Late-night salivary cortisol and cortisone should be the initial screening test for Cushing's syndrome
Mohamed et al.
The finding, in our words
In a retrospective cohort, late-night salivary cortisol had 95% sensitivity and 91% specificity, while late-night salivary cortisone had 86% sensitivity and 100% specificity; using an optimal cut-off of 14.5 nmol/L, late-night salivary cortisone achieved 95.2% sensitivity and 100% specificity with an AUC of 0.997, supporting simultaneous measurement of both as first-line screening for suspected Cushing's syndrome, and because saliva collection is non-invasive and can be done at home, it is suitable for patient-centric decentralised diagnostics.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
This study used home self-collected saliva samples to successfully monitor cytokines and cortisol in mothers and infants, finding that a community singing intervention significantly reduced salivary interleukin-6 levels in mothers with postnatal depression.
Kirkpatrick et al., Brain, behavior, and immunity (paywalled) · source ↗
At-home saliva sampling for cortisol was feasible over 12 days in two people with poststroke aphasia, with the cortisol awakening response remaining consistent across days and weeks.
Laures-Gore et al., Journal of speech, language, and hearing research : JSLHR (paywalled) · source ↗
This study found that salivary 11-dehydrodexamethasone correlates strongly with serum dexamethasone, unlike salivary dexamethasone which shows poor agreement. This validation suggests patients could self-collect saliva samples at home to verify dexamethasone absorption for the overnight suppression test.
Marshall et al., The Journal of clinical endocrinology and metabolism (paywalled) · source ↗
This study validated a lateral flow fluorescence assay using quantum dots for saliva and europium nanoparticles for serum to detect cortisol within physiological ranges. The test operates in 15 minutes with a handheld reader, supporting point-of-care and at-home monitoring without a cold chain.
Bruno et al., Journal of fluorescence (paywalled) · source ↗
The study determined that an at-home saliva collection protocol using the passive drool method was feasible for Black women with histories of abuse, with 84% of participants completing at least one full day of adherent sampling. While the decentralised approach yielded usable cortisol data, women with histories of forced sex exposure showed lower protocol adherence scores.
Tsuyuki et al., Interactive journal of medical research (paywalled) · source ↗