In an era where the discovery and development of new medicine have hit its peak, areas of study that generate new thinking and related opportunity for medicine development are of great value. Society requires new medicine as an expanding ageing population in the developed world and the emergence of Western world diseases in the developing world place pressure on our global healthcare capability. Here we explore the possible meaning of elite sport to global, cutting edge medical advance. Why the elite sports industry might drive such advance? We believe that there are two broad areas to do this:

1. Discovery of bioactive molecules with medicine development potential based upon the exploration of the molecular basis of responses to exercise and physical activity and area of research endeavor known as mechanotransduction. This area of study has revealed the incredible potential for a range of naturally occurring molecules to maintain musculoskeletal health and has identified some of the key cell types responsible for orchestrating the beneficial responses. In particular, the bone resident osteocyte has been transformed from a little studies quiescent cell type into the foreman in charge of bone shape, size, and strength and also distant kidney function.
2. The clinical need generated by sport injuries in the elite competing population. Injury in this professional group has greater meaning then in the amateur sports person in terms of both earnings and career progression. The generation of novel medicine and therapies is of great value and includes the emerging clinical specialty of regenerative medicine. This specialty includes the use of cell-based therapies and is emerging fast. At its best, a cellbased therapy will not just treat a clinical condition; rather, it will cure it. Instead of requiring multiple doses over extended periods to control a clinical condition, one dose will cure the condition through the establishment of live cells in the tissues of need. The future holds medical promise and a little acknowledged role that elite sport plays important role in the realization of that promise might well represent a legitimate area for clinical therapy discovery.

Physical exercise-induced bronchial asthma is a disease, which is one of the reasons for the removal of athletes from training and sports. At the same time, if treatment is adequate, athletes can attain high results. The algorithm of physical exercise-induced asthma diagnostics should include, in addition to the purely medical standard examination, the testing under conditions of loads modelling and in the course of natural training process for the estimation of variations in the peak rate of expiration. The prophylaxis of bronchoconstriction attacks under physical loads in athletes with this disease must be based on their teaching: keeping a diet, obligatory intense warm-up load, and use of pharmacological drugs, including those with the metabolitotropic, immunomodulative, and energotonic actions. When having physical exercise-induced asthma, the therapeutic approach must obligatorily be considered that a significant part of bronchodilators is referred to the substances forbidden in sport and will be built on this basis. At present, there exist the targeted methodologies of prophylaxis and treatment of this disease in athletes with the use of allowed medicinal agents such as antileucotrienes. They are permitted for the application to young and adult athletes and give a high therapeutic effect with insignificant number of side phenomena.

At present time, the rational search for a protection of cardiovascular system of athletes and the assessment of such protection efficiency are the very important problems in sports pharmacology and sports cardiology. It is worth noting that athletic training pharmacology, aimed at the stimulation of physical workability in the majority of sports events, can become, together with overloads, the principal reason for a deterioration of health and life’s quality as well as for the sudden death of athletes without a proper cardioprotection. The problem of protection is significantly complicated under modern conditions due to the permanent hardening of anti-doping sanctions (e.g., the recent ban on the use of trimetazidine and meldonium) that essentially limit the possibilities for sports cardiologists. Therefore, the most grounded exit, from the current position, is the use of metabolitotropic medications, in particular, those on the basis of L-carnitine (gamma-butyrobetaine). The wide spectrum of physiologic and biochemical influence of this substance on organism gives possibility to moderately affect the physical and mental workability of athletes even under the conditions of long-term intense physical loads. The complex action of pharmacological agents on the basis of L-carnitine on organism allows one to use it on all stages of the preparation with high efficiency of the cardioprotective and ergogenic effects. Despite the bans of WADA, sports cardiologist possesses a sufficient pool of pharmacological agents that can ensure the protection of myocardium under conditions of training process and competition and can preserve athlete’s health as well as his/her physical workability.

Both specific and nonspecific metabolic transformations, occurring in the body of athlete under intensive and prolonged physical loads, have been characterized in the review paper. It has been emphasized that oxidative stress, which belongs to general pathogenic factors of further myocardium pathology formation, and load induced hypoxia, which is later associated with tissue hypoxia of metabolic origin, represent the initial link of subsequent homeostatic balance changes. Changes in the activity of creatine phosphokinase-MB fraction, content of cardiac troponins I and T as well as terminal natriuretic peptides are referred to specific markers of myocardium strain. Wider range of myocardium strain nonspecific markers includes both alterations of lipid metabolism and numerous, oxidative stress mediated, metabolic changes at the level of cellular and subcellular membranes of cardiomyocytes, followed by changes in the activity of membrane-bound enzymes and lysosomal proteinase ejection first into extracellular matrix and then – into circulatory bed as well as erythrocyte membranes and their ATP content that are accompanied by deterioration of blood oxygen transport function. The above mentioned negatively influences myocardial contractility and leads to the development of hypertrophic cardiomyopathy. Identification of the markers of athlete heart strain allows timely to be corrected by pharmacological means, aimed at normalization of metabolic disorders and prevention of myocardial hypertrophy, which is the major cause of sudden coronary death among athletes.

Readjustments of functional and structural character contribute to the achievements of higher performances due to the lack of aerobic physical work capacity increase, on the one hand, whereas, on the other hand, they may become the main cause of sudden athletes’ death. Deficiency of macroergic phosphates plays an important role in the deterioration of myocardial state during loads. Therefore, searching for and estimating the mechanisms of pharmacological cardioprotective means influence on physical work capacity that are based on adenosine triphosphate, the major macroerg should rely on the studies of those principal metabolic indices, which are involved in the processes of oxygen transport, such as the expressiveness of oxidative homeostasis changes at membrane level in erythrocytes, pH shifts, and blood oxygen saturation.

