RESUMEN
Long-term treatment with inhaled corticosteroids (ICS) may potentially lead to adrenal insufficiency in children with asthma. A sufficient adrenal response can be tested using protocols involving salivary cortisol measurements. In this study, we investigated in healthy volunteers whether inhalation of fluticasone propionate, a frequently prescribed ICS, interferes with salivary cortisol measurement (with tandem mass spectrometry as well as an immuno-assay). We found that inhalation of fluticasone propionate immediately before saliva collection does not interfere with the salivary cortisol measurement when measured by mass spectrometry. These results suggest that patients with asthma using ICS can be included in research protocols based on salivary cortisol mass spectrometry measurements.
Asunto(s)
Androstadienos/efectos adversos , Broncodilatadores/efectos adversos , Hidrocortisona/metabolismo , Saliva/metabolismo , Glándulas Salivales/efectos de los fármacos , Administración por Inhalación , Adulto , Femenino , Fluticasona , Humanos , Hidrocortisona/análisis , Masculino , Nebulizadores y Vaporizadores , Saliva/química , Glándulas Salivales/metabolismo , Espectrometría de Masas en Tándem/métodosRESUMEN
OBJECTIVE: To determine the feasibility of non-invasive evaluation of adrenal response in healthy prepubertal children by standardized exercise tests. METHODS: On separate occasions, healthy prepubertal children performed a submaximal cycling test, a maximal cycling test, and a 20-m shuttle-run test. Salivary cortisol levels were determined before exercise, and 1 and 15 min after exercise. RESULTS: Immediately after cessation of the cycling and shuttle-run tests, salivary cortisol levels remained unchanged or decreased. Fifteen minutes after the shuttle-run test, salivary cortisol levels increased significantly. This increase in salivary cortisol levels was not observed 15 min after the cessation of the cycling tests. CONCLUSION: The results of this study demonstrate a different response in salivary cortisol levels after standardized cycling and running tests in prepubertal children. The increase in salivary cortisol levels found after a short standardized running test suggests that this may be a practical non-invasive method for evaluating adrenal response in healthy prepubertal children.