Cortisol assays and diagnostic laboratory procedures in human biological fluids

A comprehensive review of aptamer screening and application for lateral flow strip: Current status and future perspectives

The detection of biomarkers is of great significance for medical diagnosis, food safety, environmental monitoring, and agriculture. However, bio-detection technology at present often necessitates complex instruments, expensive reagents, specialized expertise, and prolonged procedures, making it challenging to fulfill the demand for rapid, sensitive, user-friendly, and economical testing. In contrast, lateral flow strip (LFS) technology offers simple, fast, and visually accessible detection modality, allowing real-time analysis of clinical specimens, thus finding widespread utility across various domains. Within the realm of LFS, the application of aptamers as molecular recognition probes presents distinct advantages over antibodies, including cost-effectiveness, smaller size, ease of synthesis, and chemical stability. In recent years, aptamer-based LFS has found extensive application in qualitative, semi-quantitative, and quantitative detection across food safety, environmental surveillance, clinical diagnostics, and other domains. This review provided a concise overview of different aptamer screening methodologies, selection strategies, underlying principles, and procedural, elucidating their respective advantages, limitations, and applications. Additionally, we summarized recent strategies and mechanisms for aptamer-based LFS, such as the sandwich and competitive methods. Furthermore, we classified LFSs constructed based on aptamers, considering the rapid advancements in this area, and discussed their applications in biological and chemical detection. Finally, we delved into the current challenges and future directions in the development of aptamer and aptamer-based LFS. Although this review was not thoroughly, it would serve as a valuable reference for understanding the research progress of aptamer-based LFS and aid in the development of new types of aptasensors.

Anxiolytic and Antidepressant Effect of Phaseolus vulgaris on Animal Models

An experimental study was conducted using rodents at different doses to evaluate the effect of Phaseolus vulgaris (red beans) on cage crossing, head dip, open field, elevated plus maze, and light and dark apparatus for anxiety and forced swim test for depression. The corticosterone level and histopathological evaluation was also done to correlate the antidepressive impact of the red beans. The study also identified the components responsible for the effect using GCMS. Based on the findings, red beans could be a potential non-pharmacological therapy for mild to moderate depressive patients. The anxiety model was conducted on mice weighing 20-25 gms. Group I was taken as control, group II as 500 mg/kg and group III as administered 1000 mg/kg. The tests were performed on 0th, 7th, 15th, 30th, 45th, and 60th day. The depression model research was conducted on albino rats weighing between 180 and 200 g, divided into four groups: a control group, a 500 mg/kg Phaseolus vulgaris group, a 1000 mg/kg Phaseolus vulgaris group, and a standard group treated with fluoxetine. The forced swimming test was performed on days 0, 7, 15, 30, 45, and 60, after which histopathological evaluations were conducted and blood samples were taken to assess corticosterone levels. GCMS was used to identify the constituents present in red beans, while optical spectroscopy was used to detect minerals and ions. Results showed that both doses of Phaseolus vulgaris possess anxiolytic effect and increased the struggling time of rats in depression model significantly, with the 1000 mg/kg dose showing more significant results than the 500 mg/kg dose. The GCMS results identified the presence of erucic acid, which causes an increase in α-amylase, thus reducing depression. Optical spectroscopy also showed that red beans contain zinc, which may increase BDNF and help in treating depression.

Turning Antibodies into Ratiometric Bioluminescent Sensors for Competition-Based Homogeneous Immunoassays

Here we present LUCOS (Luminescent Competition Sensor), a modular and broadly applicable bioluminescent diagnostic platform enabling the detection of both small molecules and protein biomarkers. The construction of LUCOS sensors entails the covalent and site-specific coupling of a bioluminescent sensor component to an analyte-specific antibody via protein G-mediated photoconjugation. Target detection is accomplished through intramolecular competition with a tethered analyte competitor for antibody binding. We established two variants of LUCOS: an inherent ratiometric LUCOSR variant and an intensiometric LUCOSI version, which can be used for ratiometric detection upon the addition of a split calibrator luciferase. To demonstrate the versatility of the LUCOS platform, sensors were developed for the detection of the small molecule cortisol and the protein biomarker NT-proBNP. Sensors for both targets displayed analyte-dependent changes in the emission ratio and enabled detection in the micromolar concentration range (KD,app = 16-92 μM). Furthermore, we showed that the response range of the LUCOS sensor can be adjusted by attenuating the affinity of the tethered NT-proBNP competitor, which enabled detection in the nanomolar concentration range (KD,app = 317 ± 26 nM). Overall, the LUCOS platform offers a highly versatile and easy method to convert commercially available monoclonal antibodies into bioluminescent biosensors that provide a homogeneous alternative for the competitive immunoassay.

Heat inactivation of SARS-CoV 2 enabled the measurement of salivary cortisol during COVID-19 pandemic

BACKGROUND AND AIM

Salivary cortisol has become an essential tool in the management of cortisol-related disease. In 2020 the sudden outbreak of COVID-19 pandemic caused several concerns about the use of saliva, due to the risk of contamination, and a European consensus further discourage using salivary cortisol. To decrease infectious risk, we handled specimens by applying a heat treatment to inactivate viral particles, further evaluating the impact of the COVID-19 pandemic on the use of salivary cortisol in clinical practice.

MATERIAL AND METHODS

Saliva samples were exposed for 10 min at 70 °C, then cortisol was measured using LC-MS/MS. The number of salivary cortisol examinations from 2013 to 2022 was extracted from the local electronic database: those performed in 2019, 2020, and 2021 were analyzed and compared with the historical data.

RESULTS

During 2020 we observed a decrease of 408 (-20%) examinations (p = 0.05) compared to 2019; especially in salivary cortisol daily rhythm and salivary cortisol/cortisone ratio (respectively reduction of 47% and 88%, p = 0.003 and p = 0.001). Analyzing year 2021 compared with 2020 we reported an increase of 420 examinations (+20%, p = 0.01), with a complete recovery of salivary cortisol measurement (considering 2019: p = 0.71). Major differences were observed between morning salivary cortisol (-20%, p = 0.017), LNSC (-21%, p = 0.012) and salivary cortisol rhythm (-22%, p = 0.056). No Sars-Cov2 infections related to working exposure were reported among laboratory's employers.

CONCLUSIONS

We speculate that the adoption of an appropriate technique to inactivate viral particles in saliva specimens allowed the safety maintenance of salivary collections, also during the Sars-CoV-2 outbreak.

Wearable and Implantable Cortisol-Sensing Electronics for Stress Monitoring

Cortisol is a steroid hormone that is released from the body in response to stress. Although a moderate level of cortisol secretion can help the body maintain homeostasis, excessive secretion can cause various diseases, such as depression and anxiety. Conventional methods for cortisol measurement undergo procedures that limit continuous monitoring, typically collecting samples of bodily fluids, followed by separate analysis in a laboratory setting that takes several hours. Thus, recent studies demonstrate wearable, miniaturized sensors integrated with electronic modules that enable wireless real-time analysis. Here, the primary focus is on wearable and implantable electronic devices that continuously measure cortisol concentration. Diverse types of cortisol-sensing techniques, such as antibody-, DNA-aptamer-, and molecularly imprinted polymer-based sensors, as well as wearable and implantable devices that aim to continuously monitor cortisol in a minimally invasive fashion are discussed. In addition to the cortisol monitors that directly measure stress levels, other schemes that indirectly measure stress, such as electrophysiological signals and sweat are also summarized. Finally, the challenges and future directions in stress monitoring and management electronics are reviewed.

