Salivary chromogranin A as a measure of stress response to noise

Cognitive performance, creativity and stress levels of neurotypical young adults under different white noise levels

Noise is often considered a distractor; however recent studies suggest that sub-attentive individuals or individuals diagnosed with attention deficit hyperactivity disorder can benefit from white noise to enhance their cognitive performance. Research regarding the effect of white noise on neurotypical adults presents mixed results, thus the implications of white noise on the neurotypical population remain unclear. Thus, this study investigates the effect of 2 white noise conditions, white noise level at 45 dB and white noise level at 65 dB, on the cognitive performance, creativity, and stress levels of neurotypical young adults in a private office space. These conditions are compared to a baseline condition where participants are exposed to the office ambient noise. Our findings showed that the white noise level at 45 dB resulted in better cognitive performance in terms of sustained attention, accuracy, and speed of performance as well as enhanced creativity and lower stress levels. On the other hand, the 65 dB white noise condition led to improved working memory but higher stress levels, which leads to the conclusion that different tasks might require different noise levels for optimal performance. These results lay the foundation for the integration of white noise into office workspaces as a tool to enhance office workers’ performance.

Differential responses of salivary cortisol, amylase, and chromogranin A to academic stress

Salivary biomarkers have been widely used to help diagnose stress, anxiety, and/or depression. This study aimed to compare the responses of three commonly investigated salivary stress biomarkers that represent the hypothalamic-pituitary-adrenal activity (cortisol; sCort) and the sympathetic activity (alpha-amylase; sAA and chromogranin A; sCgA), using academic oral presentation as a model of stress. Twenty postgraduate dental students attended the seminar class as presenter and audience. The presenters' performances were evaluated by the instructors suggesting more stress than the audience. The saliva was collected two times: before attending class and after an academic presentation (for presenters) or during the class (for audience). The pulse rates (PR) were also recorded. The results showed that the levels of all three biomarkers, as well as PR, were significantly higher in the presenter group compared with the audience group; however, the changes were most prominent with sCort and sAA (99.56 ± 12.76% for sCort, 93.48 ± 41.29% for sAA, 16.86 ± 6.42% for sCgA, and 15.06 ± 3.41% for PR). When compared between pre-post presentation, the levels of sCgA were not different, while those of sCort and sAA were significantly increased. These results suggest more sensitive reactivity to academic stress of sCort and sAA compared with sCgA and that the response of sCgA did not necessarily follow sAA pattern even though both are claimed to reflect the sympathetic activity. More studies are needed to elucidate the roles of sCgA in stress.

Salivary Biomarkers of Stress, Anxiety and Depression

Stress, anxiety and depressive disorders are often characterized by the activation of the stress axis, which results in similar symptoms at some point in these disorders. These disorders are closely related to each other—they occur simultaneously or follow one another. The diagnosis of stress, anxiety and depression is not a perfect procedure currently—it is based on patient observation and an interview with the patient and their family. There are no laboratory tests that would dispel the doubts of the doctor making the diagnosis and allow the appropriate treatment to be implemented as soon as possible. Therefore, this study will review the components of saliva that could be helpful in the quick diagnosis of stress, anxiety and/or depression. Such potential salivary biomarkers could also be useful in monitoring the effectiveness of pharmacological treatment prescribed by a psychiatrist. The following are promising salivary biomarkers of stress, anxiety or depression: cortisol, immunoglobulin A (sIgA), lysozyme, melatonin, α-amylase (sAA), chromogranin A (CgA) and fibroblast growth factor 2 (FGF-2). To the best valuable potential salivary markers of stress, we can include cortisol, lysozyme, sAA and CgA. To differentiate depression from stress, salivary cortisol and melatonin can be helpful. Fluctuations in the concentrations of the above-mentioned substances in saliva indicate a particularly strong relationship with typical human psychological problems, such as stress, depression or anxiety.

