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Bendinskas K, Liu J, Jandev V, Careem FR, Hidoyatov M, Garofalo R, Norful AA, Padilla JJ, Schnall R. Hair and nail cortisol levels are associated and affected by glucocorticoid use. Psychoneuroendocrinology 2024; 168:107139. [PMID: 39047612 DOI: 10.1016/j.psyneuen.2024.107139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 05/13/2024] [Accepted: 07/13/2024] [Indexed: 07/27/2024]
Abstract
Hair and nail cortisol is increasingly studied as a physiologic proxy for chronic stress response. Glucocorticoid use is an expected confounder for cortisol measurement, yet there remains little evidence of whether external cortisol use should be subject to exclusion in study subjects. In a group of 209 youth (15-22 year-olds), we analyzed hair and fingernail cortisol concentrations. We assessed topical, nasal, oral, and injectable glucocorticoid use via a questionnaire. Extensively validated methods were used for hair and nail cortisol extraction and measurements. The median value of hair cortisol was 10.2 pg/mg (n=200), and the median value of nail cortisol was 7.06 pg/mg (n=203). Topical glucocorticoid use significantly increased hair and nail cortisol concentrations (p<0.005). Hair and nail cortisol concentrations were positively associated (p<0.0001, n=194). Spearman correlation coefficients demonstrated that the positive correlation between hair and nail cortisol values was higher in participants who used external glucocorticoids. Topical glucocorticoids moderated the association between hair and nail cortisol values (p=0.006). Based on these findings, we recommend that the assessment of topical glucocorticoid use must be performed when collecting hair/nail samples and that subjects reporting glucocorticoid use should be excluded from all future hair and nail cortisol studies; also, all outliers must be excluded to account for glucocorticoid medication underreporting and yet-unknown confounders.
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Affiliation(s)
- Kestutis Bendinskas
- Department of Chemistry, SUNY-Oswego, 296 Shineman Bldg., 30 Centennial Dr., Oswego, NY 13126, USA.
| | - Jianfang Liu
- School of Nursing, Columbia University, 560 West 168th Street, New York, NY 10032, USA.
| | - Vikrant Jandev
- Department of Chemistry, SUNY-Oswego, 296 Shineman Bldg., 30 Centennial Dr., Oswego, NY 13126, USA.
| | - Fathima Raviya Careem
- Department of Chemistry, SUNY-Oswego, 296 Shineman Bldg., 30 Centennial Dr., Oswego, NY 13126, USA.
| | - Muhammadzohir Hidoyatov
- Department of Chemistry, SUNY-Oswego, 296 Shineman Bldg., 30 Centennial Dr., Oswego, NY 13126, USA.
| | - Robert Garofalo
- Department of Pediatrics Northwestern's Feinberg School of Medicine, Ann& Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Chicago, IL 60611, USA.
| | - Allison A Norful
- School of Nursing, Columbia University, 560 West 168th Street, New York, NY 10032, USA.
| | - Janeth Juarez Padilla
- School of Nursing, Columbia University, 560 West 168th Street, New York, NY 10032, USA.
| | - Rebecca Schnall
- School of Nursing and Department of Population and Family Health, Columbia University, 560 West 168th Street, New York, NY 10032, USA.
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Pham AT, van Dijk BAC, van der Valk ES, van der Vegt B, van Rossum EFC, de Bock GH. Chronic Stress Related to Cancer Incidence, including the Role of Metabolic Syndrome Components. Cancers (Basel) 2024; 16:2044. [PMID: 38893162 PMCID: PMC11171137 DOI: 10.3390/cancers16112044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 05/23/2024] [Accepted: 05/26/2024] [Indexed: 06/21/2024] Open
Abstract
Epidemiological results on the link between chronic stress and cancer initiation have been inconsistent. This study examined the relation between chronic biological stress, indicated as hair cortisol (HairF) and hair cortisone (HairE), and cancer incidence, adjusting for metabolic syndrome (MetS) components. We analyzed HairF and HairE samples from 6341 participants from the population-based cohort Lifelines in 2014. A linkage with the Dutch Nationwide Pathology Databank (Palga) provided the cancer incidence from 2015 to 2021. The association between dichotomized HairF and log-transformed HairE (LogHairE) and cancer incidence was estimated using Cox regression. MetS components were evaluated as confounders or moderators. Of the 2776 participants with known HairF levels and no cancer history, 238 developed cancer. The HairF level did not predict cancer incidence (HR: 0.993, 95%CI: 0.740-1.333). No confounders or moderators were identified. Among the 4699 participants with known HairE levels and no cancer history, 408 developed cancer. There was no association between LogHairE and cancer incidence (HR: 1.113, 95%CI: 0.738-1.678). When including age as a confounder and gender as a moderator, LogHairE was statistically significantly associated with cancer incidence (HR: 6.403, 95%CI: 1.110-36.92). In a population-based cohort, chronic biological stress, measured by HairE, was associated with cancer incidence, after controlling for age and gender.
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Affiliation(s)
- An Thanh Pham
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands; (B.A.C.v.D.); (G.H.d.B.)
- Faculty of Pharmacy, Ton Duc Thang University, Ho Chi Minh City 700000, Vietnam
| | - Boukje A. C. van Dijk
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands; (B.A.C.v.D.); (G.H.d.B.)
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), 3511 CV Utrecht, The Netherlands
| | - Eline S. van der Valk
- Department of Internal Medicine, Division of Endocrinology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (E.S.v.d.V.); (E.F.C.v.R.)
| | - Bert van der Vegt
- Department of Pathology & Medical Biology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands;
| | - Elisabeth F. C. van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands; (E.S.v.d.V.); (E.F.C.v.R.)
| | - Geertruida H. de Bock
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands; (B.A.C.v.D.); (G.H.d.B.)
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3
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May AK, Smeeth D, McEwen F, Moghames P, Karam E, Rieder MJ, Elzagallaai AA, van Uum S, Pluess M. Hair hormone data from Syrian refugee children: Perspectives from a two-year longitudinal study. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2024; 18:100231. [PMID: 38645423 PMCID: PMC11026725 DOI: 10.1016/j.cpnec.2024.100231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/26/2024] [Accepted: 03/26/2024] [Indexed: 04/23/2024] Open
Abstract
For numerous issues of convenience and acceptability, hair hormone data have been increasingly incorporated in the field of war trauma and forced displacement, allowing retrospective examination of several biological metrics thought to covary with refugees' mental health. As a relatively new research method, however, there remain several complexities and uncertainties surrounding the use of hair hormones, from initial hair sampling to final statistical analysis, many of which are underappreciated in the extant literature, and restrict the potential utility of hair hormones. To promote awareness, we provide a narrative overview of our experiences collecting and analyzing hair hormone data in a large cohort of Syrian refugee children (n = 1594), across two sampling waves spaced 12 months apart. We highlight both the challenges faced, and the promising results obtained thus far, and draw comparisons to other prominent studies in this field. Recommendations are provided to future researchers, with emphasis on longitudinal study designs, thorough collection and reporting of hair-related variables, and careful adherence to current laboratory guidelines and practices.
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Affiliation(s)
- Andrew K. May
- Department of Psychological Sciences, School of Psychology, University of Surrey, Guildford, UK
| | - Demelza Smeeth
- Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Fiona McEwen
- Biological and Experimental Psychology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- Department of War Studies, King's College London, London, UK
| | | | - Elie Karam
- Department of Psychiatry and Clinical Psychology, Balamand University, St Georges Hospital University Medical Center, Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Lebanon
| | - Michael J. Rieder
- Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Abdelbaset A. Elzagallaai
- Physiology and Pharmacology, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Stan van Uum
- Division of Endocrinology and Metabolism, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
| | - Michael Pluess
- Department of Psychological Sciences, School of Psychology, University of Surrey, Guildford, UK
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Boswell L, Vega-Beyhart A, Blasco M, Quintana LF, Rodríguez G, Díaz-Catalán D, Vilardell C, Claro M, Mora M, Amor AJ, Casals G, Hanzu FA. Hair cortisol and changes in cortisol dynamics in chronic kidney disease. Front Endocrinol (Lausanne) 2024; 15:1282564. [PMID: 38638132 PMCID: PMC11024788 DOI: 10.3389/fendo.2024.1282564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 03/06/2024] [Indexed: 04/20/2024] Open
Abstract
Objective We compared hair cortisol (HC) with classic tests of the hypothalamic-pituitary-adrenal (HPA) axis in chronic kidney disease (CKD) and assessed its association with kidney and cardiometabolic status. Design and methods A cross-sectional study of 48 patients with CKD stages I-IV, matched by age, sex, and BMI with 24 healthy controls (CTR) was performed. Metabolic comorbidities, body composition, and HPA axis function were studied. Results A total of 72 subjects (age 52.9 ± 12.2 years, 50% women, BMI 26.2 ± 4.1 kg/m2) were included. Metabolic syndrome features (hypertension, dyslipidaemia, glucose, HOMA-IR, triglycerides, waist circumference) and 24-h urinary proteins increased progressively with worsening kidney function (p < 0.05 for all). Reduced cortisol suppression after 1-mg dexamethasone suppression (DST) (p < 0.001), a higher noon (12:00 h pm) salivary cortisol (p = 0.042), and salivary cortisol AUC (p = 0.008) were seen in CKD. 24-h urinary-free cortisol (24-h UFC) decreased in CKD stages III-IV compared with I-II (p < 0.001); higher midnight salivary cortisol (p = 0.015) and lower suppressibility after 1-mg DST were observed with declining kidney function (p < 0.001). Cortisol-after-DST cortisol was >2 mcg/dL in 23% of CKD patients (12.5% in stage III and 56.3% in stage IV); 45% of them had cortisol >2 mcg/dL after low-dose 2-day DST, all in stage IV (p < 0.001 for all). Cortisol-after-DST was lineally inversely correlated with eGFR (p < 0.001). Cortisol-after-DST (OR 14.9, 95% CI 1.7-103, p = 0.015) and glucose (OR 1.3, 95% CI 1.1-1.5, p = 0.003) were independently associated with eGFR <30 mL/min/m2). HC was independently correlated with visceral adipose tissue (VAT) (p = 0.016). Cortisol-after-DST (p = 0.032) and VAT (p < 0.001) were independently correlated with BMI. Conclusion Cortisol-after-DST and salivary cortisol rhythm present progressive alterations in CKD patients. Changes in cortisol excretion and HPA dynamics in CKD are not accompanied by significant changes in long-term exposure to cortisol evaluated by HC. The clinical significance and pathophysiological mechanisms explaining the associations between HPA parameters, body composition, and kidney damage warrant further study.
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Affiliation(s)
- Laura Boswell
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Group of Endocrine Disorders, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
- Endocrinology and Nutrition Department, Althaia University Health Network, Manresa, Spain
| | - Arturo Vega-Beyhart
- Group of Endocrine Disorders, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Miquel Blasco
- Group of Nephrology and Transplantation, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
- Nephrology Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Luis F. Quintana
- Group of Nephrology and Transplantation, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
- Nephrology Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Gabriela Rodríguez
- Biochemistry and Molecular Genetics Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Daniela Díaz-Catalán
- Group of Endocrine Disorders, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Carme Vilardell
- Endocrinology and Nutrition Department, Althaia University Health Network, Manresa, Spain
| | - María Claro
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Mireia Mora
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Group of Endocrine Disorders, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabo´ licas Asociadas (CIBERDEM), Carlos III Health Institute, Madrid, Spain
| | - Antonio J. Amor
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Gregori Casals
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Biochemistry and Molecular Genetics Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Felicia A. Hanzu
- Endocrinology and Nutrition Department, Hospital Clínic de Barcelona, Barcelona, Spain
- Group of Endocrine Disorders, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabo´ licas Asociadas (CIBERDEM), Carlos III Health Institute, Madrid, Spain
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5
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Zapater-Fajarí M, Crespo-Sanmiguel I, Montoliu T, Hidalgo V, Salvador A. Hair cortisol and dehydroepiandrosterone and their associations with optimism and pessimism in older people. Horm Behav 2024; 159:105474. [PMID: 38194858 DOI: 10.1016/j.yhbeh.2023.105474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 12/17/2023] [Accepted: 12/19/2023] [Indexed: 01/11/2024]
Abstract
The cumulative negative effects of prolonged Hypothalamic-Pituitary-Adrenal axis (HPA axis) activation are associated with several age-related diseases. Some psychological traits such as optimism and pessimism have been shown to be related to both health and the stress response, although their relationship with the HPA axis is inconclusive. More stable HPA axis biomarkers, such as hair samples of cortisol (HC) and dehydroepiandrosterone (HDHEA), would help to clarify the association between these psychological traits and HPA axis functioning. The main aim of this study was to test the relationships between optimism and pessimism and chronic stress biomarkers measured in hair (HC and HDHEA). Additionally, a secondary objective was to explore sex differences in HC and HDHEA levels and their relationship with these psychological traits. We measured optimism, pessimism, and their combination (dispositional optimism) using the Life Orientation Test Revised (LOT-R) and chronic stress biomarkers (HC and HDHEA) in 119 healthy participants (46 men and 73 women) between 56 and 81 years old who belonged to a university program. Regression analyses controlling for perceived stress and BMI indicated that higher dispositional optimism was related to lower HC and HC:HDHEAratio (β = -0.256, p = .008 and β = -0.300, p = .002, respectively). More specifically, higher pessimism was related to higher HC (β = 0.235; p = .012) and HC:HDHEAratio (β = 0.240; p = .011), whereas higher optimism was associated with a lower HC:HDHEAratio(β = -0.205; p = .031). Moderation analyses showed no sex differences. To date, this is the first study to investigate the link between these traits and HC and HDHEA in older people. Our results confirm that positive and negative expectations about the future (i.e. optimism and pessimism) may play an important role in health due to their relationship with the HPA axis. They also strengthen the idea that the negative effects of pessimism have a greater weight than the protective effects of optimism in their relationship with HPA axis regulation.
