Could there be stem cell doping or gene doping at the ongoing Paris Olympics right now?
I’ve wondered about such things happening throughout several past Olympics. In fact, I asked this kind of question 12 years ago. Authorities are taking such possibilities even more seriously.
What would stem cell doping mean?
How could cells or genetic changes potentially help athletes perform better?
Theoretically, infusions of certain cells could give athletes advantages in various competitions including the Olympics. For instance, they could improve recovery after training or preliminary events. Modified blood cells might enhance oxygenation. Blood doping has been around for more than a dozen years.
There may also be possible athletic enhancements via genetic methods whether given into cells or tissues like muscles.
The cellular infusions potentially could involve stem cells or other cell types. This might more broadly be called cell doping.
It now seems relatively well-established that gene and cell doping attempts happen. Such efforts are explicitly prohibited today.
How do we define gene or cell doping?
The World Anti-Doping Association or WADA has implemented policies on cells and genetic approaches toward enhancements. They explicitly talk about cell doping and gene doping.
Gene or cell doping is defined as “The non-therapeutic use of genes, genetic elements and/or cells that have the capacity to enhance athletic performance.”
While WADA does not mention stem cells specifically, there is an implication of their potential involvement. Here are the M1 WADA policies on what is prohibited in terms of blood materials including cells:
“M1.1. The Administration or reintroduction of any quantity of autologous, allogenic (homologous) or heterologous blood, or red blood cell products of any origin into the circulatory system except donation by Athletes of plasma or plasma components by plasmapheresis performed in a registered collection center.
M1.2. Artificially enhancing the uptake, transport or delivery of oxygen. Including, but not limited to: Perfluorochemicals; efaproxiral (RSR13); voxelotor and modified haemoglobin products, e.g. haemoglobin-based blood substitutes and microencapsulated haemoglobin products, excluding supplemental oxygen by inhalation.
M1.3. Any form of intravascular manipulation of the blood or blood components by physical or chemical means.”
Does this include bone marrow cells or specifically bone marrow or hematopoietic stem cells? I would assume so but it’s not completely clear. Another section called M3 touches more on cells and possible gene doping.
What about gene doping?
WADA also weighs on gene therapy-type approaches and throws in cells there too. Let’s take a look:
“M3.1. The use of nucleic acids or nucleic acid analogues that may alter genome sequences and/ or alter gene expression by any mechanism. This includes but is not limited to gene editing, gene silencing and gene transfer technologies.
M3.2. The use of normal or genetically modified cells.”
Section M3.2 is very broad. It seems to suggest the use of any kind of cells might be doping.
Can athletes get any cells or blood materials before an event?
There might be legitimate reasons to get a blood infusion like an accident or surgery.
But the M1 section seems to generally prevent even receiving blood. Going back to section M1, I’m not clear on why donating blood would specifically be relevant but maybe ADA doesn’t want to discourage blood donation.
If an athlete had an orthopedic injury, could they receive a stem cell injection of say a muscle before an event? It seems like this would be considered stem cell doping. Section M1 would seem to prohibit even PRP. Note that I don’t believe that stem cells or PRP are clearly effective for orthopedic injuries.
Detection has challenges
Unlike detectable chemical drugs, how would the WADA know if blood or cells had been received by an athlete?
I don’t see a way to readily detect cells, especially if the material is autologous.
Detection of gene doping could be even more difficult.
Are they now going to test athletes for the presence of introduced genetic material? Then you’d likely also have to have a baseline sequence of the person’s genome too. In that case, what about privacy?
The main approach to detect gene doping is to do PCR testing for striking changes in the expression of certain genes like myostatin (look for a decrease), EPO, or IGF-1. Would you test blood? Tissue like muscle? See the video I’ve included above which has a great discussion of these issues. It also raises the idea of potentially using CRISPR for gene doping.
What about gene and cell doping at the Paris Olympics?
For the time being, it appears that enforcement of WADA policies on cell doping and gene doping will be nearly impossible. For that reason, are these rules such as for Olympic athletes competing right now mostly on the honor system?
We’ve seen many cases of athletes in The Olympics using banned substances, even some that can be detected. They are willing to take such risks.
If introduced genes or cells are largely undetectable in athletes, it seems likely that some athletes or teams might succumb to the temptation to go for it.
Gene and cell doping is almost certainly happening right now in Paris.
Hmm, Paul, this seems a bit of a jump:
“If introduced genes or cells are largely undetectable in athletes, it seems likely that some athletes or teams might succumb to the temptation to go for it. Gene and cell doping is almost certainly happening right now in Paris.” Almost certainly? I’d go “may be.” Mainly, apart from “blood doping,” it’s not clear that any of these methods actually works in humans to help athletic performance, let alone that they are safe. Might someone (or a doctor supervising a particular sport in a country) try it? Sure. But “almost certainly”? And, of course, if they did and it didn’t confer any advantage, which seems to me most likely, how upset should we be? (Even apart from the school of thought that thinks these should be allowed.)
We disagree on this. Hundreds of pro athletes have gotten unproven stem cells, PRP, etc. over the past 12 years. This is well documented. The actual number of such athletes getting unproven cells may be much higher, in the thousands. Athletes are willing to do risky things.
Many athletes have been caught doping in more traditional ways like with chemical substances where there’s an even higher risk of getting caught. The internet says that there are about 10,000 athletes attending the Olympics. You think that none have gotten unapproved cells or gene interventions of any kind? I find that highly unlikely. Remember WADA’s standards for cell doping are pretty strict. Quite a few Olympic athletes could have even gotten PRP or cells in the lead-up to the Olympics. I believe the odds are with 10K athletes that some did. Some may have even tried gene modulating stuff that’s out there too.
I don’t know how upset, if at all, we should be. There is a fairness issue. Even if such efforts didn’t work, it seems unfair to try them.
Maybe the Athletes use stem cell therapy because it works to treat inflammation which is seen in most sports injuries and they get good results and faster recover times which allows them to compete at the top of their game for the biggest event of their lives?