Biomarkers in Stress Related Diseases/Disorders: Diagnostic, Prognostic, and Therapeutic Values

Various internal and external factors negatively affect the homeostatic equilibrium of organisms at the molecular to the whole-body level, inducing the so-called state of stress. Stress affects an organism's welfare status and induces energy-consuming mechanisms to combat the subsequent ill effects; thus, the individual may be immunocompromised, making them vulnerable to pathogens. The information presented here has been extensively reviewed, compiled, and analyzed from authenticated published resources available on Medline, PubMed, PubMed Central, Science Direct, and other scientific databases. Stress levels can be monitored by the quantitative and qualitative measurement of biomarkers. Potential markers of stress include thermal stress markers, such as heat shock proteins (HSPs), innate immune markers, such as Acute Phase Proteins (APPs), oxidative stress markers, and chemical secretions in the saliva and urine. In addition, stress biomarkers also play critical roles in the prognosis of stress-related diseases and disorders, and therapy guidance. Moreover, different components have been identified as potent mediators of cardiovascular, central nervous system, hepatic, and nephrological disorders, which can also be employed to evaluate these conditions precisely, but with stringent validation and specificity. Considerable scientific advances have been made in the detection, quantitation, and application of these biomarkers. The present review describes the current progress of identifying biomarkers, their prognostic, and therapeutic values.

Biomarkers in Stress Related Diseases/Disorders: Diagnostic, Prognostic, and Therapeutic Values

Various internal and external factors negatively affect the homeostatic equilibrium of organisms at the molecular to the whole-body level, inducing the so-called state of stress. Stress affects an organism's welfare status and induces energy-consuming mechanisms to combat the subsequent ill effects; thus, the individual may be immunocompromised, making them vulnerable to pathogens. The information presented here has been extensively reviewed, compiled, and analyzed from authenticated published resources available on Medline, PubMed, PubMed Central, Science Direct, and other scientific databases. Stress levels can be monitored by the quantitative and qualitative measurement of biomarkers. Potential markers of stress include thermal stress markers, such as heat shock proteins (HSPs), innate immune markers, such as Acute Phase Proteins (APPs), oxidative stress markers, and chemical secretions in the saliva and urine. In addition, stress biomarkers also play critical roles in the prognosis of stress-related diseases and disorders, and therapy guidance. Moreover, different components have been identified as potent mediators of cardiovascular, central nervous system, hepatic, and nephrological disorders, which can also be employed to evaluate these conditions precisely, but with stringent validation and specificity. Considerable scientific advances have been made in the detection, quantitation, and application of these biomarkers. The present review describes the current progress of identifying biomarkers, their prognostic, and therapeutic values.

The interactive effect of occupational noise on attention and short-term memory: A pilot study

Introduction:

Human performance is influenced by several job-related factors and workplace conditions, including occupational noise. This influence can occur at sound pressure levels lower than the ones that cause physiological damage, such as hearing loss, being mediated by the noise characteristics. However, studies concerning this issue are still scarce. Study.

Aim:

The aim of this study was to investigate the effects of three noise conditions on attention and short-term memory: standard condition (C1), environmental noise without alarm sounds (C2), and environmental noise with alarm sounds (C3).

Materials and Methods:

First, noise levels were measured during a normal workweek in a fast food establishment. Second, an experiment was designed to simulate the noise normally prevailing in the workplace. The noise levels were fixed at 45 ± 0.3 dB(A) (C1), 60 ± 0.4 dB(A) (C2), and 68 ± 0.4 dB(A) (C3). The influence of noise on participants’ attention and short-term memory was assessed with the following test battery: serial recall, response inhibition, and Stroop interference. Because annoyance, stress, and discomfort perceptions during the tests can influence results, visual analog scales to assess these variables were applied in the end of each trial. Fifteen undergraduate students were included in this pilot study (20–23 years; M = 21.6; SD = 0.8; all female).

Results:

The results demonstrated that participants’ performance during the tests was lower in C3, that is, the number of errors was higher and the reaction time longer. Participants also experienced higher levels of discomfort, stress, and annoyance perceptions in this condition. However, task performance was not found to be influenced by these perceptions.

