Modulation of exercise training related adaptation of body composition and regulatory pathways by anabolic steroids.

Anabolic steroids have a long history of abuse in amateur and professional athletics. However, their interaction with training and the resulting effects on body composition and tissue adaptation, relying on a concert of factors and pathways, remain under investigation. This study aims at investigating the changes of body composition and the expression of selected genes and pathways essential for this adaptation process. Therefore, male wistar rats were treated with the anabolic steroid metandienone in two groups (n = 16; metandienone, metandienone + exercise) alongside with control groups (n = 16; control, exercise). Following a 6-week steep-angle treadmill training protocol, weight of organs, visceral fat and muscles was determined. M. gastrocnemius was histologically assessed by ATPase staining, mRNA and protein levels of factors of regeneration, hypertrophy and myogenesis and selected master regulators and markers were determined. Results show additive effects of anabolic steroids and exercise on body, tibia and reproductive organs weight. Mm. gastrocnemius and soleus weight was increased by training but not anabolic steroids. Muscle fiber diameter and composition remained unchanged. Visceral fat mass and fat cell size was affected by training and anabolic steroids but no additive effects could be observed. Exercise and anabolic steroids result in a complex regulation of the expression of genes in M. Gastrocnemius involved in skeletal muscle metabolism, hypertrophy, inflammation and regeneration. In summary, our data suggests distinct molecular mechanisms involved in the adaptation of the skeletal muscle to anabolic androgenic steroids and exercise. Metandienone treatment neither results in skeletal muscle hypertrophy nor liver-toxic effects but in an induction of skeletal muscle regeneration and an activation of endocrine negative feedback. Moreover our study demonstrates that visceral fat and bone responds with higher sensitivity to ASS and exercise than the skeletal muscle. This apparent plasticity of adipose and bone tissue rather than skeletal muscle could indicate a potentially superior future role of fat rather than muscle related parameters to detect and AAS abuse in a biologic passport strategy in professional athletes.

Drug-drug interaction and doping: Effect of non-prohibited drugs on the urinary excretion profile of methandienone.

The potential consequences of drug-drug interactions on the excretion profile of the anabolic androgenic steroid methandienone (17ß-hydroxy-17α-methylandrosta-1,4-dien-3-one) are discussed. More specifically, we have evaluated by in vitro and in vivo experiments the effects of 7 non-prohibited drugs (fluconazole, ketoconazole, itraconazole, miconazole, fluoxetine, paroxetine, and nefazodone) on the main metabolic pathways of methandienone. These are selected among those most commonly used by the athletes. The in vitro assays were based on the use of human liver microsomes, specific recombinant enzyme isoforms of cytochrome P450 and uridine 5'-diphospho-glucuronosyl-transferase. The in vivo study was performed by analyzing urines collected after the oral administration of methandienone with and without the co-administration of ketoconazole. Methandienone and its metabolites were determined by liquid chromatography-mass spectrometry-based techniques after sample pretreatment including an enzymatic hydrolysis step (performed only for the investigation on phase II metabolism) and liquid/liquid extraction with t-butyl methyl-ether. The results from the in vitro experiments showed that the formation of the hydroxylated and dehydrogenated metabolites was significantly reduced in the presence of itraconazole, ketoconazole, miconazole and nefazodone, whereas the production of the 18-nor-hydroxylated metabolites and glucuronidation reactions was reduced significantly only in the presence of ketoconazole and miconazole. The analysis of the post-administration samples confirmed the in vitro observations, validating the hypothesis that drug-drug interaction may cause significant alterations in the metabolic profile of banned drugs, making their detection during doping control tests more challenging.

Efficient approach for the detection and identification of new androgenic metabolites by applying SRM GC-CI-MS/MS: a methandienone case study.

