Status report on measurement of salivary estrogens and androgens

Salivary Progesterone Levels in Female Patients with a History of Idiopathic Scoliosis: A Retrospective Cross-Sectional Study

Idiopathic scoliosis is a condition characterized by a three-dimensional curvature of the spine. However, in addition to the spinal curvature, it has also been reported that patients with idiopathic scoliosis can display other abnormal physiologic parameters, such as hormone imbalances, genetic variants, and micronutrient deficiencies. The present study evaluates the salivary progesterone levels from a historical cohort of patients seeking treatment at a single integrative medicine clinic. A group of female patients with a history of idiopathic scoliosis is compared to a group of non-scoliosis female patients. Salivary progesterone levels were 49% higher in non-scoliosis patients compared to the scoliosis group (p < 0.05). When compared by the menstrual cycling status, non-scoliosis females had a 60% higher average progesterone level, while the progesterone level among non-cycling, non-scoliosis females was 39% higher than non-cycling scoliosis females. These results suggest a potential relationship between salivary progesterone and idiopathic scoliosis among female patients.

Chemical analysis in saliva and the search for salivary biomarkers – a tutorial review

A review of the uses of saliva biomarkers, detection methods and requirements for new biomarkers.

The feto-placental unit, and potential roles of dehydroepiandrosterone (DHEA) in prenatal and postnatal brain development: A re-examination using the spiny mouse

Synthesis of dehydroepiandrosterone (DHEA) by the fetal adrenal gland is important for placental oestrogen production, and may also be important for modulating the effects of glucocorticoids on the developing brain. We have preciously shown that the enzymes and accessory proteins needed for DHEA synthesis-cytochrome P450 enzyme 17α-hydroxylase/17,20 lyase (P450c17), cytochrome-b5 (Cytb5), 3β-hydroxysteroid dehydrogenase (3βHSD)-are expressed in the adrenal gland from 30 days gestation, and DHEA, cortisol and aldosterone are present in fetal plasma from this time. Explant culture of fetal adrenal tissue showed that the spiny mouse adrenal gland, can synthesize and secrete DHEA from at least 0.75 of gestation, and suggest that DHEA may have an important role(s) in placental biosynthesis of oestrogens and in modulating the actions of glucocorticoids in the developing brain in this species. Post-natally, increased immuno-expression of P450c17 and Cytb5 expression in the zona reticularis of the adrenal gland and a significant increase in the synthesis and secretion of DHEA in plasma from 8 to 20 days of age in the spiny mouse, are representative of a period of high adrenal androgen production consistent with the human phenomenon of adrenarche. The studies summarised in this review also show that DHEA is produced de novo in the developing brain of the spiny mouse. These results showed that the spiny mouse brain can indeed produce DHEA from pregnenolone in a time-dependant manner, and coupled with the identification of P450c17 and Cytb5 protein in several regions of the brain, support the idea that DHEA is an endogenous neuro-active steroid in this species. Together, the studies outlined in this review indicate that the androgen DHEA is an important hormone of adrenal and Central Nervous System (CNS) origin in the fetal and postnatal spiny mouse. Disturbance of the development of these fetal tissues, and/or of the relationship between the fetal adrenal gland and placenta during pregnancy, may have significant consequences for fetal development, placental function, and maturation of the brain. It is proposed that such disturbances of normal adrenal function could account for some of the neuropathologies that arise in juvenile and adult offspring following illness and stress experienced by the mother during pregnancy.

Noninvasive saliva collection for DNA analyses from free-ranging Tibetan macaques (Macaca thibetana)

Cryptic and endangered fauna, including many primate taxa, pose challenges for noninvasive collection of biomaterials. As a result, application of noninvasive genotyping to primates has been limited to the use of samples such as feces and hair for the extraction of PCR-amplifiable DNA. We present a method for noninvasive collection of saliva from habituated, free-ranging monkeys. The method utilizes a low-cost apparatus that controls for contamination and is usable with individual, free-ranging primates. Saliva samples were collected from 18 individuals in a population of Tibetan macaques (Macaca thibetana) in the Valley of Wild Monkeys in Huangshan, People's Republic of China. DNA was extracted from these samples and PCR-amplified for both mitochondrial and nuclear genes, Cytochrome B and MHC-DR Beta 1, respectively. These results indicate this is an effective technique for the noninvasive collection of saliva across age and sex class, and dominance rank in a free-ranging, terrestrial primate species. This device could have wide application for obtaining high-quality saliva samples from free-ranging primate populations for use in epidemiological studies, hormonal analyses of HPA axis function, pathogen screening, noninvasive genotyping, and behavioral genetics.

