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Zhou Y, Liu Z. Saliva biomarkers in oral disease. Clin Chim Acta 2023; 548:117503. [PMID: 37536520 DOI: 10.1016/j.cca.2023.117503] [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: 04/23/2023] [Revised: 07/26/2023] [Accepted: 07/31/2023] [Indexed: 08/05/2023]
Abstract
Saliva is a versatile biofluid that contains a wide variety of biomarkers reflecting both physiologic and pathophysiologic states. Saliva collection is noninvasive and highly applicable for tests requiring serial sampling. Furthermore, advances in test accuracy, sensitivity and precision for saliva has improved diagnostic performance as well as the identification of novel markers especially in oral disease processes. These include dental caries, periodontitis, oral squamous cell carcinoma (OSCC) and Sjögren's syndrome (SS). Numerous growth factors, enzymes, interleukins and cytokines have been identified and are the subject of much research investigation. This review highlights current procedures for successful determination of saliva biomarkers including preanalytical factors associated with sampling, storage and pretreatment as well as subsequent analysis. Moreover, it provides an overview of the diagnostic applications of these salivary biomarkers in common oral diseases.
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Affiliation(s)
- Yuehong Zhou
- Wenzhou Medical University Renji College, Wenzhou, China
| | - Zhenqi Liu
- Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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2
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The association between the cortisol and cortisone awakening responses. Psychoneuroendocrinology 2023; 152:106075. [PMID: 36933271 DOI: 10.1016/j.psyneuen.2023.106075] [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: 05/25/2022] [Revised: 01/29/2023] [Accepted: 03/04/2023] [Indexed: 03/20/2023]
Abstract
The cortisol awakening response (CAR) is often assessed in the saliva and considered to be representative of serum cortisol. However, free cortisol is rapidly converted into cortisone as it passes from the serum into the saliva. Because of this enzymatic conversion, the salivary cortisone awakening response (EAR) may be more closely related to serum cortisol dynamics than the salivary CAR. Therefore, the purpose of this study was to measure the EAR and CAR in saliva and compare it to the serum CAR. METHODS Male participants (n = 12) had an intravenous catheter placed for serial serum sampling and completed two overnight laboratory sessions, wherein participants slept in the laboratory and saliva and serum samples were collected every 15 min after volitional awakening the following morning. Serum was assayed for total cortisol and saliva for cortisol and cortisone. The CAR and EAR was assessed in saliva and the CAR in serum via mixed-effects growth models and common awakening response indices (area under the curve [AUC] relative to the ground [AUCG] and relative to the increase [AUCI], and change scores [Δ]). RESULTS There was a distinct rise in salivary cortisone following awakening demonstrating the presence of a discernable EAR (βQuadratic = -41.18, [95%CI = -68.90 to -13.46], p < 0.004, Conditional R2 = 0.641). Two EAR indices (AUCG: p < 0.001 and AUCI: p = 0.030) were associated with the corresponding serum CAR indices. CONCLUSION We demonstrate for the first time a distinct cortisone awakening response. The results suggest the EAR may be more closely related to serum cortisol dynamics during the post-awakening period, and thus, may be a biomarker of interest in addition to the CAR for assessing hypothalamic-pituitary-adrenal axis functioning.
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Huang T, Howse FM, Stachenfeld NS, Usselman CW. Correlations between salivary- and blood-derived gonadal hormone assessments and implications for inclusion of female participants in research studies. Am J Physiol Heart Circ Physiol 2023; 324:H33-H46. [PMID: 36426884 DOI: 10.1152/ajpheart.00399.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Even in the 21st century, female participants continue to be underrepresented in human physiology research. This underrepresentation is attributable in part to the perception that the inclusion of females is more time consuming, less convenient, and more expensive relative to males because of the need to account for the menstrual cycle in cardiovascular study designs. Accounting for menstrual cycle-induced fluctuations in gonadal hormones is important, given established roles in governing vascular function and evidence that failure to consider gonadal hormone fluctuations can result in misinterpretations of biomarkers of cardiovascular disease. Thus, for cardiovascular researchers, the inclusion of females in research studies implies a necessity to predict, quantify, and/or track indexes of menstrual cycle-induced changes in hormones. It is here that methodologies are lacking. Gold standard measurement requires venous blood samples, but this technique is invasive and can become both expensive and technically preclusive when serial measurements are required. To this end, saliva-derived measures of gonadal hormones provide a means of simple, noninvasive hormone tracking. To investigate the feasibility of this technique as a means of facilitating research designs that take the menstrual cycle into account, the purpose of this review was to examine literature comparing salivary and blood concentrations of the primary gonadal hormones that fluctuate across the menstrual cycle: estradiol and progesterone. The data indicate that there appear to be valid and promising applications of salivary gonadal hormone monitoring, which may aid in the inclusion of female participants in cardiovascular research studies.
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Affiliation(s)
- Tingyu Huang
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Fiona M Howse
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| | - Nina S Stachenfeld
- The John B. Pierce Laboratory, New Haven, Connecticut.,Yale School of Medicine, New Haven, Connecticut
| | - Charlotte W Usselman
- Cardiovascular Health and Autonomic Regulation Laboratory, Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada.,McGill Research Centre for Physical Activity and Health, McGill University, Montreal, Quebec, Canada
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de Mira MC, Lamy E, Santos R, Williams J, Pinto MV, Martins PS, Rodrigues P, Marlin D. Salivary cortisol and eye temperature changes during endurance competitions. BMC Vet Res 2021; 17:329. [PMID: 34649565 PMCID: PMC8515720 DOI: 10.1186/s12917-021-02985-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 07/30/2021] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study was to investigate the usefulness of salivary cortisol (SC) and eye temperature measured by infrared thermography (IRTET) as biomarkers to manage competitions more effectively and monitor horse welfare in endurance competitions. Based on previous studies, it was hypothesised that pre-exercise baseline SC and IRTET would be higher in younger or less experienced horses, and that post-exercise variation from baseline would be higher in the top finishers. Results Salivary cortisol measured in 61 competing at qualifier 40 km and 80 km rides showed an abrupt variation (93–256% rise) of the baseline SC levels [median ± interquartile range (IQR) = 0.27 ng/dl ± 0.36] obtained at the Pre-Inspection (PI) into Vet Gate (VG)1 independently of the covered distance, but modest or even lower in the subsequent Vet Gates, e.g. VG2 or VG3. The IRTET measured concomitantly in 16 horses showed significant (p < 0.05) higher levels at the PI in less experienced horses participating in the 40 km ride (median ± IQR = 35.7 °C ± 1.4) than their counterparts in the 80 km ride (median ± IQR = 35.0 °C ± 1.5), but not SC. Baseline SC levels at the PI of horses classifying in the Top5 in the 40 km ride category were significantly (p < 0.05) higher median ± IQR = 0.90 ng/ml ±0.61) when compared to horses positioned from 10th position on (median ± IQR = 0.16 ng/ml ±0.40). A lower IRTET in the PI was correlated with better placement (p < 0.05) and those in the Top5 (median ± IQR = 33.9 °C ± 0.0) had a significantly (p < 0.5) higher variation (+ 10.65%) into the last VG. Conclusion Pre-exercise baseline IRTET levels, but not SC, were higher in less experienced horses in the 40 compared to their counterparts in the 80 km ride competitions. SC and IRTET showed different indications according to the competition. In the40 km ride competition, higher baseline pre-exercise SC levels seemed to be linked to a better classification outcome. In contrast, in the 80 km ride horses, the higher IRTET variation from pre-exercise into final Vet Gate was the parameter associated with a better performance. A more controlled environment and a larger sample are needed to confirm these results and monitor horse welfare in competitions.
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Affiliation(s)
- Monica C de Mira
- MED - Mediterranean Institute for Agriculture, Environment and Development, Institute for Advanced Studies and Research, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554, Évora, Portugal.
