Oral contraceptives alter circadian rhythm parameters of cortisol, melatonin, blood pressure, heart rate, skin blood flow, transepidermal water loss, and skin amino acids of healthy young women

Intraday Variations in Skin Water Parameters

INTRODUCTION

Three interrelated skin water assessments include stratum corneum hydration (SCH) via electrical measurements, skin water using tissue dielectric constant (TDC) measurements, and transepidermal water loss (TEWL). These are differentially used for skin physiology research, clinical assessments of dermatological conditions and to assess skin water in diabetes and lymphedema. Often volar forearm skin is used for assessments done at various times of day (TOD). The present goal was to assess the extent of intraday variability in SCH, TDC, and TEWL.

METHODS

Twelve medical students self-measured SCH, TDC, and TEWL on their forearm every 2 h from 08:00 to 24:00 h on 2 consecutive days. All participants were well trained and pre-certified in all procedures. Tests for parameter differences among TOD were via the nonparametric Friedman test.

RESULTS

No significant differences in SCH or TEWL were found among TOD over the 16-h interval for either day or combined. Contrastingly, TDC decreased slightly but significantly from morning through evening. There was no evidence of a diurnal pattern. Interestingly, a significant nonlinear relationship between TEWL and SCH was detected.

CONCLUSION

Findings indicate only minor intraday variations with TOD trend except for TDC which decreases slightly from morning through evening. The clinical relevance relates to the confidence now gained associated with the parameter estimates when measured at different TOD during normal clinic hours or beyond. This should help in estimating the potential importance of small differences if measured at a different TOD. From a physiological viewpoint, the findings uncover and describe an interesting nonlinear relationship between TEWL and SCH which may serve to propel further investigations that might better characterize this process.

Gender minority stress and diurnal cortisol profiles among transgender and gender diverse people in the United States

The field of behavioral neuroendocrinology has only begun to explore the lived experiences of transgender and gender diverse (TGD) people exposed to stigma. In light of escalating attacks and legislation targeting TGD people in the United States, it is crucial to examine the physiological pathways through which gender minority stressors become embodied, impact health, and contribute to health inequities. The Trans Resilience and Health Study included baseline data collection from fall 2019 to spring 2020 from a sample of 124 TGD people, reflecting a diversity of gender identities (e.g., trans masculine, trans feminine, and nonbinary) and ages (range = 19-70 years old; M = 34.10), living in Michigan, Nebraska, Oregon, and Tennessee. These analyses examine experiences of gender-related enacted stigma in association with hypothalamic-pituitary-adrenal (HPA)-axis functioning. Among those experiencing the highest levels of enacted stigma, findings show a blunted cortisol awakening response and sluggish daily decline that resulted in elevated concentrations at bedtime compared to those experiencing less enacted stigma. These results of flattened diurnal activity are consistent with an emergent literature on discrimination as a social determinant of potential stress pathophysiology. In contrast, community connectedness was associated with a larger, more dynamic cortisol awakening response. These findings emphasize the importance of incorporating gender-minority stress and resilience measures when studying HPA-axis functioning among TGD people.

Potential effects of shift work on skin autoimmune diseases

Shift work is associated with systemic chronic inflammation, impaired host and tumor defense and dysregulated immune responses to harmless antigens such as allergens or auto-antigens. Thus, shift workers are at higher risk to develop a systemic autoimmune disease and circadian disruption with sleep impairment seem to be the key underlying mechanisms. Presumably, disturbances of the sleep-wake cycle also drive skin-specific autoimmune diseases, but epidemiological and experimental evidence so far is scarce. This review summarizes the effects of shift work, circadian misalignment, poor sleep, and the effect of potential hormonal mediators such as stress mediators or melatonin on skin barrier functions and on innate and adaptive skin immunity. Human studies as well as animal models were considered. We will also address advantages and potential pitfalls in animal models of shift work, and possible confounders that could drive skin autoimmune diseases in shift workers such as adverse lifestyle habits and psychosocial influences. Finally, we will outline feasible countermeasures that may reduce the risk of systemic and skin autoimmunity in shift workers, as well as treatment options and highlight outstanding questions that should be addressed in future studies.

Effect of the one-day fasting on cortisol and DHEA daily rhythm regarding sex, chronotype, and age among obese adults

Introduction

Physiological and biochemical processes in the human body occur in a specific order and show rhythmic variability. Time dependence characterizes the secretion of cortisol and dehydroepiandrosterone (DHEA). One-day fasting implies alternating fasting days and eating days. The study aimed to determine how 24-h fasting affects the daily rhythm of cortisol and DHEA levels in obese people while taking into account gender and chronotype.

Methods

Forty-nine obese patients (BMI 32.2-67.1 kg/m²; 25 women and 24 men) underwent a 3-week hospital-controlled calorie restriction diet to reduce body weight. During hospitalization, patients fasted for 1 day, during which only water could be consumed. Samples of whole mixed unstimulated saliva were collected at 2-3-h intervals over a 64-h period and analyzed for cortisol and DHEA by immunoassays. The individual chronotypes were assessed by the morning and evening questionnaire, according to Horne and Östberg. Three components of daily rhythm were evaluated: amplitude, acrophase, and the so-called MESOR.

Results

Cortisol rhythm showed differences in amplitude (p = 0.0127) and acrophase (p = 0.0005). The amplitude on the fasting day was 11% higher (p = 0.224) than the day after. The acrophase advanced on the day of fasting, 48 min earlier than the day before (p = 0.0064), and by 39 min to the day after fasting (p = 0.0005). In the rhythm of DHEA, differences were found in the MESOR (p = 0.0381). The MESOR on the fasting day increased.

Discussion

Our results obtained during 64 consecutive hours of saliva sampling suggest that one-day fasting may affect three components of cortisol and DHEA daily rhythm. Additionally, no differences were found in the daily rhythm between the morning and evening chronotypes and between females and males. Although aging did not influence daily cortisol rhythm, DHEA amplitude, MESOR, and acrophase changed with age. To the best of our knowledge, this is the first presentation of changes in DHEA rhythm during one-day fasting.

Evaluation of a new connected portable camera for the analysis of skin microrelief and the assessment of the effect of skin moisturisers

BACKGROUND

Silicone replicas and non-contact methods are effective methods to analyse the micrometric scale of the skin microrelief. Yet, they imply data capture in research facilities. The capabilities of a new connected portable camera were evaluated to analyse microrelief under nomadic conditions, also studying the effect of moisturisers.

MATERIALS AND METHODS

3D depth maps were constructed using shape-from-shading algorithms. Roughness heterogeneity (Spa) was computed, and skin profiles were extracted to calculate roughness amplitude (Ra, Rq), as well as furrows/plateaus characteristics. Validation of the connected camera was performed on tanned cowhide leather and on the inner forearm skin of a single subject. The forearms of 18 subjects (23-60 years old) were also evaluated. While living their regular life, they self-performed triplicate acquisitions at various times. The effects of a placebo and of cream containing moisturisers-saccharide isomerate, urea or xylitylglucoside-anhydroxylitol-xylitol-were investigated, using untreated control skin as a reference.

RESULTS

Validation of the device on leather and forearm skin shows high repeatability. The 18 subjects show the known correlation between age and changes in microrelief. While testing formulas, 8 h after a single application, all decreased Spa (-1.6/-2.1 folds). Only saccharide isomerate and xylitylglucoside-anhydroxylitol-xylitol decreased Ra (-2.4/-2.8 folds). The sectional area of plateaus was reduced from -1.5 (urea) to -2.1 folds (xylitylglucoside-anhydroxylitol-xylitol). The height of plateaus is also decreased by all moisturisers, from -1.5 (urea) to -2.1 folds (xylitylglucoside-anhydroxylitol-xylitol).

