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Detection of HGH Met With Skepticism

By Amy Shipley
Washington Post Staff Writer
Friday, December 21, 2007

Despite tens of millions of dollars in research over the last decade, international anti-doping authorities are uncertain about whether they will be able to deter use of human growth hormone at the 2008 Summer Games in Beijing.

The current blood test for HGH has significant shortcomings and is still not available for widespread implementation, anti-doping officials say, and a urine test has yet to be developed.

"It's not at the stage where we would say it is state-of-the-art," said David Howman, director of the World Anti-Doping Agency.

Though some officials say they expect a long-awaited blood test to be available for drug testing in the coming months, others say they are skeptical given years of delays and missed deadlines. Others, meantime, question whether the test will be effective when it becomes available, given that it will be able to detect HGH for only 20 to 24 hours after an athlete takes the drug.

The detection constraints, doping officials acknowledge, mean the blood test would be useless at major sporting events such as the Olympics because athletes could stop taking the drug just before a particular competition. Only surprise tests administered between competitions would be effective, the officials say.

It is not known how many athletes are using HGH, although the report on performance-enhancing drugs in professional baseball released last week highlighted the popularity of the drug among major league players, many of whom switched from steroids to HGH after baseball instituted a drug-testing program in 2003.

"Use of human growth hormone has risen, because, unlike steroids, it is not detectable through urine testing," said former senate majority leader George J. Mitchell, the report's author.

More than 50 of the 92 players mentioned in the report either acknowledged using HGH or were alleged to have purchased it. Several told Mitchell and his investigators that it had become popular even though it was typically about 10 times more expensive than steroids. A former player "told us that human growth hormone is now the drug of choice for those players who can afford it," Mitchell wrote in the report.

The issue of HGH abuse has long concerned anti-doping officials who oversee Olympic and other sports.

Growth hormone, which stimulates growth and cell production, is naturally present in the bloodstream. As soon as a synthetic form of HGH, which is known as recombinant growth hormone (rHGH), was released in 1985 to treat patients with growth hormone deficiency or wasting diseases such as AIDS, anti-doping officials anticipated it would be obtained by athletes seeking to increase muscle mass or speed recovery from injury.

Unlike anabolic steroids, HGH is not on the federal controlled substances list, but it is available only by prescription, and it is illegal to prescribe HGH for anything but a valid medical condition. In the aftermath of the release of the Mitchell report, Sen. Charles E. Schumer (D-N.Y.) introduced legislation this week that would amend the Controlled Substances Act to classify HGH -- like steroids -- as a Schedule III substance, which would make possession a crime without a prescription.

The Mitchell report described scenarios in which players obtained HGH, which is taken by injection, from black-market dealers who bought the drug from legitimate patients or disreputable doctors who wrote bogus prescriptions.

Major League Baseball and the NFL are jointly funding research by noted anti-doping chemist Don Catlin into developing a urine test for HGH, but several chemists expressed skepticism that such a test would ever be perfected because the substance is found in only trace amounts in urine.

Professional baseball and football players currently submit to urine tests for steroids. The MLB and NFL players' unions have opposed blood testing for HGH, saying it is an invasion of privacy. Their opposition has been sharply criticized by anti-doping officials and members of Congress, although the lack of a reliable, available test has prevented them from forcing the issue.

The current blood test was used only on a limited basis at the 2004 Summer Games, the 2006 Winter Games and in other circumstances, but has never produced an announced positive result.

The slow pace in developing an effective test for a substance that has been the subject of nearly a dozen research projects in the last decade reflects the difficulty in detecting synthetic HGH in the blood, unforeseen problems over the last three years in getting a pharmaceutical company to mass-produce the test, and disputes within the scientific community over the type of test that should be developed.

One chemist who has done HGH research for nearly two decades criticized international officials for pursuing a method of detection that he claimed was backed only by "marginal" science. The chemist, Peter Sonksen, who is based in London, said the International Olympic Committee and later WADA erred by failing to fully back his approach to HGH detection despite having invested significantly in it in the late 1990s.

Sonksen said he developed a test that identifies HGH indirectly by measuring other markers in the blood. It has a detection window of several days, he said. The test in which WADA has invested most heavily since 2004 is a vastly different one developed by a team of German scientists. It is the test anti-doping authorities expect will be ready by this spring, and it is said to detect HGH directly. The current test "will only pick people up who injected a few hours earlier," Sonksen said. "It's not very good at all."

Another lab official said there has been virtually no information disseminated to the various WADA-accredited laboratories about the test, raising questions about whether it would be rigorous enough to withstand legal challenges.

"Because it's a brand-new test and it doesn't have a track record, they're going to need a lot of" backing for the test, said the official, who requested anonymity because of the sensitive nature of the topic. "I don't know where they are in their studies. I'm skeptical. I want to see the bacon. I haven't seen any data yet."

Other WADA and U.S. Anti-Doping Agency officials say the German-developed test has been peer-reviewed and is scientifically sound. They also say they have continued to support Sonksen's approach and envision an eventual two-pronged test that uses the direct and indirect methods of detecting HGH in the blood.

The current test "is certainly is a valid test for growth hormone," USADA senior managing director Larry Bowers said. But "it would be nice to have a test with a somewhat longer window of opportunity."

WADA science director Olivier Rabin said providing too many details about the readiness of a test for release could alert athletes who are using the substance

"We hope in the not-too-distant future to be able to catch athletes," Rabin said. "We do not want to say when the test is implemented or will be implemented . . . What we want to do is catch one or more athletes and say to the world, 'Now, the test is implemented.' "

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