Conclusion:

This study provided important insights about the different noise conditions that workers are exposed in a fast food restaurant, and how they influence participants’ performance. Further research should involve workers, exploring how these conditions are implicated in their performance in the field.

The effects of combined exposure to noise and heat on human salivary cortisol and blood pressure

Purpose. Noise and heat are the most important physical hazardous agents that can affect physiological parameters. This study investigated the independent and combined effects of noise and heat exposure on human saliva cortisol and blood pressure. Methods. In this experimental study, 72 students were exposed to noise (at sound pressure levels of 45, 75, 85 and 95 dB(A)) and heat (at wet bulb globe temperatures [WBGTs] of 22, 29 and 34 °C) for 30 min. Samples of saliva and blood pressure were taken before and after each independent and combined exposure. Results. The results revealed that the average saliva cortisol and blood pressure in male and female subjects increased significantly after independent exposure to noise at 95 dB(A) and a WBGT of 34 °C. The combined exposure to noise and heat increased saliva cortisol and blood pressure, which was statistically significant for three combinations of 95 dB(A) at 34 °C, 95 dB(A) at 29 °C and 85 dB(A) at 34 °C. Conclusions. Combined exposure to noise and heat could affect saliva cortisol and blood pressure in both male and female groups. Further studies are recommended to capture other combinations of physical hazardous agents, especially in the field.

Psychophysiological measurement of affective responses during speech perception

When people make decisions about listening, such as whether to continue attending to a particular conversation or whether to wear their hearing aids to a particular restaurant, they do so on the basis of more than just their estimated performance. Recent research has highlighted the vital role of more subjective qualities such as effort, motivation, and fatigue. Here, we argue that the importance of these factors is largely mediated by a listener's emotional response to the listening challenge, and suggest that emotional responses to communication challenges may provide a crucial link between day-to-day communication stress and long-term health. We start by introducing some basic concepts from the study of emotion and affect. We then develop a conceptual framework to guide future research on this topic through examination of a variety of autonomic and peripheral physiological responses that have been employed to investigate both cognitive and affective phenomena related to challenging communication. We conclude by suggesting the need for further investigation of the links between communication difficulties, emotional response, and long-term health, and make some recommendations intended to guide future research on affective psychophysiology in speech communication.

Changes in salivary chromogranin A levels in adults with atopic dermatitis are correlated with changes in their condition

Stress-induced scratching is an issue in patients with adult atopic dermatitis (AD). Symptoms of stress-induced AD are common in clinical practise. Salivary chromogranin A (CgA) level has research value as a possible index related to a patient's psychological stress. Using saliva, which is easily collectable, we compared two assessments of the severities of AD and stress with the levels of stress proteins in the saliva of 30 patients with AD in the Department of Dermatology of Shimane University between April 2015 and May 2017. The severities of AD and stress were assessed using the Scoring Atopic Dermatitis (SCORAD) score and State-Trait Anxiety Inventory score, respectively. Additionally, the assessments included those of personality using the Tokyo University Egogram (TEG)-II score and quality of life using the Dermatology Life Quality Index score. Simultaneously, we measured their salivary CgA levels. The change in salivary CgA per protein in patients with AD was correlated with their changes in SCORAD score (correlation coefficient, r = 0.596, P = 0.001) and objective SCORAD (r = 0.608, P < 0.001). The changes in CgA per protein correlated with those in TEG-II A (r = 0.370, P = 0.022), while the changes in SCORAD score correlated with those in DLQI (r = 0.309, P = 0.048). Our results suggest that changes in a patient's condition are reflective of the changes in the patient's stress. The changes in salivary CgA level in patients with AD correlated with the changes in their condition.

