insert a gene won’t spread the gene as widely through a person’s body as viruses injected into the bloodstream would. But many cells near the site of injection could take in the gene, perhaps enough to improve athletic performance. Microscopic, synthetic spheres of fat molecules called liposomes can also shuttle doping genes into the body. To prevent dopers from evading detection by simply changing delivery vehicles, scientists are also exploring a third approach to developing tests: proteomics, the detailed study of all the proteins in the human body. Regardless of the vehicle used, adding a new gene to the body’s tightly woven web of interacting genes and proteins will cause ripples of change to spread throughout that web. “There will be a body-wide response no matter what gene you use or where in the body you put it,” Friedmann says, “and those changes can be used as a signature of doping.” Painful biopsies wouldn’t be required. Because the cascade of changes in protein activity would be widespread, anti-doping officials could test using blood, urine, hair or even sweat. Tools developed for the burgeoning fields of genomics and proteomics allow scientists to see the activity levels of thousands of genes or proteins simultaneously. In preliminary unpublished experiments, Friedmann and his colleagues injected a type of muscle cell with the gene for IGF-1. Activity of hundreds of genes changed as a result, including a boost in the activity of genes that control production of cholesterol, steroids and fatty acids. All of these changes might be detectable with simple blood tests. WADA is funding half a dozen or so ongoing studies on this proteome-based detection strategy, but research in this area is still at an early stage. “There’s good reason to think that’s likely to work, and a number of labs are having some nice results,” Friedmann says. As for whether any tests for gene doping will be ready in time for the Beijing Olympics, anti-doping authorities aren’t giving away many hints that might help dopers evade detection. “We never say when our tests are going to be in place,” WADA’s Rabin says. Even if detection methods do lag behind the games, dopers may want to think twice before assuming they’re in the clear, Friedmann notes. “With stored [blood and urine] samples, one always has the option of going back some months or years later and checking again with the newest tests.” Just in case the dangers of tampering with a person’s genetic makeup weren’t enough of a disincentive.

new age of biotechnology

A new age of biotechnology promises bigger, faster, better bodies—and no existing tests will catch it.by Michael Behar; additional reporting by Jocelyn Rice Image courtesy of MashDnArt under a Creative Commons license

The chime on H. Lee Sweeney’s laptop dings again: another e-mail. He doesn’t rush to open it. He knows what it’s about. He knows what they are all about. The molecular geneticist gets a handful every week—often many more, depending on what is in the news—all begging for the same thing, a miracle. Ding. A woman with carpal tunnel syndrome wants a cure. Ding. A man offers $100,000, his house, and all his possessions to save his wife from dying of a degenerative muscle disease. Ding, ding, ding. Jocks, lots of jocks, plead for quick cures for strained muscles or torn tendons. Weight lifters press for larger deltoids. Sprinters seek a split second against the clock. People volunteer to be guinea pigs.

Sweeney has the same reply for each ding. “I tell them it’s illegal and maybe not safe, but they write back and say they don’t care. A high school coach contacted me and wanted to know if we could make enough serum to inject his whole football team. He wanted them to be bigger and stronger and come back from injuries faster, and he thought those were good things.”

The coach was wrong. Gene therapy is risky. In one experiment a patient died. In another the therapy worked, but 4 of the 10 human subjects—young children—got leukemia. To some, such setbacks are minor hiccups, nothing to worry about if you want to cure the incurable or win big. In the last several years, Sweeney, a professor of physiology and medicine at the University of Pennsylvania, and a small cadre of other researchers have learned how to manipulate genes that repair weak, deteriorating, or damaged muscles, bones, tendons, and cartilage in a relatively short time. They can also significantly increase the strength and size of undamaged muscles with little more than an injection. At first the researchers worked with only small laboratory rodents, mice and rats. More recently their efforts have shown promise with dogs. Human testing is years away, but gene therapy has already become a controversy in professional and amateur sports, where steroids, human growth hormone, and other performance-enhancing drugs have been a problem for years. With the Olympics opening in Beijing on August 8, the subject is only going to get hotter. “It’s the natural evolution of medicine, and it’s inevitable that people will use it for athletics,” Sweeney says. “It’s not clear that we will be able to stop it.”

Sweeney became interested in gene therapy in 1988, shortly after scientists pinpointed the gene responsible for Duchenne muscular dystrophy . He wanted to find out if there was a way to counteract the disease genetically. Children with muscular dystrophy lack the gene required to regulate dystrophin, a protein for muscle growth and stability. Without enough dystrophin, muscle cells atrophy, wither, and die. Sweeney’s plan was to introduce the dystrophin gene by hitching it to the DNA of a virus that can transport genes into cells. As it turned out, viruses were too small to carry that gene, so Sweeney began searching for a smaller gene that would at least mimic dystrophin. He settled on a gene that produces insulin-like growth factor 1 (IGF-1), a powerful hormone that drives muscle growth and repair. The IGF-1 gene fit nicely inside a virus and was more appealing because it could potentially treat several kinds of dystrophy. In a series of experiments beginning in 1998, Sweeney and his team at the University of Pennsylvania injected IGF-1 genes into the muscles of mice and rats and watched in wonder as damaged tissue repaired itself.

It’s inevitable that people will use gene therapy for athletics. It’s not clear that we will be able to stop it. For years afterward, Sweeney spent much of his time scrutinizing the rats and mice he had injected with IGF-1 genes. He put them through a rigorous exercise program, strapping weights to their hind legs and repeatedly prodding them up a three-foot-high ladder. After two months, the rodents could lift 30 percent more weight, and their muscle mass had swollen by a third—double what his control group of mice (those without IGF-1) achieved with weight training alone. In another experiment Sweeney gave IGF-1 to mice but curbed their exercise. They too bulked up, jumping 15 percent in muscle volume and strength.

Next up for testing were dogs, which come closer than rodents to approximating human biology. The results were similarly striking. Sweeney has now begun developing and testing another type of gene therapy in dogs and comparing its effects to those of IGF-1. The new therapy is based on a protein called myostatin, which normally regulates muscle growth. By dosing dogs with the gene for a myostatin precursor, Sweeney has found he can throw a wrench into the molecular machinery of myostatin signaling, removing a critical check on muscle growth and allowing deteriorating muscles to regain their strength.

On a visit to the University of Pennsylvania, I ask Sweeney to show me his IGF-1 mice. He leads me to a cramped lab where a bubbling tank of liquid nitrogen spews a cold fog across the floor. Rows of transparent plastic containers, each about the size of a shoe box, are stacked on a chrome pushcart, a pungent, musky odor emanating from them. Inside each box are several chocolate-colored mice. Sweeney points out two groups in neighboring containers and asks, “Which set do you think we’ve given IGF-1?” I lean in for a closer look. The mice in the left box look as if they have been watching Buns of Steel videos . Each mouse boasts a rock-hard rump and shockingly large, perfectly chiseled gastrocnemius and soleus muscles (which, in humans, make up the calf). In the adjacent cage, two control mice appear scrawny by comparison. The results are impressive, and I wonder out loud just how easy it would be for someone to reproduce Sweeney’s results in a human. “I wouldn’t be surprised if someone was actively setting up to do it right now,” he says. “It’s not that expensive, especially if you are just going to do it to a small population of athletes.”

+++ That is exactly what worries officials at the World Anti-Doping Agency and the U.S. Anti-Doping Agency. In anticipation of the 2004 summer Olympics, in Athens, the world agency put gene doping on the International Olympic Committee’s prohibited list, which includes everything from cough syrup to cocaine. The prohibition defines gene doping as “the nontherapeutic use of genes, genetic elements, and/or cells that have the capacity to enhance athletic performance.” But no one thinks for a minute that gene doping isn’t already starting to happen. “Sport is supposed to be fun,” says former Olympic swimmer Richard Pound , ex-president of the world agency and a vocal champion of the antidoping cause. “But it is surrounded by people who are conspiring to destroy the athlete and the game.”

Gene doping is different from chemical performance-enhancing techniques. Human growth hormone, for example, occurs naturally in the body and will accelerate cell division in many types of tissue. Taken in high doses, it can provide a head-to-toe muscle boost and can even add a few extra inches of height. Anabolic steroids are chemical relatives of testosterone. They are believed to be in wide use in professional sports—although most athletes deny it—and their illegal use recently ignited explosive, high-profile controversy in Major League Baseball and Olympic track-and-field events. Last year track star Marion Jones admitted that she had used steroids while training for the 2000 Olympics and was stripped of all five of her medals. Steroids are also popular with weight lifters because they foster new muscle growth in the upper body. Synthetic erythropoietin, or EPO, a chemical naturally produced by the kidneys, is a favorite of triathletes, marathon runners, Tour de France cyclists, and others who engage in long periods of aerobic activity. EPO flushes fatigued muscles with oxygen to stave off exhaustion.

These and other substances can be detected in blood and urine tests because they drift through the circulatory system for hours, days, or months. Gene doping is not so easy to spot. Genetic modifications become an indistinguishable element of the DNA in targeted muscles. The only way to prove that someone has used gene doping is to biopsy a suspicious muscle and look for signs of DNA tampering. It is not hard to imagine that most athletes will object to having bits of flesh sliced from the very muscles they’ve spent years honing. “Athletes aren’t going to say, ‘Hey, take a muscle biopsy before my 100-meter run,’” comments Johnny Huard , who developed his own set of muscle-building genes as professor of molecular genetics, biochemistry, and bioengineering at the University of Pittsburgh School of Medicine.

Lack of easy detection makes gene doping extremely attractive to athletes. But the incredible muscle-building power of doping is the big draw. Sweeney believes gene-doped athletes would readily surpass their personal bests and could even smash world records. Sprinters and weight lifters would see the most benefit, their peak speeds and maximum strength amplified. “Athletes would be able to push their muscles harder than ever before because their muscles would repair themselves so much faster,” he says. “And they wouldn’t have to retire when they were 32.”

Antidoping agency officials are convinced that athletes will try gene doping, despite its dangers. “In the current climate there is even more pressure than when I was competing,” says Norway’s 1994 Olympic speed skating gold medalist, Johann Koss , a physician and former member of the World Anti-Doping Agency’s executive board. “People will take shortcuts. Being the best in the world offers huge financial gains.”

In a poll, American athletes said they would take any drug that would help them win, even if they knew the drug would eventually kill them. Pound cites a poll of American athletes who said they would take any drug that would help them win, even if they knew the drug would eventually kill them. “Nobody ever said athletes are ?the smartest people in the world,” he comments. “This is why there has to be paternalism. This is why I don’t let my kids drive the car at age 13, even though they tell me they can do it safely.”

Pound has good reason to worry. The newest gene therapies work on mice, rats, and dogs with no apparent adverse effects. Until clinical trials are completed, however, it is impossible to know exactly what the effects will be on humans. Sweeney acknowledges, for instance, that IGF-1 could make precancerous cells grow faster and stronger.

