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Byg LM, Bilenberg N, Glintborg D, Andersen MS, Wesselhoeft R. The longitudinal relationship between prenatal maternal cortisol and preschool internalising problems. Psychoneuroendocrinology 2024; 168:107141. [PMID: 39059226 DOI: 10.1016/j.psyneuen.2024.107141] [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: 03/15/2024] [Revised: 07/02/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024]
Abstract
INTRO Prenatal exposure to synthetic glucocorticoids may increase the risk of emotional symptoms in childhood partly by reducing fetal growth. We explored if physiological levels of prenatal maternal cortisol were associated with internalising problems in boys and girls and if this was mediated by birth weight. METHODS Mother-child dyads from the prospective Odense Child Cohort (n=1162) were included if maternal serum cortisol (3rd trimester), offspring birth weight, and Child Behaviour Checklist (CBCL) assessments in preschool age were available. Crude and adjusted associations between cortisol and internalising problems were determined in linear mixed models stratified by offspring sex. Covariates included parental psychiatric history, parity, maternal age, education, smoking during pregnancy, and gestational age at birth. In the presence of significant associations, we evaluated the potential mediating role of birth weight. RESULTS The study sample included 601 boys and 561 girls and internalising problems were assessed at mean ages 2.3 (±0.4) and 5 (±0.5) years. In the crude analysis, cortisol was positively associated with internalising problems in boys (p-value 0.017) and in girls (p-value < 0.0001). In the adjusted analyses, there was no statistically significant association between cortisol and offspring internalising problems in boys or girls (all p-values > 0.15). There was no mediation by birth weight. DISCUSSION Maternal serum cortisol was positively associated with offspring internalising problems in boys and girls, but there was no association following adjustment for potential confounders and no mediation through birth weight. Maternal third-trimester cortisol levels do not predict preschool offspring internalising problems in our study.
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Affiliation(s)
- Lars Meinertz Byg
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia; Child and Adolescent Mental Health Southern Denmark, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Niels Bilenberg
- Child and Adolescent Mental Health Southern Denmark, Mental Health Services in the Region of Southern Denmark, Odense, Denmark
| | - Dorte Glintborg
- Department of Endocrinology and Metabolism, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Marianne Skovsager Andersen
- Department of Endocrinology and Metabolism, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Rikke Wesselhoeft
- Child and Adolescent Mental Health Southern Denmark, Mental Health Services in the Region of Southern Denmark, Odense, Denmark; Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark.
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2
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Balasamy S, Atchudan R, Arya S, Gunasekaran BM, Nesakumar N, Sundramoorthy AK. Cortisol: Biosensing and detection strategies. Clin Chim Acta 2024; 562:119888. [PMID: 39059481 DOI: 10.1016/j.cca.2024.119888] [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: 06/03/2024] [Revised: 07/22/2024] [Accepted: 07/23/2024] [Indexed: 07/28/2024]
Abstract
Cortisol, a crucial steroid hormone synthesized by the adrenal glands, has diverse impacts on multiple physiological processes, such as metabolism, immune function, and stress management. Disruption in cortisol levels can result in conditions like Cushing's syndrome and Addison's disease. This review provides an in-depth exploration of cortisol, covering its structure, various forms in the body, detection methodologies, and emerging trends in cancer treatment and detection. Various techniques for cortisol detection, including electrochemical, chromatographic, and immunoassay methods were discussed and highlighted for their merits and applications. Electrochemical immunosensing emerges as a promising approach, which offered high sensitivity and low detection limits. Moreover, the review delves into the intricate relationship between cortisol and cancer, emphasizing cortisol's role in cancer progression and treatment outcomes. Lastly, the utilization of biomarkers, in-silico modeling, and machine learning for electrochemical cortisol detection were explored, which showcased innovative strategies for stress monitoring and healthcare advancement.
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Affiliation(s)
- Sesuraj Balasamy
- Centre for Nano-Biosensors, Department of Prosthodontics and Materials Science, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, Tamil Nadu, India
| | - Raji Atchudan
- School of Chemical Engineering, Yeungnam University, Gyeongsan 38541, Republic of Korea
| | - Sandeep Arya
- Department of Physics, University of Jammu, Jammu, Jammu and Kashmir 180006, India
| | - Balu Mahendran Gunasekaran
- School of Chemical & Biotechnology (SCBT), SASTRA Deemed University, Thanjavur 613 401, Tamil Nadu, India; Center for Nanotechnology & Advanced Biomaterials (CENTAB), SASTRA Deemed University, Thanjavur 613401, Tamil Nadu, India
| | - Noel Nesakumar
- School of Chemical & Biotechnology (SCBT), SASTRA Deemed University, Thanjavur 613 401, Tamil Nadu, India; Center for Nanotechnology & Advanced Biomaterials (CENTAB), SASTRA Deemed University, Thanjavur 613401, Tamil Nadu, India
| | - Ashok K Sundramoorthy
- Centre for Nano-Biosensors, Department of Prosthodontics and Materials Science, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, Tamil Nadu, India.
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Mao R, Zhou F, Hong Y, Li Y, Zhu C, Jin L, Li S. CRH upregulates supervillin through ERK and AKT pathways to promote bladder cancer cell migration. Cell Biol Int 2024. [PMID: 39090812 DOI: 10.1002/cbin.12227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 07/10/2024] [Accepted: 07/18/2024] [Indexed: 08/04/2024]
Abstract
Corticotropin-releasing hormone (CRH) has been well documented playing a role in the regulation of cellular processes, immune responses, and inflammatory processes that can influence the occurrence and development of tumors. Supervillin (SVIL) is a membrane-associated and actin-binding protein, which is actively involved in the proliferation, spread, and migration of cancer cells. This work investigated CRH's influence on bladder cancer cells' migration and relevant mechanisms. By using human bladder cancer cells T24 and RT4 in wound healing experiments and transwell assay, we found that the migration ability of the T24 cells was significantly increased after CRH treatment. In vivo experiments showed that CRH significantly promoted the metastases of T24 cells in cell line-derived xenograft (CDX) mouse model. Interestingly, downregulation of SVIL by SVIL-specifc small hairpin RNAs significantly reduced the promoting effect of CRH on bladder cancer cell migration. Furthermore, CRH significantly increased SVIL messenger RNA and protein expression in T24 cells, accompanied with AKT and ERK phosphorylation in T24 cells. Pretreatment with AKT inhibitor (MK2206) blocked the CRH-induced SVIL expression and ERK phosphorylation. Also, inhibition of ERK signaling pathway by U0126 significantly reduced the CRH-induced SVIL expression and AKT phosphorylation. It suggested that cross-talking between AKT and ERK pathways was involved in the effect of CRH on SVIL. Taken together, we demonstrated that CRH induced migration of bladder cancer cells, in which AKT and ERK pathways -SVIL played a key role.
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Affiliation(s)
- Rongchen Mao
- Department of Pharmacology, Basic Medical Sciences, Nanjing Medical University, Nanjing, China
| | - Feier Zhou
- Department of Pharmacology, Basic Medical Sciences, Nanjing Medical University, Nanjing, China
| | - Yali Hong
- Department of Pharmacology, Basic Medical Sciences, Nanjing Medical University, Nanjing, China
| | - Yongqi Li
- Department of Pharmacology, Basic Medical Sciences, Nanjing Medical University, Nanjing, China
| | - Chao Zhu
- Department of Pharmacology, Basic Medical Sciences, Nanjing Medical University, Nanjing, China
| | - Lai Jin
- Department of Pharmacology, Basic Medical Sciences, Nanjing Medical University, Nanjing, China
| | - Shengnan Li
- Department of Pharmacology, Basic Medical Sciences, Nanjing Medical University, Nanjing, China
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Buccellato KH, Peterson AL. The role of cortisol in development and treatment of PTSD among service members: A narrative review. Psychoneuroendocrinology 2024; 169:107152. [PMID: 39094515 DOI: 10.1016/j.psyneuen.2024.107152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 06/17/2024] [Accepted: 07/28/2024] [Indexed: 08/04/2024]
Abstract
Posttraumatic stress disorder (PTSD) is a pervasive issue within military populations, with approximately 29 % of post-9/11 service members experience PTSD at some point in their lifetime. One potentially important factor in PTSD development and treatment response is dysregulation of the stress response system stemming from exposure to multiple traumas and sustained operational stress associated with military training and deployment. In particular, the end-product of the hypothalamic-pituitary-adrenal (HPA) axis, cortisol, is of particular interest to researchers examining physiological stress response in the context of mental health. Research exploring cortisol has been ongoing for decades, both to further understand its pathways and mechanisms, and to develop potential novel PTSD treatments. This paper provides a narrative review of some of the published literature examining cortisol's role in PTSD as a potential factor in development, maintenance, and treatment augmentation, with emphasis on military populations. The results of this review highlight the importance of exploring alterations to the stress response system, and cortisol in particular, for the evaluation and treatment of PTSD in the military, the need for more comprehensive work towards understanding development of these alterations through military training and service, and its impact on long-term PTSD outcomes.
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Affiliation(s)
- Kiara H Buccellato
- Department of Psychology, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX 78249, USA; Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.
| | - Alan L Peterson
- Department of Psychology, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX 78249, USA; Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA; Research and Development Service, South Texas Veterans Health Care System, 7400 Merton Minter, San Antonio, TX 78229, USA
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AlSahman L, AlBagieh H, AlSahman R. Is There a Relationship between Salivary Cortisol and Temporomandibular Disorder: A Systematic Review. Diagnostics (Basel) 2024; 14:1435. [PMID: 39001325 PMCID: PMC11241310 DOI: 10.3390/diagnostics14131435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/29/2024] [Accepted: 06/30/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND This systematic review examines and evaluates the relationship between salivary cortisol levels and temporomandibular disorder (TMD) in young adult patients. METHOD Six databases-PubMed, Scopus, Web of Science, Google Scholar, ProQuest, and Cochrane Library-were utilized to screen eligible studies. A systematic search was performed based on PECO questions and eligibility criteria. The research question for this review was "Do salivary cortisol levels correlate with TMD in individuals aged 18-40?" The risk of bias for quality assessment was determined by the Cochrane tool. PRISMA guidelines were followed while performing this review. RESULT A total of fourteen studies were included in this review. Of these, eleven were observational studies (four cross-sectional and seven case-control), and three were randomized control trials. Eleven of the included studies presented a low to moderate risk in the qualitative synthesis. The total sample size of the included studies was 751 participants. The included studies suggest higher salivary cortisol levels in TMD patients than in healthy individuals. CONCLUSIONS The findings of this review indicate higher salivary cortisol levels in adult patients with TMD than in healthy controls. Thus, supportive psychological treatment and clinical modalities should be provided to patients with TMD. Moreover, higher-quality studies with low heterogeneity are required to support this finding.
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Affiliation(s)
- Lujain AlSahman
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University Riyadh, Riyadh 57448, Saudi Arabia;
| | - Hamad AlBagieh
- Oral Medicine and Diagnostic Sciences Department, College of Dentistry, King Saud University Riyadh, Riyadh 57448, Saudi Arabia;
| | - Roba AlSahman
- Faculty of Dentistry, Royal College of Surgeons, D02YN77 Dublin, Ireland;
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Yan Z, Liu X, Liu H, Xu H, Liu Y, Li C, Wang B, Cui S, Jia T, Yang D, Zhang C, Liu X, Buesching CD, Liu D. Assessment of stress levels and reproductive condition in giant pandas: insights from hair, faecal and saliva samples. CONSERVATION PHYSIOLOGY 2024; 12:coae044. [PMID: 38962510 PMCID: PMC11221559 DOI: 10.1093/conphys/coae044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 05/29/2024] [Accepted: 06/14/2024] [Indexed: 07/05/2024]
Abstract
Concerted conservation efforts have brought the giant panda (Ailuropoda melanoleuca) back from the brink of extinction, but pandas continue to face anthropogenic threats in the wild and breeding success in captivity remains low. Because stress can have detrimental impacts on reproduction, monitoring stress- and sex-steroid levels would help assess the effectiveness of conservation mitigation measures in panda populations as well as monitor the welfare and reproductive health of captive animals. In this proof-of-concept study, we used faecal sex steroid and cortisol concentrations (n = 867 samples collected from five males and five females at Beijing Zoo every 4 days over the course of 12 months) as a reference to investigate if testosterone, estradiol, progesterone and cortisol can be meaningfully measured in panda hair (n = 10) using radio-immuno-assays. Additionally, we calculated the ratio of testosterone to cortisol (T:C ratio) for each male, which can provide a biomarker of stress and physical performance. Our findings revealed distinct monthly variations in faecal sex-steroid and cortisol concentrations, reflecting reproductive seasonality and visitor-related stress among individual pandas. Notably, the oldest male had a significantly lower T:C ratio than other males. Our results confirm that the level of sex steroids and cortisol can be assayed by panda hair, and the hair cortisol concentrations correlate significantly with that in faeces with one month lag behind (r = 0.68, P = 0.03). However, the concentrations of hormones detected in saliva are lower than those in faeces by two orders of magnitude, making it difficult to ensure accuracy. By assessing the applicability of hair, faecal and salivary sampling, we can infer their utility in monitoring the reproductive status and acute and chronic stress levels of giant pandas, thereby providing a means to gauge the success of ongoing habitat restoration efforts and to discuss the feasibility of sample collection from wild populations.
