Endurance in a pill

**steve** · #1 07-27.-2009

This probably explains the lack of scandals this year.

Quote:

Originally Posted by cyclingnews.com

The AFLD head also said he is "convinced that two new products have been used during the Tour, two drugs that are not yet on the market."

The first, Hematide, works on the same biochemical pathway that erythropoeitin (EPO) does, but is a different molecule. It would, therefore, likely defeat the traditional test for EPO. The drug, made by Affymax, is still in phase three clinical trials.

The second drug that Bordry suspects is AICAR (aminoimidazole carboxamide ribonucleotide), or the so-called "exercise in a pill" which made news in 2008. Scientists discovered that in mice, the drug can boost endurance in the absence of actual training. The drug was found to convert fast-twitch muscle fibers to the more efficient slow-twitch fibers that benefit endurance athletes.

From wikipedia:

In 2008, researchers at the Salk Institute discovered that AICAR given to experimental mice significantly improves their performance in endurance-type exercise, apparently by converting fast-twitch muscle fibers to the more energy-efficient, fat-burning, slow-twitch type.

They also looked at the administration of GW 501516 (also called GW1516) in combination with AICAR. Given to mice that did not exercise, this combination activated 40% of the genes that were turned on when mice were given GW1516 and made to exercise. This suggests it may be possible to obtain some of the benefits of exercising without actually exercising.

Because of the enhanced endurance effects, this could potentially be used by athletes to enhance their performance. One of the lead researchers from this study has developed a urine test to detect it and has made the test available to the International Olympic Committee, and the World Anti-Doping Agency has added AICAR to the prohibited list from 2009 onwards.

Cobblestones · #2 07-29.-2009

I think this is very important news. There has also been an article in the German journal Spiegel about it (which had daily and very level-headed Tour de France coverage).

It was a conundrum for me that riders are still performing at levels of 1990's and early 2000's (the darkest period of cycling) while hematocrit levels have come down to more normal value in the mid-lower 40s. Possible explanations were (i) the use of HBOCs or PFCEs (ii) an elaborate scheme of transfusions, blood letting, dilution and whatnot or (iii) increasing the efficiency of oxygen uptake. Now it seems the latter is the most likely. But let me step back for a moment.

A lot of blood manipulation should be detectable with the blood passport (which is basically a more sophisticated approach for setting limits on biological parameters than the old 50% crit threshold). The passport itself has not yet been used to convict riders for doping. What has happened is that the 50% rule has been invoked to ban riders from races (without it becoming a doping infraction) and that the passport has helped to single out riders for targeted testing (which has then sometimes resulted in non-negatives and doping convictions). Still, all convictions have come either from non-negative tests, or from circumstantial evidence such as affiliation with doping networks such as OP or the Vienna lab. At this point, I think the blood passport is at best a partial success. I think it could be used more aggressively by applying it in the same way as the 50% rule, i.e., by banning riders from competing for medical reasons without making it an actual doping conviction.

In terms of doping tests, we know that mostly, the labs are years behind the athletes. Only in the case of CERA, where the structure of the molecule was communicated to anti-doping labs such that tests could be developed faster than usual, this wasn't the case. Different types of EPO and/or CERA molecules require different tests. The labs do good work but will always be behind (hence the blood passport and the idea of retroactive testing of up to 5 years).

Hematide is different enough from any EPO/CERA product that completely different tests have to be employed. Now the use of hematide (at least in large doses) should be obvious on the blood passport. However, since the passport has neither been used for doping convictions nor for banning riders from competing, and since there's no test for hematide, it's a free for all. Still, because the crit levels are nowhere near 50% it alone cannot explain the current level of performance.

What I find more interesting in this respect is AICAR. First of all it is a substance which is naturally occurring in the human body. So, just as testosterone, the presence of AICAR is no indication of doping. Only an increase of AICAR above a certain threshold would be. At present, I think there is no such threshold defined (although AICAR is on the list of banned substances and there seems to be a test for it). This means that even if it's found in testing, it might not be clear whether one can get a doping conviction or not (at least it would give Vrijman a new hatchet job to do).

