2026 · The Journal of clinical endocrinology and metabolism · paywalled
The Utility of Salivary 11-Dehydrodexamethasone as a Marker of Dexamethasone Absorption
Marshall et al.
The finding, in our words
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.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
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.
A validated LC-MS/MS assay successfully measured 13 steroid hormones and two synthetic steroids in saliva, requiring only 50 microlitres, or down to 2 to 5 microlitres for nine analytes. This shows saliva's viability for non-invasive, patient-centric microsampling and decentralised monitoring in paediatric, neonatal and adult populations.
During ACTH stimulation, salivary cortisol correlated only weakly with serum and gave modest accuracy: saliva does not reliably replace serum cortisol for adrenal insufficiency. A concrete limit.
Salivary glucocorticoid concentrations were comparable across Salivette Cortisol, passive drool and SalivaBio collection methods, and remained stable for 72 hours at room temperature and 4 degrees Celsius with no significant degradation after repeated freeze-thaw cycles. In children under six years, the SaliPac pacifier swab was well tolerated and collected sufficient saliva for steroid analysis in under four minutes.
Nineteen healthy adults showed high compliance to a three-day home salivary sampling protocol, with 95% collecting the correct number of samples. Morning cortisol and cortisone profiles had moderate reproducibility, requiring three to four days of sampling to achieve high reliability, indicating that home-based protocols can support decentralised stress-hormone monitoring.