| | - Elsa Lamy
- MED - Mediterranean Institute for Agriculture, Environment and Development, Institute for Advanced Studies and Research, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554, Évora, Portugal
| | - Rute Santos
- MED - Mediterranean Institute for Agriculture, Environment and Development, Institute for Advanced Studies and Research, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554, Évora, Portugal.,VALORIZA - Research Centre for Endogenous Resource Valorization, Edifício BioBIP, Campus Politécnico, 10, 7300-555, Portalegre, Portugal
| | | | - Mafalda Vaz Pinto
- MED - Mediterranean Institute for Agriculture, Environment and Development, Institute for Advanced Studies and Research, Universidade de Évora, Pólo da Mitra, Ap. 94, 7006-554, Évora, Portugal
| | - Pedro S Martins
- Departamento de Medicina Veterinária, Universidade de Évora, Núcleo da Mitra, Apartado, 94 7006-554, Évora, Portugal
| | - Patrícia Rodrigues
- Departamento de Medicina Veterinária Portugal, Escola Universitária Vasco da Gama, Av. José R. Sousa Fernandes, Campus Universitário - Bloco B, Lordemão, 3020-210, Coimbra, Portugal
| | - David Marlin
- David Marlin Consulting, AnimalWeb Ltd, Cambridge, CB4 0WZ, UK
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Tarumi W, Shinohara K. Olfactory Exposure to β-Caryophyllene Increases Testosterone Levels in Women's Saliva. Sex Med 2020; 8:525-531. [PMID: 32561330 PMCID: PMC7471126 DOI: 10.1016/j.esxm.2020.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 05/30/2020] [Accepted: 06/03/2020] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION From previous studies, we hypothesized that olfactory exposure to β-caryophyllene stimulates women's libido. However, Japan's sex culture is so closed that it is difficult to test this possibility without accumulating scientific evidence. Therefore, it is necessary to measure the concentration of sex-related hormones in saliva, an experimental technique that is relatively easy to obtain research permission, and to obtain a scientific basis to convince ethics committee reviewers. AIM The aim of this study is to investigate whether β-caryophyllene increases salivary testosterone concentrations associated with libido and vaginal sensation during intercourse in women. METHODS 19 women in the follicular phase of the menstrual cycle participated in the study. The subjects then sat in front of the odor exposure device we had created. Each subject was exposed to dipropylene glycol for 20 minutes, followed by 3% β-caryophyllene for 20 minutes. Saliva was collected 4 times: before and after control exposure, and before and after β-caryophyllene exposure. MAIN OUTCOME MEASURE Salivary testosterone and estrogen concentrations were measured with a competition ELISA. RESULTS β-caryophyllene significantly increased the salivary concentration of testosterone (control vs β-caryophyllene; 0.97 ± 0.05 vs 1.13 ± 0.03, P = .00, 95% confidence interval of control: 0.84-1.09, 95% confidence interval of β-caryophyllene: 1.04-1.20) but not estrogen (control vs β-caryophyllene; 1.05 ± 0.03 vs 1.07 ± 0.04, P = .69, 95% confidence interval of control: 0.96-1.12, 95% confidence interval of β-caryophyllene: 0.98-1.15). STRENGTHS & LIMITATIONS The personal preferences of the subjects and the order of exposure may have affected the results. CONCLUSION β-caryophyllene may be a remedy with fewer side effects for women with decreased libido. We believe that β-caryophyllene may be a remedy for women with decreased libido. However, this hypothesis must be tested by further clinical studies. Wataru Tarumi, Kazuyuki Shinohara. Olfactory Exposure to β-Caryophyllene Increases Testosterone Levels in Women's Saliva. J Sex Med 2020;8:525-531.
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Affiliation(s)
- Wataru Tarumi
- Division of Neurobiology and Behavior Department of Translational Medical Sciences Course of Medical and Dental Sciences Nagasaki University, Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuyuki Shinohara
- Division of Neurobiology and Behavior Department of Translational Medical Sciences Course of Medical and Dental Sciences Nagasaki University, Graduate School of Biomedical Sciences, Nagasaki, Japan.
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Srinivasan M, Muthukumar S, Saibaba G, Manikkaraja C, Abdulkader Akbarsha M, Archunan G. Salivary luteinizing hormone: An open window to detect oestrous period in buffalo. Reprod Domest Anim 2020; 55:647-651. [PMID: 31991006 DOI: 10.1111/rda.13649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/05/2020] [Accepted: 01/23/2020] [Indexed: 11/29/2022]
Abstract
Silent oestrus is an unsurmountable problem in the management of buffalo reproduction. In addressing this issue, we have earlier reported variation in the levels of urinary luteinizing hormone (LH) through the different phases of oestrous cycle with an extended window during the mid-oestrous phase. Based on this report, the present study is designed to assess the salivary LH levels in buffalo during the different phases of oestrous cycle. Bovine LH ELISA kit was used to determine the level of salivary LH. We observed a notable variation in salivary LH levels during the different phases of oestrous cycle. The maximum LH level, 39.07 mIU/ml, observed during oestrus, which was significantly (p < .05) higher than other consecutive phases. Altogether, the results showed a significant (p < .05) fold variation during oestrus compared with other phases. Therefore, the study convincingly shows that salivary LH has the potential of application in development of a modality for non-invasive oestrous detection in buffalo.
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Affiliation(s)
- Mahalingam Srinivasan
- Pheromone Technology Laboratory, Department of Animal Science, Bharathidasan University, Tiruchirappalli, India
| | | | - Ganesan Saibaba
- Pheromone Technology Laboratory, Department of Animal Science, Bharathidasan University, Tiruchirappalli, India.,Department of Animal Science, Volcani Center, Agricultural Research Organization, Rishon LeTzion, Israel
| | - Chidambaram Manikkaraja
- Pheromone Technology Laboratory, Department of Animal Science, Bharathidasan University, Tiruchirappalli, India
| | | | - Govindaraju Archunan
- Pheromone Technology Laboratory, Department of Animal Science, Bharathidasan University, Tiruchirappalli, India
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Carlson LJ, Shaw ND. Development of Ovulatory Menstrual Cycles in Adolescent Girls. J Pediatr Adolesc Gynecol 2019; 32:249-253. [PMID: 30772499 PMCID: PMC6570576 DOI: 10.1016/j.jpag.2019.02.119] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 01/29/2019] [Accepted: 02/04/2019] [Indexed: 10/27/2022]
Abstract
Irregular menstrual cycles due to anovulation are well described in the first few years after menarche, but the normal developmental trajectory from anovulatory to mature ovulatory cycles during adolescence remains undefined. In this article we review the very limited understanding of this final stage of female reproductive axis development and discuss why additional research in this area is critical to the health of women.
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Affiliation(s)
- Lauren J Carlson
- Pediatric Neuroendocrinology Group, Clinical Research Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina
| | - Natalie D Shaw
- Pediatric Neuroendocrinology Group, Clinical Research Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina.
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8
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Hammond TT, Au ZA, Hartman AC, Richards-Zawacki CL. Assay validation and interspecific comparison of salivary glucocorticoids in three amphibian species. CONSERVATION PHYSIOLOGY 2018; 6:coy055. [PMID: 30279992 PMCID: PMC6158758 DOI: 10.1093/conphys/coy055] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 08/30/2018] [Accepted: 09/04/2018] [Indexed: 05/23/2023]
Abstract
Amphibians are one of the most threatened groups of species, facing stressors ranging from habitat degradation and pollution to disease and overexploitation. Stress hormones (glucocorticoids, GCs) provide one quantitative metric of stress, and developing non-invasive methods for measuring GCs in amphibians would clarify how diverse environmental stressors impact individual health in this taxonomic group. Saliva is an advantageous matrix for quantifying GCs, as it is sampled less invasively than plasma while still detecting both baseline and acute elevation of GCs within a short timeframe. Little work has employed this method in amphibian species, and it has never been pharmacologically and biologically validated. Here, we conduct analytical, pharmacological and biological validation experiments for measuring salivary corticosterone in three amphibian species: the American bullfrog (Rana catesbeiana), the green frog (Rana clamitans) and the northern leopard frog (Rana pipiens). These species are faced with a broad range of environmental challenges, and in part of its range R. pipiens populations are currently in decline. In addition to demonstrating that this method can be reliably used in multiple amphibian species, we present an examination of intrinsic biological factors (sex, body condition) that may contribute to GC secretion, and a demonstration that saliva can be collected from free-living animals in the field to quantify corticosterone. Our findings suggest that saliva may be useful for less invasively quantifying GCs in many amphibian species.
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Affiliation(s)
- Talisin T Hammond
- Department of Biological Sciences, University of Pittsburgh, 105 Clapp Hall, 5th Ave. at Ruskin Ave., Pittsburgh, PA, USA
| | - Zoe A Au
- Department of Biological Sciences, University of Pittsburgh, 105 Clapp Hall, 5th Ave. at Ruskin Ave., Pittsburgh, PA, USA
| | - Allison C Hartman
- Department of Biological Sciences, University of Pittsburgh, 105 Clapp Hall, 5th Ave. at Ruskin Ave., Pittsburgh, PA, USA
| | - Corinne L Richards-Zawacki
- Department of Biological Sciences, University of Pittsburgh, 105 Clapp Hall, 5th Ave. at Ruskin Ave., Pittsburgh, PA, USA
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Miočević O, Cole CR, Laughlin MJ, Buck RL, Slowey PD, Shirtcliff EA. Quantitative Lateral Flow Assays for Salivary Biomarker Assessment: A Review. Front Public Health 2017; 5:133. [PMID: 28660183 PMCID: PMC5469882 DOI: 10.3389/fpubh.2017.00133] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 05/22/2017] [Indexed: 12/17/2022] Open
Abstract
Saliva is an emerging biofluid with a significant number of applications in use across research and clinical settings. The present paper explores the reasons why saliva has grown in popularity in recent years, balancing both the potential strengths and weaknesses of this biofluid. Focusing on reasons why saliva is different from other common biological fluids such as blood, urine, or tears, we review how saliva is easily obtained, with minimal risk to the donor, and reduced costs for collection, transportation, and analysis. We then move on to a brief review of the history and progress in rapid salivary testing, again reviewing the strengths and weaknesses of rapid immunoassays (e.g., lateral flow immunoassay) compared to more traditional immunoassays. We consider the potential for saliva as an alternative biofluid in a setting where rapid results are important. We focus the review on salivary tests for small molecule biomarkers using cortisol as an example. Such salivary tests can be applied readily in a variety of settings and for specific measurement purposes, providing researchers and clinicians with opportunities to assess biomarkers in real time with lower transportation, collection, and analysis costs, faster turnaround time, and minimal training requirements. We conclude with a note of cautious optimism that the field will soon gain the ability to collect and analyze salivary specimens at any location and return viable results within minutes.