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Affiliation(s)
- Mariola Zapater-Fajarí
- Laboratory of Cognitive Social Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain
| | - Isabel Crespo-Sanmiguel
- Laboratory of Cognitive Social Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain
| | - Teresa Montoliu
- Laboratory of Cognitive Social Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain
| | - Vanesa Hidalgo
- Laboratory of Cognitive Social Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain; Department of Psychology and Sociology, Area of Psychobiology, University of Zaragoza, Teruel, Spain.
| | - Alicia Salvador
- Laboratory of Cognitive Social Neuroscience, Department of Psychobiology and IDOCAL, University of Valencia, Valencia, Spain; Spanish National Network for Research in Mental Health CIBERSAM, 28029, Spain
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6
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Mytareli C, Athanasouli F, Andreadaki E, Thanasoula F, Angelousi A. Hair cortisol and endocannabinoid measurement in patients with adrenal incidentalomas: a case-control study. Hormones (Athens) 2024; 23:113-120. [PMID: 37792214 DOI: 10.1007/s42000-023-00495-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/22/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE The role of endocannabinoids (ECs) in the regulation of the hypothalamic-pituitary-adrenocortical axis has already been studied; however, data are scarce in humans. The aim of our study was to analyze EC [anandamide (AEA) and 2-arachidonoylglycerol (2-AG)] and cortisol (F) levels in hair samples of patients with adrenal incidentalomas (AIs) in comparison with those found in controls and assess their association with the hormone profile. METHODS Forty-four patients with AIs [32 with non-functioning AIs (NFAIs) and 12 with possible autonomous secretion (PACS)] and 44 controls were recruited. Basal and post-1 mg overnight dexamethasone suppression test (ODST) F, adrenocorticotropic hormone, dehydroepiandrosterone sulfate, and 24-h urinary free cortisol were analyzed. After hair collection, EC and F levels were measured by liquid chromatography tandem-mass spectrometry. RESULTS There was no difference between the groups regarding age, sex, and metabolic status. Significantly decreased hair AEA and 2-AG levels were found in patients with AIs compared to controls (p < 0.001 and p = 0.002, respectively) as well as between NFAI or PACS and controls (p < 0.001 or p = 0.002 and p = 0.038 or p = 0.02, respectively). Among the AI patients, EC levels tended to be lower in the PACS group. AEA hair levels were negatively correlated with F levels post-1 mg ODST (rs = -0.257, p = 0.033). We found no significant difference comparing hair F between the groups. CONCLUSION Our findings suggest that hair EC measurement could be a potential biomarker in the evaluation of patients with AIs, whereas hair F analysis is not a useful diagnostic test for mild hypercortisolemia.
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Affiliation(s)
- Chrysoula Mytareli
- Unit of Endocrinology, 1St Department of Internal Medicine, NKUA, Laikon General Hospital, 11527, Athens, Greece
| | - Fani Athanasouli
- Unit of Endocrinology, 1St Department of Internal Medicine, NKUA, Laikon General Hospital, 11527, Athens, Greece
| | - Evangelia Andreadaki
- Unit of Endocrinology, 1St Department of Internal Medicine, NKUA, Laikon General Hospital, 11527, Athens, Greece
| | - Foteini Thanasoula
- Unit of Endocrinology, 1St Department of Internal Medicine, NKUA, Laikon General Hospital, 11527, Athens, Greece
| | - Anna Angelousi
- Unit of Endocrinology, 1St Department of Internal Medicine, NKUA, Laikon General Hospital, 11527, Athens, Greece.
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7
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Faresjö Å, LeTran A, Olsen OJ, Faresjö T, Theodorsson E, Jones M. Measuring cortisol concentration in hair month-by-month two years retrospectively. ALL LIFE 2023. [DOI: 10.1080/26895293.2023.2172461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- Åshild Faresjö
- Department of Health, Medicine and Caring Sciences; Public Health, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Anh LeTran
- Department of Health, Medicine and Caring Sciences; Public Health, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Ole J. Olsen
- Department of Health and Care Sciences, University of Tromsö, Tromsö, Norway
| | - Tomas Faresjö
- Department of Health, Medicine and Caring Sciences; General Practice, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Elvar Theodorsson
- Department of Biomedical and Clinical Sciences; Clinical Chemistry, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Michael Jones
- Department of Psychology, Macquarie University, North Ryde, Australia
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8
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Kitani RA, Nicolaides NC, Mantzou A, Chatzidaki E, Michou M, Polychronaki N, Letsou K, Pervanidou P, Kanaka-Gantenbein C. Differences in segmental hair cortisol concentration analysis among children and adolescents with overweight and obesity, their parents, and normal weight peers. Hormones (Athens) 2023; 22:623-632. [PMID: 37688736 DOI: 10.1007/s42000-023-00482-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/28/2023] [Indexed: 09/11/2023]
Abstract
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.
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Affiliation(s)
- Rosa-Anna Kitani
- Postgraduate Course on "The Science of Stress and Health Promotion", Medical School, National and Kapodistrian University of Athens, Thivon and Levadias str, 11527, Athens, Greece.
| | - Nicolas C Nicolaides
- Postgraduate Course on "The Science of Stress and Health Promotion", Medical School, National and Kapodistrian University of Athens, Thivon and Levadias str, 11527, Athens, Greece
- First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Aimilia Mantzou
- First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Evi Chatzidaki
- First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Maria Michou
- Postgraduate Course on "The Science of Stress and Health Promotion", Medical School, National and Kapodistrian University of Athens, Thivon and Levadias str, 11527, Athens, Greece
- Human Ecology Laboratory, Department of Economics and Sustainable Development, Harokopio University, 17671, Athens, Greece
| | - Nektaria Polychronaki
- First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Konstantina Letsou
- Postgraduate Course on "The Science of Stress and Health Promotion", Medical School, National and Kapodistrian University of Athens, Thivon and Levadias str, 11527, Athens, Greece
| | - Panagiota Pervanidou
- Postgraduate Course on "The Science of Stress and Health Promotion", Medical School, National and Kapodistrian University of Athens, Thivon and Levadias str, 11527, Athens, Greece
- First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Christina Kanaka-Gantenbein
- Postgraduate Course on "The Science of Stress and Health Promotion", Medical School, National and Kapodistrian University of Athens, Thivon and Levadias str, 11527, Athens, Greece
- First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
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9
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Botschek T, Hußlein V, Peters EMJ, Brosig B. Hair cortisol as outcome parameter for psychological and neuropsychiatric interventions-a literature review. Front Psychiatry 2023; 14:1227153. [PMID: 37881597 PMCID: PMC10595010 DOI: 10.3389/fpsyt.2023.1227153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/22/2023] [Indexed: 10/27/2023] Open
Abstract
Background Studies measuring hair cortisol concentration (HCC) have been increasingly conducted to document stress-related, endocrine changes aggregated over time. Previous studies have shown that HCC reflects abnormalities in the hypothalamic-pituitary-adrenocortical axis (HPA axis) in the context of somatic diseases, such as Cushing's syndrome. HCC variations also reveal a corresponding alteration in HPA-axis-function in mental disorders, highlighting its potential role as a biomarker for interventions targeting mental health problems. Aims The aim of this study was to investigate the role of HCC in various psychological and neuropsychiatric interventions and to explore the extent to which HCC can serve as a predictive or outcome parameter in such interventions by conducting a PRISMA-compliant review of the literature. Methods From May to July 2022, the databases Web of Science, Google Scholar, PsychINFO, and ResearchGate were systematically searched using different combinations of relevant keywords. Studies of different types that examined HCC in the context of a wide range of psychological and neuropsychiatric interventions were included. Studies in languages other than English or German and animal studies were excluded. The MMAT tool was used, to assesses the Risk of bias. Results The initial search identified 334 studies. After applying the inclusion and exclusion criteria, 14 publications with a total number of 1,916 participants were identified. An association between HCC and PTSD, depressive disorders, and ongoing social and family stress can be documented. The effect of relaxation techniques, mental training, CBT, or PTSD therapy on HCC has been studied with equivocal results. Some studies found decreased HCC after treatment, while others did not show a clear effect. Baseline HCC appears to be of particular importance. In some studies, higher baseline HCC was associated with increased treatment response, providing a predictive value for HCC. Discussion HCC is increasingly being used as a biomarker for the mapping of psychological and neuropsychiatric interventions. However, due to the wide range of study populations and interventions, results are still heterogeneous. Nevertheless, HCC seems to be an encouraging biological parameter to describe the trajectory of different interventions aimed at improving mental health.
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Affiliation(s)
- Tim Botschek
- Family Psychosomatics, Department of Pediatrics and Neonatology, Justus-Liebig University Giessen, Gießen, Germany
| | - Vincent Hußlein
- Family Psychosomatics, Department of Pediatrics and Neonatology, Justus-Liebig University Giessen, Gießen, Germany
| | - Eva M. J. Peters
- Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University Giessen, Gießen, Germany
- Psychosomatics and Psychotherapy, Charité Center 12 Internal Medicine and Dermatology, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - Burkhard Brosig
- Family Psychosomatics, Department of Pediatrics and Neonatology, Justus-Liebig University Giessen, Gießen, Germany
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10
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Colding-Jørgensen P, Hestehave S, Abelson KSP, Kalliokoski O. Hair glucocorticoids are not a historical marker of stress - Exploring the time-scale of corticosterone incorporation into hairs in a rat model. Gen Comp Endocrinol 2023; 341:114335. [PMID: 37302763 DOI: 10.1016/j.ygcen.2023.114335] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 05/31/2023] [Accepted: 06/06/2023] [Indexed: 06/13/2023]
Abstract
Hair glucocorticoids are increasingly popular biomarkers, used across numerous research fields, and studied species, as a measure of stress. Although they are suggested to be a proxy of the average HPA axis activity spanning a period of weeks or months into the past, this theory has never been tested. In the present study, adrenalectomized rats with no endogenous (adrenal) glucocorticoid production were used to study how circulating glucocorticoid levels would be reflected in the glucocorticoid levels found in hair samples. By dosing the animals daily with high levels of corticosterone for seven days, while sampling hairs before, during, and after treatments, a timeline for glucocorticoid uptake into hairs was constructed. This kinetic profile was compared to two hypothetical models, and the theory that hair glucocorticoids are a record of historical stress had to be rejected. Corticosterone concentrations in hairs were found to increase within three hours of the first injection, the highest concentrations were found on the seventh day of treatments, and the decrease in concentrations post-treatment suggests rapid elimination. We speculate that hair glucocorticoid levels can only be used to characterize a stress-response for a few days following a postulated stressor. An updated model, where glucocorticoids diffuse into, along, and out of hairs needs to be adopted to reconcile the experimentally obtained data. The inescapable consequence of this updated model is that hair glucocorticoids become a marker of - and can only be used to study - recent, or ongoing, stress, as opposed to historical events, weeks or months in the past.
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Affiliation(s)
- Pernille Colding-Jørgensen
- Department of Experimental Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Sara Hestehave
- Department of Experimental Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark; Department of Cell and Developmental Biology, University College London, United Kingdom
| | - Klas S P Abelson
- Department of Experimental Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Otto Kalliokoski
- Department of Experimental Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
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11
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Wright K, van Rossum EFC, Zan E, Werner N, Harris A, Feelders RA, Agrawal N. Emerging diagnostic methods and imaging modalities in cushing's syndrome. Front Endocrinol (Lausanne) 2023; 14:1230447. [PMID: 37560300 PMCID: PMC10407789 DOI: 10.3389/fendo.2023.1230447] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 07/05/2023] [Indexed: 08/11/2023] Open
Abstract
Endogenous Cushing's syndrome (CS) is a rare disease characterized by prolonged glucocorticoid excess. Timely diagnosis is critical to allow prompt treatment and limit long-term disease morbidity and risk for mortality. Traditional biochemical diagnostic modalities each have limitations and sensitivities and specificities that vary significantly with diagnostic cutoff values. Biochemical evaluation is particularly complex in patients whose hypercortisolemia fluctuates daily, often requiring repetition of tests to confirm or exclude disease, and when delineating CS from physiologic, nonneoplastic states of hypercortisolism. Lastly, traditional pituitary MRI may be negative in up to 60% of patients with adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas (termed "Cushing's disease" [CD]) whereas false positive pituitary MRI findings may exist in patients with ectopic ACTH secretion. Thus, differentiating CD from ectopic ACTH secretion may necessitate dynamic testing or even invasive procedures such as bilateral inferior petrosal sinus sampling. Newer methods may relieve some of the diagnostic uncertainty in CS, providing a more definitive diagnosis prior to subjecting patients to additional imaging or invasive procedures. For example, a novel method of cortisol measurement in patients with CS is scalp hair analysis, a non-invasive method yielding cortisol and cortisone values representing long-term glucocorticoid exposure of the past months. Hair cortisol and cortisone have both shown to differentiate between CS patients and controls with a high sensitivity and specificity. Moreover, advances in imaging techniques may enhance detection of ACTH-secreting pituitary adenomas. While conventional pituitary MRI may fail to identify microadenomas in patients with CD, high-resolution 3T-MRI with 3D-spoiled gradient-echo sequence has thinner sections and superior soft-tissue contrast that can detect adenomas as small as 2 mm. Similarly, functional imaging may improve the identification of ACTH-secreting adenomas noninvasively; Gallium-68-tagged corticotropin-releasing hormone (CRH) combined with PET-CT can be used to detect CRH receptors, which are upregulated on corticotroph adenomas. This technique can delineate functionality of adenomas in patients with CD from patients with ectopic ACTH secretion and false positive pituitary lesions on MRI. Here, we review emerging methods and imaging modalities for the diagnosis of CS, discussing their diagnostic accuracy, strengths and limitations, and applicability to clinical practice.
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Affiliation(s)
- Kyla Wright
- New York University (NYU) Grossman School of Medicine, New York, NY, United States
| | - Elisabeth F. C. van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical College (MC), University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Elcin Zan
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| | - Nicole Werner
- New York University (NYU) Grossman School of Medicine, New York, NY, United States
| | - Alan Harris
- Department of Medicine, Division of Endocrinology, New York University (NYU) Langone Medical Center, New York, NY, United States
| | - Richard A. Feelders
- Department of Internal Medicine, Division of Endocrinology, Erasmus Medical College (MC), University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Nidhi Agrawal
- Department of Medicine, Division of Endocrinology, New York University (NYU) Langone Medical Center, New York, NY, United States
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12
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Flowers KC, Shipman KE. Pitfalls in the Diagnosis and Management of Hypercortisolism (Cushing Syndrome) in Humans; A Review of the Laboratory Medicine Perspective. Diagnostics (Basel) 2023; 13:diagnostics13081415. [PMID: 37189516 DOI: 10.3390/diagnostics13081415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/28/2023] [Accepted: 04/11/2023] [Indexed: 05/17/2023] Open
Abstract
Biochemical confirmation of a diagnosis of hypercortisolism (Cushing syndrome) is vital to direct further investigations, especially given the overlap with non-autonomous conditions, such as pseudo-Cushing, and the morbidity associated with missed diagnoses. A limited narrative review was performed focusing on the laboratory perspective of the pitfalls of making a biochemical diagnosis of hypercortisolism in those presenting with presumed Cushing syndrome. Although analytically less specific, immunoassays remain cheap, quick, and reliable in most situations. Understanding cortisol metabolism can help with patient preparation, specimen selection (e.g., consideration of urine or saliva for those with possible elevations of cortisol binding globulin concentration), and method selection (e.g., mass spectrometry if there is a high risk of abnormal metabolites). Although more specific methods may be less sensitive, this can be managed. The reduction in cost and increasing ease of use makes techniques such as urine steroid profiles and salivary cortisone of interest in future pathway development. In conclusion, the limitations of current assays, particularly if well understood, do not impede diagnosis in most cases. However, in complex or borderline cases, there are other techniques to consider to aid in the confirmation of hypercortisolism.