Identification of anabolic androgenic steroids (AAS) is a vital issue in doping control and toxicology, and searching for metabolites with longer detection times remains an important task. Recently, a gas chromatography chemical ionization triple quadrupole mass spectrometry (GC-CI-MS/MS) method was introduced, and CI, in comparison with electron ionization (EI), proved to be capable of increasing the sensitivity significantly. In addition, correlations between AAS structure and fragmentation behavior could be revealed. This enables the search for previously unknown but expected metabolites by selection of their predicted transitions. The combination of both factors allows the setup of an efficient approach to search for new metabolites. The approach uses selected reaction monitoring which is inherently more sensitive than full scan or precursor ion scan. Additionally, structural information obtained from the structure specific CI fragmentation pattern facilitates metabolite identification. The procedure was demonstrated by a methandienone case study. Its metabolites have been studied extensively in the past, and this allowed an adequate evaluation of the efficiency of the approach. Thirty three metabolites were detected, including all relevant previously discovered metabolites. In our study, the previously reported long-term metabolite (18-nor-17ß-hydroxymethyl,17α-methyl-androst-1,4,13-trien-3-one) could be detected up to 26 days by using GC-CI-MS/MS. The study proves the validity of the approach to search for metabolites of new synthetic AAS and new long-term metabolites of less studied AAS and illustrates the increase in sensitivity by using CI. Copyright © 2016 John Wiley & Sons, Ltd.

[Methandienone misuse: interest of medical anti-doping units]. / Dopage sportif à la méthandiénone : intérêt des antennes médicales de prévention du dopage.

We report a case of methandienone misuse leading to a preventive action of the Lorraine medicale anti-doping unit.

Oxidative stress and myocardial dysfunction in young rabbits after short term anabolic steroids administration.

The present study focuses on the short term effects of repeated low level administration of turinabol and methanabol on cardiac function in young rabbits (4 months-old). The experimental scheme consisted of two oral administration periods, lasting 1 month each, interrupted by 1-month wash-out period. Serial echocardiographic evaluation at the end of all three experimental periods was performed in all animals. Oxidative stress markers have also been monitored at the end of each administration period. Treated animals originally showed significantly increased myocardial mass and systolic cardiac output, which normalized at the end of the wash out period. Re-administration led to increased cardiac output, at the cost though of a progressive myocardial mass reduction. A dose-dependent trend towards impaired longitudinal systolic, diastolic and global myocardial function was also observed. The adverse effects were more pronounced in the methanabol group. For both anabolic steroids studied, the low dose had no significant effects on oxidative stress markers monitored, while the high dose created a hostile oxidative environment. In conclusion, anabolic administration has been found to create a possible deleterious long term effect on the growth of the immature heart and should be strongly discouraged especially in young human subjects.

Unexpected contribution of cytochrome P450 enzymes CYP11B2 and CYP21, as well as CYP3A4 in xenobiotic androgen elimination - insights from metandienone metabolism.

The metabolism of a variety of anabolic steroids frequently misused for doping purposes has been investigated in the last years. This research mainly focused on main and long-term metabolites suitable for detection, but detailed clearance mechanisms have rarely been elucidated. Recent studies on metandienone focused on the identification of 17ß-hydroxymethyl-17α-methyl-18-norandrosta-1,4,13-trien-3-one (20ßOH-NorMD) as long-term metabolite, however, the metabolic pathway of its generation remained unclear. Metandienone and its Wagner-Meerwein rearrangement product 17,17-dimethyl-18-norandrosta-1,4,13-trien-3-one (NorMD) were hydroxylated by different human cytochrome P450 enzymes (CYPs). Some of their hydroxylation products were chemically synthesized and characterized by mass spectrometry to allow for their trace detection in urine samples. Following oral administration of metandienone or NorMD in one human volunteer each the post administration urines were checked for the presence of those hydroxylated metabolites using GC-MS/MS analysis. The human mitochondrial steroid hydroxylating enzymes CYP11B1 and CYP11B2 were capable to metabolize metandienone leading to the formation of 11ß-hydroxymetandienone and 18-hydroxymetandienone. Following Wagner-Meerwein rearrangement, the resulting products could be assigned to 20ßOH-NorMD and 11ßOH-NorMD. The contribution of CYP11B1 and CYP11B2 in human metabolism of metandienone was confirmed by analysis of post-administration samples of metandienone and NorMD. Combined with the results from a previous study, enzymatic pathways were identified that involve CYP21 and CYP3A4 in the hydroxylation of NorMD, while CYP21, CYP3A4 and CYP11B2 take part in 20ßOH-NorMD generation from MD. The current study represents a valuable contribution to the elucidation of clearance mechanisms of anabolic steroids and also indicates that mainly non-liver CYPs seem to be involved in these processes.

[Main symptom jaundice--differential diagnosis at the bedside]. / Ikterus--Differentialdiagnose am Krankenbett.