CONCLUSION

This novel camera device enables microrelief analysis under nomadic conditions, allowing monitoring its changes along the day and upon moisturisers' application.

Physiological, Pathological, and Circadian Factors Impacting Skin Hydration

Thismanuscript focuses on the physiological, environmental, nutritional, circadian, and aging factors affecting skin tissue water and hydration parameters. The literature findings indicate a multiplicity of interacting processes among these parameters, ultimately impacting skin hydration in normal skin and playing a role in conditions such as atopic dermatitis and psoriasis. The maintenance of adequate skin hydration, aided by the proper functioning of the skin’s protective barrier, is facilitated by stratum corneum integrity with the presence of tight junctions and lipids such as ceramides, each of which is impacted by changes in most of the evaluated parameters. Abnormalities in aquaporin 3 (AQP3) expression and associated deficits in skin hydration appear to have a role in atopic dermatitis and psoriasis. AQP3 hydration-related aspects are influenced by circadian rhythms via modulations associated with CLOCK genes that alter AQP3 protein expression. Ultraviolet exposure, aging, and low temperatures are among those factors that affect skin ceramide composition, potentially leading to increased transepidermal water loss and negatively impacting skin hydration. Vitamin C, collagen, and probiotics may increase ceramide production and improve skin hydration. The extent to which each of the different evaluated factors affects skin hydration varies but is usually large enough to consider their potential effects when investigating skin in research and clinical settings.

Assessing Potential Circadian, Diurnal, and Ultradian Variations in Skin Biophysical Properties

A variety of skin measurements are routinely made in various clinical and research settings to evaluate the skin’s biophysical properties for diagnostic and research purposes. Such measurements include transepidermal water loss (TEWL), skin pH, sebum, skin blood flow (SBF), and tissue dielectric constant (TDC) as a measure of skin water. Given the various reported circadian, diurnal, and possible ultradian and other temporal variations in skin physiological processes, it is of value to have clarity as to possible temporal variations in skin’s biophysical properties associated with such processes. It was thus the purpose of this investigation to review and detail key elements of what is currently known regarding such variations and to provide a characterization that will permit informed judgments as to the sensitivity of the timing of measurements to optimize measurement reproducibility.

Understanding these variations and their possible oscillatory effects on skin biophysical properties may aid physicians in providing optimal treatment timing for dermatological conditions and offer researchers insight into optimal measurement timing. The major findings of the present investigation that systematically searched multiple databases and critically examined pertinent findings, revealed that of the several skin parameters reviewed, which included TEWL, pH, sebum, SBF, TDC, and thickness, each had at least one study describing a statistically significant within-a-day temporal change. The magnitude of these changes varied and may be large enough to be seriously considered when assessing these parameters in clinical and research settings. However, inconsistencies in reported temporal variations suggest that further systematic research is well warranted especially with respect to temporal within-a-day and day-to-day variabilities of TEWL, TDC, and mechanical properties. At present, the impact of this type of confounding variability on reported values for skin biophysical parameters is unclear and worthy of further clarification.

The Specificities of Elite Female Athletes: A Multidisciplinary Approach

Female athletes have garnered considerable attention in the last few years as more and more women participate in sports events. However, despite the well-known repercussions of female sex hormones, few studies have investigated the specificities of elite female athletes. In this review, we present the current but still limited data on how normal menstrual phases, altered menstrual phases, and hormonal contraception affect both physical and cognitive performances in these elite athletes. To examine the implicated mechanisms, as well as the potential performances and health risks in this population, we then take a broader multidisciplinary approach and report on the causal/reciprocal relationships between hormonal status and mental and physical health in young (18-40 years) healthy females, both trained and untrained. We thus cover the research on both physiological and psychological variables, as well as on the Athlete Biological Passport used for anti-doping purposes. We consider the fairly frequent discrepancies and summarize the current knowledge in this new field of interest. Last, we conclude with some practical guidelines for eliciting improvements in physical and cognitive performance while minimizing the health risks for female athletes.

Unbearable transepidermal water loss (TEWL) experimental variability: why?

Despite the wide breadth of research, much disparity exists in transepidermal water loss (TEWL) research data-possibly due to uncontrolled experimental variables. We determined whether such experimental variables significantly impact TEWL studies and cause this disparity. An initial literature search regarding TEWL was performed to determine potential confounding variables. A subsequent search procured relevant and representative studies investigating the impact of these variables on TEWL. Variables, such as age, anatomic site, and temperature, impact TEWL and should be controlled for in TEWL studies. Other variables, such as smoking and menstrual cycle, have inconclusive results or do not provide sufficient data breadth to make a conclusion regarding its effect, if such an effect exists, on TEWL metrics. Therefore, these variables require further research to determine their potential impact on TEWL. Matching for as many experimental variables as possible may reduce the disparity in TEWL data/conclusions.

Effects and mechanisms of action of light-emitting diodes on the human retina and internal clock

White light-emitting diodes (LEDs) will likely become the most used lighting devices worldwide in the future because of their very low prices over the course of their long lifespans which can be up to several tens of thousands of hours. The expansion of LED use in both urban and domestic lighting has prompted questions regarding their possible health effects, because the light that they provide is potentially high in the harmful blue band (400-500 nm) of the visible light spectrum. Research on the potential effects of LEDs and their blue band on human health has followed three main directions: 1) examining their retinal phototoxicity; 2) examining disruption of the internal clock, i.e., an out-of-sync clock, in shift workers and night workers, including the accompanying health issues, most concerningly an increased relative risk of cancer; and 3) examining risky, inappropriate late-night use of smartphones and consoles among children and adolescents. Here, we document the recognized or potential health issues associated with LED lighting together with their underlying mechanisms of action. There is so far no evidence that LED lighting is deleterious to human retina under normal use. However, exposure to artificial light at night is a new source of pollution because it affects the circadian clock. Blue-rich light, including cold white LEDs, should be considered a new endocrine disruptor, because it affects estrogen secretion and has unhealthful consequences in women, as demonstrated to occur via a complex mechanism.

Measuring melatonin by immunoassay

The pineal gland hormone melatonin continues to be of considerable interest to biomedical researchers. Of particular interest is the pattern of secretion of melatonin in relation to sleep timing as well as its potential role in certain diseases. Measuring melatonin in biological fluids such as blood and saliva presents particular methodological challenges since the production and secretion of the hormone are known to be extremely low during the light phase in almost all situations. Active secretion only occurs around the time of lights out in a wide range of species. The challenge then is to develop practical high-throughput assays that are sufficiently sensitive and accurate enough to detect levels of melatonin less than 1 pg/mL in biological fluids. Mass spectrometry assays have been developed that achieve the required sensitivity, but are really not practical or even widely available to most researchers. Melatonin radioimmunoassays and ELISA have been developed and are commercially available. But the quality of the results that are being published is very variable, partly not only because of poor experimental designs, but also because of poor assays. In this review, I discuss issues around the design of studies involving melatonin measurement. I then provide a critical assessment of 21 immunoassay kits marketed by 11 different companies with respect to validation, specificity and sensitivity. Technical managers of the companies were contacted in an attempt to obtain information not available online or in kit inserts. A search of the literature was also conducted to uncover papers that have reported the use of these assays, and where possible, both daytime and night-time plasma or saliva melatonin concentrations were extracted and tabulated. The results of the evaluations are disturbing, with many kits lacking any validation studies or using inadequate validation methods. Few assays have been properly assessed for specificity, while others report cross-reaction profiles that can be expected to result in over estimation of the melatonin levels. Some assays are not fit for purpose because they are not sensitive enough to determine plasma or saliva DLMO of 10 and 3 pg/mL, respectively. Finally, some assays produce unrealistically high daytime melatonin levels in humans and laboratory animals in the order of hundreds of pg/mL. In summary, this review provides a comprehensive and unique assessment of the current commercial melatonin immunoassays and their use in publications. It provides researchers new to the field with the information they need to design valid melatonin studies from both the perspective of experimental/clinical trial design and the best assay methodologies. It will also hopefully help journal editors and reviewers who may not be fully aware of the pitfalls of melatonin measurement make better informed decisions on publication acceptability.