High-Throughput Comprehensive Quantitative LC-MS/MS Analysis of Common Drugs and Metabolites (62 Compounds) in Human Urine

In recent years a multitude of LC-MS/MS assays have been widely reported in commercial and clinical literature demonstrating the simultaneous analyses of dozens of drugs of abuse in human samples. The utility of such assays is meant to supplant the indirect detection based on the classical spectral library approach. Direct and simultaneous analysis via LC-MS/MS technology is made possible by fast acquisition rates in multiple reaction monitoring, as well as sensitivity and high selectivity of the technology for each individual analyte in a complex mixture. Hence, unlike immunoassays, which are not well-suited for the analyses of mixtures, and which may also be prone to false positives from potential interferences, quantitative LC-MS/MS analyses are feasible for complex patient mixtures of drugs of abuse. We hereby present a robust clinical LC-MS/MS assay for the simultaneous and semi-quantitative analysis of up to 62 drugs of abuse in human urine, representing major classes that include opiates, benzodiazepines, amphetamines, etc. The assay utilizes dilute and shoot, whereby the sample is diluted ten times in internal standard reagent and thereafter submitted to the LC-MS instrument, i.e., reversed-phase liquid chromatography coupled to the electrospray ionization multiple reaction monitoring analysis, via the TSQ Endura triple-quadrupole instrument. The assay employs stable isotope-labeled internal standards with a linear response in the 30-300 ng/mL range, effectively semi-quantitative, since this analytical range is well within typical immunoassay cutoffs for most drugs.

Differences in segmental hair cortisol concentration analysis among children and adolescents with overweight and obesity, their parents, and normal weight peers

PURPOSE

Dysregulation of the stress system via incidental long exposure to glucocorticoids (GCs) can lead to weight gain. In addition, family and maternal stress can also have an impact on children's weight. Hair is used in several studies to evaluate cortisol (GC) levels in children and adolescents with excess weight as a retrospective stress biomarker, depending on the hair length the cortisol measurement depicting different time periods. We aimed to investigate whether there is a difference among segmental hair cortisol concentration (HCC) analysis between children and adolescents with overweight and obesity, their mothers, and normal weight peers.

METHODS

This study recruited 25 children aged 6-14 years with a body mass index (BMI) ≥ 85th centile and their mothers, as well as 20 children of the same age with a BMI < 85th centile. Hair cortisol concentration was measured using electrochemiluminescence immunoassay.

RESULTS

Segmental HCC analysis exhibited gradually decreasing values in all participants as segments of hair were more distantly located from the scalp. A positive correlation was found between BMI z-score and HCC of the first segment of hair in children and adolescents with elevated BMI (b = 1.84, p = 0.033), as well as with maternal HCC / of an only child (b = 15.77, p = 0.01). There were no associations between mother-child dyads and children and adolescents of different BMI groups, even though minors with excess weight exhibited higher HCC levels in all segments of hair in comparison to their normal weight counterparts.

CONCLUSIONS

Hair cortisol of all participants exhibited a gradually declining concentration. More studies with larger samples and more sensitive methods of analysis are warranted in order to draw firmer conclusions.

Multiplexed Serum Steroid Profiling Reveals Metabolic Signatures of Subtypes in Congenital Adrenal Hyperplasia

Context

Altered metabolic signatures on steroidogenesis may characterize individual subtypes of congenital adrenal hyperplasia (CAH), but conventional diagnostic approaches are limited to differentiate subtypes.

Objective

We explored metabolic characterizations and identified multiple diagnostic biomarkers specific to individual subtypes of CAH.

Methods

Liquid chromatography-mass spectrometry-based profiling of 33 adrenal steroids was developed and applied to serum samples obtained from 67 CAH patients and 38 healthy volunteers.

Results

Within- and between-run precisions were 95.4% to 108.3% and 94.1% to 110.0%, respectively, while all accuracies were <12% and the correlation coefficients (r2) were > 0.910. Metabolic ratios corresponding to 21-hydroxylase characterized 21-hydroxylase deficiency (21-OHD; n = 63) from healthy controls (area under the curve = 1.0, P < 1 × 10-18 for all) and other patients with CAH in addition to significantly increased serum 17α-hydroxyprogesterone (P < 1 × 10-16) and 21-deoxycortisol (P < 1 × 10-15) levels. Higher levels of mineralocorticoids, such as corticosterone (B) and 18-hydroxyB, were observed in 17α-hydroxylase deficiency (17α-OHD; N = 3), while metabolic ratio of dehydroepiandrosterone sulfate to pregnenolone sulfate was remarkably decreased against all subjects. A patient with 11β-hydroxylase deficiency (11β-OHD) demonstrated significantly elevated 11-deoxycortisol and its metabolite tetrahydroxy-11-deoxyF, with reduced metabolic ratios of 11β-hydroxytestosterone/testosterone and 11β-hydroxyandrostenedione/androstenedione. The steroid profiles resulted in significantly decreased cortisol metabolism in both 21-OHD and 17α-OHD but not in 11β-OHD.

Conclusion

The metabolic signatures with specific steroids and their corresponding metabolic ratios may reveal individual CAH subtypes. Further investigations with more substantial sample sizes should be explored to enhance the clinical validity.

An automatic immuno-microfluidic system integrating electrospun polystyrene microfibrous reactors for rapid detection of salivary cortisol

Conventional competitive enzyme-linked immunosorbent assay (ELISA) to measure the cortisol level in body fluid consumes a large amount of time, owing to complicated operations involved and requirement for precise control of reagent addition. We developed an automatic microfluidic system to detect salivary cortisol rapidly, and an electrospun polystyrene (PS) microfiber-based reactor providing considerable binding sites for antibody immobilization, thus resolving the time limitations of competitive ELISA. Cortisol sample, horseradish peroxidase (HRP)-conjugated cortisol, and 3,3',5,5'-tetramethylbenzidine (TMB) substrate were delivered to the PS reactor from containers in sequence by pumps automatically. The color variation due to oxidized TMB complex reflects the cortisol concentration level measured using an RGB phototransistor. In addition, the entire procedure from sample introduction to obtaining the photocurrent took only 15 min. This system can be implemented to quantify cortisol from 0.37 ng/mL to 30 ng/mL, and the limit of detection was estimated at 0.37 ng/mL.