In jaundice, tissues are yellow in color because of an excessive deposition of bilirubin secondary to hyperbilirubinemia. Bilirubin is the physiological end-product of heme metabolism. Jaundice is one of the main symptoms of hepatobiliary disease. Besides that, it might occur in the setting of cardiac, hematologic or pancreatic disorders. The onset of jaundice varies from acute with severe impairment of general condition to chronic and not being noticed by the patient at all. In the first part of this review, the physiological and pathophysiological molecular mechanisms of heme and bile metabolism are described in detail on a scientific basis. The knowledge of the main principles of heme degradation, canalicular bile secretion and enterohepatic cycling of bile salts helps to understand, why clinicians differentiate between prehepatic (hemolytic), hepatocellular and obstructive jaundice. A detailed patient's history and a careful physical examination are essential for the clinical differential diagnosis of jaundice. In combination with routinely obtained lab results, it is often possible to find the right diagnosis already at the bedside. To demonstrate this, the second part of this review sets the focus on the analysis of three case reports from the clinical point of view. The differential diagnosis of jaundice is summarized in a table.

Anabolic steroid abuse among teenage girls: an illusory problem?

BACKGROUND: Recent media reports have portrayed an alarming increase in apparent anabolic-androgenic steroid (AAS) use among American teenage girls; Congress even held hearings on the subject in June 2005. We questioned whether AAS use among teenage girls was as widespread as claimed. METHODS: We reviewed four large national surveys and many smaller surveys examining the prevalence of AAS use among teenage girls. Virtually all of these surveys used anonymous questionnaires. We asked particularly whether the language of survey questions might generate false-positive responses among girls who misinterpreted the term "steroid." We also reviewed data from other countries, together with results from the only recent study (to our knowledge) in which investigators personally interviewed female AAS users. RESULTS: The surveys produced remarkably disparate findings, with the lifetime prevalence of AAS use estimated as high as 7.3% among ninth-grade girls in one study, but only 0.1% among teenage girls in several others. Upon examining the surveys reporting an elevated prevalence, it appeared that most used questions that failed to distinguish between anabolic steroids, corticosteroids, and over-the-counter supplements that respondents might confuse with "steroids." Other features in the phrasing of certain questions also seemed likely to further bias results in favor of false-positive responses. CONCLUSIONS: Many anonymous surveys, using imprecise questions, appear to have greatly overestimated the lifetime prevalence of AAS use among teenage girls; the true lifetime prevalence may well be as low as 0.1%. Future studies can test this impression by using a carefully phrased question regarding AAS use.

[Coronary thrombosis and ectasia of coronary arteries after long-term use of anabolic steroids]. / Koronarthrombosen und -ektasien nach langjähriger Einnahme von anabolen Steroiden.

Chronic abuse of anabolic steroids is widespread. Hypertrophy of skeletal and heart muscle is a well-known effect of chronic anabolic steroid abuse. Structural alterations of blood vessels are new side effects. We report a case of a 32-year-old bodybuilder after long-term use of anabolic steroids who died of cardiac arrest. Coronary angiography and autopsy findings showed especially a hypertrophic heart, structural changes of coronary arteries, intracoronary thrombosis and myocardial infarction, ventricular thrombosis and systemic embolism

[Severe nephrotic syndrome in a young man taking anabolic steroid and creatine long term]. / Súlyos fokú nephrosis szindróma kialakulása anabolikus szteroidot és kreatint tartósan szedó fiatal férfiban.

Anabolic steroids and creatine supplementation is one of the current abuse used by body builders. It is less known that this combination beside of many deleterious effects may also cause renal damage. Authors report a case of diffuse membranoproliferative glomerulonephritis type I in a 22-year-old man who had been taking continuously methandion in a large quantity and 200 grams of creatine daily, and was sent to the outpatient nephrologic unit with typical clinical signs of nephrosis syndrome. They also call attention to the role of the continuously consumed creatine in the renal failure.

[Cholestatic jaundice and pruritus]. / Cholestatischer Ikterus und Pruritus.

The 38 year old male patient was admitted to our clinic with jaundice and invalidating pruritus of unknown origin. The primary evaluation made by the practitioner of the patient and the initial examinations performed in the clinic revealed no diagnosis. In particular, an infectious liver disease could be excluded. Reevaluation of anamnestic data revealed then the in-take of Dianabol, an often used anabolic steroid as the most possible reason for the cholestatic hepatopathy.

Metabolism of methandrostenolone in the horse: a gas chromatographic-mass spectrometric investigation of phase I and phase II metabolism.