Inflammation and Oral Contraceptive Use in Female Athletes Before the Rio Olympic Games

This study investigated the association between synthetic ovarian hormone use [i.e., the oral contraceptive (OC) pill] and basal C-reactive protein (CRP), peripheral blood immune cell subsets, and circulating pro- and anti-inflammatory cytokine concentrations in elite female athletes. Elite female athletes (n = 53) selected in Rio Summer Olympic squads participated in this study; 25 were taking an OC (AthletesOC) and 28 were naturally hormonally cycling (AthletesNC). Venous blood samples were collected at rest for the determination of sex hormones, cortisol, CRP, peripheral blood mononuclear memory and naïve CD4+ T-cells, CD8+ T-cells and natural killer cells, as well as pro- and anti-inflammatory cytokine concentrations. C-reactive protein concentrations were elevated (p < 0.001) in AthletesOC (median = 2.02, IQR = 3.15) compared to AthletesNC (median = 0.57, IQR = 1.07). No differences were reported for cortisol, cytokines, or PBMC immune cell subsets, although there was a trend (p = 0.062) for higher IL-6 concentrations in AthletesNC. Female Olympians had substantially higher CRP concentrations, a marker of inflammation and tissue damage, before the Rio Olympic Games if they used an OC. Future research should examine the potential consequences for athlete performance/recovery so that, if necessary, practitioners can implement prevention programs.

Early evening light mitigates sleep compromising physiological and alerting responses to subsequent late evening light

The widespread use of electric light and electronic devices has resulted in an excessive exposure to light during the late-evening and at night. This late light exposure acutely suppresses melatonin and sleepiness and delays the circadian clock. Here we investigate whether the acute effects of late-evening light exposure on our physiology and sleepiness are reduced when this light exposure is preceded by early evening bright light. Twelve healthy young females were included in a randomised crossover study. All participants underwent three evening (18:30-00:30) sessions during which melatonin, subjective sleepiness, body temperature and skin blood flow were measured under different light conditions: (A) dim light, (B) dim light with a late-evening (22:30-23:30) light exposure of 750 lx, 4000 K, and (C) the same late-evening light exposure, but now preceded by early-evening bright light exposure (18.30-21.00; 1200 lx, 4000 K). Late-evening light exposure reduced melatonin levels and subjective sleepiness and resulted in larger skin temperature gradients as compared to dim. Interestingly, these effects were reduced when the late-evening light was preceded by an early evening 2.5-hour bright light exposure. Thus daytime and early-evening exposure to bright light can mitigate some of the sleep-disruptive consequences of light exposure in the later evening.

Circadian Variation of Migraine Attack Onset: A Review of Clinical Studies

Several studies suggested that migraine attack onset shows a circadian variation; however, there has not been an overview and synthesis of these findings. A PubMed search with keywords "migraine" AND "circadian" resulted in ten studies directly investigating this topic. Results of these studies mostly show that migraine attacks follow a monophasic 24-hour cyclic pattern with an early morning or late night peak while other studies reported an afternoon peak and also a biphasic 24-hour cycle of attacks. The identified studies showed methodological variation including sample size, inclusion of medication use, comorbidities, and night or shift workers which could have contributed to the contradictory results. Several theories emerged explaining the diurnal distribution of migraine attacks suggesting roles for different phenomena including a morning rise in cortisol levels, a possible hypothalamic dysfunction, a circadian variation of migraine triggers, sleep stages, and a potentially different setting of the circadian pacemaker among migraineurs. At the moment, most studies show an early morning or late night peak of migraine attack onset, but a significant amount of studies reveals contradictory results. Further studies should investigate the arising hypotheses to improve our understanding of the complex mechanism behind the circadian variation of migraine attacks that can shed light on new targets for migraine therapy.

A novel comprehensive paradigm for the etiopathogenesis of multiple sclerosis: therapeutic approaches and future perspectives on its treatment

It is well recognized that variation in the geographical distribution of prevalence of multiple sclerosis (MS) exists: increasing the latitude its prevalence increases as well, but the underlying causes of such dissimilarity still remained elusive as of today. Currently, the most accredited hypothesis is that the closer to the equator the more pronounced is the amount of sunlight which, in turn, increases the production of vitamin D. Cholecalciferol is indeed deficient in MS patients, but this factor does not explain by itself the etiopathogenesis of the disease. In the present study, to search for a pattern and provide a model of the disease's etiology consistent with this regional factor, as well with its changing ethnic, sex-ratio, lifestyle variations and the other unexplained aspects of MS, an extensive analysis of peer-reviewed literature and data was conducted. The arisen hypothesis was that, increasing the latitude, the factor that varies and can have the stronger effect on the human organism, is the continuous and ever-increasing diversity of the natural light-dark cycle. The consequent effort of the suprachiasmatic nucleus to entrain the organism's circadian rhythm affects the hypothalamic-pituitary-adrenal axis resulting in desynchronizing the central and peripheral circadian clocks and pathologizing the immunitary system. To verify such hypothesis, a theoretical framework of the etiopathogenesis, coherent with the gathered literature, was conceived and a demonstration to corroborate it was eventually devised and performed. The results underscored that people living in countries subjected to a further circadian disruptive factor, as daylight saving time, have a 6.35 times higher prevalence of MS than States placed on their same latitude that do not observe it, thus strongly supporting the hypothesis. As further reinforcement of the conclusions, it is worth mentioning that the levels of polyamines rise abruptly in autoimmune diseases. Moreover, among their numerous roles, these polycations participate to the regulation of the circadian clock so their sudden variation might disrupt it. Following these interesting findings, new perspectives in therapies are, therefore, proposed.

Stress, salivary cortisol and periodontitis: A systematic review and meta-analysis of observational studies

OBJECTIVE

This meta-analysis aims to systematically assess whether periodontitis has a meaningful effect on salivary cortisol, reflecting changes on free blood cortisol levels.

DESIGN

The Cochrane Handbook and the PRISMA statement were used as reporting guidelines. The MEDLINE-PubMed, Google Scholar, EMBASE, and CENTRAL databases were searched until September 2017 to identify eligible studies, screened by seven independent authors and verified by an eighth. Studies comparing salivary cortisol level of periodontitis cases to controls were included. Data were extracted using a predefined table and since all papers were non-randomized clinical trials they were appraised using Downs and Black tool. DerSimonian random effects meta-analysis was performed using OpenMetaAnalyst.

RESULTS

Six cross-sectional studies were included, with 258 participants with chronic periodontitis and 72 with aggressive periodontitis, in a total of 573 participants. Overall results showed that aggressive periodontitis patients have, on average, 53% higher salivary cortisol levels than healthy controls 1.53 (1.11-2.12). Meta-regression exploring the relationship among salivary cortisol levels and periodontal measures, i.e., periodontitis severity, showed a global neutral effect, although this result requires future confirmation due to the low power of the model.