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Affiliation(s)
| | - Craig R. Cole
- Oasis Diagnostics Corporation, Vancouver, WA, United States
| | | | - Robert L. Buck
- Oasis Diagnostics Corporation, Vancouver, WA, United States
| | - Paul D. Slowey
- Oasis Diagnostics Corporation, Vancouver, WA, United States
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Abstract
Saliva is gaining increasing attention as a bioanalytical sample matrix. Mostly because of the easy and noninvasive collection, it is not only beneficial in endocrinological and behavioral science, but also in pediatrics. Saliva also has the advantage of being the only body fluid which can be collected even during physical exercise, for example, during sportive activities, and there are physiological characteristics that make it superior to serum/plasma or urine for specific scientific questions. This review provides an insight into the physiology of saliva formation, explaining how certain compounds enter this bodily fluid, and gives advice for collection, storage and analytical methods. Finally, it presents a number of reliable and proven applications for saliva analysis from scientific fields including endocrinology, sports medicine, forensics and immunology.
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Mass spectrometric quantification of salivary metanephrines-A study in healthy subjects. Clin Biochem 2016; 49:983-8. [PMID: 26874200 DOI: 10.1016/j.clinbiochem.2016.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 01/31/2016] [Accepted: 02/07/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Determination of metanephrine (MN), normetanephrine (NMN), and 3-methoxytyramine (3-MT) in saliva may offer potential diagnostic advantages in diagnosing pheochromocytoma. METHODS In this preliminary study, we determined metanephrine concentrations in saliva of healthy subjects and the relationship with simultaneously measured plasma metanephrines. We also studied the possible influence of pre-analytical conditions such as a collection device, awakening, posture, and eating on the salivary metanephrine levels. RESULTS Eleven healthy subjects were included. Fasting blood and saliva samples were collected in seated position and after 30min of horizontal rest. Plasma and salivary MN, NMN, and 3-MT concentrations were determined using a high-performance liquid chromatography tandem mass spectrometric technique (LC-MS/MS) with automated solid phase extraction sample preparation. Metanephrines were detectable in saliva from all participants both in seated and supine position. No significant correlations were observed between the MN, NMN, and 3-MT concentrations in saliva and plasma in seated or supine position. Furthermore, there was no difference between MN, NMN, and 3-MT samples collected with or without a collection device. CONCLUSION Metanephrines can be detected in saliva with LC-MS/MS with sufficient sensitivity and precision. Our findings warrant evaluation of salivary metanephrine measurement as a novel laboratory tool in the work-up of patients suspected of having a pheochromocytoma.
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One left dorsolateral prefrontal cortical HF-rTMS session attenuates HPA-system sensitivity to critical feedback in healthy females. Neuropsychologia 2014; 57:112-21. [DOI: 10.1016/j.neuropsychologia.2014.02.019] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Revised: 02/12/2014] [Accepted: 02/21/2014] [Indexed: 01/22/2023]
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Monitoring prednisolone and prednisone in saliva: a population pharmacokinetic approach in healthy volunteers. Ther Drug Monit 2014; 35:485-92. [PMID: 23783167 DOI: 10.1097/ftd.0b013e3182899ea2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Prednisolone (PLN) is a widely used corticosteroid in a variety of immune-mediated diseases. Treatment regimes generally consist of empirically derived treatment doses, whereas therapeutic response among patients is highly variable. Drug monitoring of serum PLN levels might support a more rational approach to dose selection, yet is invasive and laborious. In analogy to cortisol, salivary PLN may offer a good alternative for serum PLN, being a representative approximation of free serum PLN. The aims of this study were to evaluate the correlation between free serum and salivary PLN levels and to quantify this relationship within a population pharmacokinetic model. METHODS PLN and prednisone (PN) concentrations were measured in 396 samples from 19 healthy volunteers after oral ingestion of 80 mg PLN. Measurements in serum, ultrafiltrate, and saliva were performed with a recently validated liquid chromatography tandem mass spectrometry method. Population pharmacokinetic analysis was performed with nonlinear mixed effect modeling using NONMEM. RESULTS Salivary PLN levels correlated well with free serum PLN levels (r = 0.931, P < 0.01). A weaker correlation was found for PN (r = 0.318, P < 0.01), which may be explained by the finding that salivary PN levels mainly seemed to consist of PLN enzymatically converted to PN. Total and free serum PLN concentrations decreased over time after drug administration and showed a nonlinear mutual relationship, consistent with concentration-dependent protein binding. Modeled PLN pharmacokinetics corresponded with previous reports. Low to moderate interindividual variability was found for V/F and CL/F (coefficients of variation were 13.8% and 14.6%, respectively). Free and salivary PLN showed a nonlinear relationship with total PLN. An equation predicting free serum levels from salivary levels was successfully derived from the data. CONCLUSIONS This study is the first to describe the relationship between salivary and (free) serum PLN using a population pharmacokinetic model. Salivary PLN was found to be a reliable predictor of free and total serum PLN in healthy volunteers. The results of this study encourage further exploration of the use of saliva as a noninvasive and feasible method for drug monitoring of PLN.
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Lee D, Huestis MA. Current knowledge on cannabinoids in oral fluid. Drug Test Anal 2014; 6:88-111. [PMID: 23983217 PMCID: PMC4532432 DOI: 10.1002/dta.1514] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 06/21/2013] [Accepted: 06/24/2013] [Indexed: 11/09/2022]
Abstract
Oral fluid (OF) is a new biological matrix for clinical and forensic drug testing, offering non-invasive and directly observable sample collection reducing adulteration potential, ease of multiple sample collections, lower biohazard risk during collection, recent exposure identification, and stronger correlation with blood than urine concentrations. Because cannabinoids are usually the most prevalent analytes in illicit drug testing, application of OF drug testing requires sufficient scientific data to support sensitive and specific OF cannabinoid detection. This review presents current knowledge of OF cannabinoids, evaluating pharmacokinetic properties, detection windows, and correlation with other biological matrices and impairment from field applications and controlled drug administration studies. In addition, onsite screening technologies, confirmatory analytical methods, drug stability, and effects of sample collection procedure, adulterants, and passive environmental exposure are reviewed. Delta-9-tetrahydrocannabinol OF concentrations could be >1000 µg/L shortly after smoking, whereas minor cannabinoids are detected at 10-fold and metabolites at 1000-fold lower concentrations. OF research over the past decade demonstrated that appropriate interpretation of test results requires a comprehensive understanding of distinct elimination profiles and detection windows for different cannabinoids, which are influenced by administration route, dose, and drug use history. Thus, each drug testing program should establish cut-off criteria, collection/analysis procedures, and storage conditions tailored to its purposes. Building a scientific basis for OF testing is ongoing, with continuing OF cannabinoids research on passive environmental exposure, drug use history, donor physiological conditions, and oral cavity metabolism needed to better understand mechanisms of cannabinoid OF disposition and expand OF drug testing applicability. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.
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Affiliation(s)
- Dayong Lee
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, 21224, USA
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Vavilova T, Ostrovskaya I, Medvedev A. Lecture: prospects of hormone analyses in saliva. ACTA ACUST UNITED AC 2014; 60:295-307. [DOI: 10.18097/pbmc20146003295] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- T.P. Vavilova
- Evdokimov Moscow State Medical and Dental University
| | | | - A.E. Medvedev
- Orekhovich Institute of Biomedical Chemistry, Russian Academy of Medical Science
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Jasim H, Louca S, Christidis N, Ernberg M. Salivary cortisol and psychological factors in women with chronic and acute oro-facial pain. J Oral Rehabil 2013; 41:122-32. [PMID: 24313837 DOI: 10.1111/joor.12118] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2013] [Indexed: 11/30/2022]
Abstract
The aim of this study was to compare the salivary cortisol level, pain intensity and psychological factors between patients with chronic and acute oro-facial pain (OP) and pain-free subjects. Twenty-seven females with chronic OP (a diagnosis of myofascial pain according to the Research Diagnostic Criteria for Temporomandibular Disorders with at least 6 months duration), 24 females with acute OP (<10 days duration) and 27 pain-free females participated. Morning saliva was collected from all participants for analyses of the cortisol level. The pain intensity was assessed on a 0-10 numeric rating scale. The participants were evaluated by the Symptom Checklist 90-revised for levels of depression and somatisation, and the Perceived Stress Scale. The cortisol levels among the three patient groups were similar with no significant group differences. The median (interquartile range) current pain level did not differ between chronic and acute OP and was, respectively, 5 (4) and 5 (3). Patients with chronic OP showed significantly higher scores for depression, somatisation and perceived stress compared with patients with acute OP (Ps < 0.001), but there were no significant differences between acute OP and controls. To conclude, there were no differences in cortisol level between groups, despite significant higher levels of depression, somatisation and perceived stress in patients with chronic OP. This shows that psychological distress has a more important role in chronic than in acute OP. However, the relation between pain, adreno-cortical activity and psychological distress is complex and warrants further investigation.
