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Respiratory Research

, 16:155

First Online: 24 December 2015Received: 14 August 2015Accepted: 15 December 2015

Abstract

BackgroundSalbutamol abuse detection by athletes is based on a urinary upper threshold defined by the World Anti-Doping Agency WADA. However, this threshold was determined in healthy, untrained individuals and after a dose of salbutamol inhaled that might not really mirror the condition of asthmatic athletes and the experts’s guidelines for asthma management. We aimed to revise this threshold in accordance with recommended clinical practice that appear to be different from the actual WADA recommendation and in exercise conditions.

MethodsFor the present open-label design study, we included 12 trained male cyclists 20 to 40 y-o with asthma. Differently from the previous pharmacokinetic study supporting the actual salbutamol urinary upper threshold, we decided to administer a close to recommended clinical practice daily dose of 3x200 μg.d inhaled salbutamol instead of 1600 μg.d as authorized by the anti-doping policy. Urine salbutamol concentration was quantified by liquid chromatography-tandem ion trap mass spectrometry and corrected for urine density, at rest and after a 90-min cycling effort at 70-80 % of the maximal aerobic power.

ResultsThe maximum urine salbutamol concentration value peaked after the cycling effort and was 510 ng.mL. That is twice lower than the actual WADA threshold to sanction salbutamol abuse, this -legal- threshold being based on pharmacokinetic data after a daily dose that is 8 fold the total dose sequentially administrated in our study. Considering its 95 % confidence interval, this threshold value could be more stringent.

ConclusionBy using conditions in accordance with the experts’ clinical and safety guidelines for asthma management in athletes undergoing an intense exercise bout, our study suggests that the urine salbutamol concentration threshold could be lowered to redefine the rule supporting the decision to sanction an athlete for salbutamol abuse.

KeywordsSalbutamol Sport Doping Beta2 agonist Control AbbreviationsWADAWorld Anti-Doping Agency

IOCInternational Olympic Committee

EIBExercise induced bronchospasm

ATSAmerican Thoracic Society

BAbeta2-agonist

SABAShort-acting beta2-agonist

GINAGlobal Initiative for Asthma

COPDChronic obstructive pulmonary disease

APSAerosol Provocation System

FEV1Forced expiratory volume in 1 second

PD20Provocative dose 20 %, μg

VO2Oxygen consumption debt, L.min

MAPMaximal aerobic power, watt

BHRBronchial hyper-responsiveness

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Autor: Fabien Pillard - Michel Lavit - Valérie Lauwers Cances - Jacques Rami - Georges Houin - Alain Didier - Daniel Rivière

Fuente: https://link.springer.com/article/10.1186/s12931-015-0315-2







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