The phase I and phase II metabolism of the anabolic steroid methandrostenolone was investigated following oral administration to a standardbred gelding. In the phase I study, metabolites were isolated from the urine by solid-phase extraction, deconjugated by acid catalysed methanolysis and converted to their O-methyloxime trimethylsilyl derivatives. GC-MS analysis indicated the major metabolic processes to be sequential reduction of the A-ring and hydroxylation at C6 and C16. In the phase II study, unconjugated, beta-glucuronidated and sulfated metabolites were fractionated and deconjugated using a combination of liquid-liquid extraction, enzyme hydrolysis, solid-phase extraction and acid catalysed methanolysis. Derivatization followed by GC-MS analysis revealed extensive conjugation to both glucuronic and sulfuric acids, with only a small proportion of metabolites occurring in unconjugated form.

[Severe cholestasis with kidney failure from anabolic steroids in a body builder]. / Schwere Cholestase mit Nierenversagen durch Anabolika bei einem Bodybuilder.

HISTORY AND ADMISSION FINDINGS: A 28-year-old body builder was admitted because of jaundice. For 80 days, until 3 weeks before hospitalization, he had been taking moderately high doses of anabolic steroids: metandienone (methandienone), 10-50 mg daily by mouth, and stanozolol, 50 mg intramuscularly every other day. Physical examination was unremarkable except for yellow discoloration of the skin and sclerae. INVESTIGATIONS: Bilirubin concentration was raised to 4.5 mg/dl, cholestasis enzymes were normal, while transaminase activities were raised. Liver biopsy was compatible with cholestasis induced by anabolic steroids. TREATMENT AND COURSE: Although the steroids had been discontinued, the patient's general condition deteriorated over 7 weeks. Serum bilirubin rose up to a maximum of 77.9 mg/dl. In addition renal failure developed with a creatinine concentration of 4.2 mg/dl. The patient's state improved simultaneously with the administration of ursodeoxycholic acid and the biochemical values gradually reached normal levels after several weeks. CONCLUSION: Anabolic steroids can cause severe cholestasis and acute renal failure. In this case there was a notable temporal coincidence between the administration of ursodeoxycholic acid and the marked clinical improvement.

[The results of experimental study of phytoecdysteroids as erythropoiesis stimulators in laboratory animals]. / Rezul'taty eksperimental'nogo izucheniia fitoékdisteroidov v kachestve stimuliatorov eritropoéza u laboratornykh zhivotnykh.

Phytoecdysteroids alpha-ecdysone, 2-desoxyecdysterone, ecdysterone, sileneoside A, and turkesterone isolated from Rhaponticum carthamoides (Willd.) IIjin, Silene brahuica Boiss and Ajuga turkestanica (Rgl.) Repeated administration of brig increased the content of erythrocytes and hemoglobin in the blood of intact rats. The most active of them--ecdysterone, sileneoside A, and, particularly turkesterone, cause also a marked effect on red blood regeneration in hemotoxic phenylhydrazine anemia. In its capacity for simulating erythropoiesis turkesterone resembles the well-known steroidal anabolic drug nerobol.

[The effect of solubilized methandrostenolone on muscle hypertrophy and on the blood biochemical indices in rats]. / Vliianie soliubilizirovannogo metandrostenolola na myshechnuiu gipertrofiiu i nekotorye biokhimicheskie pokazateli krovi u krys.

The paper outlines a new mode of intravascular anabolic steroidal transport. The single intravenous administration of metandrostenolone aqueous solution to rats increases hypertrophy rate of MM. plantaris. It was shown that the action of a single dose (0.05 mg/kg) exceeded that of metandrostenolone oil solution in a dose of 5 mg/kg. The multiple reduction of doses of the anabolic drug and the high level of bioavailability were achieved. This effect was explained by the application of the specific transport agent.

[Death caused by pulmonary embolism in a body builder taking anabolic steroids (metanabol)]. / Zgon z powodu zatorowosci plucnej kulturysty przyjmujacego sterydy anabolizujace (Metanabol).

A 20-year-old body-builder died from pulmonary embolism. The diagnosis was delayed because he concealed long-term taking of anabolic steroids.

[Thymolytic effects of methandrostenolone]. / Izuchenie mekhanizmov timoliticheskogo éffekta metandrostenolona.

It was shown, that in castrated rats dianabol (10 mg/kg of body mass daily for 7 days) inhibits the protein synthesis in thymus. The binding analysis of 3H-dianabol showed the specific binding sites in thymic cytosol, which are identical to those for androgens. Isolated thymocytes didn't bind dianabol.