Metabolic modulators of the exercise response: doping control analysis of an agonist of the peroxisome proliferator-activated receptor δ (GW501516) and 5-aminoimidazole-4-carboxamide ribonucleotide (AICAR).

In 2008, the team of Ronald Evans, a professor at the Salk Institute Gene Expression Laboratory, published an article about the effects of two metabolic modulators branded as GW501516 and AICAR on physical endurance of laboratory animals. Both substances, also called 'exercise pills' or 'exercise mimetics', showed the ability to cause multidirectional changes in muscle metabolism. In particular, they stimulated fatty acid oxidation and promoted muscle remodelling. These compounds were regarded as very promising drug candidates for the treatment of diseases such as obesity and type 2 diabetes. GW501516 and AICAR have received considerable attention in doping control due to assumed performance-enhancing properties and recent confiscations of illicitly distributed drugs containing AICAR. Therefore, the World Anti-Doping Agency added GW501516 and AICAR to the Prohibited List in 2009. This review covers the cellular and systemic effects of the metabolic modulators' administration with special emphasis on their role in exercise metabolism. It also presents the advancements in development of methodologies for the detection of their abuse by athletes.