從治療到禁藥：基因與細胞禁藥對運動員的影響

From therapy to doping: Effects of gene and cell doping on athletes

過去一般認為只要改變少許運動基因，即可提高運動表現，但最近的一些研究已經推翻了這個想法，因為與高強度運動表現有關的基因為數相當多。世界運動禁藥管制組織於2019年公布的禁用方法，新增細胞禁藥的項目。過去研究顯示以間質幹細胞作為軟骨細胞來源，可用於治療軟骨、肌腱或骨頭損傷。反觀國內，衛生福利部於2018年通過開放6項細胞治療技術，因此，運動員應注意的是，受傷後如須要細胞治療，應先申請治療用途豁免審查以取得核准。為了防止基因與細胞治療被不守法的運動員濫用，許多國際單項運動組織已建立運動員生物護照，長期追蹤紀錄選手之血液及類固醇兩方面的數值變化，應可有效掌握違法的方法物質的使用。本文主要介紹利用基因及細胞治療以改善生理功能的策略，同時討論運動員在醫療權益以及與禁用方法之間的界線。

It has been recognized that changing few genes can improve exercise performance. However, recent researches had subverted this idea because there were so many genes related to high intensity exercise performance. In 2019, World Anti-doping Agency announced a new method: Cell therapy in the banned methods. Previous studies showed that using mesenchymal stem cells as a source of chondrocytes can be used to treat cartilage, tendon or bone damage. Recently, the Ministry of Health and Welfare (ROC) approved six cell therapy technologies in 2018. Therefore, athletes should be aware that if there is a need for cell therapy after injury, it is better to apply for therapeutic purpose and hopefully waived from review. To prevent gene and cell therapy from being abused by unruly athletes, many international individual sport organizations has established athlete biological passport. Long-term tracking of the changes in the haematological and steroidal records of players should be able to effectively grasp the use of illegal methods and substances. This article focuses on strategies including genes and cell therapy for improving the physiological functions, and discusses the boundaries between athletes' medical rights and the banned methods.