Cortisol, Chromogranin A, and Pupillary Responses Evoked by Speech Recognition Tasks in Normally Hearing and Hard-of-Hearing Listeners: A Pilot Study

Pupillometry is one method that has been used to measure processing load expended during speech understanding. Notably, speech perception (in noise) tasks can evoke a pupil response. It is not known if there is concurrent activation of the sympathetic nervous system as indexed by salivary cortisol and chromogranin A (CgA) and whether such activation differs between normally hearing (NH) and hard-of-hearing (HH) adults. Ten NH and 10 adults with mild-to-moderate hearing loss (mean age 52 years) participated. Two speech perception tests were administered in random order: one in quiet targeting 100% correct performance and one in noise targeting 50% correct performance. Pupil responses and salivary samples for cortisol and CgA analyses were collected four times: before testing, after the two speech perception tests, and at the end of the session. Participants rated their perceived accuracy, effort, and motivation. Effects were examined using repeated-measures analyses of variance. Correlations between outcomes were calculated. HH listeners had smaller peak pupil dilations (PPDs) than NH listeners in the speech in noise condition only. No group or condition effects were observed for the cortisol data, but HH listeners tended to have higher cortisol levels across conditions. CgA levels were larger at the pretesting time than at the three other test times. Hearing impairment did not affect CgA. Self-rated motivation correlated most often with cortisol or PPD values. The three physiological indicators of cognitive load and stress (PPD, cortisol, and CgA) are not equally affected by speech testing or hearing impairment. Each of them seem to capture a different dimension of sympathetic nervous system activity.

Masticatory performance alters stress relief effect of gum chewing

PURPOSE

We evaluated the effects of gum chewing on the response to psychological stress induced by a calculation task and investigated the relationship between this response and masticatory performance.

METHODS

Nineteen healthy adult volunteers without dental problems undertook the Uchida-Kraepelin (UK) test (30 min of reiterating additions of one-digit numbers). Before and immediately after the test, saliva samples were collected from the sublingual area of the participants. Three min after the UK test, the participants were made to chew flavorless gum for 3 min, and the final saliva samples were collected 10 min after the UK test. The experiment was performed without gum chewing on a different day. Masticatory performance was evaluated using color-changing chewing gum.

RESULTS

Salivary CgA levels at immediately and 10 min after the UK test were compared with and without gum chewing condition. Two-way repeated measures analysis of variance revealed significant interaction between gum chewing condition and changes in CgA levels during post 10 min UK test period. A significant correlation was found between changes in CgA levels and masticatory performance in all participants.

CONCLUSION

Our results indicate that gum chewing may relieve stress responses; however, high masticatory performance is required to achieve this effect.

Effects of olfactory stimulation from the fragrance of the Japanese citrus fruit yuzu (Citrus junos Sieb. ex Tanaka) on mood states and salivary chromogranin A as an endocrinologic stress marker

OBJECTIVE

This study investigated the soothing effects of fragrance from yuzu, a Japanese citrus fruit (Citrus junos Sieb. ex Tanaka), with salivary chromogranin A (CgA) used as an endocrinologic stress marker reflecting sympathetic nervous system activity.

METHODS

Twenty healthy women (mean age, 20.5 ± 0.1 years) participated in a randomized, controlled, crossover study. Participants were examined on two separate occasions-once using the yuzu scent and once using unscented water as a control-in the follicular phase. This experiment measured salivary CgA and the Profile of Mood States (POMS) as a psychological index before and after the aromatic stimulation.

RESULTS

Ten-minute inhalation of the yuzu scent significantly decreased salivary CgA. At 30 minutes after the inhalation period, the salivary CgA level further decreased. In addition, POMS revealed that inhalation of the aromatic yuzu oil significantly decreased total mood disturbance, a global measure of affective state, as well as four subscores of emotional symptoms (tension-anxiety, depression-dejection, anger-hostility, and confusion), as long as 30 minutes after the olfactory stimulation.

CONCLUSIONS

Yuzu's aromatic effects may alleviate negative emotional stress, which, at least in part, would contribute to the suppression of sympathetic nervous system activity.