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Affiliation(s)
- Kade C Flowers
- Department of Clinical Chemistry, University Hospitals Sussex NHS Trust, Worthing BN11 2DH, UK
| | - Kate E Shipman
- Department of Clinical Chemistry, University Hospitals Sussex NHS Trust, Worthing BN11 2DH, UK
- Department of Medical Education, Brighton and Sussex Medical School, University of Sussex, Falmer Campus, Brighton BN1 9PX, UK
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13
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Borges JV, Pires VN, de Freitas BS, Rübensam G, Vieira VC, de Souza Dos Santos C, Schröder N, Bromberg E. Behavior, BDNF and epigenetic mechanisms in response to social isolation and social support in middle aged rats exposed to chronic stress. Behav Brain Res 2023; 441:114303. [PMID: 36657665 DOI: 10.1016/j.bbr.2023.114303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 01/11/2023] [Accepted: 01/15/2023] [Indexed: 01/18/2023]
Abstract
Social deprivation can be stressful for group-living mammals. On the other hand, an amazing response of these animals to stress is seeking social contact to give and receive joint protection in threatening situations. We explored the effects of social isolation and social support on epigenetic and behavioral responses to chronic stress. More specifically, we investigated the behavioral responses, corticosterone levels, BDNF gene expression, and markers of hippocampal epigenetic alterations (levels of H3K9 acetylation and methylation, H3K27 methylation, HDAC5, DNMT1, and DNMT3a gene expressions) in middle-aged adult rats maintained in different housing conditions (isolation or accompanied housing) and exposed to the chronic unpredictable stress protocol (CUS). Isolation was associated with decreased basal levels of corticosterone, impaired long-term memory, and decreased expression of the BDNF gene, besides altering the balance of H3K9 from acetylation to methylation and increasing the DNMT1 gene expression. The CUS protocol decreased H3K9 acetylation, besides increasing H3K27 methylation and DNMT1 gene expression, but had no significant effects on memory and BDNF gene expression. Interestingly, the effects of CUS on corticosterone and HDAC5 gene expression were seen only in isolated animals, whereas the effects of CUS on DNMT1 gene expression were more pronounced in isolated than accompanied animals. In conclusion, social isolation in middle age showed broader effects than chronic unpredictable stress on behavioral and epigenetic alterations potentially associated with decreased BDNF expression. Moreover, social support prevented the adverse effects of CUS on HPA axis functioning, HDAC5, and DNMT1 gene expressions.
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Affiliation(s)
- Juliano Viana Borges
- Laboratory of Biology and Development of the Nervous System, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Ipiranga Av. 6681, 90619-900 Porto Alegre, Brazil
| | - Vivian Naziaseno Pires
- Laboratory of Biology and Development of the Nervous System, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Ipiranga Av. 6681, 90619-900 Porto Alegre, Brazil; Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, Ipiranga Av. 6690, 90610-000 Porto Alegre, Brazil
| | - Betânia Souza de Freitas
- Laboratory of Biology and Development of the Nervous System, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Ipiranga Av. 6681, 90619-900 Porto Alegre, Brazil
| | - Gabriel Rübensam
- Center of Toxicology and Pharmacology Research, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Brazil
| | - Vitória Corrêa Vieira
- Laboratory of Biology and Development of the Nervous System, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Ipiranga Av. 6681, 90619-900 Porto Alegre, Brazil
| | - Cristophod de Souza Dos Santos
- Laboratory of Biology and Development of the Nervous System, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Ipiranga Av. 6681, 90619-900 Porto Alegre, Brazil
| | - Nadja Schröder
- National Institute of Science and Technology for Translational Medicine (INCT-TM), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brasília, Brazil; Department of Physiology, Institute for Basic Health Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Elke Bromberg
- Laboratory of Biology and Development of the Nervous System, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul, Ipiranga Av. 6681, 90619-900 Porto Alegre, Brazil; Institute of Geriatrics and Gerontology, Pontifical Catholic University of Rio Grande do Sul, Ipiranga Av. 6690, 90610-000 Porto Alegre, Brazil; National Institute of Science and Technology for Translational Medicine (INCT-TM), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brasília, Brazil.
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14
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Vega-Beyhart A, Araujo-Castro M, Hanzu FA, Casals G. Cortisol: Analytical and clinical determinants. Adv Clin Chem 2023; 113:235-271. [PMID: 36858647 DOI: 10.1016/bs.acc.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Cortisol, the main human glucocorticoid, is synthesized from cholesterol in the adrenal cortex and predominantly metabolized by the liver. Interpretation of quantitative results from the analysis of serum, urine and saliva is complicated by variation in circadian rhythm, response to stress as well as the presence of protein-bound and free forms. Interestingly, cortisol is the only hormone routinely measured in serum, urine, and saliva. Preanalytical and analytical challenges arise in each matrix and are further compounded by the use of various stimulation and suppression tests commonly employed in clinical practice. Although not yet included in clinical guidelines, measurement of cortisol in hair may be of interest in specific situations. Immunoassays are the most widely used methods in clinical laboratories to measure cortisol, but they are susceptible to interference from synthetic and endogenous steroids, generally producing a variable overestimation of true cortisol results, especially in urine. Analysis by mass spectrometry provides higher specificity and allows simultaneous measurement of multiple steroids including synthetic steroids, thus reducing diagnostic uncertainty. An integrated review of cortisol in various disease states is also addressed.
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Affiliation(s)
- Arturo Vega-Beyhart
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Endocrinology and Nutrition, Hospital Clinic, Barcelona, Spain
| | - Marta Araujo-Castro
- Department of Endocrinology and Metabolism, Hospital Universitario Ramón y Cajal, Madrid, Spain; Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), Madrid, Spain
| | - Felicia A Hanzu
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Endocrinology and Nutrition, Hospital Clinic, Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Gregori Casals
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Service of Biochemistry and Molecular Genetics, Hospital Clinic, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Fundamental Care and Medical-Surgical Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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15
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Savas M, Mehta S, Agrawal N, van Rossum EFC, Feelders RA. Approach to the Patient: Diagnosis of Cushing Syndrome. J Clin Endocrinol Metab 2022; 107:3162-3174. [PMID: 36036941 PMCID: PMC9681610 DOI: 10.1210/clinem/dgac492] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Indexed: 12/27/2022]
Abstract
Cushing syndrome results from supraphysiological exposure to glucocorticoids and is associated with significant morbidity and mortality. The pathogenesis includes administration of corticosteroids (exogenous Cushing syndrome) or autonomous cortisol overproduction, whether or not ACTH-dependent (endogenous Cushing syndrome). An early diagnosis of Cushing syndrome is warranted; however, in clinical practice, it is very challenging partly because of resemblance with other common conditions (ie, pseudo-Cushing syndrome). Initial workup should start with excluding local and systemic corticosteroid use. First-line screening tests including the 1-mg dexamethasone suppression test, 24-hour urinary free cortisol excretion, and late-night salivary cortisol measurement should be performed to screen for endogenous Cushing syndrome. Scalp-hair cortisol/cortisone analysis helps in the assessment of long-term glucocorticoid exposure as well as in detection of transient periods of hypercortisolism as observed in cyclical Cushing syndrome. Interpretation of results can be difficult because of individual patient characteristics and hence requires awareness of test limitations. Once endogenous Cushing syndrome is established, measurement of plasma ACTH concentrations differentiates between ACTH-dependent (80%-85%) or ACTH-independent (15%-20%) causes. Further assessment with different imaging modalities and dynamic biochemical testing including bilateral inferior petrosal sinus sampling helps further pinpoint the cause of Cushing's syndrome. In this issue of "Approach to the patient," the diagnostic workup of Cushing syndrome is discussed with answering the questions when to screen, how to screen, and how to differentiate the different causes. In this respect, the latest developments in biochemical and imaging techniques are discussed as well.
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Affiliation(s)
| | | | - Nidhi Agrawal
- Division of Endocrinology, NYU Langone Medical Center/ Bellevue Hospital Center, New York, NY
| | - Elisabeth F C van Rossum
- Correspondence: Elisabeth F.C. van Rossum, MD, PhD, Medicine, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Richard A Feelders
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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16
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Toly VB, Fiala M, Shi S. Self-collection of hair samples during the COVID-19 pandemic. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2022; 12:100156. [PMID: 35990595 PMCID: PMC9375250 DOI: 10.1016/j.cpnec.2022.100156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/22/2022] [Accepted: 07/22/2022] [Indexed: 11/11/2022] Open
Abstract
Purpose Due to the COVID-19 Pandemic, public health restrictions were implemented that required study protocol revisions for our collection of hair cortisol samples from in-person to self-collection. The purpose is to provide descriptions of the protocol transition process from in-person hair cortisol sample collection to participant self-collection using written and video instructions as well as the acceptability and feasibility of this transition. Main results The protocol transition required revisions to the written instructions with a link to a newly developed video for hair sample self-collection. There was little difference in the initial participant agreement to provide a hair sample between in-person (79/114; 69.3%) versus self-collection (254/417; 60.9%) protocol methods. Some participants were initially hesitant to provide a self-collected hair sample but commented that self-collection was easier than they anticipated which supports the acceptability of this protocol change. However, regarding feasibility, 16.8% of participant self-collected hair samples were not received by study staff despite reminders (14.3%) or there was an issue with mail delivery or return (2.5%). Major conclusions The transition of our hair sample collection protocol from in-person to self-collection was acceptable and feasible. Providing instructions for hair sample self-collection in a variety of formats (oral, written, video) helped to decrease uncertainty and hesitancy regarding the process and promote agreement among participants. In addition, consistent follow-up communication was key to timely receipt of the hair samples from participants.
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Affiliation(s)
- Valerie Boebel Toly
- Arline H. and Curtis F. Garvin Professorship in Nursing Excellence, Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Ave. Cleveland, Ohio, 44106, USA
| | - Marisa Fiala
- Arline H. and Curtis F. Garvin Professorship in Nursing Excellence, Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Ave. Cleveland, Ohio, 44106, USA
| | - Sophie Shi
- Arline H. and Curtis F. Garvin Professorship in Nursing Excellence, Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Ave. Cleveland, Ohio, 44106, USA
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17
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Peng FJ, Palazzi P, Viguié C, Appenzeller BMR. Hormonal profile changes induced by pesticide mixture exposure in female rats revealed by hair analysis. CHEMOSPHERE 2022; 303:135059. [PMID: 35643162 DOI: 10.1016/j.chemosphere.2022.135059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/13/2022] [Accepted: 05/19/2022] [Indexed: 06/15/2023]
Abstract
Pesticide exposure has been associated with hormonal disruption in both animals and humans. However, there is limited knowledge of the combined effects of complex mixtures of pesticides on endogenous hormone levels. Here, we used hair analysis to assess the impact of a pesticide mixture comprising 19 components from multiple chemical classes at eight doses of 0-400 μg/kg body weight (bw) three times per week per component on concentrations of 36 steroid and thyroid hormones in female rats over a 90-day exposure period. We detected 13 hormones in rat hair, namely estradiol (E2), androstenedione (AD), testosterone (T), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulfate (DHEAS), pregnenolone (P5), progesterone (P4), 11-deoxycorticosterone (11-DOC), corticosterone (CORT), 3,3'-l-diiodothyronine (T2), 3,5,3'-l-triiodothyronine (T3), 3,3',5'-l-triiodothyronine (rT3), and 3,5,3',5'-l-tetraiodothyronine (T4). In comparison to the control group, hair E2 concentration was significantly lower in the two highest (200 and 400 μg/kg bw) exposure groups, whereas hair DHEAS and CORT concentrations were significantly higher in the 40 μg/kg bw and the highest exposure groups, respectively. Results from generalized additive models suggest that pesticide exposure resulted in monotonic dose responses in hair E2 concentration, CORT concentration and DHEA/CORT molar ratio but nonmonotonic dose responses in hair T concentration, DHEAS concentration, P4/P5 and DHEA/DHEAS molar ratios. The associations of E2, CORT and DHEA/CORT ratio with exposure intensity were confirmed by their significant linear relationships with hair concentrations of at least 23 of the 25 exposure biomarkers analyzed. Our results demonstrate that exposure to low levels of the pesticide mixture evaluated here can alter hair reproductive and adrenal hormones levels.
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Affiliation(s)
- Feng-Jiao Peng
- Human Biomonitoring Research Unit, Department of Precision Health, Luxembourg Institute of Health, 1 A-B rue Thomas Edison, 1445, Strassen, Luxembourg
| | - Paul Palazzi
- Human Biomonitoring Research Unit, Department of Precision Health, Luxembourg Institute of Health, 1 A-B rue Thomas Edison, 1445, Strassen, Luxembourg
| | - Catherine Viguié
- Toxalim (Research Center in Food Toxicology), Université de Toulouse, INRAE, ENVT, INP-Purpan, UPS, 31300, Toulouse, France
| | - Brice M R Appenzeller
- Human Biomonitoring Research Unit, Department of Precision Health, Luxembourg Institute of Health, 1 A-B rue Thomas Edison, 1445, Strassen, Luxembourg.
