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Measurement of Salivary Cortisone to Assess the Adequacy of Hydrocortisone Replacement. J Clin Endocrinol Metab 2016 04;101(4):1350-2



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Scopus ID

2-s2.0-85011308925   9 Citations


CONTEXT: This Commentary discusses the study of Debono et al (19) and focuses on the potential use of multiple salivary cortisone measurements to evaluate the adequacy of hydrocortisone replacement therapy. Salivary cortisone, typically measured using liquid chromatography-tandem mass spectrometry, accurately reflects plasma free cortisol because of the expression of 11-β -hydroxysteroid dehydrogenase in the salivary gland. Debono et al showed that multiple, sequential salivary cortisone measurements obtained over a 12-hour period correlated with plasma free cortisol in subjects receiving intravenous or oral hydrocortisone (authentic cortisol).

CONCLUSIONS: Hopefully, these studies will lead to a simplified protocol with fewer samples for the measurement of salivary cortisone that can reliably assess the adequacy of hydrocortisone replacement in patients with adrenal insufficiency. This protocol has to be cost-effective and be feasible to obtain timed salivary samples accurately at home. It would be a significant advance to be able to monitor hydrocortisone replacement therapy with as few as one or two salivary cortisone measurements.

Author List

Raff H


Hershel Raff PhD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Chromatography, Liquid
Salivary Glands
Tandem Mass Spectrometry
jenkins-FCD Prod-484 8aa07fc50b7f6d102f3dda2f4c7056ff84294d1d