CONCLUSION

Observational studies results suggest that subjects with aggressive periodontitis have higher salivary cortisol levels than healthy ones or patients with chronic periodontitis. Such salivary cortisol response difference may have a negative impact on the periodontium, contributing to worse the burden of aggressive periodontitis disease. In the future, wide and well-designed longitudinal studies should be carried out in order to extensively confirm this possible effect, considering the complex nature of periodontitis and its many confounders factors that may contribute to this outcome.

Biological Rhythms in the Skin

Circadian rhythms, ≈24 h oscillations in behavior and physiology, are reflected in all cells of the body and function to optimize cellular functions and meet environmental challenges associated with the solar day. This multi-oscillatory network is entrained by the master pacemaker located in the suprachiasmatic nucleus (SCN) of the hypothalamus, which directs an organism's rhythmic expression of physiological functions and behavior via a hierarchical system. This system has been highly conserved throughout evolution and uses transcriptional-translational autoregulatory loops. This master clock, following environmental cues, regulates an organism's sleep pattern, body temperature, cardiac activity and blood pressure, hormone secretion, oxygen consumption and metabolic rate. Mammalian peripheral clocks and clock gene expression have recently been discovered and are present in all nucleated cells in our body. Like other essential organ of the body, the skin also has cycles that are informed by this master regulator. In addition, skin cells have peripheral clocks that can function autonomously. First described in 2000 for skin, this review summarizes some important aspects of a rapidly growing body of research in circadian and ultradian (an oscillation that repeats multiple times during a 24 h period) cutaneous rhythms, including clock mechanisms, functional manifestations, and stimuli that entrain or disrupt normal cycling. Some specific relationships between disrupted clock signaling and consequences to skin health are discussed in more depth in the other invited articles in this IJMS issue on Sleep, Circadian Rhythm and Skin.

The circadian clock in skin: implications for adult stem cells, tissue regeneration, cancer, aging, and immunity

Historically, work on peripheral circadian clocks has been focused on organs and tissues that have prominent metabolic functions, such as the liver, fat, and muscle. In recent years, skin has emerged as a model for studying circadian clock regulation of cell proliferation, stem cell functions, tissue regeneration, aging, and carcinogenesis. Morphologically, skin is complex, containing multiple cell types and structures, and there is evidence for a functional circadian clock in most, if not all, of its cell types. Despite the complexity, skin stem cell populations are well defined, experimentally tractable, and exhibit prominent daily cell proliferation cycles. Hair follicle stem cells also participate in recurrent, long-lasting cycles of regeneration: the hair growth cycles. Among other advantages of skin is a broad repertoire of available genetic tools enabling the creation of cell type-specific circadian mutants. Also, due to the accessibility of skin, in vivo imaging techniques can be readily applied to study the circadian clock and its outputs in real time, even at the single-cell level. Skin provides the first line of defense against many environmental and stress factors that exhibit dramatic diurnal variations such as solar ultraviolet (UV) radiation and temperature. Studies have already linked the circadian clock to the control of UVB-induced DNA damage and skin cancers. Due to the important role that skin plays in the defense against microorganisms, it also represents a promising model system to further explore the role of the clock in the regulation of the body's immune functions. To that end, recent studies have already linked the circadian clock to psoriasis, one of the most common immune-mediated skin disorders. Skin also provides opportunities to interrogate the clock regulation of tissue metabolism in the context of stem cells and regeneration. Furthermore, many animal species feature prominent seasonal hair molt cycles, offering an attractive model for investigating the role of the clock in seasonal organismal behaviors.

Circulating cortisol levels after exogenous cortisol administration are higher in women using hormonal contraceptives: data from two preliminary studies

Exogenous cortisol administration has been used to test the influence of glucocorticoids on a variety of outcomes, including memory and affect. Careful control of factors known to influence cortisol and other endogenous hormone levels is central to the success of this research. While the use of hormonal birth control (HBC) is known to exert many physiological effects, including decreasing the salivary cortisol response to stress, it is unknown how HBC influences circulating cortisol levels after exogenous cortisol administration. To determine those effects, we examined the role of HBC on participants' cortisol levels after receiving synthetic cortisol (hydrocortisone) in two separate studies. In Study 1, 24 healthy women taking HBC and 26 healthy men were administered a 0.1 mg/kg body weight intravenous dose of hydrocortisone, and plasma cortisol levels were measured over 3 h. In Study 2, 61 participants (34 women; 16 were on HBC) received a 15 mg hydrocortisone pill, and salivary cortisol levels were measured over 6 h. Taken together, results from these studies suggest that HBC use is associated with a greater cortisol increase following cortisol administration. These data have important methodological implications: (1) when given a controlled dose of hydrocortisone, cortisol levels may increase more dramatically in women taking HBC versus women not on HBC or men; and (2) in studies manipulating cortisol levels, women on hormonal contraceptives should be investigated as a separate group.

24-hour rhythm of aquaporin-3 function in the epidermis is regulated by molecular clocks

Aquaporin 3 (AQP3) is located in the basal layer of the epidermis and regulates biological functions of skin such as water content and trans-epidermal water loss. A recent study showed that the biological function of skin exhibits a 24-hour rhythm, but the molecular mechanism of the variation remains poorly understood. Here we show that mice mutated in the core clock component CLOCK (Clk/Clk) show decreased stratum corneum hydration. An extensive search for the underlying cause led us to identify AQP3 as a new regulator to control the 24-hour variation in biological functions of skin. In mouse epidermis of wild-type mice, mAqp3 exhibits circadian rhythms; however, these are significantly decreased in Clk/Clk. Luciferase reporter gene analysis revealed that transcription of mAqp3 is activated by D-site-binding protein, a clock gene. A human homolog, hAQP3, also exhibited significant oscillation in human keratinocyte (HaCaT) cells synchronized with medium containing 50% serum, and this rhythm was regulated by the endogenous CLOCK/BMAL1 heterodimer. These data indicate that although the molecular mechanisms underlying the rhythmic expression of mAqp3 and hAQP3 are different, clock genes are involved in time-dependent skin hydration. Our current findings provide a molecular link between the circadian clock and AQP3 function in mouse dorsal skin and HaCaT cells.

Hormonal contraceptive use diminishes salivary cortisol response to psychosocial stress and naltrexone in healthy women

The use of hormonal contraception (HC) may affect salivary cortisol levels at rest and in response to a pharmacological or stress challenge. Therefore, the current study used a secondary data analysis to investigate the effect of HC on salivary cortisol levels in response to the mu-opioid receptor antagonist naltrexone and a psychosocial stressor, and also across the diurnal curve. Two hundred and nine women (n=72 using hormonal contraception; HC+) completed a two-session stress response study that consisted of a stress day, in which they were exposed to public speaking and mental arithmetic, and a rest day, in which unstimulated cortisol levels were measured to assess the diurnal rhythm. A subset of seventy women (n=24 HC+) also completed a second study in which they were administered oral naltrexone (50mg) or placebo in a randomized, placebo-controlled, double blind fashion. Women who were HC+ had a significantly reduced salivary cortisol response to both the psychosocial stressor (p<0.001) and naltrexone (p<0.05) compared to HC- women. Additionally, HC+ women had a significantly altered morning diurnal cortisol rhythm (p<0.01), with a delayed peak and higher overall levels. The results of the current study confirm that HC attenuates salivary cortisol response to a psychosocial stressor and mu-opioid receptor antagonism, and also alters the morning diurnal cortisol curve.