Left-Handedness and Male-Male Competition: Insights from Fighting and Hormonal Data

Male-male competition can shape some behavioral or morphological traits of males. Here we investigate if this competition could play a role in the persistence of the polymorphism of handedness in human populations. A negative frequency-dependent selection mechanism has been hypothesized, based on the fact that left-handed men may benefit from a “surprise” advantage during fighting interactions because they are rare in human populations. This advantage may thereby enhance the probability of survival of left-handed men and/or their reproductive success through an increase in social status. In this study, we first explored the association between hand preference and lifetime fighting behavior in a population of 1,161 French men. No effect of hand preference on the probability of fighting was detected, suggesting that the innate propensity to fight does not differ between left- and right-handers. However, among men who had been involved in at least one fight during their lifetime, left-handers reported significantly more fights than right-handers. To explore the biological basis of this behavior, we also investigated the testosterone concentration in saliva samples from 64 French university students. Consistent with frequencies of fights, we found a significantly higher average testosterone concentration in left-handers than in right-handers. We suggest that these behavioral and hormonal differences may be acquired throughout life due to previous experiences in a social context and may favor the persistence of left-handers in humans.

Testosterone levels and their associations with lifetime number of opposite sex partners and remarriage in a large sample of American elderly men and women

Testosterone (T) has been argued to modulate mating and parenting behavior in many species, including humans. The role of T for these behaviors has been framed as the challenge hypothesis. Following this hypothesis, T should be positively associated with the number of opposite sex partners a male has. Indeed research in humans has shown that T is positively related to the number of opposite sex partners a young man has had. Here we test, in both men and women, whether this relationship extends to the lifetime number of sex partners. We also explored whether or not T was associated with current marital status, partnership status and whether or not the participant remarried. Using a large sample of elderly men and women (each sample n>700), we show that T is positively and sizably associated with the number of opposite sex partners in men. When controlling for potential confounding variables such as educational attainment, age, BMI, ethnicity, specific use of a medication and time of sampling this effect remained. For women, the relationship between T and number of opposite sex partners was positive but did not prove to be robust. In both men and women there was no evidence for an association between T and current marital status and partnership status (being in a relationship or not). However, remarriage was positively associated with T, but only in males. Results are discussed with reference to the literature on T and sex partners, remarriage and more broadly the challenge hypothesis.

Evidence for a role of progesterone in menstrual cycle-related variability in prepulse inhibition in healthy young women

Prepulse inhibition (PPI) of the startle response is sensitive to sex, with healthy young women showing less PPI compared with age-matched men, and varies according to the menstrual cycle phase in women. Relatively less is known regarding sex and hormonal influences in prepulse facilitation (PPF). Menstrual phase-related variability in PPI is suggested to be mediated by fluctuating estrogen level, based on the observations of more PPI in women during the follicular, relative to the luteal, phase. No study has directly assessed the relationship between fluctuating hormones and PPI or PPF levels over the human ovarian cycle. To examine the roles of circulating ovarian hormones in PPI and PPF, 16 non-smoking regularly menstruating healthy women were tested during both the follicular and luteal phases on PPI and PPF and provided saliva samples for measurement of 17beta-estradiol (estrogen), progesterone and testosterone. The results showed higher levels of 17beta-estradiol and progesterone during the luteal, relative to the follicular, phase; and more PPI during the follicular phase and more PPF during the luteal phase with comparable startle amplitude and habituation during the two phases. A larger increase in progesterone was associated with a smaller decrease in PPI from the follicular to the luteal phase. No significant associations were found between changes in PPI/PPF and estrogen levels. The findings confirm lower PPI during the luteal, compared with the follicular, phase and suggest a role for progesterone, more specifically an antipsychotic-like PPI-restoration action of progesterone, during the luteal phase in PPI of young women.

Patterns of salivary estradiol and progesterone across the menstrual cycle

The aim of this study was to characterize the normality of menstrual cycles on the basis of progesterone and estradiol levels in self-collected saliva samples. Twenty-two women, ages 19-40 years, self-collected whole unstimulated saliva specimens each morning for two consecutive menstrual cycles. On the basis of presence/timing of hormone peaks, two investigators classified 24 cycles as normal, 10 as likely normal, and 10 as clearly not normal with respect to expected profiles. Our results show that whole saliva samples collected at home on a daily basis provide a noninvasive, feasible method of determining menstrual cycle profiles.