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Affiliation(s)
- Zheng Yan
- Key Laboratory for Biodiversity and Ecological Engineering of Ministry of Education, Department of Ecology, College of Life Sciences, Beijing Normal University, No.19, Xinjiekouwai Street, Haidian District, Beijing 100875, China
| | - Xiaoyan Liu
- Key Laboratory for Biodiversity and Ecological Engineering of Ministry of Education, Department of Ecology, College of Life Sciences, Beijing Normal University, No.19, Xinjiekouwai Street, Haidian District, Beijing 100875, China
| | - Haoqiu Liu
- Key Laboratory for Biodiversity and Ecological Engineering of Ministry of Education, Department of Ecology, College of Life Sciences, Beijing Normal University, No.19, Xinjiekouwai Street, Haidian District, Beijing 100875, China
| | - Haihong Xu
- Beijing Key Laboratory of Captive Wildlife Technologies, Beijing Zoo, No.137, Xizhimenwai Street, Xicheng District, Beijing 100044, China
| | - Yanhui Liu
- Beijing Key Laboratory of Captive Wildlife Technologies, Beijing Zoo, No.137, Xizhimenwai Street, Xicheng District, Beijing 100044, China
| | - Changqing Li
- Beijing Key Laboratory of Captive Wildlife Technologies, Beijing Zoo, No.137, Xizhimenwai Street, Xicheng District, Beijing 100044, China
| | - Bo Wang
- Beijing Key Laboratory of Captive Wildlife Technologies, Beijing Zoo, No.137, Xizhimenwai Street, Xicheng District, Beijing 100044, China
| | - Shengnan Cui
- Beijing Key Laboratory of Captive Wildlife Technologies, Beijing Zoo, No.137, Xizhimenwai Street, Xicheng District, Beijing 100044, China
| | - Ting Jia
- Beijing Key Laboratory of Captive Wildlife Technologies, Beijing Zoo, No.137, Xizhimenwai Street, Xicheng District, Beijing 100044, China
| | - Di Yang
- Beijing Key Laboratory of Captive Wildlife Technologies, Beijing Zoo, No.137, Xizhimenwai Street, Xicheng District, Beijing 100044, China
| | - Chenglin Zhang
- Beijing Key Laboratory of Captive Wildlife Technologies, Beijing Zoo, No.137, Xizhimenwai Street, Xicheng District, Beijing 100044, China
| | - Xuefeng Liu
- Beijing Key Laboratory of Captive Wildlife Technologies, Beijing Zoo, No.137, Xizhimenwai Street, Xicheng District, Beijing 100044, China
| | - Christina D Buesching
- Department of Biology, Irving K. Barber Faculty of Sciences, The University of British Columbia, Okanagan, Kelowna, British Columbia V1V 1V7, Canada
| | - Dingzhen Liu
- Key Laboratory for Biodiversity and Ecological Engineering of Ministry of Education, Department of Ecology, College of Life Sciences, Beijing Normal University, No.19, Xinjiekouwai Street, Haidian District, Beijing 100875, China
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Wang Q, Yu R, Fu C, Li M, Wang X, Zhu D. The relationship between male and female endogenous reproductive hormones levels and subjective cognitive decline score: A cross-sectional analysis of the Pingyin cohort study. Clin Endocrinol (Oxf) 2024. [PMID: 38952182 DOI: 10.1111/cen.15104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/01/2024] [Accepted: 06/03/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVE Reproductive hormones might impact disease course in cognitive decline. We examined the association between male and female endogenous reproductive hormones and subjective cognitive decline (SCD) score. DESIGN, PATIENTS AND MEASUREMENTS A cross-sectional study design was used with baseline data from the Pingyin cohort study, involving 1943 participants aged 45-70 years. Oestrogen (E2), testosterone, follicle stimulating hormone (FSH) and luteinizing hormone (LH) were measured in females and E2 and testosterone were measured in males. We categorised hormones into three levels of low, intermediate and high level. The 9-item subjective cognitive decline questionnaire (SCD-Q9) scores were collected to assess the symptoms of SCD. Multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence interval (CI) between categorised hormone levels and SCD status. Multivariable linear regression models were also used. RESULTS Overall, 1943 participants were involved and 1285 (66.1%) were female. The mean age at baseline was 59.1 (standard deviation 7.1) years. Women with high testosterone levels had a higher probability of having SCD compared with those with low testosterone levels (OR 1.43, 95% CI 1.01-2.05). Men with a high level of testosterone (0.59, 0.35-0.98) and high testosterone/E2 ratio (0.55, 0.33-0.90) were related to decreased chances of having SCD. Each one-unit increase of testosterone was linked to reduced SCD score in males [(β: -.029, 95% CI (-0.052, -0.007)]. CONCLUSION There was sex-specific relationship between hormone levels and SCD abnormal. Those with higher testosterone levels in females may increase likelihood of experiencing SCD. Males with higher testosterone levels and higher testosterone/E2 ratio may be associated with reduced likelihood of SCD. The roles of endogenous reproductive hormone levels and their dynamic changes in cognitive function need further investigation.
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Affiliation(s)
- Qi Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Ruihong Yu
- Pingyin Center for Disease Control and Prevention, Jinan, Pingyin, China
| | - Chunying Fu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Meiling Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiaoyi Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Dongshan Zhu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Center for Clinical Epidemiology and Evidence-Based Medicine, Shandong University, Jinan, China
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Alaedini A, Lightman S, Wormser GP. Is Low Cortisol a Marker of Long COVID? Am J Med 2024; 137:564-565. [PMID: 38521195 DOI: 10.1016/j.amjmed.2024.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 03/12/2024] [Indexed: 03/25/2024]
Affiliation(s)
- Armin Alaedini
- Department of Medicine, Columbia University Irving Medical Center, New York, NY; Division of Infectious Diseases, Department of Medicine, New York Medical College, Valhalla, NY.
| | | | - Gary P Wormser
- Division of Infectious Diseases, Department of Medicine, New York Medical College, Valhalla, NY
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Houison RJ, Lamont-Mills A, Kotiw M, Terry PC. Feeling the Stress: Salivary Cortisol Responses of Softball Umpires during National Championships. Sports (Basel) 2024; 12:128. [PMID: 38786997 PMCID: PMC11125777 DOI: 10.3390/sports12050128] [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: 03/27/2024] [Revised: 04/24/2024] [Accepted: 05/04/2024] [Indexed: 05/25/2024] Open
Abstract
Stress research in sports tends to focus on athletes, with sports officials typically being overlooked. In the current study, baseline, pre-game, and post-game cortisol levels among a sample of softball umpires were measured to assess the pattern of stress responses and determine if umpire performance (pass/fail) and position on the diamond (plate/field) could be predicted from cortisol levels. Nine male and four female participants aged 25-68 years (N = 13, M = 47.06 ± 15.65 years) each provided saliva samples on multiple occasions prior to and after officiating games at two Australian National Softball Championships. Data from 65 games were analysed. Performance was assessed using Softball Australia's official umpire assessment tool. Cortisol levels increased significantly from baseline to pre-game (p < 0.001, d = -0.69) and declined significantly from pre-game to post-game (p < 0.001, d = 0.47). Umpiring performances were correctly classified as pass or fail from baseline and pre-game cortisol levels in 61.5% of cases and umpire position on the diamond from pre-game cortisol in 63.1% of cases. Findings suggest that stress management strategies should be recommended to softball umpires for performance enhancement and to safeguard their mental health.
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Affiliation(s)
- Ronald J. Houison
- School of Psychology and Wellbeing, University of Southern Queensland, Toowoomba 4350, Australia;
| | - Andrea Lamont-Mills
- Academic Affairs Administration, University of Southern Queensland, Ipswich 4305, Australia;
| | - Michael Kotiw
- School of Health and Medical Sciences, University of Southern Queensland, Ipswich 4305, Australia;
| | - Peter C. Terry
- School of Psychology and Wellbeing, University of Southern Queensland, Toowoomba 4350, Australia;
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Lee A, Jang S, Lee S, Park HK, Kim IY, Ahn R, Seok JH, Lee KR. Comparative analysis of salivary cortisol measurements using different assay methods in relation to serum-free cortisol measurement. Pract Lab Med 2024; 40:e00393. [PMID: 38645932 PMCID: PMC11026831 DOI: 10.1016/j.plabm.2024.e00393] [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: 12/21/2023] [Revised: 03/26/2024] [Accepted: 04/08/2024] [Indexed: 04/23/2024] Open
Abstract
Objectives Salivary cortisol reflects the biologically active form of serum cortisol, offering a noninvasive evaluation method for the diurnal rhythm of the hypothalamic-pituitary-adrenal (HPA) axis. While liquid chromatography-tandem mass spectrometry (LC-MS/MS) is known for its specificity, immunoassays (IA) are commonly used because of their simplicity. This study aimed to assess the performance of salivary cortisol measurement using both IA and LC-MS/MS in comparison to serum-free cortisol measurement. Methods Assay results for 188 saliva and 94 serum samples from 47 participants were analyzed. Salivary samples collected at different time points were analyzed using IA and LC-MS/MS. Serum samples were analyzed for cortisol, cortisol-binding globulin, and free cortisol. The statistical analyses included correlations and method comparisons. Results The diurnal salivary cortisol profiles exhibited a comparable circadian rhythm pattern; however, the concentrations measured using IA were consistently higher than those measured using LC-MS/MS. The correlation analysis revealed robust associations among salivary cortisol (IA), salivary cortisol (LC-MS/MS), and serum-free cortisol levels (LC-MS/MS). However, the method comparison revealed a systematic bias between IA and LC-MS/MS in salivary cortisol measurement. Conclusions This study contributes to the ongoing debate on assay techniques by affirming the suitability of IA and LC-MS/MS for salivary cortisol measurement to assess dynamic changes in HPA axis activity. The identified systematic bias emphasizes the importance of selecting methods based on specific research or clinical requirements.
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Affiliation(s)
- Anna Lee
- Department of Laboratory Medicine, Seoul Clinical Laboratories, Yong-In, Republic of Korea
| | - Sooah Jang
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sanghoo Lee
- Center for Companion Biomarker, Seoul Clinical Laboratories Healthcare Inc., Yong-In, Republic of Korea
| | - Hyun-Kyung Park
- Department of Laboratory Medicine, Seoul Clinical Laboratories, Yong-In, Republic of Korea
| | - In-Young Kim
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
| | - Ryunsup Ahn
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Hormone Analysis Center, Minds.AI, Co. Ltd., Seoul, Republic of Korea
| | - Jeong-Ho Seok
- Research Institute of Minds.AI, Co. Ltd., Seoul, Republic of Korea
- Institute of Behavioral Sciences in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Psychiatry, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyoung-Ryul Lee
- Department of Laboratory Medicine, Seoul Clinical Laboratories, Yong-In, Republic of Korea
- Center for Companion Biomarker, Seoul Clinical Laboratories Healthcare Inc., Yong-In, Republic of Korea
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Vignesh V, Castro-Dominguez B, James TD, Gamble-Turner JM, Lightman S, Reis NM. Advancements in Cortisol Detection: From Conventional Methods to Next-Generation Technologies for Enhanced Hormone Monitoring. ACS Sens 2024; 9:1666-1681. [PMID: 38551608 PMCID: PMC11059103 DOI: 10.1021/acssensors.3c01912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 01/22/2024] [Accepted: 03/08/2024] [Indexed: 05/02/2024]
Abstract
The hormone cortisol, released as the end-product of the hypothalamic-pituitary-adrenal (HPA) axis, has a well-characterized circadian rhythm that enables an allostatic response to external stressors. When the pattern of secretion is disrupted, cortisol levels are chronically elevated, contributing to diseases such as heart attacks, strokes, mental health disorders, and diabetes. The diagnosis of chronic stress and stress related disorders depends upon accurate measurement of cortisol levels; currently, it is quantified using mass spectroscopy or immunoassay, in specialized laboratories with trained personnel. However, these methods are time-consuming, expensive and are unable to capture the dynamic biorhythm of the hormone. This critical review traces the path of cortisol detection from traditional laboratory-based methods to decentralised cortisol monitoring biosensors. A complete picture of cortisol biology and pathophysiology is provided, and the importance of precision medicine style monitoring of cortisol is highlighted. Antibody-based immunoassays still dominate the pipeline of development of point-of-care biosensors; new capture molecules such as aptamers and molecularly imprinted polymers (MIPs) combined with technologies such as microfluidics, wearable electronics, and quantum dots offer improvements to limit of detection (LoD), specificity, and a shift toward rapid or continuous measurements. While a variety of different sensors and devices have been proposed, there still exists a need to produce quantitative tests for cortisol ─ using either rapid or continuous monitoring devices that can enable a personalized medicine approach to stress management. This can be addressed by synergistic combinations of technologies that can leverage low sample volumes, relevant limit of detection and rapid testing time, to better account for cortisol's shifting biorhythm. Trends in cortisol diagnostics toward rapid and continuous monitoring of hormones are highlighted, along with insights into choice of sample matrix.
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Affiliation(s)
- Visesh Vignesh
- Department
of Chemical Engineering and Centre for Bioengineering and Biomedical
Technologies (CBio) University of Bath, BA2 7AY Bath, U.K.
| | - Bernardo Castro-Dominguez
- Department
of Chemical and Engineering and Digital Manufacturing and Design University
of Bath, BA2 7AY Bath, U.K.
| | - Tony D. James
- Department
of Chemistry, University of Bath, BA2 7AY Bath, U.K.
| | | | - Stafford Lightman
- Translational
Health Sciences, Bristol Medical School, University of Bristol, BS1 3NY Bristol, U.K.
| | - Nuno M. Reis
- Department
of Chemical Engineering and Centre for Bioengineering and Biomedical
Technologies (CBio) University of Bath, BA2 7AY Bath, U.K.
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12
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Martin-Grace J, Tomkins M, O'Reilly MW, Sherlock M. Iatrogenic adrenal insufficiency in adults. Nat Rev Endocrinol 2024; 20:209-227. [PMID: 38272995 DOI: 10.1038/s41574-023-00929-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 01/27/2024]
Abstract
Iatrogenic adrenal insufficiency (IAI) is the most common form of adrenal insufficiency in adult patients, although its overall exact prevalence remains unclear. IAI is associated with adverse clinical outcomes, including adrenal crisis, impaired quality of life and increased mortality; therefore, it is imperative that clinicians maintain a high index of suspicion in patients at risk of IAI to facilitate timely diagnosis and appropriate management. Herein, we review the major causes, clinical consequences, diagnosis and care of patients with IAI. The management of IAI, particularly glucocorticoid-induced (or tertiary) adrenal insufficiency, can be particularly challenging, and the provision of adequate glucocorticoid replacement must be balanced against minimizing the cardiometabolic effects of excess glucocorticoid exposure and optimizing recovery of the hypothalamic-pituitary-adrenal axis. We review current treatment strategies and their limitations and discuss developments in optimizing treatment of IAI. This comprehensive Review aims to aid clinicians in identifying who is at risk of IAI, how to approach screening of at-risk populations and how to treat patients with IAI, with a focus on emergency management and prevention of an adrenal crisis.
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Affiliation(s)
- Julie Martin-Grace
- Department of Endocrinology, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Endocrinology, Beaumont Hospital, Dublin, Ireland
| | - Maria Tomkins
- Department of Endocrinology, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Endocrinology, Beaumont Hospital, Dublin, Ireland
| | - Michael W O'Reilly
- Department of Endocrinology, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Endocrinology, Beaumont Hospital, Dublin, Ireland
| | - Mark Sherlock
- Department of Endocrinology, Royal College of Surgeons in Ireland, Dublin, Ireland.
- Department of Endocrinology, Beaumont Hospital, Dublin, Ireland.
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13
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Hendry E, McCallister B, Elman DJ, Freeman R, Borsook D, Elman I. Validity of mental and physical stress models. Neurosci Biobehav Rev 2024; 158:105566. [PMID: 38307304 PMCID: PMC11082879 DOI: 10.1016/j.neubiorev.2024.105566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/13/2024] [Accepted: 01/27/2024] [Indexed: 02/04/2024]
Abstract
Different stress models are employed to enhance our understanding of the underlying mechanisms and explore potential interventions. However, the utility of these models remains a critical concern, as their validities may be limited by the complexity of stress processes. Literature review revealed that both mental and physical stress models possess reasonable construct and criterion validities, respectively reflected in psychometrically assessed stress ratings and in activation of the sympathoadrenal system and the hypothalamic-pituitary-adrenal axis. The findings are less robust, though, in the pharmacological perturbations' domain, including such agents as adenosine or dobutamine. Likewise, stress models' convergent- and discriminant validity vary depending on the stressors' nature. Stress models share similarities, but also have important differences regarding their validities. Specific traits defined by the nature of the stressor stimulus should be taken into consideration when selecting stress models. Doing so can personalize prevention and treatment of stress-related antecedents, its acute processing, and chronic sequelae. Further work is warranted to refine stress models' validity and customize them so they commensurate diverse populations and circumstances.