Effect of repeated administration of lipopolysaccharide on inflammatory and stress markers in saliva of growing pigs

Although saliva could be considered to be an ideal biological sample for evaluation of biomarkers relating to stress and inflammatory responses in pigs, little is known about how these might be influenced by the presence of endotoxaemia. In the present study, the response to repeated administrations of lipopolysaccharide (LPS) was investigated, using a panel of salivary stress markers such as chromogranin A (CgA) and cortisol, as well as inflammatory/immune markers such as haptoglobin (Hp), C-reactive protein (CRP) and immunoglobulin A (IgA). Sixteen growing pigs were adapted to experimental conditions for 3 weeks, after which, 10 of the pigs were selected to receive three doses of LPS at 48 h intervals. Saliva samples were taken from all pigs prior to any LPS administration (baseline) and at time points corresponding to 3 h after each injection of LPS (T1, T2 and T3). Results showed that repeated administration of LPS induced significant elevation of salivary markers of hypothalamic-pituitary-adrenal (cortisol) and immune (Hp, CRP and IgA) activity compared to baseline levels (P < 0.05). However, rectal temperature, CRP and cortisol data suggested that the amplitude of the inflammatory response decreased with successive LPS administrations. Thus, measurement of salivary biomarkers could be a practical tool for evaluating the inflammatory response to endotoxaemia in pigs. In the case of chronic inflammatory states, salivary Hp and IgA might be more sensitive markers than CRP or cortisol.

[Chromogranin A and neuroendocrine tumors]

Chromogranin A (CgA) is the most abundant granin in gastroenteropancreatic neuroendocrine tumors (GEP-NETs). As a tumor marker is moderately sensitive and nonspecific. Despite the limitations of testing methods, which require careful interpretation, especially in the case of gastrinomas, patients treated with somatostatin analogues, and poorly differentiated tumors, it is the best tumor marker in GEP-NETs and may be of value in other tumors with neuroendocrine differentiation. CgA may be used as a marker in blood or tissue samples through immunohistochemical techniques. CgA levels correlate with tumor burden and extension and may be used for diagnosis and monitoring of GEP-NETs, especially midgut carcinoids and endocrine pancreatic tumors. It is also useful as a prognostic marker for detection of recurrence and monitoring of response to different treatments.

Measurement of chromogranin A in porcine saliva: validation of a time-resolved immunofluorometric assay and evaluation of its application as a marker of acute stress

The objective of this study was to develop and validate a time-resolved immunofluorometric assay (TR-IFMA) for porcine salivary chromogranin A (CgA) measurements, using a species-specific antibody, and evaluate its behaviour in an acute stress model. Polyclonal antibodies were produced in rabbits immunized with a synthetic porcine fragment of CgA359-379 and used to develop a sandwich TR-IFMA. This TR-IFMA was analytically validated and showed intra- and inter-assay coefficients of variation of 6.23% and 5.82%, respectively, an analytical limit of detection of 4.27 × 10-3 μg/ml and a limit of quantification of 24.5 × 10-3 μg/ml. The assay also demonstrated a high level of accuracy, as determined by linearity under dilution (r = 0.975) and recovery tests. When a model of experimental acute stress, in which animals were immobilized for 3 min with a nose snare (stressor stimulus), was applied, a significant increase (P < 0.05) in CgA levels in saliva was detected at 15 min post-stressor stimulus. These results indicate that the assay developed in this study could measure CgA in porcine saliva in a reliable way and that the concentrations of CgA in saliva samples of pigs increase after an acute stress situation.