The assessment of cortisol in human hair: associations with sociodemographic variables and potential confounders

To inform the future use of hair cortisol measurement, we have investigated influences of potential confounding variables (natural hair colour, frequency of hair washes, age, sex, oral contraceptive (OC) use and smoking status) on hair cortisol levels. The main study sample comprised 360 participants (172 women) covering a wide range of ages (1-91 years; mean = 25.95). In addition, to more closely examine influences of natural hair colour and young age on hair cortisol levels, two additional samples comprising 69 participants with natural blond or dark brown hair (hair colour sample) as well as 28 young children and 34 adults (young age sample) were recruited. Results revealed a lack of an effect for natural hair colour, OC use, and smoking status on hair cortisol levels (all p's >0.10). No influence of frequency of hair washes was seen for proximal hair segments (p = 0.335) but for the third hair segment indicating lower cortisol content (p = 0.008). We found elevated hair cortisol levels in young children and older adults (p < 0.001). Finally, men showed higher hair cortisol levels than women (p = 0.002). The present data indicate that hair cortisol measurement provides a useful tool in stress-related psychobiological research when applied with the consideration of possible confounders including age and sex.

Thermographic imaging of facial skin--gender differences and temperature changes over time in healthy subjects

OBJECTIVES

To assess changes in facial skin temperature over time, to identify sources of variation related to skin temperature and to evaluate interobserver reproducibility in measurements of the thermograms.

METHODS

62 volunteers (32 females, 30 males, mean age 23.4, range 19.5-29.5 years) underwent thermography of the face (left and right side lateral images) on four occasions with approximately 2 months between each session. Three observers recorded the images and marked regions of interest (ROIs) in each image using dedicated software. Smoking, exercise habits and use of oral contraceptives were recorded.

RESULTS

A significant difference between sessions (≤1 °C, p<0.001) and between observers (≤0.11 °C, p<0.001) was identified. The difference between sides was not significant (≤0.07 °C, p=0.7). None of the interactions between side, session and observer were significant. Smoking, exercise habits and oral contraceptive intake were not significant impact factors when included as covariates in the analysis (p>0.1). ROI temperature was significantly higher in males than in females (0.7 °C, p<0.001). A mixed model analysis of variance showed that observer had little impact on the expected standard deviation, whereas session and subject had a greater impact.

CONCLUSIONS

Face temperature is symmetrical and varies over time. The non-significant difference between sides is highly reproducible, even between observers.

Adolescents' cortisol responses to awakening and social stress; effects of gender, menstrual phase and oral contraceptives. The TRAILS study

Studies on the influence of sex hormones on cortisol responses to awakening and stress have mainly been conducted in adults, while reports on adolescents are scarce. We studied the effects of gender, menstrual cycle phase and oral contraceptive (OC) use on cortisol responses in a large sample of adolescents. Data come from TRAILS (TRacking Adolescents' Individual Lives Survey), a prospective population study of Dutch adolescents. This study uses data of 644 adolescents (age 15-17 years, 54.7% boys) who participated in a laboratory session including a performance-related social stress task (public speaking and mental arithmetic). Free cortisol levels were assessed by multiple saliva samples, both after awakening and during the laboratory session. No significant effects of gender and menstrual phase on cortisol responses to awakening were found, while girls using OC displayed a slightly blunted response (F(1, 244)=5.30, p=.02). Cortisol responses to social stress were different for boys and free-cycling girls (F(3, 494)=9.73, p<.001), and OC users and free-cycling girls (F(3, 279)=15.12, p<.001). Unexpectedly, OC users showed no response at all but displayed linearly decreasing levels F(1, 279)=19.03, p<.001) of cortisol during the social stress test. We found no effect of menstrual cycle phase on cortisol responses to social stress (F(3, 157)=0.58, p=.55). The absence of a gender difference in the adolescents' cortisol awakening response found in this study is consistent with previous reports. Our results further suggest that adolescent OC users display slightly blunted cortisol responses after awakening, and that gender differences in cortisol responses to social stress during adolescence are comparable to those described for adult populations, that is, stronger responses in men than in women. Whereas previous work in adults suggested blunted stress responses in OC users compared to men and free-cycling women, adolescent OC users showed no cortisol response. Effects of type of OC could not be studied because of low numbers of OC that were only progestin based.

Euchronism, allochronism, and dyschronism: is internal desynchronization of human circadian rhythms a sign of illness?

The authors define a subject as euchronic when the circadian parameters--tau (tau=period), Ø (acrophse or peak time), A (amplitude), and M (MESOR=24 h rhythm-adjusted mean)--of a set of circadian variables are within the confidence limits of appropriate reference values of healthy subjects (HS). We define internal desynchronization as a state in which the circadian tau of a set of rhythms differs from 24 h and when the tau of a given variable differs from that of other variables. Such a state was first observed in singly isolated HS without access to time cues and clues. Herein, data and analyses are presented demonstrating that internal desynchronization appears to be a rather common phenomenon in HS dwelling in their natural environment (i.e., in the presence of usual zeitgebers). This has been documented by longitudinal studies (n approximately=15 days) of the circadian rhythm in sleep-wakefulness, body temperature, right- and left-hand-grip strength, and reaction time involving a total of 246 HS and 134 shift workers (SW), with 45.5% showing good and 54.5% poor SW tolerance. The presence of internal desynchronization observed in SW was associated SW intolerance, with symptoms being sleep alteration/disturbances, sleeping-pill dependence, persisting fatigue (asthenia), mood alteration, and digestive complaints. Internal desynchronization was also documented in groups of HS and tolerant SW, though it was almost the rule among the intolerant SW. The authors introduce two new terms: allochronism to describe the time organization of those SW who evidence internal desynchronization without detectable clinical symptoms, and dyschronism to describe the time organization of those SW who exhibit internal desynchrobization plus the symptoms of SW intolerance or medical illness. The condition of allochronism is not restricted only to SW tolerance, as it was detected in 112 HS without medical complains when exposed to various experimental conditions, including medications and placebos, sojourn in the high Arctic summer, intensive sport training, and task-loaded cognitive performance testing. Dyschronism in SW who are sleep-deprived is associated with persisting fatigue. An unpublished Gallup survey found that 47% of 2478 respondents experienced a state of asthenia during the previous 12 months, with symptoms mimicking those of SW intolerance. In one-third of the cases, the origin of the asthenia was undetermined. Taking into account the high incidence of internal desynchronization found in past investigations and the clinical observation that sleep deprivation is a consequence of many acute and chronic medical conditions (nocturnal pain, nocturnal asthma, etc.), it is suggested that dyschronism may be responsible for the asthenia of unknown origin, at least for some persons. The interindividual (including sex-related) variability in the propensity to exhibit an altered temporal organization, whether it be transient or persistent (i.e., reversible or non-reversible) suggests the involvement of genetic factors. The Dian-Circadian genetic model previously proposed by the authors seems pertinent to conceptualize and explain the various levels and output of internal desynchronization.

The barrier component and the driving force component of transepidermal water loss and their application to skin irritant tests

BACKGROUND/AIM

According to Fick's law of diffusion, the rate of transepidermal water loss (TEWL) is determined by a barrier component and a driving force component. The objective of this study is to propose novel indicators for the assessment of skin irritation potential from chemicals using these components.

METHODS

Before and after acetone/ether (AE), sodium lauryl sulfate (SLS) and nicotinic acid methyl ester (NME) treatments, the apparent mass transfer coefficient of water, K, of the stratum corneum (SC) and the apparent water vapor pressure, P(d), at the interface between SC and epidermis were estimated as measures of the SC barrier and the driving force, respectively.

