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EPO test flaws may be failing athletes
Belgian proves natural process can trigger positive; New hope for Armstrong over 1999 allegations
Tuesday September 20, 2005
Fresh scientific doubts about the effectiveness of the test for erythropoietin (EPO) may impact on high-profile cases such as Lance Armstrong's.
Allegations that the American used banned performance-enhancing drugs during the first of his seven consecutive victories in the Tour de France in 1999 have thrust EPO back into the headlines.
When a test to detect it was developed in 2000 it was hailed as a breakthrough in the fight against doping, after the drug came to prominence in 1998 when it nearly wrecked the Tour de France. But now the cases of Armstrong and three triathletes, who have had bans lifted or who avoided punishment after testing positive for EPO, have caused some experts to question the test's reliability.
Moreover the Olympic 1500 metres silver medallist Bernard Lagat is threatening to sue the International Association of Athletics Federations for $500,000 (£277,000) after he was alleged to have tested positive for EPO in 2003. He was cleared when a second urine sample tested negative.
The blood-boosting substance, originally developed to treat kidney patients, has earned a reputation as a wonder drug which increases endurance, and its widespread use has affected the credibility of sports such as cycling and distance running.
Dick Pound, the chairman of the World Anti-Doping Agency, has insisted the test, originally developed in France, is as close to reliable as is possible but the case of the Belgian triathlete Rutger Beke gives rise to doubt. He was banned for 18 months after testing positive for EPO but his suspension was lifted last month when researchers at the Catholic University in Leuven, Belgium, said he had been found to "naturally excrete proteins that would yield a positive test".
During the research several athletes gave false positives for EPO after strenuous exercise.
"EPO is a protein," Beke said. "Everybody has it in their body. The main problem is when I do high physical activity, especially anaerobic, I produce a lot of proteins. The problem is that with everybody else there is a filter in the kidneys that stops your proteins from ending up in your urine. When I do anaerobic exercise the filter doesn't work properly and all these proteins end up in my urine.
"Now the big problem is that the anti-doping agencies don't see that the EPO proteins I produce are the same as synthetic. So I had to prove that mine are natural. Unfortunately it took 10 months."
Then last week the Spanish triathletes Virginia Berasategui Luna and Iban Rodríguez Martínez were also cleared because of doubts about how EPO came to be in their bodies.
"We are not concerned about the viability of the test - the test is quite reliable," said Pound. "What we have to follow is whether there are exercise-induced circumstances that might occur."
Wada is now advising all its accredited laboratories to check with scientists in Paris or Lausanne, where the EPO test was largely developed, when there is any doubt about a positive test. The problem may not be with the test but those analysing the results.
"I knew nothing about it before but now I'm a big expert," said Beke. "The EPO tests are little bars. The bars for synthetic protein and my natural protein - the same protein that shows up in everyone's body - show up in the same size and same place. The bars for natural EPO are in another place in these tests - except my proteins are in the same place as synthetics.
"They don't see the difference. They look at the test and see and say, 'Oh, it's EPO.' But the problem is the test is one-dimensional.
"The director from the Flemish doping lab for nine months has been saying, 'It's impossible to have an exception, the test is 100% sure.' Now, three weeks ago, he wrote a letter to the Flemish commission to say they're not so sure any more. They say it is possible to have a phenomenon, that they are looking into new testing and will have results at the end of September."
Lagat commissioned his own research in 2003 after the allegation that he had tested positive for EPO. Dr Hans Heid of the German Cancer Research Centre in Heidelberg criticised the basis on which the test had been constructed, particularly the lack of consideration given to possible influences of different nutritional, ethnic or physiological backgrounds.
Dr Martial Saugy, head of the Wada-accredited laboratory in Lausanne, agrees that, unlike most banned drugs, it is not simply a matter of looking at what is in the sample and declaring whether an athlete is guilty. "You are looking at numbers and signals but in the end what is most important here is the experience of the eyes of an expert," he said. "It's the 'now we see it - this looks like someone who has injected EPO'."
Though publicly backing the EPO test, Wada is also funding research to develop a more clear-cut method of detection. "This is not like a pregnancy test, where you are either pregnant or you're not," said Nicolle Packer, an executive vice president at Proteome Systems in Sydney, which has received one of the research grants. "It has to be prepared carefully and interpreted by an expert, who can mostly call it, I believe. But it is definitely skill-based, and that is why Wada is looking for a more clear-cut test."
Until that is developed, it seems premature to condemn Armstrong and others as cheats.
The negative positives
Bernard Lagat (middle-distance runner)
Kenya's Olympic 1500m silver medallist is threatening to sue the IAAF for suspending him briefly in 2003 after an EPO test; he was cleared when the B sample proved negative. Commissioned his own scientific research which questioned the credibility of the current EPO test.
Virginia Berasategui Luna (triathlete)
The Spaniard tested positive for EPO after winning the Lanzarote Ironman in May. She angrily denied EPO use and claimed there were a number of procedural errors in how the test was administered. Last week it was announced that no further action would be taken against her or Iban Rodríguez Martínez, another Spanish triathlete who allegedly tested positive for EPO in the same event.
Rutger Beke (triathlete)
The Belgian, who finished second in the 2003 Hawaii Ironman, was banned last year for 18 months after a positive test. After seeking help from the Catholic University in Leuven, Belgium, he proved that his body was capable of producing EPO naturally, so leading to a false positive.
Interesting article regarding EPO test problems
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