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Medicina dello Sport 2021 March;74(1):153-74

DOI: 10.23736/S0025-7826.21.03877-1


language: English, Italian

Hepcidin as possible new indirect biomarker for blood doping

Cecilia CRAVIARI 1, 2, Chiara FOSSATI 1 , Federico QUARANTA 1, Gabriele TOMASSI 1, Federica FAGNANI 1, Paolo BORRIONE 1

1 Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy; 2 Unit of Internal Medicine and Rehabilitation, Department of Rehabilitation and Geriatrics, Geneva University Hospital, Geneva, Switzerland


The fight against doping is a constantly evolving field in Sport Medicine. Regarding the detection of blood doping practices, this represents a challenge as its detection is very difficult in reason of the absence of direct tests. The athlete’s biological passport (ABP) is an indirect method introduced in 2009 by the World Anti-Doping Agency (WADA), based on analysis of different cellular and biohumoral parameters in order to identify patterns compatibles with blood manipulations. Despite the important contribution in the fight against doping, currently this method needs to be implemented by further indirect markers, in order to increase its sensitivity and accuracy. Nowadays, indeed, it is impossible to distinguish hematological variations deriving from physiological adaptations as altitude training, from those deriving from illicit use of substances or techniques able to modify blood values, like administration of recombinant erythropoietin (rHuEPO) or autologous blood transfusions. In this context, hepcidin, a peptide secreted by the liver, could represent a possible indirect marker. This molecule has already attracted the interest of the scientific community, but the mechanisms that regulate its variations still remains to be fully clarified. The purpose of this literature review is to summarize the current state of knowledge on hepcidin in athletes, in order to show the reasons why this peptide can represent a potential new indirect marker for doping detection. A narrative review was performed following an electronic search of online databases PubMed, Scopus and Web of Science for all English articles published until 2020.

KEY WORDS: Hepcidin; Doping in Sports; Doping; Sports; Blood transfusion; Anemia

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