TY - JOUR

T1 - Anabolic and lipolytic actions of beta2-agonists in humans and antidoping challenges

AU - Hostrup, Morten

AU - Jacobson, Glenn A

AU - Jessen, Søren

AU - Lemminger, Anders Krogh

N1 - CURIS 2020 NEXS 085

PY - 2020

Y1 - 2020

N2 - Inhaled beta2-adrenoceptor agonists (beta2-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 beta2-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 beta2-agonist has the potential to be anabolic and to enhance performance, as well as due to potential side effects. Despite substantial documentation that beta2-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 beta2-agonists can exert, regardless of the type of beta2-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 beta2-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 beta2-agonists while allowing treatment of asthmatic subjects without causing adverse side effects or ergogenic actions.

AB - Inhaled beta2-adrenoceptor agonists (beta2-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 beta2-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 beta2-agonist has the potential to be anabolic and to enhance performance, as well as due to potential side effects. Despite substantial documentation that beta2-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 beta2-agonists can exert, regardless of the type of beta2-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 beta2-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 beta2-agonists while allowing treatment of asthmatic subjects without causing adverse side effects or ergogenic actions.

KW - Anabolic

KW - Beta agonists

KW - Doping

KW - Hypertrophy

KW - Muscle growth

UR - http://www.scopus.com/inward/record.url?scp=85079748347&partnerID=8YFLogxK

U2 - 10.1002/dta.2728

DO - 10.1002/dta.2728

M3 - Review

C2 - 31960603

AN - SCOPUS:85079748347

VL - 12

SP - 597

EP - 609

JO - Drug Testing and Analysis

JF - Drug Testing and Analysis

SN - 1942-7603

IS - 5

ER -