Donati Francesco, Acciarini Roberta, De Benedittis Ilenia, de la Torre Xavier, Pirri Daniela, Prete Mariangela, Stampella Alessandra, Vernucci Enza, Botre Francesco
Laboratorio Antidoping, Federazione Medico Sportiva Italiana, Largo Giulio Onesti 1, 00197 Rome, Italy.
Department of Infection, Immunity & Cardiovascular Disease, Faculty of Medicine, Dentistry & Health, Royal Hallamshire Hospital, Beech Hill Road, Sheffield S10 2RX, United Kingdom.
Curr Pharm Biotechnol. 2018;19(2):124-135. doi: 10.2174/1389201019666180405165118.
Blood transfusions are banned by the World Anti-Doping Agency as a form of "blood doping". A method of detection of homologous blood transfusion (HBT) has been implemented by the accredited anti-doping laboratories worldwide; however, no internationally recognized method has been finalized so far for the direct detection of autologous blood transfusions, which can at present be revealed only by targeted longitudinal profiling of key blood parameters.
The present article reports the results of an investigation aimed to pre-select potential biomarkers of blood aging and storage that can be measured to identify the presence in the sample of reinfused blood. Microparticles from platelets and erythrocytes, erythrocytes size and density, annexin V (as a marker of phosphatidylserine externalization), and the membrane surface antigens CD 55 and CD 59, were specifically considered as potential biomarkers and measured by flow cytofluorimetric techniques.
Our results indicate that the parameters more strongly affected by the ex vivo storage of whole blood are erythrocytes size and density, annexin V and microparticles. Although the real diagnostic value of the proposed biomarkers shall obviously be confirmed by further studies carried out on blood samples collected after an actual autologous blood transfusion, these results appear very encouraging towards the development of a direct method for detecting autologous blood transfusion in sport doping.
世界反兴奋剂机构禁止输血作为一种“血液兴奋剂”形式。全球认可的反兴奋剂实验室已实施一种检测同源输血（HBT）的方法；然而，目前尚未最终确定一种国际认可的直接检测自体输血的方法，目前只能通过对关键血液参数进行有针对性的纵向分析来揭示。
本文报告了一项调查结果，旨在预先选择可用于测量以识别样本中再输注血液存在情况的血液老化和储存的潜在生物标志物。血小板和红细胞的微粒、红细胞大小和密度、膜联蛋白V（作为磷脂酰丝氨酸外化的标志物）以及膜表面抗原CD 55和CD 59被特别视为潜在生物标志物，并通过流式细胞荧光技术进行测量。
我们的结果表明，受全血体外储存影响更强烈的参数是红细胞大小和密度、膜联蛋白V和微粒。尽管所提出的生物标志物的实际诊断价值显然需要通过对实际自体输血后采集的血样进行进一步研究来证实，但这些结果对于开发一种在运动兴奋剂检测中直接检测自体输血的方法显得非常令人鼓舞。