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Affiliation(s)
- H Jasim
- Section of Orofacial Pain and Jaw Function, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Olsen C, Karriker L, Wang C, Binjawadagi B, Renukaradhya G, Kittawornrat A, Lizano S, Coetzee J, Main R, Meiszberg A, Panyasing Y, Zimmerman J. Effect of collection material and sample processing on pig oral fluid testing results. Vet J 2013; 198:158-63. [PMID: 24011474 DOI: 10.1016/j.tvjl.2013.06.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Revised: 06/20/2013] [Accepted: 06/21/2013] [Indexed: 01/07/2023]
Abstract
The effect of sampling material, sample processing, and collection order on the detection of analytes in pig oral fluid specimens was evaluated. Oral fluid samples were collected from 104 pens of commercial wean-to-finish pigs using ropes made of three different materials. Processed (centrifuged and filtered) and unprocessed oral fluid samples were tested using commercial ELISAs for porcine reproductive and respiratory syndrome virus (PRRSV) antibodies and total IgM, IgA, and IgG. Unprocessed samples were tested for PRRSV nucleic acid and processed samples were assayed for PRRSV neutralizing antibodies. Analysis of the data using repeated measures ANOVA and Tukey-Kramer adjusted t tests found statistically significant, non-uniform, and assay-dependent effects of all three factors. Therefore, when testing oral fluid specimens, swine health specialists, veterinarians, and diagnosticians should be aware of the potential impact of these factors on specific analytes. For monitoring health and welfare parameters, oral fluid samples should be collected using cotton-based materials and undergo minimal post-collection processing.
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Affiliation(s)
- Chris Olsen
- Department of Veterinary Diagnostic and Production Animal Medicine, Iowa State University, Ames, IA, USA
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18
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Priya B, Mustafa MD, Guleria K, Vaid NB, Banerjee BD, Ahmed RS. Salivary progesterone as a biochemical marker to predict early preterm birth in asymptomatic high-risk women. BJOG 2013; 120:1003-11. [PMID: 23551599 DOI: 10.1111/1471-0528.12217] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate salivary progesterone as a predictor of early preterm birth (PTB) and compare it with transvaginal sonographic (TVS) cervical length in asymptomatic high-risk women. DESIGN Prospective study. SETTING Departments of Obstetrics and Gynaecology and Biochemistry at UCMS & GTBH, Delhi, India. SAMPLE Ninety pregnant women. METHODS The progesterone concentration in saliva of asymptomatic pregnant women at high risk for preterm delivery was estimated by immunoassay, and cervical length was measured by TVS, at the first antenatal visit at 24-28 weeks of gestation, and then repeated 3-4 weeks later. MAIN OUTCOME MEASURES Early PTB, mean and critical cut-off values of salivary progesterone, and a diagnostic value comparison of salivary progesterone with TVS cervical length. RESULTS The mean value of salivary progesterone was significantly lower in all women who delivered at <37 weeks of gestation (n = 38), compared with the term group (n = 52; P < 0.001). Salivary progesterone decreased significantly from the first to the second visit, with the maximum decrease observed in women who delivered at <34 weeks of gestation (29.6%, 95% CI 17.8-41.4%, P < 0.002). The single predictive critical cut-off value for salivary progesterone was 2575 pg/ml, below which more than 80% of women delivered prematurely before 34 weeks of gestation, with sensitivity, specificity, and positive and negative predictive values of 83% (95% CI 58.6-96.4%), 86% (95% CI 75.9-93.1%), 60% (95% CI 38.6-78.8%) and 95% (95% CI 87.1-99.0%), respectively. The TVS cervical length decreased significantly (P < 0.001) in the women who delivered prematurely. CONCLUSIONS Low salivary progesterone concentration can be used for predicting early PTB in asymptomatic high-risk women.
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Affiliation(s)
- B Priya
- Department of Obstetrics and Gynaecology, University College of Medical Sciences & Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
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Abstract
UNLABELLED Saliva is the most easily available and accessible body fluid, which makes it one of the most sought after tools in diagnostic pathology. Markers expressed in saliva can be used for diagnosis and concurrent patient follow-up of diseases ranging from hereditary disorders to infections, as well as malignancies and also analysis of therapeutic levels of drugs. The emergence of hand-held devices has made possible the elucidation of point-of-care methods and research in the field has resulted in the assimilation of knowledge useful for clinical applications. CLINICAL RELEVANCE This article describes some of the latest research in saliva diagnostics and provides some information on the various hand-held devices available.
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Affiliation(s)
- Akhil Anilkumar Shankar
- Department of Oral Pathology and Microbiology, YMT Dental College, Kharghar, Navi Mumbai--410210, India
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20
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Abstract
Saliva is a complex fluid, which influences oral health through specific and nonspecific physical and chemical properties. The importance of saliva in our everyday activities and the medicinal properties it possesses are often taken for granted. However, when disruptions in the quality or quantity of saliva do occur in an individual, it is likely that he or she will experience detrimental effects on oral and systemic health. Often head and neck radiotherapy has serious and detrimental side effects on the oral cavity including the loss of salivary gland function and a persistent complaint of a dry mouth (xerostomia). Thus, saliva has a myriad of beneficial functions that are essential to our well-being. Although saliva has been extensively investigated as a medium, few laboratories have studied saliva in the context of its role in maintaining oral and general health.
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Affiliation(s)
- Manjul Tiwari
- Department of Oral Pathology and Microbiology, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
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Lee D, Milman G, Schwope DM, Barnes AJ, Gorelick DA, Huestis MA. Cannabinoid stability in authentic oral fluid after controlled cannabis smoking. Clin Chem 2012; 58:1101-9. [PMID: 22532594 PMCID: PMC3717354 DOI: 10.1373/clinchem.2012.184929] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Defining cannabinoid stability in authentic oral fluid (OF) is critically important for result interpretation. There are few published OF stability data, and of those available, all employed fortified synthetic OF solutions or elution buffers; none included authentic OF following controlled cannabis smoking. METHODS An expectorated OF pool and a pool of OF collected with Quantisal™ devices were prepared for each of 10 participants. Δ⁹-tetrahydrocannabinol (THC), 11-nor-9-carboxy-THC (THCCOOH), cannabidiol (CBD), and cannabinol (CBN) stability in each of 10 authentic expectorated and Quantisal-collected OF pools were determined after storage at 4 °C for 1 and 4 weeks and at -20 °C for 4 and 24 weeks. Results within ±20% of baseline concentrations analyzed within 24 h of collection were considered stable. RESULTS All Quantisal OF cannabinoid concentrations were stable for 1 week at 4 °C. After 4 weeks at 4 °C, as well as 4 and 24 weeks at -20 °C, THC was stable in 90%, 80%, and 80% and THCCOOH in 89%, 40%, and 50% of Quantisal samples, respectively. Cannabinoids in expectorated OF were less stable than in Quantisal samples when refrigerated or frozen. After 4 weeks at 4 and -20 °C, CBD and CBN were stable in 33%-100% of Quantisal and expectorated samples; by 24 weeks at -20 °C, CBD and CBN were stable in ≤ 44%. CONCLUSIONS Cannabinoid OF stability varied by analyte, collection method, and storage duration and temperature, and across participants. OF collection with a device containing an elution/stabilization buffer, sample storage at 4 °C, and analysis within 4 weeks is preferred to maximize result accuracy.
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Affiliation(s)
- Dayong Lee
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore
| | - Garry Milman
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore
| | - David M. Schwope
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore
| | - Allan J. Barnes
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore
| | - David A. Gorelick
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore
| | - Marilyn A. Huestis
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, NIH, Baltimore
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Bellem A, Meiyappan S, Romans S, Einstein G. Measuring Estrogens and Progestagens in Humans: An Overview of Methods. ACTA ACUST UNITED AC 2011; 8:283-99. [DOI: 10.1016/j.genm.2011.07.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Revised: 07/25/2011] [Accepted: 07/27/2011] [Indexed: 11/24/2022]
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Schapher M, Wendler O, Gröschl M. Salivary cytokines in cell proliferation and cancer. Clin Chim Acta 2011; 412:1740-8. [PMID: 21736875 DOI: 10.1016/j.cca.2011.06.026] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 06/19/2011] [Accepted: 06/21/2011] [Indexed: 01/08/2023]
Abstract
While the presence of multiple systemic steroids, amines and peptides in saliva has been reported, other hormones of the circulation do not appear in saliva. Substances present within saliva may be classified in different groups: first, those which passively display blood plasma concentrations and constitute a promising alternative to evaluate certain systemic parameters. Second, molecules which seem to play a more active, regulatory role within the upper gastrointestinal tract. Concerning the latter, a growing awareness, especially with regards to salivary peptides has been established. Up to now, understanding the distinct effects of salivary peptides known so far is in its infancy. Various publications, however, emphasize important effects of their presence. Salivary peptides can influence inflammatory processes and cell proliferation in epithelia of the upper digestive tract. These include transforming growth factors (TGFs), epidermal growth factors (EGFs), vascular endothelial growth factors (VEGFs) as well as amines such as melatonin. Of those, candidate cytokines like interleukin 8, tumor necrosis factors (TNFs) and leptin are involved in neoplastic activities of salivary glands and the oral cavity. The exact mechanisms of action are not yet completely understood, but their presence can be utilized for diagnostic purposes. Salivary gland tumors in patients may, in certain circumstances, be identified by saliva diagnostics. Saliva samples of the concerned patients, for instance, reveal significantly higher leptin concentrations than those of healthy individuals. Numerous studies postulate that, beside single indicators, the establishment of salivary hormone profiles may assist clinicians and researchers in detecting tumors and other pathologies of the oral cavity, including adjacent tissues, with high sensitivity and specificity.