Fathers have lower salivary testosterone levels than unmarried men and married non-fathers in Beijing, China

A growing body of evidence, almost entirely from North America, has found that male testosterone levels are positively associated with mating effort (male-male competition and mate-seeking behaviour), while lower testosterone levels have been associated with affiliative pair bonding and paternal care. To expand the cross-cultural scope of this research, here we investigate variation in salivary testosterone levels among Chinese men in relation to marital and parenting variables. One hundred and twenty-six men drawn from a Beijing university setting between the ages of 21 and 38 completed a questionnaire and provided both morning and late afternoon saliva samples from which testosterone levels were measured. The 66 unmarried men had slightly higher levels of testosterone than the 30 married non-fathers, but this difference was not statistically significant. However, the 30 fathers exhibited significantly lower testosterone levels than both unmarried men and married non-fathers. Among married non-fathers, marital relationship quality was not significantly related to testosterone levels. Among married fathers, men with children aged less than 4 years of age did not have lower testosterone levels than men with older children. These data are the first outside of North America to show lower testosterone levels among fathers, and lend support to the theoretical view that male testosterone levels differ according to mating and parenting effort.

Anthropometry and body composition do not predict bioavailable androgen or progesterone concentration in adolescent girls

Our objective was to test the hypothesis that anthropometry and body composition were independently associated with sex-steroid concentration in adolescent girls. Premenarcheal (age, mean +/- SD = 10.9 +/- 0.6, N = 51), perimenarcheal (age = 13.7 +/- 0.6, N = 74), and postmenarcheal (age = 16.7 +/- 0.6, N = 44) cohorts provided saliva at morning recess during the schoolday over 6 weeks. Estradiol, testosterone, progesterone, and dehydroepiandrosterone (DHEA) were quantified. Age, developmental cohort, self-reported Tanner stage of breast development and pubic-hair distribution, gynecological age, height, weight, waist/hip ratio, and percent body fat (by impedance) were assessed. Repeated measures were reduced to a mean. Data were hierarchically standardized for sexual maturation status, and then used to predict anthropometry/percent body fat. After intensive repeated sampling, individuals still varied widely in testosterone, progesterone, and DHEA concentrations within a developmental cohort (35.0 < or = coefficient of variation < or = 66.5%). Individual hormone concentration was repeatable across 2 years (0.51 < or = r(2) < or = 0.73). In spite of the variability within a cohort, there was no evidence for an association between the standardized hormone and body mass index, percent body fat, or waist/hip ratio, whether or not measures were age-adjusted (21 univariate tests; 0.19 < or = P < or = 0.96). Stratification by developmental cohort also did not reveal associations. Low estradiol assay precision precluded analyses. In conclusion, despite considerable population variation in hormone concentration after repeated sampling, no evidence supported an association between anthropometry or pecent body fat and testosterone, progesterone, or DHEA in adolescent girls.

Strategies and methods for research on sex differences in brain and behavior

Female and male brains differ. Differences begin early during development due to a combination of genetic and hormonal events and continue throughout the lifespan of an individual. Although researchers from a myriad of disciplines are beginning to appreciate the importance of considering sex differences in the design and interpretation of their studies, this is an area that is full of potential pitfalls. A female's reproductive status and ovarian cycle have to be taken into account when studying sex differences in health and disease susceptibility, in the pharmacological effects of drugs, and in the study of brain and behavior. To investigate sex differences in brain and behavior there is a logical series of questions that should be answered in a comprehensive investigation of any trait. First, it is important to determine that there is a sex difference in the trait in intact males and females, taking into consideration the reproductive cycle of the female. Then, one must consider whether the sex difference is attributable to the actions of gonadal steroids at the time of testing and/or is sexually differentiated permanently by the action of gonadal steroids during development. To answer these questions requires knowledge of how to assess and/or manipulate the hormonal condition of the subjects in the experiment appropriately. This article describes methods and procedures to assist scientists new to the field in designing and conducting experiments to investigate sex differences in research involving both laboratory animals and humans.

The diagnostic applications of saliva--a review

This review examines the diagnostic application of saliva for systemic diseases. As a diagnostic fluid, saliva offers distinctive advantages over serum because it can be collected non-invasively by individuals with modest training. Furthermore, saliva may provide a cost-effective approach for the screening of large populations. Gland-specific saliva can be used for diagnosis of pathology specific to one of the major salivary glands. Whole saliva, however, is most frequently used for diagnosis of systemic diseases, since it is readily collected and contains serum constituents. These constituents are derived from the local vasculature of the salivary glands and also reach the oral cavity via the flow of gingival fluid. Analysis of saliva may be useful for the diagnosis of hereditary disorders, autoimmune diseases, malignant and infectious diseases, and endocrine disorders, as well as in the assessment of therapeutic levels of drugs and the monitoring of illicit drug use.