It gets even more interesting when we look at how AICAR (aminoimidazole carboxamide ribonucleotide) works. On the WADA list, it says:

Quote:

... PPARdelta-AMP-activated protein kinase (AMPK) axis agonists (e.g. AICAR) are prohibited.

which doesn't really say much at all.

Let me first give a few WIKI links of relevance.
1.) PPAR
2.) AICAR
3.) AMP-activated protein kinase or AMKP
the last one being the most relevant one. In the simplest terms, AICAR works by latching on to PPARdelta (peroxisome proliferator-activated receptor delta) which leads in the end to production of AMP-activated protein kinase. So, what we really should be looking at, is the effect of AMPK (hence the third link).

From that link:

Quote:

Many biochemical adaptations of skeletal muscle that take place during a single bout of exercise or an extended duration of training, such as increased mitochondrial biogenesis and capacity [11][12], increased muscle glycogen[13], and an increase in enzymes which specialize in glucose uptake in cells such as GLUT4 and hexokinase II [14][15][13] are thought to be mediated in part by AMPK when it is activated (2).[16] Additionally, recent discoveries can conceivably suggest a direct AMPK role in increasing blood supply to exercised/trained muscle cells by stimulating and stabilizing both vasculogenesis and angiogenesis.[17] Taken together, these adaptations most likely transpire as a result of both temporary and maintained increases in AMPK activity brought about by increases in the AMP:ATP ratio during single bouts of exercise and long-term training.
During a single acute exercise bout, AMPK allows the contracting muscle cells to adapt to the energy challenges by increasing expression of hexokinase II[13], translocation of GLUT4 to the plasma membrane [9][18][19][20] for glucose uptake, and by stimulating glycolysis.[21] If bouts of exercise continue through a long-term training regimen, AMPK and other signals will facilitate contracting muscle adaptations by escorting muscle cell activity to a metabolic transition resulting in an oxidative dependent approach to energy metabolism as opposed to a glycolytic approach. AMPK accomplishes this transition to the oxidative mode of metabolism by upregulating and activating oxidative enzymes such as GLUT4, hexokinase II, PPARalpha, PGC-1, UCP-3, cytochrome C and TFAM (2).[15][13][22][23][24]

and BINGO.

Moreover, I found this gem:

Quote:

One of the effects of exercise is an increase in fatty acid metabolism, which provides more energy for the cell. One of the key pathways in AMPK’s regulation of fatty acid oxidation is the phosphorylation and inactivation of acetyl-CoA carboxylase.[17] Acetyl-CoA carboxylase (ACC) converts acetyl-CoA to malonyl-CoA, an inhibitor of carnitine parmitoyltransferase 1 (CPT-1). CPT-1 transports fatty acids into the mitochondria for oxidation. Inactivation of ACC, therefore, results in increased fatty acid transport and subsequent oxidation. It is also thought that the decrease in malonyl-CoA occurs as a result of malonyl-CoA decarboxylase (MCD), which may be regulated by AMPK.[11] MCD is an antagonist to ACC, decarboxylating malonyl-CoA to acetyl-CoA, resulting in decreased malonyl-CoA and increased CPT-1 and fatty acid oxidation.

and we have a second BINGO, because I suspect that we have found the reason for the somewhat mysterious weight loss (in particular the loss of any body fat) by some riders. How much did Wiggo lose again? Also, when you look at photos of LA, his subcutaneous fat layer is practically nonexistent. It's pretty clear now from where the riders get their 'concentration camp' look.

It all really makes sense now.

Anyway, sorry for the lengthy post, but I think I have now a fairly good idea what is going one, and I wanted to share my moment of enlightenment with you guys.

davidbod · #3 07-29.-2009

The article I read on velonews on this subject indicates the both Hematide and Aicar would not be a problem for labs to detect in urine. If that is the case why would any rider use it knowing that the lab would eventually find it in the samples. This is nothing more than LeMonde making up a headline in my opinion, but time will tell.