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Affiliation(s)
- Mirco Schapher
- University of Erlangen-Nuremberg, Department of Otorhinolaryngology, Head and Neck Surgery, Germany.
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24
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Chou IC, Lien HC, Lin HC, Fu JJC, Kao CH, Tsai CH, Lin PH, Tsai FJ. The relationship of salivary and cord blood cortisol in preterm infants. J Pediatr Endocrinol Metab 2011; 24:85-8. [PMID: 21528822 DOI: 10.1515/jpem.2011.119] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Recent studies reveal that salivary cortisol measurements accurately reflect blood cortisol levels in older children and adults; yet, the relationship between the two values in premature infants has not been established. This study explores the use of salivary cortisol as an accurate measure of adrenal steroid concentrations in premature infants to provide a reliable and less invasive tool for investigating hormonal stress response. Premature infants (n=51) were recruited, with saliva and blood collected immediately after birth, and cortisol levels measured by radioimmunoassay. A linear relationship emerged between cord plasma and salivary cortisol values in the 102 paired samples [(salivary cortisol) = 0.546 +/- 0.192 x (plasma cortisol), r = 0.481 and p = 0.0003]. Findings demonstrated that salivary and plasma cortisol levels were correlated in premature infants. This information will be useful in future studies that assess use of salivary cortisol to evaluate neonatal stress axis function.
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Affiliation(s)
- I-Ching Chou
- Children Medical Center, China Medical University Hospital, Taichung, Taiwan
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25
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Ruiz ME, Conforti P, Fagiolino P, Volonté MG. The use of saliva as a biological fluid in relative bioavailability studies: comparison and correlation with plasma results. Biopharm Drug Dispos 2010; 31:476-85. [DOI: 10.1002/bdd.728] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 08/06/2010] [Accepted: 08/27/2010] [Indexed: 11/08/2022]
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26
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Wenger-Riggenbach B, Boretti FS, Quante S, Schellenberg S, Reusch CE, Sieber-Ruckstuhl NS. Salivary cortisol concentrations in healthy dogs and dogs with hypercortisolism. J Vet Intern Med 2010; 24:551-6. [PMID: 20384959 DOI: 10.1111/j.1939-1676.2010.0494.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Measurement of salivary cortisol is a useful diagnostic test for hypercortisolism (HC) in humans. OBJECTIVES To determine whether measurement of salivary cortisol concentration is a practical alternative to plasma cortisol to diagnose HC, to validate the use of salivary cortisol, and to examine the effect of time of day and sampling location on salivary cortisol. ANIMALS Thirty healthy dogs and 6 dogs with HC. METHODS Prospective, observational clinical trial including healthy volunteer dogs and dogs newly diagnosed with HC. Salivary and plasma cortisol concentrations were measured with an immunoassay analyzer. Intra- and interassay variability, linearity, and correlation between salivary and plasma cortisol concentrations were determined. RESULTS The required 300 microL of saliva could not be obtained in 88/326 samples from healthy dogs and in 15/30 samples from dogs with HC. The intra-assay variability for measurement of salivary cortisol was 5-17.7%, the interassay variability 8.5 and 17.3%, and the observed to expected ratio 89-125%. The correlation (r) between salivary and plasma cortisol was 0.98. The time of day and location of collection did not affect salivary cortisol concentrations. Dogs with HC had significantly higher salivary cortisol values than healthy dogs (10.2 +/- 7.3 nmol/L versus 1.54 +/- 0.97 nmol/L; P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE The ROCHE Elecsys immunoassay analyzer correctly measured salivary cortisol in dogs. However, a broad clinical application of the method seems limited, because of the large sample volume required.
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Affiliation(s)
- B Wenger-Riggenbach
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse, Zurich, Switzerland
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27
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Baeken C, De Raedt R, Leyman L, Schiettecatte J, Poppe K, Kaufman L, Haes M, Vanderhasselt MA, Anckaert E, D'Haenen H. The impact of one session of HF-rTMS on salivary cortisol in healthy female subjects. World J Biol Psychiatry 2010; 10:586-90. [PMID: 17886168 DOI: 10.1080/15622970701560351] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Previous studies in healthy volunteers reported a possible impact of high frequency repetitive transcranial magnetic stimulation (HF-rTMS) on stress hormones, like cortisol. In this sham-controlled, "single blind", crossover study, we examined whether HF-rTMS had an effect on the hypothalamic-pituitary-adrenal (HPA) axis, by analysing salivary cortisol levels. Two studies were conducted. First, HF-rTMS on the left dorsolateral prefrontal cortex (DLPFC) was performed in 28 young healthy female volunteers. Second, in a comparable, but different group of 26 healthy females, HF-rTMS was performed on the right DLPFC. Salivary cortisol levels were assessed before, immediately after and 30 min after real and sham HF-rTMS. We found no support for the hypothesis that one single session of HF-rTMS on the left or the right DLPFC has an immediate or delayed impact on the HPA-axis, as measured by salivary cortisol. Although we controlled for several methodological problems in HF-rTMS research, the hypothesis that one single session of HF-rTMS on the left or on the right DLPFC can influence the HPA-axis in healthy volunteers was not supported.
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Affiliation(s)
- Chris Baeken
- Department of Psychiatry, Academic Hospital, Free University of Brussels, UZBrussel, Belgium.
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Evidence for a role of progesterone in menstrual cycle-related variability in prepulse inhibition in healthy young women. Neuropsychopharmacology 2010; 35:929-37. [PMID: 19956084 PMCID: PMC3055354 DOI: 10.1038/npp.2009.195] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Prepulse inhibition (PPI) of the startle response is sensitive to sex, with healthy young women showing less PPI compared with age-matched men, and varies according to the menstrual cycle phase in women. Relatively less is known regarding sex and hormonal influences in prepulse facilitation (PPF). Menstrual phase-related variability in PPI is suggested to be mediated by fluctuating estrogen level, based on the observations of more PPI in women during the follicular, relative to the luteal, phase. No study has directly assessed the relationship between fluctuating hormones and PPI or PPF levels over the human ovarian cycle. To examine the roles of circulating ovarian hormones in PPI and PPF, 16 non-smoking regularly menstruating healthy women were tested during both the follicular and luteal phases on PPI and PPF and provided saliva samples for measurement of 17beta-estradiol (estrogen), progesterone and testosterone. The results showed higher levels of 17beta-estradiol and progesterone during the luteal, relative to the follicular, phase; and more PPI during the follicular phase and more PPF during the luteal phase with comparable startle amplitude and habituation during the two phases. A larger increase in progesterone was associated with a smaller decrease in PPI from the follicular to the luteal phase. No significant associations were found between changes in PPI/PPF and estrogen levels. The findings confirm lower PPI during the luteal, compared with the follicular, phase and suggest a role for progesterone, more specifically an antipsychotic-like PPI-restoration action of progesterone, during the luteal phase in PPI of young women.
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Pelto GH, Zhang Y, Habicht JP. Premastication: the second arm of infant and young child feeding for health and survival? MATERNAL & CHILD NUTRITION 2010; 6:4-18. [PMID: 20073131 PMCID: PMC6860819 DOI: 10.1111/j.1740-8709.2009.00200.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Premastication of foods for infants was a crucial behavioural adaptation to neoteny that ensured nutritional adequacy during the period of complementary feeding throughout the course of human evolution until recent times.While the paps and gruels of agricultural systems provided an alternative and modern food technology appears to make it unnecessary, we argue that, in addition to its role in nutrition, premastication also played a crucial role in supporting infant health. Its abandonment, particularly in poor communities, has placed children at increased risk of inadequate nutrition and decreased ability to confront infections associated with the introduction of complementary foods.We present two empirical studies. Section I is a cross-cultural study of the ethnographic literature in order to estimate prevalence in non-Western societies.One-third of ethnographies in the worldwide sample with data on infant feeding report premastication. Section II presents the results of a qualitative study in China, conducted in order to provide data on the likelihood that this percent is incorrect due to under-reporting.The finding that 63% of Chinese university students received premasticated food as infants, whereas none of eight ethnographic studies performed in Han China identified premastication in their reports, provides support for the conclusion that the cross-cultural study grossly underestimates its prevalence in non-Western societies. Section III is a discussion of potential benefits and risks of infant exposure to maternal saliva.We conclude with the argument for a concerted research effort to determine whether premastication can solve not only the 'weanling dilemma' in poor countries but also some of the health problems among the better-off.
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Affiliation(s)
- Gretel H Pelto
- Division of Nutritional Sciences, Cornell University, Ithaca, NY 14853, USA.