RESULTS

After AE treatment, K showed marked increase and P(d) remained approximately constant. All participants reacted to NME with erythema and the laser-Doppler flowmetry (LDF) value peaked at around 30 min. While there was a change in P(d), which parallels with LDF changes, K showed little variation. Repeated SLS treatment induced a slight increase in P(d) besides an increase in K. In the meantime, all participants reacted with subtle erythema.

CONCLUSIONS

Our results suggest that not only the SC barrier but also the driving force determines variations in the TEWL rates during skin irritant tests. Together, K and P(d) will provide us with invaluable information about skin condition.

Chronophysiologie circadienne du cuir chevelu

Biological rhythms are numerous and vary according to periodicity and amplitude. Variations over the course of a day, particularly circadian rhythms have been reported in the skin of the face and forearms. However, little information is available about daily biorhythms of the scalp. The aim of the present study was to explore the chronophysiology of the scalp. We report a series of diurnal rhythms in 8 Caucasian men using the plexogram method at 4-h intervals over a 5-day period. Statistically significant biorhythms were found for the colour, hydration, barrier function and pH of the skin, and for the sebum excretion as well. The early afternoon was the time of maximum increase in redness, hydration, pH and sebum output, combined with decreased skin barrier function. The amplitude of some of these biorhythms was so discrete that their clinical relevance remained uncertain even when they appeared statistically significant. In view of the apparent synchronization between them, it is likely that a central oscillator exerts a major influence. However, only rare subjects exhibited biorhythms for all the considered physiological parameters. Hence, peripheral reactivity and/or environmental synchronizers also play an important role to define the good and bad respondors to the potential biorhythms of each individual parameter.

Rectal temperature, distal sweat rate, and forearm blood flow following mild exercise at two phases of the circadian cycle

Changes in rectal temperature during mild exercise in the middle of the rising (11:00 h) and falling (23:00 h) phases of the circadian rhythm of resting core temperature have been compared. Seven healthy males were studied at rest, while exercising on a cycle ergometer (60 min at 80 W), and during the first 30 min of recovery. Rectal temperature, forearm blood flow, and forearm sweat rate were measured at 1 min intervals throughout. During exercise, there were significant time-of-day differences in the profiles of all three variables, and in the thresholds for increases in forearm blood flow and sweating. Forearm blood flow and sweat rate were recruited more rapidly and to a greater extent with evening exercise, and rectal temperature rose less. Analysis of covariance, with rectal temperature as the covariate, indicated the associations between it and forearm blood flow or sweating were significantly different (p<0.05) between the two times of day. There were also significant (p<0.05) time-of-day effects for forearm blood flow and sweating that were independent of rectal temperature. During recovery, rectal temperature fell more quickly in the late evening than late morning. Forearm blood flow and sweating also showed time-of-day differences, but these did not co-vary with rectal temperature. Control of rectal temperature during exercise and recovery appears to be more effective in the late evening than late morning, and differences in forearm blood flow and sweating, as well as factors independent of these two variables, contribute to this difference. The results support our "heat-gain/heat-loss modes" hypothesis.

Chronobiology: biological clocks and rhythms of the skin

The cyclicity of time affects virtually all aspects of our being and is the basis of the underlying rhythmicity which is typical of our lives. To 'tell time', most living organisms use internal timing mechanisms known as 'biological clocks'. These 'clocks' coordinate our physiological and behavioral functions and interactions with our environment. One of the strongest influences on rhythmicity is the solar day. The study of these temporal rhythms in biological systems has been coined chronobiology. With the present article we aim to give an overview on chronobiology. Examples of chronobiological effects on skin will be described. Particular emphasis will be placed on circadian rhythms (including rhythms that take place within a 24-hour period, including so-called infradian and/or diurnal rhythms) but also on seasonal variations (circaannual rhythms).

Gender differences in the circadian variations in muscle strength assessed with and without superimposed electrical twitches

The circadian rhythm in muscle strength was analysed in 12 males (28 +/- 4 years, 79.6 +/- 12.3 kg, 1.80 +/- 0.05 m) and eight females (28 +/- 4 years, 60.3 +/- 5.5 kg, 1.61 +/- 0.08 m). After two familiarization sessions, participants were tested at six different times of the day (02:00, 06:00, 10:00, 14:00, 18:00 and 22:00 hours), the order of which was randomly assigned over 3-4 days. Rectal temperature (T(rec)) was measured over 30 min before each test. Peak isokinetic torques (PT) of knee extensors and flexors were then measured at 1.05 rad s(-1) and 3.14 rad s(-1) through a 90 degrees range of motion. Maximal isometric voluntary contraction (MVC) of knee extensors and flexors was measured at 60 degrees of knee flexion and the MVC of knee extensors was also assessed with superimposed electrical twitches (50 Hz, 250 V, 200 mus pulse width) in order to control for motivational effects. Three trials were performed in each condition, separated by 3 min recovery, and the highest values were retained for subsequent analyses. A significant circadian rhythm was observed for T(rec) in both males and females (acrophase, Phi, 17:29 and 16:40 hours; mesor, Me, 37.0 and 36.8 degrees C; amplitude, A, 0.28 and 0.33 degrees C for males and females, respectively). The mesor of T(rec) was higher in males than in females (p < 0.05). Significant circadian rhythms were observed for knee extensor PT at 3.14 rad s(-1) in males (Phi, 17:06 hours; Me, 178.2 N m; A, 4.7 N m) and for knee extensor PT at 1.05 rad s(-1) in females (Phi, 15:35 hours; Me, 128.7 N m; A, 3.7 N m). In males, the MVC of knee extensors demonstrated a significant circadian rhythm, but only when electrical twitches were superimposed (Phi, 16:17 h; Me, 302.1 N m; A, 13.6 N m). Acrophases of all indices of muscle strength were not statistically different between the two groups and were located in the afternoon (12:47 < Phi < 17:16 hours). The amplitude (percentage of mesor) of extensors MVC (electrically stimulated) was higher in males (6.4%) than in females (4.2%; p < 0.05). Significant circadian rhythms were not consistently observed for all indices of muscle strength whatever the gender. Our group of female subjects tended to show lower circadian amplitudes than the males. In males, maximal voluntary contraction of electrically stimulated muscles followed a circadian curve, which was not significant without the superimposed twitches. These results suggest that motivation could have a masking effect on the circadian rhythm in muscle performance and strengthen the view that peripheral factors are implicated in this rhythm.

Circadian and ultradian (12 h) variations of skin blood flow and barrier function in non-irritated and irritated skin-effect of topical corticosteroids

The skin is the organ that receives the greatest exposure to light and shows a high-amplitude circadian rhythm in epidermal cell proliferation. We have previously demonstrated that the skin barrier function has a significant circadian rhythm. Corticosteroids (CS) are the most commonly used topical treatment in dermatology. Time-dependent differences in their efficacy and side-effects would be of considerable interest. The aims of the current study were to examine time-dependent cycles in the effect of topical CS application in healthy and irritated skin on skin blood flow and its relationship to barrier function. Twenty clinically healthy, diurnally active subjects were examined at eight and nine time points over a 24 or 28 h span respectively, using non-invasive skin bioengineering techniques of laser Doppler imaging, a transepidermal water loss (TEWL) device and a skin thermometer in a 28 h session. The results of this current study demonstrate circadian and ultradian (12 h) variations in skin blood flow. A significant correlation was found between skin temperature and skin blood flow but not with TEWL. Circadian and ultradian rhythms are maintained during treatment with high-potency and mid-potency CS in healthy skin. These rhythms persist during stratum corneum disruption with and without CS application.