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18
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Michaud DS, Thomson EM, van Oosterhout P, McNamee JP. Hair cortisol as a viable tool for the assessment of an association between environmental noise exposure and chronic stress. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2022; 152:866. [PMID: 36050175 DOI: 10.1121/10.0012887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/07/2022] [Indexed: 06/15/2023]
Abstract
Entrenched in the well-established link between stress and health, noise exposure as a potential contributor to stress-related health effects receives tremendous attention. Indeed, exposure to noise can act as a stressor as evidenced through increased heart rate, blood pressure, adrenaline, epinephrine, and cortisol. Cortisol is secreted from the adrenal glands in response to stressor-induced activation of the hypothalamic-pituitary-adrenal axis. For assessment of environmental noise and stress, repeated sampling in blood, saliva, or urine is necessary to evaluate the association between environmental noise exposure and protracted changes in cortisol. Controlling for the many variables that influence the secretion of cortisol at discrete sampling intervals is challenging. Studies suggest that systemically produced cortisol integrates and remains in hair as it grows, providing a measure that integrates a cortisol response over a longer period, circumventing several limitations associated with multiple sampling. Robust evidence supports the integration of cortisol into hair, yet recent studies call into question the notion that cortisol is retained with growth. The current paper discusses the strengths and limitations of hair cortisol analysis with an emphasis on its utility as a measure of chronic stress in environmental noise studies.
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Affiliation(s)
- David S Michaud
- Health Canada, Environmental and Radiation Health Sciences Directorate, Consumer and Clinical Radiation Protection Bureau, 775 Brookfield Road, Ottawa, Ontario K1A 1C1, Canada
| | - Errol M Thomson
- Health Canada, Environmental and Radiation Health Sciences Directorate, Environmental Health Science and Research Bureau, 251 Sir Frederick Banting Driveway, Tunney's Pasture, Ottawa, Ontario K1A 0K9, Canada
| | - Priya van Oosterhout
- Department of Neuroscience, Carleton University, 1125 Colonel By Drive, Ottawa, Ontario K1S 5B6, Canada
| | - James P McNamee
- Health Canada, Environmental and Radiation Health Sciences Directorate, Consumer and Clinical Radiation Protection Bureau, 775 Brookfield Road, Ottawa, Ontario K1A 1C1, Canada
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19
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Cai Y, Ren L, Tan S, Liu X, Li C, Gang X, Wang G. Mechanism, diagnosis, and treatment of cyclic Cushing's syndrome: A review. Biomed Pharmacother 2022; 153:113301. [PMID: 35717778 DOI: 10.1016/j.biopha.2022.113301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/09/2022] [Accepted: 06/13/2022] [Indexed: 11/30/2022] Open
Abstract
Cushing's syndrome (CS) is caused by hypercortisolemia, leading to the occurrence of characteristic clinical symptoms. A small number of patients with CS have periodic and intermittent increases in cortisol levels, resulting in recurrent episodes of clinical symptoms. Such patients are known as having cyclic CS (CCS). The cortisol secretion cycle of patients with CCS is unpredictable, and laboratory tests often show negative results during the normal cortisol secretion period; therefore, the diagnosis and treatment of the disease are currently difficult. Although the pathogenesis of CCS remains uncertain, recent studies have suggested that it may be closely related to hypothalamic factors, feedback mechanisms, and tumor infarction. Our review summarizes the current state of research on the potential mechanisms, diagnosis, and treatment of CS and provides an outlook for future studies.
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Affiliation(s)
- Yunjia Cai
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, China
| | - Linan Ren
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, China
| | - Shuwen Tan
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, China
| | - Xinming Liu
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, China
| | - Chen Li
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, China
| | - Xiaokun Gang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, China.
| | - Guixia Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, China.
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20
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Kostolanská K, Šiprová H, Bartečků E, Juřica J, Řiháček I, Táborská E, Souček M, Peš O. Longitudinal Monitoring of Hair Cortisol Using Liquid Chromatography-Mass Spectrometry to Prevent Hypercortisolism in Patients Undergoing Glucocorticoid Replacement Therapy. Ther Drug Monit 2022; 44:438-447. [PMID: 35550494 DOI: 10.1097/ftd.0000000000000946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 11/10/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Currently available methods for endogenous cortisol monitoring in patients with hormonal insufficiency rely on measurements of plasma levels only at a single time point; thus, any kind of chronic exposure to cortisol is challenging to evaluate because it requires collecting samples at different time points. Hair cortisol levels acquired longitudinally better reflected chronic exposure (both cortisol synthesis and deposition) and may significantly contribute to better outcomes in glucocorticoid replacement therapies. DESIGN Twenty-two patients on cortisol substitution therapy were monitored for plasma, urinary, and hair cortisol levels for 18 months to determine whether hair cortisol may serve as a monitoring option for therapy setting and adjustment. METHODS Plasma and urinary cortisol levels were measured using standardized immunoassay methods, and segmented (∼1 cm) hair cortisol levels were monitored by liquid chromatography coupled to mass spectrometry. A log-normal model of the changes over time was proposed, and Bayesian statistics were used to compare plasma, urinary, and hair cortisol levels over 18 months. RESULTS AND CONCLUSIONS Hair cortisol levels decreased over time in patients undergoing substitutional therapy. The residual variance of hair cortisol in comparison to plasma or urinary cortisol levels was much lower. Thus, longitudinal monitoring of hair cortisol levels could prove beneficial as a noninvasive tool to reduce the risk of overdosing and improve the overall patient health.
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Affiliation(s)
- Katarína Kostolanská
- Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Helena Šiprová
- Endocrinology Ambulance, St. Anne's University Hospital, Brno, Czech Republic
| | - Elis Bartečků
- Department of Psychiatry, Faculty of Medicine, Masaryk University and University Hospital Brno, Brno, Czech Republic ; and
| | - Jan Juřica
- Department of Pharmacology and Toxicology, Pharmaceutical Faculty, Faculty of Medicine, Masaryk University, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Ivan Řiháček
- Endocrinology Ambulance, St. Anne's University Hospital, Brno, Czech Republic
| | - Eva Táborská
- Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Miroslav Souček
- Endocrinology Ambulance, St. Anne's University Hospital, Brno, Czech Republic
| | - Ondřej Peš
- Department of Biochemistry, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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21
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Gorter JW, Fehlings D, Ferro MA, Gonzalez A, Green AD, Hopmans SN, McCauley D, Palisano RJ, Rosenbaum P, Speller B. Correlates of Mental Health in Adolescents and Young Adults with Cerebral Palsy: A Cross-Sectional Analysis of the MyStory Project. J Clin Med 2022; 11:jcm11113060. [PMID: 35683448 PMCID: PMC9181041 DOI: 10.3390/jcm11113060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/21/2022] [Accepted: 05/25/2022] [Indexed: 02/04/2023] Open
Abstract
Background: It is important to gain a better understanding of mental health issues in adolescents and young adults (AYA) with cerebral palsy (CP). In this cross-sectional study, we explore if demographics, social and clinical questionnaire scores, and cortisol levels in hair samples from AYA with CP are associated with higher scores on anxiety and/or depression questionnaires. Methods: Data from a community-based sample of 63 AYA with CP (30 females; ages 16 to 30 (median age of 25)) were analyzed. Forty-one (65%) participants (20 females) provided a hair sample. Outcomes were assessed using bivariate linear regression analyses and hierarchical regression analyses. Results: Clinical depressive and anxiety symptoms were present in 33% and 31% of participants, respectively. Family functioning, B = 9.62 (95%CI: 5.49–13.74), fatigue, B = 0.15 (95%CI: 0.05–0.25), and pain, B = 1.53 (95%CI: 0.48–2.58) were statistically significant predictors of depressive symptoms. Fatigue, B = 0.24 (95%CI: 0.12–0.35) and pain, B = 1.63 (95%CI: 0.33–2.94) were statistically significant predictors of anxiety. Cortisol levels from hair samples were not found to be associated with depressive symptoms or anxiety. Conclusions: A high prevalence of mental health problems and co-occurring physical problems was found in AYA with CP. Integrating mental support into regular care for AYA with CP is recommended.
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Affiliation(s)
- Jan Willem Gorter
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 1C7, Canada; (A.D.G.); (S.N.H.); (P.R.); (B.S.)
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 1C7, Canada; (D.F.); (M.A.F.); (D.M.); (R.J.P.)
- Correspondence:
| | - Darcy Fehlings
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 1C7, Canada; (D.F.); (M.A.F.); (D.M.); (R.J.P.)
- Department of Paediatrics, Holland Bloorview Kids Rehabilitation Hospital, University of Toronto, Toronto, ON M4G 1R8, Canada
| | - Mark A. Ferro
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 1C7, Canada; (D.F.); (M.A.F.); (D.M.); (R.J.P.)
- School of Public Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 1C7, Canada;
| | - Amanda D. Green
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 1C7, Canada; (A.D.G.); (S.N.H.); (P.R.); (B.S.)
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 1C7, Canada; (D.F.); (M.A.F.); (D.M.); (R.J.P.)
| | - Sarah N. Hopmans
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 1C7, Canada; (A.D.G.); (S.N.H.); (P.R.); (B.S.)
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 1C7, Canada; (D.F.); (M.A.F.); (D.M.); (R.J.P.)
| | - Dayle McCauley
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 1C7, Canada; (D.F.); (M.A.F.); (D.M.); (R.J.P.)
| | - Robert J. Palisano
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 1C7, Canada; (D.F.); (M.A.F.); (D.M.); (R.J.P.)
| | - Peter Rosenbaum
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 1C7, Canada; (A.D.G.); (S.N.H.); (P.R.); (B.S.)
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 1C7, Canada; (D.F.); (M.A.F.); (D.M.); (R.J.P.)
| | - Brittany Speller
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 1C7, Canada; (A.D.G.); (S.N.H.); (P.R.); (B.S.)
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 1C7, Canada; (D.F.); (M.A.F.); (D.M.); (R.J.P.)
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Lee S, Park JT, Bang M, An SK, Namkoong K, Park HY, Lee E. Theory of mind and hair cortisol in healthy young adults: the moderating effects of childhood trauma. Eur J Psychotraumatol 2022; 13:2116826. [PMID: 36186166 PMCID: PMC9518292 DOI: 10.1080/20008066.2022.2116826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Experiences of negative social interactions and childhood trauma (CT) can lead to aberrant hypothalamic-pituitary-adrenal functions. Poor theory of mind (ToM) ability is related to increased social stress levels; however, studies on the relationship between ToM and cortisol remain scarce. Objective: This study aimed to evaluate the relationship between ToM and the hair cortisol concentration (HCC) in healthy young adults considering the moderating role of CT. Method: A total of 206 healthy young adults were divided into two groups based on an experience of moderate-to-severe childhood trauma (CT+ and CT-). To determine whether CT moderated the relationship between ToM and HCC, moderation analysis was conducted controlling for age, sex, years of education, and scores of perceived stress, depression, and anxiety. Results: CT+ individuals reported higher subjective stress perception and depressive symptoms than CT- individuals, whereas anxiety-related symptoms, ToM, and HCC were not different between the groups. The experience of CT significantly moderated the relationship between ToM and HCC. The association between poorer ToM ability and higher HCC was significant only in CT+ group. Conclusion: CT is a moderator of the association between ToM and HCC, indicating the importance of CT in social cognition and the stress response.
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Affiliation(s)
- Suonaa Lee
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jung Tak Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Minji Bang
- Department of Psychiatry, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Suk Kyoon An
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kee Namkoong
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hye Yoon Park
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.,Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Eun Lee
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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23
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Puglisi S, Leporati M, Amante E, Parisi A, Pia AR, Berchialla P, Terzolo M, Vincenti M, Reimondo G. Limited Role of Hair Cortisol and Cortisone Measurement for Detecting Cortisol Autonomy in Patients With Adrenal Incidentalomas. Front Endocrinol (Lausanne) 2022; 13:833514. [PMID: 35222288 PMCID: PMC8863572 DOI: 10.3389/fendo.2022.833514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 01/12/2022] [Indexed: 11/24/2022] Open
Abstract
Several studies demonstrated the diagnostic accuracy of hair glucocorticoid measurement in patients with overt Cushing syndrome, but few data are available for patients with adrenal incidentaloma (AI) and cortisol autonomy. The aim of our study was to assess whether measurement of 5 corticosteroid hormones with the ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method in the keratin matrix is useful to stratify patients with AI by the presence of autonomous cortisol secretion [ACS] (defined as serum cortisol after 1 mg dexamethasone suppression test (DST) > 138 nmol/l) or possible ACS [PACS] (defined as serum cortisol after 1 mg DST > 50 nmol/l but ≤138 nmol/l). We analysed data of 67 AI patients (32 with cortisol autonomy) and 81 healthy subjects. We did not find any significant statistical difference comparing hair cortisol, cortisone, and 20β-dihydrocortisol concentrations between healthy controls and AI patients, while 6β-hydroxycortisol and 11-deoxycortisol were undetectable. Moreover, no significant difference was found in hair cortisol, cortisone, and 20β-dihydrocortisol levels of AI patients with or without cortisol autonomy. Finally, we did not find any correlation in patients with AI between hormonal concentrations in the keratin matrix and serum, salivary, and urinary cortisol levels, or with body mass index. In conclusion, our findings suggest that hair glucocorticoid measurement is not suitable as a diagnostic test for cortisol autonomy (ACS and PACS).
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Affiliation(s)
- Soraya Puglisi
- Internal Medicine, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
- *Correspondence: Soraya Puglisi,
| | - Marta Leporati
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Turin, Italy
| | | | - Alice Parisi
- Internal Medicine, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
| | - Anna Rosa Pia
- Internal Medicine, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
| | - Paola Berchialla
- Statistical Unit, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Massimo Terzolo
- Internal Medicine, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
| | - Marco Vincenti
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Turin, Italy
- Department of Chemistry, University of Turin, Turin, Italy
| | - Giuseppe Reimondo
- Internal Medicine, Department of Clinical and Biological Sciences, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
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24
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Kim WJ, Park KM, Park JT, Seo E, An SK, Park HY, Lee E. Sex-specific association of hair cortisol concentration with stress-related psychological factors in healthy young adults. Biol Sex Differ 2021; 12:56. [PMID: 34666803 PMCID: PMC8527770 DOI: 10.1186/s13293-021-00399-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 10/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hair cortisol concentration (HCC) has received attention as a useful marker of stress, but evidence on associations between psychological factors and cortisol concentration is inconsistent. The purpose of this study was to investigate the sex differences in the relationship between cortisol concentration and psychological factors in healthy young adults. METHODS A total of 205 (103 females, 102 males) healthy young adults participated. HCC and various stress-related psychological measures were compared between sexes. Multiple linear regression analyses were performed to assess associations between HCC and stress-related psychological measures for all participants and for each sex. RESULTS The difference in HCC according to sex was not significant. The reported number of stressful life events in the past year, stress perception, depressive and anxiety-related symptoms, and emotion dysregulation were not different between sexes, either. The association between HCC and emotion dysregulation was significant in females but not males. CONCLUSION We observed a sex-specific association between HCC and psychological factors. Our findings may imply that HCC could be a useful biomarker of stress and stress-related emotion dysregulation in healthy young women.