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30
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Manolopoulou J, Mulatero P, Maser-Gluth C, Rossignol P, Spyroglou A, Vakrilova Y, Petersenn S, Zwermann O, Plouin PF, Reincke M, Bidlingmaier M. Saliva as a medium for aldosterone measurement in repeated sampling studies. Steroids 2009; 74:853-8. [PMID: 19481102 DOI: 10.1016/j.steroids.2009.05.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2009] [Revised: 05/05/2009] [Accepted: 05/20/2009] [Indexed: 12/30/2022]
Abstract
BACKGROUND Saliva is a readily available biological fluid, making it convenient in diagnosis of diseases and in multi-sampling protocols. Several salivary steroids give a useful index of free plasma levels. Increased incidence of primary aldosteronism (PA) in approximately 10% of the hypertensive population has increased interest in the mineralocorticoid aldosterone. METHODS A biotinylated-aldosterone tracer and a commercially available antibody are used in a time-resolved fluorescence immunoassay (TR-FIA) to measure salivary aldosterone (SA). Saliva was collected in various multi-sampling protocols: Investigation of diurnal rhythm in healthy and PA patients, ACTH stimulation test and posture test in healthy subjects. RESULTS Method validation showed a sensitivity of 19 ng/L and intra-/inter-assay precision between 7.2-10.1% and 8.7-15.7%, respectively. SA correlated significantly (y = 0.2995x +/- 0.01, r(2)=0.60) to plasma aldosterone measured by a commercial radioimmunoassay. SA (median; 95%CI) was at 111 (95-127)ng/L in PA (n=84) and 50 (44-56)ng/L in healthy subjects (n=60). After change in posture, aldosterone increased in both, saliva (57 (47-63)ng/L to 95 (84-117)ng/L) and plasma (26 (26-41)ng/L to 135 (110-181)ng/L). Peak levels were reached after 1h, and were higher in females than in males. CONCLUSIONS SA correlates well to plasma aldosterone and mirrors responses during conditions of stress. SA is significantly higher in PA, and the diurnal rhythm seen in the healthy is blunted in PA. We additionally found gender-dependent differential responses to posture, with higher increases in females. Measurement of aldosterone in saliva presents a useful and convenient method for application in multi-sampling studies.
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Affiliation(s)
- J Manolopoulou
- Medizinische Klinik Innenstadt der Ludwig-Maximilians-Universität, 80336 Munich, Germany.
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Meurman JH, Tarkkila L, Tiitinen A. The menopause and oral health. Maturitas 2009; 63:56-62. [PMID: 19324502 DOI: 10.1016/j.maturitas.2009.02.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2008] [Revised: 02/15/2009] [Accepted: 02/19/2009] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To review the literature about oral symptoms and signs at the menopause with an emphasis on hormone replacement therapy (HRT). To give practical guidelines for women and their physicians in menopause-related oral health problems. METHODS The PubMed and Cochrane databases was searched until mid January 2009 with key words such as "menopause", "menopausal complaints", "postmenopausal complaints" and "oral diseases", "oral discomfort", "dental health", "dental diseases", "saliva", "burning mouth syndrome", "dry mouth", "xerostomia". Because of a scarcity of controlled studies no systematic review could be conducted. RESULTS Oral discomfort is found in many menopausal women in addition to more general climacteric complaints. The principal peri- and postmenopausal symptoms are dry mouth and burning mouth (glossodynia) which, in turn, may increase the occurrence of oral mucosal and dental diseases, such as candidiasis. The mechanisms of hormone-related oral symptoms and signs are not known although oestrogen receptors, for example, have been detected in the oral mucosa and salivary glands. In principle, the histology of oral and vaginal mucosa is very similar and thus their symptoms might share a common cause. Yet, hormone replacement therapy use does not necessarily prevent or help women with oral symptoms. CONCLUSION Properly controlled long-term randomized studies are needed to assess the effect of HRT on oral discomfort. Future gene profiling could identify women who may or may not benefit from HRT with regard to oral symptoms.
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Baeken C, De Raedt R, Leyman L, Schiettecatte J, Kaufman L, Poppe K, Vanderhasselt MA, Anckaert E, Bossuyt A. The impact of one HF-rTMS session on mood and salivary cortisol in treatment resistant unipolar melancholic depressed patients. J Affect Disord 2009; 113:100-8. [PMID: 18571733 DOI: 10.1016/j.jad.2008.05.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2007] [Revised: 05/15/2008] [Accepted: 05/15/2008] [Indexed: 11/29/2022]
Abstract
BACKGROUND Recent studies indicate that medication resistant depressed patients can be successfully treated by a series of sessions of High Frequency repetitive Transcranial Magnetic Stimulation (HF-rTMS), delivered on the left dorsolateral prefrontal cortex (DLPFC). However, changes in subjectively experienced mood give only limited insight into the underlying physiological responses. Previous studies in depressed patients, as well as in healthy volunteers, have reported a possible impact of HF-rTMS on the hypothalamic-pituitary-adrenal (HPA) axis. OBJECTIVE We wanted to evaluate the emotional and neurobiological impact of one session of HF-rTMS applied on the left DLPFC in a sample of unipolar treatment resistant depressed patients of the melancholic subtype. METHODS 20 right-handed antidepressant-free depressed patients were studied using a sham-controlled, 'single' blind, crossover design. We examined subjective mood changes with Visual Analogue Scales (VAS). To examine HF-rTMS effects on the HPA-axis, we analyzed salivary cortisol levels. Mood assessment and salivary cortisol levels were assessed before and immediately after stimulation. To detect any delayed effects, all measurements were also re-assessed 30 min post HF-rTMS. The left DLPFC was determined under MRI guidance. RESULTS One session of HF-rTMS did not result in any subjectively experienced mood changes. However, salivary cortisol concentrations decreased significantly immediately and 30 min after active HF-rTMS. CONCLUSIONS Although one session of HF-rTMS on the left DLPFC did not influence mood subjectively in melancholic unipolar depressed patients, we found support for the hypothesis that a single session has a significant impact on the HPA-axis, as measured by salivary cortisol. Our results may provide more insight into the underlying working mechanisms of HF-rTMS in unipolar melancholic depression, and could add further information about endocrinological functioning in affective disorders.
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Affiliation(s)
- C Baeken
- Department of Psychiatry, University Hospital, Free University of Brussels, UZBrussel, Belgium.
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Mechanism and implication of cephalosporin penetration into oropharyngeal mucosa. J Infect Chemother 2009; 15:70-4. [DOI: 10.1007/s10156-008-0666-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2008] [Accepted: 12/26/2008] [Indexed: 10/20/2022]
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Salivary cortisol in unaffected twins discordant for affective disorder. Psychiatry Res 2008; 161:292-301. [PMID: 18977033 DOI: 10.1016/j.psychres.2007.08.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2006] [Revised: 05/25/2007] [Accepted: 08/07/2007] [Indexed: 11/23/2022]
Abstract
Dysfunction in the hypothalamic-pituitary-adrenal (HPA) axis has been proposed as a biological endophenotype for affective disorders. In the present study the hypothesis that a high genetic liability to affective disorder is associated with higher cortisol levels was tested in a cross-sectional high-risk study. Healthy monozygotic (MZ) and dizygotic (DZ) twins with (High-Risk twins) and without (Low-Risk twins) a co-twin history of affective disorder were identified through nationwide registers. Awakening and evening salivary cortisol levels were compared between the 190 High- and Low-Risk twins. The 109 High-Risk twins had significantly higher evening cortisol levels than the 81 Low-Risk MZ twins, also after adjustment for age, sex, and the level of subclinical depressive symptoms. No significant difference was found in awakening cortisol levels between High-Risk and Low-Risk twins. In conclusion, a high genetic liability to affective disorder was associated with a higher evening cortisol level, but not with awakening cortisol level. Future prospective family, high-risk and twin studies are needed to decide whether abnormalities in the HPA axis can be identified as an endophenotype of affective disorder.
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Langman LJ. The use of oral fluid for therapeutic drug management: clinical and forensic toxicology. Ann N Y Acad Sci 2007; 1098:145-66. [PMID: 17332075 DOI: 10.1196/annals.1384.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
One of the underlying tenets of clinical pharmacology is that only free drugs are pharmacologically active. It is thought that only free drugs can cross biological membranes to interact with a given receptor to alter its function, and that drug responses, both efficacious and toxic, are a function of unbound concentrations. The rationale for measuring drugs in oral fluid is that the free fraction of a drug in plasma reaches equilibrium with the drug in saliva. Although reports concerning the appearance of organic solutes in saliva have been in the literature for over 70 years, it has only been in the past 30 years that there has been emphasis on the appearance of drugs. Although many assumptions for drug level monitoring in saliva are made, the primary requisite for salivary monitoring to be useful is a constant or predictable relationship between the drug concentration in saliva and the drug concentration in plasma. Measurement of oral fluid drug levels for the purpose of managing patients and making dosage adjustments may be useful for select drugs or drug classes. However, it does not appear to be useful for the majority of drugs therapeutically monitored. Some work with antipsychotic medications has indicated that although the measurement of drug concentrations themselves may not be useful for dosage adjustment, the ratio of parent drug to metabolite may reflect altered metabolic status due to either pharmacogenetic variation or other clinical conditions. Furthermore, analysis of saliva may provide a cost-effective approach for the screening of large populations.