Daily Variations in Skin Surface Properties Using Mixed Model Methodology

In order to explore the variations over the course of a day in certain skin biophysical properties, a study was conducted on 8 female volunteers. An assessment of several skin biophysical properties was carried out on the face and the volar forearm every 4 h over a period of 48 h. The biophysical parameters were assessed on the face for sebum secretion, skin surface pH, skin colour, transepidermal water loss, capacitance and skin surface temperature. The same parameters were measured on the volar forearm (excepted for sebum secretion). A statistical analysis based on mixed effect models was conducted. Four models, with different covariance structures, were successively tested. The analysis allowed us to identify a structure that repeated itself over time in the same way over each 24-hour period for capacitance on the forearm and for sebum secretion, skin surface pH and skin colour (L* and a* parameters) on the face. Mixed effect methodology is a powerful tool to analyse longitudinal data involving correlations among repeated measurements made on the same subject.

Right- and left-brain hemisphere. Rhythm in reaction time to light signals is task-load-dependent: age, gender, and handgrip strength rhythm comparisons

In healthy mature subjects simple reaction time (SRT) to a single light signal (an easy task) is associated with a prominent rhythm with tau = 24 h of dominant (DH) as well as nondominant (NDH) hand performance, while three-choice reaction time (CRT), a complex task, is associated with tau = 24 h of the DH but tau < 24 h of the NDH. The aims of the study were to assess the influence of age and gender on the difference in tau of the NDH and DH, as it relates to the corresponding cortical hemisphere of the brain, in comparison to the rhythm in handgrip strength. Healthy subjects, 9 (5 M and 4 F) adolescents 10-16 yr of age and 15 (8 M and 7 F) adults 18-67 yr of age, active between 08:00 +/- 1 h and 23:00 +/- 1:30 h and free of alcohol, tobacco, and drug consumption volunteered. Data were gathered longitudinally at home and work 4-7 times daily for 11-20 d. At each test time the following variables were assessed: grip strength of both hands (Dynamometer: Colin-Gentile, Paris, France); single reaction time to a yellow signal (SRT); and CRT to randomized yellow, red, or green signal series with varying instruction from test to test (Psycholog-24: Biophyderm, France). Rhythms in the performance in SRT, CRT, and handgrip strength of both DH and NDH were explored. The sleep-wake rhythm was assessed by sleep-logs, and in a subset of 14 subjects it was also assessed by wrist actigraphy (Mini-Motionlogger: AMI, Ardsley NY). Exploration of the prominent period tau of time series was achieved by a special power spectra analysis for unequally spaced data. Cosinor analysis was used to quantify the rhythm amplitude A and rhythm-adjusted mean M of the power spectral analysis determined trial tau. A 24h sleep-wake rhythm was detected in almost all cases. In adults, a prominent tau of 24 h characterized the performance of the easy task by both the DH and NDH. In adults a prominent tau of 24 h was also detected in the complex CRT task performed by the DH, but for the NDH the tau was < 24 h. This phenomenon was not gender-related but was age-related since it was seldom observed in adolescent subjects. Hand-side differences in the grip strength rhythms in the same individuals were detected, the tau being ultradian rather than circadian in adolescent subjects while in mature subjects the tau frequently differed from that of the rhythm in CRT. These findings further support the hypothesis that functional biological clocks exist in both the left and right hemispheres of the human cortex.

17beta-estradiol matrixpatch removal and reapplication in postmenopausal women: theoretical predictions with an oscillating diffusion coefficient model

The pharmacokinetic performance of a matrix system for transdermal beta-estradiol (E(2)) delivery after multiple consecutive dosing in postmenopausal women undergoing hormone replacement therapy was investigated. The E(2) plasma profiles determined during the third application in 16 postmenopausal women were compared with results obtained in a published clinical study using the same patch in 24 postmenopausal women without E(2) pretreatment; they were compared with a theoretical diffusion/pharmacokinetic model. A conventional theoretical model with constant model parameter (CPM) obtained from in vitro mass balance experiments in a Franz cell type set up described successfully the transdermal E(2) bioavailability parameter AUC(0-96h) (4341.9 +/- 1513.1; calculated 4250.8) and C(average) (45.0 +/- 13.2; calculated 41.2). Also, experimentally, there was no significant drop in E(2) plasma values after patch removal and reapplication; this was corroborated by calculations. Accumulation of E(2) did not occur when several patches were applied consecutively over a period of 3 weeks. Steady state was achieved following application of the first patch. However, the differences between recorded E(2) plasma profiles and theoretical results detected at specific measurement points cannot be explained by the CPM model. Experimentally obtained plasma profiles were always lower in the morning and higher in the evening than predicted on the basis of the model. Measurements of in vivo skin temperature in the postmenopausal women showed oscillating temperature profiles in the form of a cosinor function: The temperature mesor of untreated postmenopausal women was 34.8 degrees C with an acrophase at 17.0 o'clock (95% CI: 14.30-19.30) and an amplitude of +/- 0.4 degrees C (p = 0.1). During the application of the patch the average temperature next to a patch rose 0.3 degrees C, which was statistically significant (p = 0.1). In the skin under the application of the matrix patch a mesor temperature was detected as 35.6 degrees C with an amplitude of +/- 0.5 degrees C with an acrophase at 17.51 o'clock (95% CI: 14.30-21.00) (p = 0.05). The temperature period was 24 h for all measurements and the maximum temperature was observed at about 16.30 h, and a minimum at about 5.00 h. A linear dependency was detected in in vitro experiments between the log of E(2) permeability and the temperature for stripped skin, epidermis/dermis layer, as well as for the matrix. Modeling of E(2) plasma profiles with oscillating diffusion coefficients (ODM1) with a sine wave function results in this equation: D(1) = D(0x) + Da(x).sin(k.t). D(0x) is the diffusion coefficient determined at 35.6 degrees C, k is 1/24 h, D(a) is the diffusion coefficient of the temperature amplitude, h is hour, and x stands for the respective diffusion layer. It was shown that the experimental E(2) plasma profile variations are more pronounced than can simply be explained by skin temperature variations alone (ODM1 model). A simplex fit with an oscillating diffusion coefficient in the form of a sine wave function for the stratum corneum (ODM2 model) resulted in a temperature amplitude of 1.1 degrees C, about twice as high as was determined in the in vivo measurements (ODM2 model). Therefore, other circadian parameterlike blood flow might superimpose the temperature profile. The improvement in data analysis by incorporating oscillating diffusion coefficients (ODM1 and 2) over CPM was judged from a comparison of experimental data with the calculated plasma profiles with the AIC, Akaikes model selection criterion, which allows ranking between models because it is independent of the scaling of the data points. ODM1 and ODM2 improved the data analysis over CPM by allowing better calculation of experimental C(max), t(max), the time to reach to C(max), and the fluctuation, f. No difference between CPM, ODM1, or ODM2 was found for the bioavailability parameter C(average) and AUC(0-96h).