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Affiliation(s)
- Won Jae Kim
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Kyung Mee Park
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.,Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, 363 Dongbaekjukjeon-daero, Giheung-gu, Yongin, Gyeonggi-do, 16995, Republic of Korea
| | - Jung Tak Park
- Department of Internal Medicine and Institute of Kidney Disease Research, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Eunchong Seo
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.,Department of Psychiatry, Veteran Health Service Medical Center, 53 Jinhwangdo-ro 61-gil, Gangdong-gu, Seoul, 05368, Republic of Korea
| | - Suk Kyoon An
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Hye Yoon Park
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | - Eun Lee
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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25
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Busch JR, Wang X, Lynnerup N, Jacobsen C, Jørgensen MB, Linnet K, Johansen SS, Banner J. Hair cortisol concentrations in decedents with severe mental illness – An autopsy-based cohort study. FORENSIC SCIENCE INTERNATIONAL: REPORTS 2021. [DOI: 10.1016/j.fsir.2021.100173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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26
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Kim YS, Joo SP, Song DJ, Lee TK, Kim TS. Correlation between high hair cortisol level and intracranial aneurysm rupture. Medicine (Baltimore) 2021; 100:e26193. [PMID: 34087887 PMCID: PMC8183786 DOI: 10.1097/md.0000000000026193] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 05/13/2021] [Indexed: 01/04/2023] Open
Abstract
Measurement of cortisol in hair is a reliable method for determining long-term cortisol exposure reflecting chronic stress. Research using hair cortisol concentration has been limited to mainly cardiometabolic diseases. The association between hair cortisol concentration and aneurysmal rupture has not yet been studied. We aimed to investigate the relationship between the degree of chronic stress as measured by hair cortisol concentration and aneurysmal rupture.Sixty-eight patients diagnosed with intracranial aneurysms were included in this study (ruptured group, 30; unruptured group, 38). Hair cortisol was measured in 3-cm hair segments, reflecting roughly 3 months of hair growth. For a risk factor analysis, patient-specific factors and aneurysm-specific factors as well as hair cortisol concentration were investigated.Hair cortisol concentrations were significantly higher in the ruptured group than in the unruptured group (55.8 ± 22.0 ng/dL vs. 19.1 ± 6.4 ng/dL; P < .001). High hair cortisol concentration was found to be an independent risk factor for aneurysmal rupture (odds ratio [OR]: 2.245, 95% confidence interval [CI]: 1.825-2.753; P = .013). Additionally, a history of cerebrovascular disease was significantly associated with an increased risk of aneurysmal rupture (OR: 1.577, 95% CI: 1.099-2.262; P = .040).Based on our results, we suggest that chronic stress as measured by hair cortisol concentration could be an independent risk factor for intracranial aneurysmal rupture.
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27
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Ryu J, Lee E, Kang C, Lee M, Kim S, Park S, Lee D, Kwon Y. Rapid Screening of Glucocorticoid Receptor (GR) Effectors Using Cortisol-Detecting Sensor Cells. Int J Mol Sci 2021; 22:4747. [PMID: 33947115 PMCID: PMC8124850 DOI: 10.3390/ijms22094747] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 04/22/2021] [Accepted: 04/28/2021] [Indexed: 01/02/2023] Open
Abstract
Cortisol, a stress hormone, plays key roles in mediating stress and anti-inflammatory responses. As abnormal cortisol levels can induce various adverse effects, screening cortisol and cortisol analogues is important for monitoring stress levels and for identifying drug candidates. A novel cell-based sensing system was adopted for rapid screening of cortisol and its functional analogues under complex cellular regulation. We used glucocorticoid receptor (GR) fused to a split intein which reconstituted with the counterpart to trigger conditional protein splicing (CPS) in the presence of targets. CPS generates functional signal peptides which promptly translocate the fluorescent cargo. The sensor cells exhibited exceptional performance in discriminating between the functional and structural analogues of cortisol with improved sensitivity. Essential oil extracts with stress relief activity were screened using the sensor cells to identify GR effectors. The sensor cells responded to peppermint oil, and L-limonene and L-menthol were identified as potential GR effectors from the major components of peppermint oil. Further analysis indicated L-limonene as a selective GR agonist (SEGRA) which is a potential anti-inflammatory agent as it attenuates proinflammatory responses without causing notable adverse effects of GR agonists.
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Affiliation(s)
| | | | | | | | | | | | | | - Youngeun Kwon
- Department of Biomedical Engineering, Dongguk University, Seoul 04620, Korea; (J.R.); (E.L.); (C.K.); (M.L.); (S.K.); (S.P.); (D.L.)
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28
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Świątkowska-Stodulska R, Berlińska A, Stefańska K, Kłosowski P, Sworczak K. Cyclic Cushing's Syndrome - A Diagnostic Challenge. Front Endocrinol (Lausanne) 2021; 12:658429. [PMID: 33967962 PMCID: PMC8101412 DOI: 10.3389/fendo.2021.658429] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/17/2021] [Indexed: 11/13/2022] Open
Abstract
Cyclic Cushing's syndrome (also known as intermittent or periodic) is a disease characterized by periods of transient hypercortisolemia shifting into periods of normo- and/or hypocortisolemia. Diagnosis of cyclic Cushing's syndrome is based on at least three periods of confirmed hypercortisolemia interspersed by two periods of normocortisolemia. Cyclic Cushing's syndrome is one of the greatest challenges in modern endocrinology due to its diverse clinical picture, unpredictable duration and frequency of phases, and various etiologies. We discuss a diagnostic algorithm for periodic hypercortisolemia with special regard to hair cortisol analysis and desmopressin stimulation test which both seem to be helpful in finding the correct answer.
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Affiliation(s)
- Renata Świątkowska-Stodulska
- Department of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Agata Berlińska
- Department of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Katarzyna Stefańska
- Department of Obstetrics, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Przemysław Kłosowski
- Department of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Krzysztof Sworczak
- Department of Endocrinology and Internal Medicine, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
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29
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Shi R, Dou J, Liu J, Sammad A, Luo H, Wang Y, Guo G, Wang Y. Genetic parameters of hair cortisol as an indicator of chronic stress under different environments in Holstein cows. J Dairy Sci 2021; 104:6985-6999. [PMID: 33773780 DOI: 10.3168/jds.2019-17856] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 02/09/2021] [Indexed: 11/19/2022]
Abstract
Chronic stress is a risk factor for a variety of physiological disorders because of its increased activation of the hypothalamic-pituitary-adrenal (HPA) axis; however, it is difficult to reveal environmental and genetic effects contributing to long-term HPA activity because of the complexity of chronic stress. The hair cortisol concentration (HCC) can be used to reflect the accumulation of HPA axis activity over time. Some studies suggest that the HCC might be associated with the protein concentration (PC) in the hair shaft; however, no studies have revealed a dynamic relationship between them. In the present study, 1,086 hair samples from 418 Holstein cows were collected, and the effects of environmental factors on HCC, PC, and ratio of HCC to PC (HCCP) were studied. Subsequently, regression analysis and curve fitting were used to identify for better-performing indicators of chronic stress. Additionally, univariate and bivariate genetic evaluation were used to estimate the genetic components of cortisol traits and genotype by environment interactions (G × E) under different environmental and physiological states. The results showed that HCC and PC are significantly affected by hair color, sampling year, and season, whereas HCCP is not influenced by hair color. Adjusted PC and HCCP, where confounding effects are excluded, were moderately related with chronic stress indicators. Moderate to high heritabilities were obtained for HCC (0.347 and 0.390 for winter and summer, respectively), PC (0.402 and 0.495 for winter and summer, respectively) and HCCP (0.289 and 0.460 for winter and summer, respectively) when animals in the same season were evaluated. A moderate G × E interaction was detected in this study, as indicated by the low or negative genetic correlation for the same cortisol trait in different environments (e.g. heat stress condition and thermoneutral condition). In conclusion, HCCP is not affected by hair color compared with the other 2 traits; thus, it has potential as an indicator of chronic stress. Hair cortisol traits could monitor stress response process in cattle, as well as provide a better understanding of genetic mechanism for long-term HPA activity.
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Affiliation(s)
- R Shi
- Key Laboratory of Animal Genetics, Breeding and Reproduction, MARA, National Engineering Laboratory of Animal Breeding, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China
| | - J Dou
- Key Laboratory of Animal Genetics, Breeding and Reproduction, MARA, National Engineering Laboratory of Animal Breeding, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China
| | - J Liu
- Key Laboratory of Animal Genetics, Breeding and Reproduction, MARA, National Engineering Laboratory of Animal Breeding, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China; State Key Laboratory of Animal Nutrition, Institute of Animal Science, Chinese Academy of Agricultural Sciences, Beijing 100193, China
| | - A Sammad
- Key Laboratory of Animal Genetics, Breeding and Reproduction, MARA, National Engineering Laboratory of Animal Breeding, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China
| | - H Luo
- Key Laboratory of Animal Genetics, Breeding and Reproduction, MARA, National Engineering Laboratory of Animal Breeding, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China
| | - Yajing Wang
- State Key Laboratory of Animal Nutrition, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China
| | - G Guo
- Beijing Sunlon Livestock Development Co. Ltd., Beijing 100176, China
| | - Yachun Wang
- Key Laboratory of Animal Genetics, Breeding and Reproduction, MARA, National Engineering Laboratory of Animal Breeding, College of Animal Science and Technology, China Agricultural University, Beijing 100193, China.
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Wiechers DH, Brunner S, Herbrandt S, Kemper N, Fels M. Analysis of Hair Cortisol as an Indicator of Chronic Stress in Pigs in Two Different Farrowing Systems. Front Vet Sci 2021; 8:605078. [PMID: 33585618 PMCID: PMC7876061 DOI: 10.3389/fvets.2021.605078] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/04/2021] [Indexed: 12/31/2022] Open
Abstract
Confinement to farrowing crates is known to prevent sows from performing natural behavior, impairing animal welfare and possibly causing chronic stress. Hair cortisol analyses are increasingly used to detect chronic stress in animals. In the present study, hair samples were collected in the neck of sows kept either in farrowing crates (FC, n = 31) or in a loose-housing system (LH, n = 30) in six batches. Cortisol was extracted and analyzed using chemiluminescence immunoassay. Mean hair cortisol concentrations (HCC) did not differ significantly between the systems (LH: 1.85 ± 0.82 pg/mg, FC: 2.13 ± 1.53 pg/mg, P = 0.631). HCC was also not affected by other factors, such as sows' parity, number of piglets, skin lesion score or sow's weight loss during the farrowing period. However, highly significant differences were found in hair growth rates between different regions within the 20 × 30 cm shaving area. While the hair in both lateral parts of the shaving area grew almost identically (left: 7.48 ± 3.52 mm, right: 7.44 ± 3.24 mm, P = 1.00), the hair grew more in the area above the spine (12.27 + 3.95 mm, P < 0.001). In both systems, the mean individual lesion score of sows declined from the beginning to the end of the housing period (P < 0.001). No difference was found between FC and LH sows at any time (P > 0.05). Since neither the amount of skin lesions nor HCC differed between LH and FC sows, it may be concluded that confining sows in farrowing crates did not affect chronic stress levels. However, results may be affected by a downregulation of the hypothalamic-pituitary-adrenal axis during long-term stress, resulting in lower cortisol levels over time. HCC in sows may also be influenced by a dominant stressor, such as farrowing or the presence of suckling piglets. Thus, for a comparison of different farrowing systems regarding chronic stress, the use of hair cortisol measurement seems to be limited. The present results revealed that differences in hair growth rate within the same body region exist. This important finding should be considered when collecting hair samples in pigs, since hair cortisol concentrations may vary depending on hair growth and length.
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Affiliation(s)
- Dierck-Hinrich Wiechers
- Institute for Animal Hygiene, Animal Welfare and Farm Animal Behavior, University of Veterinary Medicine Hannover, Foundation, Hanover, Germany
| | - Susanne Brunner
- Department of Statistics, TU Dortmund University, Dortmund, Germany
| | | | - Nicole Kemper
- Institute for Animal Hygiene, Animal Welfare and Farm Animal Behavior, University of Veterinary Medicine Hannover, Foundation, Hanover, Germany
| | - Michaela Fels
- Institute for Animal Hygiene, Animal Welfare and Farm Animal Behavior, University of Veterinary Medicine Hannover, Foundation, Hanover, Germany
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31
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Elevated levels of cortisol in hair precede acute myocardial infarction. Sci Rep 2020; 10:22456. [PMID: 33384452 PMCID: PMC7775435 DOI: 10.1038/s41598-020-80559-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/22/2020] [Indexed: 01/06/2023] Open
Abstract
Long term stress exposure is typical for modern societies and might trigger different diseases. This case–control study reveals that persons who had suffered an acute myocardial infarction (AMI) had elevated cortisol concentrations in the month before the acute event. Middle-aged patients admitted to cardiology clinics with acute myocardial infarction (AMI) (n = 174) were compared to 3156 controls from a population-based cohort in southeast Sweden. The median Hair Cortisol Concentrations (HCC) for those who had suffered an AMI was 53.2 pg/mg compared to 22.2 pg/mg for the control group (p < 0.001). In bivariate analysis, higher levels of HCC were strongly (OR = 5.69) and statistically significantly associated with current AMI status. The discrimination of cases with AMI from controls remained statistically significant (OR = 5.04) even after controlling for established cardiovascular risk factors in a multivariate analysis. Middle-aged persons with acute myocardial infarction had significantly elevated cortisol levels during the month before the cardiac event. This was evident for both men and women. The biomarker cortisol concentration was independently and statistically significantly related to AMI. Chronic stress seems to be a new promising risk factor for AMI.