A molecularly imprinted screen-printed carbon electrode for electrochemical epinephrine, lactate, and cortisol metabolites detection in human sweat

This study presents a novel approach to the detection of epinephrine, lactate, and cortisol biomarkers in human sweat using molecularly-imprinted polymers (MIP) embedded screen printed carbon electrode (SPCE) sensors. The epinephrine and lactate MIP SPCE sensors were fabricated by epinephrine or lactate-imprinted polyaniline co-polymerized with 3-aminophenylboronic acid and gold nanoparticles (PANI-co-PBA/AuNP) selective membrane on a commercial SPCE. The cortisol sensor was comprised of a cortisol-imprinted poly(glycidyl methacryate-co-ethylene glycol dimethacrylate) (poly (GMA-co-EGDMA)@AuNP selective membrane deposited on a SPCE. Both cyclic voltammetry (CV) and differential pulse voltammetry (DPV) were used as modes of analysis for the MIP SPCE sensors. All sensors exhibited a rapid (∼1 min) and selective response to the epinephrine, lactate, and cortisol target analytes, with excellent precision between scans for both CV and DPV analysis modes. For CV, the LOD for epinephrine, lactate, and cortisol was 8.2 nM, 13 mM, and 0.042 μM, respectively. The LOD for DPV were 0.60 nM, 2.2 mM, and 0.025 μM for epinephrine, lactate, and cortisol, respectively. The MIP SPCE sensor platforms were further validated through the successful quantification of epinephrine, lactate, and cortisol in human sweat.

Influence of the circadian cycle, sex and production stage on the reference values of parameters related to stress and pathology in porcine saliva

BACKGROUND

The concentration of biomarkers in saliva could be influenced by several factors not related to the specific condition under analyses, which should be considered for proper clinical interpretation. In the present study, the circadian rhythm of C-reactive protein (CRP), haptoglobin (Hp), Pig-MAP, S100A12, Cu, Zn, Adenosine deaminase (ADA), total protein (TP), total antioxidant capacity (TAC), total oxidant status (TOS), oxidative stress index (OSI), cortisol and α-amylase in saliva of 20 female and 20 male pigs was investigated. Moreover, the influence of sex and production phase (post-weaning, fattening and finishing) on the concentrations of biomarkers in a total of 414 healthy pigs was studied and the reference intervals for all salivary biomarkers were calculated accordingly.

RESULTS

All parameters except Pig-MAP, OSI and α-amylase varied significantly along the daytime, and most of them peak around early afternoon (13-15 h). The cosinor analysis described the temporal dynamics of circadian rhythms for all parameters. The range values showed differences between male and female pigs in 8 out of the 13 biomarkers, with higher concentrations in females in comparison to male pigs. The influence of the production phase on the salivary concentrations was observed for all the biomarkers. The highest concentrations were observed for Pig-MAP, S100A12 and α-amylase in post-weaning animals, for TP in growing pigs and for OSI in finishing animals. Most of the sex-influenced biomarkers showed the highest concentrations at growing stages with some exceptions such as ADA or Hp that showed the peak at finishing and post-weaning stages respectively.

CONCLUSIONS

It is necessary to establish the optimal daytime for routine saliva sampling to avoid circadian variations and for that end, the time interval between 10:00 a.m. to 12:00 a.m. is highly recommended. The factors sex and production phase influence the concentration of biomarkers and should be considered for proper biomarker interpretation. The reference intervals presented here for each salivary biomarker will help to correctly interpret the results of these analytes and contribute to the use of saliva as a non-invasive sample for the diagnosis and monitoring of the health status of swine farms.

Anorexia nervosa and adrenal hormones: a systematic review and meta-analysis

OBJECTIVE

Anorexia nervosa is a primary psychiatric disorder characterized by self-induced negative energy balance. A number of hormonal responses and adaptations occur in response to starvation and low body weight including changes in adrenocortical hormones. Our objective was to systematically review adrenocortical hormone levels in anorexia nervosa.

DESIGN/METHODS

We searched MEDLINE and EMBASE for studies that reported at least one adrenocortical hormone, including dehydroepiandrosterone (DHEA), DHEA-sulphate (DHEA-S), progesterone, 17-hydroxyprogesterone, pregnenolone, cortisol (serum, urine, cerebrospinal fluid, and hair sample), aldosterone, androstenedione, and testosterone in patients with anorexia nervosa and normal-weight healthy controls from inception until October 2021. Means and standard deviations for each hormone were extracted from the studies to calculate a mean difference (MD). A pooled MD was then calculated by combining MDs of each study using the random-effects model.

RESULTS

We included a total of 101 studies with over 2500 females with anorexia nervosa. Mean cortisol levels were significantly higher in anorexia nervosa as compared to normal-weight controls for multiple forms of measurement, including morning cortisol, 12-hour and 24-hour pooled serum cortisol, 24-hour urine cortisol, and after an overnight dexamethasone suppression test. In contrast, mean serum total testosterone and DHEA-S levels were significantly lower among patients with anorexia nervosa.

CONCLUSIONS

Women with anorexia nervosa have higher cortisol levels and lower DHEA-S and testosterone levels compared to women without anorexia nervosa. This finding is important to consider when evaluating low-weight women for disorders involving the adrenal axis, especially Cushing's syndrome.

Understanding the Role of Therapy Dogs in Human Health Promotion

Dogs may provide humans with a range of physical, mental and social benefits. Whilst there is growing scientific evidence of benefits to humans, there has been less focus on the impact to canine health, welfare and ethical considerations for the dogs. The importance of animal welfare is increasingly acknowledged, indicating that the Ottawa Charter should be extended to include the welfare of non-human animals supporting the promotion of human health. Therapy dog programmes are delivered across a variety of settings including hospitals, aged care facilities and mental health services, highlighting the important role they play in human health outcomes. Research has shown that that there are biomarkers for stress in humans and other animals engaged in human-animal interactions. This review aims to assess the impact of human-animal interactions on therapy dogs engaged in providing support to human health. While challenging, it is paramount to ensure that, within the framework of One Welfare, the welfare of therapy dogs is included, as it is a key factor for future sustainability. We identified a range of concerns due to the lack of guidelines and standards to protect the wellbeing of the dogs engaged in these programmes. Extension of the Ottawa Charter to include the welfare of non-human animals with leveraging through a One Welfare approach would promote animal and human health beyond current boundaries.

A wearable sweat electrochemical aptasensor based on the Ni-Co MOF nanosheet-decorated CNTs/PU film for monitoring of stress biomarker

Monitoring cortisol, a hormone released by the adrenal cortex in response to stress, is essential to evaluate the endocrine response to stress stimuli. While the current cortisol sensing methods require large laboratory settings, complex assay, and professional personnel. Herein, a novel flexible and wearable electrochemical aptasensor based on a Ni-Co metal-organic frameworks (MOF) nanosheet-decorated carbon nanotubes (CNTs)/polyurethane (PU) film is developed for rapid and reliable detection of cortisol in sweat. First, the CNTs/PU (CP) film was prepared by a modified wet spinning technology, and the CNTs/polyvinyl alcohol (PVA) solution was thermally deposited on the surface of CP film to form the highly flexible CNTs/PVA/CP (CCP) film with excellent conductivity. Then aminated Ni-Co MOF nanosheet prepared by a facile solvothermal method was conjugated with streptavidin and modified on the CCP film. Biofunctional MOF can effectively capture cortisol aptamer due to its excellent specific surface area. In addition, the MOF with peroxidase activity can catalytic oxidization of hydroquinone (HQ) by hydrogen peroxide (H₂O₂), which could amplify the peak current signal. The catalytic activity of Ni-Co MOF was substantially suppressed in the HQ/H₂O₂ system due to the formation of the aptamer-cortisol complex, which reduced the current signal, thereby realizing highly sensitive and selective detection of cortisol. The sensor has a linear range of 0.1-100 ng/mL and a detection limit of 0.032 ng/mL. Meanwhile, the sensor showed high accuracy for cortisol detection under mechanical deformation conditions. More importantly, the prepared MOF/CCP film based three-electrode was assembled with the polydimethylsiloxane (PDMS) substrate, and the sweat-cloth was used as the sweat collection channel to fabricate a wearable sensor patch for monitoring of cortisol in volunteers' sweat in the morning and evening. This flexible and non-invasive sweat cortisol aptasensor shows great potential for quantitative stress monitoring and management.