“We have absolutely no clue” about side effects, Huard says, but he and other researchers are worried about immunologic reactions to the virus that serves as the gene carrier. That reaction is apparently what killed 18-year-old Jesse Gelsinger , according to researchers at the University of Pennsylvania. Gelsinger had a rare liver disease and was participating in gene therapy research at the university when he died. The Food and Drug Administration immediately terminated all gene therapy trials there, and the incident prompted federal regulators to establish new rules for human gene therapy research.

More and more, Sweeney says, the immune system is proving to be the most difficult hurdle in developing gene therapy for humans. Treatments that appear perfectly safe in rodents and dogs can provoke a devastating immune response when adapted for humans and other primates. The problem, Sweeney says, is that the viruses researchers use for delivering therapeutic genes infect primates but not other mammals. So while a dog’s immune system will simply overlook the intruder, a human’s will recognize it and launch a massive attack. Researchers are now working to develop ways to suppress the immune system long enough for the virus to safely deliver its genetic cargo.

+++ Another concern is that the vector virus might run amok. Scientists believe that is what happened during a 1999 French gene therapy trial on a group of 10 young children with X-SCID, an immune deficiency disorder known as boy-in-the-bubble syndrome . Researchers engineered a virus to carry a replacement gene to repair the immune systems of the sick children. The technique cured nine of them, and scientists initially deemed the trial an overwhelming success. Nearly three years later, however, doctors diagnosed two boys in the study with T-cell leukemia. Two more leukemia cases have since come to light; one patient has died. Somehow the virus carrier—not the replacement gene—had managed to touch off the blood disease, an international medical team reported in 2003. A parallel study in England initially looked more promising, but recently leukemia struck one of its participants as well.

Those incidents sparked widespread condemnation that stifled nascent research initiatives. The climate for gene therapy research has since begun a slow rebound. A variety of human trials are now under way with tighter safeguards, but most experiments are confined to animals.

Beyond the medical and regulatory setbacks, the largest roadblock to commercializing the technology is money. For years Sweeney’s efforts to launch dog studies were thwarted by a lack of funding. Human trials are even costlier, so for now, Sweeney says, IGF-1 and myostatin gene therapies remain on the distant horizon. He nonetheless keeps a list of telephone numbers from desperate parents who have contacted him.

Meanwhile, amateur athletics is trying to come to grips with gene doping. Every few years the World Anti-Doping Agency hosts a symposium where scientists, regulatory officials, and athletes gather to discuss gene doping. Theodore Friedmann, who directs the program in human gene therapy at the University of California at San Diego, spearheaded the first of these workshops six years ago. “People intent on subverting gene therapy will do so,” says Friedmann, who has advised the National Institutes of Health and congressional leaders on gene-related issues. “The technology is too easy. It’s just graduate student science.”

That bothers Arne Ljungqvist , the World Anti-Doping Agency’s health, medical, and research committee chairman, who doles out several million dollars in grant money every year to research groups looking at gene doping and its detection. Additionally, Friedmann, who chairs the agency’s antidoping panel, is working to establish testing protocols. “So far the results are sitting in the form of research advances,” he says, “but not in the form of real detection methods.” One concept is to hunt for what Friedmann calls physiological fingerprints. Introducing foreign genes into muscles, he says, “is going to produce changes in the way muscles secrete things into the blood and, therefore, into the urine.” In the same way breast and colon cancer alter the pattern of proteins in the bloodstream, genes linked to IGF-1 or EPO will, in theory, leave traces. Surveillance organizations like the U.S. and world antidoping agencies “will look for those signatures and patterns that can be tied, with confidence, to the existence of a foreign gene,” Friedmann says. Although it may be years in development, Fried­mann envisions a noninvasive imaging device akin to an X-ray that detects bits and pieces of leftover viruses used to introduce performance-enhancing genes.

Ironically, the misuse of gene doping in sports is more clearly defined than its proper use. When physicians begin curing athletic injuries with gene therapy, the boundaries of healing and enhancement will blur. “There will be a fuzzy line between what is a medically justifiable treatment of injuries and what is performance enhancement,” Friedmann says. “There is nothing terribly noble about an athlete destroying a career with an injury if one can medically prevent or correct it. I would be hard-pressed to say that athletes are not eligible for this or that manipulation. It has always been obvious that there are therapeutic-use exceptions. There is no reason to think that therapeutic-use exceptions would be dis­allowed for genetic tools.”

That, of course, opens the door for abuse. In some instances, athletes would require only minuscule improvements to nudge them into the winner’s circle. “Olympic athletes don’t need to see a drastic change,” Huard says. “Sometimes the gold medalist is only a fraction of a second over the silver.” It would be very easy for a team physician to surreptitiously let therapeutic genes continue working for a few hours, days, or weeks after an officially sanctioned treatment ends.

With no viable testing mechanism on the horizon, it is possible that at least one of the 10,000-plus Olympic competitors in Beijing this summer will have experimented with gene doping. “Nothing would surprise me,” Friedmann says. For the time being, though, gene doping is not only illegal but also unsafe and probably ineffective. “If it’s done now,” he says, “it will certainly be done badly.”Additional reporting by

+++ The Muscle Maker Gene therapy offers a shortcut to bulking up: At the University of Pennsylvania, H. Lee Sweeney is developing a way to turn the liver into a factory that churns out a muscle growth promoter called myostatin propeptide . He injects a virus carrying the growth promoter gene into an animal’s veins, where it courses through the bloodstream and into the liver. There, it infects liver cells and delivers its genetic package. A signal from the virus tells the liver cells to manufacture the growth promoter, which is then secreted back into the bloodstream and ferried off to muscles throughout the body. Normally, myostatin puts the brakes on excessive muscle growth. But when there is too much myostatin propeptide around—delivered by the virus and pumped out by the liver—myostatin cannot do its job and muscles keep growing.

Click here to see the rest of DISCOVERmagazine.com's special Olympics coverage.

Gene Doping May Be Next Big Thing for Athletes Seeking Edge (2008, Aug 12)

Gene Doping May Be Next Big Thing for Athletes Seeking EdgePosted by Sarah Rubenstein The science of genetics has opened up a world of potential new treatments for tough diseases. But those of you who’ve been watching the Olympics may be interested to know genes could become the next “steroids.”

Right out of the “don’t try this at home” play book, the Baltimore Sun over the weekend ran an article detailing the many ways Olympic athletes can still manage to skirt anti-doping rules. Though the degree to which it’s happening is unclear, one interesting idea is what’s being dubbed “gene doping.”

Here’s how the newspaper explains it: Inject the body with a gene that triggers growth in specific tissues such as muscle. That could increase the muscle but be tough to detect in a test, because the enhancement was produced by the body’s own instructions.

Se-Jin Lee, a Johns Hopkins molecular biologist , found recently that with two injections over two weeks, he could increase muscle mass in mice by 60% — no training required, according to the Sun. He’s only testing in animals, but it wouldn’t be hard to try the technique in humans, he acknowledged.

China: No evidence for gene doping at Games but worry remains (2008, Aug 10)

No evidence for gene doping at Games but worry remains

www.chinaview.cn 2008-08-10 17:22:21

BEIJING, Aug. 10 (Xinhua) -- Gene doping may not be present at the ongoing Beijing Olympic Games but anti-doping experts remain worried that illegal use of gene therapy.

David Howman, director general of the World Anti-Doping Agency (WADA), voiced his concerns over illegal practices in this area on Sunday.

"We worry about unfair practices. My concern is somebody is trying to do it without having it properly, medically verified and ethically confirmed. It is like manufacturing drugs without under proper scrutiny," he said. He was here to oversee the anti-doping program at the Games which opened on Friday.

WADA plays the role of independent observer for the program and carry out about 1,000 of the 4,500 tests during the Games. It also set up an anti-doping outreach program for athletes in the Olympic Village.

"We are doing a lot of work in gene therapy because we want it to be in place for the good public health reasons. What we worry about is being abused by those want to cheat. It should not be abused by athletes," said Howman.

At this point, WADA doesn't believe gene doping is present.

"No evidence, nothing is coming forward to suggest that gene doping is going on," said WADA president John Fahey. "No gene doping is occurring a this point of time."

WADA has held three gene doping symposiums with experts, scientists, ethicists, athletes, and representatives from the Olympic Movement and governments studying the issue. The third symposium was held in Saint Petersburg in June this year.

Fahey said all participants of the symposiums agreed that more research should be done.

"There is a recognition that there must be sufficient research to find the detection process in advance because it is a concern it may become something in the lexicon of doping in the days ahead," said the Australian.

WADA has been conducting 22 projects on developing a system for detecting gene doping. Howman said combined efforts were needed to combat the problem.

"We do a lot of research and we would like to do more but we haven't got a lot of money, so we rely on other countries and research bodies to help us with it," he said.

Beijing Olympics warned of 'gene doping' threat (2008, Aug 5)

Beijing Olympics warned of 'gene doping' threatA new generation of 'genetically modified' athletes could mar the Beijing Olympics as sportsmen and women go to new lengths to realise their goals.

By Telegraph staff Last Updated: 2:36PM BST 05 Aug 2008

 Keeping clean: A doping control area at the National Aquatics Centre prior to the Beijing Olympics Photo: Reuters Leading British scientist Dr Andy Miah, who is currently in Beijing conducting research during the Games, claims that "gene doping" will become the latest headache for the sport.

Athletes will be able to improve their performance by inserting or inhaling foreign DNA. The process sees genes either injected into muscle of bone cells and their proteins fed into the tissue or red blood cells.

"In 2004, people were starting to talk about its use at the Athens Olympics," Dr Miah says in the Evening Standard. "This year the case is even stronger that this will be the first genetically-modified Games. Many scientists will say it's still not possible, but I'm not taking this for granted.

"We need to assume that it's happening. It's already feasible."

While the threat at this year's Games is thought to be minimal, Dr Miah fears London 2012 could feel the full force of the latest and most damaging threat to the sport.

He said: "London 2012 should be watching Beijing very carefully to see what's possible. There has never been a 'clean' Olympics.

"The main problem for sports is that there are so many technologies that are under the radar of antidoping that its policies do little more than to point us to successes of antidoping testing."

The 'genetically modified' process was added to the World Anti-Doping Agency list of banned substances in 2003, but today's claims are sure to put WADA on full alert.

A representative of WADA, Frederic Donze, said: "We have been preparing for gene doping since 2002.

"We have to believe that athletes will try anything to get an edge and this might occur at the Olympics and we work on that basis."

Beijing: the first genetically modified Olympics? (2008, Aug 4)

Beijing: the first genetically modified Olympics?"The curtain will rise on what many experts believe could prove to be the first genetically modified Olympics.

For the unscrupulous or overdriven Olympic athlete, the banned practice of doping by taking hormones or other drugs to enhance athletic prowess may seem so last century. The next thing in doping is more profound and more dangerous. It called gene doping: permanently inserting strength- or endurance-boosting genes into DNA.