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Affiliation(s)
- Erin Hendry
- Center for Autonomic and Peripheral Nerve Disorders, Harvard Medical School, Boston, MA, USA; Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Brady McCallister
- Center for Autonomic and Peripheral Nerve Disorders, Harvard Medical School, Boston, MA, USA
| | - Dan J Elman
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Roy Freeman
- Center for Autonomic and Peripheral Nerve Disorders, Harvard Medical School, Boston, MA, USA; Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - David Borsook
- Departments of Psychiatry and Radiology, Massachusetts General Hospital, Harvard Medical School, Department of Anesthesiology, Harvard Medical School, Boston, MA, USA.
| | - Igor Elman
- Department of Psychiatry, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
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14
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Samad S, Baloch B, Qadeer MA. Revolutionizing depression diagnosis: earwax analysis for cortisol and beyond. Bioanalysis 2024; 16:429-430. [PMID: 38415689 PMCID: PMC11216613 DOI: 10.4155/bio-2023-0240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 02/14/2024] [Indexed: 02/29/2024] Open
Affiliation(s)
- Shahzaib Samad
- Jinnah Sindh Medical University, Rafiqi H J Shaheed Road, Karachi, 75510, Pakistan
| | - Bilqees Baloch
- Ziauddin Medical College, 4/B, Shahrah-e-Ghalib, Block 6, Clifton Karachi, Sindh, 75600, Pakistan
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15
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Patel E, Ben-Shlomo A. Opioid-induced adrenal insufficiency: diagnostic and management considerations. Front Endocrinol (Lausanne) 2024; 14:1280603. [PMID: 38476510 PMCID: PMC10927719 DOI: 10.3389/fendo.2023.1280603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 09/25/2023] [Indexed: 03/14/2024] Open
Abstract
The dramatic rise in opioid use over the last two decades has led to a surge in their harmful health effects. Lesser known among clinicians is the impact of opioids on the endocrine system, especially with regard to cortisol. Opioids can suppress the hypothalamus-pituitary-adrenal (HPA) axis and may result in clinically significant adrenal insufficiency, especially in those treated at higher doses and for a longer time. A high clinical suspicion is necessary in this population for early diagnosis of opioid-induced adrenal insufficiency (OAI). Diagnosis of OAI is challenging, as the symptoms are often vague and overlap with those due to opioid use or the underlying pain disorder. Traditional assays to diagnose adrenal insufficiency have not been widely studied in this population, and more investigation is needed to determine how opioids might affect assay results. Once a diagnosis of adrenal insufficiency has been made, glucocorticoid replacement in the form of hydrocortisone is likely the mainstay of treatment, and effort should be made to taper down opioids where possible. Cortisol levels should be retested periodically, with the goal of stopping glucocorticoid replacement once the HPA axis has recovered. In this review, we provide context for diagnostic challenges in OAI, suggest diagnostic tools for this population based on available data, and offer recommendations for the management of this disorder. There is a paucity of literature in this field; given the widespread use of opioids in the general population, more investigation into the effects of opioids on the HPA axis is sorely needed.
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Affiliation(s)
- Erica Patel
- Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Anat Ben-Shlomo
- Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Multidisciplinary Adrenal Program, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States
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16
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Wolfe M, Cramer A, Webb S, Goorskey E, Chushak Y, Mirau P, Arroyo-Currás N, Chávez JL. Rational Approach to Optimizing Conformation-Switching Aptamers for Biosensing Applications. ACS Sens 2024; 9:717-725. [PMID: 38270529 PMCID: PMC10897929 DOI: 10.1021/acssensors.3c02004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/01/2023] [Accepted: 01/10/2024] [Indexed: 01/26/2024]
Abstract
The utilization of structure-switching aptamers (SSAs) has enabled the development of novel sensing platforms for the sensitive and continuous detection of molecules. De novo development of SSAs, however, is complex and laborious. Here we describe a rational approach to SSA optimization that simultaneously improves aptamer binding affinity and introduces target-dependent conformation-switching for compatibility with real-world biosensor applications. Key structural features identified from NMR and computational modeling were used to optimize conformational switching in the presence of target, while large-scale, microarray-based mutation analysis was used to map regions of the aptamer permissive to mutation and identify combinations of mutations with stronger binding affinity. Optimizations were carried out in a relevant biofluid to ensure a seamless transition of the aptamer to a biosensing platform. Initial proof-of-concept for this approach is demonstrated with a cortisol binding aptamer but can easily be translated to other relevant aptamers. Cortisol is a hormone correlated with the stress response that has been associated with various medical conditions and is present at quantifiable levels in accessible biofluids. The ability to continuously track levels of stress in real-time via cortisol monitoring, which can be enabled by the aptamers reported here, is crucial for assessing human health and performance.
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Affiliation(s)
- Monica Wolfe
- 711th
Human Performance Wing, Air Force Research Laboratory, WPAFB, Ohio 45433, United States
- UES,
Inc., Dayton, Ohio 45433, United States
| | - Alyssa Cramer
- 711th
Human Performance Wing, Air Force Research Laboratory, WPAFB, Ohio 45433, United States
- UES,
Inc., Dayton, Ohio 45433, United States
| | - Sean Webb
- 711th
Human Performance Wing, Air Force Research Laboratory, WPAFB, Ohio 45433, United States
- UES,
Inc., Dayton, Ohio 45433, United States
| | - Eva Goorskey
- 711th
Human Performance Wing, Air Force Research Laboratory, WPAFB, Ohio 45433, United States
| | - Yaroslav Chushak
- 711th
Human Performance Wing, Air Force Research Laboratory, WPAFB, Ohio 45433, United States
- Henry
M. Jackson Foundation for the Advancement of Military Medicine, WPAFB, Ohio 45433, United States
| | - Peter Mirau
- Materials
and Manufacturing Directorate, Air Force Research Laboratory, WPAFB, Ohio 45433, United States
| | - Netzahualcóyotl Arroyo-Currás
- Department
of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, United States
| | - Jorge L. Chávez
- 711th
Human Performance Wing, Air Force Research Laboratory, WPAFB, Ohio 45433, United States
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17
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Goryński K, Sobczak Ł. Quantification of prohibited substances and endogenous corticosteroids in saliva using traditional, alternative microextraction-based, and novel 3D printed sample-preparation methods coupled with LC-MS. Anal Chim Acta 2024; 1291:342236. [PMID: 38280791 DOI: 10.1016/j.aca.2024.342236] [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: 09/15/2023] [Revised: 01/06/2024] [Accepted: 01/09/2024] [Indexed: 01/29/2024]
Abstract
Oral fluid has gained significant interest as an alternative matrix for drug testing due to its easy and non-invasive collection. Despite these advantages, achieving suitably low limits of detection remains a clear challenge in the use of oral fluids for drug screening. In this study, we demonstrate that the application of commercially available SPME fibers followed by liquid chromatography tandem mass spectrometry can enable the comprehensive detection and confirmation of drugs in oral fluid samples. To this end, we develop and test a sample-preparation protocol for a panel of 46 drugs covering the most popular drugs of abuse and doping agents available worldwide. Human saliva samples were collected using a Salivette® device (CE IVD certified) and sampled using SPME devices coated with a C18 extraction phase. The proposed protocol was validated with respect to its lower limits of quantification (LLOQ), linearity, matrix effects, precision, and extraction recovery. Linearity was confirmed for all compounds (R2 > 0.97), except for testosterone (R2 = 0.953) and metandrostenolon (R2 = 0.958). Furthermore, 4 compounds suffered from matrix effects, with less than 10 % deviation from acceptance criteria. After analytical validation, saliva samples from volunteers were analyzed to determine free concentrations of cortisol at different times after awaking. Finally, a 3D-printed prototype device was designed and successfully applied to extract small molecules, thus demonstrating a new modern low-cost approach for bioanalysis.
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Affiliation(s)
- Krzysztof Goryński
- Bydgoszcz University of Science and Technology, Faculty of Chemical Technology and Engineering, Seminaryjna 3, 85-326, Bydgoszcz, Poland.
| | - Łukasz Sobczak
- Nicolaus Copernicus University in Toruń, Faculty of Pharmacy, Jurasza 2, 85-089, Bydgoszcz, Poland
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18
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Poulsen M, Overgaard M, Folsted Andersen CB, Lodberg A. Highly Responsive Bioassay for Quantification of Glucocorticoids. Anal Chem 2024; 96:2000-2007. [PMID: 38277256 PMCID: PMC10851934 DOI: 10.1021/acs.analchem.3c04435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/10/2024] [Accepted: 01/15/2024] [Indexed: 01/28/2024]
Abstract
Measurement of total cortisol levels in serum samples is currently based on immunoassays or liquid chromatography-mass spectrometry (LC-MS/MS). However, measurement of bioavailable cortisol is laborious, unreliable, and inconvenient for the patient. Therefore, a new versatile assay with the ability to measure both total and bioavailable cortisol from serum represents an important supplement to the current methods. We have generated a cell-based glucocorticoid reporter assay (HEK293F-GRE). The assay was validated for cell line stability, accuracy by dilution, precision, repeatability, reproducibility, and specificity. Additionally, the assay was tested for measuring both total and bioavailable cortisol in serum. The assay showed linearity at five dilution levels with R2 = 0.98 and an accuracy between 0.8 and 1.2. Precision (CV < 20%) was validated down to 3-6 nM dexamethasone, and estimation of the total cortisol concentration was comparable to cortisol immunoassay and LC-MS/MS in most serum samples. Moreover, the assay estimated the bioavailable cortisol fraction in serum samples to a level that agreed with the literature. The HEK293F-GRE assay holds the potential to be a complementary method for estimating cortisol in clinical practice. The ability to quantify bioavailable cortisol directly from serum samples is alluring and provides an opportunity for monitored and personal dose regimens of exogenous glucocorticoids.
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Affiliation(s)
| | - Martin Overgaard
- Department
of Clinical Research, University of Southern
Denmark, 5000 Odense C, Denmark
- Department
of Clinical Biochemistry, Odense University
Hospital, 5000 Odense C, Denmark
| | | | - Andreas Lodberg
- Department
of Biomedicine, Aarhus University, Wilhelm Meyers Allé 3, 8000 Aarhus C, Denmark
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19
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Peel A, Rushworth RL, Torpy DJ. Novel agents to treat adrenal insufficiency: findings of preclinical and early clinical trials. Expert Opin Investig Drugs 2024; 33:115-126. [PMID: 38284211 DOI: 10.1080/13543784.2024.2311207] [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: 11/06/2023] [Accepted: 01/24/2024] [Indexed: 01/30/2024]
Abstract
INTRODUCTION Adrenal insufficiency currently affects over 300/million population, with higher morbidity and mortality compared to the general population. Current glucocorticoid replacement therapy is limited by a lack of reliable biomarkers to guide dosing, inter-patient variation in metabolism and narrow therapeutic window. Increased morbidity and mortality may relate to unappreciated under- or over-exposure to glucocorticoids and impaired cortisol circadian rhythm. New agents are required to emulate physiological cortisol secretion and individualize glucocorticoid dosing. AREAS COVERED History of glucocorticoid therapy, current limitations, and novel chronotherapeutic glucocorticoid delivery mechanisms. Literature search incorporated searches of PubMed and Embase utilizing terms such as adrenal insufficiency, Chronocort, Plenadren, continuous subcutaneous hydrocortisone infusion (CHSI), and glucocorticoid receptor modulator. EXPERT OPINION Glucocorticoid chronotherapy is necessary to optimize glucocorticoid exposure and minimize complications. Current oral chronotherapeutics provide improved dosing functionality, but are modifiable only in specific increments and cannot accommodate ultradian cortisol variation. Current data show improvement in quality of life but not morbidity or mortality outcomes. CHSI has significant potential for individualized glucocorticoid dosing, but would require a suitable biomarker of glucocorticoid adequacy to be implementable. Avenues for future research include determining a glucocorticoid sufficiency biomarker, development of interstitial or systemic cortisol monitoring, or development of glucocorticoid receptor modulators.
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Affiliation(s)
- Andrew Peel
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, Australia
| | - R Louise Rushworth
- School of Medicine, Sydney, The University of Notre Dame, Australia, Sydney, Australia
| | - David J Torpy
- Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, Australia
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20
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Mirzaian M, van Zundert SKM, Schilleman WF, Mohseni M, Kuckuck S, van Rossum EFC, van Schaik RHN, van den Berg SAA. Determination of cortisone and cortisol in human scalp hair using an improved LC-MS/MS-based method. Clin Chem Lab Med 2024; 62:118-127. [PMID: 37485925 DOI: 10.1515/cclm-2023-0341] [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: 04/03/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVES Human scalp hair is an easily available but complex matrix for determination of cortisone and cortisol, and has been shown to reflect long-term glucocorticoid exposure. Hair glucocorticoid analysis has been used to detect hypo- and hypercortisolism. In this study, we describe the development and validation of a LC-MS/MS method for quantification of cortisone and cortisol in human scalp hair, and provide a novel approach for analysis and interpretation of the results. METHODS Improved sample preparation using pulverization and solid phase extraction allowed for low sample volumes (10 mg). Baseline chromatographic separation without matrix interference was achieved by reversed phase chromatography and MRM measurement in negative ion mode. Run-to-run time was 8 min. Mixed model analyses were performed to create individual patterns of cortisone and cortisol concentrations. RESULTS Matrix matched calibration curves showed excellent linearity up to 100 pg (analyte)/mg (hair) for both cortisone and cortisol (R2>0.995). LLOQ was 1.5 and 1.0 pg/mg for cortisone and cortisol, respectively. Matrix effect was negligible for hair color (recoveries 95-105 %). Cortisone and cortisol concentrations decreased from proximal to distal hair segments, following a predictable, but subject-specific pattern, with less individual variation for cortisone than for cortisol. CONCLUSIONS This improved LC-MS/MS method is able to accurately quantify cortisone and cortisol in human hair with minimum matrix interference. This new way of data analysis and interpretation including individual patterns of cortisone and cortisol will be of help with detection of pathological concentrations in both the high - and the low ranges of glucocorticoids.