A dual-color plasmonic immunosensor for salivary cortisol measurement

Lifestyle-related disorders are a public health problem worldwide and their early diagnosis represents the key to successful therapies. In this framework, rapid point-of-care (POC) tests are one of the most promising diagnostic techniques. In particular, the use of saliva is raising increasing interest as a noninvasive biological fluid in POC systems, although the low concentration of salivary biomarkers typically requires strong advances to improve the device sensitivity. In this study, the plasmonic properties of two differently shaped gold nanoparticles (i.e., nanospheres and nanostars) were combined to develop an efficient paper-based immunosensor for the naked-eye evaluation of salivary cortisol, known as one of the main stress-related biomarkers. Notably, the dual-color system facilitated an immediate and easy evaluation of cortisol levels, based on a blue-to-pink color change of the detection zone. Furthermore, the implemented strategy showed potential applicability as a rapid and portable monitoring system, allowing discriminating different target concentrations.

An Immunosensor for the Determination of Cortisol in Serum and Saliva by Array SPRi

Cortisol is a hormone which plays an essential role in the immune, endocrine, cardiovascular, renal and skeletal systems. Its level increases in response to stress, illness, injury or exhaustion, and it is therefore a significant diagnostic biomarker of stress. An immunosensor for the determination of cortisol by SPRi array was developed. The receptive part of the immunosensor is mouse monoclonal antibody against cortisol, immobilized via cysteamine linker. The optimum pH of the immunosensor is 7.4, and the optimum concentration of the antibody is 50 ng mL^-1. The immunosensor is specific for cortisol, and its linear response ranges from 0.20 ng mL^-1 (LOQ) to 8 ng mL^-1. The precision of the determination was between 3.1% and 3.3%, and the recovery between 99% and 102%. The immunosensor was validated by simultaneous determination of cortisol in serum and saliva samples by a standard method, with good agreement between the results.

A Wearable, Textile-Based Polyacrylate Imprinted Electrochemical Sensor for Cortisol Detection in Sweat

A wearable, textile-based molecularly imprinted polymer (MIP) electrochemical sensor for cortisol detection in human sweat has been demonstrated. The wearable cortisol sensor was fabricated via layer-by-layer assembly (LbL) on a flexible cotton textile substrate coated with a conductive nanoporous carbon nanotube/cellulose nanocrystal (CNT/CNC) composite suspension, conductive polyaniline (PANI), and a selective cortisol-imprinted poly(glycidylmethacrylate-co-ethylene glycol dimethacrylate) (poly(GMA-co-EGDMA)) decorated with gold nanoparticles (AuNPs), or plated with gold. The cortisol sensor rapidly (<2 min) responded to 9.8−49.5 ng/mL of cortisol, with an average relative standard deviation (%RSD) of 6.4% across the dynamic range, indicating excellent precision. The cortisol sensor yielded an excellent limit of detection (LOD) of 8.00 ng/mL, which is within the typical physiological levels in human sweat. A single cortisol sensor patch could be reused 15 times over a 30-day period with no loss in performance, attesting to excellent reusability. The cortisol sensor patch was successfully verified for use in quantification of cortisol levels in human sweat.

Sensitive and Robust LC-MS/MS Analysis of Salivary Cortisol in Negative Mode

Cortisol is one of the most important glucocorticoids involved in the regulation of human metabolism and physiological stress. Monitoring of levels of cortisol is of immense clinical benefit. In particular, salivary cortisol levels have been shown to correlate well with diurnal changes in cortisol levels in serum and have been used widely for monitoring of cortisol levels for diagnosis and prognosis purposes. We present a sensitive, fast, and robust quantitative liquid chromatography and tandem mass spectrometry (LC-MS/MS) assay for salivary cortisol in negative mode. This assay employs protein precipitation followed by reversed-phase liquid chromatographic separation, negative-mode electrospray ionization (ESI), and MS/MS detection. This assay has a total run time of 5.8 minutes and a limit of quantification of 0.5 ng/mL with a linear range up to 100 ng/mL. No carryover was observed at 10 μg/mL. This assay also incorporates the routine monitoring of prednisolone, a potential interferent to salivary cortisol.

Relationships Between Serum Cortisol, RAGE-Associated s100A8/A9 Levels, and Self-Reported Cancer-Related Distress in Women With Nonmetastatic Breast Cancer

OBJECTIVE

Elevated inflammation and psychological distress in patients with breast cancer (BCa) have been related to poorer health outcomes. Regulation of the hypothalamic-pituitary-adrenal axis and signaling of the receptor for advanced glycation end products (RAGE) are important in the inflammatory response and have been associated with increased stress and poorer health outcomes in patients with cancer. This study examined relationships among circulating cortisol, a measure of hypothalamic-pituitary-adrenal axis activity and physiological stress; s100A8/A9, a RAGE ligand and emerging cancer-related biological measure; and self-reported cancer-related distress.

METHODS

Patients with BCa ( N = 183, stages 0-IIIb) were recruited 2 to 10 weeks after surgery but before receiving adjuvant therapies. Participants provided blood samples, from which serum cortisol and s100A8/A9 levels were determined, and completed a psychosocial questionnaire. Regression analyses, adjusting for age, cancer stage, time since surgery, race, and menopausal status, were conducted examining the relationships between cortisol, s100A8/A9, and cancer-related distress (Impact of Event Scale [IES]-Revised).

RESULTS

Cortisol and s100A8/A9 levels were positively related ( β = 0.218, t (112) = 2.332, p = .021), although the overall model was not significant. Cortisol levels were also positively associated with IES-Intrusions ( β = 0.192, t (163) = 2.659, p = .009) and IES-Hyperarousal subscale scores ( β = 0.171, t (163) = 2.304, p = .022).

CONCLUSIONS

Patients with higher cortisol levels also reported higher s100A8/A9 levels and more cancer-related distress. The relationship between cortisol and s100A8/A9 supports a link between the stress response and proinflammatory physiological processes known to predict a greater metastatic risk in BCa. Stress processes implicated in cancer biology are complex, and replication and extension of these initial findings are important.