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Affiliation(s)
- Loralie J Langman
- Division of Clinical Biochemistry and Immunology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA.
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36
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Mendonza AE, Gohh RY, Akhlaghi F. Analysis of Mycophenolic Acid in Saliva Using Liquid Chromatography Tandem Mass Spectrometry. Ther Drug Monit 2006; 28:402-6. [PMID: 16778726 DOI: 10.1097/01.ftd.0000211826.65607.05] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Salivary levels of the immunosuppressive agent, mycophenolic acid (MPA), may provide a convenient and noninvasive method for drug monitoring. An analytical method was developed and validated for quantification of salivary MPA using liquid chromatography tandem mass spectrometry. Sample preparation included addition of 50 microL internal standard solution [500 microg/L indomethacin in methanol] to 100 microL saliva sample, followed by protein precipitation with 200 microL acetonitrile. Supernatants were dried and reconstituted in 100 microL of 85:15% (vol/vol) mixture of methanol and water containing 0.05% formic acid and 20 microL was injected onto the analytical column. The mobile phase comprised a gradient mixture of methanol and 0.05% formic acid, giving a total run time of 7.5 minutes. Chromatograms were obtained using mass transitions of m/z 319.0-->190.8 for MPA and m/z 355.9-->312.2 for indomethacin. The calibration curve was linear over a concentration range of 2.5 to 800 microg/L (r=0.9999) and the recovery of MPA from saliva was >90%. The inaccuracy was <10% and intra- and interday coefficient of variation ranged from 2.8% to 5.2%. Mean+/-SD of MPA concentrations in saliva (n=100) obtained from 11 kidney transplant recipients was 31.4+/-32.3 microg/L (range: 2.6 to 220.4 microg/L) and correlated well with total (r=0.909) and unbound (r=0.910) MPA concentrations in plasma. In conclusion, a simple, sensitive, and specific method was developed and validated for quantification of MPA in saliva. Additional clinical studies are required to establish the usefulness of this specimen in the clinical management of organ transplant recipients.
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Affiliation(s)
- Anisha E Mendonza
- College of Pharmacy, University of Rhode Island, 41 Lower College Road, Kingston, RI, USA
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37
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Egeland J, Lund A, Landrø NI, Rund BR, Sundet K, Asbjørnsen A, Mjellem N, Roness A, Stordal KI. Cortisol level predicts executive and memory function in depression, symptom level predicts psychomotor speed. Acta Psychiatr Scand 2005; 112:434-41. [PMID: 16279872 DOI: 10.1111/j.1600-0447.2005.00599.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE On a group level depression is related to hypercortisolism and to psychomotor retardation, executive dysfunction and memory impairment. However, intra-group heterogeneity is substantial. Why some are impaired while others remain in the normal range, is not clear. The present study aims at discerning the relative contribution of present symptom severity and hypercortisolism to impairment in the three domains of cognition. METHOD Morning saliva cortisol was measured in 26 subjects with recurrent major depression prior to a neuropsychological examination with tests known to be sensitive to cognitive impairment in depression. RESULTS Cortisol level correlated with executive dysfunction and post-encoding memory deficits, but not with processing speed. Depression level correlated with processing speed. These patterns remained significant after controlling for confounders through partial correlations. CONCLUSION The association between cortisol and cognition is not an artifact of psychiatric symptom load. High level of saliva cortisol is associated with aspects of cognition that can be dissociated from psychomotor retardation, which is dependent on symptom load.
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Affiliation(s)
- J Egeland
- Vestfold Mental Health Care Trust, Tønsberg, Norway.
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38
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Aps JKM, Martens LC. Review: The physiology of saliva and transfer of drugs into saliva. Forensic Sci Int 2005; 150:119-31. [PMID: 15944052 DOI: 10.1016/j.forsciint.2004.10.026] [Citation(s) in RCA: 307] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2004] [Revised: 10/10/2004] [Accepted: 10/10/2004] [Indexed: 11/21/2022]
Abstract
Although saliva or oral fluid "lacks the drama of blood, the sincerity of sweat and the emotional appeal of tears", quoting Mandel in 1990 [I.D. Mandel, The diagnostic uses of saliva, J. Oral Pathol. Med. 19 (1990) 119-125], it is now meeting the demand for inexpensive, non-invasive and easy-to-use diagnostic aids for oral and systemic diseases, drug monitoring and detection of illicit use of drugs of abuse, including alcohol. As the salivary secretion is a reflex response controlled by both parasympathetic and sympathetic secretomotor nerves, it can be influenced by several stimuli. Moreover, patients taking medication which influences either the central nervous system or the peripheral nervous system, or medication which mimic the latter as a side effect, will have an altered salivary composition and salivary volume. Patients suffering from certain systemic diseases may present the same salivary alterations. The circadian rhythm determines both the volume of saliva that will and can be secreted and the salivary electrolyte concentrations. Dietary influences and the patient's age also have an impact on composition and volume of saliva. The latter implies a wide variation in composition both inter- and intra-individually. Sampling must therefore be performed under standardized conditions. The greatest advantage, when compared to blood sample collection, is that saliva is readily accessible and collectible. Consequently, it can be used in clinically difficult situations, such as in children, handicapped and anxious patients, where blood sampling could be a difficult act to perform.
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Affiliation(s)
- Johan K M Aps
- UZG-P8- Department of Paediatric Dentistry and Centre for Special Care, PaeCaMed Research Unit, Ghent University, De Pintelaan 185, 9000 Gent, Belgium.
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Becker JB, Arnold AP, Berkley KJ, Blaustein JD, Eckel LA, Hampson E, Herman JP, Marts S, Sadee W, Steiner M, Taylor J, Young E. Strategies and methods for research on sex differences in brain and behavior. Endocrinology 2005; 146:1650-73. [PMID: 15618360 DOI: 10.1210/en.2004-1142] [Citation(s) in RCA: 599] [Impact Index Per Article: 31.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Female and male brains differ. Differences begin early during development due to a combination of genetic and hormonal events and continue throughout the lifespan of an individual. Although researchers from a myriad of disciplines are beginning to appreciate the importance of considering sex differences in the design and interpretation of their studies, this is an area that is full of potential pitfalls. A female's reproductive status and ovarian cycle have to be taken into account when studying sex differences in health and disease susceptibility, in the pharmacological effects of drugs, and in the study of brain and behavior. To investigate sex differences in brain and behavior there is a logical series of questions that should be answered in a comprehensive investigation of any trait. First, it is important to determine that there is a sex difference in the trait in intact males and females, taking into consideration the reproductive cycle of the female. Then, one must consider whether the sex difference is attributable to the actions of gonadal steroids at the time of testing and/or is sexually differentiated permanently by the action of gonadal steroids during development. To answer these questions requires knowledge of how to assess and/or manipulate the hormonal condition of the subjects in the experiment appropriately. This article describes methods and procedures to assist scientists new to the field in designing and conducting experiments to investigate sex differences in research involving both laboratory animals and humans.
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Affiliation(s)
- Jill B Becker
- Department of Psychology, University of Michigan, 525 East University, Ann Arbor, MI 48109, USA.
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Abstract
AbstractTechnological advances over the past decades have enabled oral fluid to expand its usefulness in the diagnosis of disease, prediction of disease progression, monitoring of therapeutic drug levels and detection of illicit drugs. The easy non-invasive nature of collection and the relationship between oral fluid and plasma levels make oral fluid a valuable clinical tool. This review describes advances over the past 5 years in the area of oral fluid as a diagnostic tool, its use in therapeutic and illicit drug monitoring, including proposed guidelines for cut-off values, and methods of collection.
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Affiliation(s)
- Robin E Choo
- Chemistry and Drug Metabolism Section, Intramural Research Program, National Institute of Drug Abuse, National Institute of Health, Baltimore, MD, USA
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41
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Kaufman E, Lamster IB. The diagnostic applications of saliva--a review. CRITICAL REVIEWS IN ORAL BIOLOGY AND MEDICINE : AN OFFICIAL PUBLICATION OF THE AMERICAN ASSOCIATION OF ORAL BIOLOGISTS 2003; 13:197-212. [PMID: 12097361 DOI: 10.1177/154411130201300209] [Citation(s) in RCA: 533] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This review examines the diagnostic application of saliva for systemic diseases. As a diagnostic fluid, saliva offers distinctive advantages over serum because it can be collected non-invasively by individuals with modest training. Furthermore, saliva may provide a cost-effective approach for the screening of large populations. Gland-specific saliva can be used for diagnosis of pathology specific to one of the major salivary glands. Whole saliva, however, is most frequently used for diagnosis of systemic diseases, since it is readily collected and contains serum constituents. These constituents are derived from the local vasculature of the salivary glands and also reach the oral cavity via the flow of gingival fluid. Analysis of saliva may be useful for the diagnosis of hereditary disorders, autoimmune diseases, malignant and infectious diseases, and endocrine disorders, as well as in the assessment of therapeutic levels of drugs and the monitoring of illicit drug use.
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Affiliation(s)
- Eliaz Kaufman
- Division of Periodontics, Columbia University, School of Dental and Oral Surgery, 630 West 168th Street, PH-7E, Room 110, New York, NY 10032, USA.
