Radioimmunoassay of cortisone in serum, urine, and saliva to assess the status of the cortisol–cortisone shuttle

Abstract

We have developed a new assay for cortisone (E) in serum, saliva, and urine involving Celite® chromatography followed by RIA with 125I-labeled E and scintillation proximity assay. The chromatography step separates cortisol (F) from E, and in combination with their RIAs, permits assessment of the status of the F–E shuttle. We report the results of basal, postcorticotropin (ACTH), and postdexamethasone E and F concentrations and their circadian fluctuations in the serum, saliva, and urine of healthy volunteers. The serum and urine F/E ratios were increased in patients with ectopic ACTH secretion, whereas in adrenal adenoma and Cushing disease only the urinary ratio was increased. In chronic renal insufficiency this ratio was increased in serum (23.5 ± 3.9) but diminished in saliva (0.38 ± 0.11), and in apparent mineralocorticoid excess the ratios were high in serum (44.3 ± 9.3) and urine (5.35 ± 0.85) compared with those of healthy subjects (serum 9.8 ± 3.5, urine 0.52 ± 0.29, saliva 0.52 ± 0.29).

Variability in hydrocortisone plasma and saliva pharmacokinetics following intravenous and oral administration to Patients with adrenal insufficiency

“…The 11 β-HSD-2 that is present in the parotid glands could account for this effect and is consistent with a much higher cortisone relative to cortisol concentration in saliva compared to plasma. 20 In summary, the pharmacokinetic analysis of intravenous plasma data identified wide interpatient variability in the clearance of hydrocortisone and correcting for weight only explained 5% of this variability. After oral administration, variability in both absorption (rate and extent) and elimination also produced differences in the shapes of the concentration-time profiles.…”

A longitudinal evaluation of the relationship between first morning urinary and salivary cortisol

“…The non‐protein‐bound cortisol circulating in blood is a lipophilic molecule that diffuses across capillary membranes of the kidney into the glomerular filtrate, traveling through the proximate convoluted tubule, then Henle's loop and the distal convoluted tubule wherein it can be reabsorbed back into circulation (Beisel et al, ; Daughaday et al, ; Lindholm, ; Schedl et al, ). Circulating, non‐protein‐bound cortisol, on the other hand, diffuses passively across the epithelial cells and the basement membrane of the capillaries surrounding the salivary glands, directly into saliva (Beisel et al, ; Daughaday et al, ; Gröschl, ; Jerjes et al, ; Levine et al, ; Lewis, ; Lindholm, ; Morineau et al, ). Despite these differences, in both cases the excretion process takes approximately 10–20 minutes (Aardal‐Eriksson et al, ; Beisel et al, ; Daughaday et al, ; Jerjes et al, ; Kudielka and Wust, ; Lindholm, ; Morineau et al, ).…”

An update: salivary hormones and physical exercise

“…Certainly, it is important to consider the influence of circadian rhythms on hormonal secretion in relation to salivary steroid hormone variations (Morineau et al, 1997).…”