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Affiliation(s)
- Mina Mirzaian
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Sofie K M van Zundert
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Wim F Schilleman
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Mostafa Mohseni
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Susanne Kuckuck
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Elisabeth F C van Rossum
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Obesity Center CGG, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Ron H N van Schaik
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Sjoerd A A van den Berg
- Department of Clinical Chemistry, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Division of Endocrinology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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21
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Mu D, Fang J, Yu S, Ma Y, Cheng J, Hu Y, Song A, Zhao F, Zhang Q, Qi Z, Zhang K, Xia L, Qiu L, Zhu H, Cheng X. Comparison of Direct and Extraction Immunoassay Methods With Liquid Chromatography-Tandem Mass Spectrometry Measurement of Urinary Free Cortisol for the Diagnosis of Cushing's Syndrome. Ann Lab Med 2024; 44:29-37. [PMID: 37665283 PMCID: PMC10485861 DOI: 10.3343/alm.2024.44.1.29] [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: 05/11/2023] [Revised: 06/20/2023] [Accepted: 08/04/2023] [Indexed: 09/05/2023] Open
Abstract
Background Twenty-four-hour urinary free cortisol (UFC) measurement is the initial diagnostic test for Cushing's syndrome (CS). We compared UFC determination by both direct and extraction immunoassays using Abbott Architect, Siemens Atellica Solution, and Beckman DxI800 with liquid chromatography-tandem mass spectrometry (LC-MS/MS). In addition, we evaluated the value of 24-hr UFC measured by six methods for diagnosing CS. Methods Residual 24-hr urine samples of 94 CS and 246 non-CS patients were collected. A laboratory-developed LC-MS/MS method was used as reference. UFC was measured by direct assays (D) using Abbott, Siemens, and Beckman platforms and by extraction assays (E) using Siemens and Beckman platforms. Method was compared using Passing-Bablok regression and Bland-Altman plot analyses. Cut-off values for the six assays and corresponding sensitivities and specificities were calculated by ROC analysis. Results Abbott-D, Beckman-E, Siemens-E, and Siemens-D showed strong correlations with LC-MS/MS (Spearman coefficient r=0.965, 0.922, 0.922, and 0.897, respectively), while Beckman-D showed weaker correlation (r=0.755). All immunoassays showed proportionally positive bias. The areas under the curve were 0.975 for Abbott-D, 0.972 for LC-MS/MS, 0.966 for Siemens-E, 0.948 for Siemens-D, 0.955 for Beckman-E, and 0.877 for Beckman-D. The cut-off values varied significantly (154.8-1,321.5 nmol/24 hrs). Assay sensitivity and specificity ranged from 76.1% to 93.2% and from 93.0% to 97.1%, respectively. Conclusions Commercially available immunoassays for measuring UFC show different levels of analytical consistency compared to LC-MS/MS. Abbott-D, Siemens-E, and Beckman-E have high diagnostic accuracy for CS.
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Affiliation(s)
- Danni Mu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Jiadan Fang
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Songlin Yu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Yichen Ma
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Jin Cheng
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Yingying Hu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Ailing Song
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Fang Zhao
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Qi Zhang
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Zhihong Qi
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Kui Zhang
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Liangyu Xia
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Ling Qiu
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Huijuan Zhu
- Department of Endocrinology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Xinqi Cheng
- Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
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22
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Emal LM, Tamminga SJ, Schaafsma FG, Jakasa I, Peremin I, Kirschbaum C, van der Molen HF, Kezic S. Exploring the potential of stratum corneum biomarkers for assessing psychological distress in health care workers: An observational pilot study. Health Sci Rep 2024; 7:e1710. [PMID: 38186941 PMCID: PMC10764658 DOI: 10.1002/hsr2.1710] [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: 08/04/2023] [Revised: 10/25/2023] [Accepted: 10/31/2023] [Indexed: 01/09/2024] Open
Abstract
Backgrounds The detection of biomarkers of a stress response in the stratum corneum (SC) could be used as objective assessment of early stress symptoms and monitoring of stress reduction interventions in health care workers (HCWs). Aim The aim of this study is to explore SC biomarkers of immune and hormonal response and skin barrier for assessment of psychological distress (PD) in HCWs. Methods Twenty-five female HCWs and 25 non-HCWs participated. SC samples were collected using adhesive tapes at baseline and 3-5 days later (T1). We analyzed 24 biomarkers (immunological, vascular, hormones, and natural moisturizing factors). Stress symptoms were assessed using three scales of Copenhagen Psychosocial Questionnaire. The study involved: identifying SC biomarkers, correlating stress symptoms and biomarkers at baseline and T1, examining stress symptoms between the groups with a Mann-Whitney test, comparing stress symptoms and biomarkers between groups using Ordinary Least Regression and investigating temporal variability of SC biomarkers at baseline and T1 using a Wilcoxon-signed rank. Results Fourteen SC biomarkers were identified. We found correlations between general stress and "IL18" (r = 0.55) physical stress and "IL1b" (r = 0.36) and cognitive stress and "MIP3a" (r = 0.38) at baseline and general stress and cortisol (r = -0.49), physical stress and cortisol (r = -0.60) and cortisone (r = -0.67) at T1. We found no differences in stress symptoms and biomarkers between the groups, except for "MIP3a" at baseline. Differences in the biomarker levels between two time points were found for "TARC," "VEGFA," "ILRA," "IL1RA/IL1a," "NMF," and "DHEA." Conclusion The SC can be suitable biological material to assess biomarkers related to immune response, hormonal response, and skin barrier function. The SC biomarkers, showed strong, moderate and weak correlations with stress symptoms. Notably, these associations include cytokines of innate immunity and well-known stress hormones, cortisol and cortisone.
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Affiliation(s)
- Lima M. Emal
- Department of Public and Occupational health, Amsterdam UMC, Amsterdam Public Health Research InstituteUniversity of AmsterdamAmsterdamNoord‐HollandNetherlands
| | - Sietske J. Tamminga
- Department of Public and Occupational health, Amsterdam UMC, Amsterdam Public Health Research InstituteUniversity of AmsterdamAmsterdamNoord‐HollandNetherlands
| | - Frederieke G. Schaafsma
- Department of Public and Occupational health, Amsterdam UMC, Amsterdam Public Health Research InstituteUniversity of AmsterdamAmsterdamNoord‐HollandNetherlands
| | - Ivone Jakasa
- Laboratory for Analytical Chemistry, Department of Chemistry and Biochemistry, Faculty of Food Technology and BiotechnologyUniversity of ZagrebZagrebCroatia
| | - Ines Peremin
- Laboratory for Analytical Chemistry, Department of Chemistry and Biochemistry, Faculty of Food Technology and BiotechnologyUniversity of ZagrebZagrebCroatia
| | | | - Henk F. van der Molen
- Department of Public and Occupational health, Amsterdam UMC, Amsterdam Public Health Research InstituteUniversity of AmsterdamAmsterdamNoord‐HollandNetherlands
| | - Sanja Kezic
- Department of Public and Occupational health, Amsterdam UMC, Amsterdam Public Health Research InstituteUniversity of AmsterdamAmsterdamNoord‐HollandNetherlands
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23
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Ok J, Park S, Jung YH, Kim TI. Wearable and Implantable Cortisol-Sensing Electronics for Stress Monitoring. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2024; 36:e2211595. [PMID: 36917076 DOI: 10.1002/adma.202211595] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/27/2023] [Indexed: 06/18/2023]
Abstract
Cortisol is a steroid hormone that is released from the body in response to stress. Although a moderate level of cortisol secretion can help the body maintain homeostasis, excessive secretion can cause various diseases, such as depression and anxiety. Conventional methods for cortisol measurement undergo procedures that limit continuous monitoring, typically collecting samples of bodily fluids, followed by separate analysis in a laboratory setting that takes several hours. Thus, recent studies demonstrate wearable, miniaturized sensors integrated with electronic modules that enable wireless real-time analysis. Here, the primary focus is on wearable and implantable electronic devices that continuously measure cortisol concentration. Diverse types of cortisol-sensing techniques, such as antibody-, DNA-aptamer-, and molecularly imprinted polymer-based sensors, as well as wearable and implantable devices that aim to continuously monitor cortisol in a minimally invasive fashion are discussed. In addition to the cortisol monitors that directly measure stress levels, other schemes that indirectly measure stress, such as electrophysiological signals and sweat are also summarized. Finally, the challenges and future directions in stress monitoring and management electronics are reviewed.
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Affiliation(s)
- Jehyung Ok
- School of Chemical Engineering, Sungkyunkwan University (SKKU), Suwon, 16419, Republic of Korea
| | - Sumin Park
- Department of Electronic Engineering, Hanyang University, Seoul, 04763, Republic of Korea
| | - Yei Hwan Jung
- Department of Electronic Engineering, Hanyang University, Seoul, 04763, Republic of Korea
| | - Tae-Il Kim
- School of Chemical Engineering, Sungkyunkwan University (SKKU), Suwon, 16419, Republic of Korea
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24
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Low SLK, Ho GF, Liu B, Koh ES, Fei Y, Teo CS, Zhu X. Exploring Guolin Qigong (Mind-Body Exercise) for Improving Cancer Related Fatigue in Cancer Survivors: A Mixed Method Randomized Controlled Trial Protocol. Integr Cancer Ther 2024; 23:15347354241252698. [PMID: 38757745 PMCID: PMC11102686 DOI: 10.1177/15347354241252698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 04/05/2024] [Accepted: 04/18/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Cancer-related fatigue and its associated symptoms of sleep disorder and depression are prevalent in cancer survivors especially among breast, lung, and colorectal cancer survivors. While there is no gold standard for treating cancer-related fatigue currently, studies of mind-body exercises such as Qigong have reported promise in reducing symptoms. This study was designed to evaluate the feasibility and effect of Guolin Qigong on cancer-related fatigue and other symptoms in breast, lung and colorectal cancer survivors while exploring their perceptions and experiences of Guolin Qigong intervention. METHODS This is an open-label randomized controlled trial with 60 participants divided into 2 study groups in a 1:1 ratio. The intervention group will receive 12 weeks of Guolin Qigong intervention with a 4-week follow-up while control will receive usual care under waitlist. The primary outcome will be feasibility measured based on recruitment and retention rates, class attendance, home practice adherence, nature, and quantum of missing data as well as safety. The secondary subjective outcomes of fatigue, sleep quality and depression will be measured at Week-1 (baseline), Week-6 (mid-intervention), Week-12 (post-intervention), and Week-16 (4 weeks post-intervention) while an objective 24-hour urine cortisol will be measured at Week-1 (baseline) and Week-12 (post-intervention). We will conduct a semi-structured interview individually with participants within 3 months after Week-16 (4 weeks post-intervention) to obtain a more comprehensive view of practice adherence. DISCUSSION This is the first mixed-method study to investigate the feasibility and effect of Guolin Qigong on breast, lung, and colorectal cancer survivors to provide a comprehensive understanding of Guolin Qigong's intervention impact and participants' perspectives. The interdisciplinary collaboration between Western Medicine and Chinese Medicine expertise of this study ensures robust study design, enhanced participant care, rigorous data analysis, and meaningful interpretation of results. This innovative research contributes to the field of oncology and may guide future evidence-based mind-body interventions to improve cancer survivorship. TRIAL REGISTRATION This study has been registered with ANZCTR (ACTRN12622000688785p), was approved by Medical Research Ethic Committee of University Malaya Medical Centre (MREC ID NO: 2022323-11092) and recognized by Western Sydney University Human Research Ethics Committee (RH15124).
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Affiliation(s)
- Sara L. K. Low
- Western Sydney University, Penrith South, NSW, Australia
| | - Gwo Fuang Ho
- University Malaya Medical Centre, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | | | - Eng-Siew Koh
- University of New South Wales, Liverpool, NSW, Australia
| | - Yutong Fei
- Beijing University of Chinese Medicine, Beijing, China
| | | | - Xiaoshu Zhu
- Western Sydney University, Penrith South, NSW, Australia
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25
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Wang R, Kogler L, Derntl B. Sex differences in cortisol levels in depression: A systematic review and meta-analysis. Front Neuroendocrinol 2024; 72:101118. [PMID: 38176541 DOI: 10.1016/j.yfrne.2023.101118] [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] [Revised: 12/11/2023] [Accepted: 12/31/2023] [Indexed: 01/06/2024]
Abstract
Higher prevalence of depression in females might be associated with sex-specific cortisol levels. Evidence exists that cortisol levels differ between healthy females and males, however a sex-specific association in depression has not been systematically assessed. Thus, the current study quantifies the existing literature on different cortisol parameters, i.e., basal cortisol, hair cortisol, cortisol awakening response (CAR), and cortisol stress reactivity comparing depressed females and males as well as sex-specific comparisons with healthy controls. Following an extensive literature research, fifty original articles were included. Depressed females had significantly higher hair cortisol, higher CAR, and lower cortisol stress reactivity compared to depressed males. In comparison with sex-matched controls, female patients had significantly higher evening basal cortisol, higher CAR and lower cortisol stress reactivity, and male patients had significantly higher general, morning and evening basal cortisol. Overall, sex as a fundamental driver of cortisol levels in depression needs to be taken into account.
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Affiliation(s)
- Rui Wang
- Department of Psychiatry and Psychotherapy, Women's Mental Health & Brain Function, Tübingen Center for Mental Health (TüCMH), Medical Faculty, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany.
| | - Lydia Kogler
- Department of Psychiatry and Psychotherapy, Women's Mental Health & Brain Function, Tübingen Center for Mental Health (TüCMH), Medical Faculty, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany; German Center for Mental Health (DZPG), partner site Tübingen, 72076 Tübingen, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Women's Mental Health & Brain Function, Tübingen Center for Mental Health (TüCMH), Medical Faculty, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany; German Center for Mental Health (DZPG), partner site Tübingen, 72076 Tübingen, Germany; LEAD Graduate School and Research Network, University of Tübingen, Germany
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26
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Zarnegar R, Vounta A, Li Q, Ghoreishizadeh SS. Nociception related biomolecules in the adult human saliva: A scoping review with additional quantitative focus on cortisol. Mol Pain 2024; 20:17448069241237121. [PMID: 38385158 PMCID: PMC10916496 DOI: 10.1177/17448069241237121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/30/2024] [Accepted: 02/15/2024] [Indexed: 02/23/2024] Open
Abstract
Nociception related salivary biomolecules can be useful patients who are not able to self-report pain. We present the existing evidence on this topic using the PRISMA-ScR guidelines and a more focused analysis of cortisol change after cold pain induction using the direction of effect analysis combined with risk of bias analysis using ROBINS-I. Five data bases were searched systematically for articles on adults with acute pain secondary to disease, injury, or experimentally induced pain. Forty three articles met the inclusion criteria for the general review and 11 of these were included in the cortisol-cold pain analysis. Salivary melatonin, kallikreins, pro-inflammatory cytokines, soluable TNF-α receptor II, secretory IgA, testosterone, salivary α-amylase (sAA) and, most commonly, cortisol have been studied in relation to acute pain. There is greatest information about cortisol and sAA which both rise after cold pain when compared with other modalities. Where participants have been subjected to both pain and stress, stress is consistently a more reliable predictor of salivary biomarker change than pain. There remain considerable challenges in identifying biomarkers that can be used in clinical practice to guide the measurement of nociception and treatment of pain. Standardization of methodology and researchers' greater awareness of the factors that affect salivary biomolecule concentrations are needed to improve our understanding of this field towards creating a clinically relevant body of evidence.