DNA technology, the clinical laboratory, and the future

OBJECTIVE

To review the advances in clinically useful molecular biological techniques and their applications in clinical practice as presented at the Ninth Annual William Beaumont Hospital DNA Symposium.

DATA SOURCES

The 10 manuscripts submitted were reviewed and their major findings were compared with literature on the same topic.

STUDY SELECTION

One manuscript reviewed the development of pharmacogenetics, 3 described analytic approaches to detect aneuploidy or cancer, 1 described transcription factor E2F-1 increase during apoptosis, 2 reported on genetic and pharmacologic factors that influence platelet aggregation, 2 described molecular methods for detecting long QT syndrome or mycobacteria, and 1 reported a modification in collection of buccal DNA.

DATA SYNTHESIS

Genomic and proteomic approaches to develop clinically useful assays have been successful. Aneuploidy can be easily detected by comparative genomic hybridization, which does not require cell culture like cytogenetics. Mutations have been characterized for a variety of hereditary cancer syndromes, 2 inherited long QT syndromes, and thromboembolism. PlA1 and PlA2 polymorphisms in platelets are associated with a difference in aggregation inhibition by estrogen, another example of genotypic pharmacogenetics. Protein expression differences may define colorectal cancer stage and explain apoptotic signal transduction. Mycobacterial detection by nucleic acid amplification and simplified buccal DNA collection demonstrate cost-effective strategies.

CONCLUSION

The working draft of the Human Genome Project is completed and the number of clinically useful molecular pathologic techniques and assays will expand as additional disease-associated mutations are defined. Expanded use of database software for genomic and proteomic screening should increase the efficiency of clinical useful assay development.

Implicit power motivation moderates men's testosterone responses to imagined and real dominance success

This study tested the hypothesis that implicit power motivation moderates individuals' testosterone responses to the anticipated success in and actual outcome of a dominance contest. Salivary testosterone levels were assessed in 42 male students at the beginning of the study, after they had imagined a success in an ensuing power contest, and immediately after the contest had taken place. Contest outcome (winning or losing against a competitor on a speed-based task) was varied experimentally. Participants' power motive was assessed with a picture-story exercise, in which an assertive, personalized (p Power) component was distinguished from an altruistic, socialized (s Power) component. In contrast to all other participants, individuals high only in p Power (a) had elevated testosterone after imagining a success in a subsequent dominance contest and (b) continued to have high testosterone levels after actually winning, but not after losing, the contest.

Salivary estradiol and progesterone levels in conception and nonconception cycles in women: evaluation of a new assay for salivary estradiol

OBJECTIVE

To determine the usefulness of salivary E2 and progesterone for noninvasive assessment of ovarian function.

DESIGN

Prospective study of salivary hormone levels in women planning a pregnancy.

SETTING

Department of Obstetrics and Gynecology at Northwestern University Medical School in Chicago, Illinois.

PATIENT(S)

Fourteen women aged 23-39 years with regular menstrual cycles who were planning a pregnancy.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

Salivary estradiol and progesterone concentrations.

RESULT(S)

The sensitivity of the E2 assay is 2.0 pmol/L; the interassay coefficient of variation was 5.2% (mean value 17 pmol/L). Recovery of E2 added to saliva was 106%. The correlation with simultaneous serum samples was 0.71. Menstrual cycle patterns contained a preovulatory depression and a midcycle surge. By comparison with nonconception cycles, the luteal phases of conception cycles had significantly elevated salivary E2 within the first 5 days after ovulation. Salivary progesterone was significantly elevated but not until 10 days after ovulation.

CONCLUSION(S)

Salivary measurements of E2 and progesterone can be used as noninvasive methods for assessment of ovarian function. Salivary specimens can be collected at home and brought to the laboratory for analysis, obviating the need for frequent phlebotomy. The sensitivity and precision of the salivary E2 assay make it comparable with assays of serum E2 for assessing changes in hormone levels.

Saliva as a fluid for measurement of estriol levels

OBJECTIVE

The purpose was to establish saliva as a reliable sample for the determination of estriol levels in pregnant women.

STUDY DESIGN

Literature and laboratory analyses were used to develop an assembly system to collect and analyze saliva for estriol level.

RESULTS

An enzyme-linked immunoassay for estriol has been developed to use whole saliva samples. Analytic performance characteristics for the assay have been determined to be appropriate for clinical determination of preterm risk assessment.

