Inside the UFC's expanded anti-doping efforts

When the UFC announced their new anti-doping policy and partnership with the United States Anti-Doping Agency, the primary changes that got peoples' attention were the whereabouts policy, the year-round out-of-competition testing, as well as the stringent penalties for positive tests. However, they arguably missed one of the pivotal aspects of the entire program: the Athlete Biological Passport.

Wouldn't it be an advance if drug agencies stopped looking for the next performance enhancing substance and instead focused on establishing what an athlete's normal blood levels and biological variables are before looking for suspicious results?

The Athlete Biological Passport (ABP) could theoretically be that solution, as well as the most effective anti-doping tool to date.

The ABP fundamentally monitors selected biological variables - known as biomarkers of doping -- over time that indirectly reveal the effects of doping rather than detect the doping substance or method itself. The data collected is analyzed and placed on the athlete's passport for comparative analysis with potential future tests. The World Anti Doping Agency (WADA) took the lead on the development of the concept and implemented it back in 2009.

While the first version of the program specifically targeted blood doping, the fourth and latest version (approved in 2013) introduced a second module to detect steroid doping.

"Anti-doping is moving rapidly toward a more forensic approach to protect clean sport through analytical and non-analytical investigations," USADA Science Director, Mathew Fedoruk (Ph. D) told BloodyElbow. "The Athlete Biological Passport is a scientific tool used to examine relevant indirect biomarkers of doping, which further allows those that aim to level the playing field with the ability to detect and deter doping through state-of-the art and complementary methods - as an analogy, we are working to create a video of an athlete's biochemistry rather than merely looking at a snapshot in time."

The ABP was most notably implemented in cycling (2009) and later in tennis (2013). It has been credited as a crucial obstacle for dopers and has seemingly helped root out drug abuse in cycling.

In an effort to shine a light on the details of the Athlete Biological Passport and its implementation in the UFC, BloodyElbow spoke to the USADA communications staff and science team.

What is the ABP and where does it fit in with anti-doping efforts?

The ABP was originally implemented for blood doping and has recently evolved to include a steroid module. Endurance-related sports saw a trend of dopers focusing on red blood cell count, specifically the hemoglobin, which carries oxygen to the muscles. Some use Erythropoietin (EPO) and other drugs, while other use blood transfusion. While the first option informs the body to create more red blood cells, blood transfusions require an athlete to remove some of his own blood, wait for his body to compensate for the drop in red blood cells, then transfuse the old blood back in to have more red cells than before.

So what the ABP does, according to USADA, is monitor selected biological parameters over time that may indirectly reveal effects of doping on the body. This approach allows anti-doping organizations to generate individual, longitudinal profiles for each athlete and to look for fluctuations that may indicate the use of performance-enhancing drugs or methods.

The longitudinal profile for each athlete is generated based on statistical tools that utilize data from an athlete's previous samples to predict the likely individual limits or reference range for future samples. If any data from a sample falls outside of the athlete's reference range, this atypical value may be indicative of doping or, in rare cases, a pathological condition.

Therefore, an athlete who had used blood doping will have an abnormally high reticulocyte percentage - immature red blood cells - which will later drop dramatically as the red blood cell count increases. In an average human, that could be a sign of anemia, but for blood dopers, that is a red flag.

Which variables are monitored by the ABP?

According to USADA, the biomarkers that can be used for blood profiling include hemoglobin, hematocrit, red blood cell count, reticulocyte number, reticulocyte percentage, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, immature reticulocyte fraction, red cell distribution width and OFF-score.

The Steroidal Module tests an athlete's urine sample to observe unique steroid variables, therefore making it a useful technique in recognizing athlete abuse of Anabolic Androgenic Steroids.

The urinary steroid profile consists of the urinary concentrations of Testosterone, Epitestosterone, Androsterone, Etiocholanolone, 5a-androstane-3a,17β-diol and 5β-androstane-3a,17β-diol, together with the specific gravity of the urine sample and specific ratios of the aforementioned steroid variables. Before the ABP, isotope ratio mass spectrometry (IRMS) analysis was most typically performed when an athlete had a T/E ratio greater than 4:1.

The Steroid Module can work through single test for targeting purposes or to prompt IRMS confirmation, although generally two or three urine tests are necessary for a longitudinal analysis.

Limitations

While the ABP appears to be a godsend of a solution for doping, it arguably remains limited in its functionality. For example, the ABP can theoretically take up to two years to accumulate the necessary data to help prove innocence or guilt.

Another issue that arises during the discussion of the ABP limitations is micro dosing, where an athlete could inject himself with small, frequent doses of EPO or other substances. Some studies have shown that this could go undetected and that the blood parameters used would not find a significant enough change to deem the result abnormal.

One infamous report was released as part of French television channel Stade 2's experiment into micro-dosing detection that had "recruited eight amateur athletes and gave them small doses of EPO after undergoing a VO2 max test, a time trial on a static bike and 3km run. They were then tested again after the month of doping, with average improvement in VO2 max among the athletes at 6.1 per cent."

According to the report, the "athletes would not have been detected by the ABP." However, WADA later released a statement that the report never followed the guidelines of the ABP and that hindered its relevance. The results were also never peer reviewed or published, which also tarnishes it legitimacy.

However, since this has been a recurring issue over the past few years, new tests have been developed with increased sensitivity to EPO.

Other critics have argued that abnormal test results do not necessary prove doping. There remains a risk of misinterpreting the physiological variations of the hematological parameters. An example of this occurred quite recently when Roman Kreuziger, a Czech professional road bicycle racer, was suspended for abnormalities in his biological passport. He was later cleared by the Czech Olympic Committee that cited that the results " did not fall outside of the expected range dictated by the biological passport software." WADA and the Union Cycliste Internationale(UCI) initially challenged the decision but dropped it one week before the hearing at the Court of Appeals because of the "availability of newly obtained information."

The UCI's influence in cycling also raises questions about how the UFC would go about implementing their policy on top athletes. In 2009 and 2010, USADA argued that the UCI was aware that Lance Armstrong was doping and could have failed to submit those samples for independent analysis.

Could that be a concern this time around as well?

Following abnormal test results, the procedures remain unclear regarding how they should be handled. USADA vaguely stated that atypical passport findings "require further investigation." However, that depends on the overseeing regulatory body and whether they attempt any targeted testing on the athletes with abnormal biomarkers.

Just recently, the International Association of Athletics Federations (IAAF) was accused of ignoring evidence of abnormal blood tests for a slew of top athletes. The list included "225 athletes from 39 countries; three Britons, as well as a staggering 58 Russians and 25 Kenyans; three London 2012 champions and scores of gold medallists from other Olympics and major championships, current and former world record holders, and winners of marathons around the world; competitors over distances from 400 metres upwards on track, road and cross-country, as well as multi-event athletes; and several athletes banned for doping."

Therefore one of the major concerns with the UFC's potential implementation of the biological passport is whether there will be any delay between the abnormal biomarkers and the targeted testing. The longer the delay, the more likely someone can get away with doping.

UFC test results continues to take weeks, not days.

In an attempt to answer that question, BloodyElbow reached out to the UFC for a response. However, our interview request with the promotion's anti-doping rep Jeff Novitzky was denied.

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While the Athlete Biological Passport is an ongoing process, there is little doubt that it is a strong addition to existent anti-doping policies.  While it may not be a tool to replace the current doping tests, it can certainly compliment traditional procedures and provide a longitudinal analysis of data to make or break a case.

It will be interesting to see how this impacts UFC athletes as they head into a new era in drug testing.

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Special thanks to BloodyElbow's Iain Kidd for his help and expertise.