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Tarantola M, Biasato I, Biasibetti E, Biagini D, Capra P, Guarda F, Leporati M, Malfatto V, Cavallarin L, Miniscalco B, Mioletti S, Vincenti M, Gastaldo A, Capucchio MT. Beef cattle welfare assessment: use of resource and animal-based indicators, blood parameters and hair 20β-dihydrocortisol. ITALIAN JOURNAL OF ANIMAL SCIENCE 2020. [DOI: 10.1080/1828051x.2020.1743783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Martina Tarantola
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Grugliasco, Torino, Italy
| | - Ilaria Biasato
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Grugliasco, Torino, Italy
| | - Elena Biasibetti
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d’Aosta, Torino, Italy
| | - Davide Biagini
- Dipartimento di Scienze Agrarie, Forestali e Alimentari, Università degli Studi di Torino, Grugliasco, Torino, Italy
| | - Pierluigi Capra
- Istituto di Scienze delle Produzioni Alimentari (ISPA-CNR), Grugliasco, Torino, Italy
| | - Franco Guarda
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Grugliasco, Torino, Italy
| | - Marta Leporati
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Regione Gonzole 10/1, Orbassano, Torino, Italy
| | - Vanda Malfatto
- Dipartimento di Scienze Agrarie, Forestali e Alimentari, Università degli Studi di Torino, Grugliasco, Torino, Italy
| | - Laura Cavallarin
- Istituto di Scienze delle Produzioni Alimentari (ISPA-CNR), Grugliasco, Torino, Italy
| | - Barbara Miniscalco
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Grugliasco, Torino, Italy
| | - Silvia Mioletti
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Grugliasco, Torino, Italy
| | - Marco Vincenti
- Centro Regionale Antidoping e di Tossicologia “A. Bertinaria”, Regione Gonzole 10/1, Orbassano, Torino, Italy
- Dipartimento di Chimica, Università degli Studi di Torino, Torino, Italy
| | | | - Maria Teresa Capucchio
- Dipartimento di Scienze Veterinarie, Università degli Studi di Torino, Grugliasco, Torino, Italy
- Istituto di Scienze delle Produzioni Alimentari (ISPA-CNR), Grugliasco, Torino, Italy
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Marteinsdottir I, Sydsjö G, Faresjö Å, Theodorsson E, Josefsson A. Parity-related variation in cortisol concentrations in hair during pregnancy. BJOG 2020; 128:637-644. [PMID: 32985075 PMCID: PMC7894509 DOI: 10.1111/1471-0528.16542] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 09/10/2020] [Accepted: 09/23/2020] [Indexed: 12/26/2022]
Abstract
Objective To investigate hair cortisol concentrations (HCC) monthly in pregnant women and to explore the effect of parity. Design Prospective cohort study from gestational week (GW) 26, at childbirth and postpartum. Setting An antenatal care clinic in southeast Sweden. Sample 390 pregnant women. Methods Cortisol was measured using radioimmunoassay in methanol extracts of ground hair samples. Main outcome measures Hair cortisol concentrations. Results Both primi‐ and multiparae exhibited an increase in HCC throughout pregnancy. Primiparae had significantly higher HCC in the latter part of the last trimester compared with multiparae (1 month P = 0.003, 2 months P = 0.038). The use of psychotropic medication in the first trimester correlated to HCC postpartum (P < 0.001). HCC in GW 14–17 was associated with HCC in GW 18–21 (primiparae and multiparae, P < 0.001), GW 22–25 (primiparae P = 0.036, multiparae P = 0.033), and 2 months postpartum (primiparae P = 0.049). HCC in GW 18–21 was associated with GW 22–25 in both primiparae (P < 0.001) and multiparae (P < 0.001) as well as 2 months prior to childbirth among primiparae (<0.037). In general, all estimates of HCC in pregnancy and postpartum showed a significant association between HCC for a specific month and the HCC in the previous month (all P < 0.001), except for the association of HCC among primiparae in GW 22–25 and 3 months prior to childbirth. Conclusions Increased cortisol concentrations in hair were observed during pregnancy, which decreased 3 months prior to childbirth in multiparae. The results indicate a quicker suppression of the hypothalamic CRH (corticotropin‐releasing hormone) production by placenta CRH in multiparous women. Tweetable abstract Multiparae have a quicker suppression of hypothalamic CRH production by placenta CRH during pregnancy compared to primiparae. Multiparae have a quicker suppression of hypothalamic CRH production by placenta CRH during pregnancy compared with primiparae.
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Affiliation(s)
- I Marteinsdottir
- Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
| | - G Sydsjö
- Faculty of Medicine and Health Sciences, Department of Obstetrics and Gynaecology in Linköping and Division of Children's and Women's Health, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Å Faresjö
- Division of Society and Health, Department of Health, Medicine and Caring Sciences. Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - E Theodorsson
- Division of Clinical Chemistry, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - A Josefsson
- Faculty of Medicine and Health Sciences, Department of Obstetrics and Gynaecology in Linköping and Division of Children's and Women's Health, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Banse HE, Getachew F, Levy M, Smits J. Influence of season and pituitary pars intermedia dysfunction on hair cortisol concentration in horses. Domest Anim Endocrinol 2020; 72:106375. [PMID: 31431311 DOI: 10.1016/j.domaniend.2019.07.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 06/21/2019] [Accepted: 07/09/2019] [Indexed: 01/09/2023]
Abstract
Hair cortisol has been demonstrated to reflect hypothalamic-pituitary-adrenal axis activity (including Cushing's disease and stress) in several species. We hypothesized that hair cortisol concentrations are increased in horses with pituitary pars intermedia dysfunction (PPID) compared with healthy adult horses and that this difference is magnified in the fall, when circulating adrenocorticotropin (ACTH) is generally the highest. Cortisol from hair collected using clippers with a #40 blade from the neck was compared between PPID horses and control horses over several months in the fall (August-December) and 1 mo in spring (May). Cortisol from hair at several sampling sites (neck, jugular furrow, sternum, and submandibular) were compared between PPID (n = 6) and control (n = 8) horses in May. Relationships between hair cortisol and ACTH were assessed in the fall. Hair cortisol when measured by weight was higher in PPID vs control horses in October and November (P ≤ 0.01) but not December (P = 0.15), May (P > 0.7), or August-September (P = 0.18). When normalized for hair length, hair cortisol was higher in PPID vs control horses in November (P = 0.0006), but not October or December (P ≥ 0.06). Hair cortisol concentrations did not differ between PPID and control horses from any collection site in May (P > 0.7). There were no consistent relationships between ACTH and hair cortisol concentrations in October, November, or December (P ≥ 0.05). These findings suggest that PPID horses have increased hair cortisol accumulation in the fall compared with control horses. Additional work is needed to clarify whether assessing cortisol per weight or per hair length is most relevant in the horse.
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Affiliation(s)
- H E Banse
- Department of Veterinary Clinical Sciences, Louisiana State University, Baton Rouge, LA 70803, USA.
| | - F Getachew
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4Z1, Canada
| | - M Levy
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4Z1, Canada
| | - J Smits
- Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 4Z1, Canada
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35
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Sandstrom A, Daoust AR, Russell E, Koren G, Hayden EP. Hair cortisol concentrations predict change in girls’ depressive symptoms. EUROPEAN JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2020. [DOI: 10.1080/17405629.2020.1774359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Andrea Sandstrom
- Department of Psychology, University of Western Ontario, London, ON, Canada
| | - Andrew R. Daoust
- Department of Psychology, University of Western Ontario, London, ON, Canada
| | - Evan Russell
- Department of Physiology/Pharmacology, University of Western Ontario, London, ON, Canada
| | - Gideon Koren
- Department of Physiology/Pharmacology, University of Western Ontario, London, ON, Canada
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Wagner M, Kratzsch J, Vogel M, Peschel T, Gaudl A, Ceglarek U, Thiery J, Hiemisch A, Körner A, Kiess W. Hair Cortisol Concentration in Healthy Children and Adolescents Is Related to Puberty, Age, Gender, and Body Mass Index. Horm Res Paediatr 2020; 92:237-244. [PMID: 31851970 DOI: 10.1159/000504914] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 11/20/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Hair cortisol concentrations (HCC) have been found to be related to various common childhood diseases, like otitis media, conjunctivitis, respiratory viral infections, and asthma. However, the confounding effects of age, gender, body mass index (BMI), pubertal stage (Tanner stages), socioeconomic status (SES) as well as of some hair maintenance procedures on HCC are still not well examined. METHODS A population-based cohort of 434 children aged between 5 and 18 years was examined for HCC between January 2012 and February 2015 in the context of the Leipzig Research Centre for Civilization Diseases (LIFE) Child study. Thereby, anthropometric data, gender, BMI, SES and pubertal status were assessed. HCC was measured by liquid chromatography mass spectrometry. RESULTS In the total cohort, HCC levels ranged between 0.95 and 29.86 pg/mg. In prepuberty, boys showed significantly higher HCC than girls (6.54 vs. 3.73 pg/mg, p < 0.05). During puberty HCC values in both genders converged. Higher BMI was significantly associated with higher HCC in both genders. In girls, HCC did not differ depending on Tanner stages. In boys, HCC was significantly higher in Tanner stage 1 than in stages 2-5. CONCLUSION Measuring cortisol concentration in hair gives information about long-term release of cortisol. We have found that puberty, gender, and BMI had a profound effect on HCC. As a result, further research should take into account the potentially confounding role of puberty, gender and BMI and may use the results of our study as a reference at determining values of HCC in healthy children.
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Affiliation(s)
- Maximiliane Wagner
- Department of Women & Child Health, Hospital for Children and Adolescents, Centre for Paediatric Research, Leipzig University, Leipzig, Germany, .,LIFE-Child-Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany,
| | - Jürgen Kratzsch
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University, Leipzig, Germany
| | - Mandy Vogel
- Department of Women & Child Health, Hospital for Children and Adolescents, Centre for Paediatric Research, Leipzig University, Leipzig, Germany.,LIFE-Child-Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Thomas Peschel
- Department of Women & Child Health, Hospital for Children and Adolescents, Centre for Paediatric Research, Leipzig University, Leipzig, Germany.,LIFE-Child-Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Alexander Gaudl
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University, Leipzig, Germany
| | - Uta Ceglarek
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University, Leipzig, Germany
| | - Joachim Thiery
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, Leipzig University, Leipzig, Germany
| | - Andreas Hiemisch
- Department of Women & Child Health, Hospital for Children and Adolescents, Centre for Paediatric Research, Leipzig University, Leipzig, Germany.,LIFE-Child-Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Antje Körner
- Department of Women & Child Health, Hospital for Children and Adolescents, Centre for Paediatric Research, Leipzig University, Leipzig, Germany.,LIFE-Child-Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Wieland Kiess
- Department of Women & Child Health, Hospital for Children and Adolescents, Centre for Paediatric Research, Leipzig University, Leipzig, Germany.,LIFE-Child-Leipzig Research Centre for Civilization Diseases, Leipzig University, Leipzig, Germany
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37
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González-Moret R, Cebolla A, Cortés X, Baños RM, Navarrete J, de la Rubia JE, Lisón JF, Soria JM. The effect of a mindfulness-based therapy on different biomarkers among patients with inflammatory bowel disease: a randomised controlled trial. Sci Rep 2020; 10:6071. [PMID: 32269278 PMCID: PMC7142151 DOI: 10.1038/s41598-020-63168-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 03/19/2020] [Indexed: 02/06/2023] Open
Abstract
Mindfulness-based interventions have shown some efficacy in decreasing stress levels and improving quality of life. However, so far, only a few studies have studied this type of intervention among patients with inflammatory bowel disease and none of them have studied their effects on inflammatory biomarkers. This current study was a two-armed, single-centre, randomised (2:1 ratio) controlled trial used to evaluate the effects of a mindfulness-based intervention (n = 37) compared to standard medical therapy (n = 20) in patients with Crohn’s disease or ulcerative colitis. The mindfulness intervention blended four internet-based therapy modules with four face-to-face support sessions. The outcomes we assessed were faecal calprotectin (primary outcome), C-reactive protein, and cortisol levels measured in hair samples at several timepoints. The between-group analysis highlighted significant decreases in faecal calprotectin and in C-reactive protein levels in the mindfulness-based intervention group compared to the standard medical therapy group at the six-month follow-up (faecal calprotectin: −367, [95% CI: −705, −29], P = 0.03; C-reactive protein: −2.82, [95% CI: −5.70, 0.08], P = 0.05), with moderate to large effect sizes (faecal calprotectin: ηp2 = 0.085; C-reactive protein: ηp2 = 0.066). We concluded that mindfulness-based therapy administered as part of standard clinical practice effectively improves inflammatory biomarkers in patients diagnosed with inflammatory bowel disease.
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Affiliation(s)
- Rafael González-Moret
- Department of Nursing, Universidad Cardenal Herrera-CEU, CEU Universities, Castellon, Spain
| | - Ausias Cebolla
- Department of Personality, Evaluation, and psychological treatments, Universidad de Valencia, Valencia, Spain.,Obesity and Nutrition Pathophysiology CIBER (CB06/03), Instituto Carlos III, Madrid, Spain
| | - Xavier Cortés
- Internal Medicine Service, Digestive Medicine Section, Hospital Universitario de Sagunto, Valencia, Spain
| | - Rosa M Baños
- Department of Personality, Evaluation, and psychological treatments, Universidad de Valencia, Valencia, Spain.,Obesity and Nutrition Pathophysiology CIBER (CB06/03), Instituto Carlos III, Madrid, Spain
| | - Jaime Navarrete
- Department of Personality, Evaluation, and psychological treatments, Universidad de Valencia, Valencia, Spain
| | | | - Juan Francisco Lisón
- Institute of Biomedical Sciences, Universidad Cardenal Herrera-CEU Universities, Valencia, Spain.,Odisesas Institute, Universidad CEU Cardenal Herrera-CEU Universities, Valencia, Spain.,Department of Medicine, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain.,Obesity and Nutrition Pathophysiology CIBER (CB06/03), Instituto Carlos III, Madrid, Spain
| | - José Miguel Soria
- Department of Biomedical Sciences, Universidad Cardenal Herrera-CEU Universities, Valencia, Spain. .,Institute of Biomedical Sciences, Universidad Cardenal Herrera-CEU Universities, Valencia, Spain. .,Odisesas Institute, Universidad CEU Cardenal Herrera-CEU Universities, Valencia, Spain.
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Song X, Cui W, Peng Z, Zhao L, Yu X, Li T, Cui L, Ma X. An initial exploration of hair cortisol responses to antidepressants in unmedicated patients with depression. J Int Med Res 2019; 48:300060519889431. [PMID: 31849246 PMCID: PMC7604987 DOI: 10.1177/0300060519889431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Major depressive disorder is associated with abnormal functioning of the hypothalamic-pituitary-adrenal (HPA) axis. Studies using hair cortisol to measure the effect of antidepressants on the HPA axis are lacking. The aim of this study was to explore the long-term effects of antidepressants on hair cortisol concentration (HCC). METHODS Participants were 42 patients and 36 healthy individuals. The patients took antidepressants for 4 weeks. Patient HCC was measured pre-treatment and post-treatment. The HCC of healthy controls was also measured. RESULTS Patient post-treatment HCC (mean ± standard deviation: 34.40 ± 32.57 pmol/mg) was significantly higher than patient pre-treatment HCC (17.42 ± 12.40 pmol/mg) and healthy control HCC (10.22 ± 7.99 pmol/mg). No significant correlation was found between Hamilton Depression Rating Scale scores and HCC at pre-treatment or post-treatment. CONCLUSIONS Hair cortisol concentration analysis could be used to monitor the dynamics of the effects of antidepressants on the HPA axis.