Analysis of circadian and ultradian rhythms of skin surface properties of face and forearm of healthy women

Biologic rhythms of cells and organisms are well documented and have been extensively studied at the physiologic and molecular levels. For the skin, many circadian changes have been investigated but few systematic studies comparing skin at different body sites have been reported. In this study we investigated facial and forearm skin circadian rhythms in eight healthy Caucasian women. Noninvasive methods were used to assess skin capacitance, sebum excretion, skin temperature, transepidermal water loss, and skin surface pH on fixed sites of the face and the volar forearm during a 48 h span under standardized environmental conditions. Using the cosinor or ANOVA methods, circadian rhythms could be detected for sebum excretion (face), transepidermal water loss (face and forearm), skin temperature (forearm), pH (face), and capacitance (forearm). No circadian rhythmicity was found for the other biophysical parameters. In addition to the 24 h rhythm component, rhythms with periods of 8 h were found for sebum excretion, of 8 and 12 h for transepidermal water loss (face and forearm), and of 12 h for skin temperature (forearm). Our study confirms that rhythms of skin surface parameters are readily measurable and that these rhythms differ between different sites. Furthermore, we demonstrate for the first time that, for transepidermal water loss (face and forearm), sebum excretion, and skin temperature (forearm), in addition to circadian rhythms, ultradian and/or component rhythms can be detected.

Cardiovascular risk and therapeutic intervention for the early morning surge in blood pressure and heart rate

The incidence of most adverse cardiovascular events appears to follow a circadian pattern, reaching a peak in the morning shortly after wakening and arising. The activities of many physiologic parameters, including hemodynamic, hematologic and humoral factors, also fluctuate in a cyclical manner over the 24h. It has been suggested that, during the post-awakening hours, the phases of these cycles synchronize to create an environment that predisposes to atherosclerotic plaque rupture and thrombosis in susceptible individuals, thereby accounting for the heightened cardiovascular risk at this time of day. Blood pressure and heart rate are part of this physiologic process, following a clear circadian rhythm characterized by a fall during sleep and a sharp rise upon awakening. This so-called 'morning surge' in blood pressure may act as a trigger for cardiovascular events, including myocardial infarction and stroke. The clinical implication of these observations is that antihypertensive therapy should provide blood pressure control over the entire interval between doses. For agents taken once daily in the morning, the time of trough plasma drug level (and lowest pharmacodynamic effect) will often coincide with the early morning surge in blood pressure and heart rate. For these reasons, chronotherapeutic formulations of drugs and intrinsically long-acting antihypertensive agents provide the most logical approach to the treatment of hypertensive patients since they provide 24 h blood pressure control from a single daily dose as well as attenuating the early morning rise in blood pressure (and in some instances heart rate).

Decreased submaximal oxygen uptake during short duration oral contraceptive use: a randomized cross-over trial in premenopausal women

Long-term oral contraceptive (OC) use is known to be associated with changes in haemostasis, cardiovascular dynamics, and carbohydrate and lipid metabolism. Less well documented are the short-term variations in cardiorespiratory responses to exercise during the menstrual cycle of OC users. In this study the short-term effects of the usage of OC on cardiorespiratory and ventilatory responses to submaximal exercise were examined. Ten women (age = 23 +/- 3 years) on monophasic OC were tested at three different times during their 'cycle': during menstruation, off OC use (off OC: days 2-4), early on OC use (EOC: days 7 - 9) and late on OC use (LOC: days 19 - 21). Times of testing were assigned randomly. On each occasion participants performed a continuous 12-min run exercise on a treadmill at three submaximal intensities (averaging 7, 8 and 9 km h(-1)), each for 4 min. Heart rate, ventilation (VE), oxygen uptake (VO2), carbon dioxide output (VCO2), respiratory exchange ratio and running economy were assessed in the last minute of each stage of exercise. No significant variations were observed between the different times for heart rate, VE, and VCO2 irrespective of the stage of exercise (p > 0.05). Using two-way analysis of variance (ANOVA) with repeated measures on both factors (three stages and three times), VO2 (ml kg(-1) min(-1)) was lower by 3% to 5.8% when participants were on early and late OC use compared to off OC regardless of the stage of the exercise (F(2,18) = 6.3; p = 0.008). Running economy (ml O2 kg(-1) km(-1)) was significantly improved (lower values) when women were on late OC use compared to off OC regardless of the stage of exercise. No significant interaction effect between stage of exercise and time of pill usage was demonstrated in any of the parameters studied. Results suggest that oral contraceptive users may expect lower VO2 and better running economy during the pill ingestion phase and consequently have implications for exercise performances.

Masculinizing effects on otoacoustic emissions and auditory evoked potentials in women using oral contraceptives

The otoacoustic emissions (OAEs) and auditory evoked potentials (AEPs) measured in two separate large scale studies were examined retrospectively for potential differences between those women using, and those not using, oral contraception (OC). Fourteen dependent variables were examined, all of which exhibited substantial sex differences. For 13 of those 14 dependent variables, the means for the users of OC were shifted away from the means of the non-users in the direction of the males. Specifically, for four different measures of OAE strength, for seven of eight measures of AEP latency or amplitude, and for two cognitive tests (mental rotation and water level), the means for the users of OC were located intermediate to those of the non-users of OC and the males. Few of these differences between users and non-users of OC achieved statistical significance, but the near universality of the direction of the difference suggests that oral contraceptives do produce a weak masculinizing effect on some auditory structures. These weak masculinizing effects appear to run contrary to the facts that the levels of both free testosterone and estradiol are lower in women using OC than in normal-cycling women. Past findings on auditory sex differences may have underestimated those sex differences.

Effects of menstrual cycle phase and oral contraceptives on alertness, cognitive performance, and circadian rhythms during sleep deprivation

The influence of menstrual cycle phase and oral contraceptive use on neurobehavioral function and circadian rhythms were studied in healthy young women (n = 25) using a modified constant routine procedure during 24 h of sleep deprivation. Alertness and performance worsened across sleep deprivation and also varied with circadian phase. Entrained circadian rhythms of melatonin and body temperature were evident in women regardless of menstrual phase or oral contraceptive use. No significant difference in melatonin levels, duration, or phase was observed between women in the luteal and follicular phases, whereas oral contraceptives appeared to increase melatonin levels. Temperature levels were higher in the luteal phase and in oral contraceptive users compared to women in the follicular phase. Alertness on the maintenance of wakefulness test and some tests of cognitive performance were poorest for women in the follicular phase especially near the circadian trough of body temperature. These observations suggest that hormonal changes associated with the menstrual cycle and the use of oral contraceptives contribute to changes in nighttime waking neurobehavioral function and temperature level whereas these factors do not appear to affect circadian phase.

Effects of estrogen replacement therapy on the circadian rhythms of serum cortisol and body temperature in postmenopausal women

Estrogen replacement therapy (ERT) seems to enhance longevity in women. Both gender and aging have been shown to influence the regulation of circadian rhythms, yet little is known about the effect of ERT on circadian regulation. The aim of this study was to determine the effects of ERT (oral conjugated estrogen: Premarin, 0.625 mg) for 6-8 weeks on circadian serum cortisol by continuous blood sampling every 15 min for 24 h with simultaneous measurements of body temperature in six healthy postmenopausal women (range, 54-61 years). The results are presented as median values (range in quartiles). The circadian amplitude of cortisol increased during ERT from 20.20 (18.35, 23.61) to 25.97 (24.94, 27.74) microg/dL (p = 0.016), whereas the timing of nocturnal nadir and morning acrophase did not differ significantly. ERT lowered the 24-h body temperature from 37.03 degrees C (36.95 degrees C, 37.07 degrees C) to 36.90 degrees C (36.77 degrees C, 36.97 degrees C) (p = 0.038), but did not alter the peak and trough body temperatures significantly. These findings are noteworthy because the increased circadian amplitude of serum cortisol during ERT contrasts with the reduction in circadian amplitude seen with normal aging. The reduction in body temperature confirms the regulatory effect of ERT in thermoregulation and has implications regarding the correlation between basal metabolic rate and life span.