Once you put that gene in, it's there for the rest of that person's life, says Larry Bowers, a clinical chemist at the U.S. Anti-Doping Agency in Colorado Springs, Colo. You can't go back and fish it out.

Scientists developed the technology behind gene doping as a promising way to treat genetic diseases such as sickle-cell anemia and the bubble boy immune deficiency syndrome. This experimental medical technology called gene therapy has begun to emerge from the pall of early failures and fatalities in clinical trials. As gene therapy begins to enjoy some preliminary successes, scientists at the World Anti-Doping Agency, which oversees drug testing for the Olympics, have started to worry that dopers might now see abuse of gene therapy in sport as a viable option, though the practice was banned by WADA in 2003.

Gene therapy has now broken out from what seemed to be too little progress and has now shown real therapies for a couple diseases, and more coming, says Theodore Friedmann, a gene therapy expert at the University of California, San Diego and chairman of WADA's panel on gene doping.

While gene therapy research has begun making great strides, the science of detecting illicit use of gene therapy in sport is only now finding its legs. To confront the perceived inevitability of gene doping, Friedmann and other scientists have started in recent years to explore the problem of detecting whether an athlete has inserted a foreign gene an extra copy that may be indistinguishable from the natural genes into his or her DNA.

It's proving to be a formidable challenge. Genetic makeup varies from person to person, and world-class athletes are bound to have some natural genetic endowments that other people lack. Somehow, gene-doping tests must distinguish between natural genetic variation among individuals and genes inserted artificially and the distinction must stand up in court.

Scientists are fighting genetics with genetics, so to speak, enlisting the latest technologies for gene sequencing or for profiling the activity of proteins to find the telltale signs of gene doping. Some techniques attempt the daunting search for the foreign gene itself, like looking for a strand of hay in an enormous haystack."

This is what living in a culture of greed, competition, and winning above all instead of fairness and loving what you do is doing to people. Even to the point of inserting this foreign DNA and not knowing for sure what it will do to your body. So we eat genetically modified food (without our knowledge) and now can genetically modify our own bodies all to profit those who don't care about the affects this is having on us... and athletes that are women who do this and get pregnant afterwards ... what risks would their children now face? Is winning and $$$ and endorsements REALLY all that important? So what will the new trend be: Bodies by Monsanto?

Genetically Modified Olympians? (2008, July 31)

Genetically Modified Olympians?Jul 31st 2008 From The Economist print edition

On the eve of the Beijing Olympics, we examine the prospect of athletes using gene therapy to enhance their performance—and of catching them if they try

FOR as long as people have vied for sporting glory, they have also sought shortcuts to the champion’s rostrum. Often, those shortcuts have relied on the assistance of doctors. After all, most doping involves little more than applying existing therapies to healthy bodies. These days, however, the competition is so intense that existing therapies are not enough. Now, athletes in search of the physiological enhancement they need to take them a stride ahead of their opponents are scanning medicine’s future, as well as its present. In particular, they are interested in a field known as gene therapy.

Gene therapy works by inserting extra copies of particular genes into the body. These extra copies, known as “transgenes”, may cover for a broken gene or regulate gene activity. Though gene therapy has yet to yield a reliable medical treatment, more than 1,300 clinical trials are now under way. As that number suggests, the field is reckoned to be full of promise.

As far as sport is concerned, the top transgene on the list, according to Jim Rupert, an anti-doping expert at the University of British Columbia, is the gene for erythropoietin. EPO, as it is known for short, is a hormone that regulates the production of red blood cells. It is already available as a drug (it was one of the first products of biotechnology companies in the late 1980s), and it has been used widely in endurance sports such as long-distance cycling. But if an athlete’s body could be stimulated to make more of it that would—from the athlete’s point of view—be better than taking it in drug form.

No dopes The reason is that EPO, like most performance-enhancing drugs, is banned. However, bans work only when they are enforced, and that requires a test which can distinguish synthetic EPO from the natural hormone made by an athlete’s body. At the moment, this is possible. The EPO from a biotechnology company’s vats has a slightly different chemical structure from the natural sort. But the evidence suggests that EPO produced as a result of gene therapy will be far harder to distinguish.

In fact, EPO doping may already have happened. In 2006, during the trial of Thomas Springstein, a German coach accused of doping his underage charges, it transpired that Repoxygen, an experimental gene-therapy product containing the gene for EPO, was already making the rounds on the black market. Repoxygen causes a controlled release of EPO, but only when the body senses a lack of oxygen. Or at least it does so in mice.

Whether black-market Repoxygen has won any races is unknown. But several other genetic therapies being tested in mice also look as if they may interest the sort of men and women who feel their athletic performance needs a little boost.

Like EPO, vascular endothelial growth factor spurs red-blood-cell formation and thus helps to supply tissues with oxygen. The gene that encodes this protein is the subject of several medical studies, and is thus a prime candidate for sporting use.

IGF-1 is also a growth factor—though it promotes brawniness in muscle rather than the production of blood cells. Inject the gene that encodes it into a particular muscle and you can affect that muscle and no other. Such specificity might be of interest to people like tennis players and javelin throwers. Meanwhile, a gene called MSTN encodes a protein called myostatin, which limits rather than enhances muscle development. In this case, therefore, the doping is designed to switch the gene off. The result is what have been nicknamed “Schwarzenegger” mice.

Once brawny muscles have been acquired, whether licitly or illicitly, other genes might then be used to tune their activity. Tweaking PPAR-delta, for instance, alters the way muscles obtain their energy. The individual fibres that comprise a muscle can run in one of two modes. In slow-twitch mode they burn fat, and are less prone to fatigue. In fast-twitch mode they burn sugar. That makes them prone to fatigue, but is useful for delivering short bursts of power. Both modes are valuable to athletes, but in different types of event. The ability to make muscle fibres specialise in one mode or the other would thus be of great benefit to unscrupulous coaches. PPAR-delta controls the switch.

Finally, animal studies on the genes for natural pain-killers called endorphins suggest that these could be used to limit the perception of pain—another desirable trait for athletes. That might consign the adage “no pain, no gain” to the history books.

There is thus a lot of potential. And although—the Springstein incident aside—there is no evidence that any of these techniques have made their way into real athletes, the authorities are taking no chances.

The World Anti-Doping Agency (WADA), sensed several years ago which way the wind was blowing. In 2003 it issued a proclamation banning “the non-therapeutic use of genes, genetic elements and/or cells that have the capacity to enhance athletic performance”. It followed this by putting its money where its mouth was. Since much of gene doping’s allure derives from its alleged undetectability, WADA committed $7.8m—a quarter of its research budget for 2004-07—to 21 projects intended to develop ways of detecting it. Now another $6.5m is up for grabs.

Broadly, there are two ways of spending this money usefully. The direct approach focuses on improving ways of detecting differences between truly natural and “therapeutically enhanced” proteins or, failing that, on detecting the “vector” used to inject the transgenes into the places where they will operate. Such vectors are often particular sorts of virus.

The indirect approach seeks second-hand signs of the transgene or its vector. Viruses, for example, may produce a characteristic immune response that can be detected. Meanwhile the transgenes themselves may alter the body’s proteome (the set of proteins active in it at any given time) or its metabolome (a list of all the by-products of the chemical reactions that go on in each cell). Changes to either of these “-omes” can, in principle, be detected in blood or urine. What is needed are points of comparison. This requires working out the typical “biosignatures” of elite sportsmen as a group, or indeed of each individual, as a baseline.

Testing times Whether gene doping will make its debut in Beijing remains to be seen—or perhaps not, if it is as hard to detect as its protagonists hope. Theodore Friedmann of the University of California, San Diego, who heads WADA’s Gene Doping Panel, reckons it probably won’t happen this time. He does not think there is, yet, a form of gene therapy that could easily be used to enhance performance. As for Dr Rupert, he says, “I would be surprised. But I have been surprised before.” It would be ironic if the first successful application of gene therapy were to people who are among the fittest on the planet. But it is possible.

Copyright © 2008 The Economist Newspaper and The Economist Group. All rights reserved.

Fairly safe Jul 31st 2008 From The Economist print edition

What athletes may or may not do ought to be decided on grounds of safety, not fairness

ANOTHER Olympics, another doping debate. And this time it is a fervent one, as recent advances in medical science have had the side-effect of providing athletes with new ways of enhancing performance, and thus of putting an even greater strain on people’s ethical sensibilities.

This is especially true of gene therapy. Replacing defective genes holds out great promise for people suffering from diseases such as muscular dystrophy and cancer. But administered to sprightly sportsmen, the treatment may allow them to heave greater weights, swim faster and jump farther (see article). And that would be cheating, wouldn’t it?

Two notions are advanced against doping in sport: safety and fairness. The first makes sense, the second less so—particularly when it comes to gene therapy. For instance, some people have innate genetic mutations which give them exactly the same sort of edge. Eero Mantyranta, a Finn, was a double Olympic champion in cross-country skiing. His body has a mutation that causes it to produce far more of a hormone called EPO than a normal person would. This hormone stimulates the production of red blood cells. A synthetic version of it is the (banned) drug of choice for endurance athletes.

Mr Mantyranta was allowed to compete because his advantage was held to be a “natural” gift. Yet the question of what is natural is no less vexed than that of what is fair. What is natural about electric muscle stimulation? Or nibbling on nutrients that have been cooked up by chemists? Or sprinting in special shoes made of springy carbon fibre? Statistically speaking, today’s athletes are unlikely to be any more naturally gifted than their forebears, but records continue to fall. Nature is clearly getting a boost from somewhere.

Given that so much unnatural tampering takes place, the onus is surely on those who want to ban doping (genetic or otherwise) to prove that it is unusually unfair. Some point out, for instance, that it would help big, rich countries that have better access to the technology. But that already happens: just compare the training facilities available to the minuscule Solomon Islands squad alongside those of mighty Team America. In druggy sports it may narrow the gap. One condition of greater freedom would be to enforce transparency: athletes should disclose all the pills they take, just as they register the other forms of equipment they use, so that others can catch up.

The gene genie is already out of the bottle From this perspective, the sole concern when it comes to enhancing athletic performance should be: is it safe for the athletes? Safety is easier to measure than fairness: doctors and scientists adjudicate on such matters all the time. If gene doping proves dangerous, it can be banned. But even then, care should be exercised before a judgment is reached.

Many athletes seem perfectly willing to bear the risks of long-term effects on their health as a result of their vocations. Aged Muhammad Ali’s trembling hands, for example, are a direct result of a condition tellingly named dementia pugilistica. Sport has always been about sacrifice and commitment. People do not admire Mr Mantyranta because he had the luck of the genetic draw. They admire him for what he achieved with his luck. Why should others be denied the chance to remedy that deficiency?