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Affiliation(s)
- Roxaneh Zarnegar
- Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK
| | - Angeliki Vounta
- Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK
| | - Qiuyuan Li
- Department of Rehabilitation, Shenzhen University General Hospital, Shenzhen, China
| | - Sara S Ghoreishizadeh
- Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK
- Department of Electronic and Electrical Engineering, University College London, London, UK
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27
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Žaja R, Stipičević S, Milošević M, Košec A, Ajduk J, Kelava I, Baća AZ, Klarica M, Ries M. Salivary cortisone as potential predictor of occupational exposure to noise and related stress. Arh Hig Rada Toksikol 2023; 74:232-237. [PMID: 38146755 PMCID: PMC10750323 DOI: 10.2478/aiht-2023-74-3785] [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: 09/01/2023] [Revised: 09/01/2023] [Accepted: 11/01/2023] [Indexed: 12/27/2023] Open
Abstract
Salivary cortisone strongly correlates with serum cortisol, and since it is less invasive to measure salivary cortisone than serum cortisol and easier than to measure cortisol in saliva, as its concentrations are much lower, we wanted to compare salivary cortisone and cortisol levels as markers of noise-induced stress reaction. The study included 104 participants aged 19-30 years, 50 of whom were exposed to occupational noise ≥85 dB(A) and 54 non-exposed, control students. All participants took samples of their saliva with Salivette® Cortisol synthetic swabs on three consecutive working days first thing in the morning. Salivary cortisone and cortisol levels were determined with high-performance liquid chromatography. In addition, they completed a 10-item Perceived Stress Scale (PSS-10) questionnaire, and occupationally noise-exposed participants also completed the Health and Safety Executive (HSE) questionnaire on occupational psychosocial risks. The exposed participants had significantly higher cortisone (P<0.001) and cortisol (P<0.001) levels than controls, and the correlation between cortisone and cortisol levels in the exposed participants was strong (ϱ =0.692, P<0.001), which suggests that salivary cortisone can replace cortisol measurements in saliva as a more reliable method than salivary cortisol and less invasive than serum cortisol. However, the level of perceived stress scored on PSS-10 in the exposed participants did not differ significantly from stress reported by controls, but correlated negatively with cortisone levels, which is contrary to our expectations and raises questions as to why.
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Affiliation(s)
- Roko Žaja
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Sanja Stipičević
- Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | | | - Andro Košec
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Jakov Ajduk
- University of Zagreb School of Medicine, Zagreb, Croatia
| | - Iva Kelava
- University of Zagreb School of Medicine, Zagreb, Croatia
| | | | - Marko Klarica
- University of Applied Health Sciences, Zagreb, Croatia
| | - Mihael Ries
- University of Zagreb School of Medicine, Zagreb, Croatia
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28
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Hantsoo L, Jagodnik KM, Novick AM, Baweja R, di Scalea TL, Ozerdem A, McGlade EC, Simeonova DI, Dekel S, Kornfield SL, Nazareth M, Weiss SJ. The role of the hypothalamic-pituitary-adrenal axis in depression across the female reproductive lifecycle: current knowledge and future directions. Front Endocrinol (Lausanne) 2023; 14:1295261. [PMID: 38149098 PMCID: PMC10750128 DOI: 10.3389/fendo.2023.1295261] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 11/13/2023] [Indexed: 12/28/2023] Open
Abstract
The aim of this narrative review is to consolidate knowledge on the role of the hypothalamic-pituitary-adrenal (HPA) axis in depression pathophysiology at different reproductive stages across the female lifespan. Despite growing evidence about the impact of gonadal hormones on mood disorders, no previous review has examined the interaction between such hormonal changes and the HPA axis within the context of depressive disorders in women. We will focus on HPA axis function in depressive disorders at different reproductive stages including the menstrual cycle (e.g., premenstrual dysphoric disorder [PMDD]), perinatally (e.g., postpartum depression), and in perimenopausal depression. Each of these reproductive stages is characterized by vast physiological changes and presents major neuroendocrine reorganization. The HPA axis is one of the main targets of such functional alterations, and with its key role in stress response, it is an etiological factor in vulnerable windows for depression across the female lifespan. We begin with an overview of the HPA axis and a brief summary of techniques for measuring HPA axis parameters. We then describe the hormonal milieu of each of these key reproductive stages, and integrate information about HPA axis function in depression across these reproductive stages, describing similarities and differences. The role of a history of stress and trauma exposure as a contributor to female depression in the context of HPA axis involvement across the reproductive stages is also presented. This review advances the pursuit of understanding common biological mechanisms across depressive disorders among women. Our overarching goal is to identify unmet needs in characterizing stress-related markers of depression in women in the context of hormonal changes across the lifespan, and to support future research in women's mental health as it pertains to pathophysiology, early diagnosis, and treatment targets.
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Affiliation(s)
- Liisa Hantsoo
- Department of Psychiatry & Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Kathleen M. Jagodnik
- Department of Psychiatry, Harvard Medical School and Massachusetts General Hospital, Boston, MA, United States
| | - Andrew M. Novick
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Ritika Baweja
- Department of Psychiatry and Behavioral Health, Penn State Health, Hershey, PA, United States
- Department of Obstetrics and Gynecology, Penn State Health, Hershey, PA, United States
| | - Teresa Lanza di Scalea
- Department of Psychiatry and Behavioral Sciences, Dell Medical School, University of Texas at Austin, Austin, TX, United States
- Department of Women’s Health, Dell Medical School, University of Texas at Austin, Austin, TX, United States
| | - Aysegul Ozerdem
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, United States
| | - Erin C. McGlade
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah School of Medicine, Salt Lake, UT, United States
- Department of Veterans Affairs, Mental Illness Research, Education, and Clinical Center (MIRECC), Salt Lake, UT, United States
| | - Diana I. Simeonova
- Department of Psychiatry and Behavioral Sciences, Brain Health Center, Emory University School of Medicine, Atlanta, GA, United States
- Goizueta Business School, Emory University, Atlanta, GA, United States
| | - Sharon Dekel
- Department of Psychiatry, Harvard Medical School and Massachusetts General Hospital, Boston, MA, United States
| | - Sara L. Kornfield
- Center for Women’s Behavioral Wellness, Psychiatry Department, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Michelle Nazareth
- Department of Neuroscience, The Johns Hopkins University, Baltimore, MD, United States
| | - Sandra J. Weiss
- Department of Community Health Systems, University of California, San Francisco, San Francisco, CA, United States
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29
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Aizpurua-Perez I, Arregi A, Labaka A, Martinez-Villar A, Perez-Tejada J. Psychological resilience and cortisol levels in adults: A systematic review. Am J Hum Biol 2023; 35:e23954. [PMID: 37395446 DOI: 10.1002/ajhb.23954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/04/2023] Open
Abstract
Resilience or the capacity to "bend but not break" refers to the ability to maintain or regain psychobiological equilibrium during or after exposure to stressful life events. Specifically, resilience has been proposed as a potential resource for staving off pathological states that often emerge after exposure to repeated stress and that are related to alterations in circulating cortisol. The aim of this systematic review of the literature was to gather evidence related to the relationship between psychological resilience and cortisol levels in adult humans. An extensive systematic search was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method in the PubMed and Web of Science databases. In total, 1256 articles were identified and, of these, 35 peer-reviewed articles were included in the systematic review. We categorized findings according to (1) the short and long-term secretion period covered by the cortisol matrices selected by studies and also according to (2) the differentiated diurnal, phasic (acute), and tonic (basal) components of the HPA output to which they refer and their relationships with resilience. Reported relationships between psychological resilience and distinct cortisol output parameters varied widely across studies, finding positive, negative, and null associations between the two variables. Notably, several of the studies that found no relationship between resilience and cortisol used a single morning saliva or plasma sample as their assessment of HPA axis activity. Despite limitations such as the great variability of the instruments and methods used by the studies to measure both resilience and cortisol, together with their high heterogeneity and small sample sizes, the evidence found in this systematic review points to the potential of resilience as a modifiable key factor to modulate the physiological response to stress. Therefore, further exploration of the interaction between the two variables is necessary for the eventual development of future interventions aimed at promoting resilience as an essential component of health prevention.
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Affiliation(s)
- Ibane Aizpurua-Perez
- Department of Basic Psychological Processes and their Development, University of the Basque Country, San Sebastian, Spain
| | - Amaia Arregi
- Department of Basic Psychological Processes and their Development, University of the Basque Country, San Sebastian, Spain
| | - Ainitze Labaka
- Department of Nursing II, University of the Basque Country, San Sebastian, Spain
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30
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Torpy DJ, Lim WT. Glucocorticoid-induced adrenal suppression: physiological basis and strategies for glucocorticoid weaning. Med J Aust 2023; 219:444-447. [PMID: 37884339 DOI: 10.5694/mja2.52140] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023]
Affiliation(s)
- David J Torpy
- Royal Adelaide Hospital, Adelaide, SA
- University of Adelaide, Adelaide, SA
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31
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Lorde N, Elgharably A, Kalaria T. Impact of Variation between Assays and Reference Intervals in the Diagnosis of Endocrine Disorders. Diagnostics (Basel) 2023; 13:3453. [PMID: 37998589 PMCID: PMC10670091 DOI: 10.3390/diagnostics13223453] [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: 09/27/2023] [Revised: 11/10/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023] Open
Abstract
Method-related variations in the measurement of hormones and the reference intervals used in the clinical laboratory can have a significant, but often under-appreciated, impact on the diagnosis and management of endocrine disorders. This variation in laboratory practice has the potential to lead to an errant approach to patient care and thus could cause harm. It may also be the source of confusion or result in excessive or inadequate investigation. It is important that laboratory professionals and clinicians know about these impacts, their sources, and how to detect and mitigate them when they do arise. In this review article, we describe the historical and scientific context from which inconsistency in the clinical laboratory arises. Examples from the published literature of the impact of the method, reference interval, and clinical decision threshold-related discordances on the assessment and monitoring of various endocrine disorders are discussed to illustrate the sources, causes, and effects of this variability. Its potential impact on the evaluation of growth hormone deficiency and excess, thyroid and parathyroid disorders, hyperandrogenism, hypogonadism, glucocorticoid excess and deficiency, and diabetes mellitus is elaborated. Strategies for assessment and mitigation of the discordance are discussed. The clinical laboratory has a responsibility to recognise and address these issues, and although a lot has been accomplished in this area already, there remains more to be done.
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Affiliation(s)
- Nathan Lorde
- Black Country Pathology Services, The Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UK; (A.E.); (T.K.)
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32
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Neal SP, Hodges WN, Velosa DC, Aderorho R, Lucas SW, Chouinard CD. Improved analysis of derivatized steroid hormone isomers using ion mobility-mass spectrometry (IM-MS). Anal Bioanal Chem 2023; 415:6757-6769. [PMID: 37740752 DOI: 10.1007/s00216-023-04953-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/25/2023] [Accepted: 09/12/2023] [Indexed: 09/25/2023]
Abstract
Over the last decade, applications of ion mobility-mass spectrometry (IM-MS) have exploded due primarily to the widespread commercialization of robust instrumentation from several vendors. Unfortunately, the modest resolving power of many of these platforms (~40-60) has precluded routine separation of constitutional and stereochemical isomers. While instrumentation advances have pushed resolving power to >150 in some cases, chemical approaches offer an alternative for increasing resolution with existing IM-MS instrumentation. Herein we explore the utility of two reactions, derivatization by Girard's reagents and 1,1-carbonyldiimidazole (CDI), for improving IM separation of steroid hormone isomers. These reactions are fast (≤30 min), simple (requiring only basic lab equipment/expertise), and low-cost. Notably, these reactions are structurally selective in that they target carbonyl and hydroxyl groups, respectively, which are found in all naturally occurring steroids. Many steroid hormone isomers differ only in the number, location, and/or stereochemistry of these functional groups, allowing these reactions to "amplify" subtle structural differences and improve IM resolution. Our results show that resolution was significantly improved amongst CDI-derivatized isomer groups of hydroxyprogesterone (two-peak resolution of Rpp = 1.10 between 21-OHP and 11B-OHP), deoxycortisone (Rpp = 1.47 between 11-DHC and 21-DOC), and desoximetasone (Rpp = 1.98 between desoximetasone and fluocortolone). Moreover, characteristic collision cross section (DTCCSN2) measurements can be used to increase confidence in the identification of these compounds in complex biological mixtures. To demonstrate the feasibility of analyzing the derivatized steroids in complex biological matrixes, the reactions were performed following steroid extraction from urine and yielded similar results. Additionally, we applied a software-based approach (high-resolution demultiplexing) that further improved the resolving power (>150). Overall, our results suggest that targeted derivatization reactions coupled with IM-MS can significantly improve the resolution of challenging isomer groups, allowing for more accurate and efficient analysis of complex mixtures.
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Affiliation(s)
- Shon P Neal
- Chemistry Program, Department of Biomedical and Chemical Engineering and Sciences, Florida Institute of Technology, Melbourne, FL, 32901, USA
| | - Walker N Hodges
- Department of Chemistry, Clemson University, 211 S. Palmetto Blvd, Clemson, SC, 29634, USA
| | - Diana C Velosa
- Chemistry Program, Department of Biomedical and Chemical Engineering and Sciences, Florida Institute of Technology, Melbourne, FL, 32901, USA
| | - Ralph Aderorho
- Department of Chemistry, Clemson University, 211 S. Palmetto Blvd, Clemson, SC, 29634, USA
| | - Shadrack Wilson Lucas
- Department of Chemistry, Clemson University, 211 S. Palmetto Blvd, Clemson, SC, 29634, USA
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33
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Karuppaiah G, Lee MH, Bhansali S, Manickam P. Electrochemical sensors for cortisol detection: Principles, designs, fabrication, and characterisation. Biosens Bioelectron 2023; 239:115600. [PMID: 37611448 DOI: 10.1016/j.bios.2023.115600] [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: 05/09/2023] [Revised: 08/09/2023] [Accepted: 08/12/2023] [Indexed: 08/25/2023]
Abstract
Psychological stress is a major factor contributing to health discrepancies among individuals. Sustained exposure to stress triggers signalling pathways in the brain, which leading to the release of stress hormones in the body. Cortisol, a steroid hormone, is a significant biomarker for stress management due to its responsibility in the body's reply to stress. The release of cortisol in bloodstream prepares the body for a "fight or flight" response by increasing heart rate, blood pressure, metabolism, and suppressing the immune system. Detecting cortisol in biological samples is crucial for understanding its role in stress and personalized healthcare. Traditional techniques for cortisol detection have limitations, prompting researchers to explore alternative strategies. Electrochemical sensing has emerged as a reliable method for point-of-care (POC) cortisol detection. This review focuses on the progress made in electrochemical sensors for cortisol detection, covering their design, principle, and electroanalytical methodologies. The analytical performance of these sensors is also analysed and summarized. Despite significant advancements, the development of electrochemical cortisol sensors faces challenges such as biofouling, sample preparation, sensitivity, flexibility, stability, and recognition layer performance. Therefore, the need to develop more sensitive electrodes and materials is emphasized. Finally, we discussed the potential strategies for electrode design and provides examples of sensing approaches. Moreover, the encounters of translating research into real world applications are addressed.