**limerickman** · #4 07-29.-2009

Quote:

Originally Posted by Cobblestones

I think this is very important news. There has also been an article in the German journal Spiegel about it (which had daily and very level-headed Tour de France coverage).

It was a conundrum for me that riders are still performing at levels of 1990's and early 2000's (the darkest period of cycling) while hematocrit levels have come down to more normal value in the mid-lower 40s. Possible explanations were (i) the use of HBOCs or PFCEs (ii) an elaborate scheme of transfusions, blood letting, dilution and whatnot or (iii) increasing the efficiency of oxygen uptake. Now it seems the latter is the most likely. But let me step back for a moment.

A lot of blood manipulation should be detectable with the blood passport (which is basically a more sophisticated approach for setting limits on biological parameters than the old 50% crit threshold). The passport itself has not yet been used to convict riders for doping. What has happened is that the 50% rule has been invoked to ban riders from races (without it becoming a doping infraction) and that the passport has helped to single out riders for targeted testing (which has then sometimes resulted in non-negatives and doping convictions). Still, all convictions have come either from non-negative tests, or from circumstantial evidence such as affiliation with doping networks such as OP or the Vienna lab. At this point, I think the blood passport is at best a partial success. I think it could be used more aggressively by applying it in the same way as the 50% rule, i.e., by banning riders from competing for medical reasons without making it an actual doping conviction.

In terms of doping tests, we know that mostly, the labs are years behind the athletes. Only in the case of CERA, where the structure of the molecule was communicated to anti-doping labs such that tests could be developed faster than usual, this wasn't the case. Different types of EPO and/or CERA molecules require different tests. The labs do good work but will always be behind (hence the blood passport and the idea of retroactive testing of up to 5 years).

Hematide is different enough from any EPO/CERA product that completely different tests have to be employed. Now the use of hematide (at least in large doses) should be obvious on the blood passport. However, since the passport has neither been used for doping convictions nor for banning riders from competing, and since there's no test for hematide, it's a free for all. Still, because the crit levels are nowhere near 50% it alone cannot explain the current level of performance.

What I find more interesting in this respect is AICAR. First of all it is a substance which is naturally occurring in the human body. So, just as testosterone, the presence of AICAR is no indication of doping. Only an increase of AICAR above a certain threshold would be. At present, I think there is no such threshold defined (although AICAR is on the list of banned substances and there seems to be a test for it). This means that even if it's found in testing, it might not be clear whether one can get a doping conviction or not (at least it would give Vrijman a new hatchet job to do).

It gets even more interesting when we look at how AICAR (aminoimidazole carboxamide ribonucleotide) works. On the WADA list, it says:

which doesn't really say much at all.

Let me first give a few WIKI links of relevance.
1.) PPAR
2.) AICAR
3.) AMP-activated protein kinase or AMKP
the last one being the most relevant one. In the simplest terms, AICAR works by latching on to PPARdelta (peroxisome proliferator-activated receptor delta) which leads in the end to production of AMP-activated protein kinase. So, what we really should be looking at, is the effect of AMPK (hence the third link).

From that link:

and BINGO.

Moreover, I found this gem:

and we have a second BINGO, because I suspect that we have found the reason for the somewhat mysterious weight loss (in particular the loss of any body fat) by some riders. How much did Wiggo lose again? Also, when you look at photos of LA, his subcutaneous fat layer is practically nonexistent. It's pretty clear now from where the riders get their 'concentration camp' look.

It all really makes sense now.

Anyway, sorry for the lengthy post, but I think I have now a fairly good idea what is going one, and I wanted to share my moment of enlightenment with you guys.

Thanks for the post, Cob.
Certainly adds to the database of knowledge as regards what benefits can be derived from those products.

Cobblestones · #5 07-29.-2009

Quote:

Originally Posted by davidbod

The article I read on velonews on this subject indicates the both Hematide and Aicar would not be a problem for labs to detect in urine. If that is the case why would any rider use it knowing that the lab would eventually find it in the samples. This is nothing more than LeMonde making up a headline in my opinion, but time will tell.

