How Close Are We to Gene Doping?

We know from the third law of motion described in the midseventeenth century by Sir Isaac Newton in his Principia Mathematica that every action in the physical universe generates an equal and opposite reaction. That’s what enables fish to swim, birds to fly, rockets to soar. It’s what allows us to sit quietly in chairs without falling through the floor or floating off into space. It seems to me very likely that the Newtonian laws of motion also explain some aspects of the emergence and evolution of new concepts. A prime example might be a nettlesome new cottage industry that has arisen to evade the international effort to curb doping in sports.

This new movement is founded on the position that it is the very existence of antidoping regulation and oversight that produces a climate of cheating and distrust in sports, and that regulation and prohibition should be replaced by a more laissez-faire approach.¹ This argument would lead us to accept all methods for enhancing performance outside of those permitted by the rules of that sport—drugs, supplements, materials, surgery, and now gene-based enhancement—should be allowed, even encouraged and valued. Some have even suggested that our society has a moral duty to promote active and unregulated use of any and all methods to achieve athletic “excellence.” Bizarrely, one prominent proponent of this approach labels such a process “natural.”²

As troublesome as traditional, drug-based doping has long been, the emergence of gene doping is seen by some to represent an ominous new opportunity in cheating technology.³ The concept of gene doping grew out of the important development in the early 1970s of a novel approach in medicine that promised to treat human disease by attacking underlying genetic defects. Thus was born the idea of gene therapy.⁴ In early, phase I safety studies, gene therapy has produced effective treatments for a number of diseases, such as pediatric immune deficiency, a genetic form of blindness, and neurodegeneration,⁵ with more sure to come in the very near future. While the efficacy of treatments has not yet been confirmed in more extensive phase III studies, the success so far teaches us is that it is clearly possible to introduce new genetic functions into human beings in forms efficient and stable enough to modify traits that produce serious disease and thus to ameliorate life-threatening illness and ease suffering.

The same methods can undoubtedly be used to enhance normal human traits, including traits that affect athletic ability. One might readily envision genetic modification of healthy young athletes to augment functions useful for athletic performance, such as muscle growth and contraction, endurance, blood production, pain perception, and oxygen delivery to exercising muscle. But how close we are to gene doping in sports is a matter of debate.

When the concept of gene doping first emerged a decade or so ago, some critics considered it improbable and far from imminent. One of my most respected colleagues, who had a prominent role in the gene therapy oversight process, called the potential for using genetic modification methods for gene doping “a lot of gale-force hand waving.” In contrast, others saw it to be the obvious next and inevitable step in doping and cheating technology and believed it offered potential advantages over drug-based doping—that it might be more effective and more difficult to detect. Many feared that gene doping would enter the world of competitive sports very quickly; in fact, the sports media have predicted that every Olympic Games in the last decade would probably be the first genetically doped games.

Indeed, several instances have come to light that can only be interpreted as serious attempts at gene doping. An athletic coach in Germany was found to be making diligent efforts to obtain a gene vector called Repoxygen that contains and expresses the erythropoietin gene and was developed to increase blood production in patients with serious diseases such as cancer and chronic kidney disease. The product of the gene, erythropoietin, is in fact one of the most widely used drugs in the world for treatment of these...