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Affiliation(s)
- Xiuli Song
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, P. R. China.,Clinical Psychology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, P. R. China
| | - Wei Cui
- Mental Health Center of Hebei Province, Baoding, P. R. China
| | - Zugui Peng
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Liansheng Zhao
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Xuezhu Yu
- Mental Health Center of Hebei Province, Baoding, P. R. China
| | - Tao Li
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, P. R. China
| | - Lijun Cui
- Mental Health Center of Hebei Province, Baoding, P. R. China
| | - Xiaohong Ma
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, P. R. China
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Wang X, Busch JR, Banner J, Linnet K, Johansen SS. Hair testing for cortisol by UPLC–MS/MS in a family: External cross-contamination from use of cortisol cream. Forensic Sci Int 2019; 305:109968. [DOI: 10.1016/j.forsciint.2019.109968] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/22/2019] [Accepted: 09/27/2019] [Indexed: 01/08/2023]
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40
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Jackson SE, Firth J, Grabovac I, Koyanagi A, Stubbs B, Soysal P, Willmott A, Yang L, Smith L. Sedentary behaviour and chronic stress in old age: A cross-sectional analysis of TV viewing and hair cortisol concentrations. Psychoneuroendocrinology 2019; 109:104375. [PMID: 31302361 DOI: 10.1016/j.psyneuen.2019.104375] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/21/2019] [Accepted: 07/05/2019] [Indexed: 12/11/2022]
Abstract
PURPOSE Several studies have reported a positive association between sedentary behaviour and perceived stress, but none using a population-based sample has examined this relationship using an objective measure of stress exposure. The aim of this study was therefore to analyse the association between sedentary behaviour (operationalised as daily TV viewing time) and levels of cortisol in hair (an objective measure of chronic stress) using data from a large population-based sample of older adults. METHOD Analyses used cross-sectional data from older adults (≥50 years) participating in Wave 6 (2012/13) of the English Longitudinal Study of Ageing. Hair cortisol concentrations were determined from the scalp-nearest 2 cm hair segment. TV viewing time was self-reported and categorised as <2, 2 < 4, 4 < 6, or ≥6 h/day. Covariates included age, sex, ethnicity, education, wealth, limiting long-standing illness, cardiovascular disease, diabetes, smoking status, alcohol intake, physical activity, body mass index, and depressive symptoms. RESULTS The sample comprised 3555 men and women, of whom 284 (8.0%) reported watching less than 2 h of TV per day, 1160 (32.6%) 2-4 h, 1079 (30.4%) 4-6 h, and 1032 (29.0%) ≥6 h. Mean hair cortisol concentrations for those spending <2, 2 < 4, 4 < 6, and ≥6 h per day watching TV were 0.862, 0.880, 0.889, and 0.934 log pg/mg, respectively. Differences between groups were not statistically significant in unadjusted (p = .088) or adjusted (p = .663) models. CONCLUSION In a large sample of older adults in England, self-reported sedentary behaviour was not associated with a biomarker of chronic stress.
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Affiliation(s)
- Sarah E Jackson
- Department of Behavioural Science and Health, University College London, 1-19 Torrington Place, London WC1E 6BT, UK.
| | - Joseph Firth
- NICM Health Research Institute, Western Sydney University, Westmead, Australia; Division of Psychology and Mental Health, University of Manchester, Manchester, UK; Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK; Positive Ageing Research Institute, Faculty of Health, Social Care, Medicine and Education, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, CM1 1SQ, UK
| | - Pinar Soysal
- Department of Geriatric Medicine, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey
| | - Ash Willmott
- The Cambridge Centre for Sport and Exercise Science, Anglia Ruskin University Cambridge UK
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Albert Health Services, Calgary, Canada; Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, Canada
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Science, Anglia Ruskin University Cambridge UK
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Berlińska A, Świątkowska-Stodulska R, Sworczak K. Factors Affecting Dexamethasone Suppression Test Results. Exp Clin Endocrinol Diabetes 2019; 128:667-671. [PMID: 31652475 DOI: 10.1055/a-1017-3217] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Dexamethasone suppression tests are basic tools in diagnostics of hypercortisolemia. Low-dose tests play major role in screening and initial assessment. High-dose tests are aimed at more elaborate diagnostics, however their clinical value is questionable. Dexamethasone is a highly potent, synthetic steroid. It is metabolized by cytochrome P450 3A4 (CYP3A4), and so are various other xenobiotics. Due to wide spectrum of substances processed by CYP3A4, interferences and interactions are not uncommon. Physicians should be familiar with drugs modifying dexamethasone metabolism, and therefore the results of dynamic tests. Other important concerns are: drugs enhancing cortisol-binding globulin production, organ dysfunction, pseudo-Cushing states, pregnancy and other physiological conditions leading to elevated blood cortisol, cyclic Cushing disease. To properly assess and assist patients, it is crucial for health professionals to understand and be able to overcome such clinical dilemmas.
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Affiliation(s)
- A Berlińska
- Department of Endocrinology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - R Świątkowska-Stodulska
- Department of Endocrinology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - K Sworczak
- Department of Endocrinology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
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Söder E, Clamor A, Lincoln TM. Hair cortisol concentrations as an indicator of potential HPA axis hyperactivation in risk for psychosis. Schizophr Res 2019; 212:54-61. [PMID: 31455519 DOI: 10.1016/j.schres.2019.08.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 07/10/2019] [Accepted: 08/05/2019] [Indexed: 12/24/2022]
Abstract
A chronic hyperactivation of the hypothalamic-pituitary-adrenal (HPA) axis is assumed to be an important indicator of vulnerability for psychosis. Despite the considerable research on this topic, putative social origins of HPA axis hyperactivation have received little attention in the literature so far. Also, the inconsistency of previous findings calls for new and reliable methods in the assessment of HPA axis activation. To address these issues, we used hair cortisol concentrations as an indicator of chronic HPA axis activation in participants at elevated risk for psychosis (clinical risk: n = 43, familial risk: n = 32) and low-risk controls (n = 35), and assessed its relation with a variety of social stressors. We also tested the interaction effect between social stressors and familial risk status on hair cortisol concentrations (moderation analysis). Participants at elevated risk for psychosis did not show significantly higher hair cortisol concentrations than low-risk controls. However, severe social stressors (child abuse experiences, traumatic events) predicted hair cortisol concentrations in the total sample. This relationship was not significantly moderated by familial risk status (as a marker of genetic risk). The results challenge the assumption that HPA axis hyperactivation is an early vulnerability indicator for psychosis but leave the possibility that it manifests only at more severe risk stages. Furthermore, the findings suggest that acquired experiences contribute to the emergence of HPA axis hyperactivation, which might occur via a gene-environment correlation rather than via a gene-environment interaction.
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Affiliation(s)
- Eveline Söder
- Universität Hamburg, Clinical Psychology and Psychotherapy, Institute of Psychology, Von-Melle-Park 5, 20146 Hamburg, Germany.
| | - Annika Clamor
- Universität Hamburg, Clinical Psychology and Psychotherapy, Institute of Psychology, Von-Melle-Park 5, 20146 Hamburg, Germany
| | - Tania M Lincoln
- Universität Hamburg, Clinical Psychology and Psychotherapy, Institute of Psychology, Von-Melle-Park 5, 20146 Hamburg, Germany
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Prado-Gascó V, de la Barrera U, Sancho-Castillo S, de la Rubia-Ortí JE, Montoya-Castilla I. Perceived stress and reference ranges of hair cortisol in healthy adolescents. PLoS One 2019; 14:e0214856. [PMID: 30947316 PMCID: PMC6448926 DOI: 10.1371/journal.pone.0214856] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 03/21/2019] [Indexed: 12/11/2022] Open
Abstract
Background Chronic stress during adolescence has usually been evaluated through subjective measures, leaving aside objective measures such as hair cortisol concentrations. Therefore, the aim of this study was to provide reference ranges for hair cortisol concentrations by sex and age and to study the relationship between subjective and objective measures of stress and temporal stability. Methods The participants were 170 adolescents aged between 12 and 14 years (mean = 12.78 years; standard deviation = 0.71 years; 52.40% girls) who completed the Perceived Stress Scale 4 and had their hair sampled. Results The results revealed hair cortisol concentrations ranging from 0.07 pg/mg to 9.54 pg/mg. Subjective and objective measures of stress were not related, nor was there intraindividual stability of the hair cortisol concentrations. Girls had higher hair cortisol concentrations, and there were no age differences. Conclusions This research provides cortisol reference values for adolescents that will allow the early detection of chronic stress. Such detection methods make it possible to prevent problems arising from stress because we can act more quickly and the treatments will be more effective. The study suggests that there is no relationship between perceived and objective stress; while perceived stress remained stable, the levels of hair cortisol were increased at 6 months. Despite the interesting findings of the study, there are some limitations: the sample was not obtained through probabilistic sampling, the age range was narrow, and some demographic, anthropomorphic and clinical factors are missing, which make the generalization of results difficult.
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Affiliation(s)
| | - Usue de la Barrera
- Department of Personality, Assessment and Psychological Treatment, University of Valencia, Valencia, Spain
| | | | | | - Inmaculada Montoya-Castilla
- Department of Personality, Assessment and Psychological Treatment, University of Valencia, Valencia, Spain
- * E-mail:
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25-Hydroxyvitamin D Measurement in Human Hair: Results from a Proof-of-Concept study. Nutrients 2019; 11:nu11020423. [PMID: 30781610 PMCID: PMC6412768 DOI: 10.3390/nu11020423] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/03/2019] [Accepted: 02/14/2019] [Indexed: 12/27/2022] Open
Abstract
Vitamin D deficiency has been implicated in numerous human diseases leading to an increased interest in assessing vitamin D status. Consequentially, the number of requests for vitamin D measurement keeps dramatically increasing year-on-year. Currently, the recognised best marker of vitamin D status is the concentration of the 25-hydroxyvitamin D (25(OH)D3) in the blood circulation. While providing an accurate estimate of vitamin D status at the point in time of sampling, it cannot account for the high variability of 25(OH)D3 concentration. In this proof of concept study we set out to provide evidence that 25(OH)D3 can be extracted from hair samples in a similar fashion to steroid hormones. Two of the authors (L.Z. and M.H.) provided hair samples harvested from the crown area of the scalp and the third author (E.L.) provided beard samples. These samples, cut into 1 cm lengths, were weighed, washed and dried. 25(OH)D was extracted using a previously published steroid hormones extraction procedure. Blood samples were taken from the subjects at the same time all tissue samples were analysed using liquid-chromatography mass spectrometry. Hair samples showed presence of quantifiable 25(OH)D3 with concentrations ranging from 11.9–911 pg/mg. The beard sample had a concentration of 231 pg/mg. Serum levels of 25(OH)D3 ranged from 72–78 nmol/L. The results presented here confirm the feasibility of measuring 25(OH)D3 in hair samples. The findings warrant further validation and development and have the potential to yield valuable information relating to temporal trends in vitamin D physiology.
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Vandeleest J, Capitanio J, Hamel A, Meyer J, Novak M, Mendoza S, McCowan B. Social stability influences the association between adrenal responsiveness and hair cortisol concentrations in rhesus macaques. Psychoneuroendocrinology 2019; 100:164-171. [PMID: 30342315 PMCID: PMC6333515 DOI: 10.1016/j.psyneuen.2018.10.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 08/27/2018] [Accepted: 10/11/2018] [Indexed: 12/14/2022]
Abstract
Hair cortisol concentrations are increasingly being used in both humans and nonhuman animals as a biomarker of chronic stress. However, many details regarding how hair cortisol concentrations relate to the dynamic activity and regulation of the HPA axis are still unknown. The current study explores 1) how the regulation of the HPA axis in infancy relates to hair cortisol concentrations (HCC) in infancy 2) whether this relationship persists into adulthood under conditions of social stability, and 3) how social instability impacts these relationships. All subjects were rhesus monkeys housed in large social groups at the California National Primate Research Center, and all had participated in a 25-hr. long BioBehavioral Assessment (BBA) at 3-4 months of age when four plasma samples were taken to assess HPA regulation, in particular cortisol responses to 1) 2-hour social separation and relocation, 2) sustained challenge, 3) dexamethasone and 4) ACTH administration. In Study 1, hair samples were collected at the end of the BBA testing from 25 infant rhesus monkeys from 2 different stable social groups. In Study 2, hair samples were obtained at three timepoints from 108 adults from 3 different stable social groups (1 in the Spring/Summer and 2 in the Fall/Winter) to examine the temporal stability of the relationship between HCC and HPA axis regulation. In Study 3, subjects included 31 infants and 33 adults from a single social group experiencing social instability following the same procedures as in Studies 1 and 2. Generalized linear models were used to determine if infants' HPA axis activity and regulation predicted HCC in infancy (Study 1), in adulthood with animals living in stable social conditions (Study 2) or in animals living in an unstable social group (Study 3). Results indicated that for both infants and adults living in stable social groups, HCC are associated with the adrenal response to ACTH in infancy. Samples collected in the winter also had higher HCC than those collected in summer. In the unstable social group, adult hair cortisol levels were higher than in the stable social groups. Additionally, there were no consistent relationships between HCC and infant HPA axis regulation among adults or infants living in a group experiencing social instability. These results suggest that the aspects of the HPA axis that drive HCC may differ depending on context. Under stable, non-stressed conditions there seems to be a trait-like association between adrenal responsivity and HCC in infancy and adulthood. However, this association may be reduced or eliminated under conditions of social stress.