There is no test for hematide As far as I know; there might be one in the future, but then you have the whole question about chain of custody and change of sample in storage debacle again. It could work or not.

There is a test for AICAR, but because it's a naturally occurring molecule, one needs to define a threshold. I don't think that has been done yet. Plenty of room to maneuver there. I think it is unclear yet what would be acceptable levels in endurance athletes.

Klodifan · #6 08-01.-2009

wow, that is fascinating. i am always so amazed at the level of insanity athletes are driven to for the sake of glory. riders really are lab rats.

Quote:

Originally Posted by Cobblestones

I think this is very important news. There has also been an article in the German journal Spiegel about it (which had daily and very level-headed Tour de France coverage).

It was a conundrum for me that riders are still performing at levels of 1990's and early 2000's (the darkest period of cycling) while hematocrit levels have come down to more normal value in the mid-lower 40s. Possible explanations were (i) the use of HBOCs or PFCEs (ii) an elaborate scheme of transfusions, blood letting, dilution and whatnot or (iii) increasing the efficiency of oxygen uptake. Now it seems the latter is the most likely. But let me step back for a moment.

A lot of blood manipulation should be detectable with the blood passport (which is basically a more sophisticated approach for setting limits on biological parameters than the old 50% crit threshold). The passport itself has not yet been used to convict riders for doping. What has happened is that the 50% rule has been invoked to ban riders from races (without it becoming a doping infraction) and that the passport has helped to single out riders for targeted testing (which has then sometimes resulted in non-negatives and doping convictions). Still, all convictions have come either from non-negative tests, or from circumstantial evidence such as affiliation with doping networks such as OP or the Vienna lab. At this point, I think the blood passport is at best a partial success. I think it could be used more aggressively by applying it in the same way as the 50% rule, i.e., by banning riders from competing for medical reasons without making it an actual doping conviction.

In terms of doping tests, we know that mostly, the labs are years behind the athletes. Only in the case of CERA, where the structure of the molecule was communicated to anti-doping labs such that tests could be developed faster than usual, this wasn't the case. Different types of EPO and/or CERA molecules require different tests. The labs do good work but will always be behind (hence the blood passport and the idea of retroactive testing of up to 5 years).

Hematide is different enough from any EPO/CERA product that completely different tests have to be employed. Now the use of hematide (at least in large doses) should be obvious on the blood passport. However, since the passport has neither been used for doping convictions nor for banning riders from competing, and since there's no test for hematide, it's a free for all. Still, because the crit levels are nowhere near 50% it alone cannot explain the current level of performance.

What I find more interesting in this respect is AICAR. First of all it is a substance which is naturally occurring in the human body. So, just as testosterone, the presence of AICAR is no indication of doping. Only an increase of AICAR above a certain threshold would be. At present, I think there is no such threshold defined (although AICAR is on the list of banned substances and there seems to be a test for it). This means that even if it's found in testing, it might not be clear whether one can get a doping conviction or not (at least it would give Vrijman a new hatchet job to do).

It gets even more interesting when we look at how AICAR (aminoimidazole carboxamide ribonucleotide) works. On the WADA list, it says:

which doesn't really say much at all.

Let me first give a few WIKI links of relevance.
1.) PPAR
2.) AICAR
3.) AMP-activated protein kinase or AMKP
the last one being the most relevant one. In the simplest terms, AICAR works by latching on to PPARdelta (peroxisome proliferator-activated receptor delta) which leads in the end to production of AMP-activated protein kinase. So, what we really should be looking at, is the effect of AMPK (hence the third link).

From that link:

and BINGO.

Moreover, I found this gem:

and we have a second BINGO, because I suspect that we have found the reason for the somewhat mysterious weight loss (in particular the loss of any body fat) by some riders. How much did Wiggo lose again? Also, when you look at photos of LA, his subcutaneous fat layer is practically nonexistent. It's pretty clear now from where the riders get their 'concentration camp' look.

It all really makes sense now.