Serological Evidence of Herpes Simplex Virus-1 (HSV-1) Infection among Humans from Bandung, West Java Province, Indonesia

BACKGROUND: Toxoplasma gondii, Rubella virus, Cytomegalovirus, and herpes simplex virus (TORCH) infection is still a significant burden in developing countries since they potentially increase perinatal death and decrease life quality by causing congenital disorders. As part of TORCH and as one of the most common infections in humans, HSV Type 1 infection also should receive attention. HSV-1 infection induces an immediate reactive oxygen species (ROS) production, indicate that ROS plays beneficial effects in several biological functions, including innate immunity and antiviral responses. HSV-1 preferentially replicate and establish latency in different subtypes of sensory neurons and in neurons of the autonomic nervous system that are highly responsive to stress hormones, including cortisol. AIM: The objective of the study was to detect the latent HSV-1 infection in adults population and its effect on ROS and cortisol levels. PATIENTS AND METHODS: Subjects were enrolled with consecutive-sampling methods among the adults population age 18–40 years old, with no health complaints. We collected their blood to examined IgG HSV-1, ROS, and cortisol levels. RESULTS: A total of 57 subjects with 27 subjects were reactive IgG HSV-1 (herpes group) and 30 subjects were non-reactive IgG HSV-1 (non herpes groups). Mean of cortisol and ROS was 223.2904 nmol/L and 2.23337 IU/mL, respectively. There was a very weak correlation between HSV-1 infection with ROS and cortisol. CONCLUSION: There is a positive effect of latent HSV-1 infection in the adult population on cortisol ROS levels.

Clinical and Technical Aspects in Free Cortisol Measurement

Accurate measurement of cortisol is critical in adrenal insufficiency as it reduces the risk associated with misdiagnosis and supports the optimization of stress dose. Comprehensive assays have been developed to determine the levels of bioactive free cortisol and their clinical and analytical efficacies have been extensively discussed because the level of total cortisol is affected by changes in the structure or circulating levels of corticoid-binding globulin and albumin, which are the main reservoirs of cortisol in the human body. Antibody-based immunoassays are routinely used in clinical laboratories; however, the lack of molecular specificity in cortisol assessment limits their applicability to characterize adrenocortical function. Improved specificity and sensitivity can be achieved by mass spectrometry coupled with chromatographic separation methods, which is a cutting-edge technology to measure individual as well as a panel of steroids in a single analytical run. The purpose of this review is to introduce recent advances in free cortisol measurement from the perspectives of clinical specimens and issues associated with prospective analytical technologies.

Aptamer-Based Biosensors for the Colorimetric Detection of Blood Biomarkers: Paving the Way to Clinical Laboratory Testing

Clinical diagnostics for human diseases rely largely on enzyme immunoassays for the detection of blood biomarkers. Nevertheless, antibody-based test systems have a number of shortcomings that have stimulated a search for alternative diagnostic assays. Oligonucleotide aptamers are now considered as promising molecular recognizing elements for biosensors (aptasensors) due to their high affinity and specificity of target binding. At the moment, a huge variety of aptasensors have been engineered for the detection of various analytes, especially disease biomarkers. However, despite their great potential and excellent characteristics in model systems, only a few of these aptamer-based assays have been translated into practice as diagnostic kits. Here, we will review the current progress in the engineering of aptamer-based colorimetric assays as the most suitable format for clinical lab diagnostics. In particular, we will focus on aptasensors for the detection of blood biomarkers of cardiovascular, malignant, and neurodegenerative diseases along with common inflammation biomarkers. We will also analyze the main obstacles that have to be overcome before aptamer test systems can become tantamount to ELISA for clinical diagnosis purposes.

Effects of late-night eating of easily-or slowly-digestible meals on sleep, hypothalamo-pituitary-adrenal axis, and autonomic nervous system in healthy young males

Aim of the current study was to assess the effects of the digestibility of late-night high calorie meal on sleep and the activities of the hypothalamo-pituitary-adrenal (HPA) and autonomous nervous system (ANS) in healthy young males. For that purpose, effects of an easily digestible meal (starch + sugar-rich meal, SSR, i.e., dessert) or a slowly digestible meal (protein + fat-rich, PFR, i.e. kebab) were investigated in a crossover design in 16 participants (20-26 year old). They did not eat anything after 07:00 PM on Day 0; had an SSR meal on Day 1 and a PFR meal on Day 2 at 10:00 PM. HPA and ANS activities were measured by cortisol awakening response (CAR) and heart rate variability (HRV), respectively. The participants provided salivary samples for CAR; had a 5-min continuous electrocardiogram recording for HRV; and filled in sleep questionnaires. Late-night eating of SSR and PFR diets increased the area under the curve of CAR (p < 0.05) but did not affect HRV parameters (p > 0.05). PFR meal significantly disturbed sleep (p < 0.05). The data suggests that increased activity of HPA, but not ANS, might be involved in pathophysiology of late-night eating and that this might be due to disturbed sleep if slowly-digestible meal is consumed.

A portable droplet microfluidic device for cortisol measurements using a competitive heterogeneous assay

Point-of-care monitoring of chemical biomarkers in real-time holds great potential in rapid disease diagnostics and precision medicine. However, monitoring is still rare in practice, as the measurement of biomarkers often requires time consuming and labour intensive assay procedures such as enzyme linked immunosorbent assay (ELISA), which pose a challenge to an autonomous point-of-care device. This paper describes a prototype device capable of performing ELISA autonomously and repeatedly in a high frequency using droplet microfluidics. Driven by a specially designed peristaltic pump, the device can collect liquid samples from a reservoir, produce trains of droplets, complete magnetic bead based ELISA protocols and provide readouts with colourimetric measurement. Here, cortisol was chosen as a target analyte as its concentration in the human body varies on a circadian rhythm which may be perturbed by disease. The prototype device draws in and analyses 350 nL of the sample containing free bioactive cortisol every 10 seconds, with a sample-to-signal time of 10 minutes, and measures favourably in the analytical range of 3.175-100 ng ml-1, with reliably lower variability compared with the well plate based assay. As most ELISA type assays share similar procedures, we envisage that this approach could form a platform technology for measurement or even continuous monitoring of biomarkers in biological fluids at the point-of-care.

Maternal Sociodemographic Factors and Antenatal Stress

Antenatal stress has been associated with adverse birth outcomes such as fetal growth restriction, low birth weight, and preterm birth. Understanding key determinants of stress in a vulnerable pregnant population has the potential of informing development of targeted cost-effective interventions to mitigate against these adverse birth outcomes. We conducted a secondary analysis of data from 150 pregnant women attending antenatal care services at a rural referral hospital in Kenya. The participants completed a sociodemographic and clinical questionnaire, the Cohen’s Perceived Stress Scale (PSS) and gave a hair sample for cortisol and cortisone analysis. The association between selected sociodemographic predictors (age, parity, marital status, maternal education, household income, polygyny, and intimate partner violence) and outcomes (hair cortisol, hair cortisone, and PSS score) was examined using univariate, bivariate and multivariate models. We found a negative association between PSS scores and household income (β = −2.40, p = 0.016, 95% CI = −4.36, −0.45). There was a positive association of the ratio of hair cortisone to cortisol with Adolescent age group (β = 0.64, p = 0.031, 95% CI = 0.06, 1.22), and a negative association with Cohabitation (β = −1.21, p = 0.009, 95% CI = −2.11, −0.31). We conclude that household income influenced psychological stress in pregnancy. Adolescence and cohabitation may have an influence on biological stress, but the nature of this effect is unclear.

