Premium
Anabolic and lipolytic actions of beta 2 ‐agonists in humans and antidoping challenges
Author(s) -
Hostrup Morten,
Jacobson Glenn A.,
Jessen Søren,
Lemminger Anders Krogh
Publication year - 2020
Publication title -
drug testing and analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.065
H-Index - 54
eISSN - 1942-7611
pISSN - 1942-7603
DOI - 10.1002/dta.2728
Subject(s) - formoterol , anabolism , pharmacology , salmeterol , adverse effect , anabolic agents , medicine , agonist , inhalation , beta (programming language) , anesthesia , receptor , budesonide , computer science , programming language
Abstract Inhaled beta 2 ‐adrenoceptor agonists (beta 2 ‐agonists) are among the most used substances in competitive sports. The 2020 Prohibited List issued by the World Anti‐Doping Agency restricts use of all selective and non‐selective beta 2 ‐agonists in‐ and out‐ of competition with few exemptions. Formoterol, salbutamol, and salmeterol are allowed by inhalation within defined dosing limits. These restrictions are in place because supratherapeutic use of beta 2 ‐agonist has the potential to be anabolic and to enhance performance, as well as due to potential side effects. Despite substantial documentation that beta 2 ‐agonists exert anabolic and lipolytic actions, these actions are not widely recognized. Furthermore, a common misconception is that the inhaled route does not exert these effects. However, given the high relative systemic bioavailability via the inhaled route, inhalation at high doses can also exert anabolic and lipolytic actions. In this review, we highlight the anabolic and lipolytic actions beta 2 ‐agonists can exert, regardless of the type of beta 2 ‐agonist and the route of administration. The doses needed to provide such effects are also associated with adverse effects and would in most cases be detected in routine doping control. Notwithstanding, the beta 2 ‐agonist regulations are associated with some challenges and given their ability to induce muscle growth and to enhance performance, it is important to continue developing effective detection strategies to prevent potential misuse of beta 2 ‐agonists while allowing treatment of asthmatic subjects without causing adverse side effects or ergogenic actions.