Anyway, sorry for the lengthy post, but I think I have now a fairly good idea what is going one, and I wanted to share my moment of enlightenment with you guys.

doctorSpoc · #7 08-06.-2009

Quote:

Originally Posted by Cobblestones

I think this is very important news. There has also been an article in the German journal Spiegel about it (which had daily and very level-headed Tour de France coverage).

It was a conundrum for me that riders are still performing at levels of 1990's and early 2000's (the darkest period of cycling) while hematocrit levels have come down to more normal value in the mid-lower 40s. Possible explanations were (i) the use of HBOCs or PFCEs (ii) an elaborate scheme of transfusions, blood letting, dilution and whatnot or (iii) increasing the efficiency of oxygen uptake. Now it seems the latter is the most likely. But let me step back for a moment.

A lot of blood manipulation should be detectable with the blood passport (which is basically a more sophisticated approach for setting limits on biological parameters than the old 50% crit threshold). The passport itself has not yet been used to convict riders for doping. What has happened is that the 50% rule has been invoked to ban riders from races (without it becoming a doping infraction) and that the passport has helped to single out riders for targeted testing (which has then sometimes resulted in non-negatives and doping convictions). Still, all convictions have come either from non-negative tests, or from circumstantial evidence such as affiliation with doping networks such as OP or the Vienna lab. At this point, I think the blood passport is at best a partial success. I think it could be used more aggressively by applying it in the same way as the 50% rule, i.e., by banning riders from competing for medical reasons without making it an actual doping conviction.

In terms of doping tests, we know that mostly, the labs are years behind the athletes. Only in the case of CERA, where the structure of the molecule was communicated to anti-doping labs such that tests could be developed faster than usual, this wasn't the case. Different types of EPO and/or CERA molecules require different tests. The labs do good work but will always be behind (hence the blood passport and the idea of retroactive testing of up to 5 years).

Hematide is different enough from any EPO/CERA product that completely different tests have to be employed. Now the use of hematide (at least in large doses) should be obvious on the blood passport. However, since the passport has neither been used for doping convictions nor for banning riders from competing, and since there's no test for hematide, it's a free for all. Still, because the crit levels are nowhere near 50% it alone cannot explain the current level of performance.

What I find more interesting in this respect is AICAR. First of all it is a substance which is naturally occurring in the human body. So, just as testosterone, the presence of AICAR is no indication of doping. Only an increase of AICAR above a certain threshold would be. At present, I think there is no such threshold defined (although AICAR is on the list of banned substances and there seems to be a test for it). This means that even if it's found in testing, it might not be clear whether one can get a doping conviction or not (at least it would give Vrijman a new hatchet job to do).

It gets even more interesting when we look at how AICAR (aminoimidazole carboxamide ribonucleotide) works. On the WADA list, it says:

which doesn't really say much at all.

Let me first give a few WIKI links of relevance.
1.) PPAR
2.) AICAR
3.) AMP-activated protein kinase or AMKP
the last one being the most relevant one. In the simplest terms, AICAR works by latching on to PPARdelta (peroxisome proliferator-activated receptor delta) which leads in the end to production of AMP-activated protein kinase. So, what we really should be looking at, is the effect of AMPK (hence the third link).

From that link:

and BINGO.

Moreover, I found this gem:

and we have a second BINGO, because I suspect that we have found the reason for the somewhat mysterious weight loss (in particular the loss of any body fat) by some riders. How much did Wiggo lose again? Also, when you look at photos of LA, his subcutaneous fat layer is practically nonexistent. It's pretty clear now from where the riders get their 'concentration camp' look.

It all really makes sense now.

Anyway, sorry for the lengthy post, but I think I have now a fairly good idea what is going one, and I wanted to share my moment of enlightenment with you guys.

good post... one correction.. 5 riders have, at this point been sanctioned under the biological passport program

Igor Astarloa (ESP) - 2003 world champion
Pietro Caucchioli (ITA)
Francesco De Bonis (ITA)
Ruben Lobato Elvira (ESP)
Ricardo Serrano Gonzalez (ESP)

what is really bad is that the recent CERA positives have NOT been sanction via the bio-passport program and vise versa.. this tells me that the bio-passport program can and is being beaten.. not good news!!