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Affiliation(s)
- Gopi Karuppaiah
- Electrodics and Electrocatalysis Division, CSIR-Central Electrochemical Research Institute (CECRI), Karaikudi, 630 003, Tamil Nadu, India; School of Integrative Engineering, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea
| | - Min-Ho Lee
- School of Integrative Engineering, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea
| | - Shekhar Bhansali
- Department of Electrical and Computer Engineering, Florida International University, Miami, FL, 33174, USA.
| | - Pandiaraj Manickam
- Electrodics and Electrocatalysis Division, CSIR-Central Electrochemical Research Institute (CECRI), Karaikudi, 630 003, Tamil Nadu, India; Academy of Scientific and Innovative Research, Ghaziabad, 201 002, Uttar Pradesh, India.
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34
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Pai J, Joshi RK, Bhaskar S, Patil S, Bv S, R S, Iyengar AR, Agarwal N, Shorie M. Revisiting the cortisol reference ranges in humans: the role of demographics. Endocrine 2023; 82:414-418. [PMID: 37501014 DOI: 10.1007/s12020-023-03456-x] [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: 04/20/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023]
Abstract
The current study explores the effect of demographics on serum cortisol expression in a study group of 52 individuals to improve the current serum reference ranges to produce personalized expression profiles consequently increasing clinical confidence in the diagnosis. The serum cortisol concentration was inspected against demographical data like age, sex, and body mass index and showed an association with age and sex. The serum cortisol values also indicated a positive association with chronic illnesses however this finding requires a more focused study for establishment. Additionally, saliva samples are also collected from the same study group at the same time through drool and an absorbent sponge and correlated with serum values to draw an alternative route of serological testing. Salivary cortisol from drool showed a linear correlation with Pearson's correlation coefficients of 0.71 and 0.72 with serum cortisol and with saliva samples collected using a porous sponge respectively. Overall, the study shows the role of demographics in shaping the reference ranges for cortisol, suggesting a path for developing personalized diagnostics. The study also highlights the efficacy of saliva as an alternative to serum cortisol to facilitate cortisol measurement for efficient stress management.
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Affiliation(s)
- Jayeeta Pai
- Cortiqa Health Private Limited, Bangalore, India.
| | | | | | - Seema Patil
- DA Pandu Memorial RV Dental College, Bangalore, India
| | - Subhash Bv
- DA Pandu Memorial RV Dental College, Bangalore, India
| | - Shriyanka R
- DA Pandu Memorial RV Dental College, Bangalore, India
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Koukoubanis K, Stefanaki K, Karagiannakis DS, Kalampalikis A, Michala L. Comparison of salivary cortisol levels between women with functional hypothalamic amenorrhea and healthy women: a pilot study. Endocrine 2023; 82:399-405. [PMID: 37440104 DOI: 10.1007/s12020-023-03448-x] [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: 03/26/2023] [Accepted: 07/02/2023] [Indexed: 07/14/2023]
Abstract
INTRODUCTION Functional Hypothalamic Amenorrhea (FHA) has been associated with excessive-chronic stress, eating disorders, and weight loss. A common feature is the increased serum cortisol, but its measurement has many limitations. Currently, salivary cortisol (SC) has been proposed as a more sensitive and adequate index. AIM To investigate the SC alterations through a 24-h period and the possible correlation with the severity of stress in women with FHA. METHODS Between July 2019 and March 2021, 12 FHA women and 12 healthy controls of comparable age were included. Psychological, eating, and physical abnormalities were evaluated by applying equivalent validated self-questionnaires. RESULTS No significant differences were found between FHA women and healthy individuals with respect to morning (8:00 am) serum cortisol and ACTH (522.5 ± 162.2 vs 442 ± 138.5 nmol/l; p = 0.204 and 37 ± 44.8 vs 17.4 ± 10.8 pg/ml; p = 0.186, respectively). Women with FHA had statistically significant higher morning SC compared to control subjects (21.8 ± 5.9 nmol/l vs 12.8 ± 3.8 nmol/l; p < 0.001), while no significant differences were found regarding the afternoon (4:00 pm) and midnight (12:00 am) SC. A significant positive correlation was found between morning SC and morning serum cortisol (rho = 0.532; p = 0.007), EAT-26 (rho = 0.527; p = 0.008) and HADS-Anxiety score (rho = 0.471; p = 0.02). Additionally, a significant negative correlation between morning SC and BMI was observed (rho = -0.53; p = 0.009). CONCLUSION Compared to serum cortisol, SC seems to express better the hypercortisolemic state of women with FHA and correlates well with the underlying contributing factors. Larger studies are needed in order to confirm these results and validate the optimal SC cut-off value associated with the development of FHA.
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Affiliation(s)
- Konstantinos Koukoubanis
- 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Katerina Stefanaki
- Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios S Karagiannakis
- Academic Department of Gastroenterology, "Laiko" General Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
| | - Andreas Kalampalikis
- 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Lina Michala
- 1st Department of Obstetrics and Gynecology, "Alexandra" Hospital, National and Kapodistrian University of Athens, Athens, Greece
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Yalçin M, Relógio A. Sex and age-dependent characterization of the circadian clock as a potential biomarker for physical performance: A prospective study protocol. PLoS One 2023; 18:e0293226. [PMID: 37874792 PMCID: PMC10597486 DOI: 10.1371/journal.pone.0293226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/04/2023] [Indexed: 10/26/2023] Open
Abstract
INTRODUCTION Circadian rhythms (CR) regulate daily cycles in behavior, physiology and molecular processes. CRs are endogenous and vary across individuals. Seasonal changes can influence CR. Accordingly, rhythms with different characteristics (amplitude, phase) are depicted during the summer months, as compared to winter. Increasing evidence points to an influence of circadian regulation on physical performance. Here, we aim to obtain a comprehensive circadian gene expression profile for physically active individuals, which can potentially be used for the identification of optimal time intervals for physical exercise. METHODS AND ANALYSIS To explore these different aspects, we propose a study where we will carry out a molecular analysis of CR by measuring the expression of specific clock and clock-controlled genes, based on a non-invasive approach using RNA extracted from saliva in physically active, healthy participants. We will collect data across two seasons and use computational algorithms to integrate the molecular data with hormonal data (cortisol and melatonin), and generate a profile of CR in healthy individuals of different sex and age groups. Finally, we will use computational tools to predict optimal time intervals for physical performance based on the above-described data, thereby retrieving valuable data on the circadian clock as a key factor for health maintenance and optimization.
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Affiliation(s)
- Müge Yalçin
- Institute for Theoretical Biology (ITB), Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Institute for Systems Medicine and Faculty of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Angela Relógio
- Institute for Theoretical Biology (ITB), Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Institute for Systems Medicine and Faculty of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany
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Molina-Hidalgo C, Stillman CM, Collins AM, Velazquez-Diaz D, Ripperger HS, Drake JA, Gianaros PJ, Marsland AL, Erickson KI. Changes in stress pathways as a possible mechanism of aerobic exercise training on brain health: a scoping review of existing studies. Front Physiol 2023; 14:1273981. [PMID: 37885801 PMCID: PMC10598664 DOI: 10.3389/fphys.2023.1273981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
Physical activity (PA) in the form of aerobic exercise (AE) preserves and improves neurocognitive function across the lifespan. However, a mechanistic understanding of the pathways by which aerobic exercise impacts brain health is still lacking, particularly with respect to stress-related pathways. One mechanistic hypothesis is that AE improves neurocognitive health in part by modifying circulating levels of stress-related hormones and signaling factors associated with the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS), as commonly measured by the biomarkers cortisol (CORT) and salivary α-amylase (sAA). Thus, this hypothesis predicts that changes in stress biomarkers, such as CORT and sAA, are possible explanatory pathways mediating the positive effects of AE on neurocognitive health. In the present review article, we provide a summary of available studies examining the possibility that exercise-induced changes to stress biomarkers could partly account for exercise-related improvements in neurocognitive health. Our review indicates that despite the intuitive appeal of this hypothesis, there is insufficient evidence available to conclude that chronic and habitual AE affects neurocognitive health by altering stress biomarker pathways. The cross-sectional nature of the majority of reviewed studies highlights the need for well-controlled studies to adequately test this hypothesis.
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Affiliation(s)
| | - Chelsea M. Stillman
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Audrey M. Collins
- AdventHealth Research Institute, Neuroscience Institute, Orlando, FL, United States
| | - Daniel Velazquez-Diaz
- AdventHealth Research Institute, Neuroscience Institute, Orlando, FL, United States
- ExPhy Research Group, Department of Physical Education, University of Cadiz, Cadiz, Spain
| | - Hayley S. Ripperger
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jermon A. Drake
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Peter J. Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Anna L. Marsland
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kirk I. Erickson
- AdventHealth Research Institute, Neuroscience Institute, Orlando, FL, United States
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, United States
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Gouldthorpe C, Power J, Davies A. Circadian rhythm disorders in patients with advanced cancer: a scoping review. Front Oncol 2023; 13:1240284. [PMID: 37829342 PMCID: PMC10565850 DOI: 10.3389/fonc.2023.1240284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/16/2023] [Indexed: 10/14/2023] Open
Abstract
Circadian rhythms can be demonstrated in several biomarkers and behavioural activities, with rhythmical patterns occurring roughly over a 24-h period. Circadian disorders occur in patients with cancer and may be associated with poor clinical outcomes. This scoping review aimed to identify circadian rhythm research and reporting practices, circadian rhythm patterns, circadian rhythm disorders, and relevant associations of circadian rhythm disorders in patients with advanced cancer. Studies involved adult patients with locally advanced or metastatic cancer and used objective measures of circadian rhythmicity. Two independent authors completed initial screening of title and abstracts, full text reviews, data extraction, and data checking. A total of 98 articles were highlighted in the scoping review, which utilised physical activity measures (actigraphy and polysomnography), biomarkers (cortisol and melatonin), or a combination. Several circadian rhythms are commonly disordered amongst patients with advanced cancer and have significant implications for symptom burden, quality of life, and survival. It remains unclear which patients are most at risk of a circadian rhythm disorder. Significant heterogeneity exists in research and reporting practices. Standardising this approach may address discrepancies in the current literature and allow for research to focus on the most relevant parameters and approaches to improving circadian rhythmicity.
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Affiliation(s)
- Craig Gouldthorpe
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- Academic Department of Palliative Medicine, Our Lady’s Hospice and Care Services, Dublin, Ireland
| | - Jenny Power
- Academic Department of Palliative Medicine, Our Lady’s Hospice and Care Services, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Andrew Davies
- School of Medicine, Trinity College Dublin, Dublin, Ireland
- Academic Department of Palliative Medicine, Our Lady’s Hospice and Care Services, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
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Bäcklund N, Brattsand G, Lundstedt S, Aardal E, Bartuseviciene I, Berinder K, Höybye C, Burman P, Edén Engström B, Isaksson A, Blomgren A, Ragnarsson O, Rüetschi U, Wahlberg J, Olsson T, Dahlqvist P. Salivary cortisol and cortisone in diagnosis of Cushing's syndrome - a comparison of six different analytical methods. Clin Chem Lab Med 2023; 61:1780-1791. [PMID: 37013440 DOI: 10.1515/cclm-2023-0141] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 03/21/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVES Salivary cortisol and cortisone at late night and after dexamethasone suppression test (DST) are increasingly used for screening of Cushing's syndrome (CS). We aimed to establish reference intervals for salivary cortisol and cortisone with three liquid chromatography-tandem mass spectrometry (LC-MS/MS) techniques and for salivary cortisol with three immunoassays (IAs), and evaluate their diagnostic accuracy for CS. METHODS Salivary samples at 08:00 h, 23:00 h and 08:00 h after a 1-mg DST were collected from a reference population (n=155) and patients with CS (n=22). Sample aliquots were analyzed by three LC-MS/MS and three IA methods. After establishing reference intervals, the upper reference limit (URL) for each method was used to calculate sensitivity and specificity for CS. Diagnostic accuracy was evaluated by comparing ROC curves. RESULTS URLs for salivary cortisol at 23:00 h were similar for the LC-MS/MS methods (3.4-3.9 nmol/L), but varied between IAs: Roche (5.8 nmol/L), Salimetrics (4.3 nmol/L), Cisbio (21.6 nmol/L). Corresponding URLs after DST were 0.7-1.0, and 2.4, 4.0 and 5.4 nmol/L, respectively. Salivary cortisone URLs were 13.5-16.6 nmol/L at 23:00 h and 3.0-3.5 nmol/L at 08:00 h after DST. All methods had ROC AUCs ≥0.96. CONCLUSIONS We present robust reference intervals for salivary cortisol and cortisone at 08:00 h, 23:00 h and 08:00 h after DST for several clinically used methods. The similarities between LC-MS/MS methods allows for direct comparison of absolute values. Diagnostic accuracy for CS was high for all salivary cortisol and cortisone LC-MS/MS methods and salivary cortisol IAs evaluated.