Increased salivary chromogranin A in women with severe negative mood states in the premenstrual phase

The present study investigated whether salivary chromogranin A (CgA), a psychological stress marker associated with sympathetic nervous system activity, changes during the menstrual cycle in women with different degrees of premenstrual psychoemotional symptoms. Forty-five women (28.6 ± 1.3 years) with regular menstrual cycles participated in this study. Salivary CgA and cortisol were measured during the follicular and late-luteal phases. The authors used the Profile of Mood State (POMS) to assess current mood states of subjects in each menstrual phase and divided the subjects into three groups depending on increase of total mood disturbance (TMD), a global measure of affective states of POMS from the follicular to the late-luteal phase: Low (4.1 ± 0.7%), Middle (18.7 ± 1.2%) and High (51.7 ± 7.4%). Results showed no intramenstrual cycle differences in salivary CgA in the Low and Middle groups. Women in the High group, in contrast, had a significantly higher level of salivary CgA in the late-luteal phase compared to that of the follicular phase. Additionally, salivary CgA level significantly and positively correlated with TMD and four emotional subscales: tension-anxiety, depression-dejection, anger-hostility and confusion in the late-luteal phase. No intergroup or menstrual-cycle difference occurred in the salivary cortisol. This study indicates a significant late-luteal increase in salivary CgA, reflecting an increase of sympathetic nerve activity in women who experience a substantial increase (>30%) in a cluster of negative psychoemotional symptoms premenstrually. Furthermore, salivary CgA, as opposed to salivary cortisol, could serve as a reliable noninvasive biomarker to more sensitively evaluate neuropsychophysiological fluctuations during the menstrual cycle.

Change of salivary stress marker concentrations during pregnancy: maternal depressive status suppress changes of those levels

AIM

The aim of the present study was to show changes in salivary cortisol and chromogranin A/protein concentrations as stress markers during pregnancy and to clarify the effect of chronic stress on stress markers.

MATERIAL AND METHODS

Salivary samples were collected from 69 pregnant women during pregnancy. Salivary cortisol levels and chromogranin A/protein titers were determined. We surveyed the women's chronic stress using the Zung self-rating depression scale and General Health Questionnaire-28.

RESULTS

Cortisol levels in the saliva of pregnant women showed biphasic change during pregnancy. Chromogranin A/protein levels in the saliva of pregnant women increased in the second and the early third trimesters and decreased to the puerperal period. Salivary cortisol concentrations of the chronic high stress group were significantly lower compared with those of the normal group. Salivary chromogranin A/protein concentrations of the chronic high stress group were also significantly lower than those of the normal group.

CONCLUSION

The titration of salivary cortisol concentrations and chromogranin A/protein levels is a useful tool to determine maternal stress levels. The elevation of cortisol and chromogranin A/protein in the saliva was suppressed in the chronic high stress group during pregnancy.

The clinical relevance of chromogranin A as a biomarker for gastroenteropancreatic neuroendocrine tumors

Chromogranin A, although it exhibits limitations, is currently the most useful general tumor biomarker available for use in the diagnosis and management of gastroenteropancreatic neuroendocrine tumors (NETs). The value of the chromogranin A lies in its universal cosecretion by the majority of neuroendocrine cells that persists after malignant transformation. Clinicians aware of the physiologic role of chromogranin A and its secretion in a variety of non-NET-related pathologic conditions can use this protein as a moderately effective tumor biomarker in the management of GEP-NETs.

Effects of hyperoxic inhalation on psychological stress-induced salivary biomarkers

This study examined the effects of hyperoxic inhalation on psychological stress-induced salivary biomarkers. To induce psychological stress, eight males (22-24 year old) were performed a simple mathematical calculation. After the task, the subjects inspired either normal air or 100% O(2) for 30 min. The control subjects (control trial) did not perform the calculation task and inspired normal air. These three trials were randomly performed at an interval of at least one week, and the two calculation trials with and without 100% O(2) inhalation were performed using a single-blinded design. A tendency for increase in salivary cortisol (s-cortisol) and chromogranin A (s-CgA) concentrations, and a significant increase in salivary alpha-amylase (s-amylase) activity were observed following the task. Hyperoxic inhalation did not affect s-cortisol and s-CgA secretion, but decreased the s-amylase activity. Changes in the increased rate of s-amylase activity and s-CgA concentration showed a significant negative correlation with each other, after the task. These results imply that hyperoxic inhalation attenuates a part of autonomic excitability resulting from psychological stress. Although both s-amylase and s-CgA are employed as biomarkers of autonomic excitability, the s-amylase and s-CgA do not appear to be regulated by the same autonomic nervous system.

