вторник, 22 октября 2013 г.

Question of the week: is there stem cell doping in the Olympics?


 

Olympic DopingHas there been stem cell doping in the Olympics?
Readers of this blog have been asking me this question more than any other in the last week.
Part of the impetus for this question is the growing number of professional athletes who more generally have received dubious stem cell treatments in foreign countries, perhaps treatments that might even be technically illegal in the U.S.
Stem cell “sports medicine” is a hot field, at least for people trying to salvage careers or become stars and the doctors trying to make money off of them.
A number of players in the NFL and in MLB have been outed in the press as having gotten non-FDA approved stem cell treatments and almost certainly countless others have gotten the same or similar treatments without anyone knowing about it.
For background on this fascinating area, here are my two posts: Sports Medicine andSports Medicine 2.0.
As the media is abuzz over the stellar performance of 16-year-old swimmer Ye Shiwen of China with some alleging doping, questions related to “cell doping” have started becoming more common.
So have Olympic athletes received dubious stem cell treatments, what some readers of this blog have gone so far as to call “doping”, to secretly make them more likely to win gold?
It’s a complex question with no black or white answer.
Why?
Because to my knowledge there is, as of yet, no explicit publicly pronouncedprohibition for Olympic athletes from getting stem cell treatments of any kind as long as there are no growth factors involved.
Thus, perhaps there can’t really be “doping” in the Olympics using stem cells because theInternational Olympic Committee (IOC) doesn’t ban it.
Surprised?
But perhaps there is an IOC ban on stem cell doping that as yet has not been publicly announced.
A key question is when would a stem cell treatment, which seems acceptable to me for an Olympic athlete, cross the line to become doping?
Let’s look at a recent case.
Malaysia’s Lee Chong Wei, an Olympic Badminton athlete, has reportedly received a stem cell treatment to try to get ready for the 2012 Olympics.
After an injury in May, the article on Lee reads that he is back on track at least in part thanks to stem cells:
However stem cell treatment, plus 13 hours’ rehab each day, and a flinty attitude have bolstered him physically and mentally, enabling him to confound those who claimed he wouldn’t make it.
To me this doesn’t seem like doping even though the details of his treatment are unknown.
What would be doping?
I would define it as something that gives an athlete an unfair advantage over others.
How would it work?
An alleged stem cell doping ring possibly linked to the 2008 Beijing Olympics is illustrative. In a piece on the expose documentary, a “doctor” is quoted about the proposed $24,000 sports medicine treatment:
“Yes. We have no experience with athletes here, but the treatment is safe and we can help you,” the doctor is heard to say. “It strengthens lung function and stem cells go into the bloodstream and reach the organs. It takes two weeks. I recommend four intravenous injections … 40 million stem cells or double that, the more the better. We also use human growth hormones, but you have to be careful because they are on the doping list.”
This expensive treatment, in my opinion, would not help athletes.
In 2008, Sports Illustrated ran a piece on stem cell doping, also related to the Beijing Olympics. Amongst others they quoted Johnny Huard, director of the stem cell research center at the Children’s Hospital of Pittsburgh at UPMC and professor in the Department of Orthopedic Surgery at the University of Pittsburgh.
Huard was contacted by the U.S. ­Anti-­Doping Agency (USADA) more than two years ago to help develop tests to detect stem cell doping from both autologous and donor cells. If athletes were to use cells from a donor, detection would be possible, according to Itescu. “You can detect other people’s DNA in your bloodstream with routine screening.” But the process would be expensive, and testing of an athlete’s DNA is a long way off for both practical and ethical reasons. The process also wouldn’t work if athletes used their own cells. “We have no way of detecting that you have injected a cell from you to you,” says Huard.
Getting back to our central question–is there stem cell doping at the 2012 Olympics?– I think the answer is likely “yes”, but only on a very small scale. However, given the secrecy of any kind of doping it is difficult to know of the potential scale of the problem.
The stakes are high enough that I do believe that some athletes, coaches, and even countries are willing to do almost anything to win and as such it has happened during and before these Olympics.
What is more important and exciting, is the positive potential of stem cell treatments (not doping!) to help not only athletes, but also everyday people lead healthier lives in the future after the technology is fully tested. But we can’t skip the research to ensure safety and efficacy.

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