In the article, it is revealed that modelling continuous physical loads in rats (treadmill running) has demonstrated a positive impact of ATP-long preparation course application on the changes in the content of one of the transition products of lipid peroxidation, malondialdehyde, and the main nonenzymatic antioxidant, reduced glutathione, as well as venous oxygen saturation and blood pH with simultaneous improvement of electrocardiogram parameters and physical work capacity increase, thus, confirming mediated cardioprotective and ergogenic action of the studied preparation. In particular, the results have demonstrated that, in the main group of animals, subjected to physical loads (treadmill running), in the face of intraperitoneal administration of 0.12 g·kg–1 daily dose of ATP-long, equal to therapeutic dosing of preparation, the basis for endurance parameter increase is the reduction of oxidative stress expression within red-cell membranes with the decrease in prooxidant-antioxidant ratio from 2.23 in control group to 1.22 conv. un. in the main group, pH value normalization in venous blood of animals and increase of its oxygen saturation up to 88.3±1.1%, which approximately corresponds to saturation at the level of 89.8±1.2% in intact animals. [...]

Sportininkams teikiama farmakologinė pagalba gerina jų darbingumą ir organizmo prisitaikymą prie vis didėjančių fizinių ir psichoemocinių krūvių. Olimpinio sporto farmakologijos uždaviniai yra šie:

1. Metabolinės pažaidos korekcija palaikant ir didinant sportininkų fizinį darbingumą.

2. Organizmo adaptacijos prie intensyvios ir ilgalaikės fizinės ir psichologinės įtampos poveikio ir imuninio pasipriešinimo didinimas.

3. Organizmo adaptacijos prie laiko ir klimatinių juostų kaitos didinimas, arba desinchroniškumo profilaktika ir korekcija.

4. Pervargimo ir patologinės būklės, susijusios su fizinių krūvių poveikiu, profilaktika.

Siekiant įgyvendinti tikslus, tenka vartoti daug farmakologinių preparatų, darančių įtaką įvairioms metabolizmo grandims sportininko organizme. Reikia atsižvelgti ir į tai, kad bet kurie farmakologiniai preparatai, kurie yra skirti fiziniam darbingumui didinti ir atsigavimui optimizuoti, yra nepakankami arba visai neefektyvūs esant priešpatologinei organizmo būsenai, arba ligai, arba esant neadekvačiam fizinių krūvių dozavimui. Sportininkams, vartojantiems farmakologinius preparatus, reikia gerai žinoti, kokius metabolizmo procesus jie veikia, kokie jų poveikio mechanizmai ir koks jų poveikis treniruočių proceso efektyvinimui. Taip pat svarbu yra žinoti nepageidautiną šių preparatų vartojimo poveikį, jų poveikio pašalinį efektą.

Išanalizavę literatūros šaltinius ir apibendrinę savo tyrimo duomenis, autoriai suformulavo šiuos pagrindinius principus, į kuriuos reikia atsižvelgti sudarant sportininkų farmakologinio aprūpinimo programą. [...]

Under current conditions with noticeably increased competition between the leading sports countries on the global stage, the greatest success is achieved, as a rule, by representatives of the country, in which the latest achievements of science and technology are best used. The level of modern sport development, those overloads that the athletes experience are so high that any attempts to stop using medicinal preparations reflect the views of not even yesterday, but the day before yesterday. Over the past 15–20 years, the volume and intensity of training and competitive loads have increased by 2–3 times, and representatives of many sports events have almost reached the limit of the human body physiological capacities. That having been said, the nutritional inadequacy of athletes’ diets, the need for recovery and preventive measures, body adaptation to intensive physical and psychoemotional loads as well as frequent climate and time zone changes necessitate the usage of pharmacological preparations contributing to work capacity increase and accelerating the recovery processes after significant loads. Unfortunately, this has led to widespread usage of doping in general and anabolic steroids, in particular.

Anabolic means are the substances the action of which is aimed at intensification of anabolic (synthetic) processes in the body, i.e. substances accelerating formation and regeneration of structural parts of cells, tissues and muscular structures. Non-Olympic sports events representatives and the youth not engaged in professional sport tend to use steroid doping as well. The prevalence of usage of banned substances and methods remains high, reliable high precision methods for the detection of many of them are absent, and athletes, not knowing the pitfalls of taking anabolic agents, continue to use them on a mass scale, which can cause both immediate and remote negative effects on health and quality of life. Therefore, every new attempt to explain potential health and life quality hazards is a step forward in the fight against doping.

This review presents modern classification of anabolic agents, headlines their action mechanism and details side effects of using representatives of all three groups of banned drugs including those recently synthesized. It is emphasized that the use of anabolics may not only lead to deprivation of medals won illegally, but cause immediate and delayed negative influences on the athlete’s body further resulting in deterioration of social adaptation, loss of health and, possibly, life itself.

The article analyses functional status of highly skilled five-a-side football (futsal) players that allows individualizing preparation process and also provides an integrated approach to the solution of players’ sportswear optimization problem.

Variation of volume and intensity of training load is caused by reserve opportunities of respiratory system of athlete’s organism. Indicators of external breath function that provide highly skilled athletes with correct selection of training loads in sports during preparatory as well as competitive periods of year training cycle are generalized in the article.

Genetic diagnostics is the advanced method of athlete’s opportunities assessment. The analysis of genetic markers has allowed objectively to define predisposition of the athlete to particular kind of activity (specialization) that has created favourable conditions for effective formation of team’s line-up in such sport as five-a-side football (futsal).

Methodical recommendations, presented in the publication, allow experts approaching the selection of athletes while taking into account their genetic markers and functionality that are considered as informative characteristics; and, as considered, it influences training and competitive process that provides achievements of high sports results in the chosen sport.