German TV reporter turns down Chinese request for help investigating stem-cell doping (2008, Jul 28)

German TV reporter turns down Chinese request for help investigating stem-cell doping

BEIJING (AP) -A German television reporter turned down a request from Chinese authorities Monday to help identify a Chinese doctor filmed in a documentary offering stem-cell therapy to athletes.

In a documentary aired last week by German ARD television, a man identified as a Chinese doctor offered stem-cell therapy to a reporter posing as an American swimming coach. The episode was filmed with a hidden camera, the doctor's face was blurred and the hospital was not identified.

Although Chinese officials have offered evidence in recent months that they are cracking down on doping before the Beijing Olympics open, the TV documentary suggests that China is still a major center for the illegal production and distribution of performance-enhancing drugs.

"Can you provide us with some information about what specific agency or entity was involved in the report done by ARD,'' Yan Jiangying, spokeswoman for the state food and drug administration, asked ARD correspondent Jochen Graebert.

Graebert, attending a Monday media conference with three dozen other journalists, turned down the request.

"No I can't,'' he replied, adding that he did not have the details. He said even if he did, he would probably not offer them.

"We are not prosecutors, we are journalists,'' he added. "It's not our duty to follow people and see if they get punished or not. ... It's not up to me to tell you.''

Sitting alongside Yan, a spokesman for the health ministry didn't dispute the incident took place, but he said the Chinese doctor was probably duping his would-be client.

"According to the view of the experts I consulted, such a technology in China and internationally is not operational,'' said Mao Qunan, the health ministry spokesman.

"Whether the doctor tricked the reporter, or the story mislead the general public, we are waiting for the media to give an explanation about the specific report about China offering gene doping to athletes.''

Du Jijun, general director of China's Anti-Doping Agency, said the country conducted 10,238 doping tests on Chinese athletes in 2007 - 74 percent out-of-competition. He said only 0.4 percent were positive. These included two athletes who were given life-bans earlier this year: swimmer Ouyang Kunpeng and freestyle wrestler Luo Meng.

A third Chinese athlete, race walker Song Hungjuan, was handed a four-year ban this year by track and field world governing body the International Association of Athletics Federations.

Du said six other Chinese athletes had failed recent doping test, but said they were young or provincial-level athletes and he did not name them.

John Fahey, head of World Anti-Doping Agency, has lauded the new Beijing laboratory that will conduct 4,500 tests for banned substances during the Beijing Olympics - 25 percent more than at the 2004 games.

The next step in doping (2008, Jul 27)

Sunday Focus | The next step in dopingBY LINDA ROBERTSON Imagine the Olympics of the future, perhaps the New Delhi Games of 2040. Then, as now, some athletes will cheat to win gold medals. Picture discus throwers with custom-built arms. Or swimmers with modified legs. Or marathon runners with enriched blood. Or gymnasts and basketball players with injury-proof joints. Or archers with brains designed for hyperconcentration. No longer will they rely on such primitive substances as steroids or worry about drug tests. They will be able to alter their own DNA.

Is this science fiction? It's called gene doping, and it might make its debut at the Beijing Olympics.

The science of implanting genes to boost the body's performance has been called the next frontier in illicit sports doping. Unless it already is happening.

''I predict multiple people will win in Beijing who have been gene-doped,'' said John Leonard, executive director of the American Swimming Coaches Association in Fort Lauderdale. ``It's not just experimental. It's been in use for four years.''

Other doping experts doubt the problematic technique of gene transfer has worked on any athlete. But the World Anti-Doping Agency, which banned gene doping in 2004, believes it is a threat to the integrity of sports and is trying to develop a detection test.

''We have no evidence that people have tried it successfully,'' WADA science director Olivier Rabin said. ``We've heard rumors. We investigate, but so far it's led nowhere.''

EASILY AVAILABLE

The technology, explained in numerous scientific articles, is available and relatively easy to implement, although the dangers include heart attack or cancer. Not just Olympians but pro baseball, football and basketball players and athletes in other major sports would benefit from increased strength and endurance. Throughout history, unethical athletes have shown a willingness to be guinea pigs if it meant the difference between winning and losing.

''Thousands of labs around the world with reasonably trained people in molecular biology have the capability,'' said Dr. Theodore Friedmann, a gene therapy expert at the University of California-San Diego. ``There is so much money in sports. Put a couple unscrupulous people together, and it wouldn't surprise me if an athlete attempted gene doping.''

H. Lee Sweeney is a scientist at the University of Pennsylvania researching cures for muscle-wasting diseases who used growth hormone to bulk up his ''Schwarzenegger mice'' and is now increasing muscle mass in dogs by 20 percent by inhibiting myostatin production. He has been contacted by various athletes, coaches and trainers, mostly in football, weightlifting and body building.

''The inquiries never stop,'' Sweeney said. ``They ask if they can be treated. They're ready to volunteer for any experiment. Some even say they'll pay me.''

No wonder because gene doping has potential to not only be effective but invisible. Why inject synthetic EPO to increase red blood cell production when you can inject the EPO gene itself? Athletes wouldn't have to bother with detectable drugs if their own cells could be stimulated to produce a natural stream of performance-enhancing proteins.

Gene doping is the bastardization of gene therapy, which is used to change traits in diseased people. This is how it works:

Human DNA is made up of 20,000 genes. They contain codes that tell cells how to function. To worm a gene into the body, a virus, like the one that causes colds and pink eye, is hollowed out and implanted with new genes for, say, stronger muscles or super-oxygenated blood. The ''vector virus,'' a little bag of protein with the gene inside, is then injected into target tissue, where it attaches to cells and dumps in the gene. The cells with new DNA replicate.

VARIETY OF USES

''Viruses can be engineered to express a whole variety of genes,'' said Dr. Richard Snyder, associate professor of molecular genetics and microbiology at the University of Florida and director of the Center of Excellence for Regenerative Health Biotechnology. There are genes to improve reaction time and increase alertness, although tinkering with cognitive functions is farther down the road, Snyder said.

A Harvard professor has located a gene that he hopes would prevent osteoarthritis and create sturdier joints. He has tested it on lame horses.

A simpler, cheaper but uncontrollable method would involve injecting a piece of DNA into a muscle to prod the pituitary gland to release growth hormone.

''It worked pretty well in pigs, which they grew faster so they could take them to market faster,'' Sweeney said. ``But they didn't want these pigs to live for 20 years. You can turn the gene on, but what happens if you can't turn it off?''

The first sign that gene doping wasn't just a Frankensteinian fantasy came before the 2006 Torino Olympics. E-mails found during an investigation of German track coach Thomas Springstein detail his efforts to obtain Repoxygen, developed to treat anemia, then taken off the market. It helps the body produce EPO.

In the shadowy subculture of sports doping, underground websites and black market labs advertise gene therapies for sale. WADA's Rabin posed as an athlete and ordered what was touted to be Repoxygen from a company in Southeast Asia. Tests showed it was synthetic EPO.

SUSPICIONS

In the TV documentary ''Doping in the Middle Kingdom,'' broadcast Monday on Germany's ARD network, a journalist posing as an American swimming coach was offered stem cell treatment for his athlete by a Chinese doctor for $24,000. During the segment, filmed by hidden camera inside a Chinese hospital, the doctor recommended ''four intravenous doses, 40 million stem cells, perhaps twice that, the more the better'' over two weeks.

''Quite frankly, this surpasses my worst fears,'' WADA's Patrick Diel told the filmmakers, who also interviewed a Chinese swimmer, now coaching in South Korea, who said the 1988 and 1992 Chinese swimming teams were fueled by steroids.

Fort Lauderdale's Leonard, a watchdog for swimming, has heard of alleged gene doping during his travels in China. Many in his sport are curious about the fate of the so-called ''Baby Army,'' a group of young swimmers from Hunan Province posting world-class times and the ''lost children'' from that group who are training in secrecy. He said the country, given its totalitarian government, well-funded sports school system and sophisticated sports science program, has the means, the will and the numbers to try new treatments.

''China is obsessed with athletic success, and there are huge political, economic and personal ramifications,'' Leonard said. ``In China's system, athletes aren't always able to say no.''

But China has made much-publicized bans on athletes who have tested positive and crackdowns on companies distributing doping products. Sweeney believes China wouldn't risk the embarrassment of hosting anything other than the ''Clean Games'' it has promised. The International Olympic Committee will conduct 4,500 tests for banned substances, a 25 percent increase over 2004 and a 90 percent over 2000.

However, Sweeney also believes an ambitious centralized government may not be able to resist the temptations of gene doping.

''If the East German sports machine was still in place, they could perfect gene doping,'' he said. ``Who would have dreamed up BALCO? Athletes are crazy and will try anything if they have someone to help them.''

But he doesn't believe gene doping would work now, at least not without serious health consequences. Most of the hundreds of gene therapy trials over the past 20 years have been unsuccessful or inconclusive, with a few striking breakthroughs, such as one for treatment of childhood blindness.

''It's a difficult and controversial field,'' Friedmann said. ``If anyone proceeded on an athlete it would be malpractice. Things can and will go wrong.''

SERIOUS SIDE EFFECTS

Monkeys injected with EPO genes developed blood the consistency of sludge. Some had clots, strokes and heart attacks. In others, bone marrow shut down and they died of anemia.

The ''marathon mice'' created at the Salk Institute died young. Other animals developed huge muscles that caused tendons, ligaments and bones to snap.

''Race horses are bred for traits of speed and power, but with no trait for bone strength they shatter those spindly legs,'' Friedmann said.

In France, three boys who had gene therapy for immune deficiencies got cancer.

''We've seen several cases of leukemia where the inserted gene hit a cancer-regulating cell,'' Rabin said.

In the U.S., a boy who volunteered for a study on genetic liver disease died.

''If gene therapy worked as well on humans as it does on monkeys or dogs it would be thriving,'' Sweeney said. ``The problem is that humans have an immune reaction to the virus vectors. Gene doping would be like an organ transplant. . . . It's heavy duty.''

To deter cheaters, WADA aims to have gene doping tests ready by 2012 for the London Olympics and for major sports leagues.

At Snyder's lab in Gainesville, research funded by WADA is focused on a blood test that would distinguish between the genes a person is born with and extra, ectopically introduced genes.

Friedmann's tests would find the antibodies that react to the viruses or identify a molecular signature for genetic changes.

Friedmann and WADA know they are in a race against ingenious dopers.

By the time a method or substance gets unmasked -- such as BALCO's ''designer'' THG -- another is in vogue.

''I love the beauty of sport,'' Friedmann said. ``But when the competition is not between athletes but between their molecular biologists and the technological companies behind them, that is not pretty.''

No gene therapy for athletes allowed in China (2008, Jul 25)

Ministry of Health: No gene therapy for athletes allowed in China

www.chinaview.cn 2008-07-25 01:03:17

BEIJING, July 24 (Xinhua) -- China has never approved any hospital to offer performance-enhancing stem-cell therapy, a Ministry of Health official said here on Thursday.