Touch-Based Stressless Cortisol Sensing

Tracking fluctuations of the cortisol level is important in understanding the body's endocrine response to stress stimuli. Traditional cortisol sensing relies on centralized laboratory settings, while wearable cortisol sensors are limited to slow and complex assays. Here, a touch-based non-invasive molecularly imprinted polymer (MIP) electrochemical sensor for rapid, simple, and reliable stress-free detection of sweat cortisol is described. The sensor readily measures fingertip sweat cortisol via highly selective binding to the cortisol-imprinted electropolymerized polypyrrole coating. The MIP network is embedded with Prussian blue redox probes that offer direct electrical signaling of the binding event to realize sensitive label-free amperometric detection. Using a highly permeable sweat-wicking porous hydrogel, instantaneously secreted fingertip sweat can be conveniently and rapidly collected without any assistance. By eliminating time lags, such rapid (3.5 min) fingertip assay enables the capture of sharp variations in cortisol levels, compared to previous methods. Such advantages are demonstrated by tracking cortisol response in short cold-pressor tests and throughout day-long circadian rhythm, along with gold-standard immunoassay validation. A stretchable epidermal MIP sensor is also described for directly tracking cortisol in exercise-induced sweat. The rapid touch-based cortisol sensor offers an attractive, accessible, stressless avenue for quantitative stress management.

Approach to the Patient with Subclinical Cushing's Syndrome

A growing number of patients with adrenal incidentalomas and subclinical Cushing's syndrome (SCS) led to an increasing number of different guidelines, and diagnostic and treatment recommendations. Excess cortisol secretion in patients with SCS is associated with several comorbidities, such as hypertension, dyslipidemia, type 2 diabetes mellitus, and obesity, which in the long-term increase mortality of these patients. Subtle cortisol secretion affects bone health, quality of life and causes depression, but due to the unapparent clinical features, patients with SCS are often at risk between over and under treatment. This narrative review aimed to summarize the latest recommendations on the approach to the patient with subclinical Cushing's syndrome.

Urine steroid profile as a new promising tool for the evaluation of adrenal tumors. Literature review

PURPOSE

To review the literature assessing the diagnostic performance of urinary steroid profiling (USP) by high-performance liquid chromatography (LC-MS) or gas chromatography (GC) coupled to mass spectrometry (MS) in the evaluation of adrenal lesions, both in terms of functionality and malignancy.

RESULTS

The evaluation of adrenal incidentalomas (AI) aims to rule out malignancy and hormone excess. Current diagnostic protocols have several limitations and include time consuming and relatively complicated multi-step processes in most cases. On the contrary, USP by LC-MS/MS or LC-GC/MS offer an easy, comprehensive and non-invasive assessment of adrenal steroid secretion. USP complements current workups used in the evaluation of AIs by improving our ability to identify malignancy and/or autonomous hormone secretion.

CONCLUSIONS

Urine steroid profiling by LC-MS/MS and GC-MS allows a thorough, non-invasive, assessment of adrenal steroidogenesis as a whole which complement the current evaluation of AIs, and holds a promising role in the diagnosis of autonomous cortisol secretion, primary aldosteronism, and adrenal malignancy.

Surface-specific washing-free immunosensor for time-resolved cortisol monitoring

Cortisol is a steroid hormone that regulates a wide range of vital processes. Its level changes with diurnal rhythm and reacts to stress. Measurement of cortisol levels is still a complex multi-step process. A reversible washing-free registration method is required. Here we describe metal-enhanced fluorescence assay based on a displacement of a dye labeled BSA-cortisol conjugate from the immune complex immobilized on the golden islands by free cortisol. This competitive approach allows time-resolved monitoring of the fluorescent signal, surface-enhanced by the gold film, and provides the possibility of continuous real-time cortisol monitoring based on the implantable surface-enhanced immunosensor, which was not demonstrated so far even in vitro.

Are there subgroups of chronic fatigue syndrome? An exploratory cluster analysis of biological markers

Background

Chronic fatigue syndrome (CFS) is defined according to subjective symptoms only, and several conflicting case definition exist. Previous research has discovered certain biological alterations. The aim of the present study was to explore possible subgroups based on biological markers within a widely defined cohort of adolescent CFS patients and investigate to what extent eventual subgroups are associated with other variables.

Methods

The Norwegian Study of Chronic Fatigue Syndrome in Adolescents: Pathophysiology and Intervention Trial (NorCAPITAL) has previously performed detailed investigation of immunological, autonomic, neuroendocrine, cognitive and sensory processing functions in an adolescent group of CFS patients recruited according to wide diagnostic criteria. In the present study, hierarchical cluster analyses (Ward’s method) were performed using representative variables from all these domains. Associations between clusters and constitutional factors (including candidate genetic markers), diagnostic criteria, subjective symptoms and prognosis were explored by standard statistical methods.

Results

A total of 116 patients (26.7% males, mean age 15.4 years) were included. The final cluster analyses revealed six clusters labelled pain tolerant & good cognitions, restored HPA dynamics, orthostatic intolerance, low-grade inflammation, pain intolerant & poor cognitions, and high vagal (parasympathetic) activity, respectively. There was substantial overlap between clusters. The pain intolerant & poor cognitions-cluster was associated with low functional abilities and quality of life, and adherence to the Canada 2003 diagnostic criteria for CFS. No other statistically significant cluster associations were discovered.

Conclusion

Within a widely defined cohort of adolescent CFS patients, clusters could be delineated, but no distinct subgroups could be identified. Associations between clusters and constitutional factors, subjective symptoms and prognosis were scarce. These results question the clinical usefulness of searching for CFS subgroups, as well as the validity of the most “narrow” CFS diagnostic criteria.

Trial registration: Clinical Trials NCT01040429

Autonomous, Real-Time Monitoring Electrochemical Aptasensor for Circadian Tracking of Cortisol Hormone in Sub-microliter Volumes of Passively Eluted Human Sweat

The proposed work involves the development of an autonomous, label-free electrochemical sensor for real-time monitoring of cortisol levels expressed naturally in sub-microliter sweat volumes, for prolonged sensing periods of ∼8 h. Highly specific single-stranded DNA (ssDNA) aptamer is used for affinity capture of cortisol hormone eluted in sweat dynamically. The cortisol present in sweat binds to the aptamer capture probe that changes conformation and modulates electrochemical properties at the electrode-buffer interface, which was studied using dynamic light scattering studies for the entire physiological sweat pH. Attenuated total reflectance-Fourier transform infrared spectroscopy and UV-vis spectroscopy were used to optimize the binding chemistry of the elements of the sensor stack. Nonfaradaic electrochemical impedance spectroscopy was used to calibrate the sensor for a dynamic range of 1-256 ng/mL. An R² of 0.97 with an output signal range of 20-50% was obtained. Dynamic cortisol level variation tracking was studied using continuous dosing experiments to calibrate the sensor for temporal variation. The sensor did not show significant susceptibility to noise due to cross-reactive interferents and nonspecific buffer constituents. The performance of the developed aptasensor was compared with the previously established cortisol immunosensor in terms of surface charge behavior and nonfaradaic biosensing. The aptamer sensor shows a higher signal-to-noise ratio, better resolution, and has a larger output range for the same input range as the cortisol immunosensor. The feasibility of deploying the developed aptasensing scheme as continuous lifestyle and performance monitors was validated through human subject studies.