The effectiveness of the Uchida-Kraepelin test for psychological stress: an analysis of plasma and salivary stress substances

Background

The hypothalamic-pituitary-adrenocortical (HPA) axis and sympathetic adrenomedullary (SAM) system are the major stress-response pathways. Plasma adrenocorticotropic hormone (ACTH) represents HPA axis activity, while plasma catecholamines are used as markers of the SAM system. Salivary alpha amylase (AA), chromogranin A (CgA), and immunoglobulin A (IgA) are candidate markers of stress activation, although their role has not been established. The Uchida-Kraepelin (U-K) test is a questionnaire that requires intense concentration and effort, and has been used as a tool to induce mental stress. However, it is not clear whether or not the test is effective as a psychological/mental stressor.

Methods

In this study, normal young women took the U-K test and serial measurements of plasma ACTH and catecholamines (dopamine, noradrenaline, and adrenaline) (n = 10), as well as salivary AA, CgA, and IgA (n = 16) before, during and after the test.

Results

We found no changes in any of these parameters at any time point during or after the U-K test.

Conclusion

Our findings indicate that the U-K test is not a suitable for measuring the psychological/mental stress of young women because the plasma data showed that it did not affect the HPA axis and SAM system. The U-K test should be employed carefully as a psychological/mental stressor due to insufficient scientific evidence of its effectiveness. In addition, salivary AA, CgA, and IgA should not simply be compared with previous reports, because the mechanism of secretion and normal range of each salivary parameter remain unknown. Salivary AA, CgA, and IgA may not be suitable candidate markers of psychological/mental stress.

Current status of salivary hormone analysis

BACKGROUND

Saliva, which offers a noninvasive and stress-free alternative to plasma and serum, is a widely accepted sample source for analysis of steroids and also of certain amines and peptides. In recent years, numerous publications have described the use of salivary hormone analysis in many fields of clinical and basic research.

CONTENT

This review provides an overview of the current applications of salivary hormone analysis. A description of the different modes of hormone entry into saliva is followed by a detailed description of analytical methods and approaches for reliable collection of saliva, including several interesting applications in diverse fields including psychiatry, stress research, clinical endocrinology, sports medicine, and veterinary medicine.

SUMMARY

Although saliva has not yet become a mainstream sample source for hormone analysis, it has proven to be reliable and, in some cases, even superior to other body fluids. Nevertheless much effort will be required for this approach to receive acceptance over the long term, especially by clinicians. Such effort includes the development of specific and standardized analytical tools, the establishment of defined reference intervals, and implementation of round-robin trials. One major problem, the lack of compliance sometimes seen in outpatient saliva donors, requires strict standardization of both collection and analysis methods to achieve better comparability and assessment of published salivary hormone data.

Salivary levels of cortisol and chromogranin A in patients with dry mouth compared with age-matched controls

OBJECTIVE

To evaluate the salivary levels of cortisol and chromogranin A (CgA) in patients with dry mouth (perceived xerostomia and hyposalivation) compared with age-matched controls.

STUDY DESIGN

We studied 174 subjects, including those with dry mouth, classified into 2 subgroups based on perceived xerostomia and salivation, and those without (control subjects). The control subjects were patients at the same hospital and healthy volunteers. Cortisol and CgA levels in stimulated whole saliva were measured using ELISA kits.

RESULTS

All subjects with dry mouth had significantly higher cortisol and CgA levels than the control subjects. The statistical associations remained significant when they were divided into the 2 subgroups, although somewhat weaker associations were observed. The influences of xerogenic drugs were found to be minimal on salivary flow rate and levels of cortisol and CgA.

CONCLUSIONS

We found significant associations between salivary cortisol and CgA levels and symptoms of oral dryness and reduced salivary flow.