He made the remarks in response to a German TV report that some Chinese hospitals offered what is described as performance-enhancing gene therapy treatment.

"China has never allowed medical institutions or staff to provide stem-cell therapy aimed at improving athletes' performance," he said.

Any medical institution or medical worker doing so would be severely punished under the law, he stressed.

The official added he welcomed media scrutiny and clues to help the government's anti-doping efforts.

In gene doping, athletes put a second copy of certain cells into their bodies to try to increase muscle mass or improve endurance.

As early as March 2004 China had implemented its Anti-Doping Code. Over the past two years, the country had launched several special investigations into performance-enhancing drugs to ensure a fair Olympics.

In these aggressive campaigns, 23 companies were punished for illegal drug trade, or selling sports performance enhancers that shouldn't have been available over the counter since last year.

In addition, three drug makers were ordered to suspend production of relevant drugs, while another 18 had their licenses revoked. Another 321 websites containing illegal drug trading information were shut down.

The race against gene doping (2008, July 27)

The race against gene dopingOfficials expect a new form of sports cheating to appear: gene transfer ... and they have turned to this UCSD researcher to help detect it. By Scott LaFee UNION-TRIBUNE STAFF WRITER July 27, 2008 Past controversy has not made this year's Tour de France scandal-free. Cycling's premier event, which ends today, has again been marred by busts for illegal doping, with at least three riders thrown out and entire teams quitting. The Summer Olympics begin Aug. 8, and rumors of illicit drug use are likely to be rampant there, too.

For the World Anti-Doping Agency, or WADA, eliminating the use of banned substances to boost performance in sports is a difficult, endless challenge – and a job likely to get tougher. Agency officials expect a new and more problematic form of sports cheating to soon appear. It's called gene transfer or, more commonly, gene doping. They have turned to University of California San Diego researchers for help.

To date, no athlete has been caught gene doping, which involves injecting genes or genetic material into the body to make it stronger, faster or more resilient. In fact, there's no solid evidence any athlete has tried it, “though I wouldn't be surprised to hear somebody had,” said Dr. Ted Friedmann, director of the Center for Molecular Genetics at UCSD. “Drugs in sports isn't going away, but gene (doping) is the next big thing.”

Friedmann is a leading authority on gene doping and a pioneer in gene therapy – the evolving medical technology that inserts healthy or modified genes into the body to treat serious, often deadly diseases such as cystic fibrosis, cancer and immune system deficiencies.

In the fight against sports doping, the metaphor is often a race, with the cheaters usually one step ahead of the watchdogs. This time, authorities want a head start. In the last few years, WADA has funded basic research programs into how athletes might use – and abuse – gene transfer, and how to detect it. Helping lead the effort is Friedmann, who will oversee a new clearinghouse for data derived from WADA-funded studies and labs around the world.

“If the idea is to pick needles out of a haystack, WADA wants all the hay in one place,” said Friedmann, who has worked with the organization since 2000. “It wants a centralized bioinformatics effort that can result in a unified approach.”

Currently, Friedmann said, there isn't much cross-talk among researchers investigating gene transfer in sports. “And there's no lab that's equipped to handle all of the data being produced.” But with help from scientists at the San Diego Supercomputer Center, Friedmann said the UCSD-based program will pull together all of the data generated, organize it, collate it and help disseminate the findings.

It's an unprecedented effort. Previous and current sports drug-testing programs have tended to be reactive, responding to revelations about the abuse of new drugs (or versions of old ones) with new, targeted tests.

In recent years, the focus has been on anabolic steroids, human growth hormone, known as HGH, and such banned drugs as erythropoietin, or EPO, which boosts blood-oxygen content. Rigorous blood and urine testing appears to have reduced steroid use. There is no widely available, effective test for HGH, but experts say one is imminent.

On June 8, highly ranked cyclist Riccardo Ricco was thrown out of the Tour de France after testing positive for Cera, a third-generation version of EPO. Authorities said Ricco may have thought his variant of Cera was undetectable, but WADA investigators had developed a test for it in collaboration with the Swiss maker.

Gene doping presents different and greater challenges for sports sentinels. Broadly speaking, it involves introducing genetic material into an athlete's cells or tissues to help them work differently or better. Usually this means making muscles grow stronger, regenerate faster or break down more slowly.

The introduced material is indistinguishable from its natural counterpart and found only in affected tissues. There is nothing to detect in blood or urine.

Friedmann said the UCSD research effort is aimed, in part, at developing a knowledge base of how gene doping affects the athlete's whole body. “We won't look necessarily for the suspect agent, but for its broader effects,” he said. “Are there specific changes in the way targeted genes are expressed or how proteins work that can be conclusively linked to gene doping?”

In medicine, the goal of gene therapy is to find an effective treatment. In sports, the goal is to generate a competitive edge.

But at what cost? The history of gene therapy has been marked by serious setbacks, including patient deaths. In 1999, Jesse Gelsinger, an 18-year-old with a rare, inherited liver disease, died from a massive immune response to the viral vector used to deliver genetic material to his cells. In 2002 in France, doctors used gene therapy to treat 12 boys with X-linked severe combined immunodeficiency, or “bubble-boy disease.” The technique effectively treated SCID, but at least three boys developed leukemia and one died.

Despite the setbacks, progress in gene therapy is being made. Dozens of clinical trials are under way, with researchers reporting varying degrees of success in treating cancers and heritable diseases.

“Gene therapy works. The proof of principle is there, but it will take decades more to refine it,” said Friedmann, who helped originate the idea in the 1970s. “Throwing genes around in a human is highly experimental. There are surprises around every corner. It's full of dangers. It should be limited only to very serious diseases.”

More to the point, no one really knows what the short-and long-term health effects of gene transfer are in a healthy human. Animal models have produced some eye-popping results. In the late 1990s, H. Lee Sweeney, a physiology professor at the University of Pennsylvania, discovered how to inactivate a protein called myostatin, which tells muscles when to stop growing. Sweeney subsequently was able to create lab mice with twice the normal muscle mass even though the rodents didn't exercise much.

Bad things happen, too. In 1997 and 1998, researchers injected synthetic EPO into monkeys and baboons. The idea was to see if boosting the oxygen-carrying capacity of the animals' blood would result in greater physical stamina and endurance.

Initially, things looked good. In both species, red blood cell counts nearly doubled within 10 weeks. Then, wrote Sweeney in a 2004 Scientific American account, the animals' blood became “so thick it had to be regularly diluted to keep their hearts from failing.”

With the right tools and know-how, Friedmann said gene doping isn't hard to do.

“The basic biology is easy. On this campus, there are probably 1,000 people who could do it. What is hard is doing (gene transfer) well and safely, and knowing what the outcome will be.”

It may be impossible to stop gene doping. “Sports is the camel's nose under the tent,” Friedmann said. “Genetic enhancement will likely touch many aspects of future life, but one of the first will probably be sports.”

Thomas H. Murray, president of The Hastings Center, an independent bioethics research center based in New York, predicted gene-doping probably wouldn't be a significant issue at the Beijing Olympics, aside from the whispers and rumors. But after that, he said, it's a different story.

As it now stands, Murray said, gene doping violates WADA rules and the general sense of what constitutes fair play. “It's ethically wrong, no different from illegal drug use,” he said.

Some observers have argued that gene transfer is OK, that it simply levels the playing field, potentially providing every athlete with roughly the same biological equipment.

Murray argues otherwise. Even if gene transfer were to become widely available and commonly used, he said the technology would have no place in sports. Who would decide which inherited, physical characteristics could be genetically altered, he asked. And where would the line be drawn?

More troubling, Murray said, “doping distorts the meaning of sports, which has nothing to do with the size of molecules or whether to use a pill or an injection. What matters here is what athletes and the people who watch athletes believe sports to be about, what they believe the whole enterprise is trying to do. Sports isn't about genetic modifications.

“If people lose heart and give in to doping,” Murray said, “sports will be changed, and not for the better.”

Bioengineering the perfect athlete (2008, Jul 16)

Bioengineering the perfect athleteLast Updated: Wednesday, July 16, 2008 | 8:04 AM ET By Matthew Herper Forbes Athletes can develop amazing strength and abilities without drugs, but world-class comptetitors are now operating near the limits of human physiology. (Ron Staton/AP)Will scientists ever create the perfect athlete?

Sure, someday. But creating drug-enhanced superhumans along the lines of Captain America or the Russian boxer who beat up Sylvester Stallone in Rocky IV is a lot harder than you'd think.

In fact, the most talked about super-steroid, a drug designed to treat muscular dystrophy, failed in a clinical trial earlier this year and has been discontinued by Wyeth, its maker.

Some drugs can dramatically improve the performance of weightlifters, sprinters and cyclists, and many current world records were probably achieved with the help of man-made chemicals. Steroids and Erythropoietin (EPO), a hormone manufactured to combat anemia in cancer and kidney dialysis patients, clearly increase strength and endurance, respectively. And because world-class athletes operate near the limits of human physiology, tiny differences add up. Tufts researcher Roger Tobin has estimated that a 10 per cent increase in a baseball player's muscle mass could double the number of home runs he hits.

But the number of really effective performance-enhancing drugs may stop there. Many athletes who dope could be loading their blood with placebos, or worse.

Human growth hormone (HGH) has been at the center of the doping scandal in baseball. But there is little evidence it actually works. When Stanford researchers pooled placebo-controlled clinical trials of HGH involving 300 patients, they found no benefit for muscle strength. Another placebo-controlled study conducted at the Garvan Institute of Medical Research in Sydney, Australia, found that athletes' performance improved whether or not they were taking real HGH because of the psychological impact of thinking they were taking strength-boosting meds.

Nine out of every 10 medicines that drug companies put into human testing fail, either because they're not safe, or because they aren't effective. Those studies may have involved too few patients to pick up an improvement in athletic performance from HGH, or athletes might need to take it for years at a time to get a meaningful improvement. In reality though, creating a new drug to do anything is tremendously difficult. Nine out of every 10 medicines that drug companies put into human testing fail, either because they're not safe, or because they aren't effective. In search of super-steroids Performance-enhancing drugs for athletes are no different. Steroids were invented 75 years ago. EPO sold by Amgen and Johnson & Johnson for its legitimate uses came around in the early 1980s, as did HGH, which is sold by Pfizer and Genentech. Scientists are trying to develop other drugs that athletes might choose to abuse, including gene therapies, a spate of experimental medicines that turn normal rodents into mighty mice, and new growth hormones. But no flood of super-steroids has yet emerged.

One of the most promising ways of increasing strength is by blocking a protein called myostatin that slows down muscle growth. Belgian blue cows, which lack the myostatin gene, are so covered with bulky, rippling muscles that they look like something out of a bovine superhero cartoon. Mice engineered to lack myostatin get far bulkier than if they are given steroids. In one documented case where a human baby lacked the gene to make myostatin, he was unusually strong. At age four he could hold a 7-pound barbell in each outstretched hand, according to the New England Journal of Medicine.