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Affiliation(s)
- Nils Bäcklund
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Göran Brattsand
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | | | - Elisabeth Aardal
- Department of Clinical Chemistry, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Inga Bartuseviciene
- Department of Clinical Chemistry, Karolinska University Hospital, Stockholm, Sweden
| | - Katarina Berinder
- Department of Molecular Medicine and Surgery, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
- Department of Endocrinology, Karolinska University Hospital, Stockholm, Sweden
| | - Charlotte Höybye
- Department of Molecular Medicine and Surgery, Karolinska Institute, Karolinska University Hospital, Stockholm, Sweden
- Department of Endocrinology, Karolinska University Hospital, Stockholm, Sweden
| | - Pia Burman
- Department of Endocrinology, Skåne University Hospital, Malmö, Sweden
| | - Britt Edén Engström
- Department of Medical Sciences, Endocrinology and Mineral Metabolism, Uppsala University, Uppsala, Sweden
- Department of Endocrinology and Diabetes, Uppsala University Hospital, Uppsala, Sweden
| | - Anders Isaksson
- Department of Clinical Chemistry and Pharmacology, Lund University, Lund, Sweden
| | - Anders Blomgren
- Department of Clinical Chemistry and Pharmacology, Lund University, Lund, Sweden
| | - Oskar Ragnarsson
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Center for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Endocrinology, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Ulrika Rüetschi
- Department of Clinical Chemistry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jeanette Wahlberg
- School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Medicine, Örebro University Hospital, Örebro, Sweden
| | - Tommy Olsson
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Per Dahlqvist
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Ciancia S, van den Berg SAA, van den Akker ELT. The Reliability of Salivary Cortisol Compared to Serum Cortisol for Diagnosing Adrenal Insufficiency with the Gold Standard ACTH Stimulation Test in Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1569. [PMID: 37761530 PMCID: PMC10527706 DOI: 10.3390/children10091569] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/03/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023]
Abstract
The ACTH (adrenocorticotropic hormone) stimulation test is the gold standard for the diagnosis of adrenal insufficiency (AI), performed with ACTH high dose (HDT) or low dose (LDT). As salivary cortisol has been proposed as an alternative to serum cortisol, our aim was to evaluate the reliability of salivary cortisol compared to serum cortisol for diagnosing AI in children. Data were collected retrospectively. Salivary and serum cortisol values derived by 80 ACTH stimulation tests were obtained (39 F, 36 M; median age 11.5 years, IQR 6.9). Sampling was performed at baseline and after 30 and 60 min from ACTH administration during the HDT, and at baseline and 10, 20, 30, 40 and 60 min after the stimulation for the LDT. A serum cortisol level > 420 nmol/L ruled out AI. The correlation coefficients between serum and salivary cortisol for the HDT (n = 24) were 0.80 at t0, 0.48 at t30 and 0.75 at t60. All patients were adrenal sufficient. In 41% of the LDT, peak serum cortisol indicated insufficient adrenal function. The correlation coefficients between serum and salivary cortisol were 0.59 at t0 and 0.33 at the peak. For a cut-off of salivary cortisol < 15 nmol/L, sensitivity was 73.9% and specificity 69.6%. Our data do not support salivary cortisol as a valid alternative to serum cortisol during LDT. Regarding the HDT, results are more encouraging, however, further studies are needed.
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Affiliation(s)
- Silvia Ciancia
- Division of Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children’s Hospital, University Medical Center, 3015 Rotterdam, The Netherlands
| | - Sjoerd A. A. van den Berg
- Department of Clinical Chemistry, Erasmus University Medical Center, 3015 Rotterdam, The Netherlands
| | - Erica L. T. van den Akker
- Division of Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children’s Hospital, University Medical Center, 3015 Rotterdam, The Netherlands
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Litteral V, Migliozzi R, Metzger D, McPherson C, Saldanha R. Engineering a Cortisol Sensing Enteric Probiotic. ACS Biomater Sci Eng 2023; 9:5163-5175. [PMID: 37647169 DOI: 10.1021/acsbiomaterials.2c01300] [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] [Indexed: 09/01/2023]
Abstract
Chronic stress can lead to prolonged adrenal gland secretion of cortisol, resulting in human ailments such as anxiety, post-traumatic stress disorder, metabolic syndrome, diabetes, immunosuppression, and cardiomyopathy. Real time monitoring of chronic increases in cortisol and intervening therapies to minimize the physiological effects of stress would be beneficial to prevent these endocrine related illnesses. Gut microbiota have shown the ability to secrete, respond, and even regulate endocrine hormones. One such microbe, Clostridium scindens, responds transcriptionally to cortisol. We engineered these cortisol responsive genetic elements from C. scindens into an enteric probiotic, E. coli Nissle 1917, to drive the expression of a fluorescent reporter allowing for the designing, testing, and building of a robust and physiologically relevant novel cortisol probiotic sensor. This smart probiotic was further engineered to be more sensitive and to respond to elevated cortisol by expressing tryptophan decarboxylase, thereby bestowing the ability to generate tryptamine and serotonin. Here we show that upon cortisol treatment the smart probiotic produces measurable amounts of tryptamine. Accumulated levels of these neuromodulators should improve mood, anxiety, and depression and drive down cortisol levels. Importantly, this work can serve as a model for the engineering of a sense-and-respond probiotic to modulate the gut-brain axis.
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Affiliation(s)
- Vaughn Litteral
- UES Corporation, 4401 Dayton-Xenia Avenue, Beavercreek, Ohio 45432-1805, United States
- Air Force Research Laboratory, 711 Human Performance Wing, Airman Bioengineering Division, Applied Biotechnology Branch, Wright-Patterson Air Force Base, Ohio 45433, United States
| | - Rebecca Migliozzi
- UES Corporation, 4401 Dayton-Xenia Avenue, Beavercreek, Ohio 45432-1805, United States
- Air Force Research Laboratory, 711 Human Performance Wing, Airman Bioengineering Division, Applied Biotechnology Branch, Wright-Patterson Air Force Base, Ohio 45433, United States
| | - David Metzger
- UES Corporation, 4401 Dayton-Xenia Avenue, Beavercreek, Ohio 45432-1805, United States
- Air Force Research Laboratory, 711 Human Performance Wing, Airman Bioengineering Division, Applied Biotechnology Branch, Wright-Patterson Air Force Base, Ohio 45433, United States
| | - Craig McPherson
- UES Corporation, 4401 Dayton-Xenia Avenue, Beavercreek, Ohio 45432-1805, United States
- Air Force Research Laboratory, 711 Human Performance Wing, Airman Bioengineering Division, Applied Biotechnology Branch, Wright-Patterson Air Force Base, Ohio 45433, United States
| | - Roland Saldanha
- Air Force Research Laboratory, 711 Human Performance Wing, Airman Bioengineering Division, Applied Biotechnology Branch, Wright-Patterson Air Force Base, Ohio 45433, United States
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Vicković S, Zdravković R, Maričić-Prijić S, Nikolić D, Pap D, Čolak E, Jovičić S. Salivary cortisol as a biomarker of stress in surgical patients. J Med Biochem 2023; 42:469-475. [PMID: 37790204 PMCID: PMC10543123 DOI: 10.5937/jomb0-42011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 02/09/2023] [Indexed: 10/05/2023] Open
Abstract
Background Surgical stress and pain result in activation of hypothalamus-pituitary-adrenal axis. The aim of this study was to establish the effects of postoperative pain and various modalities of analgesic administration on salivary and serum cortisol levels, as well as to establish the validity of salivary cortisol as a stress indicator in surgical patients. Methods A randomized controlled trial involved 60 patients scheduled for elective abdominal aortic aneurysm surgery. Patients were randomly divided into two groups depending on the model of postoperative analgesia. The first group (MI - morphine intermittently) included patients given morphine doses 0.1 mg/kg/6h s.c. intermittently. The second group (MPCA - morphine patient-controlled analgesia) included patients who received morphine via the PCA system - intravenous administration of morphine adjusted to a dose of 1 mg per shot and a lockout interval of 6 minutes.
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Affiliation(s)
| | | | | | | | - Dragana Pap
- Students Health Protection Institute, Faculty of Pharmacy, Novi Sad
| | - Emina Čolak
- University Clinical Center of Serbia, Institute of Medical Biochemistry, Belgrade
| | - Snežana Jovičić
- University of Belgrade, Faculty of Pharmacy Belgrade, Belgrade
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Nebe S, Reutter M, Baker DH, Bölte J, Domes G, Gamer M, Gärtner A, Gießing C, Gurr C, Hilger K, Jawinski P, Kulke L, Lischke A, Markett S, Meier M, Merz CJ, Popov T, Puhlmann LMC, Quintana DS, Schäfer T, Schubert AL, Sperl MFJ, Vehlen A, Lonsdorf TB, Feld GB. Enhancing precision in human neuroscience. eLife 2023; 12:e85980. [PMID: 37555830 PMCID: PMC10411974 DOI: 10.7554/elife.85980] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/23/2023] [Indexed: 08/10/2023] Open
Abstract
Human neuroscience has always been pushing the boundary of what is measurable. During the last decade, concerns about statistical power and replicability - in science in general, but also specifically in human neuroscience - have fueled an extensive debate. One important insight from this discourse is the need for larger samples, which naturally increases statistical power. An alternative is to increase the precision of measurements, which is the focus of this review. This option is often overlooked, even though statistical power benefits from increasing precision as much as from increasing sample size. Nonetheless, precision has always been at the heart of good scientific practice in human neuroscience, with researchers relying on lab traditions or rules of thumb to ensure sufficient precision for their studies. In this review, we encourage a more systematic approach to precision. We start by introducing measurement precision and its importance for well-powered studies in human neuroscience. Then, determinants for precision in a range of neuroscientific methods (MRI, M/EEG, EDA, Eye-Tracking, and Endocrinology) are elaborated. We end by discussing how a more systematic evaluation of precision and the application of respective insights can lead to an increase in reproducibility in human neuroscience.
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Affiliation(s)
- Stephan Nebe
- Zurich Center for Neuroeconomics, Department of Economics, University of ZurichZurichSwitzerland
| | - Mario Reutter
- Department of Psychology, Julius-Maximilians-UniversityWürzburgGermany
| | - Daniel H Baker
- Department of Psychology and York Biomedical Research Institute, University of YorkYorkUnited Kingdom
| | - Jens Bölte
- Institute for Psychology, University of Münster, Otto-Creuzfeldt Center for Cognitive and Behavioral NeuroscienceMünsterGermany
| | - Gregor Domes
- Department of Biological and Clinical Psychology, University of TrierTrierGermany
- Institute for Cognitive and Affective NeuroscienceTrierGermany
| | - Matthias Gamer
- Department of Psychology, Julius-Maximilians-UniversityWürzburgGermany
| | - Anne Gärtner
- Faculty of Psychology, Technische Universität DresdenDresdenGermany
| | - Carsten Gießing
- Biological Psychology, Department of Psychology, School of Medicine and Health Sciences, Carl von Ossietzky University of OldenburgOldenburgGermany
| | - Caroline Gurr
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe UniversityFrankfurtGermany
- Brain Imaging Center, Goethe UniversityFrankfurtGermany
| | - Kirsten Hilger
- Department of Psychology, Julius-Maximilians-UniversityWürzburgGermany
- Department of Psychology, Psychological Diagnostics and Intervention, Catholic University of Eichstätt-IngolstadtEichstättGermany
| | - Philippe Jawinski
- Department of Psychology, Humboldt-Universität zu BerlinBerlinGermany
| | - Louisa Kulke
- Department of Developmental with Educational Psychology, University of BremenBremenGermany
| | - Alexander Lischke
- Department of Psychology, Medical School HamburgHamburgGermany
- Institute of Clinical Psychology and Psychotherapy, Medical School HamburgHamburgGermany
| | - Sebastian Markett
- Department of Psychology, Humboldt-Universität zu BerlinBerlinGermany
| | - Maria Meier
- Department of Psychology, University of KonstanzKonstanzGermany
- University Psychiatric Hospitals, Child and Adolescent Psychiatric Research Department (UPKKJ), University of BaselBaselSwitzerland
| | - Christian J Merz
- Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University BochumBochumGermany
| | - Tzvetan Popov
- Department of Psychology, Methods of Plasticity Research, University of ZurichZurichSwitzerland
| | - Lara MC Puhlmann
- Leibniz Institute for Resilience ResearchMainzGermany
- Max Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany
| | - Daniel S Quintana
- Max Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany
- NevSom, Department of Rare Disorders & Disabilities, Oslo University HospitalOsloNorway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of OsloOsloNorway
- Norwegian Centre for Mental Disorders Research (NORMENT), University of OsloOsloNorway
| | - Tim Schäfer
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe UniversityFrankfurtGermany
- Brain Imaging Center, Goethe UniversityFrankfurtGermany
| | | | - Matthias FJ Sperl
- Department of Clinical Psychology and Psychotherapy, University of GiessenGiessenGermany
- Center for Mind, Brain and Behavior, Universities of Marburg and GiessenGiessenGermany
| | - Antonia Vehlen
- Department of Biological and Clinical Psychology, University of TrierTrierGermany
| | - Tina B Lonsdorf
- Department of Systems Neuroscience, University Medical Center Hamburg-EppendorfHamburgGermany
- Department of Psychology, Biological Psychology and Cognitive Neuroscience, University of BielefeldBielefeldGermany
| | - Gordon B Feld
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg UniversityMannheimGermany
- Department of Psychology, Heidelberg UniversityHeidelbergGermany
- Department of Addiction Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg UniversityMannheimGermany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg UniversityMannheimGermany
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Kastelic M, Gregurić Gračner G, Tomažič I, Kvapil P, Harej M, Dovč A. Comparison of Cortisol Concentrations in Different Matrices in Alpine Ibex ( Capra ibex) at the Zoo. Animals (Basel) 2023; 13:2491. [PMID: 37570299 PMCID: PMC10417618 DOI: 10.3390/ani13152491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
The usefulness of blood collection using venipuncture versus kissing bugs or medicinal leeches and the collection of saliva, faeces, hair, urine, and tears for measuring "immunoreactive" C (iC) concentration in Alpine ibexes was verified using commercial enzyme immunoassays. The mean value of serum C was highest in serum collected using venipuncture and lowest in serums collected using kissing bugs. Statistically significant differences were observed between venipuncture and kissing bugs and between leeches and kissing bugs. However, no statistically significant difference was found in C concentrations between samples collected with venipuncture and those collected with leeches. The highest mean value of C concentration was measured in serum (all three methods), followed by that in hair and faeces, and the lowest mean value was found in saliva. Statistically significant differences were found between saliva and faeces samples and between saliva and hair samples. The difference between the concentrations for faeces and hair was not statistically significant. A significant difference in C concentration between males and females was found in saliva. A significant difference in C concentration among different ages was measured in serum obtained using venipuncture in all three groups and in faeces between the groups older than ten years and younger than 10 months. Highly significant differences in C concentrations were also found between hair sampled in summer and hair sampled in autumn. Collecting tear and urine samples is a laborious procedure and is therefore less acceptable for C determination. Due to the small number of samples, statistical values are not given for these two matrices.
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Affiliation(s)
- Marjan Kastelic
- Zoo Ljubljana, Večna Pot 70, 1000 Ljubljana, Slovenia; (M.K.); (P.K.); (M.H.)