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Williams C, Giannopoulos T, Sherriff EA. ACP best practice no 170. Investigation of infertility with the emphasis on laboratory testing and with reference to radiological imaging. J Clin Pathol 2003; 56:261-7. [PMID: 12663636 PMCID: PMC1769925 DOI: 10.1136/jcp.56.4.261] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This review will discuss the investigation of infertility, with emphasis on laboratory testing and reference to the value of other investigations, including clinical and radiological. The role of laboratory investigations is viewed within an appropriate clinically directed pathway that includes medical, surgical, and social history together with environmental factors. Because embryology and assisted reproduction techniques are developing rapidly and produce continuous changes in everyday practice, this article gives a critical review of the plethora of tests that are currently used.
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Affiliation(s)
- C Williams
- Wrexham Maelor hospital, Croenewydd Road, Wrexham, Clwyd LL13 7TD, UK
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43
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den Hartog HM, Nicolson NA, Derix MMA, van Bemmel AL, Kremer B, Jolles J. Salivary cortisol patterns and cognitive speed in major depression: a comparison with allergic rhinitis and healthy control subjects. Biol Psychol 2003; 63:1-14. [PMID: 12706961 DOI: 10.1016/s0301-0511(03)00050-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Few studies have investigated the relationship between cortisol and cognitive functions other than memory in depression. This study investigated daily salivary cortisol patterns (basal cortisol levels at 08:00, 16:00, and 21:00 h and flatness of the diurnal curve) in relation to cognitive speed and memory. Twenty-seven unmedicated outpatients with major depressive disorder (MDD) were compared with 36 healthy controls and with 20 allergic rhinitis patients, to determine whether effects should be ascribed to MDD or to more general disease-related processes. MDD patients were characterised by a flatter diurnal cortisol curve and by reduced cognitive speed. Flatter cortisol curves were associated with cognitive slowness. However, this relationship is unlikely to be causal; after control for depressive symptoms and group membership, flatness of the diurnal cortisol curve was no longer a significant predictor of cognitive slowness. Thus, MDD and related depressive symptoms appeared to be independently associated with altered cortisol secretory patterns and with decrements in cognitive speed.
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Affiliation(s)
- H M den Hartog
- Department of Psychiatry and Neuropsychology, Institute of Brain and Behaviour, Maastricht University, Brugakker 58-61, 3704 MX Zeist, The Netherlands.
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Nejtek VA. High and low emotion events influence emotional stress perceptions and are associated with salivary cortisol response changes in a consecutive stress paradigm. Psychoneuroendocrinology 2002; 27:337-52. [PMID: 11818170 DOI: 10.1016/s0306-4530(01)00055-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Numerous studies over the last few decades have successfully utilized "psychological" stressors to examine stress-induced cortisol release as a function of the hypothalamic-pituitary-adrenal (HPA) cascade. In contrast, research examining the effect emotionally-laden stressors may have on cortisol release is scarce. Moreover, the results from the few studies that have examined subjective perceptions of emotional stress and their relationship to cortisol release are mixed. Thus, little is known about the impact an emotionally-charged stressor may have on cortisol responsivity and even less is understood about the relationship between cortisol release and perceived emotional stress. The primary goal of the present research was to investigate the effect of consecutive, emotionally stressful events on cortisol release. The secondary goal was to examine the influence perceptions about emotionally stressful events might have on cortisol responsivity. This is the first study to identify two distinct patterns of cortisol release that were significantly reversed (P=0.006) in response to high and low emotion events presented in a consecutive stress paradigm that were associated with perceptions of emotional stress.
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Affiliation(s)
- Vicki A Nejtek
- Department of Psychiatry, UT Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd., Dallas, TX 75390-9070, USA.
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Hampl R, Hill M, Stárka L. Detection and Quantification of 7-Hydroxydehydroepiandrosterone Epimers in Three Body Fluids. ACTA ACUST UNITED AC 2002. [DOI: 10.1135/cccc20020010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
3β,7α-Dihydroxyandrost-5-en-17-one (1) (7α-OH-DHEA) and its 7β-hydroxy epimer 2 (7β-OH-DHEA) - 7α- and 7β-hydroxydehydroepiandrosterone - were detected and quantified in three human body fluids: in blood serum, saliva and ejaculate. Specific radioimmunoassay and gas chromatography-mass spectrometry have been used. For the first time the data on changes of these dehydroepiandrosterone metabolites are reported for a representative group of healthy subjects of both sexes (172 females and 217 males) during the life span. The serum levels of both 7-hydroxydehydroepiandrosterone epimers in serum and also in semen were in the low nanomolar range, while concentrations by one order of magnitude lower were found in saliva, but still within the detection limit. The results will serve as a basis for comparative studies of 7-hydroxydehydroepiandrosterone levels under various pathophysiological conditions, with a particular respect to autoimmune disorders.
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Abstract
OBJECTIVE The purpose was to establish saliva as a reliable sample for the determination of estriol levels in pregnant women. STUDY DESIGN Literature and laboratory analyses were used to develop an assembly system to collect and analyze saliva for estriol level. RESULTS An enzyme-linked immunoassay for estriol has been developed to use whole saliva samples. Analytic performance characteristics for the assay have been determined to be appropriate for clinical determination of preterm risk assessment. CONCLUSION Saliva can serve as a reliable sample for estriol determination when coupled with an appropriate assay method.
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Affiliation(s)
- H F Voss
- Biex, Inc., Dublin, California 94568, USA
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47
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The Concept of Stress and Its Relevance for Animal Behavior. ADVANCES IN THE STUDY OF BEHAVIOR 1998. [DOI: 10.1016/s0065-3454(08)60362-9] [Citation(s) in RCA: 248] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Lloyd JE, Broughton A, Selby C. Salivary creatinine assays as a potential screen for renal disease. Ann Clin Biochem 1996; 33 ( Pt 5):428-31. [PMID: 8888975 DOI: 10.1177/000456329603300505] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Salivary creatinine concentrations are 10-15% of serum creatinine concentrations in healthy populations but have not previously been measured in patients with renal disease. The Cobas Mira automated Jaffé method was adapted to measure salivary creatinine concentration. The method was linear to 1200 mumol/L, had a mean recovery of 78% and a detection limit of 6 mumol/L. Intra-assay variability was 13.5, 5.5 and 1.4% at 10.6, 17.8 and 128.4 mumol/L, respectively. Inter-assay variability was 35.0 and 4.8% at 6.2 and 130.4 mumol/L, respectively. The median salivary creatinine concentrations was 8.5 mumol/L (range 6-18 mumol/L) in healthy subjects (n = 23), and 84 mumol/L (range 18-591 mumol/L) in patients with renal disease (n = 25). Salivary and serum creatinine concentrations were not related in healthy subjects, however, a significant relationship was found in the patients (r = 0.784, P < 0.001). Using salivary creatinine concentration of 16.8 mumol/L as a cut off value, all patients would have been detected with one false positive result (sensitivity 100%, specificity 95.7%, efficiency 97.7%). Thus, salivary creatinine estimations may be used to identify subjects with serum creatinine concentrations above 120 mumol/L.
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Affiliation(s)
- J E Lloyd
- Department of Clinical Chemistry, City Hospital, Nottingham, UK
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KIRSCHBAUM CLEMENS, PLATTE PETRA, PIRKE KARLMARTIN, HELLHAMMER DIRK. ADRENOCORTICAL ACTIVATION FOLLOWING STRESSFUL EXERCISE: FURTHER EVIDENCE FOR ATTENUATED FREE CORTISOL RESPONSES IN WOMEN USING ORAL CONTRACEPTIVES. ACTA ACUST UNITED AC 1996. [DOI: 10.1002/(sici)1099-1700(199607)12:3<137::aid-smi685>3.0.co;2-c] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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50
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Enwonwu CO. Pathogenesis of oral Kaposi's Sarcoma in HIV-infection: relevance of endogenous glucocorticoid excess in blood and saliva. EUROPEAN JOURNAL OF CANCER. PART B, ORAL ONCOLOGY 1996; 32B:271-4. [PMID: 8776425 DOI: 10.1016/0964-1955(95)00089-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Endogenous glucocorticoid excess with concomitant hypercortisolaemia and increased saliva levels of the free active hormone, is a common feature of HIV-infected/AIDS patients. Exposure of the oral tissues to virtually uninterrupted high burden of glucocorticoids through saliva may contribute to the high frequency of oral Kaposi's sarcoma (KS) in these patients. AIDS-KS cells contain unusually high levels of glucocorticoid receptor protein and recent studies indicate that growth of these cells in culture is significantly stimulated by glucocorticoids, particularly in the presence of growth factors, such as oncostatin-M. The suggestion that glucocorticoid excess may be important in the pathogenesis of KS in AIDS is not in conflict with the suspected aetiological role of newly reported KS-associated herpesviruses (KSHV), since steroid hormones may upregulate the expression of the viral gene. The latter is consistent with the observation that infection by specific oncogenic viruses does not necessarily result in cancers in the human, and does require the presence of other cellular factors or events.
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Affiliation(s)
- C O Enwonwu
- Department of Oral and Craniofacial Biological Sciences, University of Maryland, Baltimore 21201, USA
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