Evaluation of the MAIIA dipstick test to detect recombinant human erythropoietin in plasma

Recently a novel technology, referred to as the 'EPO WGA MAIIA' test, has been developed by Swedish researchers to discriminate between endogenous and recombinant human erythropoietin. In contrast to existing electrophoretic methods that are used by antidoping laboratories, this dipstick-based technique is simple and fast. Moreover it can be applied to either blood or urine specimens. These characteristics could prove advantageous if the test were adopted by antidoping authorities to determine blood doping in sport. We evaluated the sensitivity of EPO WGA MAIIA to detect the presence of recombinant human erythropoietin (rhEPO) in some archived plasma specimens which had been collected from healthy, active subjects either 72 h or 96 h after a 'microdose' intravenous injection of rhEPO. Under these conditions the test had modest sensitivity to discriminate rhEPO, with only two of nine subjects exceeding an arbitrary cut-off 3.09 SDs beyond the expected population mean. Sensitivity was improved to five out of six subjects if positivity was assessed according to the subject's own previous values rather than a population-based threshold. We conclude that, with further refinement, the dipstick test may supplement existing antidoping tests.