Aptamer-Based Lateral Flow Biosensor for Rapid Detection of Salivary Cortisol

We have developed a disposable point-of-care (POC) aptamer-based biosensor for the detection of salivary cortisol. Nonstressful and noninvasive sampling of saliva compared to that of blood makes saliva an attractive biological matrix in developing POC devices for biomarker monitoring. Aptamers are attractive as recognition elements for multiple reasons, including their specific chemical synthesis, high stability, lack of immunogenicity, and cell-free evolution. A duplex aptamer conjugated to the surface of Au nanoparticles (AuNPs) by Au-S bonds is utilized as the sensor probe in a lateral flow assay (LFA) device. The addition of saliva samples containing cortisol makes the cortisol-aptamer undergo conformational changes and dissociate from the capture probe. Increasing cortisol concentration in the dispensed saliva sample results in increased dissociation and leads to increased binding of AuNP conjugate on the test line. Therefore, the color intensity of the test line on the LFA is a direct function of the concentration of cortisol in saliva. This simple and fast method provides detection in the cortisol range of ∼0.5-15 ng/mL, which is in the clinically accepted range for salivary cortisol. The limit of detection was 0.37 ng/mL, and the accuracy was confirmed by enzyme-linked immunosorbent assay (ELISA) testing results. High selectivity was observed for salivary cortisol against other closely related steroids and stress biomarkers present in saliva.

Cortisol hypersecretion and the risk of Alzheimer's disease: A systematic review and meta-analysis

BACKGROUND

Morning cortisol levels have been reported to be elevated among patients with Alzheimer's disease (AD); yet no meta-analysis has been conducted to confirm the existence and magnitude of this association. It also remains unclear whether hypercortisolism is a risk factor for AD.

METHODS

PubMed, EMBASE, and PsycINFO were systematically searched for eligible studies. Cross-sectional data were pooled using random-effects meta-analyses; the differences in morning cortisol levels between patients and cognitively normal controls were quantified. Longitudinal studies were qualitatively synthesised due to methodological heterogeneity.

RESULTS

17,245 participants from 57 cross-sectional studies and 19 prospective cohort studies were included. Compared with cognitively normal controls, AD patients had moderately increased morning cortisol in blood (g = 0.422, P < 0.001; I² = 48.5 %), saliva (g = 0.540, P < 0.001; I² = 13.6 %), and cerebrospinal fluids (g = 0.565, P = 0.003; I² = 75.3 %). A moderate elevation of morning cortisol was also detected in cerebrospinal fluids from patients with mild cognitive impairment (MCI) versus controls (g = 0.309, P = 0.001; I² = 0.0 %). Cohort studies suggested that higher morning cortisol may accelerate cognitive decline in MCI or mild AD patients, but the results in cognitively healthy adults were inconsistent.

CONCLUSIONS

Morning cortisol was confirmed to be moderately elevated in AD patients and may have diagnostic and prognostic values for AD.

Implantable Nanosensors for Human Steroid Hormone Sensing In Vivo Using a Self-Templating Corona Phase Molecular Recognition

Dynamic measurements of steroid hormones in vivo are critical, but steroid sensing is currently limited by the availability of specific molecular recognition elements due to the chemical similarity of these hormones. In this work, a new, self-templating synthetic approach is applied using corona phase molecular recognition (CoPhMoRe) targeting the steroid family of molecules to produce near infrared fluorescent, implantable sensors. A key limitation of CoPhMoRe has been its reliance on library generation for sensor screening. This problem is addressed with a self-templating strategy of polymer design, using the examples of progesterone and cortisol sensing based on a styrene and acrylic acid copolymer library augmented with an acrylated steroid. The pendant steroid attached to the corona backbone is shown to self-template the phase, providing a unique CoPhMoRE design strategy with high efficacy. The resulting sensors exhibit excellent stability and reversibility upon repeated analyte cycling. It is shown that molecular recognition using such constructs is viable even in vivo after sensor implantation into a murine model by employing a poly (ethylene glycol) diacrylate (PEGDA) hydrogel and porous cellulose interface to limit nonspecific absorption. The results demonstrate that CoPhMoRe templating is sufficiently robust to enable a new class of continuous, in vivo biosensors.

Urinary Cortisol Increases During a Respiratory Outbreak in Wild Chimpanzees

Abstract: In mammals, the excretion of cortisol can provide energy toward restoring homeostasis and is a major component of the stress response. However, chronically elevated cortisol levels also have suppressive effects on immune function. As mounting an immune response is energetically costly, sick individuals may conserve energy by exhibiting certain sickness behaviors, such as declining activity levels. Due to the complex interplay between immune function and sickness behaviors, endocrinological correlates have received growing attention in the medical community, but so far, this subject was investigated rarely. Furthermore, given the complexities of studying illnesses and immunity in natural settings, correlates of sickness behaviors have yet to be studied in non-human primates in the wild.

Methods: We measured urinary cortisol levels using liquid chromatography–mass spectrometry in a group of wild habituated chimpanzees in Taï National Park, Côte d'Ivoire, before, during, and after a respiratory disease outbreak (main causative pathogen: human respiratory syncytial virus A, with coinfections of Streptococcus pneumoniae). Changes in cortisol levels were then related to urinary neopterin levels, a biomarker of immune system activation.

Results: Urinary cortisol levels were found to be more than 10-fold higher during the outbreak in comparison with levels before and after the outbreak period. Increasing cortisol levels were also associated with increasing neopterin levels. Interestingly, rather atypical patterns in a diurnal decline of cortisol levels were found during infection periods, such that levels remained raised throughout the day.

Conclusion: In conclusion, cortisol increase was related to cellular immune response. Our results suggest that cortisol is a mediator of infectious disease pathogenicity through its impact on the immune system and that wild chimpanzees may be facing energetic stress when sick. By monitoring immune challenges in wild-living animals, our study demonstrates that immune defenses have costs and that these costs are context-specific.

Does selection for behavioral and physiological performance traits alter glucocorticoid responsiveness in bank voles?

One of the key elements of an animal's Darwinian fitness is its ability to adequately respond to and cope with challenging situations. Glucocorticoid hormones, such as corticosterone, affect an organism's ability to overcome such challenges. We hypothesized that changes in the glucocorticoid response curve contribute to the evolution of increased performance during challenging conditions, and tested it on bank voles (Myodes glareolus) from a multidirectional artificial selection experiment, which involves lines selected for high aerobic exercise metabolism achieved during swimming (A - Aerobic), predatory behavior towards a cricket (P - Predatory) and ability to maintain body mass on a low-quality herbivorous diet (H - Herbivorous), as well as unselected control lines (C - Control). We elicited a glucocorticoid response either by restraining the animal or by maximum pharmacological stimulation, and measured plasma corticosterone levels at baseline, during the response and during the recovery phase. Response-level corticosterone was higher in females, and recovery from maximal level was faster than that of males. Selection did not affect baseline or stress-induced corticosterone levels, but it decreased the maximum corticosterone level in Aerobic and Predatory lines, reducing the difference between stress-induced and maximum levels. Recovery from restraint-induced corticosterone level tended to be slower in the Herbivorous than in the other lines, an effect that was stronger in females than in males. In conclusion, successful selection for increased performance in challenging conditions was not associated with changes in absolute values of the glucocorticoid response to stress, but can affect other characteristics of the glucocorticoid response curve.