CONCLUSION

Saliva can serve as a reliable sample for estriol determination when coupled with an appropriate assay method.

Testosterone is correlated with regional morphology of the human corpus callosum

Theoretical speculation in humans (S.F. Witelson, Psychoneuroendocrinology 16 (1991) 131-153) and empirical findings in animals (R.H. Fitch, P.E. Cowell, L.M. Schrott, V.H. Denenberg, Int. J. Dev. Neurosci. 9 (1991) 35-38) suggest that testosterone (T) may play a significant role in the development of the corpus callosum (CC). However, there are currently no empirical studies directly relating T concentrations to callosal morphology in humans. The purpose of the present study was to investigate the relationship between free T concentrations as determined by radioimmunoassay, and the mid-sagittal area of the corpus callosum, as determined by magnetic resonance imaging (MRI). Subjects were 68 young adult (20-35 years), neurologically normal, right-handed males. All subjects underwent MRI and provided two samples of saliva for radioimmunoassay of T and cortisol. Anatomical regions of interest included total brain volume, left and right hemisphere volume and regional areas of the CC. CC regions were defined using two different measurement techniques, each dividing the CC into six sub-sections. Anatomical measurements were performed blind with respect to the hormone levels of subjects. A significant positive correlation between T concentration and cross-sectional area of the posterior body of the CC was found. This finding was consistent across the two measurement techniques and was not attributable to individual differences in total brain volume. All correlations between cortisol and CC sub-regions were non-significant. The results of this study are consistent with the notion that T, at an earlier stage in development, may play a significant role in modulating cortical/callosal architecture in humans.

Direct colorimetric monoclonal antibody enzyme immunoassay for estradiol-17β in saliva

We developed a direct microtiter plate enzyme immunoassay to measure estradiol-17β in saliva. The assay has a commercially available monoclonal antibody, raised against estradiol-17β–6-carboxymethyloxime–bovine serum albumin, and a homologous horseradish peroxidase conjugate measured colorimetrically. The detection limit (equivalent to B0 − 3 SD) is 365 amol/well or 7.3 pmol/L when 50-μL samples are assayed. Cross-reactivity with estrone and estriol, testosterone, or progesterone is &lt;0.2%. Estradiol-17β was measured in daily samples over five natural menstrual cycles and eight cycles stimulated as a preliminary to in vitro fertilization, and the concentrations and fluctuations found agreed with previously published data. This method gives results in ∼3 h and may be useful for fertility monitoring and management.

Salivary testosterone levels in left- and right-handed adults

It has been proposed that prenatal testosterone (T) may contribute to the development of hand preference and cerebral functional asymmetry in humans. To investigate any persisting association between T and asymmetry in adulthood, left-handed (LH) and right-handed (RH) men and women were administered a hand preference questionnaire and the Fused Dichotic Words Test. Testosterone was measured in samples of saliva. Results showed that LH subjects of both sexes had lower salivary T concentrations than their RH counterparts. Among LH males, subjects with a right-ear advantage in dichotic listening tended to have lower T concentrations than subjects with a left-ear advantage. These results are consistent with the notion that T may be involved in the development of hand preference and cerebral functional asymmetry.

Effect of marginal ascorbic acid deficiency on saliva level of cortisol in the guinea pig

Male guinea pigs subjected to prolonged marginal ascorbic acid deficiency developed moon facies and oedema, features of functional adrenal hypercorticism. Compared with age- and sex-matched controls fed an adequate diet for a similar period, ascorbate deficiency had no effect on submandibular gland weight but elicited a significant (p < 0.005) reduction in stimulated whole-saliva flow rate. Plasma cortisol concentration (nmol/L) was significantly increased (p < 0.005) in the deficient animals (998.21 +/- 57.19 compared to 254.66 +/- 15.62 for the controls). Associated with marked hypercortisolaemia in the deficient animals was a significant (p < 0.01) but less prominent increase in the whole-saliva cortisol level, resulting in a mean saliva/plasma cortisol ratio of 46% for this group compared to 72% for the controls. Increased corticosteroid levels suppress immunological and inflammatory responses, particularly neutrophil function, impair production of some cytokines, inhibit collagen synthesis, and impair wound healing and bone matrix formation. Numerous conditions such as ageing, stress, smoking, ionizing radiation, ingestion of drugs, protein malnutrition, diabetes, and several other pathological states, which are among the risk factors for xerostomia and periodontal/oral mucosal lesions, promote tissue depletion of ascorbate. This study suggests that increased salivary and blood levels of glucocorticoids in these conditions may be important in reducing the ability of the host to mount an effective immune response to oral pathogens.