Hong Kong: Lab Chief Sees Need For ‘Game-Changing’ Approach To Testing: Paulick Report 12/11/15

By: Ray Paulick

Sunday’s Hong Kong International Races at Sha Tin race course will, from a drug control standpoint, be among the cleanest anywhere in the world.

Overseas horses are tested upon their arrival, then will be drug screened once again prior to Sunday’s races, standard protocol by the Hong Kong Jockey Club, which does pre-race testing on all runners throughout the year. Following the races, approximately 25 percent of runners – including the first- and second-place finishers – will be tested, and split samples will be taken, with some of them stored in a deep freeze for possible “retrospective” testing at some future date.

It’s all part of a comprehensive integrity program established by the Hong Kong Jockey Club – one that would be difficult to duplicate in the U.S. or elsewhere. Horses are required to stable at the track, medications are strictly controlled and all veterinarians are employees of the Hong Kong Jockey Club. There is enhanced security, closed circuit TV cameras throughout the stable area and a robust out-of-competition testing program. It’s all done with the idea of maintaining confidence of participants, horseplayers and the Hong Kong government.

The Hong Kong Jockey Club’s Racing Lab, since 1999 headed by Dr. Terence Wan, is among the most modern and well-financed in the world, with 55 employees and 38 state-of-the-art mass spectrometers. It even has its own closed circuit TV system, with more than 50 cameras inside the lab strategically focused on equipment and samples.

With all that, Hong Kong has one of the lowest positive drug test rates in the world. Over a 10-year period ending in June 2014, only 0.07 percent of post-race test samples were reported as positive: that’s seven in 10,000.

By comparison, the average rate of positives from post-race samples of member countries of the International Federation of Horseracing Authorities over a similar time frame was 0.38 percent, more than five times higher.

The Hong Kong Racing Lab does outside work, Wan said, and the rate of positives for overseas post-race samples tested is 2.6 percent – 37 times higher than the rate of post-race positives for Hong Kong’s races. So it’s safe to say that Hong Kong’s low number of violations is not due to an inability to detect prohibited substances.

Wan, who studied in the United States – first at the Lowell Technological Institute, then the University of Wisconsin and finally at MIT, where he earned a PhD – worked as a forensic scientist in Hong Kong before focusing on drug testing in racing. In Hong Kong, even with all the security measures taken, he knows that some people will always try to get an edge.

“Any time there is a possibility of winning prize money and fame,” he said, “there is always this attraction to win at all costs.”

Wan cited a survey conducted by physician Robert Goldman over a period of years beginning in the early 1980s that demonstrated this “win at all costs” attitude. The Goldman Survey or Goldman’s Dilemma, as it is known, asked elite human athletes if they would take a drug guaranteeing them victory in every competition, but with one caveat: the drug would kill them in five years. Stunningly, over several sample groups, more than half the athletes surveyed said “yes.”

The desire to cheat, however, is a minor concern to Wan compared to the explosive growth of human drugs that he believes may be finding their way into horse racing.

“The biggest challenges in Hong Kong as well as elsewhere is there are always new drugs coming on the market, new ways of doping,” he said. “We currently are testing thousands of targets, but it can easily increase to tens of thousands because of drug development companies coming up with new possibilities that are effective, that have biological effect. It’s difficult to catch up.”

Wan refers to the capability gap – the difference between what testing labs can detect vs. the total number of drugs on the market. “Today the gap is only so big,” he said, holding up his forefinger and thumb. “Tomorrow the gap is bigger (holding his hands well apart from each other) because the growth of available drugs is much faster than the growth in capability of the individual labs. And so the capability gap is increasing, and there must be a better way of doing drug control than we do now, which I would call conventional drug testing.

“Testing for the drug or the metabolites – one drug at a time or one metabolite at a time from biological fluid, whether it’s urine, blood or even hair – that’s okay for now,” he said. “But more and more of the drugs are very polar, which means they are like the substance of the body so they don’t have much differentiation.”

Wan said proteins and peptides present a specific challenge.

“The body has a lot of them, but the drugs themselves, what I would call the biologic drugs, like proteins and peptides, it’s difficult to analyze these substances. The proteins are more expensive, there is a cost involved. But nowadays you don’t have to use the proteins, you can use part of the proteins, what I would call peptides, that bind to the same receptor as the proteins. Maybe the effect is slightly less, but it is still effective. The proteins are expensive but the small peptides are cheap, a few American dollars per amino acid.

Making these peptides even more problematic is the fact they can be custom synthesized. “You can play with the makeup of the amino acids,” he said, “changing the peptides a little bit. It may still have the same effect but it would be extremely difficult for a doping control lab to find the modified peptides. And modification is easy. The knowledge is out there. You chop down the protein to the peptides and they are still effective, and you change one of the amino acids, they are still active, and then you patent part of a protein of 30 or 40 amino acids with a slight variance, but they still bind to the same receptor, producing the same effect. For example, dermorphin, I’m sure, would have 40 or 50 variants that have been patented and are effective, acting similarly to the same receptor, causing analgesia in that particular case.  So how can we catch up, without even knowing what amino acid they have switched?”

Wan said the answer may not lie in conventional drug testing.

“We must have some kind of game-changing way of doing testing,” he said. “What we want to control is the effect on the animal. We are doing indirect testing, chemical testing, trying to find banned substances or the metabolite in the sample. I’m thinking we should move on to biological testing, testing for the effect rather than for the presence of the banned substances. You may have heard of testing for bio-markers or biological passports in the human world. Basically these are longitudinal profiles of athletes. These tests do not target specific substances – steroids or growth hormones – but they are looking at the effect which is manifested because the drug has an effect on the body.”

The testing measures different metabolites and proteins in the body. When significant change occurs in that metabolome and proteome, the suspicions would be that certain banned substances may have caused those changes.

“Even though there’s no way to tell based on these tests that the animal has been exposed to what kind of substance, the changes are out of the ordinary, they are abnormal,” Wan said. “I think we have to think about this game-changing way of doing doping control, and not just test for one drug at a time, one metabolite at a time. This is extremely difficult. Several labs right now are starting research into this direction. We have to change our way of thinking. I believe there is a future in biological markers or profiling.”

Wan said this new approach would not completely take the place of conventional drug testing and that rules need to be changed, as they have been in human sports, so that abnormal profiles can lead to sanctions, whether or not the source of the change is detected.

“More pragmatically,” he said, “because there is change in the profile, the athlete will be targeted for more testing, more frequency of testing. It’s a complement to conventional drug testing. It’s one way of solving a number of problems, including the undetectable substances.”

This won’t come without a cost.

“The biological markers are hugely expensive,” he said. “The labs, the authorities, have to come together. I am all for collaboration and harmonization. This is a major problem that I see. It’s not just the U.S. or China or elsewhere. We have to pool resources to work together and share the cost of this major development, what I see as a game changing development that will be hugely expensive.”