Additive effect of erythropoietin use on exercise-induced endothelial activation and hypercoagulability in athletes.

Purpose: Recombinant human erythropoietin (rHuEPO) is known to increase thrombotic risk in patients and might have similar effects in athletes abusing the drug. rHuEPO is prohibited by anti-doping legislation, but this risk has not been investigated thoroughly. This analysis was designed to evaluate...

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Publicado en:European Journal of Applied Physiology Vol. 120; no. 8; pp. 1893 - 1905
Autores principales: Heuberger, Jules A. A. C., Posthuma, Jelle J., Ziagkos, Dimitrios, Rotmans, Joris I., Daniels, Johannes M. A., Gal, Pim, Stuurman, Frederik E., Spronk, Henri M. H., Ten Cate, Hugo, Burggraaf, Jacobus, Moerland, Matthijs, Cohen, Adam F.
Formato: research tables/charts randomized controlled trial Journal Article
Publicado: Springer Nature Aug2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2020
      vid: 120
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00421-020-04419-0
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        144423649
      ppf: 1893
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        atl: Additive effect of erythropoietin use on exercise-induced endothelial activation and hypercoagulability in athletes.
      aug:
        au:
          Heuberger, Jules A. A. C.
          Posthuma, Jelle J.
          Ziagkos, Dimitrios
          Rotmans, Joris I.
          Daniels, Johannes M. A.
          Gal, Pim
          Stuurman, Frederik E.
          Spronk, Henri M. H.
          Ten Cate, Hugo
          Burggraaf, Jacobus
          Moerland, Matthijs
          Cohen, Adam F.
        affil: Centre for Human Drug Research, Zernikedreef 8, 2333 CL, Leiden, The Netherlands
      sug:
        subj:
          Exercise
          Blood Coagulation Drug Effects
          Erythropoietin Pharmacodynamics
          Endothelium Drug Effects
          Proteins Metabolism
          Endothelium Metabolism
          Athletes
          Erythropoietin Adverse Effects
          Male
          Middle Age
          Adult
          Platelet Activation Drug Effects
          Comparative Studies
          Multicenter Studies
          Randomized Controlled Trials
          Evaluation Research
          Validation Studies
          Human
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Male
      ab: Purpose: Recombinant human erythropoietin (rHuEPO) is known to increase thrombotic risk in patients and might have similar effects in athletes abusing the drug. rHuEPO is prohibited by anti-doping legislation, but this risk has not been investigated thoroughly. This analysis was designed to evaluate whether rHuEPO impacts hemostatic profile and endothelial and platelet activation markers in trained subjects, and whether the combination with exercise affects exercise induced alterations.Methods: This double-blind, randomized, placebo-controlled trial enrolled healthy, trained male cyclists aged 18-50 years. Participants were randomly allocated (1:1) to receive subcutaneous injections of rHuEPO (epoetin-β; mean dose 6000 IU per week) or placebo (0.9% NaCl) for 8 weeks. Subjects performed five maximal exercise tests and a road race, coagulation and endothelial/platelet markers were measured at rest and directly after each exercise effort.Results: rHuEPO increased P-selectin (+ 7.8% (1.5-14.5), p = 0.02) and E-selectin (+ 8.6% (2.0-15.7), p = 0.01) levels at rest. Maximal exercise tests significantly influenced all measured coagulation and endothelial/platelet markers, and in the rHuEPO group maximal exercise tests led to 15.3% ((7.0-24.3%), p = 0.0004) higher E-selectin and 32.1% ((4.6-66.8%), p = 0.0207) higher Platelet factor 4 (PF4) levels compared to the placebo group.Conclusion: In conclusion, rHuEPO treatment resulted in elevated E- and P-selectin levels in trained cyclists, indicating enhanced endothelial activation and/or platelet reactivity. Exercise itself induces hypercoagulability, and the combination of rHuEPO and exercise increased E-selectin and PF4 levels more than either intervention alone. Based on this, exercise potentially increases thrombotic risk, a risk that might be enhanced in combination with rHuEPO use.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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