Given all that biological evidence, a drug that blocks myostatin would seem like a slam dunk as a treatment for muscular dystrophy — and as a drug ripe for abuse by athletes. Wyeth, one of the world's largest pharmaceutical companies, created a myostatin-blocking drug and put it into clinical trials for Duchenne muscular dystrophy, a muscle-wasting disease that kills hundreds of men each year before they reach their mid-thirties. Over-the-counter supplements that claimed to block myostatin took off with weightlifters.

But earlier this year, Wyeth published disappointing results about its myostatin blocker, MYO-029. And then, deep in a filing with the U.S. Securities and Exchange Commission, Wyeth quietly announced that it had canceled all testing of the experimental drug.

Se-Jin Lee, the molecular biologist at Johns Hopkins University who discovered myostatin in mice in 1992, says it's "disappointing" that MYO-029 is dead, but he still believes blocking myostatin holds promise. Acceleron, a Cambridge, Mass.-based biotech firm, is still pursuing the approach. As for those dietary supplements, "They must be bogus."

But what really disappoints Lee is that discussion of a promising treatment for a devastating disease becomes entangled in discussions of doping. The benefits go far beyond the Duchenne muscular dystrophy, a disease that is diagnosed in only 600 American boys a year, to diseases like cancer and AIDS. Such drugs could even have a big effect on the muscle weakening that comes with aging.

"Everybody gets old; everybody is going to lose muscle mass," Lee says. "If you look at the benefit of buying people five more years of independent living, it seems a little out of whack to be worrying about sports records."

And despite all the difficulties inherent in drug development, medicines that could enhance athlete performance are still moving forward. Acceleron and some other companies are working on several different drugs that hit myostatin. And Affymax, a Palo Alto biotech firm, is working on what may be a cheaper, easier to use version of EPO.

These are baby steps, but also reminders that someday, performance-enhancing drugs will be able to really push the limits of what the human body can do — like it or not.

The amazing adventures of gene doping man (2008, Jun 21)

The amazing adventures of gene doping manDan Silkstone June 21, 2008 THE breakout star of this year's Beijing Olympics just might be a name you've never heard before.

Ladies and gentlemen, please welcome to the winners' podium . . . Gene.

Gene is neither man nor woman, athlete nor coach.

Gene doping is a sophisticated method of cheating and a phrase you'll be hearing a lot more of soon.

It is the stuff of comic books - superhumans born from laboratory experiments, incredible bulk, designer viruses and alien incursions into human DNA.

If it all sounds a little far-fetched, you haven't been keeping up as science streaks past science fiction.

Many experts believe gene doping is already happening and warn that tinkering with human DNA to boost performance could seriously injure or even kill those who try it.

Oh, and a test to detect it is years away - perhaps as much as a decade.

At stake is the integrity of sport itself.

Only years after Sydney's 2000 Olympics do we realise that the Games some dubbed "friendly" were more like pharmaceutical.

Many of the best-known medallists, particularly in athletics, have handed back their medals as investigation of the infamous BALCO laboratory and other cheat rings uncovered systematic doping.

Since Sydney, the possibilities offered by science have multiplied rapidly.

Now the question is: could the biggest dopes of all, this August, be the hundreds of millions expecting a fair contest? Dr Peter Larkins is a former head doctor for Australia's athletics team and past president of Sports Medicine Australia.

"I think it is happening now," he says of gene doping.

"I can't believe that 10 years after gene therapy has been proven and we have mice that grow muscles twice the size of normal mice and mice that are called marathon mice because they run all day, I can't believe the scientists who have been unethical enough to help athletes cheat for the last 30 years aren't giving that technology to some people.

" Associate Professor Bob Stewart, a drugs-in-sport expert from Victoria University, is also pessimistic.

"We just have to accept the fact that athletes and biochemists are a jump ahead of the WADA (World Anti-Doping Agency) testers," he says.

"In sport, there is enormous incentive to pursue that competitive edge ...

There is no evidence at all that these Games are going to be clean.

The context hasn't changed, the rewards for getting an edge in performance are as high as ever.

The testing is not better for the substances that are out there.

" WADA is taking the threat seriously.

Gene doping has been banned since 2003, when it was still just a fanciful idea.

In the past fi ve years, $8 million has been spent by WADA, fi ghting against it.

Earlier this month, Russia £ once the world capital of state-sponsored drug cheating - played host to the third WADA conference on gene doping.

Warnings rang out that the practice posed a massive threat to the integrity of elite sport as the anti-drug body called for urgent action from the world's scientists.

Dr Olivier Rabin is WADA's science director.

He says his duty is to try to anticipate the future of drug cheating and be ready.

"Gene therapy is currently making huge progress at addressing many illnesses and is better and better mastered by the experts," he says.

"That leads to what we call gene doping.

" Almost all doping originates as legitimate medical treatment.

When technology offers the sick and infirm new ways to rebuild wasted tissue or replace red blood cells, it seldom takes long for rogue scientists and desperate athletes to muscle in on the game.

The gold medal question: is it happening already? "Nobody knows," Rabin admits.

It is a startling admission from the man who is a world expert on the subject.

Rabin says there is no clear-cut evidence of gene doping.

"We have heard rumours.

There is a German coach being investigated.

" German athletics coach Thomas Springstein was sacked by his club in 2006 after he was caught supplying steroids to his athletes.

When Springstein's computer was seized, authorities found emails discussing the purchase of repoxygen - a gene treatment, developed for anaemia, that makes the body produce erythropoietin (EPO).

"We work on the assumption that it will happen one day, if it has not already," Rabin says.

As it waits for a test, WADA has worked hard to build links with the labs developing gene therapy for illnesses such as muscular dystrophy and motor neurone disease.

"Some of them tell us that following scientifi c symposia or workshops, they are being approached by athletes and coaches interested in the technology and asking if it is possible to inject their athletes," Rabin says.

"We have even had a case of a coach approaching a scientist and asking if his whole team could be treated, so we know there is a huge interest from some athletes in this and from the part of the sport community interested in doping.

" Clearly, there are athletes who want gene doping technology.

There are also people who wish to sell it.

It is the scientists who don't talk to WADA who are the most worrying.

Rabin made contact last year with one such lab over the internet.

Posing as an athlete, he purchased repoxygen.

But when the substance was received and tested, it proved to be standard EPO - sold at an inflated price.

There are, Rabin says, trends and fashions in doping.

Cheating athletes want the latest, undetectable substances.

Ultimately, though, athletes are not stupid.

"They will use a drug if they believe it will work and they believe they are not going to get caught.

If it does work, they will keep going.

" How close are we to a test? Larkins says "about 10 years" but Rabin says preliminary work shows gene doping does leave a detectable "signature".

"It is clear today that we do not have a test and are still at a research level. But things can move fairly quickly ∑ it could be weeks or it could be years."

Australia is at the forefront of the search.

In a laboratory at the quaintly named National Measurement Institute in Sydney, Dr Kerry Emslie and her team are working hard. "It is a needle in a haystack we are looking for. It is not easy," she says.

Emslie says a reliable test is probably years away but thinks the signs are encouraging. She wrote a paper last year for the Government, assessing the potential threat posed by gene doping. Lose the initial fight, she warns, and as technology improves, we will see more and more genetic manipulation and enhancement.

So how does it work?

First, the gene that governs a certain desirable function is isolated ˜ the source is usually another person. Then, in a laboratory, it is amplified ˜ made more powerful. The gene is then inserted into a viral vector, a virus that has had the harmful part of its structure deactivated but which retains the ability to penetrate and colonise human cells. It is a sort of biological Trojan Horse.

Adenovirus ˜ a common cause of respiratory problems ˜ is most often used but other viruses such as herpes simplex or even HIV are being looked at. The vector is injected into the athlete and begins to take over cells. Once inside, the altered gene becomes part of the cell's DNA and recodes it to behave differently ˜ producing, for example, more and stronger muscle or creating EPO, which in turn creates more red blood cells.

The virus colonises cells at the same rate it would if carrying disease. Once the gene is embedded, it will be expressed. There is no turning back.

Emslie thinks the viral vector leaves a trace that could be the basis for a test. But so little of the vector is required to start the process that searching for it is extremely difficult. Another option is to search for the body's immune reaction to the virus. At the moment, the only way to test for genetic manipulation is to take a muscle biopsy ˜ an invasive procedure that athletes would never submit to.

The search is annoyingly slow. Anyone charged with doping will automatically challenge the finding in court and a testing regime considered untried or experimental would not withstand legal scrutiny. While the cheats may gamble with untried and cutting-edge technology, the drug testers must be certain.

Rabin says that as testing for synthetic EPO gets better, the focus of cheats will shift to gene doping. Currently, athletes must be tested soon after administering EPO. When they remove themselves to distant training locations, they are hard to uncover. But WADA has been cracking down on such practice and is now forcing athletes to continually disclose their whereabouts. Time is running out for the EPO cheats.

Dr Harry Rothenfluh is national testing manager for the Australian Sports Anti-Doping Authority. He says the lack of a test does not give potential gene dopers a free pass. "Finding a test is going to be a real challenge but we also have intelligence functions looking at information coming in and seeking information."

The organisation now has an intelligence staff of six scientists and former law enforcement people. They trawl internet sites where athletes seek information, forge close ties with labs and try to predict where illegal medical technology might be found. "We aren't just relying on testing because we don't know how far away a test will be."

If this brave new world all sounds a little Frankenstein, Larkins says we should have seen it coming. "We've always known genetics determines talent and genetic selection of athletes has gone on since the 1960s," he points out.

Ian Thorpe endured a doping scandal in 2007 because his natural production of hormones was abnormal. Thorpe was a genetic freak. It's easy to see how a rival might be tempted to cheat. No matter how hard you train, the Thorpes of this world have an inbuilt genetic advantage. Why not redress that imbalance?

Larkins says it is a tragedy for sport and a danger for its future that we simply will not know until years after Beijing who, if anyone, was cheating.

"If anyone performs too well in Beijing, the cloud will be over them for the next 10 years. Every fantastic performance now is tainted ∑ it is a really sad thing for sport."

Blood samples taken during the Games will be frozen for eight years and retested once new detection methods are developed. A star two months from now could be unmasked as a cheat two years hence.

Because of the cost and scientific complexity, it is unlikely that huge numbers of athletes are gene doping. But, as the BALCO case showed, it is those near the top who have the most reason to use such methods and the best means of accessing them.

There are plenty of ethical problems with gene doping. But far more pressing are the medical questions surrounding the embryonic science. Experiments and trials over the past decade have demonstrated an impressive capacity to retool human bodies by tinkering with DNA. They have also uncovered some terrible side effects.

And while accessing substances from a legitimate laboratory is one method of gene doping, once research is published, it can be relatively simple for others to "follow the recipe" and replicate gene treatments in secret labs.