Beyond Glucocorticoids: Integrating Dehydroepiandrosterone (DHEA) into Animal Welfare Research

Animal welfare researchers are committed to identifying novel measures for enhancing the quality of life of individual animals. Recently, welfare scientists have emphasized the need for tracking multiple indicators of an animal's behavioral, emotional and mental health. Researchers are currently focused on integrating non-invasive physiological biomarkers to gain insight into an individual's welfare status. Most commonly, the animal welfare community has analyzed glucocorticoid hormones and their metabolites as a measure of stress. While glucocorticoids provide valuable information about hypothalamic-pituitary-adrenal (HPA) axis activity, there are limitations to utilizing these hormones as the sole measure of long-term stress and welfare. Other biomarkers, such as dehydroepiandrosterone and its sulfate ester-collectively referred to as DHEA(S)-help provide a more complete picture of HPA activity. DHEA(S) counteracts the effects glucocorticoids by having anti-aging, immune-enhancing and neuroprotective properties. Recent studies have examined the ratio of glucocorticoids to DHEA(S) as a way to better understand how the HPA axis is functioning. There is evidence that this ratio serves as an indicator of immune function, mental health, cognitive performance and overall welfare. We review studies that employed the glucocorticoid:DHEA(S) ratio, outline methodological considerations and discuss how researchers can integrate glucocorticoids, DHEA(S) and the glucocorticoid:DHEA(S) ratio into welfare assessments.

Effects of an Informational Video About Anesthesia on Pre- and Post-Elective Cesarean Section Anxiety and Recovery: A Randomized Controlled Trial

Background

Showing an informational anesthesia video can reduce the preoperative anxiety of parturients undergoing elective cesarean section (CS). However, the best method for presenting such videos remains unclear, and whether such videos can reduce the anxiety level of women during the entire perioperative period for CS (including preoperative and postoperative) has not been studied yet.

Material/Methods

This study was a single-center prospective randomized trial. We randomly divided 121 pregnant women who were scheduled to undergo elective cesarean section (CS) into 2 groups: one group was shown an informational video (video group) and another group was not (control group). Spielberger’s state-trait anxiety inventory was used to evaluate the perioperative anxiety level of parturient women at 3 time points: 1 day before CS, after video education, and 2 days after CS. Salivary cortisol level was evaluated to assess the patients’ anxiety level at these 3 time points. Finally, the maternal satisfaction scale for CS and an obstetric quality-of-recovery score (OBsQoR-11) were used to evaluate the satisfaction and recovery of the parturient women 2 days after CS.

Results

Watching a video about anesthesia significantly reduced the anxiety level of the parturient women during the perioperative period (1 day before CS: p=1.00, p=0.96; after video education: p<0.01, p=0.004; 2 days after CS: p=0.01, p=0.01). The postoperative satisfaction scores were significantly improved in the video group (p=0.007). OBsQoR-11 scores in the video group and control group were not significantly different (p=0.48). Maternal anxiety level was moderately positively correlated with cortisol hormone level.

Conclusions

Showing an informational video about anesthesia (video+education) can significantly reduce perioperative anxiety and improve satisfaction after CS. Although it did not improve the postoperative recovery, it was still significant for anesthesia.

Salivary Cortisol Interactions in Search and Rescue Dogs and their Handlers

Simple Summary

Stress affects both people and animals every day. Working dogs are exposed to the same stressors as their handlers during work. Our research was conducted during search and rescue dog exams. The aim of the study was to investigate if handler stress during the exam affects his or her dog’s stress level. We observed a strong relationship of salivary cortisol between the dogs and their handlers, which was most prevalent in female dogs and female handlers.

Abstract

Search and rescue dogs are an important link in the search for missing persons. The aim of the study was to assess exam stress in search and rescue dogs and their handlers. The study included 41 rescue teams taking exams of field and rubble specialties. The level of cortisol, which is the main glucocorticosteroid modulating stress reactions in humans and dogs, was analyzed. The biological material used to assess the hormone concentration was saliva collected in a non-invasive way. In total, 164 test samples were collected: two from the dog and two from the handler before and immediately after the exam. Rescue exams were shown to significantly increase salivary cortisol in both dogs and their handlers. Strong interactions between cortisol levels in human–dog teams were also found with a more pronounced effect in female dog–female handler dyads.

Flexible, low volume detection of chronobiology biomarkers from human sweat

The work demonstrates the development of a chronobiology tracking system using an affinity-based electrochemical detection modality. This serpentine electrode based system is non-invasive, label free, and economical enabling passive sweat tracking.

A sensitive chemiluminescence based immunoassay for the detection of cortisol and cortisone as stress biomarkers

An electrochemically based antibody immobilization was used to perform environmentally and clinically relevant immunoassays for stress hormones biomarkers (cortisol and cortisone) using chemiluminescence (CL) detection. To achieve CL detection, the ferrocene tag on the antibodies was first oxidised, and this then acted as a catalyst for the luminol and hydrogen peroxide CL reaction. The conditions were optimised and measurements were made with an incubation time of 30 min. Using this approach limits of detection were obtained of 0.47 pg ml−1and 0.34 pg ml−1alsoR20.9912 and 0.9902 for cortisol and cortisone respectively with a linear concentration from 0 to 50 ng ml−1. The method was then applied to Zebrafish whole body and artificial saliva samples. For the Zebrafish sample recoveries of 91.0% and 90.0% were obtained with samples spiked with cortisol and cortisone, for artificial saliva the recoveries were 92.59% and 90.73% respectively. Interference studies showed only minor effects on the measurement of the analyte. A comparison between this procedure and the standard enzyme-linked immunosorbent assay (ELISA) procedure gave approximately the sameR2values.

Biphasic Dose-Response and Hormetic Effects of Stress Hormone Hydrocortisone on Telomerase-Immortalized Human Bone Marrow Stem Cells In Vitro

Although high levels of stress hormones are associated with well-known negative health outcomes, their low levels can have health-promoting effects by virtue of the phenomenon of mild stress-induced hormesis. We have studied the effects of a wide range (between 100 nmol/L and 150 μmol/L) of hydrocortisone (HC) on human bone marrow stem cells in vitro. Telomerase-immortalized human mesenchymal stem cells (hTERT-MSCs) were exposed to various doses of HC for different durations (1-6 days) and analyzed for survival and metabolic activity by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay, for cell migratory ability by a wound-healing assay and for osteoblastic and adipogenic differentiation abilities in vitro. Our findings indicate that hTERT-MSCs exposed to HC resulted in a biphasic hormetic dose–response in some measures but not all. Although the mitochondrial and metabolic MTT activity assay clearly showed low-level stimulatory (between 0.1 and 1 µmol/L) and high-level inhibitory effects (from about 10 µmol/L onward), the cytostatic and differentiation-inducing effects were mostly linear at concentrations between 1 and 100 µmol/L. Further long-term studies will elucidate whether chronic or intermittent exposure of human cells to stress hormones has physiologically beneficial hormetic effects.