Cortisol is the most potent glucocorticoid produced by the human adrenal. It is synthesized from cholesterol and its production is stimulated by pituitary adrenocorticotropic hormone (ACTH) which is regulated by corticotropin releasing factor (CRF). ACTH and CRF secretions are inhibited by high cortisol levels in a negative feedback loop. In plasma a majority of cortisol is bound with high affinity to corticosteroid binding globulin (CBG or transcotin). Cortisol acts through specific intracellular receptors and affects numerous physiologic systems including immune function, glucose counter regulation, vascular tone, and bone metabolism.
Antigen Description
Corticosteroids are a group of natural and synthetic analogues of the hormones secreted by the pituitary gland. These include glucocorticoids, such as dexamethasone, flumethasone and β-methasone. Synthetic glucocorticoids are commonly used in veterinary medicine as anti-inflammatory agents, and illicit use as growth-promoters is suspected. Dexamethasone is rapidly absorbed and excreted in urine and faeces, primarily as the parent molecule, tracer and inactive 6-hydroxy metabolites.
Keywords
Cortisol
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Background
Cortisol is a steroid hormone classified as a glucocorticoid and is commonly known as a stress hormone. It is primarily synthesized in the zona fasciculata of the adrenal cortex and regulated by the hypothalamic hormone, CRH, and the pituitary hormone, ACTH. Cortisol release follows a diurnal cycle and is increased in response to stress and low blood glucose levels. The hormone serves multiple functions in the body. It helps raise blood sugar levels through gluconeogenesis, suppresses the immune system, and aids in the metabolism of fats, proteins, and carbohydrates. Cortisol also has the effect of reducing bone formation. These functions are mediated by cortisol binding to specific receptors within cells, namely glucocorticoid or mineralocorticoid receptors. Upon binding, these receptors interact with DNA, influencing gene expression and ultimately regulating various physiological processes.
To detect and quantify cortisol levels in biological samples, such as blood, saliva, or urine, researchers employ immunoassays, including enzyme-linked immunosorbent assays (ELISAs). The HRP-conjugated cortisol provides researchers and healthcare professionals with a valuable tool to assess cortisol levels in different physiological and pathological conditions. This includes studying the stress response, assessing adrenal function, investigating hormonal imbalances, and diagnosing certain disorders related to cortisol dysregulation. By accurately measuring cortisol levels, insights can be gained into the impact of stress on health, the effectiveness of interventions, and the development of personalized treatment strategies.
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References
MANAGEMENT OF ENDOCRINE DISEASE The role of surgical adrenalectomy in primary aldosteronism
Primary aldosteronism is common and contributes to adverse cardiovascular, kidney, and metabolic outcomes. When instituted early and effectively, targeted therapies can mitigate these adverse outcomes. Surgical adrenalectomy is among the most effective treatments because it has the potential to cure, or attenuate the severity of, pathologic aldosterone excess, resulting in a host of biochemical and clinical changes that improve health outcomes. Herein, we review the role of surgical adrenalectomy in primary aldosteronism while emphasizing the physiologic ramifications of surgical intervention, and compare these to other targeted medical therapies for primary aldosteronism. We specifically review the role of curative adrenalectomy for unilateral primary aldosteronism, the role of non-curative adrenalectomy for bilateral primary aldosteronism, and how these interventions influence biochemical and clinical outcomes in relation to medical therapies for primary aldosteronism.
Effects of Acute Exercise on Drug Craving, Self-Esteem, Mood, and Affect in Adults with Polysubstance Use Disorder: Protocol for a Multicenter Randomized Controlled Trial y
Background: Novel treatments for substance use disorders are needed. Acute bouts of exercise can improve mood states and craving in nonclinical populations. Exercise effects in those with polysubstance dependence are understudied; controlled trials are needed. Objective: This protocol describes a clinical study examining the short-term psychological effects of 2 types of physical activity, soccer and circuit training, in patients with substance use disorders. Effects will be compared with a nonexercise control group. Specific aims are to investigate whether there are differences between the activities and the duration of changes. Methods: This study is a short-term multicenter randomized control trial with a crossover design. Patients consecutively admitted to 4 inpatient treatment centers were invited to participate in 3 conditions, each lasting 45 minutes, within one week. The order of the conditions was randomized. There were a total of 5 assessments, taken at baseline, immediately before each condition, immediately after each condition, and 1, 2, and 4 hours postintervention, enabling patterns of change over time to be observed. Psychological effects were assessed with self-report questionnaires, which included scales for craving, state anxiety, positive and negative affect, self-esteem, and mood. Exercise intensity was assessed with the Borg Rating of Perceived Exertion scale and a heart rate monitor (Polar M200; Polar Electro Ltd). Cortisol was assessed in saliva before and 4 hours after the intervention. Results: A total of 39 patients were included in the study. Data collection was completed in 2019. Conclusions: We anticipate larger improvements in the intervention groups than among controls, indicating positive psychological effects during and after exercise. The study will add clinically relevant information about the short-term psychological effects of exercise in the treatment of substance use disorders, using activities that are easily accessible in different clinical settings.
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