"Doing this is much more complicated than injection of EPO," Rabin says. "We know that from experiments conducted on animals that if you cannot regulate correctly expression of the EPO gene, then you die. Your blood becomes so thick that it coagulates."

If you think that is enough to scare athletes away, think again. Rabin estimates that during the late 1990s, when EPO abuse was in an early phase, 20-30 young cyclists died from the substance. "We know people will take the risk . . . when you are an athlete in your 20s, you feel invincible."

ASADA's Rothenfluh says human trials of gene therapy are still in the early stages and it is vital that athletes realise the danger. "There have been some pretty high-profile cases. A young man in the US died as a result of his body reacting to the virus inserted and there were some kids in another trial for whom the treatment accidentally activated leukaemia. There are some pretty major risks but the lesson of history is some athletes won't care."

Rothenfluh says there is a quantum leap between traditional drug cheating and gene doping. With traditional doping, an athlete can stop taking the drug if harmful side-effects become apparent. Quit taking steroids, EPO or human growth hormone and there's a fair chance your body will recover. "But once you've put a gene inside a viral vector into your system, it is not really possible to get it back out."

Larkins also fears the consequences. "You are manipulating your cells' biology at a micro level," he says. "In the studies of this, more mice die than actually survive."

But the mice that do survive have 30% bigger muscles, more power and more strength, he says, or can run all day without ever training.

Victoria University's Stewart says the effect of gene doping on the coming Games is uncertain, but says gene doping, coupled with next-generation EPO products, means there is now a distinct gap between the cheats and the testers.

He proposes a radical solution ˜ opening the doors to supervised and controlled doping. "It's really a matter of finding policy measures that aren't as punitive and are based around education, harm-minimisation and protecting the health and wellbeing of athletes and not worrying too much whether someone has an unfair advantage.

"As fans, we pretend and fantasise about naturally gifted athletes and sheer hard work but we already use genetics to identify athletes for sports, then we target them and train them up and feed them specific diet. There's not much accident in it."

It's an interesting idea but unlikely to happen soon and it hardly seems fair to the overwhelming majority of athletes who do not cheat. Instead, it seems, we are in a new era where gold medals will be provisional and world records arrive with asterisks attached.

It's not ideal to catch drug cheats years after the event, WADA says. But it is better than not catching them at all.

Gene genie is out of the bottle, and cheats may escape Dan Silkstone June 21, 2008 "It is clear today that we do not have a test and are still at a research level. But things can move fairly quickly ∑ it could be weeks or it could be years."

Australia is at the forefront of the search.

In a laboratory at the quaintly named National Measurement Institute in Sydney, Dr Kerry Emslie and her team are working hard. "It is a needle in a haystack we are looking for. It is not easy," she says.

Emslie says a reliable test is probably years away but thinks the signs are encouraging. She wrote a paper last year for the Government, assessing the potential threat posed by gene doping. Lose the initial fight, she warns, and as technology improves, we will see more and more genetic manipulation and enhancement.

So how does it work?

First, the gene that governs a certain desirable function is isolated ˜ the source is usually another person. Then, in a laboratory, it is amplified ˜ made more powerful. The gene is then inserted into a viral vector, a virus that has had the harmful part of its structure deactivated but which retains the ability to penetrate and colonise human cells. It is a sort of biological Trojan Horse.

Adenovirus ˜ a common cause of respiratory problems ˜ is most often used but other viruses such as herpes simplex or even HIV are being looked at. The vector is injected into the athlete and begins to take over cells. Once inside, the altered gene becomes part of the cell's DNA and recodes it to behave differently ˜ producing, for example, more and stronger muscle or creating EPO, which in turn creates more red blood cells.

The virus colonises cells at the same rate it would if carrying disease. Once the gene is embedded, it will be expressed. There is no turning back.

Emslie thinks the viral vector leaves a trace that could be the basis for a test. But so little of the vector is required to start the process that searching for it is extremely difficult. Another option is to search for the body's immune reaction to the virus. At the moment, the only way to test for genetic manipulation is to take a muscle biopsy ˜ an invasive procedure that athletes would never submit to.

The search is annoyingly slow. Anyone charged with doping will automatically challenge the finding in court and a testing regime considered untried or experimental would not withstand legal scrutiny. While the cheats may gamble with untried and cutting-edge technology, the drug testers must be certain.

Rabin says that as testing for synthetic EPO gets better, the focus of cheats will shift to gene doping. Currently, athletes must be tested soon after administering EPO. When they remove themselves to distant training locations, they are hard to uncover. But WADA has been cracking down on such practice and is now forcing athletes to continually disclose their whereabouts. Time is running out for the EPO cheats.

Dr Harry Rothenfluh is national testing manager for the Australian Sports Anti-Doping Authority. He says the lack of a test does not give potential gene dopers a free pass. "Finding a test is going to be a real challenge but we also have intelligence functions looking at information coming in and seeking information."

The organisation now has an intelligence staff of six scientists and former law enforcement people. They trawl internet sites where athletes seek information, forge close ties with labs and try to predict where illegal medical technology might be found. "We aren't just relying on testing because we don't know how far away a test will be."

If this brave new world all sounds a little Frankenstein, Larkins says we should have seen it coming. "We've always known genetics determines talent and genetic selection of athletes has gone on since the 1960s," he points out.

Ian Thorpe endured a doping scandal in 2007 because his natural production of hormones was abnormal. Thorpe was a genetic freak. It's easy to see how a rival might be tempted to cheat. No matter how hard you train, the Thorpes of this world have an inbuilt genetic advantage. Why not redress that imbalance?

Larkins says it is a tragedy for sport and a danger for its future that we simply will not know until years after Beijing who, if anyone, was cheating.

"If anyone performs too well in Beijing, the cloud will be over them for the next 10 years. Every fantastic performance now is tainted ∑ it is a really sad thing for sport."

Blood samples taken during the Games will be frozen for eight years and retested once new detection methods are developed. A star two months from now could be unmasked as a cheat two years hence.

Because of the cost and scientific complexity, it is unlikely that huge numbers of athletes are gene doping. But, as the BALCO case showed, it is those near the top who have the most reason to use such methods and the best means of accessing them.

There are plenty of ethical problems with gene doping. But far more pressing are the medical questions surrounding the embryonic science. Experiments and trials over the past decade have demonstrated an impressive capacity to retool human bodies by tinkering with DNA. They have also uncovered some terrible side effects.

And while accessing substances from a legitimate laboratory is one method of gene doping, once research is published, it can be relatively simple for others to "follow the recipe" and replicate gene treatments in secret labs.

"Doing this is much more complicated than injection of EPO," Rabin says. "We know that from experiments conducted on animals that if you cannot regulate correctly expression of the EPO gene, then you die. Your blood becomes so thick that it coagulates."

If you think that is enough to scare athletes away, think again. Rabin estimates that during the late 1990s, when EPO abuse was in an early phase, 20-30 young cyclists died from the substance. "We know people will take the risk . . . when you are an athlete in your 20s, you feel invincible."

ASADA's Rothenfluh says human trials of gene therapy are still in the early stages and it is vital that athletes realise the danger. "There have been some pretty high-profile cases. A young man in the US died as a result of his body reacting to the virus inserted and there were some kids in another trial for whom the treatment accidentally activated leukaemia. There are some pretty major risks but the lesson of history is some athletes won't care."

Rothenfluh says there is a quantum leap between traditional drug cheating and gene doping. With traditional doping, an athlete can stop taking the drug if harmful side-effects become apparent. Quit taking steroids, EPO or human growth hormone and there's a fair chance your body will recover. "But once you've put a gene inside a viral vector into your system, it is not really possible to get it back out."

Larkins also fears the consequences. "You are manipulating your cells' biology at a micro level," he says. "In the studies of this, more mice die than actually survive."

But the mice that do survive have 30% bigger muscles, more power and more strength, he says, or can run all day without ever training.

Victoria University's Stewart says the effect of gene doping on the coming Games is uncertain, but says gene doping, coupled with next-generation EPO products, means there is now a distinct gap between the cheats and the testers.

He proposes a radical solution ˜ opening the doors to supervised and controlled doping. "It's really a matter of finding policy measures that aren't as punitive and are based around education, harm-minimisation and protecting the health and wellbeing of athletes and not worrying too much whether someone has an unfair advantage.

"As fans, we pretend and fantasise about naturally gifted athletes and sheer hard work but we already use genetics to identify athletes for sports, then we target them and train them up and feed them specific diet. There's not much accident in it."

It's an interesting idea but unlikely to happen soon and it hardly seems fair to the overwhelming majority of athletes who do not cheat. Instead, it seems, we are in a new era where gold medals will be provisional and world records arrive with asterisks attached.

It's not ideal to catch drug cheats years after the event, WADA says. But it is better than not catching them at all.

Hustle and muscle (2008, June 14)

Hustle and muscleSaturday June 14 2008 21:45 IST

Praveen Raja

Early in 2008, when Olivier Rabin, science director at the World Anti-Doping Agency (WADA) was quizzed on whether WADA had developed dope tests for both Selective Androgen Receptor Modulators (SARMs) and Myostatin inhibitors, he nodded in the affirmative.

“In fairness to athletes who stay clean, we don’t say when detection tools are available,” he had said. “We say when we detect the first athletes using the drugs.”

We have to wait to tell if that optimism was feigned. But we already know what these two doping agents can do. These two new classes of drugs, which have made WADA’s 2008 list of prohibited substances, have super powerful muscle-building capabilities.

Unlike testosterone and other tried and tested steroids, SARMs and myostatin inhibitors target individual muscle groups.

Here’s how SARMs gets their name. An androgen is a male sex hormone (such as testosterone). Androgens bind to chemicals on the surface of certain muscles, and initiate cellular processes, like inhibiting or regulating muscular growth. An SARM molecule can activate certain chemicals in the muscle without affecting others. In effect, SARMs can safely ‘switch off’ certain fibres of muscles from bowing to heredity. The muscle just keeps growing. Athletes could build strength, and increase muscle mass or bone density without harmful side-effects or getting caught.

Myostatin inhibitors get the job done in a different way. They block Myostatin, a naturally occurring protein in the body that stops growth of skeletal muscle. An experiment was performed on mice whose myostatin genes had been disabled and they turned into what scientists called ‘Schwarzenegger mice’.

In WADA’s own words: “Based upon their mechanisms of action and early clinical results in humans, these compounds have the potential to be used as doping substances.”

WADA has reasons to be wary. No one could have forgotten the case of disgraced German coach Thomas Springstein, who was accused of gene doping athletes, including minors. The substance used was Repoxygen, a substance that stimulates the production of red blood cells. That infamous substance joined the WADA list in 2006 and still remains one of the most elusive of drugs to detect.