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Affiliation(s)
- J.J. Vandeleest
- California National Primate Research Center, University of California-Davis, One Shields Avenue, Davis, CA, 95616, USA,Corresponding author: California National Primate Research Center, University of California-Davis, One Shields Avenue, Davis, CA 956167, USA, Phone: 1-530-752-1506, Fax: 1-530-752-2880,
| | - J.P. Capitanio
- California National Primate Research Center, University of California-Davis, One Shields Avenue, Davis, CA, 95616, USA
| | - A. Hamel
- Department of Psychology and Brain Sciences, 441 Tobin Hall, University of Massachusetts, Amherst, MA, 01003 USA
| | - J. Meyer
- Department of Psychology and Brain Sciences, 441 Tobin Hall, University of Massachusetts, Amherst, MA, 01003 USA
| | - M. Novak
- Department of Psychology and Brain Sciences, 441 Tobin Hall, University of Massachusetts, Amherst, MA, 01003 USA
| | - S.P. Mendoza
- California National Primate Research Center, University of California-Davis, One Shields Avenue, Davis, CA, 95616, USA
| | - B McCowan
- California National Primate Research Center, University of California-Davis, One Shields Avenue, Davis, CA, 95616, USA,Department of Population Health & Reproduction, School of Veterinary Medicine, University of California-Davis, One Shields Avenue, Davis, CA, 95616, USA
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Savas M, Wester VL, de Rijke YB, Rubinstein G, Zopp S, Dorst K, van den Berg SAA, Beuschlein F, Feelders RA, Reincke M, van Rossum EFC. Hair Glucocorticoids as a Biomarker for Endogenous Cushing's Syndrome: Validation in Two Independent Cohorts. Neuroendocrinology 2019; 109:171-178. [PMID: 30759443 DOI: 10.1159/000498886] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 02/12/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS The current diagnostic workup of Cushing's syndrome (CS) requires various tests which only capture short-term cortisol exposure, whereas patients with endogenous CS generally have elevated cortisol levels over longer periods of time. Scalp hair assessment has emerged as a convenient test in capturing glucocorticoid concentrations over long periods of time. The aim of this multicenter, multinational, prospective, case-control study was to evaluate the diagnostic efficacy of scalp hair glucocorticoids in screening of endogenous CS. METHODS We assessed the diagnostic performances of hair cortisol (HairF), hair cortisone (HairE), and the sum of both (sumHairF+E), as measured by a state-of-the-art LC-MS/MS technique, in untreated patients with confirmed endogenous CS (n = 89) as well as in community controls (n = 295) from the population-based Lifelines cohort study. RESULTS Both glucocorticoids were significantly elevated in CS patients when compared to controls. A high diagnostic efficacy was found for HairF (area under the curve 0.87 [95% CI: 0.83-0.92]), HairE (0.93 [0.89-0.96]), and sumHairF+E (0.92 [0.88-0.96]) (all p < 0.001). The participants were accurately classified at the optimal cutoff threshold in 86% of the cases (81% sensitivity, 88% specificity, and 94% negative predictive value [NPV]) by HairF, in 90% of the cases (87% sensitivity, 90% specificity, and 96% NPV) by HairE, and in 87% of the cases (86% sensitivity, 88% specificity, and 95% NPV) by the sumHairF+E. HairE was shown to be the most accurate in differentiating CS patients from controls. CONCLUSION Scalp hair glucocorticoids, especially hair cortisone, can be seen as a promising biomarker in screening for CS. Its convenience in collection and workup additionally makes it feasible for first-line screening.
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Affiliation(s)
- Mesut Savas
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Obesity Center CGG (Centrum Gezond Gewicht), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Vincent L Wester
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Obesity Center CGG (Centrum Gezond Gewicht), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Yolanda B de Rijke
- Obesity Center CGG (Centrum Gezond Gewicht), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - German Rubinstein
- Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Stephanie Zopp
- Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Kristien Dorst
- Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Sjoerd A A van den Berg
- Department of Clinical Chemistry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Felix Beuschlein
- Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-Universität München, Munich, Germany
- Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitäts-Spital Zürich, Zurich, Switzerland
| | - Richard A Feelders
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Martin Reincke
- Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Elisabeth F C van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,
- Obesity Center CGG (Centrum Gezond Gewicht), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands,
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Abdulateef DS, Mahwi TO. Assessment of hair cortisol in euthyroid, hypothyroid, and subclinical hypothyroid subjects. Endocrine 2019; 63:131-139. [PMID: 30191442 DOI: 10.1007/s12020-018-1743-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 08/30/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Hypothyroidism is associated with an increase in serum cortisol level while the long-term activity of hypothalamic-pituitary-adrenal (HPA) axis in hypothyroid, and subclinical hypothyroid (SCH) subjects has not been studied. This study aimed to assess the hair cortisol levels as a long-term activity of HPA axis in hypothyroid, SCH and a group of healthy adult subjects. Also, it aimed to examine the correlation of hair cortisol levels with hypothalamic-pituitary-thyroid (HPT) axis and anthropometric measures. METHODS We prospectively evaluated a group of normal, SCH and hypothyroid subjects. Serum TSH, FT4, and FT3 were measured as a component of the HPT axis. Hair samples were collected, prepared, followed by extraction of hair cortisol and measurement in pg/mg of hair. Hair cortisol levels were compared in normal, SCH and hypothyroid groups and correlated with HPT axis and anthropometric data. RESULTS A total of 65 healthy volunteers were analyzed, and the mean hair cortisol level was reported to be 17.38 pg/mg of hair. Hair cortisol level was slightly higher in the SCH subjects, 18.19 pg/mg of hair; however the difference was not significant. Compared to the euthyroid subject, a significantly higher hair cortisol level was recorded in the hypothyroid subjects, 24.17 pg/mg hair, p < .05. Hair cortisol was significantly and positively associated with each of the serum TSH, age, weight and BMI (p < .05). CONCLUSIONS Overt hypothyroidism but not SCH is significantly associated with higher hair cortisol levels compared to normal subjects, and a significant relation between hair cortisol with HPT axis was found. Also, weight and BMI were positively correlated with hair cortisol level.
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Affiliation(s)
- Darya Saeed Abdulateef
- Physiology Department, College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan region, Iraq.
| | - Taha Othman Mahwi
- Department of Medicine, College of Medicine, University of Sulaimani, Sulaymaniyah, Kurdistan region, Iraq
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Garcia-Leon MA, Peralta-Ramirez MI, Arco-Garcia L, Romero-Gonzalez B, Caparros-Gonzalez RA, Saez-Sanz N, Santos-Ruiz AM, Montero-Lopez E, Gonzalez A, Gonzalez-Perez R. Hair cortisol concentrations in a Spanish sample of healthy adults. PLoS One 2018; 13:e0204807. [PMID: 30265722 PMCID: PMC6161874 DOI: 10.1371/journal.pone.0204807] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 09/15/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Hair cortisol concentration (HCC), as a novel promising method to retrospectively measure hypothalamic-pituitary-adrenal (HPA) axis activation, is being increasingly studied. We tested the relationships between HCC and a range of possible confounding variables in a Spanish sample of healthy adults and pregnant women. METHODS The number of healthy adults who participated in the study was 529, being 270 males and 259 females, with a combined mean age of 37.88 years (SD = 15.66). Additionally, a separate sample of 62 pregnant women was also recruited with a mean age of 32.95 (SD = 3.67), and in the first trimester of pregnancy. Each participant was interviewed before the study to obtain sociodemographic and lifestyle variables, and a hair sample was taken from the posterior vertex of the head, cut as close to the scalp as possible. Assuming the average growth rate of head hair is 1 cm per month, a 3-cm segment was analysed, in order to measure the cortisol concentrations from a three-month period. For the pregnant women, hair samples for each trimester of pregnancy were analysed. RESULTS The mean hair cortisol concentration was 127.91 (111.52) pg/mg for the general sample. The variables of age, education, employment status, use of hair dyes, use of oral contraceptives, and physical exercise had a significant relation to HCC. When adjusted for further variables, only education and physical exercise remained statistically significant. When including the use of oral contraceptives and only with respect to females, only physical exercise remains statistically significant. For the subsample of pregnant woman, the mean hair cortisol concentration was 334.51 (409.77) pg/mg for the first trimester, 302.18 (270.24) pg/mg for the second trimester, and 331.31 (295.46) pg/mg for the third trimester of pregnancy. None of the assessed confounding variables (age, body mass index, previous miscarriages, employment status, hair dyes, dependent children and physical exercise), except education level, was related to HCC. CONCLUSIONS In this sample of healthy Spaniards, results suggested an association between HCC and physical exercise and educational level. In pregnant women, the prevalence of HCC was higher than in non-pregnant woman, and was related to educational level. This study emphasises the need to determine the relationship between HCC and confounders such as sociodemographic and lifestyle variables in the general population and specific groups formed by individuals such as pregnant women.
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Affiliation(s)
- Maria Angeles Garcia-Leon
- School of Psychology, University of Granada, Granada, Spain
- Mind, Brain and Behavior Research Center (CIMCYC), Granada, Spain
| | - Maria Isabel Peralta-Ramirez
- School of Psychology, University of Granada, Granada, Spain
- Mind, Brain and Behavior Research Center (CIMCYC), Granada, Spain
| | | | - Borja Romero-Gonzalez
- School of Psychology, University of Granada, Granada, Spain
- Mind, Brain and Behavior Research Center (CIMCYC), Granada, Spain
| | - Rafael A. Caparros-Gonzalez
- School of Psychology, University of Granada, Granada, Spain
- Mind, Brain and Behavior Research Center (CIMCYC), Granada, Spain
| | - Noelia Saez-Sanz
- School of Psychology, University of Granada, Granada, Spain
- Mind, Brain and Behavior Research Center (CIMCYC), Granada, Spain
| | - Ana Maria Santos-Ruiz
- Health Psychology, School of Science Health, University of Alicante, Alicante, Spain
| | - Eva Montero-Lopez
- School of Psychology, University of Granada, Granada, Spain
- Mind, Brain and Behavior Research Center (CIMCYC), Granada, Spain
| | | | - Raquel Gonzalez-Perez
- Department of Pharmacology, CIBERehd, School of Pharmacy, University of Granada, Granada, Spain
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Greff MJE, Levine JM, Abuzgaia AM, Elzagallaai AA, Rieder MJ, van Uum SHM. Hair cortisol analysis: An update on methodological considerations and clinical applications. Clin Biochem 2018; 63:1-9. [PMID: 30261181 DOI: 10.1016/j.clinbiochem.2018.09.010] [Citation(s) in RCA: 136] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 09/06/2018] [Accepted: 09/23/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Hair cortisol analysis is increasingly being appreciated and applied in both research and medicine, aiding endocrinologists with diagnosis. CONTENT We provide an overview of hair cortisol research in general and an update on methodological considerations including the incorporation of cortisol into hair, hair growth rates, and sampling procedures, mincing vs. grinding of samples during preparation for extraction, various extraction protocols, and quantification techniques. We compare the clinical utility and application of hair cortisol with traditional methods of measurement while acknowledging the limitations of analysis including variations in hair growth parameters. We explore the value of hair cortisol in cases of Cushing syndrome (particularly Cyclical Cushing), Adrenal insufficiency (including Addison's disease), therapy monitoring, cardiovascular disease, stress, and mental illness. SUMMARY Hair cortisol provides a unique objective biomarker for the analysis of endogenous cortisol levels for not only clinical diagnostic purposes but also in research. The use of hair cortisol has great potential for advancing patient care.
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Affiliation(s)
- Michael J E Greff
- Robarts Research Institute, Western University, Canada; Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, Canada
| | - Jeffrey M Levine
- Robarts Research Institute, Western University, Canada; Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, Canada
| | - Awatif M Abuzgaia
- Robarts Research Institute, Western University, Canada; Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, Canada
| | - Abdelbaset A Elzagallaai
- Robarts Research Institute, Western University, Canada; Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, Canada; Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, Canada
| | - Michael J Rieder
- Robarts Research Institute, Western University, Canada; Department of Paediatrics, Schulich School of Medicine and Dentistry, Western University, Canada; Department of Physiology and Pharmacology, Schulich School of Medicine and Dentistry, Western University, Canada; Division of Clinical Pharmacology, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, Canada
| | - Stan H M van Uum
- Division of Clinical Pharmacology, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, Canada; Division of Endocrinology and Metabolism, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, Canada.
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Hohlbaum K, Bert B, Dietze S, Palme R, Fink H, Thöne-Reineke C. Impact of repeated anesthesia with ketamine and xylazine on the well-being of C57BL/6JRj mice. PLoS One 2018; 13:e0203559. [PMID: 30231081 PMCID: PMC6145541 DOI: 10.1371/journal.pone.0203559] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 08/22/2018] [Indexed: 12/11/2022] Open
Abstract
Within the scope of the 3Rs of Russel and Burch, the number of laboratory animals can be reduced by repeated use of an animal. This strategy only becomes relevant, if the total amount of pain, distress or harm the individual animal experiences does not exceed the severity of a single manipulation. For example, when using imaging techniques, an animal can be examined several times during a study, but it has to be anesthetized each time imaging is performed. The severity of anesthesia is thought to be mild according to the Directive 2010/63/EU. However, the Directive does not differentiate between single and repeated anesthesia, although repeated anesthesia may have a greater impact on well-being. Hence, we compared the impact of single and repeated anesthesia (six times at an interval of three to four days) by injection of ketamine and xylazine (KX) on the well-being of adult female and male C57BL/6JRj mice. After anesthesia, well-being of mice was assessed according to a protocol for systematic assessment of well-being including nesting, the Mouse Grimace Scale (MGS), a test for trait anxiety, home cage activity, and the rotarod test for motor activity, food intake, and body weight, as well as corticosterone (metabolite) analysis. Repeated anesthesia increased the MGS in mice of both sexes and caused short-term effects on well-being of female mice in the immediate post-anesthetic period, indicated by longer lasting effects on trait anxiety-related behavior. However, corticosterone metabolite concentrations suggested that mice habituated to the stress induced by repeated KX administration. Hence, the mildly negative effects on well-being of repeated KX anesthesia do not seem to accumulate over time using the respective regimen. However, further observations for severity classification are warranted in order to more specifically determine the duration of mild distress and trait anxiety.
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Affiliation(s)
- Katharina Hohlbaum
- Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- Institute of Pharmacology and Toxicology, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
- * E-mail:
| | - Bettina Bert
- Institute of Pharmacology and Toxicology, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Silke Dietze
- Institute of Pharmacology and Toxicology, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Rupert Palme
- Unit of Physiology, Pathophysiology and Experimental Endocrinology, Department of Biomedical Sciences, University of Veterinary Medicine, Vienna, Austria
| | - Heidrun Fink
- Institute of Pharmacology and Toxicology, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
| | - Christa Thöne-Reineke
- Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Department of Veterinary Medicine, Freie Universität Berlin, Berlin, Germany
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