- Institute for Poultry, Birds, Small Mammals and Reptiles, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia
| | - Gordana Gregurić Gračner
- Department of Animal Hygiene, Behaviour and Animal Welfare, Faculty of Veterinary Medicine, University of Zagreb, Heinzelova 55, 10000 Zagreb, Croatia;
| | - Iztok Tomažič
- The Group for Biological Education, Department of Biology, Biotechnical Faculty, University of Ljubljana, Večna Pot 111, 1000 Ljubljana, Slovenia;
| | - Pavel Kvapil
- Zoo Ljubljana, Večna Pot 70, 1000 Ljubljana, Slovenia; (M.K.); (P.K.); (M.H.)
| | - Mojca Harej
- Zoo Ljubljana, Večna Pot 70, 1000 Ljubljana, Slovenia; (M.K.); (P.K.); (M.H.)
| | - Alenka Dovč
- Institute for Poultry, Birds, Small Mammals and Reptiles, Veterinary Faculty, University of Ljubljana, Gerbičeva 60, 1000 Ljubljana, Slovenia
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Mumm H, Dreyer AF, Bleses D, Glintborg D, Jensen TK, Boye H, Trecca F, Andersen MS. Maternal cortisol levels in third trimester and early language development: A study of 1093 mother-child pairs from the Odense Child Cohort. J Neuroendocrinol 2023; 35:e13314. [PMID: 37449529 DOI: 10.1111/jne.13314] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/31/2023] [Accepted: 06/02/2023] [Indexed: 07/18/2023]
Abstract
Language development during early childhood is considered an important marker of fetal neurodevelopment. Prenatal cortisol exposure plays a critical role in maturation of the fetal brain; however, the effect on offspring language development needs further investigation. In this prospective observational study we aimed to evaluate the association between maternal third trimester cortisol and early longitudinal offspring language development in the Odense Child Cohort (OCC) and to test whether there were sex differences in the association. The study cohort included 1093 mother-child dyads (570 boys and 523 girls). Fasting morning serum (s-) cortisol was collected from third trimester (gestational week 26-28) pregnant women and measured by liquid chromatography-tandem mass spectrometry. Offspring receptive and productive vocabulary assessments by MacArthur-Bates Communicative Development Inventories parent reports were completed every third month from children age 12-37 months. Levels of cortisol were higher in women carrying a girl (858 ± 214 nmol/L) than in women carrying a boy (820 ± 222 nmol/L). Higher third trimester maternal cortisol levels showed a positive association with development of productive vocabulary in boys at age 12-21 months (OR = 1.23, SE = 0.07, p = .005) and age 22-37 months (OR = 1.09, SE = 0.06, p = .967). Higher maternal cortisol levels in the third trimester were positively associated with receptive vocabulary in girls at 12-21 months of age (OR = 1.16, SE = 0.05, p = .002). Maternal third trimester s-cortisol levels were positively associated with early language development in children at age 12-37 months.
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Affiliation(s)
- Hanne Mumm
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Anja Fenger Dreyer
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Dorthe Bleses
- TrygFonden's Centre for Child Research and School of Communication and Culture, Aarhus University, Aarhus, Denmark
| | - Dorte Glintborg
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Tina Kold Jensen
- Odense Child Cohort, Hans Christian Andersen Hospital for Children, Odense University Hospital, Odense, Denmark
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark
- OPEN Patient data Explorative Network (OPEN), University of Southern Denmark, Odense, Denmark
| | - Henriette Boye
- Odense Child Cohort, Hans Christian Andersen Hospital for Children, Odense University Hospital, Odense, Denmark
- OPEN Patient data Explorative Network (OPEN), University of Southern Denmark, Odense, Denmark
| | - Fabio Trecca
- TrygFonden's Centre for Child Research and School of Communication and Culture, Aarhus University, Aarhus, Denmark
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Beiner E, Lucas V, Reichert J, Buhai DV, Jesinghaus M, Vock S, Drusko A, Baumeister D, Eich W, Friederich HC, Tesarz J. Stress biomarkers in individuals with fibromyalgia syndrome: a systematic review with meta-analysis. Pain 2023; 164:1416-1427. [PMID: 36728497 DOI: 10.1097/j.pain.0000000000002857] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/25/2022] [Indexed: 02/03/2023]
Abstract
ABSTRACT Evidence suggests an involvement of hypothalamic-pituitary-adrenal (HPA) axis dysregulation in the development and maintenance of fibromyalgia syndrome (FMS). However, studies on the stress response via the HPA-axis in individuals with FMS show conflicting results. To better understand the relationship between FMS and HPA-axis dysregulation, we (1) systematically summarized the current level of evidence on HPA biomarkers in individuals with FMS compared with individuals without and (2) evaluated whether FMS is associated with a specific pattern of HPA dysregulation. The main outcome measures were cortisol, adrenocorticotropic hormone (ACTH), corticotropin-releasing hormone (CRH), epinephrine, and norepinephrine. A systematic search of MEDLINE, EMBASE, and PsychMed yielded 47 studies eligible for meta-analysis, including 1465 individuals with FMS and 1192 FMS-free controls. No main effect of FMS was found on altered levels of blood cortisol, ACTH, CRH, and epinephrine. Compared with controls, salivary and urinary cortisol levels were decreased in individuals with FMS, whereas blood levels of norepinephrine were increased. However, heterogeneity of data was high with significant evidence for publication bias. Overall, the data are compatible with association of FMS with adrenocortical hypofunction in the presence of increased sympathetic tone. However, the data are partially contradictory, so it must be assumed that the data are highly dependent on the respective study designs, patient samples, and analytical methods and do not necessarily demonstrate an abnormal HPA-axis function in FMS.
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Affiliation(s)
- Eva Beiner
- Department of General Internal Medicine and Psychosomatics, Medical Hospital, University of Heidelberg, Heidelberg, Germany
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McCrory C, McLoughlin S, Layte R, NiCheallaigh C, O'Halloran AM, Barros H, Berkman LF, Bochud M, M Crimmins E, T Farrell M, Fraga S, Grundy E, Kelly-Irving M, Petrovic D, Seeman T, Stringhini S, Vollenveider P, Kenny RA. Towards a consensus definition of allostatic load: a multi-cohort, multi-system, multi-biomarker individual participant data (IPD) meta-analysis. Psychoneuroendocrinology 2023; 153:106117. [PMID: 37100008 PMCID: PMC10620736 DOI: 10.1016/j.psyneuen.2023.106117] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 03/16/2023] [Accepted: 04/16/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Allostatic load (AL) is a multi-system composite index for quantifying physiological dysregulation caused by life course stressors. For over 30 years, an extensive body of research has drawn on the AL framework but has been hampered by the lack of a consistent definition. METHODS This study analyses data for 67,126 individuals aged 40-111 years participating in 13 different cohort studies and 40 biomarkers across 12 physiological systems: hypothalamic-pituitary-adrenal (HPA) axis, sympathetic-adrenal-medullary (SAM) axis, parasympathetic nervous system functioning, oxidative stress, immunological/inflammatory, cardiovascular, respiratory, lipidemia, anthropometric, glucose metabolism, kidney, and liver. We use individual-participant-data meta-analysis and exploit natural heterogeneity in the number and type of biomarkers that have been used across studies, but a common set of health outcomes (grip strength, walking speed, and self-rated health), to determine the optimal configuration of parameters to define the concept. RESULTS There was at least one biomarker within 9/12 physiological systems that was reliably and consistently associated in the hypothesised direction with the three health outcomes in the meta-analysis of these cohorts: dehydroepiandrosterone sulfate (DHEAS), low frequency-heart rate variability (LF-HRV), C-reactive protein (CRP), resting heart rate (RHR), peak expiratory flow (PEF), high density lipoprotein cholesterol (HDL-C), waist-to-height ratio (WtHR), HbA1c, and cystatin C. An index based on five biomarkers (CRP, RHR, HDL-C, WtHR and HbA1c) available in every study was found to predict an independent outcome - mortality - as well or better than more elaborate sets of biomarkers. DISCUSSION This study has identified a brief 5-item measure of AL that arguably represents a universal and efficient set of biomarkers for capturing physiological 'wear and tear' and a further biomarker (PEF) that could usefully be included in future data collection.
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Affiliation(s)
- Cathal McCrory
- The Irish Longitudinal Study on Ageing, Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland.
| | - Sinead McLoughlin
- The Irish Longitudinal Study on Ageing, Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
| | - Richard Layte
- Department of Sociology, Trinity College Dublin, Ireland
| | - Cliona NiCheallaigh
- Department of Clinical Medicine, Trinity College Dublin and St James's Hospital, Ireland
| | - Aisling M O'Halloran
- The Irish Longitudinal Study on Ageing, Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
| | - Henrique Barros
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal, Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Lisa F Berkman
- Harvard Center for Population and Development Studies, Harvard. T.H. Chan School of Public Health, 9 Bow Street, Cambridge, MA 02138, USA
| | - Murielle Bochud
- Center for Primary Care and Public Health (Unisanté), Department of Epidemiology and Health Systems, University of Lausanne, Route de la Corniche 10, 1010 Lausanne, Switzerland
| | | | - Meagan T Farrell
- Harvard Center for Population and Development Studies, Harvard. T.H. Chan School of Public Health, 9 Bow Street, Cambridge, MA 02138, USA
| | - Silvia Fraga
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal, Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Emily Grundy
- Institute for Social & Economic Research, University of Essex, UK and Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Michelle Kelly-Irving
- Centre for Epidemiology and Research in Population Health (CERPOP), Université de Toulouse, Inserm-Université Paul Sabatier, Toulouse, France
| | - Dusan Petrovic
- Center for Primary Care and Public Health (Unisanté), Department of Epidemiology and Health Systems, University of Lausanne, Route de la Corniche 10, 1010 Lausanne, Switzerland
| | - Teresa Seeman
- David Geffen School of Medicine, UCLA, Los Angeles, CA 90095, USA
| | - Silvia Stringhini
- Center for Primary Care and Public Health (Unisanté), Department of Epidemiology and Health Systems, University of Lausanne, Route de la Corniche 10, 1010 Lausanne, Switzerland; Unit of Population Epidemiology, Division of Primary Care, Geneva University Hospital, Faculty of Medicine, University of Geneva, Switzerland
| | - Peter Vollenveider
- Department of Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland, University of Lausanne, Lausanne, Switzerland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing, Department of Medical Gerontology, School of Medicine, Trinity College Dublin, Ireland
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Shaikh S, Nagendra L, Shaikh S, Pappachan JM. Adrenal Failure: An Evidence-Based Diagnostic Approach. Diagnostics (Basel) 2023; 13:diagnostics13101812. [PMID: 37238296 DOI: 10.3390/diagnostics13101812] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/14/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
The diagnosis of adrenal insufficiency (AI) requires a high index of suspicion, detailed clinical assessment including detailed drug history, and appropriate laboratory evaluation. The clinical characteristics of adrenal insufficiency vary according to the cause, and the presentation may be myriad, e.g. insidious onset to a catastrophic adrenal crisis presenting with circulatory shock and coma. Secondary adrenal insufficiency (SAI) often presents with only glucocorticoid deficiency because aldosterone production, which is controlled by the renin angiotensin system, is usually intact, and rarely presents with an adrenal crisis. Measurements of the basal serum cortisol at 8 am (<140 nmol/L or 5 mcg/dL) coupled with adrenocorticotrophin (ACTH) remain the initial tests of choice. The cosyntropin stimulation (short synacthen) test is used for the confirmation of the diagnosis. Newer highly specific cortisol assays have reduced the cut-off points for cortisol in the diagnosis of AI. The salivary cortisol test is increasingly being used in conditions associated with abnormal cortisol binding globulin (CBG) levels such as pregnancy. Children and infants require lower doses of cosyntropin for testing. 21-hydoxylase antibodies are routinely evaluated to rule out autoimmunity, the absence of which would require secondary causes of adrenal insufficiency to be ruled out. Testing the hypothalamic-pituitary-adrenal (HPA) axis, imaging, and ruling out systemic causes are necessary for the diagnosis of AI. Cancer treatment with immune checkpoint inhibitors (ICI) is an emerging cause of both primary AI and SAI and requires close follow up. Several antibodies are being implicated, but more clarity is required. We update the diagnostic evaluation of AI in this evidence-based review.
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Affiliation(s)
- Salomi Shaikh
- KGN Diabetes and Endocrine Centre, Mumbai 400001, India
| | - Lakshmi Nagendra
- Department of Endocrinology, JSS Medical College, JSS Academy of Higher Education and Research Center, Mysore 570015, India
| | - Shehla Shaikh
- Department of Endocrinology, Saifee Hospital, Mumbai 400004, India
| | - Joseph M Pappachan
- Department of Endocrinology & Metabolism, Lancashire Teaching Hospitals NHS Trust, Preston PR2 9HT, UK
- Faculty of Science, Manchester Metropolitan University, Manchester M15 6BH, UK
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PL, UK
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Lee ZY, Tran T. Genomic and non-genomic effects of glucocorticoids in respiratory diseases. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2023; 98:1-30. [PMID: 37524484 DOI: 10.1016/bs.apha.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Cortisol is an endogenous steroid hormone essential for the natural resolution of inflammation. Synthetic glucocorticoids (GCs) were developed and are currently amongst the most widely prescribed anti-inflammatory drugs in our modern clinical landscape owing to their potent anti-inflammatory activity. However, the extent of GC's effects has yet to be fully elucidated. Indeed, GCs modulate a broad spectrum of cellular activity, from their classical regulation of gene expression to acute non-genomic mechanisms of action. Furthermore, tissue specific effects, disease specific conditions, and dose-dependent responses complicate their use, with side-effects potentially plaguing their use. It is thus vital to outline and consolidate the effects of GCs, to demystify and maximize their therapeutic potential while avoiding pitfalls that would otherwise render them obsolete.
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Affiliation(s)
- Zhao-Yong Lee
- Infectious Disease Translational Research Program, National University of Singapore, Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Thai Tran
- Infectious Disease Translational Research Program, National University of Singapore, Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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50
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Schumacher MM, Santambrogio J. Cortisol and the Dexamethasone Suppression Test as a Biomarker for Melancholic Depression: A Narrative Review. J Pers Med 2023; 13:jpm13050837. [PMID: 37241007 DOI: 10.3390/jpm13050837] [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: 04/14/2023] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
The dexamethasone suppression test (DST) assesses the functionality of the HPA axis and can be regarded as the first potential biomarker in psychiatry. In 1981, a group of researchers at the University of Michigan published a groundbreaking paper regarding its use for diagnosing melancholic depression, reporting a diagnostic sensitivity of 67% and a specificity of 95%. While this study generated much enthusiasm and high expectations in the field of biological psychiatry, subsequent studies produced equivocal results, leading to the test being rejected by the American Psychiatric Association. The scientific reasons leading to the rise and fall of the DST are assessed in this review, suggestions are provided as to how the original test can be improved, and its potential applications in clinical psychiatry are discussed. An improved, standardized, and validated version of the DST would be a biologically meaningful and useful biomarker in psychiatry, providing a tool for clinicians caring for depressed patients in the areas of diagnosis, treatment, and prognosis, and predicting the risk of suicide. Additionally, such a test could be a crucial part in the generation of biologically homogenous patient cohorts, necessary for the successful development of new psychotropic medications.
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Affiliation(s)
| | - Jacopo Santambrogio
- Adele Bonolis AS.FRA. Onlus Foundation, 20854 Vedano al Lambro, Italy
- Presidio Corberi, ASST Brianza, 20812 Limbiate, Italy
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