If experts are to be believed, in the future, an athlete could point to any of his muscles and simply ask his coach or doctor to ‘supersize it’ — like in a McDonalds. The same experts also warn that the ‘X-men’ athlete could debut at the 2008 Olympics. The future is now.

suvheart@gmail.com

Gene doping - sport's next big challenge (2008, Jun 12)

Gene doping - sport's next big challengeMatt Slater 12 Jun 08, 01:06 PM

What links sheep's testicles, Scandinavian fungi , strychnine and fine cognac?

Are they the contents of the cupboard under my kitchen sink? Vague memories from my stag do? The honourable way out for a rural Swedish chemist with a well-stocked drinks cabinet?

No. They are all things athletes (or Vikings) have tried to enhance performance.

Of course, they've also tried lots of amphetamines, steroids and naturally-occurring substances to help them go citius, altius and fortius , and that has made things quite tricky for those trying to maintain fair play.

No matter how many pills, rubs and potions the sporting authorities ban, the inescapable feeling is that they are slamming barn doors after the horse has bolted.

Sisyphus and his big stone , the Forth Rail Bridge 's maintenance team, Fabio Capello ...they've got nothing on sport's anti-doping regimes when it comes to endless and thankless tasks.

But at least they're still trying. And it was with this noble cause in mind the World Anti-Doping Agency (Wada) held its third Gene Doping Symposium in St Petersburg this week.

For those of you who don't know what that is, a symposium is a big chinwag...only kidding...gene doping is the evil twin of gene therapy and has been described as a doper's dream come true and curtains for clean sport.

Now I'm no scientist but I think I get the basic idea behind gene therapy : let's cut out the middleman (drugs) and get the body to heal itself. If a gene isn't working properly (and causing problems), let's change, manipulate or repair it.

The potential benefits to sufferers of illnesses like cystic fibrosis, muscular dystrophy or sickle cell anemia are huge. Be it encouraging the production of blood cells, boosting muscle growth or controlling the production of a certain hormone, genetic manipulation could be the answer.

Can you see why this might interest fit and healthy people who want to run faster, throw further, ride longer, but don't fancy the complications and risks of taking drugs?

Can you see how testers might be worried about how they're going to tell the difference between oxygen-bearing red blood cells or testosterone the body has produced naturally, and oxygen-bearing red blood cells or testosterone the body has been engineered to produce naturally?

And they are worried, there's no doubt about that.

This was made clear to me by Professor Theodore Friedmann , the head of Wada's gene doping panel and perhaps the world's foremost authority on gene therapy, when I spoke to him earlier this year.

"Gene doping is clearly an issue that will come to us sooner or later - so we should be worried in a general sense," he explained.

"If the question is should we be worried about it clouding the Beijing Games the answer isn't at all clear and is probably closer to no than yes.

"But Wada is taking it very seriously. They want to stay ahead of the question, they want to shape the issue rather than just respond to it.

"And anybody tempted to cheat should count on it being detectable. People in legitimate gene therapy need to be able to track genes and detect their action. New things are coming and we have promising evidence we can find things that way."

Friedmann also stressed just how foolish it would be for any athlete to dabble in what remains a very experimental area.

"Sport represents the first opening to gene transfer that is not for disease management but for the enhancement of human traits," he said.

"Any attempt to use genetic tools of this sort in sport would first of all be fraught with danger, and secondly would, in my view, be medical malpractice or professional misconduct if carried out by a medic or trainer.

"But there is a possibility of illicit use anywhere in the world. Trying to develop a legitimate clinical application for human beings is complicated but making disabled viruses or moving genes around in animal studies is within the grasp of several thousand laboratories in the UK alone. It's not that complicated.

"Illicit use in sport won't be concerned with the niceties of safe clinical research - they won't go to those extremes. So it will be done and it will be done badly.

"You are going to find mishaps and catastrophes before you find real efficacy in sport performance, I'm afraid."

So gene doping looks set to become the next line in the sand for those willing to follow Tom Simpson 's infamous maxim, "if it takes 10 to kill you, take nine and win".

The British cyclist was the BBC's Sports Personality of the Year in 1965. Two years later he died on the climb up Mont Ventoux during the Tour de France 's 13th stage.

Dehydrated by a stomach bug, he had been so doped up on amphetamines and brandy he rode beyond the pain barrier and didn't stop until his body shut down.

His death shocked sport but nothing much actually changed - cyclists, and other athletes, continued to take risks and it wasn't too long before more of them started dropping dead for wanting sporting glory too much.

But Simpson's case and gene therapy's potential benefits pose another dilemma.

Would the 1965 world road race champion have been so weakened that day if he had access to modern (and legal) sports medicine? Would today's sports drinks, supplements and vitamin shots have helped? Would he have died if his team were tracking his heart rate from the team car?

Probably not, but these are legitimate scientific advances, aren't they?

Yes, but then so is Prozac , Viagra and hormone replacement therapy . Should we deprive today's athletes of medical improvements many in society take for granted?

"The long-term question is how we answer all these questions when gene transfer technology is better understood and the tools are safer," said Friedmann.

"Athletes should not be deprived of real therapeutic tools, even preventive tools. Do we want to see sport go in that direction?"

And with that hospital pass to Wada's ethics panel I will leave you.

Matt Slater is a BBC Sport journalist focusing on sports news. Our FAQs should answer any questions you have.

WADA meeting to investigate gene doping in sport (2008, June 2)

WADA meeting to investigate gene doping in sport The Associated Press Published: June 2, 2008

The threat gene doping poses to the integrity of sport will be investigated next week ahead of the Beijing Olympics. Anti-doping leaders and genetics experts will meet in St. Petersburg, Russia to hear details of new research and developments, as well as ongoing ethical concerns.

Gene doping is an illegal spinoff of gene therapy, which typically alters a person's DNA to fight diseases like muscular dystrophy and cystic fibrosis.

The four-day Gene Doping Symposium, starting on Sunday, will be the World Anti-Doping Agency's third such gathering since 2002.

Sports Doping Researchers to Tackle Mount Everest (2008, May 26)

Sports Doping Researchers to Tackle Mount Everest HILDEN, GERMANY, May 26, 2008 (MARKET WIRE via COMTEX) ----In the run-up to the Olympics scientists use live mice for the first time on the "roof of the world" to develop new tests for gene doping Hilden, Germany / Everest Base Camp, Nepal - May 26, 2008 - In the run-up to the Summer Olympics, scientists are taking an innovative approach to develop new molecular testing methods for performance manipulation on the genetic level. A team of researchers from the University of Pennsylvania today is attempting to climb Mount Everest, taking with them for the first time live mice to the "roof of the world". The effort is being supported by the World Anti-Doping Agency (WADA) and the molecular diagnostics company QIAGEN. The purpose of the researcher's historic climb is to investigate tissue and blood samples from the mice to create a molecular signature for altitude-induced hypoxia. The scientists' ultimate goal is the development of novel testing methods for gene doping by comparing such natural molecular signatures with induced signatures that would be created by gene doping. Such practices have been listed on WADA's index of banned substances since 2003, but the identification of athletes using gene doping is still not possible. Accordingly, experts consider gene doping to be one of the most urgent problems in sports today.

The scientific team headed by Prof. Dr. Tejvir S. Khurana and Dr. Gabriel Willmann is specifically looking to find those genes that are active in a low-oxygen environment and thus enable the organism to adapt to the altered environmental conditions. In general, hypoxia has a positive influence on the body's performance as it stimulates the creation of erythropoietin (EPO), a naturally occurring hormone that promotes the production of red blood cells. When applied artificially, EPO can be easily discovered. However, if gene activity is manipulated in a way that the body produces more "natural" EPO and therefore more red blood cells without being exposed to a low oxygen environment, existing doping-detection methods prove ineffective - at least so far. Now, the University of Pennsylvania scientists intend to solve this problem by developing markers for a test that can discriminate between naturally induced activations and activations induced through gene doping.

"We are very excited that the attack on the summit is now beginning. From a research point of view, a major challenge of this endeavor will be the extraction of samples from the mice under these extreme conditions," said Dr. Gabriel Willmann, one of the initiators of the research project. "The cooperation with QIAGEN, as the world's leading provider of sample and molecular testing technologies, will help us enormously to successfully collect, process and analyze the samples. Therefore, we are confident that first results will be ready for presentation shortly after our return."

According to Peer Schatz, Chief Executive Officer of QIAGEN, this expedition shows how molecular biology is increasingly helping to find solutions for critical issues in many areas of our daily lives: "We are very pleased to partner with the team from the University of Pennsylvania in this exciting project, in which our sample and assay technologies will be used for the development of testing methods in the harshest of conditions. We are also proud to be contributing to the team's so important goal of making anti-doping controls more effective."

In addition to new testing methods for the identification of doping offenders, the scientists also hope to generate new data that may lead to a better treatment of muscular dystrophy. The incidence of this genetic disease is comparatively low, yet it is also incurable and leads to a significant loss of expectation of life. As the disease also affects respiratory muscles, patients in an advanced stadium experience a level of hypoxia comparable to the effects of exposure to extreme altitudes.

Background Gene Doping

Gene doping as defined by the WADA encompasses the non-therapeutic use of cells, genes, genetic elements, or of the modulation of gene expression, having the capacity to enhance athletic performance. An example for such doping approaches is a method to increase the organism's own production of EPO using an active agent called HIF-stabilizers. Usually, a protein called hypoxia-induced factor (HIF) ensures the sufficient supply of oxygen to cells as it stimulates the production of EPO in low oxygen environments. When the oxygen concentration rises, both the production of HIF and of EPO decreases. This process is driven by an enzyme called HIF-PH, which reduces HIF. So called HIF-stabilizers can be used to stop the enzyme from functioning, resulting in a slower reduction of HIF and thus higher EPO levels. New products for the treatment of anemia currently under development tackle exactly this mechanism using HIF-stabilizers.

Note

Photos of the expedition, info graphics explaining the application of molecular tests and pictures describing the principles of gene doping can be ordered from: pr@qiagen.com.

Background QIAGEN

QIAGEN N.V., a Netherlands holding company, is the leading global provider of sample and assay technologies. Sample technologies are used to isolate and process DNA, RNA and proteins from biological samples such as blood or tissue. Assay technologies are used to make such isolated biomolecules visible. QIAGEN has developed and markets more than 500 consumable products as well as automated solutions for such consumables. The company provides its products to molecular diagnostics laboratories, academic researchers, pharmaceutical and biotechnology companies, and applied testing customers for purposes such as forensics, animal or food testing and pharmaceutical process control. QIAGEN's assay technologies include one of the broadest panels of molecular diagnostic tests available worldwide. This panel includes the only FDA-approved test for human papillomavirus (HPV), the primary cause of cervical cancer. QIAGEN employs more than 2,700 people in over 30 locations worldwide. Further information about QIAGEN can be found at www.qiagen.com. Contact: Public Relations QIAGEN Tel.: +49 2103 29 11826 Mail: PR@qiagen.com Copyright Copyright Hugin AS 2008. All rights reserved.

SOURCE: Qiagen N.V.